CHIPIN Philosophy

India has made great strides in various fields in the past few decades. It has one of the strongest emerging economies and commands a better name and a high degree of respect in the world.
In spite of progress in many fields, SANITATION AND HYGIENE have gone the other direction. More and more epidemics of infectious diseases like plague, dengue fever, meningitis and Chikungunya, are erupting. Nearly the whole population is infested with worms and has been exposed to tuberculosis.
Majority of Indian illnesses are infectious diseases, which are the direct result of poor hygiene and sanitation. These diseases have long been eradicated in developed countries, but they are part of daily  medical practice in India.

We cannot depend only on Government with all its other concerns to change this situation. Government with all its other concerns has not prioritized this issue. Even if it does something, it is bound to fail until we change the public attitude. No country can change from "third world" status to "developed" status without tackling sanitation and hygiene first.

Mass education is needed to teach people  to use the trash bins, bag their garbage, and not to spit, urinate and defecate just any where. One can never deploy enough cleaners, if the  public keeps throwing wrappers and garbage every where. There is no shame in cleaning up after yourself. The government of India's "total sanitation campaign" aims at providing toilets to all village households within the next few years. Without mass education, the public will not use them as they should. Mass education will enlighten people to the health deprivation the country is facing and we will get a consensus to push the government to prioritize the issues like making sewage processing plants, not dumping sewage in rivers, changing Indian railway's practice of dumping human excreta on the railway tracks and animal control.

High population should not be used as an excuse, China with a larger population is doing much better in terms of sanitation and hygiene. High poverty level is not an excuse either, as many poor Caribbean countries are much cleaner. Narrow lane in cities of old Europe are so clean, that one should also not use that as a defense.

A Doctor’s prospective

One of the CHIPIN founders is a medical doctor and left India in 1981. His journey took him to Iran, then to England and he is finally settled in USA. He was able to see the differences in the regions of world from medical prospective.

Iran and the rest of the Middle east region does not have as bad problem of sanitation and hygiene as in India. Their many people put their garbage in plastic bag before throwing out, restaurants use gloves and tongs to handle food and only a few people defecate and urinate in public.

Medically one can see much less proportion of infectious disease, compared to India. Here we see more genetic diseases due to close relative marriages and lifestyle related diseases due to smoking and addictioms.
When he moved to England and America, the medical scene changed again. Infectious diseases, that make more than 80% of sickness in India are not known in all advanced countries of the West. Following are some examples:

Diarrhea: In the west ,its treatment is mostly without any antibiotic. Doctors do not think in the line that their counterparts in India do. In India it is mostly due to amoeba and sometimes even cholera and other serious community outbreaks.

Abdominal pain: In India, its commonest cause is amoeba or worms and patient is treated for that. In the west both these are not known. Actually you may have hard time finding medicine to treat worms.
Chronic Cough: In India, tuberculosis is the prime suspect. Most Western doctors on the other hand have never seen a case in their lifetime.

Skin Disease: In India, the first treatment of chronic skin rash is to treat worms in the tummy. Not so in the west. As mentioned, you do not get anti-worm medicine here.

In the west infectious diseases, which is still so prevalent in India, have been nearly eradicated a long time back. Medical students learn about them more as a history of medicine. If a person comes back with malaria, typhoid or tuberculosis from India, his/her diagnosis and treatment becomes a big challenge to the doctors in the west.

In India, people die early of infections diseases and the average life span is about 10 year less than the west. This is why we do not live long enough to manifest the non-infectious diseases, like high blood pressure, diabetes, heart disease and cancers that comprise majority of diseases there.

In India we re still struggling with the same diseases that this physician dealt with in 1970s before leaving India. He feels that unlike the progress in other fields, the medical scene has actually gone backwards in India. Some reasoning behind this thinking are as follows:

1, He remembers being able to drink tap water in schools and home. Now filters are mandatory everywhere.

2, Dengue and chikungunya was taught in the medical college as a disease of Africa. It is common in India now.

3, Multidrug resistant tuberculosis was not common then and now it is so much worse.
When this NRI doctor visits his doctor friends in India, the situation in the hospitals, nursing homes and their own homes is no different. Again the insides of the buildings are very clean but surroundings are full of filth. This shows that people in India have become very tolerant to dirty outdoors. It does not bother even the doctors.

An education on sanitation and hygiene is needed for the whole county. We should try to get involvement of higher and richer strata of the society first. Not only they can afford to spend money on garbage bags etc. , it is this section of the society that produces maximum garbage also.

Moreover this section of the society can influence community and the government to make the changes.

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