Addressing asthma is a big challenge

Pritha Roy Choudhury, CNS Correspondent, India
This is the fourth day this week that Ashmi has been absent from school. A student of Class 4, Ashmi has been performing very well and has been an academic achiever for the third consecutive year. Mrs Hemvat, her class teacher is really worried— “She is not only a bright student but also is a very active child who takes part in most of the activities. But this year she has been absent most of the days.” Ashmi has been suffering from breathing problems for the past two years, but the problem has increased this year.

Regular visits to the doctors have resulted in the administration of high doses of cortisone and regular usage of inhalers and antibiotics. “Initially she did have problems, I would not sleep for nights together as she made wheezing sounds and had bouts of cough. I was very scared. We would visit the paediatrician from time to time and he gave her steroids. She was fine then. But she keeps getting these attacks though of lesser intensity. I have stopped visiting the doctor as we all hear about the side effects of cortisone,” said Ashmi’s mother, Mrs Dutta. Mrs Dutta is also confused about her condition, most of the time she refuses to go to school saying she is having breathing difficulties. But these days the wheezing sound and the bouts of cough are missing in most of the days. Asthma, Non Communicable Disease (NCD), is characterised by breathlessness, wheezing, and bouts of cough accompanied with headache and weakness. According to WHO estimates, asthma has already affected more than 235 million people across the globe but according to the Global Burden of the Disease study, the number of people suffering is much higher at around 334 million.

The disease is predicted to increase worldwide over the next 10 years. When I recently visited a small clinic in an urban slum, a chit chat with Dr Grover, a registered medical practitioner running the clinic, revealed that everyday there are 5 to 6 children visiting the clinic with breathing problems. The high pollution and dusty weather, accompanied with unhygienic living conditions, is the reason for such high number of children suffering from breathing difficulties. Dr P K Goswami, Senior Advisor, Institute for Global Development, raised concern on the rampant usage of fossil fuels by the marginalised section of the people both in urban and rural areas. “Commonest cause of asthma in our country is because of pollution from fuel like cow dung, straws, wood, kerosene etc. killing young women and young children in all low income countries particularly India. Other causes may be smoking, lack of physical activity and air pollution. Resorting to usage of clean fuel for household purposes is the only way we can minimise the number of asthma patients,” said Goswami.

Asthma is not a curable disease, but can be managed to a great extent if diagnosed early and treated properly. Most of the asthma patients go untreated because the disease is either not diagnosed or under treated when diagnosed. An article in the Times of India quoted  Dr S K Chhabra, head of cardio-respiratory physiology, at V P Chest Institute, Delhi  saying, “Wrong diagnosis of the disease has led to many people not suffering from asthma being administered steroid inhalers which can have a serious effect on the patient.” While mortality from asthma is low, a person suffering from this disease faces not only physical problems but also social, psychological, and economic problems. “I want to learn dancing, but my mummy is scared. There are times when I am in full form and enjoying dancing that I get bouts of cough and breathing difficulties. I feel very bad,” says Sushma, a 10 year old who aspires to be a dancer.

It has been seen that indoor pollution also results in asthma attacks. Lack of proper ventilation in the house, use of deodorants/air fresheners or use of other aromatic substances can trigger asthma attacks. Sticking to local sustainable food instead of the junk food and avoiding the triggers and allergens can be effective in tackling the disease. American college of Allergy, Asthma and Immunology states that asthma is among the most common chronic childhood illnesses, accounting for 10.5 million missed school days a year. It also accounts for 14.2 million lost workdays for adults. The researchers also estimated asthma-related costs, including the direct cost of health care and indirect costs such as decreased worker productivity, at around $60 billion annually.

Pritha Roy Choudhury, Citizen News Service - CNS
May 5, 2016