Vector Issue 10 - 2009

Many of you
may recognise
the
painting as
Van Gogh’s Wheatfields
with Crows. Each of you
will be struck by some aspect
of the painting and form your
own impression of it. What if you
were then told that this was Van
Gogh’s last painting before his
suicide? Given this key piece of
information, do your perceptions
then change? The flying birds
perhaps, are crows, harbingers
of death; the chaotic landscape a
reflection of his inner turmoil. In
reality, Wheatfields
is not
Van Gogh’s
last painting.
Does this fact
once again
completely alter
the perceptions
proceeding
from the
previous one?
This was the
eloquent example
with which
the Consul-
General of India,
Sydney, Mr
Amit Dasgupta,
commenced his
talk to medical
students at the University of Sydney. As
part of the Global Health Stream, the
Medical Faculty’s international health
curriculum, we had the valuable opportunity
of speaking with the Consul-General
on Thursday 17 September about health
issues in India. Prior to his appointment
in Sydney, Mr Dasgupta has held various
diplomatic positions across the world,
from Cairo to Kathmandu. His wide
experience is reflected in the numerous
books he has edited and written in both
fiction and non-fiction. Caught up as
we are in the world of medical facts, the
Consul-General’s talk was an important
eye-opener into the more philosophical
issues surrounding health policy.
a conversation with the
Indian Consul General
Words Kruthika Narayan, Medical student, University of Sydney
Van Gogh’s Wheatfields was a
poignant illustration of how essential
pieces of information shape the way
we perceive a situation and how these
perceptions may not always be correct.
As the Consul-General emphasised, this
is particularly important in addressing
the various issues of international health.
It highlights that a health model which
works in one developing country situation,
may not necessarily be transplanted
with equal effectiveness to another. In
India, as the Consul-General explained,
the diversity in language, culture and
customs within states, let alone between
them, makes the implementation of
health policy a complex issue, requiring
a different approach in each region.
The burgeoning of chronic disease
in India highlights the importance of
targeted health intervention programs.
According to 2009 WHO statistics,
the age–standardised mortality rate for
cardiovascular disease is 382/100 000
and studies suggest that chronic diseases,
particularly cardiovascular, are
fast becoming the main cause of mortality
in urban and rural populations. Not
to mention diabetes, the prevalence
of which was estimated to be greater
than 31 million in 2005 and growing.
The Consul-General spoke of some of
the health interventions implemented by
the Government to counter this increase
in chronic illness. Recognising that a
centralised approach to health policy
would be less effective, one strategy
has been to empower village councils or
‘Panchayats’, funded by, but not accountable
to, the Government. Composed
of local villagers and an elected leader,
these Panchayats have a better picture of
the cultural and social characteristics of
a region, and are in a position to know
what policies would be most suitable.
Another includes the health education
programs, run by the Central
Health Education Bureau, focusing on
the education of women and children
and taking into account the differences
in beliefs between regions.
These two strategies mentioned by
Mr Dasgupta reiterate that approach
is the key message. Health interventions
need to be tailored and not run
as an identical franchise from state
to state, or as the Consul General put
it, ‘McDonalised’. It comes back to
how we interpret the picture of chronic
disease in India, or in any country;
ensuring the individual characteristics
of that particular picture are what
shape our perceptions and actions.
november 2009 vector9
www.ghn.amsa.org.au