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World Heart Day: Diabetes, stress are root causes of cardiovascular problems, insists Dr Naresh Trehan

Why more than 60 million people in India have fallen prey to heart diseases and what factors are contributing to spread of heart epidemic in the country.

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On the occasion of World Heart Day, iamin caught up with Dr. Naresh Trehan, one of the most prominent cardiovascular and cardiothoracic surgeons in India, to bust the myths related to heart diseases and understand how government can help in filling gaps in healthcare sector in India.

In conversation with our correspondent, Dr. Trehan, Chairman and MD, Medanta, The Medicity, Gurgaon also sheds light on why more than 60 million people in India have fallen prey to heart diseases and what factors are contributing to spread of heart epidemic in the country.

India has arguably become the ‘heart disease capital in the world’. What factors, according to you, have contributed to this?

We have approximately 60 million patients with heart diseases in India. There are two important factors that are contributing to this. Firstly, Indian genes are arguably more vulnerable to heart problems. Secondly, the transition of India from a food deficient country to a food surplus one can also be cited as a reason.

We Indians love to celebrate. Don’t we? It’s in our culture. And we celebrate either with sweets or food with high quantity of oil, ghee or butter.

The food intake per Indian has gone up tremendously, while the physical activity has gone down. Machines have taken over and people aren’t burning calories. This is the reason why millions have fallen prey to heart diseases.  We need to keep a check on our lifestyle, otherwise the numbers will keep increasing.

What are the solutions in sight?

Diabetes and stress are root causes of cardiovascular problems. Once these are taken care of, cases of heart attacks will automatically go down. What has to be understood is that unchecked eating habits with inadequate exercise leads to diabetes. Also, excessive stress leads to excessive consumption of tobacco products which again gives rise to many heart-borne diseases.

The mantra is simple: regular exercise for at least an hour a day, being aware of what you eat with less oil, sugar, dairy products and meat; and regular check-up after the age of 30.

If we follow this mantra, the risk of getting a heart attack becomes much lesser. One should at least give 45 minutes to cardiovascular exercises coupled with 15 minutes of yoga. Apart from yoga and exercise, meditation also helps in beating stress which has become an integral part of our lifestyles.

People with history of diabetes and heart attack in family should remain cautious with their diet and should regularly get their check-ups done. Nearly 20% patients who suffer heart attack die with 10% of them succumb even before reaching hospital.

What have been some of the key developments in field of cardiology in past two decades in India?

Last two decades have witnessed a paradigm shift. Cardiac care has reached various cities other than metros, and even in smaller towns. The technological advancement in medical field has also added to this.

But we need to be careful about this mushrooming of health centres. Treatment of heart disease is a subject of great care and complications should be taken up only by highly trained professionals. Nowadays, people who aren’t trained properly use patients as research subjects. For cardiac ailments, one has to be more agile and alert because any uncalled for treatment can be highly dangerous.

What is the potential of medical tourism in India? How can it be explored and what role do hospitals like Medanta play?

At present, medical tourism is a $2.5 billion industry in India and if few things are taken care of by the government, it can increase at a breathtaking rate of 15-20%.

India has established itself as an affordable healthcare destination for the people of Central Asia, Middle East, Afghanistan, Pakistan, African countries and to some extent European and American countries as well because in their countries, high quality healthcare costs fortune.

Open heart surgery, kidney transplant, liver transplant and even heart transplants are some of the reasons that prompt medical tourists to come to India. But things are changing now.

Despite India emerging as one of the finest medical tourism destination, the numbers aren’t really impressive. Dubai and Thailand, arguably, are giving us a tough competition also because living standards are better here. This is where government should pitch in.

A medical tourist wouldn’t only contribute to country’s economy while getting treatment, but much like a normal tourist, he will visit the places in country after getting treatment. Therefore, his contribution to Indian economy is quite significant.

Yet it goes without saying that a tourist starts facing problems, the moment he or she lends in India. Visa issues, immigration, pollution, lack of public transport and worst of them all, a lack of sense of security are some of the many pet peeves of the tourists.

The government needs to work towards creating an environment in which an outsider feels safe. Only then, India will be able to survive the competition and live up to its reputation of being one of the finest medical tourist destinations globally.

Are you happy with quality of doctors that are coming out today of the medical schools?

Some are decent enough and some are really bad. Actually, today, the medical education has become a scam in India with rampant corruption.

Anybody in India today can get into a medical school and become an MBBS doctor irrespective of his capabilities and educational credentials. The government needs to take care of this.

First of all, no school with fake credentials should be given licence to operate; and secondly, the government should keenly monitor the quality of medical education that’s being imparted.

The government should  ensure that no compromise whatsoever is done in this regard because it’s matter of people’s lives.

India again has become number one in exporting doctors to the West.  Is it having any adverse effect on country’s healthcare sector?

Yes, it is adversely affecting the healthcare sector because when people with high quality of education and capabilities go out, the country’s healthcare is bound to suffer. This exodus also contributes in making quality healthcare services dearer.

The government needs to work towards reversing the trend of brain drain. Enough facilities should be given to them, so that they see a bright future in India instead of West.

What are your views about field of medical research in India, and how do you compare it with West? What measures have been taken in Medanta to promote medical research?

Medical research in India is going through a rough patch. In pursuit of copying the West, we have forgotten that our requirement is different and far greater than that of West. West is advanced and disciplined in this regard. Medical research is handled with maturity and care. But in India, field of medical research is in shambles.

We talk about quality healthcare for Indians at an affordable price but this can’t happen unless, the government lays emphasis on medical research to produce quality medicine in India.

You claim to provide high quality healthcare at an affordable price. But, even at present, not more than 10% Indians can afford to get treated at hospitals like Medanta. What’s your take on this?

This is true. We do provide healthcare for economic weaker sections of society as well, but yes, by and large, high quality healthcare is still unaffordable to most of Indians and that’s where the synergy between government, private hospitals and NGOs comes into picture.

If the dream of affordable healthcare is to be made a reality, the government needs to work upon a mechanism in which public health infrastructure and private hospital can work together using each other’s facilities. NGOs can play a huge part in it.

But the government should also ensure that a private institution is paid adequately and timely for the services. Even today, we provide treatment to people under CGHS, DGHS and many other government schemes at affordable prices.

But even years after the patients get well, government doesn’t pay the bills. This puts excessive pressure on private hospitals because they aren’t operating for charity and it require a lot of money to function. I would say affordable healthcare for all Indians is tough, but not impossible. 


This article was published on iamin.in. For more such hyperlocal stories, visit their website.

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