Friday, August 10, 2012

Editorial: Preventive Healthcare


Preventive healthcare is not among our country’s strong points. The counter that there are just too many of us to be adequately screened to catch health complications before they become, well, complicated, is lame because it has not even been attempted in earnest to be discarded as impractical. But the worries of the country are perhaps too many for any of the challenges to get adequately addressed before they explode. That is not the case with Sikkim which enjoys the benefits of a State for a population smaller than a large locality in the metros. In welcome developments of late, this advantage has been leveraged well with the launch of a series of programmes and Missions which stand the best chance of succeeding well in India in Sikkim. Starting with the skill development initiative, on to the CM’s Merit Scholarship Scheme to the CM’s Rural Housing Mission, these are undertakings which, now that the policy has been dictated, carry the potential of elevating Sikkim to a new level of well-being if the executive can deliver effectively when it comes to implementation. But we began with the healthcare scenario, and hence return to it now. The Chief Minister's Comprehensive Annual and Total Check up for Healthy Sikkim Programme [CATCH] programme has been underway for close to two years now, and its results should be leading to further course corrections in the healthcare sector in Sikkim soon. This effort, even though little understood beyond those who are implementing it, and unfortunately not as effectively publicised and explained as it should be, is among the more important initiatives underway in the State. There are several illnesses plaguing Sikkim, which, if diagnosed in time, could not only save many lives, but also improve general well-being because the two health-related challenges which are the most glaring in Sikkim – Cancer and Depression – are not only little understood, but also extremely expensive, as much in monetary terms as the suffering they impose on the entire family. Both can be detected before they reach the advanced stage when the suffering increases along with the chances of fatality. The CATCH programme would do well by working in proper screenings to detect these health issues in the earlier stages so that the healing can begin in time as well.
While one is on issues of preventive healthcare, attention needs to also be drawn on the challenges posed labour-intensive projects like hydel. One needs to however first realise that increasing influx is invariably a direct indication of a region’s developmental graph. Since just about everyone in Sikkim subscribes to the belief that “influx” is swamping Sikkim, then, by the same count, one could also safely assume that Sikkim is developing rather well. The increased influx has also caused an increased paranoia among the locals who want more stringent measures to keep “outsiders” out. How this can be achieved without upsetting the development cart is something for the policy-makers to figure out, for now, let’s limit this to health concerns. Because the influx till some years ago, used to come in a trickle, it never really expressed itself as a health issue which needs to be addressed. But now that some major labour-intensive projects have gotten underway, Sikkim needs to work out how it will protect its health better. One does not attempt to claim here that the migrant population which follows large projects are “unhealthy” or that they are vectors of possible epidemics, it is just that precaution is always the more advisable option. Take for example the cholera outbreak at the Teesta Stage V dam-site in 2001, the disease obviously came out of the labour colony there. A proper screening of people joining the ranks in large projects will not only protect the locals, but would also be a safeguard that the employees at a project site will appreciate. Even if some protest the idea, the screening methodology should be adopted. And this should be followed up with periodic and honest inspections of project sites to ensure that workers are housed in healthy environs. This is as important for health issues as for the basic human rights of the employees engaged there. An honest appraisal of the labour colonies at project sites at present will present a rather desultory projection and what one overlooks when one ignores the destitution of labour colonies is that the ‘local’ population around project sites interact extensively with the residents especially in matters of trade and business. These are not major undertakings and clear directions to the district authorities and patronage for earnest NGOs should get the job done. After all, people brought in to labour on projects from which Sikkim will eventually earn deserve to be treated better and ensured better health as well...

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