According to Dr KK Verma, Senior Paediatrician, District Hospital, Bahraich, “Indoor air pollution like smoking ‘bidis’, cooking on chulhas, etc, increase the risk of pneumonia. There are a host of other sources of indoor air pollution in rural areas. The kitchen in villages is made of kutcha walls which increases the risk of spread of infections. The kitchen should be made outside the space where the child lives and should be constructed of “pucca” walls. Children in villages generally feed while sitting on the floor. This practice should be avoided. Homes should be regularly whitewashed. Homes should be made of ‘pucca’ bricks. Urban people have less chances of contracting infections because they have access to clean drinking water. Rural masses do not have this facility which increases manifold the risk of pneumonia.”
According to Dr. Kumud Anup, Private practising Paediatrician, Lucknow, tobacco smoking is the main cause of indoor air pollution. She opines, “In urban areas tobacco smoke is a major source of indoor air pollution. Children are exposed to passive form of smoking which is extremely dangerous and increases the risk of pneumonia. Tobacco smoking greatly increases the susceptibility to not only pneumonia but also asthma and several other infections. Hence to protect children from the ill-effects of passive smoking, smoking should be strictly prohibited inside homes. This will help contain the chances of pneumonia and other related illnesses.
Even among the medical community there is lack of awareness about the relation between indoor air pollution and infections. This was gathered from the opinion of Dr PK Mishra, Gynaecologist, District Hospital, Bahraich, who does not consider indoor air pollution to be a factor in increasing risk of childhood pneumonia. According to him, “Tobacco smoking or cooking on chulhas does not directly increase risk of pneumonia. Although it can suffocate the child but does not lead to any infection.”
Tobacco smoking increases the risk of pneumonia. This can be estimated from the survey of pneumonia patients at the Bahraich District Hospital. The mother of a two and a half year old child suffering from pneumonia told that many members of her family smoke and use other tobacco products. Also food is cooked on a chulha. Another three day old child sufferer’s mother told that food is cooked on chulha in her home and that the child’s father uses tobacco in the form of cigarette, “bidi” and “gutkha”.
Better healthcare, proper nutrition and improvement in environment are the factors that can independently lead to decrease in deaths due to childhood pneumonia. Thus these factors play an important role in the upliftment of the living standard of society. The Government should take into consideration these factors before the implementation of health programmes. Improvement in the standard of living and the adopting healthy and hygienic practices will together lead to the decrease in the incidence of childhood pneumonia and other infections.
Rahul Kumar Dwivedi – CNS
(Translation: Somya Arora - CNS)