| |
So goes an old Naga folk song which
discloses man’s desire to be healthy and free from
maladies. This desire prompts him to ally himself with
the forces of nature in the attainment of good health. A
healthy society begets healthy citizens and the outlook
of the society reflects the nature of it citizens.
Nagaland today is a bundle of contradictions. Despite
great strides made in the field of science and
development, Nagaland still is peopled by a myopic
society, ensconced in its traditional shell. The
unwillingness and reluctance to adopt a healthy lifestyle
has resulted in neglecting the vital health problems
which plague the State today.
Nagaland has a population density of 73 persons per sq.
km. (1991 census). It is afflicted with a host of serious
health problems. Its dependence on the other States
because of its economic liabilities has further plunged
it into an abyss of ignorance and acute
under-development.PROBLEMS
GALORE
Traditional Traps
The history
of the Naga society is steeped in myths, beliefs and
customs. Its ancient predomination roots still hold it
back and prevent it from fully evolving into a civilized
health-conscious society.
During important ceremonies, all the male members of the
family shake their shawls behind the Naga gate as a
symbolic sign of cleansing themselves of evils and intone
‘sickness and death, may I never be a prey to
thee’. This sums up the belief of the Nagas that
sickness, epidemics and deaths are the curses of an angry
deity who had to be appeased through rituals and
offerings. These beliefs, though discontinued among the
more educated masses, is still prevalent in rural and
urban areas where people still flock to quacks for
remedies rather than going to qualified doctors.
Because of inter-tribal conflicts, most villages were
situated on hill tops, far away from water sources and
they suffered from acute water shortage and
accessibility. But even now, when tribal warfare has
become non-existent, some villagers still refuse to move
to more favourable locations.
The old concept of health evolved around superstitions.
People seldom took bath and their houses were cleaned
only once in a year, thereby creating a sanctuary of dirt
and disease at home. Old habits die hard and many of
these age old habits still exist widely.
In rural homes, chicken coups and pigsties are attached
to the houses and other domesticated animals are
sheltered in the verandahs. This practice has lead to
epidemics as these animals acted as carriers of
communicable diseases. In rural interiors, zoonotic
diseases are fast becoming a major health problem.
Any open space, away from the public eyes, is used for
disposal of waste and defecation. Unclean environments
created by the lack of proper latrines and sewage
disposal systems have accelerated the spread of
infectious/water-borne diseases such as typhoid,
diarrhoea and dysentery. Added to this is the lack of
clean drinking water in the rural villages.
Food Habits
A Naga’s
diet consists mainly of meat, its derivatives and rice
without any regard for a balanced diet. Ailments such as
hypertension, heart diseases, and acute gastritis are on
the rise due to excessive consumption of meat, salt and
chillies. Heavy intake of local brew have manifested
itself in the high death rate from liver cirrhosis and
even heart diseases.
Economy
Nagaland is a
mountainous state with little or no resources of its own.
Its inhabitants had always been dependent on the
neighbouring states for its needs. Its cultivation is
insufficient to feed its masses and most of its resources
are undeveloped or exploited recklessly. Flagrant
devastation of the little resources available - its vast
timber forest - has further aggravated its economic
decline.
70 per cent of the population live in villages. The
crippling economy of the State has produced a low middle
class of people who have to fend for their daily living
neglecting personal hygiene. Thus for the common man,
health has become a secondary necessity and an
unaffordable and distant reality.
Health Management
Most of the
government hospitals in the State are ill-equipped.
Doctors and nurses work under extremely frustrating
conditions due to lack of proper medical equipments,
drugs and other support systems.
The biggest government hospital in the State capital is
today in a state of ruin. Gross misuse of the inadequate
funds and the general apathy towards health portrays the
dissolving health machinery in the State. Health and the
running of the hospitals have become big business, as can
be seen from the corrupt practices going on. A huge pile
of unwanted and unnecessary equipments has been lying
idle, in the face of acute shortage of even basic medical
equipments and medicines everywhere.
Promotive and preventive health measures are totally
neglected, giving importance only to the curative health
care. The Nagas still have to take in more of the finer
values as that of its health consciousness and personal
health care to evolve into a truly healthy society.
Apart from the naked structures that are standing, the
PHCs in the rural areas, devoid of medical facilities,
stand out as a living testimony to the declining and
collapsing health care delivery system in the State.
The present doctor population ratio in Nagaland is
1:3713 and the hospital bed population ratio is 1:969.
These figures clearly indicates the dearth of doctors and
medical facilities for the people. Moreover, health
personnel are unwilling to work in rural areas. The
traditional methods of treatment, with herbs and
medicinal plants, used in the rural areas are still very
crude and cannot substitute the need for modern
medicines.
Mental Health
The Nagas
lead a carefree life. However with the worsening of the
law and order situation in the State, there is tension
and fear in the minds of the people. Daily life is filled
with apprehension, fear and anxiety. This has taken its
toll psychologically and physically. Anyone can go
berserk any day; worse still is the psychological fate of
the younger generation who are destined to grow up with
terror.
Family Planning
As per the
1991 census, the birth rate was 18.5 and the death rate
is 3.3. The gap between the annual birth rate and death
rate is widening. Considering the population of Nagaland
today, these figures are alarming to say the least. The
rate of population growth is one of the highest in the
country. In the olden days, a big family depicted
prosperity and wealth. This practice has resulted in
over-population in towns and villages aggravating
congestion, pollution and numerous other health hazards.
The couple protection rate, according to a study is just
9 per cent showing the reluctance of the public to resort
to birth control and other measures in family planning.
PRIORITY AREAS
Health Education
Nagaland
boasts of a literacy rate of 66.19 per cent (1991
census). But the knowledge and consciousness of health is
negligible even among the literate masses. Education
alone can help the people in improving their health
status.
Health education needs to be focused on the importance of
good health; through school health programmes, mass
media, seminars, health camps etc.
Health Care Delivery System
The existing
health care delivery system is outdated and needs to be
reformed to make it people-friendly. In rural areas, for
lack of health centres, the only alternative is the
traditional methods which needs to be properly developed
to meet the needs.
Specific areas which need immediate attention are
women’s and children’s health. Gender-bias is
prevalent. Children in rural areas are undernourished.
Weak mothers produces weak babies who develop various
diseases at later stages. Though the government
statistics show that Maternal Mortality Rate (MMR) to be
4 per 1000 and Infant Mortality Rate (IMR), 48 per 1000
live births, the actual figures are much more as the
statistics from rural areas where the mortality rates are
higher are not included.
Steps to be taken in the field of health care delivery
system also include monitoring the health care delivery
system in primary health centres, setting up of a modern
and well-equipped diagnostic centre so that people
don’t have to travel outside the State even for
simple tests, setting up of a mental health care centre
,and above all, research and development of Indigenous
System of Medicine (ISM) which are more convenient and
affordable.
Development
According to
the 1991 census, in Nagaland, 88 per cent of the towns
and villages have been provided with pipeline drinking
water. These figures are not correct. In most villages,
the pipe-line is rusting away with not a drop of water.
The roads in most of the villages remain untarred. Apart
from those which are near the towns, the interior
villages still have no approach roads linking it to the
towns. Transportation of patients to the major hospitals
becomes a difficult task.
The priority areas in development are:
- Supply of safe
drinking water.
- Construction of low
cost latrines and efficient sewage disposal
systems
- Agricultural
development through scientific farming using
improved seeds
- Employment generation
through provision of credit facilities,
especially to low income women
Eco-health
The vast forests in the State have been
exploited, disturbing the fragile eco-balance of the
area. The climate has become warmer and drier.
Unmonitored disposal of wastes, sewage disposal and use
of non-biodegradable products have polluted even the
water sources. Excessive use of pesticides and increase
of automobiles have created air-pollution causing
increase in diseases. Ways to bring back the eco-balance
are:
Legislation needs to be enacted to protect the forests,
to encourage planting of trees and herbal plants and to
control pollution.
Programme Intergration
Most of the
Naga villages are under the direct responsibility of the
village Councils or Panchayats. Development works are
taken up by the V.D.B. (Village Development Boards). But
there is no health component whatsoever in these
projects. This amounts to a gross insensitivity to the
growing health problems of the State.
Therefore health should be integrated in developmental
activities for total well-being of the people.
Role of NGOs
There is a
need for a survey to gauge the enormity of the health
problems plaguing the State. The people’s
co-operation and involvement should be the deciding
factor in matters of health and development.
The concept of NGOs is new in Nagaland and is only
emerging just now. There are no professional NGOs to
guide the younger ones.
The people have lots of reservation and skepticism about
the NGOs as they believe that NGOs are only profit
seeking organisations. The public is mostly ignorant of
the works and responsibilities that can be undertaken by
the NGOs especially in the health sector. The government
is looked up to for each and every need by the people.
Though the trend is slowly changing, there still needs a
lot to be done before the NGOs can really gain the
confidence of the people and involve them in their works.
The challenges facing the NGOs are varied and numerous.
Nagaland needs the combined efforts of the government and
the NGOs to correct the wrongs and to get onto the road
to health and prosperity.
[index]
|
