health problems in mumbai 1. 2kumar gandhi. c-11 health in mumbai

HEALTH PROBLEMS IN MUMBAI

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2 KUMAR GANDHI. C-11Health in Mumbai

Health In Mumbai

• Mumbai is the most popular city of India. It is the commercial place and the sixth most populated city of the world.

• There are many beggars and pickpockets in Mumbai. All these problems increase the need of Mumbai health and safety


• Mumbai health and safety is badly affected by the pollution. There are more chronic health problems resulting due to modernization, liberalization and globalization of the market. The pollution causes allergies, infection and other diseases among the Mumbai public. The health and safety services available are very less then their requirement. The disaster training is also not in pace with the changing environment.


• The rate of chronic sickness such as diabetes, hypertension and coronary artery disease (CAD) increased in Mumbai last year.

• This is according to data analyzed by the NGO Praja Foundation between January and December 2008.


• Rising Rates of Diabetes and Hypertension Among Mumbaikers

• The group looked at results taken from 25 public hospitals and four state hospitals and dispensaries in India's capital city

Read more at Suite101: Chronic Diseases on the Rise in Mumbai: Health Concerns Linked to a Fast-Paced Lifestyle in India's Capital http://india.suite101.com/article.cfm/chronic_diseases_on_the_rise_in_mumbai#ixzz0kVv91T7U

6KUMAR GANDHI. C-11Health in Mumbai

Effect on Human Health From Waste • Damage to central and peripheral nervous systems,

blood systems and kidney damage. • Affects brain development of children.• Chronic damage to the brain. • Respiratory and skin disorders due to

bioaccumulation in fishes.• Asthmatic bronchitis.• DNA damage.• Reproductive and developmental problems.• Immune system damage.• Lung Cancer.• Damage to heart, liver and spleen.


Health Problems In MUMBAI

Public Health• In spite of substantial reductions in mortality rate over

the years, health care in Bombay remains far below the expected level.

Management and disposal waste• More than 5000 metric tons of solid waste is generated

every day in Mumbai. The municipal corporation is in charge of the disposal of this waste, and evidently cannot cope with the task.

8KUMAR GANDHI. C-11

Health in Mumbai

Hospitals• Mumbai has about 22,000 hospital beds distributed

in about 1000 health care centers. Of these about 17 are municipal hospitals which can be afforded by the urban poor who make up 50% of the population.

Major health problems• Among Mumbai's major health problems one must

surely count AIDS and Tuberculosis . Chronic respiratory problems due to air pollution are endemic among a large fraction of the population. Malaria and polio make occasional appearances.


Ways to improve health and safety in Mumbai

• If all the educational institutions in Mumbai provide proper training and education to the students then problem can be solved to some extend

• The students should be given training to avoid or reduce the harmful effects of pollution.

• All the health institution should be well equipped with the proper medical facilities to cater to any kind of problem.


• If all the academic institution take part in the health and safety program of Mumbai then the level of problem will be reduced to greater extend.

• The number of professionals should be increased, all kids of equipments required should be provided with, timely assessment of environmental risk and impact should be conducted.

• Education is the best solution to the Mumbai health and safety problem.


Health Services in Mumbai

• Mumbai is one of India's largest cities and an important commercial and industrial centre.

• Despite everyday pronouncements of major breakthroughs and advances in medical and health technology, the basic health needs of a majority of the population in Mumbai are not yet met even in a rudimentary manner.

• Mumbai has a vast supply of public and private health care services.

• The Central Government has its own dispensaries, which are available only for their employees.


• Further, there are the Employees' State Insurance Scheme (ESIS) health care services that include hospitals and dispensaries which cater to employees in the organized sector.

13KUMAR GANDHI. C-11Health in Mumbai

SOURCES:-• http://www.asiarooms.com/travel-guide/india/mumbai/usef

ul-information/mumbai-health-and-safety-mumbai.html

• theory.tifr.res.in/bombay/amenities/sanitation

• http://india.suite101.com/article.cfm/chronic_diseases_on_the_rise_in_mumbai

• http://www.bcpt.org.in/webadmin/publications/pubimages/healthservices.pdf

KUMAR GANDHI. C-1114 Health in Mumbai

http://www.asiarooms.com/travel-guide/india/mumbai/useful-information/mumbai-health-and-safety-mumbai.html

http://www.asiarooms.com/travel-guide/india/mumbai/useful-information/mumbai-health-and-safety-mumbai.html

http://india.suite101.com/article.cfm/chronic_diseases_on_the_rise_in_mumbai

http://india.suite101.com/article.cfm/chronic_diseases_on_the_rise_in_mumbai

HEALTH PROBLEMS IN

MAHARASHTRA

Health problems in Maharashtra

• Many women in the rural areas face the problem of infections of the reproductive tract.

• Deficiency of Vitamin A, Iron, Iodine which has led to large number of goiter cases

• Gastrointestinal disorders, like dysentery and parasitic infections are common, leading to marked morbidity and malnutrition.

• Malaria and tuberculosis still remain a problem in many tribal areas

• Genetically transmitted disorders like sickle cell anaemia and different forms of thalassaemia are also common. All these defects lead to the early destruction of red blood cells and add to the overall anaemia.

• Arthritis (inflammation of the joint) is a major problem of people of more than 55 years of age

• Osteoporosis is a silent disease in which bones become extremely fragile. It is extremely painful and takes a long time to heal. It is on a rise among the elderly.

• Depression is also one of the problems faced. Change in appetite and sleep patterns, persistent fatigue, lethargy, aches and other unexplainable physical problems

• Blood pressure refers to the force exerted by circulating blood on the walls of your blood vessels. Typical values for a healthy adult human are approximately 120/80. Large variations in blood pressure levels can be dangerous, so it always helps to keep your pressure under control.

• A heart attack is caused by the death of the heart muscle due to loss of blood supply caused by blockage in one or more of the coronary arteries. It is on a rise especially in the urban areas in males and also females

• Among elderly men, cancers of the prostrate and colon are the most common while for women it is breast cancer.

• Other cancers found in geriatric patients are skin, lung, pancreas, bladder, rectum and stomach cancer.

• Tuberculosis deaths can be prevented through modern anti-TB treatment such as DOTS that has to be undertaken for a prescribed duration.

Health Problems In MAHARASHTRA

Healthcare in Maharashtra

• Maharashtra, despite being the financial capital, is plagued by two major issues.

Food availability (rather access) which is the cause of unacceptable levels of malnourishments.

The declining sex-ratio, especially in the 0 to 6 year age group.• District hospitals have most of the essential medical equipment,

there is a severe shortage of these facilities in FRUs and CHCs.• Urban areas, especially in and around Mumbai and South-Western

Maharashtra are well endowed, but the rest of the state lags behind in health infrastructure.

Public Expenditure on Health

• Despite overall economic development, the state has failed to give the required significance to health and healthcare.

• Health expenditure as a percentage of Net State Domestic Product (NSDP) at current prices has declined from the levels of 1.0 per cent in the 80s to 0.7 per cent in 2001-02

• As proportion of total govt. spending from over 6% in 1980 reduced to 4.6% in 2001-02.

PUBLIC HEALTH

• Health care in Mumbai remains far below the expected level Management and disposal of waste:• More than 5000 metric tons of solid waste is generated every

day in Mumbai.• The municipal corporation is in charge of the disposal of this

waste, and evidently cannot cope with the task Hospitals:• 22,000 hospital beds distributed in about 1000 health care

centers, of these about 17 are municipal hospitals.

Major Issues

• Public care sector out-patient care is inadequate or under-utilised because of inconvenient timings or location, long queues, language barriers and rude staff

• Inadequate equipments, poorly maintained equipments, lack of manpower, delay of financial approvals from the bureaucracy, over crowding and the sharp deterioration in the quality of their services have forced many patients to turn to private hospitals.

• Even for the subsidised public health care, the poor have to pay extra as bribes due to rampant corruption. The other expenditure is on the medicines, which the public hospitals do not provide, the reason often quoted as “not in stock”, although they are funded to provide medicines.

HEALTH PROBLEMS IN

INDIA

India has made rapid strides in the health sector since Independence: life expectancy has gone up markedly, the infant mortality rate has been halved, 42 per cent of children receive the essential immunizations. We have a huge private healthcare infrastructure. And yet, critical health issues remain: infectious diseases continue to claim a large number of lives, babies continue to die needless deaths from diarrhea and respiratory infections, and millions still do not have access to the most basic healthcare.

HEALTH IN INDIA

APOORAV MEHTA ( M-31)

• India, the second most populous country in the world, is a bewildering collection of contradictions.

• If the people in some regions live in abysmal conditions, and thousands die from preventable and treatable illnesses, islands of good health such as the southern state of Kerala have health indicators comparable to those of developed countries.

• Faced with massive problems of ill-health (the burden of disease), Indians have had to address the question of how to provide a health infrastructure that is accessible to the people


• Life expectancy at birth and infant mortality are two important indicators of a society's health and the billionth Indian baby is less likely to die in childhood, more likely to live a long life. She can expect to live beyond her 60th year, twice as long as her great-grandfather did.

• If in 1947, 146 of every 1,000 babies born died before their first birthday, the infant mortality rate (IMR) is half that today, at 68/1,000


THE BURDEN OF DISEASE: WHAT AILS INDIANS?

• At present, infectious and parasitic diseases dominate.

• As Indians live longer, chronic diseases, related to aging, are expected to take a greater toll.

• The 2001 Census for the first time records people with visual, hearing, locomotors and mental disabilities.

• Indian women often tolerate ill health without complaint


At present, infectious and parasitic diseases dominate.

• They killed 2,121,000 people in 1998.• Tuberculosis kills 500,000 Indians each year• Almost 100,000 people died from respiratory infections in 1998• Some 1,25,000 women died from complications of pregnancy, in

1998.• 100,000 deaths in 1998 could be attributed to nutritional

deficiencies, more than half of which were simple protein-calorie malnutrition.

• HIV affected 4.58 million Indians in 2005• Malaria affects 2.6 million people each year, and killed at least

20,000 people in 1999.• India has the largest burden of leprosy patients in the world, with a

caseload of over 4 million patients.


As Indians live longer, chronic diseases, related to aging, are expected to take a

greater toll.• Cancers killed 653,000 people in 1998.

• Cardiovascular diseases, which includes those with an infectious origin, such as rheumatic heart disease, killed 2,820,000 people in 1998.

• Diabetes: In 1994 there were 20 million diabetics in India.

APOORAV MEHTA ( M-31))

The 2001 Census for the first time records people with visual, hearing, locomotor and mental

disabilities.

• 60-100 million Indians are affected by disability. • Between 4 million and 14 million Indians are blind. The most

common causes of blindness is cataract• 3.2 million people with hearing impairment in India.• Over 16 million people, are affected by locomotor

disabilities. The two most common causes are poliomyelitis and cerebral palsy.

• 3 per cent of India's children have delayed development (mental retardation)


Indian women often tolerate ill health without complaint

• Almost half tolerated their illnesses without treatment

• A considerable proportion of women suffer silently from a range of gynecological problems

• 100,000 Indian women die of pregnancy-related causes each year.


HEALTH INFRASTRUCTURE IN INDIA

1. Public health services

• India has a vast health care sector, estimated at Rs 126.27 billion in 1998.

• This health care sector is broadly divided into the public and private sectors.

• Public health services consist of the following 'step-up referral' network of sub-centre's, primary health centers, community health centers and district hospitals.


2. Doctors, nurses, hospitals and dispensaries

• 523,000 allopath and 115,500 practitioners of other systems of medicine provided health services to the Indian population.

• Institutional services were provided by 17,000 hospitals and 28,000 dispensaries (mostly privately owned and in the urban areas), with 95,000 beds, and supported by 566,000 nurses.

• Health providers are trained at 165 medical colleges, which turned out 12,000 graduates and 3,140 postgraduates in 1991.

• However, more than 80 per cent of out-patient services and a smaller proportion of hospital services were provided in the private sector.


3. Infrastructure is primarily in the private sector

which provides at least 80 per cent of health services in the country. The role played by non-governmental organizations working in health is also significant.


4. Indigenous medicine

1. Every rural community has its own local health tradition, using thousands of plants for medicinal purposes. As many as 700,000 traditional dais (midwives) conduct the majority of rural deliveries, 60,000 bone-setters treat orthopedic problems, 80,000 herbal healers provide primary health care for various conditions. Millions of people use home-based remedies.

2. The classical systems include Ayurveda, Siddha Tibetan medicine, Unani-Tibb ,and Homoeopathy . Some of these

date back thousands of years, and depend on a codified system of knowledge, some documentation, and institutions of teaching, research and manufacture. Medical practice is largely not institutionalized.

3. Overall, there has been no effort to strengthen these systems. Yet only four per cent of the national health budget is devoted to

these systems. There have been very limited efforts to evaluate these systems. Most Ayurvedic colleges do not have the required infrastructure and faculty


THE CRUX OF THE PROBLEM

• Health policy• Problems of access• The private-public debate• Quality of care• The global economy and Indian people's

health


Health policy

• No community participation in building up the health services

• It emphasized a primary health care approach to prevent illness and promote good health

• Disease control programs is driven more by donor organizations than the country's epidemiological realities.

• Selective health interventions have become even more focused after the World Bank's 1993 World Development Report recommended limiting government health money to the most 'cost-efficient' interventions.


Problems of access

• Only one in two women seeks treatment for illness, usually because the nearest health service is too far away, or it's too expensive.

• People access to health care is limited by their

ability to pay, as well the availability of services.


The private-public debate

• One out of two people seeking hospitalization go to the private sector, which handles a larger proportion of out-patients than of in-patients.

• In 1991, the Indian government's health care expenditure was less than two per cent of its gross domestic product, and just 21.7 per cent of total health expenditure

• Total expenditure on health is 5.2 per cent of the GDP, but out of this, only 13 per cent is spent by the government.

• Private health care is not the privilege of the rich but often the only option of the poor as well.

• In private hospitals, average costs for medicines, doctors' and hospital fees can amount to twice a family's monthly income.

• User charges in government hospitalsAPOORAV MEHTA ( M-31)

Quality of care

• The quality of health care available in India is extremely variable -- from corporate hospitals with the latest equipment, highly-qualified doctors and patient-friendly services, to small outfits with unqualified staff, lacking even basic equipment or a continuous supply of water and electricity.


The global economy and Indian people's health

• In 1991, India began instituting a structural adjustment programs (SAP), as a condition of a loan from the International Monetary Fund to bail it out a financial crisis.

• In the health sector, this meant cuts in public health spending, the introduction of service charges in public services, and handing over even more responsibility to the private sector which already accounted for three-fourth of health expenditure.


NEW HEALTH CARE DRIVE IN INDIA1) Implementation of "PURA PROJECT- of

VISION 2020 with adequate health care facilities.

2) More Nursing Colleges to be opened to balance the requirement of Paramedics.

3) Emphasis should be given towards cleanliness, sewage system, drainage system, and prevention of overcrowding of the hospitals, in metros and in the cities.

4) More public health related research in Industrial areas and in hospitals within that locality.


5) We may have to follow these simple principles behind having petrol stations in the highways i.e., keeping hospitals at a certain distance according to population so that emergency services can be made easily.

HEALTH PROBLEMS

GLOBALMINESH KORADIA 23

Global Health Global health is the health of populations in a global context

and transcends the perspectives and concerns of individual nations.

Health problems that transcend national borders or have a global political and economic impact, are often emphasized.

Global health is about worldwide improvement of health, reduction of disparities, and protection against global threats that disregard national borders.

Minesh Koradia C-23

Global HealthThe major international agency for health is the

World Health Organization (WHO).

Other important agencies with impact on global health activities include UNICEF, World Food Program (WFP) and the World Bank.

Minesh Koradia C-23

Major Health Issues

One billion people lack access to health care systems. Cardiovascular diseases (CVD) are the number one group

of conditions causing death globally. An estimated 17.5 million people died from CVD in 2009, representing 30% of all global deaths. Over 80% of CVD deaths occur in low- and middle-income countries.

Around 11 million children under the age of 5 die from malnutrition and mostly preventable diseases, each year.

Minesh Koradia C-23

Major Health Issues In 2002, almost 11 million people died of infectious

diseases alone, far more than the number killed in the natural or man-made catastrophes that make headlines.

AIDS/HIV has spread rapidly. UNAIDS estimates for 2008 that there are roughly:– 33.4 million living with HIV– 2.7 million new infections of HIV– 2 million deaths from AIDS

Minesh Koradia C-23

Major Health Issues 1.6 million people still die from pneumococcal diseases every year,

making it the number one vaccine-preventable cause of death worldwide.

Malaria causes more than 300 million acute illnesses and at least 1 million deaths, annually.

More than half a million people, mostly children, died from measles in 2003 even though effective immunization costs just 0.30 US dollars per person, and has been available for over 40 years.

These and other diseases kill more people each year than conflict alone.

Minesh Koradia C-23

New challenges in health

Having survived the scourges of childhood, young people confront health threats at a very vulnerable time, initiating sexual activity and entering the age of identity-seeking and risk-taking.

In south Africa, HIV/AIDS can reduce GDP growth by as much as a fifth. it is by far the leading cause of death among young people ages 15-29 in sub-Sahara Africa. In other reason non- communicable diseases are now leading cause of death for young women. Injuries caused by accidents and violence are the leading cause for young men.

If death rate are the benchmark, young people are a healthy group: the average 10- year old has a 97 percent chance to reach age of 25.

Minesh Koradia C-

23


Mortality is a misleading measure of youth health. Youth is when people begin smoking, consuming alcohol and

drugs, engaging in sex, and having more control over their diet and physical activity- behaviors that persist and affect their future health.

In many countries people begin to have sex before age of 15. The full effects of some of these youthful behaviors on health will be felt only in adulthood. This lead to depleting the economy of productive human capital and increasing public health cost.

Minesh Koradia C-23


As young people experiment, they take more health risk, as they get older the tendency falls. Policies can do much to help young people manage these risks, especially if they make young people more aware of the long term consequences of their actions today.

Minesh Koradia C-23

The Key Points

HIV/AIDS afflicts some 40 million people worldwide and about 27 million in sub-Saharan Africa. It is the most virulent health scourge of our generation.

Even in the absence of AIDS, developing world health systems are overwhelmed by disease. Other infectious diseases killed roughly 9 million people in developing nations last year — about three times as many as died from AIDS.

A significant percentage of developing world populations, particularly in rural areas, has virtually no access to meaningful health care. Poor infrastructure, especially inadequate transportation, plays a major role in health care shortfalls.

Minesh Koradia C-23

The Key Points

The research-based pharmaceutical industry has launched a significant effort to support developing world health systems, including donations of critical medicines and long-term agreements to provide antiretroviral drugs (ARV) for AIDS at prices at or below cost. Some AIDS medications have been provided free.

Over the last four years, the industry has provided $1.9 billion in assistance. In partnership with the United Nations, the industry has established the Accelerating Access Initiative (AAI) to expand access to ARV and other AIDS medications. By the end of 2001, 72 nations were exploring the AAI program and 14 (including 10 in Africa) had signed AAI accords.

Minesh Koradia C-23

The Key Points

The door is wide open to generic AIDS treatments in Africa because relatively few ARV are under patent in African countries. But even generics may be beyond the financial means of many developing countries. A study in the Journal of the American Medical Association said "the dearth of international aid finance, rather than patents, is most to blame for the lack of antiretroviral treatment in Africa.”

Conquering AIDS will require significant new resources. As the United Nations recognized in 2001 by creating the Global Fund for AIDS, Tuberculosis and Malaria, defeating AIDS requires a worldwide effort of all sectors of society.

Minesh Koradia C-23

Health Problems in all over World

Health Problems in all over World

Hunger Is the Major World Health Problem World Health Organization (WHO) findings in a new study. Some 170 million children in poor countries are underweight, mainly from lack of food. From more than 25 major preventable risks selected for in-depth study, the report finds that the top 10 globally are, in order of occurrence:- 1) Childhood and maternal underweight2) Unsafe sex3) High blood pressure;4) Tobacco5) Alcohol

6) Unsafe water, sanitation and hygiene7) High cholesterol8) Indoor smoke from solid fuels 9) Iron deficiency 10) Overweight/obesity.

High Blood Pressure

• High blood pressure is a medical condition in which:- – blood pushes in the artery wall too hard that it

creates pressure. – This happens because the arteries walls become

too narrow due to the deposition of fats in it. – It is also known as hypertension as it creates

tension in the arteries.

ASTHAMA

• Asthma is a very common disease, affecting about one in every forty people, and approximately two thirds develop symptoms in early childhood. It is characterized by

• Narrowing of the airways of the lung (bronchi) due to tension or spasm of the muscles in the bronchial walls.

• The respiratory tract invariably becomes congested with thick sputum.

Diabetes

• Diabetes mellitus is a common disease in the United States. It is estimated that over 16 million Americans are already caught with diabetes, and 5.4 million diabetics are not aware of the existing disease.

• Diabetes is a metabolic disorder where in human body does not produce or properly uses insulin, a hormone that is required to convert sugar, starches, and other food into energy.

AIDS?

• AIDS is caused by HIV.• HIV is a virus that gradually attacks

immune system cells.• As HIV progressively damages these cells, the

body becomes more vulnerable to infections, which it will have difficulty in fighting off.

• It is at the point of very advanced HIV infection that a person is said to have AIDS.

• It can be years before HIV has damaged the immune system enough for AIDS to develop.

Diarrhoeal diseases

• A range of diarrhoeal diseases caused by a large number of non-typhoidal Salmonella serovars (NTS).

• These NTS, which usually have a broad vertebrate host range, show dramatically more severe and invasive presentation in immunocompromized individuals especially HIV carriers, including severe and progressive diseases such as chronic granulomatosis disease, blockade of IL-12/ IL-23 /IL-17 and TNF, suppurative foci and bacteremia which may be recurrent.

Depressive

• Major depressive disorder (also known as clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by:-– All-encompassing low mood accompanied by

low self-esteem– loss of interest or pleasure in normally

enjoyable activities

TUBERCULOSIS

• Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is Mycobacterium tuberculosis.

• It was first isolated in 1882 by a German physician named Robert Koch who received the Nobel prize for this discovery.

• TB most commonly affects the lungs but also can involve almost any organ of the body.

• tuberculosis usually can be treated successfully with antibiotics.

http://www.medicinenet.com/script/main/art.asp?articlekey=26602

health problems in mumbai 1. 2kumar gandhi. c-11 health in mumbai

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