Call it the cost of development or dubious urban-rural parity. Lifestyle diseases, widely believed to be exclusively urban phenomenon, are silently but steadily creeping in in rural areas of Madhya Pradesh over the last decade.
Till recently, psychosomatic diseases like cardiac problems, diabetes and cancer were considered to be something necessarily that the ‘well off’ and mostly urban people suffered from. But the medical fraternity has observed a steady rise in the incidence of these diseases in rural areas too.
While no demographic or epidemiological studies are available for the State, doctors working in the field for more than 15-20 years now are alarmed at the rate at which the rural population is falling prey to diabetes, heart problems and cancers.
“Indian genes are to be blamed for this. The Indian ethnicity clubbed with diabetes exponentially increases the risk of heart attack. And with changing habits in rural areas, more and more people from the rural background are being exposed to the risk of these diseases,” says Choithram Hospital consultant interventional cardiologist Dr Alkesh Jain.
A few habits that have changed over the years are: increased use of piped water as against drawing water from wells or hand-pumps; tendency of the younger generation to outsource most of the jobs in their fields instead of doing it themselves along with hired labourers and, in case of women, a little reprieve in house-hold work with changing times owing to an array of factors including availability of bio-gas or LPG for cooking.
“But this is just not all. Their food habits are to be blamed too,” claims Choithram Hospital senior clinical nutritionist Padmaja Joshi. For instance, in Malwa region, most houses in rural areas have at least one cow. Milk is easily available, it is consumed raw most of the times and there is a tendency of over-eating milk products.
“Though most of them do get fresh vegetables, the idea of having a salad is rare. The food basically has high-fat and low-fibre contents,” Padmaja says. “Add to this, the deep-fried food (‘dal bhaati’ being a favourite dish with most) and sprinkling of ‘sev’ on every possible thing.”
“Also, more and more people prefer eating poha, jalebi and rabdi etc but most of them are not aware that shop-owners use and re-use the cooking oil, which leads to carcinogenic diseases,” Padmaja adds.
Says Digpal Dharkar of Indore Cancer Foundation who has been conducting numerous cancer awareness and detection camps in rural areas of the State for the last 20 years, “Cancer too is a lifestyle disease now. The incident of cancer in next 25 years is going to double.”
The two most prevalent cases are that of cancer of mouth and throat in case of males and breast cancer and cancer of cervix/uterus in females, Dr Dharkar informs. “Mind you, these are as much prevalent in rural areas as in urban. It’s a false belief that breast cancer is a bane for those urban females who marry late or have children late (or sometimes do not have any issue).
This is something very much prevalent in rural woman. The main reason, particularly for cervical cancer, being lack of awareness and very low personal hygiene,” he says.
Another increased cause of concern in rural areas is rise in the incidence of diabetes. As mentioned by Dr Jain, Indians have a pronounced vulnerability to diabetes because of which we tend to contract the disease 10 years earlier than people in western countries.
Studies have shown that diabetes mellitus is a fast-growing phenomenon in India and soon every fourth diabetic in the world would be an Indian. This obviously is applicable more to the rural population due to its sheer size as compared to urban population.
Adds MGM Medical College Department of Community Medicine Dr Sanjay Dixit, “Lifestyles in rural areas have changed over the years. What is needed is a little more awareness and implementing what is known to many but practiced by few.
“For instance,” says Dr Dixit, “Knowledge, attitude and practice (KAP) are very much important in prevention of such lifestyle diseases. We now add B to KAP, that is, behavioural changes that are necessary to bring about the requisite changes.”