1. Human health… an indicator of good environment

2. Environment related diseases Communicable diseases: malaria, tuberculosis, dengue, chikungunya, kala azar, bird flu, swine flu, E.coli epidemic… Non communicable diseases: cancer, asthma, hypertension, cardiovascular diseases, Parkinson's disease, Alzheimer's disease…

3. Kala azar/ black fever/ leishmaniasis Second biggest killer in the world Symptoms include fever, enlarged spleen, enlarged liver and black pigmentation on the skin Caused by protozoa Leishmania donovani Vector is the sand fly Phlebotomus, thrives in warm, moist organic matter, such as mud walls, waste…

4. Kala azar patients at district hospital, Motihari, East Champaran

5. More patients

6. Japanese encephalitis/ brain fever Causes fever, affects the brain Viral disease, spread by a mosquito of genus Culex Pigs and birds are alternate host for the virus. Disease can be transmitted only from a pig to the human being

7. Pig rearing is common in Eastern Uttar Pradesh

8. A scene from the Baba Raghav Das Medical College - 2005

9. Chikungunya Chikungunya, a viral disease borne by the Aedes aegypti mosquito Causes fever and joint pains Mosquito breeds in small pools of clean water In 2006, the diseases re-emerged after 30 years of being dormant

10. Water shortage in Haveri district in Karnataka forces people to store it at home

11. Coconut husk and shells accumulate water and help breed mosquitoes

12. Polio Viral disease, caused by drinking water contaminated with faeces of an infected child The virus affects the central nervous system and leads to muscle weakness and paralysis Prevention through vaccine India has been polio free for an year

13. Vaccines are promoted to control this water borne disease

14. Silicosis and tuberculosis Occupational hazard - linked to mining In absence of proper equipment, people breathe in dust which injures the lungs and makes it easy for the TB bacterium to infect In silicosis, there is inflammation and scarring of lung tissue to forms lesions

15. TB treatment is long, needs to be supplemented with good nutrition

16. Exposure to silica dust at work place causes silicosis. Disease often misdiagnosed as TB

17. Arsenic poisoning Caused by high levels of arsenic in drinking water The toxin is present in the rocks and is released when the rock comes in contact with air (as in case of deep bore wells) Affects the skin, lungs…

18. Skin lesions are the first sign of arsenic poisoning

19. Cancer Linked to a variety of environmental toxins Causes mutations in the host cells Cigarette smoke was the first chemical to be linked to lung cancer Food additives like aspartame is linked to cancer in lab animals Recently, WHO has classified diesel as a carcinogen Pesticides – enough evidence

20. Pesticides are used extensively in agriculture

21. Vehicular emissions have carcinogens

22. Obesity The food that you eat forms your environment Obesogens in food can make you fat – Pesticides – Food additives like high fructose sugar, ajinomoto – Medicines – Persistant organic pollutants

23. Junk food epidemic

24. Toxins at home

26. How do we deal with these diseases The health system is unequipped – State subject – The centre runs only some crucial programs like that for immunization of children. The National Rural Health Mission is also implemented by the centre – In absence of a strong public health system, private players are raking in money

27. Clean up the environment? Collaboration with different ministries – Clean air (Ministry of Environment and Forest) – Reduction in use of pesticides (Ministry of Agriculture, Mministry of Chemicals and Fertilizers) – Clean food (Ministry of Food Processing Industries) – Sanitation (Ministries of urban and rural development)

28. Too many business interests for this to happen