Dr. Chakrabarti on Challenges in Children’s Healthcare in Asia

On Monday October 26th, the University of Toronto’s Pre-Medical Society and UTIHP’s Global Health Engage collaborated in hosting the ‘The Challenges of Children’s Healthcare in Asia’ fundraising event featuring keynote speaker Dr. Prantar Chakrabarti, Head of the Department of Hematology at the Nil Ratan Sircar Medical College and Hospital in Calcutta, India. All proceeds went to Hemoglobal, a Canadian charity dedicated to improving the lives of children affected by blood disease worldwide.

Dr. Chakrabarti was introduced by Hemoglobal Executive Director, Nancy Olivieri, as a man who wants to change the face of healthcare for patients in India – and his two-hour talk was nothing short of inspiring. Drawing on his own clinical experience in Calcutta he painted a sobering picture of the state of children’s healthcare in South Asia. He delved into the underlying social factors that continue to plague health systems in low and middle income countries and advocated the need for health infrastructure to be a made a priority by the government.

Despite the burgeoning economic success of countries like India, social progress has been stunted compared to neighboring countries. Chakrabarti described India, an enormous country in demographic and epidemiologic transition, as an “economic giant becoming a social pygmy,” drawing attention to the stark contrast between remarkable economic growth and declining indicators of social progress.

Chakrabarti highlighted inequities in literacy rates and hygiene practices that have contributed to India’s public health failings, as compared to other South Asian countries. A fast growing population, a rapidly changing disease profile, and lack of infrastructure were cited as key inhibitors to healthcare efficiency in the subcontinent. According to Dr. Chakrabarti, the greatest obstacle impeding access to care for children affected by blood disease in India is socioeconomic status. Prophylaxis and treatment for haemophiliacs, for example, is completely impractical in developing countries despite a relatively universal global prevalence. Failure to treat such conditions invariably contributes to the cycle of poverty and exacerbates the underlying determinants of poor health. The correlation between cognitive impairment and chronic nutritional anaemia is one such example that is seen far too often in Dr. Chakrabarti’s practice. Children experience neurocognitive delays as a result of a poor diet begin to fall behind in school, fail to obtain the education they need to improve their lives and thus, the cycle of poverty continues.

He highlighted the severity of health coverage disparity especially for rural populations where a childhood diagnosis of blood disease can be a death sentence due to the lack of financial means or access to health services. The need for comprehensive health insurance policy in India is critical, explained Chakrabarti, since financial reimbursement for medical procedures is extremely poor and many conditions, such as blood diseases, are not covered at all. However, non-communicable diseases present a difficult problem for policymakers and thus impede many policy reform initiatives. This is a significant problem in a country where two out of every three deaths are attributed to non-communicable disease, not to mention over fifty million diabetics that make India the diabetes capital of the world.

High mortality rates for non-communicable diseases in developing countries are indicative of a greater problem of wealth disparity and inadequate government funding toward intervention policies and programs. India’s health expenditure sits at just 4% of the country’s GDP, well below the global average of 9.9% and Canada’s 10.9%. According to Chakrabarti, India’s staggering population is a major liability in terms of enacting adequate health policy, but perhaps, it is also a major asset. After all, given the right opportunities and resources, such a vast population holds unimaginable potential for innovation and scientific discovery.

Despite the persistent public health issues facing India, Chakrabarti made sure to point out the immense beauty of India’s culture and history as he offered hope for the future of the public health in the subcontinent. In light of India’s increasing presence in the global economic stage and new directions in political leadership, Chakrabarti was confident in India’s potential to prosper in both economics and health, that is, if healthcare infrastructure is made a greater priority by the country’s leaders.

Dr. Chakrabarti’s lecture beautifully articulated the need for public health advocacy in South Asian countries with hard-hitting evidence, humor, and passion. He left the the auditorium with a sense of immediacy and inspiration, and a call to action for all those interested in novel solutions to health issues in developing nations.

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