The Economic Times - - Saturday Feature - PK Kr­ish­naku­mar & S Sanan­daku­mar

Ker­ala has long been known for spec­tac­u­lar feats in the field of health and boast­ing of so­cial de­vel­op­ment in­di­ca­tors com­pa­ra­ble to de­vel­oped coun­tries. But an alarm­ing in­crease in cases of killer ail­ments can­cer, kid­ney and liver dis­eases is threat­en­ing to put its rep­u­ta­tion in jeop­ardy.

About 2,50,000 peo­ple in the state un­dergo can­cer treat­ment with the ad­di­tion of at least 42,000 ev­ery year while liver and kid­ney trans­plants are be­com­ing com­mon in su­per spe­cial­ity hos­pi­tals.

“It is dif­fi­cult to get a fig­ure of those af­fected by liver dis­eases in Ker­ala . But ap­prox­i­mately 150 to 200 liver trans­plants take place in the state a year. The num­ber of those with liver dis­eases will be many time more than that,’’ said Dr Mathew Ja­cob, hep­ato pan­cre­ato bil­lary sur­geon of Aster Medcity in Kochi.

While the in­fras­truc­ture is grow­ing to face this health cri­sis — spe­cialised hos­pi­tals are mush­room­ing to treat such dis­eases — ex­perts point out that pre­ven­tion is the best cure for such killer dis­eases and that it re­quires mul­ti­ple ac­tion in­clud­ing some ad­just­ment in life­style.

Ris­ing af­flu­ence, changes in life­style, new food habits, pes­ti­cide residues in food prod­ucts, obe­sity and ris­ing in­ci­dence of di­a­betes have all con­trib­uted in vary­ing de­grees to the health cri­sis, they said.

Ex­perts agree that there is wide­spread aware­ness of the dis­eases and their causes. And the state has whole­heart­edly em­braced or­ganic farm­ing due to the out­cry over the pes­ti­cide residue in the veg­eta­bles and fruits com­ing from neigh­bour­ing states. Much more needs to be done.

Malay­alis’ dis­like for phys­i­cal labour, which has led to a steady stream of mi­grant labour­ers from other states into con­struc­tion and other ar­eas, may well have a role to play. High liquor con­sump­tion is a prob­lem in the state, but junk food and obe­sity could be a big­ger is­sue as only 45% of liver dis­eases are al­co­hol re­lated.

“Nearly 55% of the cases are non-al­co­holic fatty liver dis­eases and in­clude men, women and even young­sters,” said Dr Philip Au­gus­tine, a lead­ing gas­tro en­terol­o­gist and man­ag­ing di­rec­tor of Lakeshore Hospi­tal in Kochi. “Junk food, lack of ex­er­cise, obe­sity all signs of im­proved stan­dard of liv­ing are trig­ger­ing the dis­ease,” he said.

The re­cent deaths of a pop­u­lar film ac­tor and a di­rec­tor from liver dis­eases have served to high­light the is­sue. “If you look at the re­cent deaths of two celebri­ties, ac­tor Kal­ab­ha­van Mani died from al­co­holin­duced liver cir­rho­sis and di­rec­tor Rajesh Pil­lai from non-al­co­holic liver dis­ease. He was obese, weigh­ing nearly 140 kg,’’ Dr Au­gus­tine said.

The in­crease in the in­ci­dence of can­cer is equally alarm­ing, ex­perts say. Ac­cord­ing to Sasid­ha­ran Nair, man­ag­ing di­rec­tor, Malap­pu­ram Can­cer Cen­tre and Re­search In­sti­tute, the es­ti­ma­tion that 42,000 new cases of can­cer are di­ag­nosed ev­ery year, which is based on the can­cer registry of Re­gional Can­cer Cen­tre, Thiru­vanan­tha­pu­ram, might be on the lower side be­cause many pri­vate hospi­tal might not be re­port­ing their num­bers.

“In some cases the pa­tients them­selves may de­cide not to re­port the dis­ease,” he said.

Nair, how­ever, said aware­ness has seen in­creased “re­port­ing” by pa­tients. Plus mod­ern di­ag­nos­tic equip­ment are de­tect­ing the dis­ease at a cur­able stage. “So the sur­vival rate in the state is ac­tu­ally high,” he said.

Lung can­cer and oral can­cer are most com­mon among men. How­ever, the most strik­ing in­crease is in the case of breast can­cer among women, Nair said.

Nair said there is a need to set up mod­ern di­ag­nos­tic equip­ment in ev­ery district head­quar­ters to help de­tect the dis­ease early.

Narayanan Potti, sec­re­tary, Cochin Can­cer So­ci­ety, said it will soon in­tro­duce a mo­bile unit to de­tect breast can­cer. It will be “a Volvo bus with mam­mo­gram unit, scan­ning ma­chine, test­ing cen­tre, chang­ing room, etc.” that will tour dif­fer­ent parts of the state, he said.

The mo­bile unit will have a doc­tor and two nurses who will help women to un­dergo the test to de­tect breast can­cer.

“Many res­i­dent as­so­ci­a­tions have come for­ward to tie up with us”, Potti said. “The to­tal cost of the project will be around Rs 1.8 crore,” he said. Higher in­ci­dence of di­a­betes among young pop­u­la­tion is trig­ger­ing more kid­ney ail­ments in the state.

“The di­a­betic pa­tients are aware about the im­pact of the dis­ease on heart and take nec­es­sary pre­cau­tions. They don’t take as much care about the kid­neys where the prob­lems de­velop at a later age,’’ said nephrol­o­gist Dr Jayant of Amala In­sti­tute of Med­i­cal Sciences.

The World Health Or­gan­i­sa­tion has said that around 10% of the world pop­u­la­tion de­velop kid­ney prob­lems. But in Ker­ala it could be higher as even teenagers get af­flicted with kid­ney dis­eases due to in­fec­tion and con­gen­i­tal prob­lems, Dr Jayant said.

The long wait­ing list for kid­ney trans­plants has given rise to thriv­ing il­le­gal trade in kid­ney. This par­al­lel trade led priest Davis Chi­ramel to launch the Kid­ney Fed­er­a­tion of In­dia which sup­ports poor pa­tients.

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