SOCIOLOGY <<Back
 
 
065
MEDICAL PRACTICE IN INDIA: ITS SOCIOLOGICAL IMPLICATIONS
D Banerji: Antiseptic 1962, 59, 125-29.

Before the advent of western system of medicine in the eighteenth century, the practice of the empirical indigenous system of medicine of very high standard was in vogue in India. However, with growing industrialization in Europe allopathic system made spectacular progress of which Indian sub continent could not remain unaffected during British rule. As a result, indigenous systems of medicine declined and became more or less cult of the quacks. Only a small fraction of the educated Indians have a chance to acquire knowledge of western medicine and only a few could afford to avail these services while millions of Indians living all over the country had very little use of very advanced medical institutions based in big cities. Even after 14 years of political independence India continues to be the home of preventable epidemics as well as has high incidence of innumerable communicable diseases. Extreme poverty is perhaps the most important factor responsible for the poor state of health of the people in India. A plan for having better nutrition, better water supply, housing and better education will certainly result in great improvement in the national health. In the initial stage of social development all efforts should be directed to provide basic elementary medical and public health services to the entire population. The doctor going to work in an interior village in India must have a wide and varied knowledge of the preventive and curative aspects of medicine, all specialization rolled into one. The state must provide free medical care to all, particularly to the poor. In the concept of socialized medicine there is no place of top sided approach of having highly trained doctors who have nothing to offer to the public other than some useless mixtures. What is urgently needed is a social transformation of the practice of public health and medicine in India.

KEY WORDS: MEDICAL PRACTICES, SOCIAL ASPECTS.

066
SOME SOCIAL ASPECTS OF THE NATIONAL TB PROGRAMME
D Banerji: Bull Dev Prev Tuberc 1964,10,47-50.

Health problems in India form only a small part of the large variety of pressing socio-economic problems that face the community. Pulmonary tuberculosis, among the health problems, is one of the many problems which need immediate attention. In the resources that are available for dealing with the different problems, the share which could be given to tuberculosis could not be big. If, due to some special reasons, a disproportionate slice of the resources is used up in applying advanced technological methods to satisfy a fraction of the total needs of the community, other problems may be accentuated. Logically a solution of the tuberculosis problem in India should form an integral part of a comprehensive overall social development plan for the community. If the tuberculosis control programme is according to the felt need, generated by the disease in the community, it would be in consonance with the other health and social programmes evolved for dealing with the other felt needs. Available information shows that it is possible to develop a minimal nation wide tuberculosis casefinding and treatment programme through the general health services. If the available resources in the future improve, then a corresponding qualitative and quantitative improvement in the working of the tuberculosis programme could be easily affected. It also appears reasonable to expect such a programme to produce an impact on the epidemiology of the disease.

KEY WORDS: SOCIAL ASPECTS, CONTROL PROGRAMME, ECONOMIC ASPECTS.
 

 
  OPERATIONS RESEARCH  
 
A : Problem Definition
 
076
A SOCIOLOGICAL STUDY OF THE AWARENESS OF SYMPTOMS SUGGESTIVE OF PULMO NARY TUBERCULOSIS
D Banerji & Stig Andersen: Bull WHO 1963, 29, 665-83

This study was undertaken in 34 villages and 4 town blocks where a few weeks earlier an epidemiological survey was carried out. All persons above 20 years whose photofluorograms were read as inactive, probably active, or active by at least one reader, were age sex matched with an equal number of X-ray normals, to form the experimental and control groups respectively. Thus, a total of 2,106 were eligible for social investigation. Interview sheets, with particulars of the name and location of village, household number, and individual number and the identifiable data of the interviewees were made available to the social investigators at random for contacting and interviewing them at their homes. The interviews were non- suggestive in nature and deep probing on the details of symptoms experienced by the respondent, which were fully recorded. About 79% of the experimental group and 83% of the control group were satisfactorily interviewed, which constituted the data further analysed. Of the numerous symptoms recorded, only that were associated with pulmonary tuberculosis were considered, of which cough occurring for one month or more, fever for a month or more, pain in the chest, haemoptysis and all combination of these four symptoms were analysed statistically.

Cough was found to be the most important single symptom. It was not only the most frequent symptom alone or in combination in the experimental group but was less frequent in the control group that 69% of sputum positive and 46% of radiological positive had cough while only 9% of the control group had it. Considerably fewer people had fever and pain in the chest. Pain in the chest appears to be non- specific, giving a ratio of only 2:l among the experimental and control groups while fever was in the ratio of 6:l and haemoptysis was ll:l. It was seen that 69% of the sputum positive cases, 52% of the X-ray active or probably active, 29% of the inactive and 15% of the normals (control group) had at least one of the above mentioned symptoms. In all the groups, the proportion of symptoms were higher among males than among females. In both males and females the prevalence of symptoms was higher in the middle age groups than among the younger or older groups. This age variation was more marked in the females. The findings of the study were analysed further along with the data obtained from a couple of minor investigations, conducted in the rest of the 28 villages which formed the total of the villages surveyed epidemiologically. This brought out further that 95% of bacteriologically positive cases are aware of symptoms, 72% experience 'worry awareness' and 52% form the action taking group. The above findings have been of considerable importance in planning further studies and in formulating the National Tuberculosis Programme.

KEY WORDS: SOCIAL AWARENESS, SYMPTOMS, SOCIAL ASPECTS, CASE, SUSPECT CASE.
 

 
  MISCELLANY  
 
A : Health Economics
 
177
INDIA'S NATIONAL TUBERCULOSIS PROGRAMME IN RELATION TO THE PROPOSED SOCIAL AND ECONOMIC DEVELOPMENT PLANS
D Banerji: Proceed 20th Natl TB & Chest Dis Workers Conf, Ahmedabad, 1965, 210-16.

It has been shown that most of the infectious tuberculosis cases in a rural community in south India are at least conscious of symptoms of the disease; about three fourths of them are worried about their symptoms and about half are seeking relief at rural medical institutions. It is well known that the existing facilities deal with only a very small fraction of even those patients who are actively seeking treatment. India's National Tuberculosis Programme has been designed to mobilise the existing resources in order to offer suitable diagnostic and treatment services to those who already have felt - need. India's health administrators have to initiate suitable administrative and organizational reorientation of the existing medical and health services to satisfy this already existing felt needs. The more provision of such services could very well motivate the remaining tuberculosis patients to seek the help from the medical institutions. This motivational force is expected to get reinforced as a result of progress in the field of education, mass communication, transport and industrial and agricultural production. Simultaneously, progress in the social and economic plans will offer the needed resources for strengthening the existing health services in terms of personnel, funds, equipments and supplies. Further more, social and economic development, by increasing awareness of the population, will ensure a more effective utilization of the existing services. Thus, social and economic growth will not only help in the development of an epidemiologically effective tuberculosis control programme, but the very rise in the standard of living itself might make a significant impact in controlling the disease in the country.

KEY WORDS: CONTROL PROGRAMME, SOCIAL ASPECTS, ECONOMIC ASPECTS, HEALTH PLAN.
 
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