Monday, June 27, 2005

Munna Bhai MBBS tricks do work!!

Munna Bhai M.B.B.S
We all love this movie, a movie that emphasizes on the humane side of doctors.
In India even today doctor profession is the most respected one. They are treated as God and why not? After all they save lives.
If you take the movie, what Munna Bhai does has to do more with human relationships and psychology than actually prescribing some medicines.

I used to wonder you know whether Munna Bhai MBBS tricks will work in a real world.

Guess what, it does work along with medicine and attention.

I came across this wonderful article in Washington Post its part of series on ‘Psychiatry's Missing Diagnosis’

It deals with fact the schizophrenia patients farewell in poorer countries like India and Nigeria than their counterpart in USA and Europe. What could the factors that leads to it, if you look into it, its just amazing.

It’s the social network and the way the patient is being treated.

Instead of being isolated in a mental asylum for life, in countries like India and Nigeria society accepts and embraces them.

It talks about a patient; Krishna Devi who was treated for schizophrenia, ten years ago is now completely cured woman. It seems Devi had stopped taking her medication long ago. And can talk and act normally just like any normal person. In US or Europe only a few lucky ones can even have that.

So what hidden assets that Devi had that made the difference than her counter part in US, a doting family and an embracing village that never excluded her from social events, family obligations and work.

The article further talks about families and other social networks that support schizophrenia patient unlike western countries where most patients are homeless, in group home or worst in jail.

The Indian patients’ had fared well because of the culture, which values social connectedness. This research has been conducted by WHO for the past 3 decades.

When the initial findings came out in 1970s, lot of western psychiatrists refused to believe it and even thought there was something wrong with the study. So they repeated it again and guess what the second trial also produced the same result.

The research concluded or the explanation given was that the stronger family ties in poorer countries have a profound impact on recovery.

In America, doctor-patient conversations are confidential. And psychiatrist focuses primarily on brain chemistry. In India we all know it’s the other way, doctor-patient discussions always includes families, since families are considered central to the problem and the solution.

To quote from the article

“If you have a cardiovascular problem, I would prefer to be a citizen in Los Angeles than in India," said Benedetto Saraceno, director of the department of mental health and substance abuse at WHO's headquarters in Geneva. "If I had cancer, I would prefer to be treated in New York than in Iran. But if you have schizophrenia, I am not sure I would prefer to be treated in Los Angeles than in India."

We all know the family doctor back in India not only plays the doctor role but sometimes even acts as a family adviser. That’s because Indian doctors are seen not only as medical experts, but as wise authority figures.

The study by WHO has tracked about 3,300 patients and follow-ups. The study spanned a dozen countries -- capitalist and communist, eastern and western, northern and southern, large and small, rich and poor. The results were pretty much consistent and even surprising patients in poorer countries spent much lesser time in hospital, were well connected socially and even employed. Not only that the patients from these countries also showed less likely to suffer relapses and had longer periods of health between relapses.

Most these cases have been observed in rural villages where joint families are still present, unlike urban where it tends to be more nuclear family.

I guess that’s the price we have to pay for urbanization of our cities. Needless to say the number of parents in old age homes has also gone up in Indian cities.
Now That’s a different story for next time.

I strongly recommend you folks to read this.

References: The Washington Post
(Thanks to Washington Post)

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