Unless we breathe well, we cannot live
Millions of people around the
world struggle to breathe, and more than 10 million die each year due to lung
diseases including tuberculosis, asthma, pneumonia, influenza, lung cancer and
chronic obstructive pulmonary disease.
Nonetheless, lung health is less
well recognized as a key health indicator as compared to blood pressure or
weight. Lung diseases afflict people in every country and every socioeconomic
group, but take the heaviest toll on the poor, the old, the weak and the young.
There is a critical need to raise awareness of the importance of lung health
and bring it to the top of the public health agenda.
Pneumonia is the single largest
cause of death in children worldwide. Despite being preventable and curable, it
is the world's (and India’s) leading killer of children under five, claiming
one young life every 20 seconds -- 4,300 young lives lost every day, which is
more than those due to AIDS, malaria and measles combined. Every year, it kills
an estimated 1.6 million children under the age of five years, accounting for
18 percent of all deaths of children under five years old worldwide. India is
one of the 15 countries which together account for 75 percent of child
pneumonia deaths.
Yet children can be protected
from pneumonia, which can be prevented with simple interventions and treated
with low-cost medication and care. Tragically, only an estimated 1 out of every
5 children with pneumonia receives antibiotics.
Physicians Penny Enarson and
Graham Steve of the International Union Against Tuberculosis and Lung Disease
(The Union), spoke of some simple, cost-effective interventions at the
community/family level to curb pneumonia and other respiratory diseases in
children. They say: “Routine immunization against pertussis, diphtheria,
measles, (also hib and pneumococcal vaccine where available) is the one of the
most equitable interventions globally to prevent childhood diseases.”
Moreover, they write health
workers can use these vaccination visits – usually four in the first year of
the child’s life – to promote and educate caregivers on the merits of exclusive
breast feeding for the first six months of life as it is critical in preventing
pneumonia. “There is scientific evidence to support that breast milk contains
antioxidants, hormones and antibodies a child needs for growth and
development,” they continue. “They should also educate mothers on the dangers
of exposing children to indoor air pollution from cooking and second hand
tobacco smoke. Improving ventilation inside homes, not having an infant on back
during cooking and not permitting smoking close by an infant will go a long way
in reducing respiratory diseases in children.”
A child’s exposure to second hand
tobacco smoke adversely affects lung functioning, increasing the risk of acute
respiratory illnesses by 60 percent; chronic respiratory symptoms by 24 to 40
percent and asthma by 21 percent.
Enarson and Dr Steve Graham also
insist upon promoting good hygiene practices and educating mothers of the
importance of hand washing in preventing diarrhea and acute respiratory
infections. Caregivers should be able to recognize the signs and symptoms of
pneumonia and seek/access prompt appropriate care as pneumonia progresses very
quickly in severity.
“Pneumonia is one of public
health’s most solvable problems”, says Dr Ajay Mishra, Managing Director of the
Nelson Hospital for Pediatric and Neonatal Medicine at Aliganj, Lucknow. “We
have safe, effective and affordable tools to help children. Children should
have access to effective and affordable treatment using antibiotics, which
typically cost less than one dollar per dose.”
Gourdas Choudhuri, Vice-
Chairman, Institute of Digestive and Hepato-biliary Sciences, Medanta Medicity,
Gurgaon and a noted public health expert cautions that, “Lifestyle disorders
play a crucial role in upping the risk to pneumonia. Obese children are also malnourished
and so have a compromised immune system. So it is important to ensure that
children keep an ideal body weight and use the sports field and/or do plenty of
exercise to keep their lungs healthy.”
Neelam Singh, Consultant
Obstetrician and Gynaecologist and Chief Functionary of Vatsalya Resource
Centre on Health says: “Pneumonia is a major life threatening disease of
children after diarrhea. However, the kind of awareness drive that is needed
for pneumonia prevention is lacking. There is still a lot of ignorance and a
special drive needs to be conducted to spread awareness. The government has
made great progress in this field and treatments are available in government
hospitals too. However, the pressure of large number of patients, shortage of
experts, lack of infrastructure, and non-availability of medicines are some of
the concerns in the public health system that need attention.”
The forthcoming 43rd Union World
Conference on Lung Health to be held in Kuala Lumpur is designed to reinforce
the importance of addressing the problem of childhood pneumonia and other
respiratory diseases with a view to meet the Millennium Development Goal 4 of
reducing child mortality by two thirds.
More than 1 million young lives
could be saved annually with vaccines and antibiotics, by reducing indoor air
pollution in the form of cook stove gases and tobacco smoke and through
exclusive breastfeeding for the first six months of life.
Shobha Shukla
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