Dr Tester Ashavaid, Director-Lab Research, Consultant Biochemist HOD, Lab Medicine, P D Hinduja Hospital has been researching on various aspects of women related health hazards. She speaks on the major women health concerns of India in an interview with Raelene Kambli
Which are the major women related health concerns that plague India today? How do we overcome them?
In India, only 46.9 per cent of the 246 million households have toilets. 49.8 per cent defecate in the open and 3.2 per cent people use public toilets. Situations have to improve. Census of 2011 data collected on houses, household amenities and assets reveal that 63.2 per cent of homes have telephones. Nearly half of Indians 1.2 billion people have no toilets at home, but more people own a mobile phone. Providing toilets to every household and good sanitary conditions will safeguard women, and will provide health relief to 70- 80 per cent women in India. Bio toilets are available and they should be introduced. It will help to safeguard women and improve sanitary conditions. The government is trying but the entire programme has to become more aggressive and should be well monitored.
Health hazards by inhaling smoke from wood stoves for cooking is another aspect. Smoke inhalation from burning wood or charcoal over an open pit leads to premature deaths mostly among women and children who are often home all day. Four out of every five rural and one out of every five urban households in India primarily depend on direct burning of solid biomass fuel like fuel wood, crop residue and cattle dung in traditional mud stove/ three stone fire for cooking. Smoke from wood burning stoves contain a complex mixture of gases and particles. The size of the particles is directly linked to their potential for causing problems. Small particles less than 10 micrometers in diameter pose the greatest problems, because they can get deep into the lungs and some may even get into the blood stream. It causes increased respiratory symptoms eg., irritation of airways, coughing, watering of eyes or difficulty in breathing. It decreases lung functions, aggravates asthma, and develops chronic bronchitis, chronic interstitial lung disease, pulmonary artery hypertension etc. It also causes irregular heartbeat, and premature death in people with heart and lung disease due to particle pollution. Fuel efficient stoves should be introduced in Rural India.
Thirdly, according to the ICMR, cancer of the cervix is common in Indian women. It hits the younger women population whose lives are shattered after they know of it. It occurs because of viral infection caused by human papillomavirus(HPV). The incidence is higher in rural India than in metros. Herpes is one of the cause of cervical cancer which is again caused bad hygiene, too many children, low nutrition levels and early marriage contributing these women to a higher risk. 3 dose HPV immunisation coverage for routine immunisation is recommended and should be made mandatory for young women.
Breast cancer is another major cancer among Indian women. An increasing number of women are in between 25 to 40 years of age which is a disturbing trend. There is lack of awareness about the disease and hence these are diagnosed at a later stage ie. At stage III and IV and this leads to a lower five year survival rate as compared to the west. Screening for breast cancer is an ‘alien’ word for most people and hence they need to be screened early. In the west, most cancers (more than 75 per cent) detected are with mammography which present at stage1 and stage II resulting in good survival. India needs to reach this achievement which is possible only by aggressive promotion of screening and awareness (which includes self-examination ) and proper treatment.
Is there a direct link between poor sanitation and these health concerns?
Yes, there are direct link between poor sanitation and poor health. Government has taken initiatives in terms of setting up good sanitation practices but that is not adequate. India is a vast country and it need greater resources. Every household must have bio toilets (in villages) and fuel efficient cook stoves. Schooling for girls should by compulsory and every school girl should be taught good sanitation and hygiene guidelines, breast self-examination awareness is a must. This will ensure a fall in cancer cervix and cancer breast.
Is there a need for a right to healthcare bill in India?
Yes, these is a need for a right to healthcare bill in India which will improve health condition of women in India.
What is your message to the industry?
It is very important for women to prioritise health. If you have educated a woman on good sanitation practices you have an educated a family.
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