‘Beyond pandemic, vigil on non-communicable diseases should not stop’

The progress and prosperity of a place is directly dependent on the health and well being of its inhabitants. With the Covid-19 pandemic exposing the state of poor health infrastructure, people have realised the importance of a sound public health system. To understand Bengaluru’s public health grievances, challenges, possible solutions and the efforts being taken to tackle the issues, DH spoke to a cross-section of citizens to get their insights.

Vijay Shastrimath, a social and political activist, points out several challenges being faced by the public health system of the city: Low health awareness, poor access to healthcare especially among the urban underprivileged, affordability as the dominant private sector has made the services expensive, and the lack of accountability from the authorities.

He says, “Public spaces such as bus stands, parks, footpaths are the sources of many communicable diseases and these are spreading across the city at an exponential rate. Public spaces are overcrowded with poor planning, hazardous environment and social complexities.”

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Noting the government’s failure to manage the hygiene of the city, he adds, “The recent rains have once again exposed the government’s mismanagement. There are no proper dustbins across the city, and garbage has become the main cause for waterlogging during rainy days. Clogged drainage and water stagnation lead to many water-borne infections.”

Vijay highlights the rising levels of sound, air, and water pollution causing adverse health outcomes. Stressing on the effects of the pandemic on public health, he remarks, “The health and well being of Bengalureans have been severely impacted because of social and economic challenges posed by the pandemic. Many have lost jobs and faced difficulty paying for basic expenses like food and housing. The government has failed miserably to address the public health crisis.”

Dr Syed Ismail, a government medical officer, says that the rising number of Dengue cases in the city has created an alarming situation. He has this to say as plausible solutions to the problem: “With 331 Dengue cases being reported so far, the authorities are now on a war-footing to implement the vector control programmes.”

To prevent these diseases, he says, vector control is the fundamental approach. “For that, sanitisation infrastructure should be improved and people should be informed about disease control and proper water storage practices. Mosquito-breeding places should be destroyed and early medical consultation should be sought when symptoms occur.”

Ismail calls for the strengthening of ward committees and to have good collaboration among civic departments, private agencies and the public to remove all the black spots in the wards.

Prema M, an ASHA worker, notes that the health awareness among people has relatively improved after the onset of pandemic. She says, “When we go to houses, especially in slum areas, to create health awareness, people are very receptive and do the required things. We undertake ward level surveys for Dengue and other diseases, sanitise the area and urge the public to keep their premises clean. We are constantly watching out for cement water tanks, flower pots, etc where the water gets stored and if we find any larva, we remove them and sanitise the place.”

“The Mahila Arogya Samithi (MAS) programme, where we form a committee of 10 women from 100 families, is very helpful in spreading health awareness among lower sections of the society. After the pandemic and other occasional Malaria, Dengue outbreaks, people have become relatively hygienic now and constantly seek our assistance to clear their doubts. We have taught slum-dwellers how to use particular apps to consult the doctor when diseases strike,” Prema adds.

Savinitha, a community health professional, says that public health infrastructure has been given more attention due to the pandemic. But beyond infectious diseases, the vigil on non-communicable diseases should not stop, she notes.

“Similar to the health trend seen globally with regards to non-communicable diseases, in Bengaluru diabetes and hypertension cases are on the rise. There is a proposal to set up ‘Namma clinics’ based on Delhi’s Mohalla clinic model for better detection of these diseases,” says Savinitha.

She feels Bengaluru’s public health systems can be more inclusive wherein citizens from the marginalised communities are served better. Stressing on the need to destigmatise the pervasive mental health issues, she adds: “The Mental healthcare act that was passed in 2017 decriminalises suicide, and it gives patients with mental health illness more autonomy.”

Common mental issues such as depression and anxiety are increasing, she points out. “They are also very much a public health issue as they mostly stem from systemic failures. They should be dealt on par with physical health issues.”