Friday, August 7, 2009

From SARS to Swine Flu: Who is Laughing All the Way to Their Banks?

The Epidemics Act is promulgated to fight swine flu situation in Maharashtra: news.

Even pigs should know how to respect the laws of the land...!

I WAS a dutiful parent, providing all the mandatory vaccinations to both my children as they were born: In the eighties when my children were born, these were primarily oral polio vaccines and the DPT injections against some scourges which used to take so many lives away and resulted in wastage of limbs.

Every parent I knew used to take all these precautions for the safety of their children, regardless of their background, their religion, etc. And the childbirth was mostly in hospitals and this helped the newborns to get the best possible medical attention and timely vaccinations which helped the eradication of these ailments.

But recent surveys seem to indicate that there is as resurgence of some of these ailments in some parts of Kerala, especially in Malabar. These reports were available for some time and it appears there is a regression in our vigilance against such childhood ailments which could cripple our kids for a life time. It is a dangerous tendency and needs to be curbed.

But why the slippage in our vigilance against such ailment? Some doctors say the media is primarily responsible as they highlight some stray incidents of extremely rare occurrence of side-effects of such vaccination, as a recent Malayala Manorama news report exemplified. They say these reports cause fear in the minds of people and cause them to keep away from vaccinations.

This diagnosis looks silly. As they say such side-effects take place extremely rarely and so reports of such side-effects also need to be extremely rare. And nobody in their right mind could claim that a rare report of a rare incident in one or two news media could have such a major impact on society.

Then what is the real problem?

To my mind, the problem is with our medical care system which has become completely commercialized and profit-oriented. They are looking for as money to make and even vaccinations have now become a good chance to mint money.

This had started in 80s itself when they started administering vaccinations for a large number of new ailments like Hepatitis B, for which I had to shell out a big amount of money. The vaccine was being promoted by a multinational pharmaceutical company and the pediatricians then recommended it strongly. Most parents accepted it, though the amount was often beyond their means. It is well known that a part of this money went directly to the doctors concerned.

Then a few years down the road, the vaccine became locally available and the prices came down drastically and now it seems there is no pressure on the parents to go for it. So what it means is that the medical profession was being a willing tool in the hands of the pharmaceutical industry and the losers were people who were forced to pay through their noses, but the ultimate result was the loss of trust between the medical professionals and their clients.

Of course there were other factors like religious fanatics, naturopaths and many others who kept up a campaign against vaccination for a variety of reasons. But I do feel that what proved to be the real tragedy was the loss of faith in the medical profession.

Now we see reports about a variety of epidemics from time to time from SARS to bird flu to swine flu, and naturally people are concerned. In Pune, where the first swine flu death took place the other day, it is more like panic.

But in spite of the seriousness of the situation, I do wonder whether some of these concerns are over-done, are we not being hoodwinked by a rapacious industry in cahoots with a profession which has lost its ethical moorings, looking for new ways to make a kill selling us cures for a flu which, as some reports say, is as harmful as a common cold in most cases?


Unknown said...

Dr A P Vijayan writes in an email:

Dear Chekkutty,

Now I realise that basically we have no serious disagreements; more over we share many concerns in common! Thank you very much for the comments on the malpractices related to vaccines.Many of your observations on the unholy alliances of medical profession & pharma industry in our country is too glaring to be hidden by few of us..! You are absolutely correct & I accept your allegations on the unethical praactices in medical profession.

(Doctors like B.Ekbal are the most hated persons in our profession... they could have very easily become the favourite leaders of our profession/enjoyed posh life if they were able to ignore the unethical practices among their colleagues/profession or the plight of common man!..Most of the doctors even now refer them as cheats...I expect the same commitments from people like you who used to talk for common man/poor parents than the erred colleague in another newspaper.)

Unknown said...

Dr Sashikumar Kurup writes in an email:

Dear NPC,

Most beautifully and aptly written.
It is very true from my experience that almost all people still have
enough faith in medical science, and get their children vaccinated.
There are a few cranks in any society holding views on things like UFOs, Mantian visits, bacteria-less world etc etc. Bot they do not cut much ice with the general population and may be safely ignored as being insignificant. Naturopaths come under this category. Most of
them are retired teachers and headmasters who haue enough time on
their hands to indulge in hobbies, and correspondence courses (mostly
from MP, Bihar, Jharkand, and other such developed places) are
available to nourssh their fantastic theories. The general public have more sense, they listen to the advice of the Govt, however flawed it may appear at times, rather than these cranks. Newspaper reports like the Manorama one have a limited and short term impact. I am only
questioning the ethics of a one-sided and unbalanced reporting that
has the potential to confuse people, but looking at the queues on immunisation days, the impact of such articles is not earth-shaking.

As you say, many drug companies are promoting costly new vaccines for diseases that at most can cause an orddnary respiratory infection like syndrome. The immunisation pnogramme by the Govt is funded otberwise and ordinany doctors do not make money from this particlar programme.
The Manorama report is pernicious in the sense that it attempts to
undermine the credibility of this pnogramme. If we doctors who
strongly reccommend such vaccinations were so cynical, spare the thought that we could make much more money treating these patients for illnesses rather than indignantly and sometimes emotionally arguing
for it's prevention in the first place. I am the first to admit that
there are many unethical practicioners among doctors, and the result is seen in the way the pronounciations of the IMA has so little credibility with the public. But we also have a Dr Babu here who is fighting against the MNC pnoduct endorsement of the IMA. Such people and their activism will never find a space in the mainstream media. A
rare event of an immunisation abscess will get a box report. That is my criticism, I do not wish the media to paint doctors with an halo, there are many I know who get commissions from lab tests and scans.

But lt is painful when genuine and rare aberrations arising as a
natural corollary of any well-intentioned medical programme are the only things which the media sees fit to highlight on it's front