Human Animal Interface of Swachh Bharat, infections and antibiotic resistance

   Patients are always curious and ask “doctor, why have I got infection? From where? I eat good, maintain good health?” there are no ready answers. But there are certain factors in environment, which cause infections. More infections will require more antibiotics to be used and hence make bacteria resistant and difficult to treat. In fact, this one factor can undo all the advancement of medical science and push us back by centuries to pre-antibiotic era. Not uncommonly, response to antibiotics is not good and doctors are blamed for not doing enough. It is hard for the patient to know and understand the complexity of situation.

Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. Antibiotic resistance evolves naturally or could also be engineered by applying an evolutionary stress on a population. If stress (Antibiotic) is applied on bacteria, a mutation or gene is generated. In other words, evolve into highly resistance bugs because of use of antibiotics. If a bacterium carries several resistance genes, it is called multi resistant or a superbug. Antibiotic resistance is a consequence of evolution of bacteria.

The antibiotic action is an environmental pressure; those bacteria which have a mutation allowing them to survive will live on to reproduce. When these bacteria are cause of infection and severe illness, even the best medical care does not prevent death in every case.

Antimicrobial resistance is a major public health problem globally while all types of AMR are concerning, antibacterial resistance (ABR) is seen as currently posing the most serious health threat. India has some of the highest antibiotic resistance rates among bacteria that commonly cause infections in the community and healthcare facilities, shows the latest Department of Biotechnology (DBT) report. Antibiotic resistance among bacteria high in India, reveals report.

The Scoping Report on Antimicrobial Resistance in India, as it is called, was prepared for DBT and Research Councils United Kingdom (RCUK) by the Center for Disease Dynamics, Economics & Policy, India (CDDEP).The Antimicrobial resistance is spreading is popping up in India, from the fecal matter of animals to groundwater for drinking. This is a concern as microorganisms can spread from animals to people and from the environment to humans.  This contamination is one of the important cause of increased infections and hence use of more antibiotics in community.

Swachh Bharat  if truly applied can actually contribute and  solve problem of antibiotic overuse and hence resistance to antibiotic  to some extent. Garbage and undisposed poop of human and animals cause generation of infections and diseases, hence leading to increased need for antibiotics.  That requires 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.  Although as I mentioned    disposal of animal waste remains a challenge for Swachh Bharat as current policies  do not address this issue, which contaminates  air and water sources.

Stray animals still defecate at every place.  Poop of Stray dogs, cattle and pigs stays in environment and causes life threatening infections. Pet owners also do not show responsible behavior towards community in the absence of proper rules. Hundreds of diseases are described due to poor control of human animal interface.  My appeal to higher authorities is to form policies and create awareness in this regards can do wonders for community acquired infections and hence tackle with menace of antibiotic resistance as well. True application of Swachh Bharat  in controlling human animal interface can improve health of millions in the country.

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Swatch Bharat obstacle: declare “open defecation free zone” only if free of infectious, toxic dog & animal poop.



Swachh Bharat obstacle: declare “open defecation free zone” only if free of infectious, toxic dog & animal poop

I truly admire and applaud Mr Narender Modi, Hon’able Prime Minister for drawing attention of 100 billion people to the issue of cleanliness outside their homes. No one had ever thought that a Prime minister would refer to this so called trivial issue and make a heartfelt appeal to people. Lot of public interest has now been generated and there is a race among public officials to get their area declared as free from open defaecation. Even celebrities and movie actors like Amitabh Bachchan, Akshay Kumar have backed this cause. All these efforts are really appreciable, but the prime credit still goes to Modiji who spearheaded this movement.

But there is still a serious issue, which is a stumbling block to the realisation of a ‘Swatch Bharat’ dream and remains unattended. I want to draw attention of everyone  towards the problem of animal poo in our country. It is all around us. It is an obstacle to fulfilment of Swachh Bharat Abhiyaan and  a pan-Indian problem. It is actually even a bigger health problem than open defecation by humans. Humans defecate in country side and in open fields. 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.

       Life threatening infections : As a doctor, I would like to bring to your notice that 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. A dog’s digestive system can handle just about anything that it eats and this makes its poop very toxic. Animal faeces contain pathogens, which are known to cause severe diseases, infections and organ failure. These heavy loads of bacteria increase the risk of infections in the community. But pregnant women, children and people with suppressed immune systems may are more prone to these infectionsMany 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.

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 in our country. 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.  This may be an important cause of high rates of community acquired infections among our population.

             Transform health of the country: Hence it should be mandatory that all the  dog and animal (stray or pet) droppings are properly collected and disposed off. This single step can do wonders as it will reduce infections, people’s suffering and eventually reduce use of antibiotics. It can help reduce mortality, morbidity, drug resistance and medical costs by preventing many infections. It is my request to highest authorities to create awareness, form policies about disposal and control of animal waste and implement them strictly  to  bring a turnaround in infection rates in our country.

      It is missing key component  TOWARDS A SWACHH BHARAT. My request is to create awareness and form proper policies by higher authorities to cure millions and reduce infections in whole country.


If you agree please sign the petition


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