The reports of this survey will appear internationally in published form in the future. According to the author,Dr. Waseem, Qureshi, this is the largest multi-specialty epidemiological survey conducted in India so far. This article, 'An unique survey' has been taken from the online edition of 'Greater Kashmir' -6 Shaban-Ul-Mu’Azam, 1428 AH Srinagar,Monday, August 20, 2007 under the
Dr. Waseem, Qureshi sums up his experiences about Bishnah Study a Multi-specialty Medical Survey carried out in Jammu regarding gas emissions and respiratory diseases. Below are the excerpts taken from the original article.
"With the aim to study the effect of Indoor air pollution on health in the Jammu and Kashmir State, the Chitranjan Mobile Teaching cum Survey Hospital of the Government Medical College Srinagar, conducted door-to-door survey at the Bishnah area of Jammu from January to beginning of March 2006, besides providing treatment (medical as well as surgical) to the poor and needy patients of the said area. The survey team was headed by Dr. Nazir Ahmad Wani - the in charge camp officer and Dr. Ghulam Hassan - Physician Specialist accompanied by team of specialists of ophthalmology (Eye) ,Gynecology, Anesthesiology, and Radiology. The facilities for accommodation and other requirements were provided by Sh. Ashwani Kumar Sharma, the Member Legislative Assembly, Government of Jammu and Kashmir, Bishnah constituency.
Bishna has a total population of 1, 32,581 as per latest census with total area of 12405.95 hects, having 86 villages in total, close to the line of control.
This rural community is comprised of people belonging to Schedule Caste (47%) Schedule Tribe (24%) and other backward classes (29%). The people live in grass and wood based dwellings called Jonpdi and kulla by the local population. They use biomass for cooking and heating purposes which includes wood of local trees including taali, peepal jamun, keekar, safida jootikali and trees of mango, orange, lemon and mulberry; dried dung cakes, other plants and crop residues. These on combination create dense smoky atmosphere in the dwellings at an average of 6 to 8 hours per day. Mostly women and small children are exposed to this air pollution who remains confined to homes, compared to working males and school children who remain usually outside these dwellings during the day time. Pinewood, as used by Gujjars and people of hilly regions of Kashmir Valley, is not found at Bishnah. The survey reports reveal the occurrence of respiratory disease as the commonest illness in this population, especially the non- smoking women and children Majority (62%) of the population have dry cough and breathlessness as the prominent symptoms.
As per the questionnaire from the mothers, more than 60% of the infants and young children suffer from possible recurrent infertinns. As per the survey, more than 49% of the adult men and women suffer from chronic obstructive lung disease, predominantly emphysema (a lung disease leading to destruction of distal airways). This disease is usually due to cigarette smoking as per the world wide literature, but striking thing is that here at Bishnah, this disease is mostly found in nonsmoking women compared to non smoking males and smokers of both sexes.
According to scientific evidence biomass smoke inhalation is the main cause of this respiratory illness in this rural community contrary to Gujjar lung ( a disease mimicking chest tuberculosis radio logically); found in Gujjar community and other rural population of hilly regions of Kashmir Valley, the people of rural Bishnah have only chronic obstructive lung disease (mostly emphysema ), confirming that the former disease (Gujjar Lung ) is only due to indoor air pollution with pinewood smoke, as the other biomass fuels such as dried dung cakes, plants and crop residues are almost common to both of these populations.
Next prominent, respiratory illness observed was chest tuberculosis as revealed by our mass scale radiological survey. The said patients were referred to the DOTS centre of the Revised National Tuberculosis Control Programme (RNTCP) located at the sub-district hospital Bishnah for registration and appropriate treatment....
There are internationally published evidences indicate increased frequency of respiratory disease in Kashmir and Ladakh regions of the Jammu and Kashmir State. However, till date there were no such published evidences of such illnesses in the Jammu region........ .....As per the gynecologist’s observation the frequency of adverse pregnancy outcome like still births and low birth weight is very high in the Bishnah area. Scientific evidences again support the fact that exposure of women to indoor air pollution with biomass smoke could be the main contributory factor.
According to the Ophthalmologist’s (eye specialists) report, occurrence of cataract(whitening of lens of eyes) is found in more than 25% of the population (mostly females) which stands the highest reported prevalence in India so far.Scientific evidences support this fact that toxins from biomass fuel smoke are absorbed in the body which accumulates in the lens resulting in its opacity. Second prominent cause could be the direct exposure of eyes to heat while blowing into chulla by the house wives.....
The aim of the present report was to make the people aware of the possible health hazards of the indoor air pollution due to biomass smoke combustion in this rural community which can be prevented if life style of the said population is improved through proper government policy.
...The first and the most important step in the prevention of illnesses resulting from the use of biomass fuels are to educate public administrators and politicians to ensure their commitment for the improvement of public health. There is utmost requirement to collect better and systematic information about exact exposure levels experienced by households in different districts and develop a model for predicting the exposure levels based on fuel use and household data therein (exposure atlas) to protect the health of children, women and elderly persons. It is suggested that the provision of electricity as the cleanest source of heating and lighting will definitely lead to improved health outcome in this part of the developing world''.
(The author is Director & Principal Physician, Chittranjan Mobile Teaching Cum Service Hospital, GMC, Srinagar)
To read the full report: http://www.greaterkashmir.com/full_story.asp?Date=15_4_2006&ItemID=2&cat=12
|
