Editor,
Apropos the article “Education and Health – Need for a Special Assembly Session” by Toki Blah (ST February 6, 2014), the author has put forward two of the most important issues that confront us today. For, it is education alone that will allow us to advance and indeed protect our cultural identity for the future. However, that discussion is beyond the scope of this letter. I write to point out several glaring factual and interpretative errors in the article which I feel it would be amiss if not corrected.
First, I find it shocking that someone would say that we have been able to wipe out contagious and communicable diseases. That statement in itself is literally wrong – infectious diseases are now the world’s biggest killer of children and young adults and account for more than 13 million deaths a year – one in two deaths in developing countries. it is incredulous to even contemplate it in a State where many die even of vaccine preventable diseases. I was unable to find the most recent health data statistics for the State and these figures may be out of date but they are the latest ones available online on the Government of Meghalaya websites. These show that there were 33,979 smear positive cases of malaria with 237 deaths in 2007. Figures that are widely held to be grossly under reported! Indeed, during the height of the malaria season entire villages may have to be hospitalized for malaria. The same statistics show that only 14.1% of children are fully immunized. As I have pointed out these statistics may be out of date but they show that we are nowhere near wiping out communicable diseases. Indeed, we should hang our heads in shame to be living in a society where children still die of measles, whooping cough and diarrhoea in the 21st century.
When seen through the perspective of a city dwelling educated Shillong elite, it may indeed seem that non-communicable diseases are ion the rise but you only have to go down to Umsning to see the true burden that infectious diseases impose on us. It would also be worthwhile to remember that more than 80% of our population lives in rural areas. However, that point is also moot as we have seen Shillong is also not immune to outbreaks of epidemics like Menningococcemia.
The second gross error of the article is that Tuberculosis and AIDS are lifestyle diseases. This is another factual error – Tuberculosis is caused by the mycobacterium, M. tuberculosis and AIDS is a result of infection by the HIV virus. It is disappointing that people who formulate opinion and speak out for the public would be so ignorant of basic facts. I say this because these are very important issues that cannot be taken lightly – infectious diseases are still the most important killers in our society. Malaria and tuberculosis represent the greatest threat and to have them dismissed as conquered and ignored is a frightening prospect.
Thirdly, yes, non-communicable diseases are indeed increasing in prevalence especially in the urban areas but to put emphasis on them over other issues is simply wrong. Only 3.4% of women in the state have a full concept of family planning methods; only 34% have a safe delivery and only 11.7% received full ante-natal care. Infant mortality rates are 56/100,000 and maternal mortality ratio is 402/100,000 live births, at par with sub Saharan Africa. Our rural population will simply not survive long enough to develop Coronary Artery Disease and Chronic renal failure. It is these warped priorities that result in absurdities like the government spending more money on more visible issues when the true killers are something else. It is often a matter of he who shouts loudest getting the most attention and, therefore, it is irresponsible to distract society to look away from the real issues. Some infectious diseases are now known as neglected diseases because of the rarity in wealthier countries and investment in treatment and prevention methods has been lacking. Also access to existing interventions in areas where they are needed has been limited. This is the same situation that we now encounter in our State where the decision making occurs in the confines of Shillong and issues affecting the rural poor are neglected.
I hope that when articles are written, they be adequately researched and it is ensured that at least the basic facts are right. I also hope that editorial standards are maintained such that grossly erroneous statements of facts are not reproduced. While I have no misgivings about opinions being expressed, it is the responsibility of the editor, I presume, to check facts before they are printed.
Yours etc.,
Dr. G Rynjah, MD
Via email