Overcoming the barriers

Published : Oct 14, 2000 00:00 IST

EPILEPSY as a social problem is of a much greater magnitude than the medical problems it poses. Compared to diseases such as malaria, Acquired Immune Deficiency Syndrome (AIDS) and tuberculosis (T.B.), epilepsy has received a low level of attention. The argument is that the former are more pressing problems.

It is owing to the efforts of Indian neurologists and neurosurgeons, especially Dr. K.S. Mani, the eminent neurologist from Bangalore, and campaigns by national bodies of neurology, neurosurgery and the Indian Epilepsy Society, that epilepsy has been rem oved from the Mental Health Act and is treated like any other illness now. However, much more needs to be done: drugs must be made available at cost price and diagnosis must be accurate. Better training of nurses and general practitioners and specialists is mandatory. Better epidemiological work and statistical accuracy are called for. The use of a cheap drug like phenobarbitone (sold as gardenal) calls for a reappraisal of Western literature to suit India's economic conditions. Phenobarbitone is availa ble at the affordable price of Rs.15 for 100 tablets and can be stocked in hospitals. It is a relatively safe drug.

However, the biggest hurdles to overcome are the psycho-social factors. These essentially relate to the nature of jobs epileptics can perform; whether they, especially women who have epilepsy, can marry; and whether they should be given driving licences and also to prejudices against the patients. A sustained effort by the local and national action groups of patients and their families is necessary to overcome these barriers.

While serious diseases such as diabetes and hypertension are glorified, epilepsy is often hidden from society and is the condition neglected. In an excellent analysis in Green Journal, Neurology 2000; Martha Morrez and Timothy Pedley say: "Epileps y is still a great burden to Americans. A disturbing fact is the misinformation in the print media, and this is only the tip of the iceberg. As Internet becomes more popular, the opportunity for increased misinformation would be greater..." If this is th e situation in the United States, it can be no different in a country like India with a population of one billion.

One has to be optimistic but guardedly so - epilepsy in 85 per cent of the sufferers can be successfully controlled with drugs, some even cured. Almost 10 per cent of them will need years of follow-up and 5 per cent will need surgery. All this calls for team work, and neurologists must work to achieve that goal.

The TVS group sponsored the Indo-British workshop on epilepsy in Chennai, while the 15th K. Gopalakrishna Endowment Lecture and the third E.S. Krishnamoorthy (who was a model civil servant and a scholar in Sanskrit and music) Endowment Lecture were spons ored by the respective families.

Chennai has indeed come a long way in area of neurosciences.

One must not forget the thoughtfulness and Gandhian approach of savants, namely Dr. K.S. Sanjivi, who founded the VHS (Voluntary Health Services) in 1958, and M.C. Subramaniam, who founded the PHC in 1953, for the betterment of society.

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