Affluence without Education has added to the health problems of rural population

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 3-Day medical camp by Mohammad Shafi Educational Welfare Trust

Affluence without Education has added to
the health problems of rural population

Hypertension, Diabetes, HCV are quiet common. Majority are
aware they suffer from hypertension but are either not getting
treatment or are on sub-optimal therapy

Delayed introduction of Insulin and use of sub-optimal
dosage of insulin is also quite common

From our correspondent

BUREWALA: Mohammad Shafi Educational Welfare Trust organized a three day medical camp at Chak No. 409 EB from April 9th to 11th 2013. Dr. Musarrat Riaz FCPS Consultant Physician and Diabetologist at Baqai Institute of Diabetes and Endocrinology (BIDE) of Baqai Medical University examined two hundred five patients during the three days. All the patients had their blood pressure checked and facilities of blood sugar check up was also available for the patients with diabetes or those suspected to be suffering from diabetes. Hypertension was found to be most common medical disorder seen among the patients followed by patients with diabetes while Hepatitis- C was also seen quite common. These were the confirmed HCV positive cases after necessary investigations but most of them were not getting any treatment for various reasons. For detailed disease pattern see the accompanying Table-I.


Some of the patients were suffering from both hypertension as well as diabetes. Two of the patients also had suffered from stroke but recovered. One had still high blood pressure while the other had high blood pressure as well as high blood sugar and at serious risk of having another attack of stroke. A few of the patients with hypertension were on monotherapy and their blood pressure was not yet under control. One patient on Ace Inhibitor had sever cough a known side effect of ACE Inhibitors but he was not informed by the treating physician who was advised to replace ACE Inhibitor with ARBs and other antihypertensive drugs.

Dr. Musarrat Riaz Consultant Physician and Diabetologist at Baqai Institute of
Diabetes and Endocrinology (BIDE) Baqai Medical University examining
patients at a medical camp organized by Mohammad Shafi Educational &
Welfare Trust at Chak No. 409 E.B. Tehsil Burewala, Distt.Vehari.

Other diseases which were seen included osteoarthritis, rheumatoid arthritis, muscular pain, frozen shoulder, low back pain, scabies, chest infections, asthma, thyroid disease, worms and infestations, COPD, Headache, Urinary Tract Infection, Allergic Rhinitis, Epilepsy, psoriasis, dental infection and general weakness. A child with speech disorders was asked to consult a paediatrician while another child who had very high random blood sugar was very weak, malnourished who was suspected to be suffering from Insulin Dependent Diabetes. As such the parents were advised to get him properly investigated. If the Type-1 diabetes is confirmed, he should be put on Insulin therapy. Those hypertensive’s that were not getting any treatment were counseled to start treatment otherwise they will suffer from serious complications including organ damage. Two patients with diabetes who were advised insulin therapy twice daily were just taking the morning dose and when asked why they were not taking the second dose, they said the insulin vial finishes too quickly. They were counseled that they must get their blood sugar checked regularly, preferably go for blood sugar monitoring at home and consult their treating physician regularly as the insulin dosage might have to be adjusted. Those patients suffering from high blood pressure and on mono therapy were counseled that sometimes the patient has to take more than one drug to control blood pressure and in some cases even three drugs have to be prescribed. Hence they must regularly consult their treating physician who will adjust their dose and make necessary changes in drug therapy. These patents were also advised to take low dose enteric coated Aspirin regularly once their blood pressure is controlled. Patients with diabetes were also advised to take low dose enteric coated aspirin if there were no contra indications for which they must consult their doctor regularly.
Patients suffering from osteoarthritis, rheumatoid arthritis and other muscular disorders were informed that these diseases cannot be cured just like hypertension and diabetes. With the advancing age, these diseases do get worse but with appropriate medications, they will get lot of relief from pain and inflammation and their quality of life will be much better. Some of these patients had given up treatment and were getting treatment from Hakeem’s and Homeopaths. They were informed about the likely adverse effects of such a treatment in the long run. They were advised not to believe the false promises of cure of these diseases but continue medical treatment.

Patients with Thyroid Diseases were advised to have proper investigations and get treatment. Patients suffering from some gynaecological problems including recurrent abortion, depression and anxiety due to infertility, those with serious eye diseases were advised to consult respective specialists in the city. Patients with frozen shoulder were counseled to consult physiotherapist besides taking drugs. Some of the patients were also provided free drugs. Vitamin D deficiency was also seen in quite a few patients. After careful examination, blood pressure measurement and blood sugar test, they were given prescription and advised to consult the doctors on regular basis. They were further informed that patients with diabetes, high blood pressure had to continue the drugs indefinitely and they should not stop medication without the advice of their treating physician. 
After attending this three day camp one gets the impression that affluence without education has added to the health problems of the rural population. Most of them are not aware of the importance of life style modifications and regular treatment. In the past the rural population used to do lot of hard work requiring manual labour but with affluence and mechanization, normal farming has been replaced with Tractors which are routinely used. Use of traditional drinks like Lassi and Shakanjbeen has been replaced by cold drinks which are considered a status symbol. Too much use of fats without any labour, use of automobiles for transport rather than walking which was quite common in the good old days has resulted in obesity, hypertension, diabetes and many other disorders. The people tend to consult physicians or go to the public hospitals when they are seriously sick but as soon as they get some symptomatic relief, they stop medication being unmindful of the complications and serious consequences like organ damage.
There is a Basic Health Unit located at a distance of one and a half Kilometer outside the village and a doctor is also posted but since patients seldom get any medication, this facility is not being used properly. On the other hand, many well educated, well trained and competent physicians and surgeons, specialists in different fields are now available in the city of Burewala. Many of the doctors have established private hospitals with adequate facilities. Some of the prescriptions which we saw showed that the patients had been very well examined, they had proper work up and correctly diagnosed and put on appropriate medications. But if the patients discontinue treatment or do not comply with drug therapy, doctors cannot help them. It is the patent education alone which is going to make a difference. They need to be convinced of the benefits of regular treatment and compliance with drug therapy. Timely introduction of Insulin therapy and use of insulin in appropriate dosage needs to be encouraged and emphasized to keep diabetes under control and thus save the patients from its known micro vascular and macro vascular complications. Proper foot care and regular eye check by the patients with diabetes also needs to be emphasized. At the camp they were informed about the importance of these measures.
This three day medical camp did provide us an opportunity to see the disease pattern and patients attitude towards their health problems. It provided us an opportunity for screening, counseling and patient education apart from providing the some drugs and medicines. This medical camp is going to be a regular feature in the days to come and we intend to arrange enough quantity of drugs needed based on the disease pattern that we saw. Friends and well wishers from the Pharmaceutical Industry will be approached for donation of drugs and medicines for future medical camps.

Students of Government Girls Primary School at Chak No. 409 EB who earned 
First, Second and Third Position in the recently held annual examinations
were presented gifts by Mohammad Shafi Educational Welfare Trust. Photograph 
taken on the occasion shows them along with school teachers. Also seen in the 
picture are Mr. M.Arshad Secretary of the Trust and Ch. Mohammad Siddiq 
an elder from the village besides others.

 Visit to Girls Primary School

A visit to Girls Primary School located in the Village Chak No. 409 EB was also organized. Gifts were presented to the First, Second and Third position holders in the recently held annual examination from Nursery Class to Class-V. Master Mohammad Arshad Headmaster at a High School in Burewala City who is Secretary of Mohammad Shafi Educational & Welfare Trust had organized this visit. Chaudhry Mohammad Siddique an elder from the Village who is also member of the Boys High School Committee was also present on the occasion and they both presented the gifts to position holders. On request and suggestions from the school teachers, four ceiling fans, three Black Boards and Three Mats for students were also provided to the school on behalf of Mohammad Shafi Educational & Welfare Trust. The teachers were also assured that this prize distribution ceremony for the position holders will be made a regular annual feature. Not only that the Trust will try to meet their other needs as well within its limited resources from time to time. Few deserving people in the village were also provided some financial assistance from Zakat Funds on behalf of the Trust.