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Health Care

29 Apr 2024

10 mins

Elevating Healthy Work Culture: World Day for Safety and Health at WorkEvery year, on April 28th, the International Labour Organization (ILO) organizes World Day for Safety and Health at Work. This day highlights the importance of creating safe workplaces and spreading awareness about the real impact of work-related accidents and diseases. It was organized in 2003 to urge us to consider how occupational safety and health can be prioritized in global and local policy-making. It is a call to action to bolster our national systems and align them with top international standards for labor safety. A FUNDAMENTAL RIGHT A safe and healthy workplace is the fifth Fundamental Principle and Right at Work. On April 28, 2023, some special implements were made during the World Day for Safety and Health at Work, which every worker must be aware of. The International Labour Organization (ILO) celebrated a big decision during the 110th International Labour Conference. They decided that having a safe and healthy workplace is super important—it is actually a basic right for all workers around the world! Not just that, but two specific rules about keeping workers safe—Conventions Nos. 155 and 187 [https://webapps.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_874743.pdf]—got a special status—they are now called Fundamental Conventions, making them extra important. It means that wherever you work, you should feel safe and healthy while you are there. It has now become a fundamental right at work. WHY DOES WORKPLACE SAFETY MATTER? Why is it essential to consider workplace safety as a fundamental right? Well, get ready to uncover some eye-opening facts and figures that emphasize just how critical this matter truly is. Nearly 60% of people worldwide spend a big chunk of their time working. So, it is pretty huge that everyone deserves a safe and healthy workplace, right? Think about it—since we spend so much time at work, it is like a second home. And just like we want our homes to be safe, we should expect the same from our workplaces. This is not just about physical safety, though. It is also about our mental and social well-being. We want to go to work feeling good, both physically and mentally. But sometimes, workplaces can have hazards—things that can make us sick or hurt us. These risk factors can lead to serious health problems, making it hard for us to keep working. STUNNING STATS According to a report by the WHO and ILO, most of the deaths related to work were respiratory and cardiovascular diseases [https://www.mrmed.in/health-library/heart-care/diagnosis-of-cardiovascular-disease]. * The biggest reasons for these deaths were lung problems like chronic obstructive pulmonary disease [https://www.mrmed.in/health-library/respiratory-disorder/all-about-chronic-obstructive-pulmonary-disease] (which caused around 450,000 deaths), strokes [https://www.mrmed.in/health-library/heart-care/stroke-causes-types-symptoms-treatment] (which caused about 400,000 deaths), and heart issues like ischaemic heart disease (which caused around 350,000 deaths). * Also, some deaths happened because of injuries at work, which made up about 19% of all work-related deaths. In total, around 360,000 people died because of these injuries. * In 2016 alone, nearly 2 million people worldwide died because of work-related diseases [https://www.who.int/news/item/17-09-2021-who-ilo-almost-2-million-people-die-from-work-related-causes-each-year] and injuries! That is a huge number. These risks at work are also a big environmental concern. * Recent 2023 stats estimated an annual 36,700 fatalities, 1,83,00,000 injuries, and 18,50,000 diseases [https://oem.bmj.com/content/75/Suppl_2/A144.1] related to occupational hazards in India. It is seriously shocking to see so many people literally being killed by their jobs. This is a wake-up call to all countries to protect the health and safety of their workers. WHAT ARE THE PRIMARY OCCUPATIONAL RISKS IN WORKPLACES? Workers are exposed to some occupational risks as part of their professional activities. These risk factors are a major public health issue and are responsible for work-related deaths. A recent European observational study estimated the following occupational risk factors from 20,000 workers [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967294/#app1-ijerph-20-03632] at their workplaces. Occupational Risk Factors Physical factors 1. Noise 2. Working in bad weather 3. Vibrating machines and tools 4. Ultrasound 5. Extreme Temperatures (hot or cold) 6. Non-ionizing radiation 7. Ionizing radiation Ergonomic risk factors 1. Inappropriate working postures 2. Poor handling of loads Biological factors 1. Work in contact with products of human origin 2. Waste disposal and management works 3. Food industry 4. Work in contact with animals or animal products Chemical agents exposure [https://www.mrmed.in/health-library/cancer-care/cancer-causing-chemicals] 1. Handling chemicals or cosmetics 2. Exposure to fumes, gases, and/or dust 3. Fiber (asbestos, refractory ceramic, insulation wool, etc.) Atypical working hours 1. Weekend work 2. Working irregular hours 3. Work in alternating shifts 4. Night shifts Psychosocial factors 1. Emotional demands of the job 2. Work requirements 3. Autonomy of organization 4. Socioeconomic fears 5. Support at work (colleagues, employer, supervisor) 6. Recognition at work (colleagues, employer, supervisor) 7. Conflict at work * Climate The impact of climate change on occupational health has also recently emerged as a concern. Climate-related hazards, particularly extreme weather events, limit work output and duration and pose risks to workers’ health and safety. * Informal Jobs Now, here is another concern: some people work in what we call "informal" jobs. That means they don't have all the protections and benefits that other workers might have. For them, staying safe at work can be even tougher. They might not have the right equipment or training, and they are more likely to get hurt or sick because of it. * Mental Health Health and safety also go beyond physical concerns. The COVID-19 pandemic has alarmed us to address mental health issues in the workplace. A safe and healthy working place supports mental health, and good mental health, of course, enables people to work productively. Issues such as depression and anxiety are pervasive in workplaces, impacting productivity and performance. When left untreated, the economic cost is estimated at US$1 trillion annually. Fact Box Occupational Risk FactorsDeaths Linked to Each Factor: WHO report (2000-16)Long Working HoursApproximately 750,000 deathsExposure to air pollutants (particulate matter, gases, and fumes)Approximately 450,000 deaths. WHAT CAN BE DONE? A CALL-TO-ACTION The above risk factors are clearly becoming major health concerns worldwide. So, what can be done? Here are six proactive steps that every workplace in every country can take to promote workers' well-being and safety. 1. Clear Rules and Procedures: It is super important for your workplace to have clear rules in place to keep you safe and healthy. Make sure you know what they are and follow them! 2. Regular Health Check-ups: Regular check-ups and follow-ups with your doctor are a great way to catch any health issues early on. Your employer should help out by providing some basic health screenings for everyone once a year. 3. Working Together: We are all working on this together! Governments, employers, and workers need to team up to ensure a safe and healthy work environment for everyone. Let us encourage collaboration between health and labor ministries to tackle workplace health issues head-on. 4. Support for Everyone: No one should be left out. Everyone deserves access to support systems, especially if they work in informal jobs. Let us push for policies that ensure everyone gets fair treatment and support if they get sick or injured at work. 5. Making Health a Priority: Taking care of our health at work is not just good for us; it is good for society, too! Governments and organizations should invest in workers' well-being. That way, we can all grow and be resilient, even in the face of challenges like climate change. 6. Positive Workplaces: Let us create workplaces where everyone feels happy and healthy. When we cultivate well-being, it not only benefits us individually but also enhances the effectiveness and success of our workplaces. THE BOTTOM LINE It is super important to ensure that every worker, no matter where they work or what they do, has a safe and healthy workplace. It is not just about keeping us safe—it is about looking out for each other and making sure everyone can work without worrying about occupational hazards.

Dr. Vijayalakshmi

Health Care

26 Apr 2024

10 mins

Telemedicine in India: Can Virtual Care Lead the Way?Virtual care has become a key player in helping India work towards providing healthcare for everyone. The COVID-19 pandemic really pushed both doctors and patients to start using telemedicine in India more often. There have been some recent positive changes in policy, advancements in technology, and improvements in infrastructure that put India in a good position to skip ahead and possibly do better than some Western healthcare systems. This blog talks about what we can learn from moving to virtual care, the emergence of telemedicine in India and suggests ways that India could use virtual healthcare to ensure all its citizens can access the healthcare they need, even with limited public health resources. WHAT IS TELEMEDICINE? Telemedicine involves using technology like computers and smartphones to get medical care from a distance. This means you can talk to your doctors and get help without having to visit them in person. You can get diagnosed, monitor your health, discuss your concerns, and even receive prescriptions—all online. Telemedicine in India has grown significantly in recent years. COVID-19'S IMPACT ON VIRTUAL HEALTHCARE IN INDIA When India had to go into a COVID-19 lockdown on March 23, 2020, it really shook up the regular way healthcare was delivered. Many hospitals had to switch things around, moving patients from being admitted to the hospital to getting care while they stayed at home. Because of this, the number of people seeing their doctors in person dropped by 32% [https://yourstory.com/2020/12/india-recorded-3x-increase-online-consultations-practo-report], but the number of online doctor visits jumped by 300%. In fact, the online consultation market grew a lot, reaching $163 million in March 2021. Thus, this pandemic has been the time when telemedicine in India has peeked up. INDIA'S HEALTHCARE CHALLENGES: A CLOSER LOOK India faces a big challenge with its healthcare system. * GDP on Healthcare: The country spends only 1.28% of its total GDP (Gross Domestic Product) on healthcare, which is one of the lowest rates in the world. * Access to healthcare: In India, people living in rural areas or homegrown cities often have less access to healthcare compared to those in cities. * Out-Pocket-Expenses: Personal payments for healthcare cover nearly 62.6% of the total health spending in India [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10041239/], which is one of the highest rates in the world. Not surprisingly, the cost of healthcare is a big reason why many people in India remain poor. * Universal Healthcare: To really help lift its large population out of poverty, India needs to include steps to provide healthcare for everyone, no matter where they live or how much money they have. This is known as Universal Healthcare (UHC), and it is crucial for improving the lives of millions of Indians. And this can be greatly achieved through implementing telemedicine in India. IS INDIA EQUIPPED FOR VIRTUAL CARE? India is in a great position to start using virtual healthcare widely due to the fast-growing digital market. * Digital landscape: With over half a billion people already using the internet, the country is ready to embrace online health services. * Regulatory Frameworks: In terms of rules and regulations, the government took a big step in March 2020 by introducing the Telemedicine Practice Guidelines. These guidelines help clear up any confusion about whether online medical services are allowed and provide a detailed set of rules for both patients and doctors to follow. This ensures that everyone is legally protected when using virtual care. * Technical Infrastructure: On the technical side, the launch of the Ayushman Bharat Digital Mission (ABDM) [https://abdm.gov.in/] in 2021 really helped set up a strong foundation for virtual healthcare. This mission created a digital network that lets patients and healthcare providers easily share important health information like medical history, test results, and prescriptions. The system also includes a comprehensive list of healthcare organizations and professionals all over the country, making it easier to connect and coordinate care. HOW IS VIRTUAL HEALTHCARE PRACTICED IN INDIA? India set up a unique free telemedicine service called eSanjeevani [https://esanjeevani.mohfw.gov.in/#/] in 2020, which is the first of its kind in the world. It has two main parts: eSanjeevani Ayushman Bharat–Health and Wellness Centre (AB–HWC) and eSanjeevaniOPD (Outpatient Department). eSanjeevani AB–HWC works like this: There are two main parts to eSanjeevani: 1. eSanjeevani Ayushman Bharat-Health and Wellness Centre (AB-HWC) (Doctor-Doctor): This is a service where doctors at small health centers in rural areas can connect with specialists at bigger hospitals to help patients. It is like a virtual link between the junior doctors and the specialist. 2. eSanjeevaniOPD (patient-doctor): This allows people to have doctor appointments from their homes using their phones. It's like having a regular doctor visit, but online. By 2022, it had reached a massive milestone of completing 3 crore consultations [https://pib.gov.in/PressReleasePage.aspx?PRID=1809569#:~:text=Doctor%2Dto%2DDoctor%20telemedicine%20service%20is%20based%20on%20a%20Hub,%2Fhospital%2Fmedical%20college).]. On one busy day, it even managed to do 1.7 lakh consultations. The top 10 states using eSanjeevani the most are Andhra Pradesh, Karnataka, West Bengal, Tamil Nadu, Uttar Pradesh, Bihar, Maharashtra, Madhya Pradesh, Gujarat, and Assam. These are just the beginning steps, but they show a lot of promise for how telemedicine can change healthcare in India. FUTURE TRENDS IN INDIAN TELEMEDICINE: VR AND AI The telemedicine market in India was worth $1.9 billion in 2022, and it is expected to grow to $10.7 billion by 2028 [https://www.financialexpress.com/business/digital-transformation-new-trends-in-telemedicine-technology-in-2024-3310901/]. New, embraced technologies like virtual reality (VR) and artificial intelligence (AI) are making telemedicine even better. With VR, patients can feel like they are in the same room as their doctors, even if they're far away. AI helps doctors give personalized treatments and analyze patient data more effectively. In the end of 2024, we will see more e-clinics, which are like regular clinics but online. WHAT IS REQUIRED FOR INDIA TO SUCCEED IN VIRTUAL HEALTHCARE? To make virtual healthcare work well in India, there are some important things that need to be considered. i. First, Regulations There need to be new rules and ways of managing things to deal with issues like keeping people's information safe and making sure everyone gives permission for their data to be used. When new health apps or systems are created, they need to be checked to make sure they're worth the money and actually help patients. ii. Second, Education Everyone needs to learn how to use virtual healthcare, especially in places where it is not common yet, like villages and city slums. This means teaching people about it in schools and setting up places in communities where people can learn more about it. iii. Third, Guidelines doctors and other healthcare workers need to figure out which parts of healthcare can be done online and come up with clear guidelines for how to do it safely and effectively. They also need to learn how to use new technology to provide care in different ways. iv. Lastly, Training There need to be more healthcare workers who understand how to use technology to provide care, not just doctors and nurses. This includes training more paramedics and other health workers. For example, having more trained midwives could help save a lot of lives by providing better care for pregnant women and newborn babies. A PATH TO UHC (UNIVERSAL HEALTH COVERAGE) Telemedicine is changing the way healthcare works, making it easier for people to get quality care no matter where they live. And as technology keeps improving, telemedicine will continue to grow and help more people in the future. Some key investments from the government side will be a big help in making virtual care even better, faster, and more helpful on the path towards universal healthcare. And who knows? India's progress in this area might inspire other developing countries to follow suit. So, while there have been bumps in the road, the future of healthcare in India looks promising.

Dr. Vijayalakshmi