Human health… an indicator of good environment

Environment related diseases

• Communicable diseases: malaria, tuberculosis, dengue, chikungunya, kala azar, bird flu, swine flu, E.coli epidemic…

• Non communicable diseases: cancer, asthma, hypertension, cardiovascular diseases, Parkinson's disease, Alzheimer's disease…

Kala azar/ black fever/ leishmaniasis

• Second biggest killer in the world• Symptoms include fever, enlarged spleen,

enlarged liver and black pigmentation on the skin

• Caused by protozoa Leishmania donovani• Vector is the sand fly Phlebotomus, thrives in

warm, moist organic matter, such as mud walls, waste…

Kala azar patients at district hospital, Motihari, East

Champaran

More patients

Japanese encephalitis/ brain fever

• Causes fever, affects the brain• Viral disease, spread by a mosquito of genus

Culex• Pigs and birds are alternate host for the virus.

Disease can be transmitted only from a pig to the human being

Pig rearing is common in Eastern Uttar Pradesh

A scene from the Baba Raghav Das Medical College - 2005

Chikungunya

• Chikungunya, a viral disease borne by the Aedes aegypti mosquito

• Causes fever and joint pains• Mosquito breeds in small pools of clean water• In 2006, the diseases re-emerged after 30

years of being dormant

Water shortage in Haveri district in Karnataka forces people to store it at home

Coconut husk and shells accumulate water and help breed mosquitoes

Polio

• Viral disease, caused by drinking water contaminated with faeces of an infected child

• The virus affects the central nervous system and leads to muscle weakness and paralysis

• Prevention through vaccine• India has been polio free for an year

Vaccines are promoted to control this water borne disease

Silicosis and tuberculosis

• Occupational hazard - linked to mining• In absence of proper equipment, people

breathe in dust which injures the lungs and makes it easy for the TB bacterium to infect

• In silicosis, there is inflammation and scarring of lung tissue to forms lesions

TB treatment is long, needs to be supplemented with good nutrition

Exposure to silica dust at work place causes silicosis. Disease often misdiagnosed as TB

Arsenic poisoning

• Caused by high levels of arsenic in drinking water

• The toxin is present in the rocks and is released when the rock comes in contact with air (as in case of deep bore wells)

• Affects the skin, lungs…

Skin lesions are the first sign of arsenic poisoning

Cancer

• Linked to a variety of environmental toxins • Causes mutations in the host cells• Cigarette smoke was the first chemical to be

linked to lung cancer• Food additives like aspartame is linked to

cancer in lab animals • Recently, WHO has classified diesel as a

carcinogen• Pesticides – enough evidence

Pesticides are used extensively in agriculture

Vehicular emissions have carcinogens

Obesity

• The food that you eat forms your environment• Obesogens in food can make you fat– Pesticides– Food additives like high fructose sugar, ajinomoto–Medicines – Persistant organic pollutants

Junk food epidemic

Toxins at home

How do we deal with these diseases

• The health system is unequipped– State subject– The centre runs only some crucial programs like

that for immunization of children. The National Rural Health Mission is also implemented by the centre

– In absence of a strong public health system, private players are raking in money

Clean up the environment?

• Collaboration with different ministries– Clean air (Ministry of Environment and Forest)– Reduction in use of pesticides (Ministry of

Agriculture, Mministry of Chemicals and Fertilizers)

– Clean food (Ministry of Food Processing Industries)

– Sanitation (Ministries of urban and rural development)

Too many business interests for this to happen