Diseases can be preventable or unpreventable, have good or bad prognosis. But once patient enters hospital, what ever may be the reason or genesis of ailment, it becomes a moral responsibility of doctors. Health care professionals can be trash-talked or ridiculed by media and anyone, even for worst prognostic cases. But large numbers of deaths happen due to preventable causes like accidents , drains, live electric wires, water contamination, dengue, malaria, recurring floods etc. In fact the burden of negligence here is massive and these deaths are unpardonable. Who ultimately carries the moral burden of millions of preventable deaths?
Common causes of such disease, sufferings and death , specially in developing and poor countries:
- Dietary risks and diseases spread by water sanitation and hygiene. These have direct linked with bad sanitation and poor hygiene practices. Poor sanitation is the leading cause of diarrhea, malnutrition, cholera, jaundice ( hepatitis A and E) , worm infestations, typhoid and other enteric fevers, which lead to chronic malnutrition and lowered immunity that further feed the infectious disease cycle. Apart from infectious disease like diarrhea, but also pneumonia and tuberculosis, which are leading killers across all age groups.
- Undernourishment in children will cause them to be underweight, stunted and wasted, and makes them more vulnerable to infections. They are at higher risk of dying of childhood infections.
Working sewage-disposal systems, waste disposal management, protection of water supply from contamination and hand-washing practices are essential components to reduce preventable deaths.
- Poor sanitation, unsafe water and low public health also increase drug-resistant infections in low-income and middle-income countries. Lowering of antibiotic consumption can not be achieved because superbugs , and antibiotic resistance are already in the environment and continue to spread through contaminated food, water and hospital equipment.
Antibiotics overuse is rampant as they are used to treat diarrhea and upper respiratory tract infections. Improving sanitation, providing clean water, adopting personal hygiene and getting vaccinated can reduce infections.
- Air pollution : air pollution is a public health crisis. Masses are forced to breathe in air which contains pollutants in unsafe limits, some are carcinogenic. It is a cause of millions of deaths It is besides many fold of this number live their life with morbidity. Polluting vehicles, industry, lesser trees and plantations, poor practices and not enough governance and policies have resulted in poisonous air to breathe. Diseases like COPD, asthma and lung cancer are few common ailments.
- A::Dog bite (rabies ), Animal poop and Human – animal interface: Not properly disposed animal poop is a cause of generation of infections and diseases, requiring heavy use of antibiotics and consequently leads to emergence of further antibiotic resistance bacteria. This cycle of production of infections and use of antibiotics perpetuates a vicious cycle. Stray animals still defecate at every place. Poop of Stray dogs, cattle and pigs stays in environment and causes life threatening infections. Hundreds of diseases are described due to poor control of human animal interface.
But stray animals and dogs are everywhere. Owner of pet dogs make them defecate outside their own houses and on the roads and wherever their dogs chooses. This poop dried and mixed with dust, acts a source of infection to the community.
| B:: Life threatening infections : dog’s and animal faeces is a big health hazard. It is even worse than a dog bite since it spreads infection in entire community. Animal faeces contain pathogens, which are known to cause severe diseases, infections and organ failure. Many diseases may be spread by millions of these dogs and other animals like pigs, cattle as their faeces contain parasites, bacteria and viruses. These include life threatening bacterial infections by E. coli, MRSA, Leptospira, Salmonellosis, Campylobacteriosis, brucellosis, Rickettsia and parasitic infections like Giardiasis, Whipworm, Hookworm, Roundworms, Tapeworms, Cryptosporidiosis, Echinococcosis, Leishmaniasis etc. Viral infections like rabies, influenza and other viruses may also spread through these animals.
C:: Environmental health Hazard: Storm water runoff due to extensive rainfall can wash off all these droppings into drains, many of which are connected to river systems and water sources. This can lead to a widespread source of waterborne illnesses. Dry poop on the roads is mixed with dust particles and in the air. So everyone is living in a highly infectious environment.
6. Mosquito borne diseases: millions die because of vector borne disease , as mosquito control has been inadequate. Malaria, dengue, chickengunya and many other lethal diseases spread due to mosquitoes.
7. Preventable natural disasters exacerbated by human activity: floods, famine, disease outbreaks.
8. Road, rail accidents and other accidents: are mostly preventable errors.
The role of health care professionals in present day circumstances remains misunderstood and underappreciated, as they assume the responsibility for continuous care of the sick or injured. People who have never treated a patient in their life time influence health policies, which effects millions. Excessive preventable deaths are just a symptoms of a larger problem. Who is the one who feels moral burden of millions of preventable deaths?