Tag Archives: blood sugar

free clinic

What New Delhi’s Free Clinics Can Teach U.S.

Rupandeep Kaur, 20 weeks pregnant, arrived at a medical clinic looking fatigued and ready to collapse. After being asked her name and address, she was taken to see a physician who reviewed her medical history, asked several questions and ordered a series of tests, including blood and urine. These tests revealed that her fetus was healthy but that Kaur had dangerously low hemoglobin and blood pressure levels. The physician, Alka Choudhry, ordered an ambulance to take her to a nearby hospital.

All of this, including the medical tests, happened in 15 minutes at the Peeragarhi Relief Camp in New Delhi, India. The entire process was automated — from check-in, to retrieval of medical records, to testing and analysis and ambulance dispatch. The hospital also received Kaur’s medical records electronically. There was no paperwork filled out, no bills sent to the patient or insurance company, no delay of any kind. Yes, it was all free.

The hospital treated Kaur for mineral and protein deficiencies and released her the same day. Had she not received timely treatment, she may have had a miscarriage or lost her life.

This process was more efficient and advanced than any clinic I have seen in the West. And Kaur wasn’t the only patient; there were at least a dozen other people who received free medical care and prescriptions in the one hour that I spent at Peeragrahi in early March.

The facility, called the “mohalla” (or people’s) clinic, was opened in July 2015 by Delhi’s chief minister, Arvind Kejriwal.  This is the first of 1,000 clinics that he announced would be opened in India’s capital for the millions of people in need. Delhi’s health minister, Satyendar Jain, who came up with the idea for the clinics, told me he believes that not only will they reduce suffering but also overall costs — because people will get timely care and not be a burden on hospital emergency rooms.

The technology that made the instant diagnosis possible at Peeragarhi was a medical device called the Swasthya Slate. This $600 device, the size of a cake tin, performs 33 common medical tests including blood pressure, blood sugar, heart rate, blood haemoglobin, urine protein and glucose. And it tests for diseases such as malaria, dengue, hepatitis, HIV and typhoid. Each test only takes a minute or two, and the device uploads its data to a cloud-based medical-record management system that can be accessed by the patient.

The Swasthya Slate was developed by Kanav Kahol, who was a biomedical engineer and researcher at Arizona State University’s department of biomedical informatics until he became frustrated at the lack of interest by the medical establishment in reducing the cost of diagnostic testing. He worried that billions of people were getting no medical care or substandard care because of the medical industry’s motivation in keeping prices high. In 2011, he returned home to New Delhi to develop a solution.

Swasthya Slate is a mobile kit that empowers front-line health workers with usable technology for prevention diagnosis care and referral of diseases. The Swasthya Slate kit was launched in the state of Jammu and Kashmir by the Ministry of Health in 2014. (Swasthya Slate)

 

Kahol had noted that, despite the similarities between medical devices in their computer displays and circuits, their packaging made them unduly complex and difficult for anyone but highly skilled practitioners to use. They were also incredibly expensive — usually costing tens of thousands of dollars each. He believed he could take the same sensors and microfluidics technologies that the expensive medical devices used and integrate them into an open medical platform. And with off-the-shelf computer tablets, cloud computing and artificial intelligence software, he could simplify the data analysis in a way that minimally trained front-line workers could understand.

By January 2013, Kahol had built the Swasthya Slate and persuaded the state of Jammu and Kashmir, in Northern India, to allow its use in six underserved districts with a population of 2.1 million people. The device is now in use at 498 clinics there. Focusing on reproductive maternal and child health, the system has been used to provide prenatal care to more than 22,000 mothers. Of these, 277 mothers were diagnosed as high-risk and provided timely care. Mothers are getting care in their villages now instead of having to travel to clinics in cities.

A newer version of the Slate, called HealthCube, was tested last month by nine teams of physicians and technology, operations and marketing experts at Peru’s leading hospital, Clinica Internacional. They tested its accuracy against the Western equipment that they use, its durability in emergency room and clinical settings, the ability of minimally trained clinicians to use it in rural settings and its acceptability to patients. Clinica’s general manager, Alvaro Chavez Tori, told me in an email that the tests were highly successful, and “acceptance of the technology was amazingly high.” He sees this technology as a way of helping the millions of people in Peru and the rest of Latin America who lack access to quality diagnostics.

The opportunity is bigger than Latin America, however. When it comes to healthcare, the U.S. has many of the same problems as the developing world. Despite the Affordable Care Act, 33 million Americans ,or 10% of the U.S. population, still lacks health insurance. These people are disproportionately poor, black or Hispanic, and 4.5 million are children. They receive less preventive care and suffer from more serious illness — which are extremely costly to treat. Emergency rooms of hospitals are overwhelmed by uninsured patients seeking basic medical care. And even when they have insurance, families are often bankrupted by medical costs.

It may well be time for America to build mohalla clinics in its cities.

What Loneliness Does to Your Health

One of the myriad reasons workplace wellness is not performing well is that all humans have about 100 risk factors, of which obesity, high blood sugar, high blood pressure and high cholesterol are only four. If those four are in pretty good shape but the other 96 are out of whack, don’t expect good health results.

Further, putting bandages on symptoms of metabolic disease has limitations. Such bandages do not address the root causes of metabolic syndrome. According to Wiki, “Root cause analysis (RCA) is a method of problem solving used for identifying the root causes of faults or problems. A factor is considered a root cause if removal thereof from the problem-fault sequence prevents the final undesirable event from recurring; whereas a causal factor is one that affects an event’s outcome but is not a root cause. Though removing a causal factor can benefit an outcome, it does not prevent its recurrence within certainty.” [Emphasis mine.]

One thing sorely missing from most modern wellness methods is RCA. Unless one deals with RCA in metabolic syndrome, it will continue to recur.

Some other huge health risks factors are job misery, terrible marriages, very poor money-handling skills, envy, general lack of contentment in life and loneliness. Another health risk is how far you live from a “dial-911 first responder.” Yet another is how safe your neighborhood is. I could go on and on. Worksite wellness does nothing to address the vast majority of personal health risks. My book, An Illustrated Guide to Personal Health, elaborates on such health risks.

This article will cover just one of those risks, loneliness, which among other things is a root cause of metabolic syndrome. (Let’s hope this information does not inspire true believers in wellness penalties to look for ways to charge lonely employees higher payroll deductions.)

Loneliness harms your immune system, makes you depressed, diminishes cognitive skills and can lead to heart disease, vascular disease, cancer and more. Loneliness is roughly the health risk equivalent of being a diabetic who smokes and drinks too much. Read on.

An article from the National Science Foundation explores the health hazards of loneliness. According to this article, “Research at Rush University has shown that older adults are more likely to develop dementia if they feel chronic loneliness.”

Moreover, John Cacioppo, neuroscience researcher of the University of Chicago, says of loneliness, “One of the things that surprised me was how important loneliness proved to be. It predicted morbidity. It predicted mortality. And that shocked me.”

Dr. Sanjay Gupta recently wrote, “The combination of toxic effects [of loneliness] can impair cognitive performance, compromise the immune system and increase the risk for vascular, inflammatory and heart disease.”

According to studies in Europe, loneliness has about the same health risk as obesity.

An article in Caring.com says, “A 2010 Brigham Young University review of studies involving more than 300,000 people concluded that loneliness is as unhealthy as smoking 15 cigarettes a day or being an alcoholic.

This is a headline in the U.K.’s Express: “Loneliness is as big a KILLER as diabetes.” The article describes how loneliness is like a deadly disease that decreases life expectancy and makes you more susceptible to cancer, heart disease and stroke. The study behind that conclusion was published in the Proceedings of the National Academy of Science.

Here are some personal observations:

Why do many people have so few friends as they age?

  • Maintaining long-term friendships takes a lot of work and investment of time.
  • Don’t let your career stand in the way. Don’t wait for someone to befriend you; reach out.
  • Some people have invested their time and energy solely in a spouse, who may predecease them by 25 years, or in children, who fly the nest in time.
  • Many people have invested much in work-related friendships, which, while genuine at the time, can wilt almost immediately when they retire or move on.
  • In friendships, one has to give more than he takes. Make yourself likable. Who wants to spend time with someone who complains all the time? People like that are often avoided by people around them.
  • Be a good listener.
  • If you’re lonely, try joining something…a place of worship, a book club, a hiking club, anything. In every community are places where everyone is welcome.

In the end, a true measure of your wealth is the number of lifelong friends you have. Having lifelong friends is a joy and a perfect cure for loneliness.