Disaster

Water worries: In the shadow of every pediatrician lives the soul of a preventive medicine expert. So we are quick to realize the implications of environmental desecration and depletion. The UN World Water Development Report to be presented in March in Japan says we are so deep in a water crisis that in the next 20 years, water supply per person will fall by one third. Currently 5 million people die annually of water borne illnesses of which 2 million are below 2 years. By UN norms the absolute minimum water needs are 50 L per person per day--5 L for drinking, 20 L for sanitation and hygiene, 15 L for bathing, and 10 L for food preparation. But in water starved countries round the world their daily quota is a measly 7·5 L per day. Life on this planet was born with "water as it's home, medium and fundamental necessity" and it's inexorable depletion may well beget it's disappearance. (The Lancet interactive 15 March 2003)

Revisiting the www: What is wrong with the internet as it is today? Why can't we have instantaneous medical consults via the internet today? The problem is that the internet is a noisy bazaar where transmission of important high quality information is unpredictably disturbed by the noise of junk mail, spam and e-commerce. These serious flaws lead 34 US scientists to sit together in 1996 and develop a new internet dedicated solely to the development of innovative technologies. Internet2 as it is called is developing technology which will help clinicians transfer verbal, visual and digital data online for immediate consultations. This means medical consults will be done over the internet, using a video camera, microphone, and electronic stethoscope while the patient is still in the GP's office. Palpation may also be possible using haptic technology. (The Lancet interactive 8 March 2003, www.internet2. edu)

Who dunnit? Is the health care system itself the mother of many diseases? A recent article which concludes that the major chunk of HIV infections in Africa upto 1988 were due to contaminated needles rather than risky sexual contact seems to imply just that. The data quoted by the authors include data where there seems to be inverse relations between risky sexual behavior and HIV prevalence. For example, Yaounde in Cameroon had a high level of risky behavioral markers yet a low and stable prevalence of HIV and just the reverse was true in Ndola in Zambia. In Zimbabwe in the 1990s, HIV infections increased by 12% a year whereas other sexually transmitted diseases were declining by 25%. Another anomaly is the continued reporting of HIV in children of seronegative mothers. While public health experts are concerned that this article may dilute their efforts in reducing risky sexual behavior, it is a point worth some consideration and thought. (eBMJ 1 March 2003)

Bullish budget: The Union budget is trying to boost investment into private health initiatives and is trying to promote India as a location for foreigners to access health care. It has provided tax benefits to financial institutions who give loans to hospitals with more than 100 beds. It will support institutions like the Apollo group which cater to patients from Asia, Arab countries, Africa and maybe even the UK in the near future. The budget has also proposed a universal health insurance scheme in which an annual premium of Rs 365 will cover upto Rs 30,000 in medical facilities. Definitely a small though wavering step in the right direction. (eBMJ 8 March 2003)

Gouri Rao Passi,
Consultant, Department of Pediatrics,
Choithram Hospital & Research Center, Indore.
Email: [email protected]