The Tribune, Chandigarh, India

World Tuberculosis Day falls on March 24
TB & human rights
Prof A.K. Janmeja
[ Head of the Department of Chest Diseases and TB, GMCH, Chandigarh. ]

The term human rights (HR) refers to an internationally agreed upon set of principles and norms contained in the charter of the United Nations. These principles are to be followed by the governments all over the globe. In practical terms, it shows what the governments can do, cannot do and should do. Respect for human rights requires the governments to refrain from interfering — directly or indirectly — with the enjoyment of HR. Fulfilment of the rights requires the governments to adopt appropriate legislation and to take administrative, budgetary, judicial, promotional and other measures towards the full realisation of HR.

TBis not only a health problem. It is also a social, economic and political matter. It manifests itself wherever there is negligence, exploitation, illiteracy and widespread violation of human rights. The disease is spread by an airborne microbe. However, all those who get infected with the TB bacteria do not develop the disease. Being poor, a member of a minority group, a migrant refugee, a child and a prisoner, or having a weak immune system due to HIV or substance abuse, makes one more prone to TB. They are not only vulnerable; the impact is much more serious and far-reaching because of their limited access to treatment created by stigma, lack of information and inadequate resource allocation. Therefore, it can be argued that the real cause of the spread of TB epidemics in specific populations is not merely the microbe; it is a complex set of socio-economic and political factors outside human biology alone.

TB and poverty: The link between TB and poverty has long been noted. Increased probability of becoming infected and of developing active TV are associated with malnutrition, crowding, poor ventilation and low-level sensation. All these factors are associated with poverty. In the West, there was a significant decline in TB before the advent of TB drugs. This was due to the reduced transmission-improved working conditions and diminished overcrowding. In India, those who earn less than Rs 350 a month, have twice the prevalence among those earning Rs 1000 per month.

Prevalence among those with no schooling is four times higher than that in graduates. Not only does poverty predispose one to TB; TB also increases poverty. About 75% of the TB cases occur between 15 to 55 years of age — in the most productive period of life. On contracting TB, one’s 30% or more of the annual income is lost. Often debt triggers the sale of assets, pushing the family deeper into poverty. Everybody has a right to a certain standard of living adequate for health and well being, including food, clothing, housing, the necessary medical care and the right to security in the event of sickness.

TB and children: In India, approximately 30% of all TB cases occur in children under the age of 15 years. Children are exposed to the disease primarily through contact with infectious adults and continue to be at risk till adults remain untreated.

Children are also vulnerable to indirect impacts of other family members having TB. If the principal provider is ill and cannot work; his children are at risk because of malnutrition which increases susceptibility to TB and brings other deleterious effects on health as well as education.

Children may be taken out of school or sent to work. Both of the scenarios deprive them of their right to education. The rights of the child make it obligatory for the States to take appropriate measures to diminish mortality, to combat disease and malnutrition and to ensure healthcare.

TB and women: Worldwide, TB is the leading cause of death in young women and the stigma attached to having TB sticks more dangerously to women. The stigma can cause abandonment by the husband or his family and the consequent loss of socio-economic support. Married women face harassment by in-laws and unmarried women are worried about the reduced chances of marriage and the possibility of being dismissed from work. Gender discrimination — denying girls and women access to education, information and socio-economic and political participation — can create increased health risk.

TB and prisons: The prevalence of TB and the related mortality in prisons are considerably higher than in the general population. Prisoners are predominantly male and young persons who come from poor socio-economic strata. Independent of these vulnerabilities, prison conditions, overcrowding, poor ventilation and inadequate hygiene and nutrition along with HIV/AIDS, foster TB. No matter how limited are the country’s resources, prisoners have the right to healthcare that meets the community standards.

TB and substance abuse: Substance abuse is a significant risk for TB. The abuse of drugs and alcohol is often a cofactor alongside poverty, unemployment and homelessness. Those who smoke more than 20 cigarettes a day have double the death rate from TB than the non-smoker. The menace is fuelled by the lack of awareness of risks in the general population and the intense marketing campaigns by the tobacco industry directed at women and young people. In such situations, the people have a right to information on health risks. Messages countering such promotion campaigns must be loud, clear and authentic.

TB and AIDS — a dual epidemic: Conditions that enhance vulnerability to TB — poverty, homelessness, substance abuse, psychological stress, poor nutritional status and overcrowding — must be related to vulnerability to AIDS. Both epidemics register their highest rates in disadvantaged segments. The WHO stresses the point that public health efforts to prevent and control the spread of HIV/AIDS are more likely to succeed if policies promote and protect human rights.

TB in migrants and refugees: Migration is a social phenomenon caused by various factors including poverty and globalisation. The transient nature of work and the long-duration of TB treatment make it difficult for migrant workers to balance their economic needs with their health needs. Even when health facilities are available, language difficulties unfamiliarity with new places and fear can be significant barriers on the way to healthcare. States are under the obligation to respect the right to health by refraining from denying or limiting equal access for all such persons to preventive and curative health services.

Tuberculosis has long been linked with social stigma and discrimination. We can change the situation by recognising TB as a curable disease — just like any other ailment. Every person with TB has the right to be treated for his or her disease. No one can deny that. So, let us stop denying people this basic human right!

HEALTH EVENTS
AROGYA: focus on health tourism

India has a rich heritage of well codified health care systems now referred to as Indian systems of Medicine. Ayurveda evolved in India and was in use for about 5000 years before Christ as the natural way of healing or naturopathy. For centuries it was the only system of medicine. Around the same time, other variations like the concept of "Yin Yang" developed in China while Unani saw its beginning in Greece. These three age-old systems, based on herbs and diet, offer a powerfully effective and gentle way to heal, with the least danger of side-effects.

The fast pace of life, tensions, mental stress and strains, modern societal pressures and today’s way of life have once again created interest in a holistic approach to health—a conscious return to nature. Naturopathy sees health and disease in holistic terms taking into account the inherent relationship between the individual and cosmic spirit, the individual and the cosmic consciousness, energy and matter. Naturopathy seeks to take human beings not only back to nature but also back to the fundamentals of nature.

Health Tourism has recently emerged as a significant segment of the overall tourism spectrum in the country. Kerala, which calls itself "God’s own country", has successfully exploited its exotic places and resorts for providing Ayurvedic health care to the people among whom are a large number of foreigners who specially come to the state for treatment. This has resulted in the creation of a large number of income and employment opportunities for the local people besides helping the farmers in the cultivation of medicinal herbs and plants. Many five-star hotels have started offering an array of treatments based on ISM, incorporating the "East meets West" philosophy. Ayurveda is being rediscovered through the medium of health clubs in many hotels. Every year in February, UP Tourism organises a yoga festival at Rishikesh which is attended by a large number of overseas people besides thousands of persons from within the country. This, however, is once a year activity. But the Arogya seminar on March 31 in Chandigarh will be held to spread ISM-related healing packages throughout the country.

Northern Indian states such as Himachal Pradesh, J & K, Punjab, Haryana, Uttaranchal, UP, Rajasthan and even Chandigarh and Delhi offer vast potential to develop health tourism. Himachal has already shown the way by introducing Panchkarma packages in some of the scenically located HPTDC hotels. These packages should be within the reach of the common man. Chandigarh, which has earned the distinction of being a transit destination, can be developed as an ideal health tourism destination with its scenic and serene environs and nature trails, so conducive to the promotion of this type of activity.

Despite a huge infrastructure dispersed throughout the country, the true potential of the Indian medical systems—Ayurveda, Siddha, Unani, Yoga, Naturopathy and Homoeopathy are yet to be realised.

With this aim in view a seminar—"Arogya on ISM and H and Health Tourism" is being organised on Sunday at Hotel Shivalikview, Chandigarh, under the aegis of the Union Ministry of Health and Family Welfare, the Chandigarh Tourism Department, CITCO and with support from the Departments of Ayurveda of the North Indian states. This is the first time that such an event has been conceived and organised.

An exposition with the display of various aspects of the Indian systems of medicines, health tourism, herbs and medicinal plants, publications and the latest technology in the ISM have been planned (from March 31 to April 2) at the lawns of the hotel.

Another aim of the seminar is to put the ISM on a higher pedestal and to get its due importance in the policy and plans of the state governments by bringing both the public and the private sectors on a common platform and to work out a strategy for the northern Indian states to jointly promote Ayurveda and other systems and share the experience and expertise.

The event is being coordinated by the ITFT. Recommendations made at the seminar will be forwarded to the authorities concerned for consideration. ITFT also proposes to make this event an annual feature. For more details one can contact Prof Narinder Kumar, Coordinator, AROGYA, SCO-1—3, Sector 17-D, Chandigarh.

— Kamaleshwar Sinha

Diet for lustre
Radhika Oberoi

Question: I am in my early thirties but have started getting wrinkles on my face and hands. Can I delay this aging process by improving upon my diet ?

Answer: Certainly. Vitamin C, present in fruits like orange, grape, lemon, amla, guava, mango and strawberry, slows the development of wrinkles and premature aging of the skin. Besides, zinc also helps in the production of new and healthy skin cells. Zinc is present in foods like red meat, seafood, and nuts.

Question: I am 20 years old. Of late, my hair has started thinning and falling. Will you please tell me the reason as well as the remedy?

Answer: There can be many reasons for hairfall. Thyroid insufficiency can often lead to the loss or thinning of hair. Low protein intake can also be a reason. Increase your intake of meat, poultry items, fish, eggs, dried beans, peas, whole pulses, cheese and milk. Vitamin A is also a very important nutrient for shiny and healthy hair. It is present in liver, fish liver oil, carrot, green leafy vegetables, butter and papaya. Avoid tea and coffee. The elements in tea and coffee deplete minerals in the body which are needed for the growth of healthy hair. Drink plenty of water. Shun fried foods, starches and sweets. Take adequate rest and exercise.

Question: My eyes always look dull and tired. They also have dark circles. Please suggest a suitable dietary remedy ?

Answer: Good sleep, fresh air and exercise contribute to youthful-looking bright eyes. Add lots of citrus fruits, lightly cooked dark and green vegetables, carrots, fish liver oils, egg yolk, liver, yellow fruits, butter and margarine to your diet. Under the eyes, dark circles are usually caused by anaemia — iron deficiency — for which iron supplements can be added to your diet.

Question: I am a 16-year-old girl. I am very fond of long nails, but my nails keep cracking. What should I do ?

Answer: If nails crack, flake or break, have more of vitamin B and iodine. Foods such as egg, fish or any other seafood are rich sources of these nutrients. Besides, calcium found a milk and milk products helps strengthen the nails.

Question: Drinking lots of water ‘‘makes our skin better’’. Is it true that the more water we take, the more hydrated our skin becomes?

Answer: About two litres of water (10 to 12 glasses ) a day is recommended for good health and supple skin.

AYURVEDA & TOTAL HEALTH
Methi: abundant benefits & uses
Dr R. Vatsyayan, Ayurvedacharya

USED in many forms such as fresh leaves, dried plants and seeds, methis is at the same time a vegetable, an aromatic spice and a medicine. Ayurvedic seers of olden days gave no reference of it in their work and it was only the treatises of later origin which mentioned methi’s curative and healing properties. Methi has been used both as food and medicine in almost all ancient civilisations.

Called methika in Sanskrit, fenugreek in English and Trigonella foenum-graceum scientifically, methi is bitter in taste and light, unctuous and hot in effect. It aggravates pitta but pacifies vata and kapha. It is cultivated as a quick cash crop but its other variety grows wild in the plains of India. Leaves of methi contain various nutrients like protein, carbohydrates, vitamins and minerals while many alkaloids and oils have been separated from its seeds.

Methi has very good medicinal properties. Its green leaves are mainly digestive, appetiser, anti-flatulent, mildly laxative and anti-inflammatory. Methi seeds are more hot in effect and are a hervine tonic. Methi is also considered to be very effective in post delivery cases as it promotes lactation and controls body-aches.

Pandit Bhavprakash has written that methi relieves indigestion, colic and distention and also checks nausea and vomiting. The seeds are quite useful in treating a number of other disorders like arthritis, low backache, sciatica and muscular pain. Recent clinical trials confirming that methi seeds possess good anti-diabetic properties have inspired many pharmaceutical companies to come up with new herbo-mineral combinations which contain methi in suitable forms. Here are some common uses of methi:

Digestive disorders: As a home remedy, methi seeds are useful in combating indigestion, flatulence and sluggishness of the liver. A simple decoction of the seeds helps alleviate colic problems due to the retention of gas.

Sciatica and low backache: Seasoned ayurvedic physicians advise patients to use methi seeds in the Sciatica-Lumbago Syndrome and also in the early stage of rheumatoid arthritis. For this purpose, 1 gm of the powder of methi and sonth each is given with a little jaggery and warm water two or three times a day.

Post-delivery cases: Take 250 gm of crushed methi seeds and fry these in ghee with one kilogram of wheat flour and then add the same amount of sugar to it. Two teaspoonfuls of this combination, if given daily with warm milk in post delivery cases, help in quick normalisation besides promoting sufficient lactation in nursing mothers.

Diabetes: As an adjunct, one teaspoonful of powdered methi seeds can be taken daily by diabetics. The same amount of seeds can be soaked in a cup of water at night. This water should be taken in the morning. The regime also lowers the serum lipid level besides helping in weight reduction.

In most of the Indian homes, methi seeds are an indispensable part of the spice-shelf whereas its green leaves are cooked and consumed as a vegetable. Since methi seeds are hot in effect, patients suffering from high blood pressure and haemorrhagic disorders are advised not to take it in high doses and for a long period.