Interview with Rama Naidu

Chronic Care Foundation is an NGO committed to empowering the community with an accessible, efficient health care system that improves the safety and quality of care of patients with chronic, cardiovascular disease, diabetes and kidney disease in India; through prevention, advocacy, education and collaboration amongst stakeholders within the community. We chatted up with Mrs. Rama Naidu, the Chief Executive Officer of the Chronic Care Foundation of India. In this interview she speaks about CCF and various issues concerning healthcare.

VP: When was Chronic Care Foundation created and what is its vision?

R.Naidu: CCF was set up in December 2006 as a not for profit foundation ( Registered Public Charitable trust) with a one time grant, largely on the recommendation of a WHO study, that identified inadequate efforts by developing countries in combating NCCDs, most resources being directed towards fighting communicable, infectious diseases such as Aids, TB, Malaria, etc. and Acute care during epidemics and disasters.

CCF therefore seeks to become the focal point of public stakeholder effort, leading to prevention by:

Advocacy and Policy proposals based on sound Medical knowledge for all Stakeholders, incl. Govt.,

Generating more knowledge and information of current diagnosis and treatment in different parts of the country through market research and analysis,

Assist disease prevention through Education and Awareness of Delivery partners,

Outreach and collaboration with stakeholders in delivery

Our Vision:

To promote good health by proactively minimizing the incidence and effects of chronic disease in society.

VP: Which are the key areas in health care, which India must presently concentrate on?

RN:I am not an expert on this, however, based on our findings and the ground reality there is dire need to improve the Health care delivery for the common man in this country. It needs to be made accessible, affordable and reliable. Secondly, we need to face upfront the impacts and effects of the consumerism that is ruling the market, it is playing havoc with peoples lives. We need to stop aping the west blindly, that is not progress for a country when the only figures apart from inflation that are rising are those of people being affected by chronic diseases.

VP: Could you please explain to our readers what chronic diseases really are?

RN: To put it simply, chronic diseases are diseases of long duration and generally slow progression. These diseases are ongoing, generally incurable illnesses or conditions, such as heart disease, asthma, cancer, and diabetes. These diseases are often preventable, and frequently manageable through early detection, improved diet, exercise, and treatment therapy.

Usually, chronic diseases are linked to the wealthy and elderly sections of the society. However, researches have proved that all sections of the society and people from different age groups including those who are in working life are equally vulnerable to chronic diseases. People from both, developing and developed countries are affected by these chronic diseases.

Chronic diseases have attained endemic proportions today in India. As per surveys, chronic diseases accounts for nearly 53% of all deaths in India. Currently India is home to over 60 million coronary heart patients and over 57.2 million diabetes patients. These chronic illnesses also continue to afflict a growing number of children and teens through their life style habits, generally acquired at the prime of age.

The problem of childhood obesity is considered one of the emerging major health issues in India and children in the pre-adolescent age group of 8-12 years are increasingly facing this problem The increasing prevalence of overweight, obesity and its consequences prompted the World Health Organization to designate obesity as a global epidemic. Obesity is one of the major causes of chronic diseases like cardiovascular and kidney disease, diabetes and hypertension. Various studies also indicate that the prevalence of overweight and obesity amongst children of all ages is increasing in developing countries in the past few decades. According to a study conducted by the Diabetes Foundation of India in 2006, there has been a 13 per cent rise in the number of Delhi school children identified as overweight and obese in just three years. Seven per cent of Delhi’s school children are likely to develop serious heart problems by the time they are in their early thirties. In addition, the percentage of overweight and obese in the age group 14-18 is 28 per cent today.

In 2008 the figures are even moretroublesome and upsetting. According to Dr Anil Kapur, MD, of the Denmark-based World Diabetes Foundation (WDF), Obesity and obesity-related problems claims many more lives than AIDS. Chronic Diseases adversely impact the economy of the country also. Chronic diseases impacts economic productivity, and deplete the quality and quantity of country’s labor force.

India has lost almost $1 billion due to chronic diseases in 2007 (Express News Service). India’s loss in terms of loosing potentially productive years due to deaths from cardiovascular diseases in people aged between 35-64 years is one of the highest in the world. By 2030, the loss is expected to rise to 17.9 million years which is 940% more than the loss estimated in the USA. The projected foregone national income for India due to heart diseases, strokes and diabetes during the period 2005-2015 is estimated to be more than $200 billion.

In the light of the above facts and figures there is an urgent need to deal with these problems at an early stage. Thus effective treatment and prevention of obesity must start in childhood/teenage itself, and improving the eating habits of the children are one of the main preventive steps towards reducing incidence of obesity. CCF believes that to make a meaningful and significant contribution; there is a necessity to create awareness and educate the community on all aspects of care and management of such diseases enabling the community to lead healthy, active, and productive lives. Also early diagnosis and effective treatment can prevent or delay many of the complications associated with these chronic diseases.

VP: Is treatment of chronic diseases expensive? Are the slums in urban areas able to get themselves treated? And what more can be done to help them?

RN: Treatment of chronic diseases, once time has lapsed is expensive as then it becomes a matter of controlling the disease and a complete cure may not be possible. This then becomes a life long affliction and costs a lot of money. Families have gone bust trying to treat family members, especially if there is no insurance cover for diseases like diabetes. People living in slums, firstly do not even get diagnosed at the right time, and sometimes it’s too late. What needs to be done is to create awareness, for instance the Muslim pockets of the community, where CCF has conducted our programs we found that 65% are already sick or on the borderline, it is got to do with their food habits and controlled life style especially the women folk. Cultural limitations cause them to stay indoors, no exercise, rich food and more sadly a complete lack of knowledge about these diseases.

If our people who govern this country and the people who run big commercial establishments and civil society do not come together and more importantly they need to put aside the ‘money and what’s in it for us’ factor, we will grow into a sick country with severe economic impacts.

VP: You certainly have an interesting logo. What is the story behind it?

RN: Our logo can be viewed from two perspectives a ‘real life’ one and a spiritual one.

The logo represents CCF’s endeavour of bringing back quality health into the life of people by dealing with three prime diseases and challenges, which are affecting our society today. Three protective blue rings that stand as a sentinel against Diabetes, Cardiovascular & Kidney Diseases. The rings also stand for the CCF’s endeavour of bringing together all the three prime stakeholders, which are the private sector, civil society-Government, and Medical Fraternity on one platform, a true public private partnership for good health.

The blooming flower is the resultant effect of these initiatives, which also represents an artist’s visualisation of a human life with a long, healthy and blossoming life.

The colours of the logo represent the critical organs associated with the diseases mentioned.

The rings represent three critical chakras in the human body as well as the caring hands of the foundation that nurture ‘health’ without which there is no life. The central rising symbol signifies the central life force – the ‘Kundalini’.

Kundalini is a psycho-spiritual energy, the energy of the consciousness, which is thought to reside within the sleeping body, and is aroused either through spiritual discipline or spontaneously to bring new states of consciousness, including mystical illumination.

When the person is in good heath, each chakra clearly shows its own coloration, the number of petal “spokes,” and its speed of vibration is even. In poor health, their coloration becomes cloudy and their rotation becomes irregular and sluggish. A more detailed explanation is available on our web site

VP: People from abroad come to get treated in India, and yet many people in India do not have access to such facilities. Comment…

RN: Yes medical tourism is yet another ‘Fad’ now a days, however, we Indians have stopped living in a real world a long time ago, we channel our energies only towards a very niche segment of society i.e. the ‘haves’ the rest of India only matters when it is election time.

This business of medical tourism is going to such an extent that there will come a stage when we Indians will be neglecteddue to our ‘color’, there will be reservations in hospitals for non-Indians, it is already happening, with segments reserved.

A lot of money is spent under the garb of providing health care for the masses; the conditions are deplorable as was evident in the recent Delhi blasts and our emergency services and disaster management.CCF has launched a research study, which will assess the gap between supply and demand as well as the quality and cost of care across India. We hope that this will not be just another report that will rot in shelves, as we will draw our work plan based on the outcome and through it will be an uphill task we hope to catalyze change. The study will be released in November 08.

VP: What measures has CCF undertaken to create awareness about chronic diseases?

RN: CCF has some of the most distinguished medical specialists in the country on our Medical Advisory Board. They review and verify all content and tools, for medical relevance and authenticity. MEDICAL ACTION GROUP of CCF consists of volunteer doctors, who work with the CCF team in the pilot programs with the public; we are always looking for more doctors in the action group who can support our activities. Some of the programs that have been conducted are:

– Public Health Awareness campaigns in Urban slums and semi urban areas.

– Community Health talks and clinics

– Tools have been prepared to bring awareness and educate ordinary people:

Magic shows & Street theatre with messages

Health messages through comic books

Healthy living for semi urban children through Animated cartoon film

Handbooks, posters, leaflets, other mass media tools

VP: What are the short-term goals of CCF?

RN: Our immediate objectives are to create awareness, among the masses. In our one and a half years of operation we have prepared tools to do so, however we are today at a stage to raise funds to meet the objectives. Chronic diseases is not yetas ’glamorous’ an area like AIDs, or Cancer where a lot of money is being siphoned, so we do find it difficult to raise funds as visibility , VIP/celebrityinvolvement is the essence in Donors. However, we hope to succeed in our efforts soon.

VP:How does CCF fund itself? Has the government provided any help?

RN: CCF is presently supported by a one-time grant by the Baxter Foundation, USA. We are purely a charitable registeredpublic trust and depend on donations and grants for our operations. Our efforts to seek Govt. support has not fructified as yet, however there is hope. As you know to even get an appointment in our Govt. offices one has to have contacts and people who can open doors.

VP: How can Indian citizens help take this cause forward?

RN: There are many ways that our fellow Indians could help; I am stating some examples here: They can donate a small amount of Rs. 100/- for the books for mass free distribution in various languages and this will help us to distribute the books to 150 people for their money. Companies could sponsor Health camps where we create awareness and also conduct free blood diagnostic tests, people can volunteer their time to conduct awareness programs in their localities, we will provide the tools and guide them. The young and vibrant Medical practitioners can give time and resources, so can retired professionals. There are many such ways, they could sponsor the comic books or cartoon animation film for the under privileged schoolchildren, etc people could contact me at [email protected] and we will be happy to explore the options with them based on their interest and capabilities to deliver.

Compiled by

Shravya Jain