Dentistry in India

Dentistry in India: Boom or Bust Business?

According to global statistics, the dental market in the world is growing steadily for the last five years. The major bulk of the market expansion is attributed to Asian countries, where India is said to be the forefront of this progress. As a matter of fact, dentistry in India is so huge that it will become the single largest nation market for dental services, products, and materials. Having said that, the dentistry in India faces a serious challenge; that is, the oral health care awareness in the Indian population is decreasing. This leads to the shrinking of the demand in dental services. You can click here to know more about figures and statistics about this decline. This begs us to the question, is dentistry in India a boom or bust business?

Dentistry in India: Boom or Bust Business

Over the last decade, India has become an international destination for medical treatment and services, including dental procedures. As per the recent government data, dental tourism accounts for the tenth of India’s medical tourism. And this number is seen to grow in the coming years.

Dental procedures and services in India is fairly cheap in contrast to its Western counterparts. For instance, a dental filling in the United States or in Europe ranges from $300 to $400. But in India, you can undergo a dental filling treatment for 20 bucks. Basically, you can avail the same services using state of the art equipment and technology at a very reasonable price.

The burgeoning population of India is a good sign that the demand for dental services will always be there. In fact, an increasing number of higher learning institutions are offering programs to accommodate the current and future needs of dentistry in India.

Challenges of Dentistry in India

  • Oral Care Infrastructure

Almost 99 percent of the dental service providers in India are private entities. There are a few multinational companies that have an active presence in the country’s dental market. After earning their degrees, dentists in India set up their own clinics, where most can be found in the city. The challenge about the infrastructure of dentistry in India is the competition. Each year, at least 200,000 students graduate from dental schools. And with the declining awareness in oral health care in the country, the supply of dental practitioners in the country will surpass the demand.

  • Marketing

Some dental practitioners see having a website as an effective marketing tool, which is good. However, most of them fail to look after the website and maintain it. Creating a website requires a lot of time and effort. Ideally, it will take a year, utmost, to evaluate and assess how the website contributed to the practice’s marketing efforts.

Restrictive Indian Abortion Laws Require Reform

With the widely controversial Donald Trump Policy roller coaster both making global headlines and impacting an immediate ripple-effect if you like on women’s abortion rights worldwide, the already heated abortion debate now enters a hard-line period of conflicted exchange in many global countries, developed and undeveloped alike, including of course, the Mother of the East, India.

In 1971, abortion was made legal in India when the Medical Termination of Pregnancy Act was passed with an aim to reduce illegal abortion and maternal mortality. In a society that frequently considers sexuality as taboo, the MTP act was a welcome move and a validation of a woman’s fundamental right. It also established bodily sovereignty wherein each woman has the sole right to make decisions about what happens to her body. The word ‘abortion’ has always been a sensitive topic. Throughout history, induced abortions have been a source of considerable debate and controversy. Many countries still consider it as murder, while women’s rights insist it to be a woman’s fundamental right to have control over her body.

Here are some things you should know about Abortion in India. So stay safe and well informed.

What is Abortion?

Mainstream Wikipedia defines abortion as the removal or expulsion of an embryo or fetus from the uterus, resulting in, or caused by, its death. This could occur either spontaneously as a miscarriage, or be artificially induced through chemical, surgical or other means.

When can it be done?

Abortion in India is legal only up to twenty weeks of pregnancy under specific conditions and situations which are broadly defined as:

  1. The continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury of physical or mental health
  2. There is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.

A woman has the right to abort:

  • If the woman has a serious disease and the pregnancy could endanger her physical/mental health
  • If the continuation of pregnancy could lead to substantial risk to the newborn leading to serious physical / mental handicaps
  • If the pregnancy is the result of rape
  • If the socio-economic status of the mother hampers the progress of a healthy pregnancy and the birth of a healthy child.
  • If the contraceptive device irrespective of the method used (natural methods/ barrier methods/ hormonal methods) failed

Permission/Consent:

  • If a woman is married, her own written consent is sufficient. Her husband’s consent is not required
  • If a woman is unmarried and over 18, she can provide her own written consent
  • If a woman is unmarried and under 18, she must provide written consent from her guardian
  • If a woman is mentally unstable, she must provide written consent from her guardian

Where and Who can perform the abortion:

Abortions can be performed in any medical institution that is licensed by the government to perform medically assisted terminations of pregnancy. Such institutions must display a certificate issued by the government.

Abortions must be performed by a doctor with one of the following qualifications:

  • A registered medical practitioner who has performed at least 25 medically assisted terminations of pregnancy
  • A surgeon who has six months’ experience in obstetrics and gynaecology
  • A person who has a diploma or degree in obstetrics and gynaecology
  • A doctor who was registered before the 1971 Medical Termination of Pregnancy Act and who has three years’ experience in obstetrics and gynaecology
  • A doctor who registered after 1971 and has been practising in obstetrics and gynaecology for at least a year

Types of Abortion treatment:

There are two types of abortion treatment, ‘Medical’ and ‘Surgical’ abortion:

Medical abortion: A type of non-surgical abortion which involves taking medication to cause an early miscarriage. Abortifacient pharmaceutical drugs made by combination of two medications, mifepristone and misoprostol is an option for women who are 10 weeks pregnant or less.

Abortion pill from 10 weeks up to 24 weeks: Involves taking medication to cause the womb to contract and push out the pregnancy.

Surgical abortion: Surgical abortion is a procedure that ends a pregnancy by removing the fetus and placenta from the mother’s womb and involves a quick, minor operation. There are two types of surgical abortion:

Vacuum aspiration ( first trimester) which removes the pregnancy by gentle suction with local anaesthetic.

Dilation and evacuation is done when an abortion occurs in (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration, dilation and curettage and the use of surgical instruments (such as forceps) to clear the uterus of fetal and placental tissue.

Evolution of the MTP Act

To understand the issues surrounding abortion in India, it is necessary to contextualise the evolution of the MTP Act, which liberalised abortion laws in India. The MTP was enacted two years before the landmark judgement of the US Supreme Court in Roe v Wade – which held that laws which criminalise all abortions, except those required to save a mother’s life, were unconstitutional and violated the right to privacy of a pregnant woman. But this right should be balanced against the right of the state’s legitimate interest in protecting both the pregnant woman’s health and the potentiality of human life at various stages of pregnancy.

The Medical Termination of Pregnancy Act, 1971 needs to be amended to better address the varying concerns of Indian women be they rape survivors, married women or sexually active single women.

Meniere’s Disease In India: Audiologists Hearing The Call

Menieres-disease-in-India-Audiologists-hearing-the-call

Meniere’s disease (Idiopathic endolymphatic hydrops) is an inner ear disorder characterized by recurrent vertigo, fluctuating hearing loss, tinnitus or ringing in the ear and a feeling of fullness or pressure in the ear. Fluid build-up in the inner ear creates pressure and causes damage to organs responsible for balance and hearing. This disease is named after the French physician Prosper Meniere who first described the condition in 1861. It is usually seen in young and middle aged adults. 75% of cases occur in 30-60 year olds but it can occur in anyone, even children. The disease is diagnosed by an audiologist through clinical examination and audiometry test.  The relapsing nature of the disease may affect balance, hearing and the patient’s quality of life.

The exact cause of Meniere’s disease is unknown, but it is believed that build-up of excess fluid in the inner ear and the body’s inability to reabsorb the fluid plays an important role in creating the symptoms. Meniere’s disease affects 2 out of 1,000 people in the world. Approximately 100,000 people develop this disease every year. People who are at greater risk include those who had middle or inner ear infection, respiratory infection, head injury, those with a history of allergies, smoking, alcohol use and taking certain medicines like aspirin.

The primary signs and symptoms of Meniere’s disease can be a combination of vertigo, hearing loss, tinnitus, sensitivity to loudness, impaired vision and feeling of fullness in the ear. A typical attack might start with a feeling of fullness in the ear, increasing tinnitus and hearing loss followed by severe vertigo which is often accompanied by nausea and vomiting. An attack might last for 20 minutes to four hours or even longer, after which signs and symptoms improve. Attacks often occur in cluster, for example you could have severe vertigo and only mild tinnitus or you could have mild vertigo, severe hearing loss and frequent tinnitus. Episodes could be frequent or there may be periods of remissions in between for weeks or months. The frequency, duration and severity of each episode vary, especially early in the disease. Although Meniere’s disease is considered a chronic condition, various treatment strategies can help relieve symptoms and minimize its long-term impact on patient’s life. An MRI is often suggested to rule out tumour of 8th cranial nerve.

The prevalence of hearing loss in India was estimated to be around 5.9 to 16.56 per cent. More than 5 million Indians suffer from hearing impairment. According to the WHO, India is among the countries that have the highest prevalence of hearing loss. It is estimated that there are more than 500,000 people affected by Meniere’s disease in India. The increasing number of cases is attributed to the increasing risk of air pollution, noise pollution and chemical toxicity.

The treatment of ear disorder in India dates back to the early fourth century through the use of Ayurvedic Medicine.  However, Audiology is relatively new only half a century ago. Audiologists are specialists that help in diagnosing and treating patients of Meniere’s disease and other hearing related damage. Audiology has grown exponentially during this short period of time and made significant progress in the treatment of hearing loss. A large proportion of audiologists in India are performing test, post-surgical rehabilitation for cochlear implants and hearing aid fitting in children as well as adults. However, the number of audiologist is not enough to help the growing number of people with hearing disability. There is a severe shortage of audiologist in the country. No matter how audiologists want to be part of the solution, the ratio between audiologist means each specialist should handle 20,000 patients a day which is impossible. Due to this shortage, many people with hearing disability go untreated. This is situation is impending the government’s hope of eradicating hearing impairment in the next 20 years.

Emotional instability, stress and improper diet are the common trigger factors for Meniere’s disease.  There are many ways from many cultures to treat Meniere’s disease. In Ayurveda in India the disease is believed to happen because of Vata and Pitta disorder. Excess heat (Pitta) can produce symptoms like vertigo, headaches and migraine while Vata can cause tinnitus or ringing in the ear. Ayurvedic treatments are very successful in treating Meniere’s disease and its accompanying symptoms since it produces balance from the root cause. Patients just need to follow certain diet, take Ayurvedic herbs and implement lifestyle changes.

In traditional Chinese medicine the ideas about the cause of Meniere’s disease has a direct link with the kidney (shen) and the endocrine system. Kidney qi weakens with age and hearing difficulty as well as failure in vision arises as a result. Chinese medicine treatment of Meniere’s disease is based on dealing with symptoms, eliminating condition of excess and tonifying the body in case of deficiency. The treatment aims to nourish yin, detoxify the kidneys and replenish the body. Taking special Chinese herbs, patent Chinese medicine such as Qiju Dihuang bolus, Guipi bolus, Fugui Bawei , Longdan Xiegan is recommended. Acupuncture and moxibustion are also helpful for alleviating the symptoms of tinnitus and vertigo.

In Western medicine treatment comprises of symptom management, medication, chemical ablation and surgery is considered. Medical treatments are aimed to reduce symptoms, prevent hearing loss and reduce the severity of attacks. Doctors recommend low sodium diets to help control water retention and reduce inner-ear fluid pressure. Doctors may prescribe medication to reduce vertigo and nausea to lessen the severity of the attack. To reduce fluid retention (diuretic) medications can also be prescribed. Noninvasive therapies and procedures, such as vestibular rehabilitation therapy, hearing aid and Meniett device can benefit people with Meniere’s disease. Surgery is needed if the symptoms are severe and the patient does not respond to other treatments. Surgical procedures may include endolymphatic sac procedures, vestibular nerve section or labyrinthectomy. People experiencing symptoms of Meniere’s disease should consider all options and seek medical advice to find out what particular treatment is right for them.

 

Children’s Health In India: The Ultimate Frontier

Our children are our future. But what are some of the gravest challenges to children’s health in India? Lack of sanitation … water issues, food, environmental problems?

India even with their leap and advancements in the tech industry are still struggling in managing health especially with regards to their children. One of the reasons behind this is that in India, 84% of all health care expenditure is out of the pocket. High health expenses places huge number of families at risk of falling into poverty. As such, malnourishment becomes something that millions of children in India are at risk with. Furthermore, children with mental issues are not given the necessary attention especially since there are little to no services of programmes that revolve around them. In addition, children with disabilities and mental disorders are stigmatized and hence have little access to health facilities. Something like auditory processing can be a struggle that a lot of parents in India face.

Another thing to note is that when compared to the world, India actually ranks as one with the poorest health records along with the highest TB prevalence. Polio eradication is actually backsliding and every three out of four children have anaemia. Health indicators differ greatly across the country with varying social sector budget. Its mental health budget stays at 1% of the total health budget.

Two million children die every year from diseases that could have been prevented according to UNICEF India. Even though prospects for India’s children seem to be improving, there is still a lot more that needs to be done as it still lags behind the world.  During infancy, less than 50% of children receive full immunization and this number has been dropping over the years.

One of the main problems with regards to children’s health in India can be attributed poor sanitation. Despite longstanding efforts by the various levels of education government and communities at improving coverage, drinking water supply and sanitation in India continues to be insufficient. As such, the lack of adequate sanitation and clean water result to significant negative health impacts that affected both children and adults alike. In fact, diarrhea is experienced by about 10 million visitors annually.

Despite the efforts of the government behind its mass toilet-building programme, there are millions of Indians who continue to defecate in the open despite having a household toilet. This is mostly found in the rural areas of India where people find going outdoors to be much more comfortable and this resulted to the rejection of new latrines making them mostly unused. This in turn lead to children becoming highly exposed to a bacterial brew which makes them sick resulting to them unable to attain a healthy body weight no matter how much food they eat.

Children’s health in India is indeed something that needs to be addressed. There is more that needs to be done and the government will not be able to fix the problem on their own and they need to work hand in hand with the community and share with the efforts in providing a safe and clean environment that benefit everyone and mostly the children. It is also important to help them realize how their old ways and practices are affecting and holding their growth and development.

Waste Management in India: Opportunities in Rubbish

It is quite apparent that India has mountains of garbage, and the cities are drowning in sewage. Is there any hope?

It’s not like the government has not been taking actions to handle India’s waste crisis. However, there is more that can be definitely done. The Jawaharlal Nehru National Urban Renewal Mission (JnNURM) was a massive city-modernisation scheme launched by the Government of India under Ministry of Urban Development. It aims to create ‘economically productive, efficient, equitable and responsive Cities’ by a strategy of upgrading the social and economic infrastructure in cities. However, aside from that, there has been no national level effort found to address the problem.

This basically means that municipal corporations got their hands full and will not be able to deliver solutions right away. It should be noted that for about eight years, officials of Hyderabad’s municipal corporation have been conducting interviews with locals and were quite unsuccessful with their efforts. This can be attributed to the track record of dumpsite operations and maintenance in India making the task of finding new landfills in and around cities is nearly impossible along with the Not in My Backyard (NIMBY) phenomenon. What corporations can do however is to take measures in their own hands by reducing landfill fires and open burning, and control pollution which is the result of leachate and odor and vector nuisance. This in turn, provides the needed relief to adjacent communities and allows corporations some time to plan better. Working closely with the community is also of utmost importance as they navigate through this sensitive issue. This is made possible by increasing clarity and transparency over such issue.

Indeed, waste management is a shared effort and should not be handled by the government and corporations by themselves. The community needs to join with the cause by practicing proper waste management procedures in an effort to reduce waste. Of course, waste will not go away overnight but such activities will make sure that this lessens over time.

Waste management goes under different category that needs to be separated from each other. This in turn makes recycling much easier and more efficient than before.  For instance, BMW of Bio-medical Waste means any waste generated in health care processes like diagnosis, treatment or immunisation of human beings or animals. BWM needs to be handled in a timely manner not it causing any adverse effect to human health and environment. It also needs to be segregated in containers at point of generation and handled and disposed off in accordance with prescribed standards.

Another popular waste product that is used on a regular basis is the batteries. It should be noted that batteries that are not disposed properly can end up to leak with used lead acid batteries and their components which can be very dangerous. As such, the community is advised to deposit used batteries with dealer, manufacturer, importer, assembler, recycler, re-conditioner or designated collection centres instead of throwing them away. Cleaners services of plastic waste also needs to be handled effectively especially since plastic takes a very long time for them to decompose compared to other types of waste. Finding the nearest recycling center is able to make waste management activity much easier to handle. We can only hope for the best with India’s waste management problem.