The University of Nalanda, built in the 4th century, was also one of the greatest achievements of ancient India. Ayurveda, the system of traditional medicine, has its origins in India.
Today there are 28 states and 7 Union territories in the country. The Government of India has introduced various health programs and policies. But most of the development indicators paint a grim picture, especially of the remote rural parts, where access to proper health care is still a major challenge. Rural poor often resort to alternative medicines and home remedies, which are cheaper than visiting qualified and trained health professionals. Religious beliefs and superstitions also add to their reluctance.
Among many others, diabetes is one of the fastest growing health problems in India. Estimates show that India is home to around 40 million diabetics. This number gives India the dubious distinction of being home to the largest number of diabetics in any one country.
The high rate of prevalence of complications is disturbing. The picture becomes all the more gloomy with reports that many patients already have these complications at the time of diagnosis. It is a widely accepted fact that more than 35-40% of people show the presence of some diabetes related complications at the time of diagnosis.
India has a distinct need for a comprehensive diabetes care program. ...
Most of the health budget is focused around immunization, providing clean drinking water and sanitation to the majority of the people. The government does not seem to have the finances to undertake any major program for non communicable diseases in general and diabetes in particular.
Studies show that diabetic foot syndrome, which is a common yet preventable complication of diabetes, is even more neglected aspect of the disease in India. Peripheral sensory neuropathy, improper footwear, lack of patient knowledge about foot care and uncontrolled diabetes are some of the factors contributing to this syndrome.
In India, footwear practices vary widely. Apart from a significant proportion of people walking barefoot outdoors, a majority of Indians walk barefoot indoors. While visiting religious shrines, people always go barefoot. In a tropical country like India, where the pavements or asphalt roads become very hot, and the rural pathways are uneven and dusty, walking barefoot can lead to injury. Furthermore, use of footwear like Hawaian chappal, which has a rubber sole supported by a strap in the first inter-digital space, but no back strap, exposes the feet to injury. Shoes, when worn by either sex, are often pointed and thus further expose the foot to injury. Also, the practice of not wearing socks, particularly in Indian females can result in a hyperkeratotic and fissured heel or a callosity of the first interdigital space or injury to the great toe.
Overview of the case
Murali, 60, has migrated to the US recently from the southern part of India. He has spent most part of his life working as a postman in a remote Indian village. Ever since his wife died two years back, he has been having constant health problems. With no proper medical facilities in