Rural Health: Requires Heart Based Approach.
I attend mainstream discussions on rural health. Sometimes I happen to be a panelist. What is interesting is that the discussions are always dominated by three issues; the dearth of doctors, the conditions they face in rural areas, and what sort of incentives they need to accept rural postings. Nobody touches the subject from any other angle. It is all about doctors, medical colleges, and drug and vaccine delivery. It is assumed that these are the solutions and once provided they will result in health.
When I get to speak I always point out, these are really secondary issues. What we should be worried about is the abysmal state of health we see all around us. We always talk about increasing the number of doctors. Why? What about decreasing the number of sick people? What about talking about genuine public health needs like safe food, environment, housing, waste management, and eco friendly livelihoods? What about the medical errors and misadventures that are causing disease epidemics? What about the rural people falling prey to pesticides and herbicides used abundantly in agriculture and DDT mix sprays that are targeted at malaria control? What about the drugging of pregnancy, caesarians, use of vaccines and drugs in infancy and childhood?
Thus these discussions are absolutely meaningless. Let us set right agriculture, set right our views about health, allow AYUSH (holistic) practitioners the first access during pregnancy, childbirth, infancy and childhood. In remote tribal pockets we are doing just that. We are replacing chemical agriculture with organic agriculture, ensuring irrigation, crop rotation and diversification, encouraging millets, vegetables, and tubers, setting up household level backyard organic kitchen gardens, setting up SHG's, Farmers Clubs and Federations to allow farmers get organized, get access to markets and hence ensure good incomes. Health comes from food. Food comes from a nutrient rich soil.
We are also now trying to reintroduce cows in agriculture and trying to restrict the use of hormones, antibiotics and vaccines for livestock and poultry despite opposition from vested interests. But we are unable to come full circle because of the greatest stumbling block. The Anganwadi workers (rural health workers) are trained to sicken children and people with drugs and vaccines which are target driven. The mothers do not get benefits unless they agree to this system. The PHC's and CHC's (local health units) do not have AYUSH (holistic) doctors and therefore people are ultimately being poisoned.
You cannot push poisons into people, ensure a highly toxic environment, ensure toxic food, a directionless education system that makes rural mostly tribal folk turn away from traditional eco friendly livelihoods, introduce fast foods into rural markets and expect people to stay healthy. That is foolishness at its level best.
The tribal people were the most healthy on earth. Their diet consisted of a diverse food basket comprising millets, a wide range of vegetables, tubers and forest produce. They also had access to plenty of meat. Hunting and other group exercises kept them healthy. Their traditional culture, song and dances kept them happy. They had extensive knowledge of herbal and natural medicines which they transferred to the next generation. They had tradition medicine men and women in charge of health. Living with nature and elements in itself the most effective way to preserve health. But in discussions around rural health these vital elements are always missing.