Time for public health focus on mental illnesses

Its a whole new perspective gained in reading chapters in public health. Its a macroscopic view of things at population level. There is a big difference in the events at tissue level and when it unfolds as a population phenomenon. 

Mental health has never received the attention it deserved from public health professionals in India. We have always been running after stamping sparks of tuberculosis and malaria. With diseases undergoing epidemiological transition and societies in demographic transition, it is high time doctors adopt a refined focus on new priorities. 

A national commitment translating in clear policies would lay the stepping stones for implementing strategies for improving mental health of the public. There is acute shortage of manpower to deliver mental health services. MCI norms for psychiatry departments are relevant in this regard. Regional centres should train and retrain sufficient number of professionals in handling mental health problems at all levels, village to apex. A strong referral system should work as the spine of mental health infrastructure in India. 

One out of ten people around us suffers from one or the other form of mental illness. The weaknesses in our health system to tackle the increasing burden of mental illnesses (thanks to urbanization and industrialization) are clear on the surface now. All we need is a multipronged strategy to bring down the burden of  psychiatric illnesses.

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Roll number 24

Green
Green

Roll number 24 is again absent. Govind Sir was curious to know what prevented Sumati from attending school. It has been three days since she went on leave. He remembers her mother telling him on Monday that Sumati is sick after passing loose motions.

Govind Sir enquired about Sumati – “Does anyone know why Sumati hasn’t come since last three days?”

Sumit, sitting on the second bench, replied – “Sir, she fell unconscious. She is admitted in Taluk hospital.” Sumit lived in Sumati’s neighborhood. 

The school was situated in a beautiful fenced portion of the land overlooking Bhavsagar lake. In the premises of the school grew flowering plants and vegetables. Yellow and red roses, orange marigolds and white lilies made the school a pleasant area for learning lessons and playing games. Children loved being at the school because they were not only taught lessons from the textbooks, but also lessons on life with all its carefulness and gentleness.

Govind Sir was the only teacher there since the time his elderly predecessor died of an old age illness. A man in his early thirties, Govind Sir was struck by the realization that the duty of a school teacher counts among the greatest social services one can do to mankind. He found immeasurable satisfaction in making his 6-10 year old pupils play games based on life skills and teaching lessons on morality and values from the textbooks printed at government press. But, today, he was a worried man. His eyes caught the stillness of Bhavsagar lake while he wondered what has happened to Sumati. He decided to visit her at the taluk hospital in the evening.

Sumati was a seven year old girl being brought up in a joint family of at least ten members. Govind Sir has always found her unique in that she never cried on her first day at school. An year has passed and she has never displayed an emotion other than a wide bright smile that was more from her eyes than from her lips. She was once asked who her best friend was. She said everyone in her class are her best friends. When the same question was asked to others in the class, there was a unanimous reply – “Sumati.” Her mother brought her to school everyday and exchanged kisses at the gates.

Rajanna was Sumati’s grandfather. He enjoyed a rare distinction in the village. The villagers regarded him as a brave man who rescued several families when the mighty Godavari river flooded. That was more than two decades back when a young Rajanna swam across the Godavari and brought his wife, his aged mother and many children to safety. Everyone lived in gratitude towards him for saving their lives.

Lake
Beautiful water body

Rajanna lived life on his terms. In grandiose terms, he worked as a Mestri (contractor) in the Indian Railways. The truth was that he worked for several years as a daily wage laborer who crushed stones and then laid them on new railway tracks. When he felt overtly conscious of his entrepreneurial skills and leadership abilities, he started guiding small groups of workers in crushing and laying stones on the track. Today, he was a happy man because he had some twenty workers who took orders and guidance from him.

His son Ramesh took up the job of painting used furniture and selling them at cheaper prices. Rajanna and Ramesh ate breakfast together and took the road towards taluk office. Ramesh had to walk another kilometer from the railway crossing while Rajanna stopped and worked there till evening. However, there was another reason for which they had to walk out together in the mornings. They were men who loved open air. They enjoyed the privacy in the openness of the lakeshore.

The family was addicted to the pleasure in open air bowel evacuation. The activity was a significant effort undertaken on a regular basis in the wee hours of the morning. After all, in a family that dines together, defecation should also be a coordinated collective event. 

Rajanna was walking back home from the distant field on the shores of Bhavsagar. He placed the corroded aluminium bucket in the bathroom. He saw the sun shining across the horizon. He had to meet his friends at the local tea shop. The shopkeeper has an old television which entertained his customers. But today wasn’t like his other days at the tea shop. There was an unusual silence. He found that his friends’ interest was captivated by the speech of India’s Prime Minister Narendra Modi. It was not just the habitual tone of his voice that caught their attention today. Today, its the topic of his speech that interested them- sanitation. 
The Prime Minister was addressing the Indian Sanitation Conference 2016. Shortened as INDOSAN, this conference was being held in New Delhi. Shri Narendra Modi said that sanitation is of utmost importance in our lives. He gave the illustration of things at his village where villagers reared goats in the toilets built under Total Sanitation Campaign. Listening to his speech on the television, Rajanna remembered how he was utilizing the wet latrine constructed in his backyard. The Prime Minister went on to say that the action that an individual does in the open field has its repercussions back in his home. His family suffers from diseases arising from the infectious material discharged in the field. Rajanna heard the PM describe how children bear the brunt of this menacious practice of the elder members. He felt the whole world of his friends at the tea shop moving away from him. He felt like a student thirsty for knowledge listening to his revered teacher giving lessons on life’s hardcore reality. He remembered his granddaughter lying sick on the hospital bed. He remembered seeing Sumati playing with her friends in the open fields. The Prime Minister’s words started hitting him hard. He knew he had to change.

Evening came. Rajanna, Ramesh and Govind Sir reached the taluk hospital to visit little Sumati. Doctor said that she is doing well and fit for discharge. Govind Sir asked the doctor to take a minute to explain what disease was Sumati suffering from. Doctor explained to Govind Sir how bacteria and viruses enter the child’s stomach and cause disease. Rajanna quickly connected the doctor’s explanation with what he heard the PM speak in the morning. He knew deep inside his mind that somewhere he had been doing wrong. 

The next day, Rajanna again woke up in the morning. He again picked his aluminium bucket up. But this day, he took a new route. He performed the activity in the old toilet. The rusted tap in the toilet was repaired. After the family members ate their breakfast, Rajanna announced his decision to everyone present – We will use the latrine from today.

Like always, Sumati exchanged kisses with her mother at the school gates. Govind Sir started  attendance call. Roll number 24 sprang up in joy – “Present, Sir!”

Please check the number and dial again

Its a funny feeling watching these commercials of Reliance Jio, Idea Cellular and other networks. What’s the whole purpose of cheap call rates, full talk time and superfast internet if you do not have a person to talk to? 

Technology has shrunk our worlds into a five inch touchscreen. There were days when we wrote letters, dropped them in the postbox and forgot about it till an inland post was delivered. Today, we fret over a person’s status changing from ‘online’ to ‘last seen’ and those blue ticks. 

The latest TV commercial of a popular mobile network shows people excited about 4G speed of internet connectivity. They are happily talking to the person at the other end with the new connection.

I wouldn’t be changing to a network for extra speed and less cost. I want to be sure that there is someone waiting for me to connect at a super-speed. Till then, I would be connecting with the persons in my life with an incredibly infinite speed, the speed of my thoughts.

Now, that could be a real or virtual connection. After all, reality is subjective. 

Bring passion into research

Read the story of yet another illegal journal business. 

Medical Council of India has made it compulsory for doctors to have a certain number of publications to stay in practice. Now, when something is made mandatory and individual interests are disregarded, how do they manage to keep up the quality of research?

Scam journals are harvesting junk research. Compulsions are never the way to set things straight. If the quality of medical research has to improve, the research must have passion in it. 

Will the frantic run after answered research questions ever stop?

Gain by losingĀ 

If you want to lose, say, 5 kilos in a month or two, do not turn to yoga. Yoga is a holistic long term endeavor. For crash weight loss, which inevitably leads to a crash weight gain, all that you need is a combination therapy with strict diet regulation and brisk physical exercise. 

Changeover to a diet rich in vegetables and fruits. Boiled vegetables or raw vegetables in a salad are equally beneficial. Include a cup of cooked pulses for the protein need. Sugars and oils should be a complete no-no. That means you should grow an appetite for sugarless decoctions. 

When you stop sourcing external fats into your body, your body has to depend on its fat stores. Ultimately, you will have a trimmed tummy and deflated waist.

Physical activity is a must and should complement the diet. Burn all that you eat. Burn the adipose stores. Thirty minutes of daily brisk walking should help. Avoid sitting for more than 15 minutes at a place. Adopt an active routine. Keep moving around.

Remember. We have legs, not roots. So we are not the ones to stay and rot. An active lifestyle is the healthy lifestyle.

Movies that move

Christopher McCandless wasn’t just another human being. Some say he practised the minimalist philosophy. For an average movie enthusiast, Into The Wild is an out-of-the-box story.

I had no clue who the real-life protagonist was until I did some online research on the story. This movie will always be my strong recommendation for a troubled soul. It has the power to energize a tired heart. 

Some movies are so relatable that the individual instantly connects to the characters. The story helps them make a confident decision. It makes people feel that theirs is not the first time such a situation has emerged. The connection they make with the story and its characters bear lasting influence on their mind.

I have learned many lessons from Into The Wild through the story and the dialogues. Movies are a treat for the eyes and treatment for the soul.

Sleep for a healthy mind

Took an online anxiety test on a mental health website. Results were positive. I was afraid if I’m having anxiety neurosis. I have been too easily irritated and restless lately. 

I was finding it difficult to focus on a single activity. Lot of irrational overthought matters went round and round inside my mind. Maybe I need a good sleep. All that I probably need is some rest. 

A long night’s slumber could be my panacea. 

Offline is the new Online


Nothing can stop the mind from wandering. Boredom is only a phase to pass through. The bad habit is that when you limit your imagination. 
Reality is expensive. A visit to fasci-‘nation’ is hardly few seconds away. Let go of all the inhibitions, weaknesses, fatigue and confusion. Your strength lies in the power of your thoughts.

Reality is virtual. We are all just manifest in the time called Present. Let go of all restrictions imposed on your mind. Think your brain out. A problem without a solution is never a problem. There is a solution to everything in life. Exercise your brain to find out. 

With social networking sites infecting our brain and fingers, serious damage is being inflicted on our capacities to think and analyse. Real life situations are to be dealt with. Attention has to be sought in real life with the knowledge and skills learnt in the hard way. It is meaningless to worry about conversations that stopped after the blue ticks. 

Our love for phones and social networking sites should never supersede the love we have for individuals. Ease up the tensions in the virtual life and embrace the true happiness that awaits in the hard world around you.

So go offline for a while and put your things in line. 

Joy in reading


Sipping tea on a sunny morning. Windows open to gentle incoming breeze. Ceiling fan playing low frequency music. I open a book on public health and read how India achieved the polio-free status. 

This subject could not be interesting if I had approached it with the fear of exams. Everything starts making perfect sense when I read it with the curiosity to understand the history of public health milestones in India. 

Poliomyelitis eradication is the next big success story the world will script after the small pox era.