Heroes of Health

In India, 70% of the population lives in rural areas and about 15% in urban slums; further about one-third of our population is below the poverty line. Since the profit-oriented private medical services dominate over the public health services, most of the rural and urban poor people are deprived of proper medical care. Still the money factor does not stop certain young doctors from extending their services to the rural Indian masses for whom even minimal medical care could be a matter of life and death.

Last night I watched a short documentary which featured 18 individuals who have pioneered innovative ways to improve the health of poor people around the world and were named ‘Heroes of Health’ for 2005 by Time magazine. It’s simply amazing to see how some people are ready to go out of their way to help mankind without expecting anything back in return. Just knowing that their actions could help others live a healthy normal life, is enough for them to go on with their un-selfish deeds.

What made watching this even more worthwhile for me was the fact that it featured an Indian couple. Abhay and Rani Bang, founders of the Society for Education, Action and Research in Community Health, are among 18 heroes of Global Health named by the magazine for their work in solving health problems in the developing world. SEARCH (Society for Education, Action and Research in Community Health), is considered a grassroots health organisation that has succeeded in cutting infant mortality rates in Maharashtra’s rural Gadchiroli district by up to 75%.

Over the last two decades, SEARCH which operates in 42 villages has provided a lifeline in an area where doctors and health facilities are scarce. SEARCH works in the Naxalite areas of Gadchiroli district of Maharashtra, an area where infant mortality is high, and where newborns can die of simple causes — pneumonia, the basic lack of medical personnel, equipment and drugs. In such a situation, rudimentary, inexpensive techniques and village health workers trained by SEARCH are saving lives.

According to the magazine, Abhay and Rani Bang decided to work on high child-mortality rate in the developing world, a subject the medical community had long abandoned, after a baby boy died before them without treatment in Maharashtra’s rural Gadchiroli district. In 1989, the pair published their research in the journal Lancet. “Within a year or two, there was an entirely new approach to women’s health worldwide” says Abhay. “The global population policy changed from looking at mere reproduction to the whole issue of women’s reproductive health. That was our first experience of how powerful this approach could be.”

The doctors also used this approach to tackle a problem that the medical community had long abandoned — the persistently high rate of child mortality in the developing world. The model was chalked out after two years of detailed surveys on child mortality. The Bangs identified 18 causes of newborn death, from the obvious, like malnutrition, to the surprising, like the practice of expectant Gond mothers of starving themselves and their unborn child in the belief that it led to an easier birth.

In 1999, the Bangs published the results of their efforts, again in the Lancet. They had cut child mortality in Gadchiroli by half — a figure that would fall to a quarter by 2003 — for a cost of just $ 2.64 (Rs 115) for each child saved. Today thanks to the Bangs endless hardwork and efforts, around 80 village health workers and 120 traditional midwives have learnt to diagnose and treat major killers such as neonatal sepsis and infant pneumonia. Even illiterate village midwives can now count the respiratory rate of a child and diagnose pneumonia using a ‘breath counter’ improvised from a simple abacus by Dr Abhay Bang. The Bangs home-based neonatal care model, which has attracted global attention, has successfully helped tackle the high rate of infant mortality. The adoption of this model in Gadchiroli has reportedly brought down the infant mortality rate to 35 per 1,000 live births. The centre has separate huts housing the lab, surgery, pharmacy, wards, library and even a shrine to the Gond goddess Danteshwari.

Their chartered programme is now being adopted across India, where more than a quarter of the 4 million annual newborn deaths occur, and in Nepal, Bangladesh, Pakistan and parts of Africa. “The great thing about these projects is that they can be replicated and scaled up — and inspire even more pioneering approaches to improving health worldwide”TIME’s sciences editor Philip Elmer-DeWitt said.

SEARCH was earlier honoured by the Maharashtra government for its work among tribals, and in 1996 was presented the Sheshadri Gold Medal by the Indian Council of Medical Research for its outstanding contribution to community health.

India and it’s people need more individuals like Abhay and Rani Bang since most of our government policies fail to address the basic health and medical needs of the vast majority, e.g. communicable diseases and other diseases of poverty, even though simple yet highly cost-effective knowledge and technology is readily available. Thanks to the efforts of people like the Bangs, Over the years, there has been some improvement in the health status of children in India. This is reflected in reduced mortality rates. Nevertheless, two million infants die each year, almost the same number as in 1960.