Why Routine Non Communicable Diseases Are Killing More People, Even In Kashmir?

by Aasia Hassan

Sooner or later this pandemic will be over, but the deadly and silent pandemic of Non-Communicable Diseases will persist

Outside view of SKIMS Srinagar.
Outside view of SKIMS Srinagar.

While the world is trying hard to fight the present global pandemic of Covid-19, which was recognised by the World Health Organisation (WHO) as a public health emergency on January 30, 2020, and later a global pandemic on March 11, 2020, the world is silently facing another pandemic that is “The Pandemic of Non-Communicable Diseases”. Non Communicable Diseases (NCDs) are a group of conditions that include cardiovascular diseases, chronic respiratory diseases, cancers, diabetes, and mental illnesses. According to the data of the Institute for Health Metrics and Evaluation, NCDs represent 70 per cent of all global mortality.

According to the Global Burden of Diseases Data, NCDs cause 28 times more deaths than human immunodeficiency virus (HIV), but receive 17 times less funding. The comparison with Ebola, Zika, Severe Acute Respiratory Syndrome (SARS), and H1N1 is even more damning.

NCDs are chronic and often life-long in nature. These require continuous medical attention usually for a lifetime. If the proper care and treatment is not received, it can have devastating effects for people suffering from such diseases. Soon after the countrywide lockdown, almost every day we hear unfortunate news about the sudden demise due to cardiac arrests, we hear the surge of kidney failures and other types of non-communicable diseases. With the countries trying to contain the spread of Covid-19, the response to NCDs have been impacted. The virus caused great disruptions to health care facilities and increased the NCD burden, as people with NCDs are at greater risk of becoming severely infected with the virus. Apart from this, they have risk factors of their own.

I am writing this because I personally experienced something like this.

Back in June my father during dinner complained of breathlessness, gave the impression that it is a sore throat, so we stopped our meals and I made him green tea with ginger and lemon. The first thing that comes to our mind is maybe I got infected with Covid-19. It was only me and my father here at Srinagar. As his symptoms started to get worse and he didn’t want me to be worried, he tried to act cool, but as of now, he started to sweat.

An inside view of an SMHS hospital ward dedicated to Covid-19 care in Kashmir. Watch the oxygen cylinders, now the basic requirement. KL Image: Bilal Bahadur

So I called my uncle who lives nearby and meanwhile also called my brother in law who is a doctor posted at SKIMS Soura but was out of town at that time. He told me to rush to Soura without any unnecessary delay and while you are at it get a Trop-T Kit and then go to emergency. So my uncles came and we went to SKIMS Soura, and it was a heart attack- “an acute myocardial infarction”. My father was immediately shifted to the cardiology ward where he was admitted for 10 days and then angioplasty (a procedure to restore blood flow through the artery by inserting stents at the place of blockage) was performed. He was discharged a couple of days after with a long list of life-saving drugs.

My point here is that, with the grace of Allah, we were lucky to be in Srinagar at that particular time and got the right treatment at the right time. Had we been at our home town i.e Kupwara, we may not have made it on time, like what happens to a number of patients from other districts, as our health care facilities are very poor, most of the sub-district hospitals don’t even have an ECG facility, and the patients are referred to Srinagar after they have wasted a considerable amount of time in these hospitals and by the time they reach Srinagar, it is too late in most of the cases.

My other point is that my father has a history of cardiovascular disease, and used to go for routine checkups, but in these trying times, especially at that time, when the nation-wide lockdown was imposed, most of the hospitals were completely restricted to Covid clinics, and most of the private clinics stopped consultations, and even patients themselves were reluctant to go to health care facility centres because of the fear of getting infected. People tend to ignore their illnesses, medications and regular health checks in these pandemic times. Patients with non-communicable diseases require sustained care and cannot afford to delay their consultations. Lack of physical activity also contributed to the increasing rate of cardiovascular diseases.

Officials spraying disinfectant in the corner of the graveyard in Tangmarg on April 25, 2020. In the background, some locals are busy preparing the grave. KL Image: Bilal Bahadur

While the lockdown was imposed in March 2020 in India, speaking particularly about Kashmir, it is actually under lockdown since August 2019. After August 2019, Kashmir witnessed a wave of fear, schools and colleges were closed, and indefinite curfew along with internet blockade was put in place. Lack of access to education, unemployment, and unrest became an increasing cause of stress among the younger generation giving rise to mental health issues. Drug abuse and smoking are also rising in Kashmir.

According to a report of the United Nations Drug Control Programme (UNDCP), around 70000 people are drug addicts in Kashmir alone. These account for the cases which are reported and so many cases of such substance abuse go unreported. These factors I believe either separately or collectively are responsible for the increasing surge of cardiac arrests coming forward day in and day out these days in the younger generation in Kashmir.

Aasia Hassan

The prolonged winter also poses a great risk to people suffering from NCDs. There is a decrease in physical level activity, exercise is limited, which in turn causes problems as physical activity is essential for controlling symptoms and risk factors such as obesity, hypertension and elevated glucose levels. Nutrition also plays an important role, we as Kashmiris especially during winters consume a large amount of animal fats, rather than green and other coloured vegetables.

The general belief is that non-communicable diseases are risk factors of Covid-19, but NCDs have risk factors of their own. At this time, when the whole world is busy in fight against Covid-19, it is important to remember the role that non-communicable diseases play, and sooner or later this pandemic of Covid-19 will be over, but the deadly and silent pandemic of Non-Communicable Diseases will persist.

(The author is a research scholar at the Indian Law Institute, New Delhi, pursuing masters in Constitutional Law. The opinions expressed in this article are those of the author’s and do not purport to reflect the opinions or views of Kashmir Life.) 

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