FEATURE

Are we in the dark age of money?

Prof. B. M. Hegde,
hegdebm@gmail.com

"This is the latest whiz kid among cardiac stents. Nowhere else in the world you will have a stent like this. I have done 56 so far. No complications at all, affordable too."  This is how a cardiologist starts his live streaming video at the National Interventional Council (NIC) conference in a five start hotel in Delhi where the conference organisers received several crores of rupees for the extravaganza. Paper advertisements and TV serials are old hat now medical advertisement and publicity look like kindergartens stuff. Now live streaming of a flamboyant cardiologist in a so called medical conference where normally science of medicine has to be debated is the in-thing. Even the Chinese device maker whose stent is not passed by the "great" FDA has beena part of the sponsors and must have also paid Crores. How much will this brand ambassador, the flamboyant cardiologist,get?  Where is medical ethics? Where is our great MCI the watch dog which is supposed to keep the watchful eye on medical ethics? What ethics does the MCI follow for itself in regulating medical education? What have we come to and what about the safety of our rich patients who go to the hospitals? Today a case can be made out for angioplasty in any one of any age who goes to the hospital as coronary artery blocks (not coronary artery disease) can be demonstrated in anyone,including children. In this scenario who is safe?

Pharma companies "plotted to destroy cancer drugs to drive up prices" After purchasing five different cancer drugs from GlaxoSmith Kline, Aspen Pharmacare tried to sell them in Europe for up to 40 times their previous price is another headline today (SundayTimes April 15th 2017). Busulfan is an old hat in treating leukaemia. It used to sell for Sterling Pound 5.20 a couple of years ago which now sells at 65.20 in England. This is an old drug and nothing new or exciting about it!  While bargaining the rise in price of cancer drugs in Spain the company wanted to raise the price by 4000 times! When the government did not agree they threatened to stop cancer drug supply in that country to take the country for a ride. In fact, it would have been a great boon for the Spaniards to live without the dangers of these anti-cancer drugs.

The cover story of the OUTLOOK magazine of April 17th 2017 is still worse. We have been fighting a losing battle against vaccinations for decades. Outlook writes under the head when a baby is a business: “Scared middle class buys unwanted vaccines, nearly fifteen of them, as big pharma-mostly foreign-helps doctors to rake in the moolah of 30-300%!” The more dangerous trend is the IAP, Indian Academy of Paediatricians, an apex body to look after the child specialists in the country has now been found to be partner in this venal business! On January 20of 2017 Dr. Vipin Vashista, a former convener of IAP, was unceremoniously eased out of IAP for blowing the whistle on the big money nexus in the IAP! The Health Ministry, I am told, is in the know of things, but prefers to do nothing!  May be the Ministry is afraid of the big wigs in vaccine business! Are we ready to bring forth a full generation of Indians with crippled immune system thanks to so many useless and dangerous vaccines when they are born? Parents are lost in the cacophony of vaccine threats and advertisements and the hapless victims do not have a voice in the true sense of the word. Another good soul fighting for the voiceless infants is Dr. Jacob Puliyal in Delhi. He is a good friend and a fellow traveller in the anti-useless vaccine fight

We are already in the dark ages of money which James Kennedy, a journalist, calls as monetary Fascism. “Milton Friedman and the Chicago School of economics claimed to have refined and developed modern,  scientific tools of ‘free market capitalism’, capable of unlocking ever greater rewards from Adam Smith’s simple, primitive concept of free markets.”“In truth, it was nothing more than a cloak of deception – providing cover for the unscrupulous behaviour of investment bankers, corporate raiders, speculators, off-shore corporation, debt mongers and bubble pushers (typically one and the same).  The enhanced rewards came from the pilfering of capital investments and technology from generations past, the liquidation of employees and off-shoring of production, the pilfering of pension accounts and the termination or spin-out of R&D departments and option packages to executives and directors that focused on short term stock price targets,” says Kennedy and gives the example of AT &T: Bell Labs, once part of AT&T, was the father of all modern telecommunication and electronics technology today was “ morphed into Lucent Technology”.  Lucent quickly “looted the legacy portfolio of Bell Laboratories” to enrich themselves and shareholders, leaving a worthless shell that was eventually merged with Alcatel.

So far so good but these do not deal with human life and health. But when monetary fascism comes to medical business life becomes difficult for humans and the very human race is threatened with slow annihilation for the sake making money for the few! Today we have seen only a few of the glaring dangers of monetary fascism in medicine but this is only the tip of the iceberg. The big belly under the water is the whole gamut of corporate monstrosity in medicine which is for another day.  I am reminded of what Benjamin Rusk warned the American Constitution writes about not letting any one system of medical care to dominate and monopolise the medical care. They did not pay heed to his warning and we are suffering the consequences today.

When nutrition was discovered in your backyard

Ever since she participated in the 15-day nutrition camp that was held in her Nuagaon village in the Bissam Cuttack block of Odisha’s Rayagada district, Chandrabati Kadraka, 22, has been a happy woman. For the first time since her daughter, Tiki, was born two years and four months ago, she now knows how to properly nurture her into a healthy child. Her baby girl is weak and, consequently, falls ill quite frequently, giving the young mother sleepless nights. 

“Fortunately, I have understood the importance of having a balanced meal put together from locally grown produce. We have a variety of foods, including various types of tubers and roots gathered from nearby forests, which are unique to our diet. Previously, we were hesitant to feed them to our kids. However, at the camp, I came to know how our tribal foods are highly nutritious, particularly for children,” elaborates Chandrabati. In Nuagaon, 12 mothers with children under three years of age attended the camp.

According to Bichitra Biswal of Living Farms, “Kondh tribal farmers were growing different varieties of traditional foods in the upland and hill areas. But with time, most shifted to cash crop cultivation for money. Naturally, the highly nutritious foods have disappeared from their plates. Through the camps, we are trying to generate awareness around the good values of their indigenous fare.”

Nutritionist Tapaswini Swain explains, “Tribal people are believed to be the closest to nature. They consume foods with very minimal processing, and the duration from the field to the plate is less, hence the bio-availability of nutrients is very high. Millets, for example, grow in abundance, and are a storehouse of nutrients as they contain protein, fibre as well as micro-nutrients such as beta carotene, iron and calcium.”

Every six months, Living Farms conducts an assessment of dietary diversity in 200 villages across Bissam Cuttack, Muniguda, and Chandrapur blocks. “In Rayagada, there is immense food diversity – from pulses, millets, and other grains to fruits, vegetables, tubers, and mushrooms. We are promoting their nutritive value aggressively in order to encourage the locals to consciously make them a part of their food regime so that their health parameters improve. During our assessments, we found a marked change among those consuming these items regularly,” reveals Biswal.

Emphasizing on the need to have fresh, locally grown or gathered produce, Mangi Kumuruka, 65, enumerates the wide array of millets they have to choose from. “There’s mandia or ragi (finger millet), juara (great millet), bajra (spiked millet), kangu (Italian millet), kodua (kodo millet), khira (barnyard millet), and suan (little millet). Millets are full of iron and calcium, and it’s important for pregnant women to have them. As it is, tribal women are largely dependent on deriving nutrition from forest foods, and it’s even more critical to have these when they are expecting so that both mother and child remain healthy during those critical days,” she explains.

Pratima Kumuruka, another Kondh tribal woman, adds, “There are no chemical fertilisers in our foods, so we do not see many pregnancy-related complications among tribal women. Rather, if we take millets and pulses regularly, our children are healthier.”

These days, Krushna Toiba and his wife, Latika, of Badeipadar village, too, are convinced that millets provide sufficient nutrition to children. That’s why when the Accredited Social Health Assistant (ASHA) worker of their village asked them to start complementary feed for their seven-month-old child, the duo decided to give mandia. “Today, our daughter eats all types of millets, and she is healthy,” shares Krushna with a smile.

Indeed, after participating in the nutrition camp and interacting with activists of Living Farms, there has been a definite transformation in the way the tribal people approach food. Notably, families like Toiba’s have even started cultivating little kitchen gardens to ensure a steady supply, whatever the season. 

“While earlier they used to typically grow three or four types of vegetables, and that too during the monsoon season, nowadays they sow 15-20 varieties and harvest throughout the year,” says Biswal. 

Latika, for instance, has grown nearly 27 varieties of vegetables and fruits for family consumption in the small patch in her backyard. “We do not buy from the local haat (market) as we produce enough for all of us,” she declares proudly. Most women have taken to growing nutrition gardens in their backyard. “We collected seeds from neighbouring villages by sharing seeds of traditional crops, and presently we have a variety of seeds. So much so that we do not have to buy them from the market; rather, we collect and preserve our own,” says Majia Kumuruka.

Whereas good farming practices are one aspect of healthy eating, preparing meals is another. A few elderly tribal women have concerns about the indifference of the younger generation with regard to the traditional preparations. “Our food is our identity. Once our food is lost, we will be lost,” remarks Rupa Kumuruka, 52, of Badeipadar village, rather ominously. However, since Living Farms has been organising recipe festivals, there’s been a revival of interest. At these festivals, community elders rustle up some delicious dishes from millets and other forest foods. They tweak these versions to attract the youngsters, who prefer spicy street fare easily available in haats. Young daughters-in-law are trying their hand at making ladoos, halwa, and pakoda from finger millet, niger and foxtail millet. “In the recipe festival, the emphasis is on making wholesome dishes that children will relish,” says Biswal.

Lalita Mandai, whose son is going to turn three, says, “I have learnt how to use ingredients for interesting meals. I now know how to prepare a special kind of chattua (food powder) from millets and nuts. It is better than any kind of ready baby food in the market.” 

Chandrabati also adds millets, pulses, and tubers to their diet. “At home, I used to make khechudi with cooked rice, pulse, and vegetables. But I have begun adding different tubers to this mix. Another dish Tiki loves is my millet kheer that is high on iron and calcium,” she says.