Recently, I was surprised by the efforts that the government takes in checking TB cases by distributing free medicines through the nearest centres. The system is made so fool-proof that the medicines are taken by the patients regularly in the presence of a medical officer.  In fact a doctor or at least a nurse visits the house of the patient and guides the family members about the importance of taking the medicines regularly, the various precautions that the family should take and ensures that the medicines are distributed from the most convenient location.  The hospitals are monitored strictly.  The doctors are to maintain proper records and collect the empty strips of the tablets dispensed to the patients.  All this even in a metro like Bangalore!  I was highly impressed with all this.  However, there is another side to these efforts which needs immediate attention from the government.

The government also distributes Antiretroviral therapy (ART) medicines for people living with HIV free of cost through few of their hospitals.

Any medicine is most effective only when consumed along with a nutritious balanced diet, especially the strong medicines that are dispensed forpeople living with HIV and TB..  Most of these people belong to families which are very poor or are below poverty line.

People living with HIV have one more disadvantage.  They are most often disowned by their own families and are left to fend for themselves with not even good jobs to earn their livelihood.  Thus most of them find it difficult to even get two square meals a day to feed their hunger.  From where should they afford nutritious food?

Now, let me come to the actual issue.  The recent spurt in the prices of essential food-grains is a big blow for the common man.  What is the point of advertising on national media about  importance of nutritious food for the pregnant, people living with HIV and TB, children and so on when such food is beyond the reach of the common man?

The price of apples is Rs.110-120 per kilogram.  So, there is no use proclaiming that ‘an apple a day keeps a doctor away’.  If not apples, the poor were at least trying to eat rice and dal regularly to fill their stomachs.  Now dal, which is the poor man’s only source of proteins, costs Rs.100+ per kilogramme.  The price of milk keeps going up once in every few months!  Thus the poor cannot afford milk too, which is the only source of calcium for them.  The price of rice is touching the roof at Rs.30+per kilogramme.  So, if the poor man decides to eat only raagi balls, what should he eat that with, because he cannot afford to buy dal.  The prices of most of the vegetables are also beyond his reach.  He has to satisfy himself with onions, tomatoes and chillies boiled in water!  Which medicine will be effective with such a poor meal?

The Public Distribution System (PSD) is almost ineffective as most of the really poor families fall outside its coverage, as the income level fixed to categorise families ‘below poverty line’ is very low.  In fact, nobody can survive with such a low income.  For instance, a class four Government employee earning Rs.10000/- per month is much above the BPL.  But imagine the plight of one such employee having to take care of a family of five or six members, one or two of whom have some serious illness mostly due to malnutrition!  With the kind of cost of living in Bangalore how can such a family survive without help from the PDS?

We are discussing so seriously about the effects of economic recession on the middle class families and the growing number of people losing their jobs or not getting jobs.  At least many of such families have one or two other earning members or some savings to take care of them.  But is the Government aware of the plight of the poorer sections of the society?  What steps is it taking to ensure that everybody is able to get at least two nutritious meals per day, let alone extra accessories such as  fruits, nuts, milk and ghee?

While the efforts of the Government in helping the poor fight serious illnesses by distribution of essential medicines free of cost are well appreciated, it is also our duty to remind them of their role in ensuring that the common man is fed well to check malnutrition.  Otherwise, their efforts in fighting the diseases will be defeated and most of the patients may die of malnutrition rather than because of the diseases!

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