‘Despite huge burden, no national programme for rheumatic diseases’

Even though there are 50 million people in India suffering from osteoarthritis of knee and another five million with rheumatoid arthritis, there is no national programme for rheumatic diseases.

Written by Anuradha Mascarenhas | Pune | Published: August 31, 2018 8:45:37 am
‘Despite huge burden, no national programme for rheumatic diseases’ Dr Hanumant Tandale (left) with Dr Arvind Chopra

Despite data from the WHO’s Community Oriented Programme for Control of Rheumatic Diseases (COPCORD) in India showing there are 50 million people suffering from osteoarthritis of knee and another five million with rheumatoid arthritis, there is no national programme for rheumatic diseases.

Eighty-six-year-old Dr Hanumant Tandale, who retired as medical officer at the primary health centre in Bhigwan village, Pune, was a key figure in the WHO programme. He will be felicitated at the national meeting of osteoarthritis research, which commences on August 31.

In an interview with The Indian Express, Tandale said several national health programmes were set up over the years to control various diseases. But this is one area where despite the WHO COPCORD presenting robust data. The programme had been launched in 1996 in Bhigwan.

The team of Tandale and Dr Arvind Chopra, director of Centre for Rheumatic Diseases, along with several others, worked in Bhigwan in the 1990s. Recalling his work in the village when the programme was launched, Tandale said, “There were very few doctors and the population was just 7,000. I had a list of all the people living in the village and after conducting a detailed house-to-house survey, we found 774 people suffering from severe arthritis.”

Chopra recalled how one person, Vimlabai Gade, was almost considered dead by the villagers due to her crippling arthritis. “We brought her to Inlaks Hospital in Pune and treated her. She recovered and returned to her village,” said Chopra.

The Chopra-Tandale partnership demonstrated how grassroots doctors helped in the success of the entire WHO COPCORD programme, which was extended to 17 sites all-over India under the Government and Bone and Joint Decade India, an international collaborative movement in 2000 – 2010 AD to raise awareness on the impact of bone and joint conditions.

“Almost a fifth of the Indian population suffers from some form of rheumatic pain that needs medical attention. At least 10 per cent of the arthritis patients in the community may suffer from inflammatory forms of arthritis, which included rheumatoid arthritis and ankylosing spondylitis, which can lead to deformities, poor quality of life and increase in premature deaths. On the other hand, at least 30 per cent of the arthritis patients in the community suffer from osteoarthritis that affects knees and spine predominantly leading to pains and significant loss of normal quality in life,” said Chopra.

Several concerns will be raised at a national meeting of osteoarthritis research update (OACON 2018) and the state annual meeting of rheumatology (MRACON), beginning August 31. It will be underway till September 2.

As many as 250 delegates will participate, according to Chopra, who is the principal organiser of both meetings. Bone and joint disorders are the most common ailment in the community, but are grossly neglected by healthcare and medical education agencies, including the government and insurance sector, Tandale said.

Tertiary hospitals and rheumatologists generally focus on inflammatory arthritis, which require very early diagnosis and highly specialised medicines like the new biological drugs to control the underlying immunity driven inflammation and prevent severe complications. Degenerative disorders like osteoarthritis are often neglected by the medical fraternity at an early stage though a lot can be achieved with careful use of exercise and posture care, good health practices, and drugs to enhance cartilage health, which is the core target by the disease and management.

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