Country Profile

India

Health and Fitness Aspects of Indian Population

by Dr. G. L. Khanna, Scientific Officer, Head Department of Physiology, Sports Authority of India, Bangalore, India

 

General Information

Health of an individual is important for the society. It is inseparably connected with the social health. Health in India is more or less conferred with absence of disease and some physical condition alone. The Indian literature reveals that mind is the soul of our of health and if the mind becomes listless and gloomy, we are sure to develop mental and bodily diseases and ill health. Rigveda has mentioned that a person is not born to be a victim of diseases and ill health. According to the ancient Indian literature health is a complex concept in which our mental wholesomeness and bodily well beings are fused in an inseparable manner. If the mind is ill the body is bound to be affected sooner or later and if the body is ill the mind is affected.
 
Sanskrit proverb says that the self should be protected even at the cost of riches and the relatives is too true to be refuted. If the self is destroyed what remains in the world and if the self is healthy and intact, what is lost in the world? The self is the center of our worth and makes life worth living in this world. Our life loses every meaning, if one loses health.
 
In 1992, the WHO has given an honest answer, people are not getting healthier either in the rich or poor countries. The average life span of the human being has increased, it is due to better food shelter and sanitation and not better medicine. Hence the base line is the purchasing power of the per capita income. Poised through man is on the threshold of the twenty-first century, he still shares the psyche of his primitive fore fathers ready and willing to believe in medical magic through intellectual evidence is to the contrary - an intriguing an whimsical insight into human behavior.
 
Right to health as declared by the supreme court in India is part of the fundamental right to life and liberty. But in reality health is a low priority concern for the government and the people. It receives the attention of many only at the outbreaks of the epidemics. Health for all by 2000 AD may be a goal for more difficult to reach than education for all. WHO is reported to have expressed regret that there is no way to reach the goal.
 
A National health policy was adopted by the Government of India during the sixth plan and health care programmes were redesigned and restructured to help, realize the objectives of the policy.
 
Health is the subject in the concurrent list of Indian constitution and hence the responsibility lies with both the Union and State Governments. Shortage of resources as well as manpower is the main impediment in providing sustainable health care delivery systems.
 
Health care become part of the minimum needs programmes. Health and family welfare programmes were integrated and the idea of community participation in health care was promoted.
 
More-over, although the very factors that influenced the health of primitive communities such as food and shelter, continue to be as important as before. These fundamental building blocks of preventive health have been forgotten in constructing the glorious edifice of therapeutic medicine.
 
Nowhere can this irony be realized better than in the current health scenario of India. A glance at the table gives us the rough and ready estimates incidence of the common diseases affecting us. The preponderance of communicable disease and a rising incidence of noncommunicable diseases speaks for itself.
 
This is a sad tilt of balance unlikely to be remedied in the near future for the simple reason that private health care has a strangle hold on the nation completely marginalised the governments's role, driven solely by the profit motive, the universal business dictum is therapeutic medicine is lucrative but preventive medicine is not.
 
In term of ideology, this is tantamount to saying "cure disease" and not preventive diseases'. In other words the health care industry lost sight of health, for diseases the woods for the trees.
 
Immunization was launched in 1985 to protect children from "Vaccine preventable diseases" diphtheria, tetanus, whooping cough, tuberculosis, polio and measles. During the 7th plan emphasis was placed on the preventing and promotive aspects and organizing comprehensive health services which would be easily accessible in rural and tribal areas.
 
A joint report of the WHO and the UNICEF brings out the inseparable link between health care and socio-economic development in a definition of primary health care which says the PHC is essentially health care made universally available and accessible to individuals and families in the community by mean acceptable to them through their full participation and at a cost that the community can afford.

 

It forms an integral part both of the country's health system of which it is the nucleus and also put of the over all socio-economic development of the country. The PHC has become the focus of health care and the only hope for moving nearer to the goal of "Health of All".
 
 
Population
 
The 50th Independence day celebration saw a belated return of the population issue to the fore front of national concern, even if appearing some what backstaged by the forthright attack on corruption. It was prioritized population growth among the key matters requiring the nation's urgent focused attention. A social movement is required to tackle population growth. Women's poor status and too rapid a population growth are directly linked. No less than the nuclear armaments issue, the population question encompassing.
 
Developing nation have a total population of some million. The population in these countries are reproducing at the rate of about 2.6% a year. This means that the number of people doubles every 25 years in the developing countries. The family planning has found one solution to limit the number of children born to each family to two.
 
India adds 45000 people every day and 16 million people every year to its population. Although efforts control population have averted 200 million births. If the current trends continue India will overtake China's population by 2050. Already the world population is over 5000 million with China contributing 1250 millions and India 9500 millions.
 
Registrar General of India recently disclosed the population figure. By 2016 less than 20 years from now the population will be 1.26 billion making India the most populous country. Our country will be reduced to metamorphical equivalent of a garbage heap crawling with million's of illiterate undernourished people.
 
The key to resolve it was education and awareness by non governmental organization and voluntary bodies should participate in a bigger way in the campaign for awareness among the people especially those in the rural sector.
 
In a study conducted it was proved that there is a relation of number of children with women education, the empirical evidence of various countries has shown the population growth of a region and its economic development are closely related.Economic development is in turn related to health of the population. Our policies, programmes and action have been limited by the concept of poverty alleviation - not leading the people to thrive beyond their needs.
 
The overall cost of the health care - both private and public is likely to be about 6 percent of GDP in 2000. It is suggested that integrated voluntary approach against the present fissiparous approach giving statutory status with autonomy to the board, giving assistance to these organizations by government and development of local communities for common activities for the voluntary agencies to be more effective.
 
Health care is affected in India because of prevailing turbulence, social tension and violence can be attributed directly to inadequate attention to the quality of life of the people and in that sense to the essential issues of governance of India.
 
India has taken lot of steps to control population like male sterilization, pills, condoms etc. There are some religious factors as well as psychological factors and all the other allied subjects. Increased population is a major source of human suffering. This suffering is due to a shortage of resources such as food and raw materials.
 
The main problem is to expand the resources of country to meet the huge demands of the expanding population. Technology has considerably improved the resources, but it cannot go on indefinitely. In so far as clinical preventive health measures are concerned, their scope is limited to immunization where appropriate, in the case of communicable diseases, until and unless the woefully inadequate public hygiene and sanitation is improved in India. There will be little protection against such diseases.
 
 
Pollution
 
2.5 million premature deaths took place in the country every year due to environment pollution. In the capital of India alone 8000 persons died every year due to various bad effects of pollution. Concept of development of health of the people and not of things is to be inculcated in India. Stress on pollution control is required.
 
 
Smoking
 
Currently three million deaths are caused world wide by tobacco and the developing countries account for one third. Estimates from Indian council of medical research show that about 0.8 million people die every year from tobacco related causes which implies that one death occurs every 40 seconds in the country. If the tobacco use continues unchecked The annual toll will touch 1.5 million by 2020. In India there are an estimated 214 million tobacco users above 15 years of age, one third of them female. Smoking is prevalent among 53 percent of adult male and 3 percent of adult females.
 
In India there are about 0.4 million cases of cancer, 1.3 million persons with heart ailment and at least 7 million suffer from chronic obstructive lungs disease half of all cancers in men and one fourth of all cancers in women are attributed directly to tobacco use. Steps have been taken to control smoking in the public places. Still people have to be educated towards the harmful effect of smoking.
 
 
Nutrition
 
In several surveys in India it has been found that half of the rural population in India is underweight with up to the quarters being so classified in deprived communities. There seems to be three basic causes of underweight i. e. food deprivation, gastrointestinal infection or metabolically induced anorexia. Many observations have acknowledged the paucity or complete lack of food stocks in a large proportion of rural Indian households with family depending upon daily food purchases and having a precarious earning power. Recent studies have demonstrated the presence of multiple micronutrients deficiencies in adults with associated immunological deficits. Indian would require about a third more food to be consumed to make the population healthy. To increase the intake of food, clearly the general economic improvement in India need to be improved by various means. Additionally, living condition of the rural poor improve sanitation to decrease chronic ill-health.
 
The Indian population can be divided into three categories - the upper affluent segment, a small fragment, middle class and lower poor class. The upper affluent class is urbanized, literate and health conscious and completely easy of health. The health problem likely to be encountered are those of affluence like obesity, diabetes, hypertension and cardiovascular disease. While dietary advice would counsel moderation in the intake of fat and sugar and in the choice of fat, it would be as important to stress a healthier overall lifestyle that would include regular exercise, avoidance of smoking and excessive indulgence in alcohol, conscious relaxation of mind and body etc.
 
The second class is the middle class for which the health advice will be balanced nutrition and since it is under corner of the educational system school teaching will be more effective. The control of population, family planning to provide better health care to the limited children will be better advice for the middle class.
 
The third class is the disadvantaged poor and are unapproachable. However, within the limited resources, a number of means and methods are being applied to provide better health care to the poor, the anganwadi workers, balasevikas, village health guide, day care worker, community nutrition worker. Some messages are being passed to drink boiled water, elementary sanitation and hygiene immunization, oral rehydration and use of the cheap vegetables. However primary education on health, providing safe drinking water, raising the socio-economic status, better sanitation and hygiene, campaign against smoking can help them to improve the health condition of the poor classes.
 
A national programme of nutritional support to primary education was conducted on 15th August 1995 to 110 million children in classes I to IV in more than half million primary schools in a period of three years as part of poverty alleviation package and as incentive to improve school attendance and to provide nutritious food. 56 millions children were to be covered in 4426 blocks and urban slums in all states and Union territories.
 
 
Fitness
 
As India celebrates 50 years of independent democracy, there really no better time than now to recognize the importance of a fit life. Sometimes fitness may seem like a light weight topic when we consider the more sobering task of society in overcoming poverty, hunger and assorted social inequalities. However, a fit and healthy body is the primary support behind a creative mind and a generous spirit and the integration of the these three mind, body and spirit makes total fitness.
 
 
Exercise
 
Saner voices now prevail and hold that moderation is the key. It is interesting to note that this advice was given long ago in ancient India by the physician Caraka. In the current milieu the sensible and convenient modes of exercise are largely confined to walking and yoga for the average individual. Of all the self help measures the relaxation technique to combat stress and maintain mental equilibrium is the most vital but also the most difficult to implement. Here again it is a case of harking back to tradition: Yoga, pranayams, meditation, mollifies and rhythmic chanting accompanying religious ritual etc. are paramount stress relievers.
 
 
Traditional Exercise System
 
Waking up early taking a walk to the river for daily ablution performing "Surya Namaskaram" circumambulating the temple premises etc. are the vernacular version of current thoughts on exercise pattern to augment health, it may be noted that a similar physical benefit may be gleaned through to ritual of Muslim prayer too.
 
 
Mass Fitness Program
 
To develop health and fitness through physical activity and sport a mass fitness program in India is to be launched. The following steps are considered to be taken up to improve the fitness level of Indians.
 
1. To educate the mass about the importance of fitness through different media
2. To create health consciousness among masses
3. To create environment for physical activity by providing play fields,
trainers, physical education teachers, social workers
4. To introduce compulsory physical edu cation programme in educational
institutions.
 
To implement health and fitness programs the following steps have been recommended:
 
1. All educational institutions must provide basic information on health and
fitness
2. All universities should have compulsory physical education and sport
programmes as a part of educational curriculum.
3. Formation of community clubs to be encouraged to promote health, fitness -
with minimum facilities for physical activity.
4. Industry and private sectors to play a dominant role in improving the
environmental condition and improving living condition, socio - economic
status and fitness of employees.
5. In rural areas: panchayats - to be made responsible for such programs.
6. Social organization to be involved in mass fitness programs
7. Government organization should have well defined programs to promote
fitness
 
To summarize a number of steps are required to be taken up to promote health and fitness in India
 
Dr. G.L. Khanna is the Scientific Officer and Head of the Department of Physiology at the Sports Authority of India. He may be reached at: Sports Authority of India, Netaji Submas Southern Centre, Banfalore 560056 India, Tel: (91)-80-3355647, Fax: (91)-80-3355214.
 
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