Sikkim moves to 'catch' health problems

Preventive health checks! The exclusive preserve of the affluent in most parts of India but not in the hill state of Sikkim where the government-backed Comprehensive Annual and Total Check-up for Healthy (CATCH) programme aims to reach out to people even in the remotest areas.

The state's unique initiative, a slow yet sure way towards a healthier Sikkim, promises to "catch" any health problems even before they occur. The flagship programme is aimed at providing a universal and comprehensive check-up on an annual and periodical basis. A head-to-foot health check-up of all citizens is done and a database maintained, say officials.

Once the check is done, a conscious attempt is made to provide comprehensive care based on the history of the patient.

Launched in August 2010, CATCH covered 50 percent of the state's estimated 607,000 population by the end of 2012.

Scattered health security-based programmes are being converged at all levels and being executed by building partnerships in the health sector. At present, one state referral hospital, four district hospitals, 25 primary healthcare (PHC) centres, 147 sub centres (PHSCs) are functioning in the state.

There is also a medical college, based on the private-public partnership module. All are working together to implement CATCH in various capacities.

"Our aim is to provide community-based comprehensive annual health check-ups and care, free of charge. We will bring healthcare to the doorsteps of the people and make Sikkim the healthiest state in India," Chief Minister Pawan Chamling told The Journal.

The first step is to collect detailed medical history of a citizen and maintain it in a universal database. This database can be updated on each annual health check-up. This is followed by a thorough physical check-up during which a screening of major health problems is done. In case any disease is detected, the patient is sent for free consultation to the appropriate doctor. After that, a laboratory investigation is done.

Counselling on a healthy lifestyle and preventing further problems follow.

The citizens are graded according to their health status and a real-time database can be obtained to find out the overall health status of Sikkim.

This database also helps the state government allocate resources within the health sector as and when required. Efficient planning of the health sector is possible because of the maintenance of an annual patient health record.

Based on available records, the major causes of deaths in Sikkim have been found to be heart and blood vessel diseases, alcohol-related complications, respiratory diseases, cancer and tuberculosis.

Eighty-three percent of urban households and 94 percent of rural households depend on the public medical sector for healthcare. Sikkim ranks highest among all Indian states in the proportion of households that use the public medical sector as their main source of healthcare.

According to Ramesh Dahal from Yangyang town: "This is a good initiative for those who are poor and cannot afford treatment. In a recently-concluded CATCH health check-up camp, the doctors checked my sugar and blood pressure. I was advised what to eat and how to lead a healthy lifestyle. It was extremely informative for the villagers, too."

"We hardly get any time to think of our health since we are so occupied with our farms. But with this system at least we will be able to get regular check-ups," Dahal said.

Aita Rani from Basilakha added that the elderly have been the main benefactors as they are unable to go to the hospitals themselves.

It's not entirely without problems though.

"The CATCH authorities don't have any medicines except for basic ones such as paracetamol. We have to buy most of our medicines ourselves. Even then, I feel it's a good initiative by the government," Aita said.

But what a boon it is for people like Mansingh Subba from Sumic-Mangthang village, who pointed out that the nearest dispensary was a 30-minute walk away.

"The main road is far away from here. So it was helpful when doctors came to us and conducted check-ups. Otherwise, we have to walk for half-an-hour to reach the dispensary."

(Meghnad Sahasrabhojanee can be contacted at meghnad.saha@gmail.com)