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Why is healthcare neglected in developing countries?

May 21, 2009

In this year’s Interim Budget presented in the Lok Sabha in February 2009, there were significant allocations for the continuation of various Health Schemes (for example  rural drinking water projects, midday meal schemes, child development schemes, Rural sanitation programmes,the National Rural Health Mission, death and disability covers) but there is no indication as to whether budget allocations for Healthcare have increased over the previous year. In 2008, last year’s budget, there was a 15% increase over the previous year’s (2007) budget allocations for Health. When the new government presents its final budget with a brand new Health Minister, one can only hope that Healthcare gets priority. For human development to keep up with a country’s financial health, or in fact for financial growth to continue, Health as well as Education need top priority. 

Here is WHO data on the health situation in different countries. The figures (which can be customized and made into a table according to one’s  needs by choosing the criteria one wants) are a few years old as latest authentic data was not available. However one can get a good comparison with our neighbours as well as a few developed countries like the U.K, the U.S and Japan, and it’s sobering. (Click on it to get a clearer image which will open in a new window).

 

Only Bhutan (107), Pakistan (100), and Nepal (99) fare worse than India (82) when it comes to infant mortality per thousand live births. China (37) is next but they are still a whole lot better than the other three! Thailand and Sri Lanka are at 26.  It’s the same story when it comes to maternal mortality. Nepal is in the worst state here with 830 deaths per 100,000 live births. China scores better on all criteria as compared to India. 

That India needs to spend more money on Health is staring the Indian government in its face. But governments, particularly governments of developing countries don’t seem to care enough. However Thailand, despite it not being a First World country, seems to be doing alright. 

The table below tells us how much priority different governments give to Health.

If developed countries are spending so much on the health of their populace it’s probably because their population is more educated, more aware and therefore demand their rights. Considering that people in poor countries do not have their basic needs like clean drinking water met and do not have access to basic medical care, they should actually be more demanding. They are not. Public Health Systems in poor countries may be pathetic but the poor are not casting their votes for better Healthcare. And governments are getting away with not fulfilling its populace’s health needs.

Ignorance of their rights, a sense of helplessness and lack of access to organised groups who will fight for them for free is a major hurdle for the poor in developing countries. Also poor and illiterate populations are often swayed by religious and/or caste issues which governments use to mask their failings. Freebies are also flung at the poor for the same reason. A poor person will get taken in by fancy freebies and ignore larger health issues. In the just concluded 2009 Lok Sabha elections there was a mad scramble to attract the poor in Orissa by offering cheap rice:

At least four political parties have been competing with each other to provide cheap rice to the BPL families across the state, which comprises nearly 55 lakh families, and are considered as a major chunk of the vote banks in the state

This desperate attempt to woo voters went so far that the Election Commission had to intervene and stop the Chief Minister’s photograph being used while advertising the scheme. Anyway, the Rs 2/- per kg rice scheme worked. It’s said that this was one of the reasons why Naveen Patnaik won. 

There is another reason why the poor are less demanding when it comes to healthcare. In places like India the poor feel they have a choice  - traditional remedies. While some traditional medicine is good, one cannot depend on it entirely. Only education and awareness can change all this.  And in any case there is no substitute of good clean water and sanitation facilities. Half of India has no toilets!  

Interestingly China, which is developing at a much faster rate than India, is  spending very little on the health of its people (as a percentage of its total expenditure) despite it being a so-called communist country.  Even a country like Thailand spends more (10%) on health than China. True, China’s mortality statistics are better than that of most developing countries (not Thailand) and this is so because their expenditure in actual terms is higher. The table below gives the per capita expenditure on Health. China, like India, suffers from a bloated population, so there are more people to cover per Health Rupee, but then both India and China spend very little on health if one looks at percentage spend.  

The table gives the per capita expenditure on health.

per-capita

India’s figures are shameful. As for China, that country can easily bring its Health Systems on par with that of developed countries like the UK and the US but it isn’t doing it. As of 2005, it was spending  just 1% on Health! I wonder why they say that Communist countries are meant to benefit the masses.

To improve the health scenario in India the money allocated also needs to reach the intended. There needs to be better control from the top to reduce corruption. There have been appeals from many quarters to not take tainted ministers in the cabinet and I hope the government listens. The rot should not exist at the top. For starters. 

Related Reading: India’s rising defence expenditure is not too high if compared to that of other countries
Will India’s Power and Transport take that big leap forward?
Taxes on petrol and diesel very high in India

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37 Comments leave one →
  1. Vinod permalink
    May 21, 2009 3:15 pm

    Vey informational. I learnt something today. Thanks

  2. Ketan permalink
    May 21, 2009 3:49 pm

    Governments always want the public to think that they don’t because they don’t have the money etc. But in reality the money is there, the will is missing.

  3. May 21, 2009 4:43 pm

    apne yahaan itne log hai (population), thode bahot mar bhi gaye to kisi ko koi farak nahi padta…

    Abhi agar in ministers ke ghar ka koi mare to pataa chale unhe!!

  4. May 21, 2009 6:50 pm

    That was revealing! And I totally agree with the reasons you have attributed this to – ‘Ignorance of their rights, a sense of helplessness and lack of access to organised groups who will fight for them for free is a major hurdle for the poor in developing countries’… In our country, political battles are not fought on these core issues.. Despite the fact that half of India does not have toilets and next non-existant healthcare – these were total non issues in the elections.. Unless our leaders care about improving things – things will remain this way.. It is indeed shocking to see the disparity between what a first world country spends on health care and what developing countries spend..

  5. Rohan permalink
    May 21, 2009 7:53 pm

    To add to that…
    Demand and Provision are two different things, although they have to co-exist.
    And i side with the fact that we are actually okay with the state of affairs in government hospitals. this should not be the case. I think, healthcare encompasses not just good hospitals and good public sanitation but health education as well…the root of all evil lies in illiteracy and that needs to be tackled hand-in-hand with this.

  6. May 21, 2009 10:43 pm

    Indian democracy is all wrong – it is about masking real issues like health care with non-issues like caste and/or religion and for this, politicians are to be blamed…They want to take the easy way out…

  7. May 21, 2009 11:18 pm

    Nita, I think one can learn a lot more about how to improve healthcare in India by comparing states rather than compare India with other countries. Of course, comparing countries also gives insights but no real solutions.

    Take for example, the analysis in this post. The casual reader might assume that health is simply correlated to expenditure, and just increasing the money spent will improve the health of Indians. However, as you yourself point out, developing countries that spend a lot less on health than can still have healthcare on par with developed countries. And, simply central government expenditure cannot explain why Tamil Nadu has much better healthcare than Rajasthan.

    For example, you mentioned maternal mortality. Do you really think that increasing expenditure will decrease mortality rates ? Most likely not. Indian families, especially those in the North simply do not value the lives of women. One routinely hears about women being burnt for dowry, female infanticide and honour killings there. So until, these attitudes change or are made to change, there is little point in spending more money.

    The core issue at hand is more social than fiscal.

  8. May 21, 2009 11:32 pm

    Hey Nita, might I suggest one more reason for the neglect of healthcare in developing countries? At the risk of sounding textbook-ish, Maslow’s Hierarchy of Needs (http://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs) came to mind. People unconsciously rank their needs differently, and healthcare does not necessarily figure high on their list.

    Why? Look at the Maslow pyramid. The bottom-most layer is “physiological” needs – air, food, water, sleep and so on. Now we all know how poorly our country ranks in these basic needs. Hence, people are left clamoring for these basic needs, and they do not feel the need to exercise their right to healthcare. If they’re not getting food or water, they don’t really care that much about the state of their local hospital, or if one even exists. Health and security, I might add, comes at the second level of the pyramid.

    Countries like US, UK and Japan are really strong on the basic needs, and hence we see higher spending on higher order needs. People there have moved up the pyramid, while many Indians are still stuck at the bottom. My two paise worth…

  9. May 22, 2009 6:58 am

    Hi Nita,
    I am back after a long hiatus and a huge list of feed reads that I am trying to clear :D

    A very informative piece and I must say it is more to do with “priorities” and “affordability”. The root cause also lies in the health organization itself. For example, doctor and service charges are so expensive in some countries. Many wishes to earn 200% income and chooses to charge a high fee for their services. There is no-ending to selfishness and greed.

  10. May 22, 2009 7:44 am

    Given India and China’s poor show, I wonder if the size of the country’s population is any factor. Do our governments think that with an unmanageable exploded population already, what difference does it make if a proportion of them are unhealthy?

    Second: I do sincerely pray that Ramadoss doesn’t return as the Health Minister!

    • Dev permalink
      May 22, 2009 8:08 am

      Mahendra and Nita, I was talking with a Chinese friend of mine regarding Chinese people much healthier in spite of their govt not spending much on health care..
      And he jokingly remarked, “we are naturally healthy because our food is healthiest in the world”
      Any takers of this theory?? My limited exposure to pure Chinese cuisine, which most of the times I famously dont like ;), does indicate some substance in this theory..

      • Vinod permalink
        May 22, 2009 8:37 am

        They have some very healthy options in their daily diets. Lot of soupy but filling dishes. They also have some extremely unhealthy options as well. But the fact of the former goes some way in keeping the health of the population, I reckon.

      • Bombay wadapav eater permalink
        May 27, 2009 2:05 am

        Crap. Everyday Chinese and for that matter Japanese food is pretty unhealthy with loads of MSG (ajinomoto) in almost every product be it soy sauce or any of the readymade sauces which they use in plenty. The oil is cheap and refined. In the process of refining oil, you loose a lot of nutrients and natural flavours and worse is solvents and chemicals need to be added. At least that is the case here in the Asian market. I have never been to China but in Japan, it is also very predominant but the Japanese live very long and people think it is because of fish. But the old-fashioned or let’s say top-end Chinese and Japanese food is definitely healthy if unrefined cold-pressed oils, soy sauce made in the traditional manner and tofu made out of soybean free from any genetic manipulation. A good example is the shojin ryori – the Zen temple cusine. I guess that similar cuisine is found in the Buddhist temples in China and also TCM schools? But psychology and exercises are also imp. in maintaining health. In China, many start their day with Tai Chi or Qigong.

        Bombay wadapav eater, the chinese in china use pork oil but I guess that’s unhealthy too! But there is certainly something good about their diets from what I observed while we roamed around in China. And I talking of the diets of the poor. And yes, they exercise! – Nita.

        • Bombay wadapav eater permalink
          May 28, 2009 6:59 pm

          Indeed even the poor eat lots of fresh vegetables and probably have better diets than the richer in many cases I guess. Lard or animal fats are very unhealthy. Macdonalds uses the same for their potato fries, etc. I mentioned Macdonalds since I have no clue how it is now but it was indeed fashionable to go there in Bombay when they just started and I bet it is the same in China. The streetside dosa without chutney is much healthier than macdonalds or pizza hut et al.

    • rags permalink
      May 22, 2009 8:45 am

      No he won’t :-). PMK’s been kicked out of the UPA. (they brought it upon themselves).

  11. rags permalink
    May 22, 2009 8:46 am

    Damn. I forgot to address. That was in repsonse to Mahendra’s comment.

  12. rags permalink
    May 22, 2009 9:13 am

    India has to definitely improve its spending on healthcare. Primary Health Centres are woefully understaffed and have minimum facility. Besides the concept of hygiene doesn’t exist in many govt. hospitals…

    I guess China is more concerned about image rather than the actual health of it’s citizens. But we are no one to complain considering we are far below them in all indicators. Atleast they got some system in place that’s working.

    I’m wondering…. in the recently concluded elections.. how many parties promised better heath facilities in their manifestos….

  13. May 22, 2009 9:24 am

    Vinod, Ketan, Sakhi, thanks.

    Smitha, sad isn’t it how much our populace is dependent on the goodwill of the netas!

    Rohan, when you said that “healthcare encompasses not just good hospitals and good public sanitation but health education as well…the root of all evil lies in illiteracy and that needs to be tackled hand-in-hand with this” you echoed my thoughts!

    sraboneyghose, I guess in a democracy the people get what they ask for, well, more or less.

    Vikram, ofcourse, execution is most important. However if you say that in certain states there is a resistance to provide healthcare to women, on the part of the government more effort needs to be put in. Whether it is in monetary terms as payment to social workers or public information campaigns and so on.

    Pranav, one cannot doubt maslow’s need hierarchy but health expenditure includes a whole gamut of things, including provison of drinking water, and ofcourse food and shelter. However what I meant to say is that when the poor are starving they need to have some long term measures to ward off starvation and it is the govt’s job to provide this. Rs 2/- per kg rice schemes are short term but they lull the populace into thinking that the government has done a lot. Actually the govt. has done nothing!

    Kiran, welcome back. I agree that a social mindset on part of doctors is missing but then those who become docs want to make money, like those in any other profession. You and me may believe that a social mindset in necessary but then it is necessary in all professions. I guess only a handful of good individuals really care about the social milieu around them and by this I don’t mean that everyone should leave their professions and do social work. I don’t think it’s necessary to do social work. Just doing one’s own job well is enough. For example a teacher in a municipal school who does her job properly can make a huge difference to a lot of kids.

    Mahendra, I guess the more the population the more money that needs to be invested. I think India can afford it but execution is also a problem in India.

    Dev, yes I do agree that diets play a part. The Chinese eat healthier food in terms of a lot of vegetables. I saw that when we went to China. Even the poor do so while the very poor in India tend to eat dal rice, particularly in certain regions. However traditional diets for example in Maharashtra like Bajra and Jawar roti are nowadays being looked down upon and that’s sad. Our traditional diets are good, if they are followed. Also the Chinese eat smaller portions, even the well to do who can afford food. Also one more thing. The Chinese are very hardworking. They are very active most of the time. You have to see it to believe it, it’s amazing, their dedication to work! I am actually a great admirer of the Chinese people although I have great contempt for their government.

    rags, apparently the media did not publicize the manifestos of the various parties and in any case I did not see healthcare being mentioned. The media was quite caught up in the politicking. Apparently that is what gets them TRP’s.

    • Dev permalink
      May 22, 2009 8:49 pm

      Nita, thanks for your reply. Yes, knowing many Chinese, I agree completely with you regarding their being hard working and their dietary habits etc. I find most of them incredibly humble too..
      And yes, our traditional diets are good, if they are followed. My grandmother, at 85+, doesnt know anything about health diets and organic food, but she is the healthiest person I have seen in my life….

  14. May 22, 2009 9:25 am

    In AP for example, they have this public private partnership where poor people can approach private hospitals for treatment and the bills are charged to the Government. I heard that the scheme was doing well in spite of the doctors and bureaucrats. There was also an incentive scheme for doctors working in Govt. hospitals doing critical jobs to encourage them more. Positive steps, these. But I am not sure about the current status of that project. If someone from AP knows, please share.

    Destination Infinity
    PS: Like Vikram pointed out, I too don’t think that the amount spent for health care is proportional to the quality. As long as we don’t bother about the quality, not even a 1000% increase in health care budget will benifit.

  15. May 22, 2009 11:24 am

    Nita

    I have to agree with Vikram on some of the issues he raises.

    In the UK, not that you will get the Deptt of Health or the NHS to admit it, there are huge inefficiencies in the system. While caregivers have more and more ‘management’ stuff to do, the NHS is very poorly managed but it is so enormous that any change management exercise will cost rather a lot. So while the service remains free at the point of delivery (unlike in France), a rising expenditure isn’t necessarily some kind of proof that we are getting better healthcare. Indeed 60 years after the NHS was founded, the cost is a big question and I wouldn’t rule out paying in some form in the future.

    Since we are talking of government expenditure, so as far as socialised medicine goes, the taxonomy here may interest you:
    http://economix.blogs.nytimes.com/2009/05/08/what-is-socialized-medicine-a-taxonomy-of-health-care-systems/

  16. May 22, 2009 4:57 pm

    The filtering of the money allocated for anything in India is a huge problem. Be it education or health. nothing seems to reach where its needed.

  17. cutting_chai permalink
    May 22, 2009 5:25 pm

    Hi Nita,
    interesting post…regarding diet, chinese food is low in fibre and they eat a lot of meat. We see a very high incidence of colorectal cancers in the local population. I think the average Indian diet is more balanced.

  18. May 22, 2009 7:20 pm

    well our politicians sure are healthy , wealthy and wise :) An interesting post I came across a while back :) http://swordfury.wordpress.com/2009/05/14/equality-vs-efficiency-the-case-of-universal-health-care/

  19. Naveen permalink
    May 22, 2009 7:53 pm

    Nita,
    Laurie Garrett in ‘Betrayal of Trust: The Collapse of Global Public Health':

    “While science is searching for technological solutions, what really stymied most of the world today is frighteningly basic. CT-scans, Open heart surgery, hormone treatments, gene therapies, fiber optic visualizations- these are all great boons for medicine, but they have contributed comparatively little to key indicators of public health like life expectancy, infant mortality, and infectious disease deaths. On the contrary what most of the world need even today is ancient, non-technological and preventative: potable water; plentiful, nutritious, uncontaminated and healthy food; decent housing; appropriate water and waste disposal; correct social and medical control of epidemics; wide-spread or universal access to maternal and child health care; clean air and most importantly knowledge of personal health.”

    I think this probably explains why health and expenditure don’t always correlate. Unfortunately in developed countries, public health institutions are slowly turning into biotechnology and fMRI research hubs. And there is so little formal public health education in the developing world.

    Antibiotic resistant diseases are probably the biggest impending public health threat to India (and thus world). Ciprofloxacin and other antibiotics are found in high concentrations in drinking water in many places in India because of reckless drug manufacturers. Healthcare workers also don’t care a thing and still overdose people with antibiotics for every sneeze.

  20. May 22, 2009 10:29 pm

    DI, a public private partnership is a good idea and there should be more such projects. And yeah, it’s true that quality is important but so is money to build health infrastructure. One can only pray that quality is taken into consideration as well!

    Shefaly, Thanks for that information about the UK!
    About the point that Vikram raised, I have not doen a post on the wide difference in human development across the different states of India for two reasons:. One, most people know it, and secondly it will create some kind of discomfort amongst readers. You know the kind I mean. :) :)

    Reema, not totally!

    cutting_chai, thanks. true what you say, the Chinese eat a lot of meat but they eat a lot of fibre as compared to Indians. But then I am not talking of the traditional Indian diet, but the kind of bare minimum food that the poor in India eat. Few can afford vegetables. Somehow I feel that the Chinese poor people are not that poor! But maybe I am wrong.

    Vishesh, your comment reminded me of the swearing in ceremony which was full of pot bellies and white hair! :) I was thinking that perhaps they should have a limit on the maximum weight allowed for a minister!!

    Naveen, public health has reached an all new level in the west hasn’t it! Here in India as you say the requirements are entirely different. I agree with your about the overdosing with antibiotics. And unfortunatly it difficult to argue with docs about this! There are so many health issues in India that are environment related too! And there is zero infrastructure. We have a long long way to go!

  21. May 24, 2009 7:30 pm

    Hi Nita,

    First time-post on your blog, but an avid reader. I’m finishing up my masters in International Health & Development and am coming over to India to work for 6mths on a health project. Your post is regarding health care expenditure is informative, and such discussions/dialog are much needed. Two things that I wanted to note:

    – You’re right in your follow-up comments that increased spending doesn’t necessarily translate to better health outcomes. Take the US for example. They spend more than most West European countries but health outcomes (mortality and morbidity) are often better for the Scandinavian countries.
    – The solution (in my humble opinion) is a two-prong approach: 1) engaging the local community and building a civic society on the ground that will advocate for their rights; 2) efforts to increase transparency at the national/state level.

    Just a top-down approach or a bottom-up approach doesn’t work — both have to be spurred. This can only happen when activists/advocacy groups can help to increase awareness of the rights that every Indian citizen to proper health, education and economic self-sufficiency.

    If you’re interested, I wrote an article about malnutrition in India a while back. Here’s the link: http://mombasagirl.blogspot.com/2009/03/hungry-before-you-reach-for-that-snack.html

  22. May 24, 2009 9:19 pm

    Very apt article, I guess the govt. should have something substantial for health in this budget, and now they won’t have the nay-sayers pulling them down.

  23. Vinod permalink
    May 24, 2009 10:32 pm

    About health in India, have you guys seen the Mahesh Bhat Documentary ‘Poison on a Plate’ about Genetically modified foods ?

  24. May 25, 2009 6:51 pm

    Once while trekking in Nepal I asked my guide what would happen if a villager in the forest had an appendix issue. The guide said “Oh he will simply die”. Then I asked what would happen if that happened to me and he said “Oh we would call a helicopter to rescue you”. That is how it works in developing countries.

  25. May 26, 2009 12:01 pm

    Nita, Dr. Abhay Shukla was the keynote speaker at the AID conference this year, here are the key points I took from his talk,

    1) Need Rights Based Approach to Health. Health is not a fundamental right in our Constitution and this is a serious impediment in getting officials to deliver health services. Serious deterioration in health care since the mid 1990s.

    2) 40 % of Indians have to take out loans or sell assets to get healthcare. Medical Expenses are a major reason for poverty.

    3) Level of child mortality, lowest income quintile child is 5 times more likely to die than highest quintile.

    4) Level of hospitalization, lowest income quintile 4 per 1000 and highest quintile 40 per 1000 (much if it unnecessary)

    5) As above point illustrates, ethics is a serious concern in medical services. Especially with private healthcare, there are a number of irrational elements, like exxageration, unnecessary hospitalization and other forms of patient exploitation. Both poor and rich are victims.

    6) Top down spending inefficient and highly corruption prone.

    7) We need to ‘communitize’ health services and institutionalize community monitoring of health services.

    Dr. Shukla then described his NGO CEHAT’s Village Health Report Card initiative in Maharashtra. Basically through this card, villagers systematically documented the performance of heath officials. The program greatly improved accountability, stopped illegal practices and empowered grass root functionaries.

    Finally he mentioned that we need to campaign for the National Health Bill 2009 and ensure that health is made a fundamental right.

    Vikram, thanks for this very useful information! I too have heard of cases where people have become bankrupt because of health costs. I agree with all your points and also that accountability is something that needs to made mandatory. We have a long way to go! – Nita.

  26. Bombay wadapav eater permalink
    May 27, 2009 3:23 am

    Nita

    My notion why healthcare in India does not play such an important role is because of the illiteracy and superstitious mentality mostly seen among this group. I guess education, population control, poverty eradication, sufficient food and hunger management come before healthcare in the to-do list in India. There is so much similarity between rural India and Africa. You will see a lot of quacks or probably shaman, so-called traditional African or Ayurveda specialists sitting with a mat with loads of plastic bottles filled with herbs, in some cases bones, etc. This does show that people tho’ poor and or illiterate are concerned about health and wellbeing but their attitude is different. Most of them believe that some evil spirit or evil thing is following the soul, the reason for the person to become sick in the first place. I remember as a teen when adverts for vaccination promotions or population control were shown on TV, many thought that the kid got measles since Goddess Durga “Devi aali” is angry or sth similar. So I guess that many in the rural area wouldn’t even take advantage of free vaccines or condom distribution for aids prevention or population control. There are lifeline buses with doctors going travelling in villages offering basic care in India. I wish more would be done.
    Even I don’t believe that a doctor can cure everything. I believe in prevention is better than cure. A good diet, exercise and being happy and stress-free is probably much more important in maintaining good health. I am also a pretty anthroposophical person so I started vaccinating my son at a pretty late stage as compared to the general European crowd and I will not give him too many unnecessary vaccines.
    Germany enjoys a better healthcare system as compared to its European neighbours but at the cost of us youngsters. The social system works here in such a way that I am paying in the pension scheme but the money is paid as pension to the old now. So I have no guarantee of getting a good pension when I am old. It would depend on the future kids who would be paying in the system and the problem now is there are too many oldies and not enough youngsters to pay our generation. Similarly I pay into the healthcare system and statistically speaking mostly the old people use it. People complain and are scared that when we get old, we won’t enoy all this what the oldies nowadays are enjoying. In Finland, Sweden and some other countries certain treatments are not carried when a person reaches 75. I don’t know if it is similar in teh UK. But I know that UK petients have a lot of waiting time. Here in Germany all oldies get their hip and knee replacements and rehabilation and such luxuries even after 85.

    • May 27, 2009 5:08 pm

      Thanks for that interesting comment Bombay wadapav eater! Very interesting to know about how foreign countries manage their healthcare. About the superstitions in India, I agree. My maid’s mother died and when I asked her why she told me that she looked at an unlucky stone and died the next day!

  27. openlight permalink
    May 27, 2009 7:53 am

    It will be neglected due to –

    1. Too many people to treat, leave the number of people to take care of

    2. Uneducated people are unaware of their rights and treatment given to them, they have total blind faith in their doctor.

    3. Its an state subject and hence, every individual will harp this but will not take active participation on individual level of preventing any medical treatment in future by exercise, proper diet, even educated and aware persone do not indulge in it.

    4. Popularity of fast foods, alcohol, smoking and sedentary lifestyle has increased the pressures on available health resources.

    5. exploding population

    Rest, on individual basis all of us should adopt an healthy lifestyle, have natural fruits and vegetables as possible and avoid junk food (and alcohol and smoking) and spread this message to as much we can.

    openlight, that’s a very interesting point you brought out, about even educated people not bothering to improve their lifestyles even though they know what’s wrong. – Nita.

  28. May 28, 2009 8:18 pm

    Highly populated countries always tend to have bad HDI (Human Development Index). That’s the reason why you will see despite India and China making it to one of the top economies, have really bad ranks when it comes to HDI.

    The fact that Scandinavian countries have better HDI than the US despite the small expenditure is one testimony to this. Reducing population is not the solution, but may be better penetration of the healthcare and education policies to the rural parts of the nation. That is something with regards to India.

    If we look at what were those successful policies that took the Far East nations ahead, it would be their emphasis on education and healthcare in the ’60s and ’70s.

    I don’t think India is any time going to come above the rank 100 in HDI. Wikipedia says 128 at present!

  29. December 1, 2009 8:16 pm

    Nita,

    I think another aspect that is also neglected in India is first-aid. I myself have seen a couple of situations where all the people could do was call for a vehicle to transport a patient to the nearest hospital and given the traffic conditions in India, that could take forever and in that time, first-aid can be a life saver.

    I am trained in first-aid and I took the training with a vengeance after coming to Germany mainly because of the importance in trying to save a human life. I agree that some aspects are not applicable to India (prompt help from paramedics or defibrillators in public places) but there are simple tips that could come handy as well.

    I have written a post about it - http://sowmyagopal.blogspot.com/2009/11/first-aid-what-first_13.html. The post is centred around Germany and with the viewership you have, you can reach a lot of people when you write about it. Please do so, as and when you find time. Thanks.

  30. Dr.sudeep verma permalink
    April 21, 2011 11:14 am

    THE WORLD SUFFERS A LOT . NOT BECAUSE THE VIOLENCE OF BAD PEOPLE , BUT BECAUSE OF THE SILENCE OF GOOD PEOPLE….

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