Rotavirus, one of the leading causes of diarrheal infections in India

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• Accounts for about 40% of all diarrhea cases
• Rotavac introduced to combat the spread of this infection among infants and young children
New Delhi, 21 June 2017: Statistics indicate that one of the leading causes of moderate-to-severe diarrhea in India is Rotavirus and accounts for about 40% of all diarrhea cases requiring treatment. More children across India die due to diarrhea than AIDS, malaria, and measles combined. It has also been estimated that India alone contributes to 22% of all global diarrheal deaths in children below 5 years. Among those more vulnerable include malnourished children and those with poor access to medical care.

Between 80,000 to 1,00,000 children die in India annually due to Rotavirus diarrhea and another 9 lakh are admitted to the hospital with severe diarrhea. A highly contagious disease, Rotavirus is spread when a child comes in contact with infected water, food, or hands. This is known as the fecal-oral route. This virus can survive for long periods of time on hands and various surfaces. This condition also increases the risk of dehydration in very young children.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Rotavirus attacks the villus tip cells of the small intestine, obstructing digestion and absorption. Once the villi become blunted, the malabsorption of carbohydrates leads to diarrhea. In young infants and children, this infection can further cause severe diarrhea, dehydration, electrolyte imbalance, and metabolic acidosis. The virus is shed in high concentration in the stool of the infected children. They can easily catch an infection by touching something that is contaminated and then putting their hands in the mouth. The risk of infection is more in hospitals and day care settings.”

Last year, the health ministry launched India’s first, indigenous rotavirus vaccine called Rotavac. Developed indigenously under a public-private partnership between the Ministry of Science Technology and the Health Ministry, this vaccine is expected to significantly reduce hospitalization and other conditions associated with diarrhea due to Rotavirus infection.

Adding further, Dr Aggarwal, said, “Making this vaccine free of cost is indeed a great move by the government. It is immensely important for the health and well-being of children in the country. Apart from vaccination, it is important to create awareness on maintaining adequate hygiene and sanitation and also ensure access to clean drinking water to avoid any such infections from spreading.”

Here are some tips to prevent Rotavirus infection from spreading.
• Maintain proper hygiene around the house. Clean all surfaces and the floor thoroughly.
• Wash your hands after you change the infant’s diaper or use the washroom.
• Practice food safety at home.
• Drink clean water and keep all containers closed.

Picture Abhi Baki Hai, Mere Dost…

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The “Dilli Chalo” movement organized by the Indian Medical Association on the 6th of this month was a resounding success. The capital witnessed a huge nation-wide participation of doctors. More than one lakh doctors were connected to each other that day and achieved the required critical mass of 1% of collective consciousness.

I will here try to elucidate on what is “collective consciousness”. Some of you would be familiar with the term.

Consciousness is an energized field of information with powers to do everything in the universe. Collective consciousness is the internet of the collective souls of many people in a group and is the strongest superpower ever available in the universe. As per the Vedic texts, whatever is the intent of collective consciousness will become a reality.

Scientifically speaking, collective consciousness is based on the principle of critical mass, which is 1% of the defined population under study.

The origin of the critical mass comes from “100th monkey phenomenon”.

“Long ago in Japan a monkey called Emo used to eat dirty apples everyday picked up from the ground. One day by accident the apple fell down in a river, the dirt got washed off and he ate the washed apple. Obviously it tasted delicious. The monkey started washing the apple thereafter every day before eating. His fellow monkeys started following the same. The process of following went on. When the 100th monkey washed the apple and ate it, a strange phenomenon was noticed. All monkeys in and around that state started washing the apple before eating.” This 100thmonkey was the critical mass.

Once this mass is crossed, the information will spread like a wild fire and the intent becomes a universal reality. The Merriam Webster English Dictionary gives the meaning of critical mass as “a size, number, or amount large enough to produce a particular result”.

We are not criminals and no criminal prosecution clause should be made applicable to medical professionals as also in the West Bengal Clinical Establishments (Registration, Regulation and Transparency) Bill 2017 and now in the recently passed Karnataka Private Medical Establishments Amendment Bill 2017.

We need to remain true to the spirit of “IMA 1 Voice”. Our focus should not shift. We should not weaken in our resolve to achieve justice for the medical fraternity in the country.

Today “Dilli Chalo” has proven our strength as IMA 1 Voice. Now is the time to sustain and further strengthen the IMA 1 Voice movement.

I ask all those who attended or participated digitally in the movement to become IMA brand ambassadors and speak out about IMA all across the country.

We achieved the required critical mass of 1% of collective consciousness on 6th June. People have been sensitized. But, this is not the end of the road for us. Lot more needs to be done. What decisions we take now will be crucial.

Here I am reminded of that iconic line from the Shahrukh Khan movie ‘Om Shanti Om’… “Picture abhi baki hai, mere dost…

Yes, picture abhi baki hai, mere dost…

Our next slogan is “Do not force us to go to a nation-wide strike from 18th August”.

Revised WMA Declaration of Delhi on Health and Climate Change: For comments

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Document no: SMAC 206/Climate Change REV2/Apr2017 Original:
Title: Revised WMA Declaration of Delhi on Health and Climate Change
Destination: Constituent Members Action(s) required:
For Comments
Note: The Associate Members submitted this proposed statement to the General Assembly in Taipei (October 2016), under the initiative of the Junior Doctors Network (JDN). The General Assembly passed it to the 204th Council Session, which decided to circulate it to the members for comments. The Council in Livingstone (April 2017) considered the compromise version based on the comments received and decided to return the draft to the rapporteur for further work in view of the discussion during the meeting, before a new circulation.
Suggested Keywords: Climate change, air pollution, environment, Paris Agreement, Marrakesh Agreement, COP, mitigation, heat waves, flooding

1.      Compelling evidence substantiates the numerous health risks posed by climate change, which threaten populations of low, middle and high-income countries. These include more frequent and potentially more severe heat waves, droughts, flooding and other extreme weather events including storms and bushfires. The resulting climate change, especially warming, is already leading to changes in the areas in which disease vectors flourish. There is reduced availability and quality of potable water, and worsening food insecurity leading to malnutrition and population displacement. Global warming is universal but its effects are unevenly spread and many of the areas most strongly affected are least able to manage the challenges it poses.

2.      Tackling climate change offers opportunities to improve health and wellbeing both because of the health co-benefits of low carbon solutions and because mitigation and adaptation allow action on all the social determinants of health.  Transition to renewable energy, the use of active transport, dietary change including a reduction in consumption of red meat, may all contribute to improving health.  Mitigation actions, such as those on reducing indoor and outdoor air pollution, will reduce health harms suffered predominantly by poorer people.

3.      The social determinants of health are those factors that adversely affect health through exposure before and after people are born and as they grow live, and work.  They are worse in the poorest populations of all countries and also vary between countries.  Those with generally the poorest health and lowest life and health expectancy will be least able to adapt to deal with global warming exacerbating adverse social determinants of health.  Assisting these countries is a common but differentiated responsibility.

4.      Climate change research and surveillance is important and the WMA supports studies seeking to describe the patterns of disease that are attributed to climate change, including the impacts of climate change on communities and households; to quantify and model the burden of disease that will be caused by global climate change including emergent diseases; to describe the most vulnerable populations.

5.      The Paris Agreement highlights a transition to a new model of global collaboration to address Climate Change and represents an opportunity for the health sector to contribute to climate action.  It includes a series of actions to be undertaken in each nation to attempt to limit the global increase in average temperature to less than 1.5 C.


6.    The World Medical Association and its Constituent Members:

6.1     Urge national governments urgently to recognize the serious health consequences of climate change and to adopt strategies to adapt to and mitigate the effects of climate change;

6.2        Urge national governments to work to ensure fulfillment of national commitments to the Paris Agreement, including both mitigation and adaptation measures as well as action on losses and;

6.3     Urges national government to ensure that climate financing must include designated funds to support the strengthening of health systems, and health and climate co-benefit policies and through this, to ensure the availability of sufficient global, regional and local financing for climate mitigation, adaptation measures, disaster risk reduction, and the attainment of the Sustainable Development Goals (SDGs);

6.4        Urge national governments to engage with health sector representatives in developing and implementing climate change plans and emergency planning and response on local, national and international levels;

6.5        Urge national governments to provide for the health and wellbeing needs of people displaced by environmental causes both within their countries and others including those becoming refugees due to the consequences of environmental changes.

7.      National Medical Associations and their physician members should:

7.1        Advocate for sustainable, environmentally responsible low-carbon practices across the health sector to reduce the environmental impact of health care facilities and practices.

7.2        Prepare for the infrastructure disruptions that accompany major emergencies, in particular by planning in advance for the delivery of services during times of such disruptions and increased patient care demands;

7.3        Encourage and support advocacy for environmental protection and greenhouse gas emissions reductions including through emissions trading systems and/or carbon taxes.

8.      The WMA and its Constituent Members should:

8.1        Encourage sustainable low-carbon living including active lifestyle, low-carbon agricultural and food production processes and diet, and sustainable production and consumption patterns;

8.2        Seek to build professional and public awareness of the importance of the environment and global climate change to personal, community and societal health;

8.3        Work towards the integration of key climate change concepts and competencies in undergraduate, graduate and continuing medical education curricula;

8.4        Collaborate with WHO and other organizations as appropriate, to produce educational and advocacy materials on climate change for national medical associations, physicians, other health professionals, as well as the general public;

8.5        Work towards increasing resilience including by preparing physicians, physicians’ offices, clinics, hospitals and other health care facilities for the infrastructure disruptions that accompany major emergencies, in particular by planning in advance the delivery of services during times of such disruptions;

8.6        Seek to ensure that physicians are involved in the planning and delivery of primary ill-health prevention strategies in relation to climate change, working with NGOs, IGOs and governments;

8.7        Advocate for their respective governments adequately funded climate change research and collaborate with governments, NGOs and other health professionals to develop knowledge about the best ways to address health impacts of climate change;

8.8        Work collaboratively with government and NGOs to develop systems for event alerts in order to ensure that health care systems and physicians are aware of climate-related events as they unfold, and receive timely accurate information regarding the management of emerging health events.

9.      The WMA urges National Medical Associations to:

9.1        Work with health-care institutions, and individual physicians to adopt climate policies and act as role models by striving to reduce their carbon emissions, for instance by adopting more sustainable travel policies and increasing the use of on-line meetings.

9.2        Recognize environmental factors as a key element inherent within the social determinants of health (SDH) agenda, and encourage governments to foster collaboration between the Health and non-health sectors in addressing these determinants.

Dr KK Aggarwal
National President IMA & HCFI

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