A letter to health stakeholders | The only way to a healthy Sikkim

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Hello, stakeholders of health,


The more we look at our public craze for politics, the more we become convinced that we have been blinded by our overzealousness towards politics. Some of us are so consumed by it that we look at everything from a political lens. That in itself may not be wrong. But we have become so hopelessly prejudiced by our political preferences that we can never evaluate anything without being detached from our sentiments. We have been sucked into the vortex of social outrage.

It is good to have such political energy. Not every society has such a high level of political interest, let alone such intense sentimental investment. However, we need to redirect this political energy towards a more profitable goal.

Because Sikkim has become so politically overcharged, there will be some social activism or politically driven movements around health-related issues somewhere down the line. There will be an exchange of banter amongst political parties. The demand for the construction and upgradation of health centres/hospitals, the appointment of health personnel, their transfer, the supply of medicine, equipment, ambulances, etc. will be a major agenda politically. Much as these are crucial matters to our healthcare system, I dare the Sikkimese people, health activists, media and politicians to reorient our healthcare priorities and policies and restart the journey all over again.

The significance of good health can never be gainsaid. However, its concept has not been grasped by the majority of people. There are limited, inadequate and skewed ideas about it. Some people relate good health to going to the gym. Another group of people relate good health to good food and a disciplined lifestyle and the third group of people associate good health with good medical treatment. All three of these ideas are indeed related to good health but they only have secondary significance. These are upstream methods applicable to those who have somehow survived health hazards at earlier stages of life. How many of our children die young, much before they ever get to the gym, before they learn lessons on how to live a disciplined life before they earn enough to buy and eat a balanced diet and before they grow old enough to avail themselves of good medical treatment? How sad is it when they die either at birth or by easily preventable diseases like diarrhoea, pneumonia, fever, TB, etc?

We are missing a fundamentally important issue. Good health in its truest sense is fundamentally related to cleanliness – at personal, family and the community level. If health is our priority, we have to run a massive campaign across the state. And we have to do it for all we are worth. In other words, madly! Our state health minister must know that if Sikkim has to become healthier, the first priority has to be cleanliness. Hospitals, nurses and doctors are primarily a part of curative measures.

Prime Minister Narendra Modi was bang on when he launched Swachh Bharat. But fundamental problems with the campaigns were the over-emphasis on publicity, public and aesthetic cleaning. General awareness about cleanliness among people was striking by its absence.
We have so little idea and, even worse, often flawed ideas about cleanliness. It is not merely about cleaning our surroundings once in a blue moon for photo ops. Nor it is only about keeping our houses clean and dumping the dirt outside. Cleanliness involves a supply of clean water, maintenance of clean homes and a clean community.

Hundreds of children die due to diarrhoea. Even hundreds of adults suffer from this menace. It is high time that we realise that the occurrence of diarrhoea is a reflection of unclean water, unclean surroundings and unclean food preparation. If only the government and people would divert all their energy and resources to ensuring clean water, clean surroundings and better education, we would overcome this trouble.
Here are a few suggestions.

  1. Because Sikkimese people have an intense fascination with political rallies, it would be appropriate to invite a health expert as a keynote speaker. He/she can demonstrate and present cleanliness/health-related facts to the people. These health experts must be told not to get too toady about politicians and not to waste their time praising politicians and glorifying politics.
  2. As an urgent measure, every poor household must be supplied with a good water filter. Now again, potential suppliers will be running to the health minister and relatively wealthy families will be asking their panchayats and councillors to write their names on the beneficiaries list. But every citizen deserves to drink clean water. In Sikkim, only big leaders and top bureaucrats seem to deserve such water. Haven’t we seen them seated in the front rows with packaged water in government programs? Dear sirs and madams, we also have the same Sikkimese tummy which is equally vulnerable.
  3. Many Sikkimese houses are infested with cockroaches and other bugs. How many of us know the damage they can cause by way of contaminating our food? If there is a case of children repeatedly falling sick or looking sickly, there is a likelihood of their kitchen being infested with such bugs. The only way to prevent this menace is to seal houses with mesh in the windows and keeping the house clean. Mismanaged garbage, littered food waste and unwashed utensils provide a wonderful environment for these bugs to thrive.
  4. Most rented apartments do not get enough water. ‘If you cannot provide enough water, you have no right to rent out an apartment’ policy is the need of the hour. Remember that the dirty toilets and kitchens of your tenants will eventually affect your well being.
  5. Most Sikkimese children do not eat vegetables. Their parents do not seem to realize the need to include vegetables and fruits in their kids’ diet. Vitamin deficiencies will ultimately manifest themselves in multiple forms.
  6. The midday meal concept is not designed to make a profit to the providers. This is inherently a social activity. Our social activists and school teachers must be alert and do their bit to ensure that school children get the best food possible – in terms of both cleanliness and nutrients.
    There are many such small things that can make a big difference to our healthcare system.
    Only about 10 per cent of any given population need expensive health equipment and treatment. Good hospitals have a role to play. But if cleanliness is maintained in the aforementioned areas, our life expectancy could soar to 80+ in another decade or so.
    Should we not use politics and our political energy in making it happen? Let us stop politicizing everything. Demonizing politicians all the time doesn’t work. Much is left to the people to do. Young people aspiring to become politicians seem to like rallies, flags, press conferences, speeches and so forth. No issues. But let’s give it a try too. As they say – there is no harm in trying. Politics will wait for you and all of us.

Respectfully Yours, Jiwan Rai

By Jiwan Rai, the author can be contacted at jiwanr@gmail.com

NB: Views/Opinions expressed in the article or write up is purely of the author or writer. For any queries or contradictions the author can be contacted in his/her email id.

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