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| HEALTH TRIBUNE | Wednesday, July 2, 2003, Chandigarh, India |
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Why swallow a bitter pill? A sick medical college looks for financial oxygen Mental workload interferes with driver’s alertness: study AYURVEDA &
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Why swallow a bitter pill? Many Indians do not consult a doctor even when they are unwell. A major reason for the seeming indifference is the cost of treatment. While the charges are nominal at government health establishments, often the cost of the medicine they prescribe is steep, especially for the poor. The recent initiative taken by the Haryana’s Health Department will surely go a long way in helping such persons. Doctors working in all government medical colleges, hospitals and other establishments have been asked to prescribe only generic medicines or their salts. This will help in keeping the costs low, since generic medicines are typically priced much lower than their branded counterparts. This is because once the patent of a medicine expires, any company is free to manufacture it without paying royalty to the patent-holder. In any case, the price of a medicine is seldom related to the cost of its components (salts). The price is based on a more nebulous concept of “value”. This means getting what the company can extract from the market. Often there are allegations of certain unscrupulous doctors getting a “cut” for prescribing certain medicines. This is what medical representatives make their living from, persuading doctors that their brand, which often varies slightly from the other brands in composition, is the better one. It may even be the case, but often the patients tend to follow the doctor’s orders literally, and in the process spend a lot of money. To take an example from a report published in the columns of The Tribune recently, 10 tablets of citrazine would cost between Rs 1.30 and Rs 25 for the generic version, and between Rs 23.10 and Rs 29.95 for the branded ones. In any case, medical representatives are not welcome in government hospitals, if the latest indications from the state’s health department are to be taken seriously. What if the medicines are prescribed in spite of their being banned in other countries? Commonly used medicines like Perinorm, taken for treating nausea and vomiting, are banned for persons below 18 years by the US Federal Drug Administration. Yet this is often done, and observers contend that the rules clearly tilt in favour of the drug manufacturers who have little consideration for the users. These kinds of distortions must be corrected. Nimesulide is another controversial drug. A public interest litigation (PIL) filed by the Social Jurist, a group of lawyers, in the Delhi High Court claims that the commonly used drops of the drug were being marketed without the approval of the Drugs Controller General of India. The spotlight on the drug resulted in its withdrawal from the market to a certain extent when Dr Reddy’s Lab formally announced last month that it had stopped manufacturing its “fixed dosage combinations”. However, other versions followed, and the “suspensions” market is said to be worth Rs 17 crore. The mark-up for the drug is, according to market experts, 1,350 per cent! The mechanism for exercising control over the cost of drugs dates back to the 1960s, while the first Drug Price Control Order was issued in 1979. It was based on the recommendations of the Hathi Committee. The order was later revised in 1987 and in 1995. These modifications resulted in loosening the government controls over pricing. The market for medicines in India is estimated at Rs 18,500 crore. Out of this, as much as 70-75 per cent is not regulated. Even the segment that is not regulated is being squeezed because manufacturers are concentrating on the drugs the prices of which are not controlled. According to the Indian Drug Manufacturers Association, as many as 25 per cent of the drugs sold in India are spurious. This is a very serious charge, and unfortunately the governments have not been taking the right kind of deterrent action against such criminals. The very extent of the spread of this evil indicates an unholy-nexus among various vested interests which should be dealt with sternly. Recently the government cracked down on unlicensed and spurious drug manufacturers in Madhya Pradesh. Legitimate drug manufacturers say the drug prices here are among the lowest in the world. However, the purchasing power of Indians is also among the lowest. Any effort, like that of the Haryana Government, for making treatment affordable for patients, is laudable. Of course, government hospitals treat only a fraction of the ailing, but they do treat a large number of poor persons, who are definitely likely to benefit from the move to shift to generic drugs. At the same time, as consumers, we all have to be more aware, about the kinds of experimentation that is done as well as the lack of responsibility in prescribing drugs.
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A sick medical college looks for financial oxygen
Best known for repeated strikes, Homoeopathic Medical College and Hospital, Sector 26, Chandigarh, looks forward to the Chandigarh Administration either to bail it out or take it over to upgrade the level of education provided at this prestigious institution. The harbinger of homoeopathic medical education in North-West India, starting classes in 1974 at a house in Sector 35, the college had sought a plot from the Administration to start postgraduate courses to upgrade knowledge in the cheapest system of medicare. It got a piece of land that would cost Rs 6 crore. The college, running on the fees charged from the students, has only Rs 1.5 crore, according to Principal K. K. Dhiman. The Administration could have helped the college by allotting land at the rate at which the recently opened schools had got. The Administration agreed to give the college 2.4 acres of land for starting postgraduation courses, but the institution could not afford the land offered. A trust-run private institution affiliated to Panjab University and recognised by the Central Homoeopathic Education Council, it is touted as one of the 10 best colleges in the country. Principal Dhiman had also sent a proposal to the Department of Forests, Chandigarh Administration, to provide a piece of land for growing medicinal plants the funding for which was to be done by the Chandigarh Homeopathic Medical Council. This project was conceived to check adulteration as well as to drastically bring down the prices of medicines. He feels homoeopathy will play a major role in the post-WTO patenting regime after the year 2005 when the prices of a large number of allopathic medicines will shoot up. India is otherwise a leader in this system of medicare which originated in Germany. It has the promise of being the cheapest mode of medicare for the crores of poor Indians. The college is faced with certain fundamental problems. A third year student says despite having a good faculty and sufficient facilities, the lack of indoor patients prevents the students from having a proper exposure. The pathology laboratory does not have testing facilities for cancer, diabetes and many other ailments. The college is not able to recruit the best of faculty because of fund shortage. The staff members have to make do with a salary that cannot be considered a proper remuneration for a qualified professional. With postgraduate courses in homoeopathy available only in Jaipur for students from this area, upgradation of knowledge is not possible for most of them. Apart from the lack of these facilities, the college does not have a hostel for students. It has a strength of between 200 and 240 students and 25 permanent faculty members. It, however, boasts of entertaining more than a hundred OPD visitors. The college administration says it only charges Rs 3 per day from a patient, and if somebody is considered poor, he or she need not pay. The 25-bed hospital attached to the college has devised a strategy to provide students more opportunities for OPD exposure. It is planning to open six OPDs in peripheral areas of the city to reach out to the poorest sections of society. The college is run by a trust comprising mostly academicians, lawyers and former bureaucrats. |
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Mental workload interferes with driver’s WASHINGTON: A new research on driving in real traffic has found that undertaking complex mental tasks can reduce a driver’s ability to detect visual targets by as much as 30 per cent. The research confirms that mental workload can interfere with the capacity to detect visual targets, discriminate among them and select a response. Higher-level mental tasks take attentional resources away from the road, resulting in those all-too-familiar post-accident reports. Already knowing that external distractions divert drivers, the authors — at the Direccisn General De Trafico, Spain’s Public Administration for Traffic Safety and the Universidad Complutense in Madrid — studied internal distractions produced by the driver’s own thoughts or cognitive activity unrelated to the task of driving. “It is easy to understand how one cannot see because of
not looking, but it is less obvious to explain how one looks but does not see”, they explained. —
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AYURVEDA &
YOU By Dr R.Vatsyayan Can you guess which plant is an integral part of most of our everyday personal care products? Before you hurry to find an answer, just have a thought of some of these items — toothpaste, shaving cream, post-shaving lotion, mouth-wash and fresheners, cough syrups and green digestive capsules, etc. Most of these products, of any brand, have menthol as one of the
ingredients. The answer may leave all of us a bit astonished as menthol is the active substance of pudina, the herb we have been using in our kitchen for centuries. The ancient ayurvedic literature calls it “putiha”. There are more than 20 of its varieties, some original and others hybrid. The garden mint or the spear mint is the most commonly available specie of pudina. It has been described as pungent in taste and hot, sharp, dry and light in effect. Pudina is mainly a pacifier of “kapha” and “vata”. Widely acclaimed as carminative, digestive, aromatic and an anti-emetic agent (that allays nausea and vomiting), pudina is valued as a stimulant, expectorant, anti-spasmodic killer of intestinal worms and a mildly analgesic herb. Fresh pudina leaves, on chemical analysis, are found to have moisture, protein, carbohydrates and minerals like calcium, phosphorus, iron and a volatile oil. Different varieties of pudina contain different active substances. Menthol and peppermint which give a tingling cool sensation are its popular derivatives which are extensively used in the modern pharmaceutical industry. Pudina is famous for its use in digestive upsets like nausea, vomiting, distension and diarrhoea. Here are some of its simple and remedial uses: Indigestion — Prepare an infusion of pudina leaves by boiling a couple of its leaves in a glass of water. Taking three table spoonful of it after adding a little rock salt at the interval of two or three hours makes a good carminative and digestive aid. It also helps to ameliorate nausea, vomiting, distaste, morning sickness, flatulence and abdominal colic of mild intensity. Urticaria
— Pudina comes very handy to cure itchy skin rashes or urticaria originated due to food allergies. Take a few leaves of pudina by mashing it with a few pieces of black pepper and a pinch of ajwain. It also immediately neutralises the incompatibility of any food article. Bad breath
— Simply chewing a few leaves of fresh pudina helps in controlling bad odour of the mouth. “Sat pudina” or peppermint is an essential ingredient of many popular tooth powders also. Another of its kind can be made at home by finely crushing together ash of almond shell 250 gm, nagarmotha, bark of moulsiri, kattha and hararh 50 gm each and clove, ash of phitkari and dalchini each 25 gm. Just add and crush 10 gm of peppermint to this powder. To fight bad breath and conditions like spongy gums, this makes an excellent tooth powder. Other uses
— Equal quantities of “sat pudina” and “sat ajwain”, if put in a small glass bottle, and kept in the sun with a closed cap for an hour get liquefied. By this method a unique combination is achieved which can be used both internally and externally in a number of ailments. A few drops of it in a cup of warm water act as a good digestive and anti-spasmodic aid, whereas if applied externally it is an effective pain balm. Old timers will recall the famous “amritdhara” drops of the pre-Partition era. This is the exact formula of once very popular and effective medicine. Besides being used for garnishing and flavouring dishes, salads and soups, pudina makes some of the mouth-watering chutneys in our kitchen. “Arq pudina” the aqueous extract drawn by the distillation method, is the famous medicine used by ayurvedic and Unani physicians.
— The writer is a Ludhiana-based ayurvedic
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