Wednesday, February 20, 2019

Nida, a success story: Addressing social determinants of health to improve health equity

Nida came to us, at Samir Malik Heart Care Foundation Fund, in 2014, with complaints of breathlessness on exertion. She was born with an atrial septal defect (ASD), which had been diagnosed four years back during a routine health checkup in school. Her parents took her to a hospital, where she was advised open heart surgery to correct the condition at an estimated cost of around Rs 1.5 lakh. Her father, a welder, was the sole earning member of his family, which had six dependent family members. He had no insurance cover, ESI or CGHS. So, clearly, he could not afford the surgery.

He was then referred to us by the doctor who had first diagnosed the child.

When Nida came to us in 2014, she was 9 years old; after reviewing her condition, the Samir Malik Heart Care Foundation Fund decided to adopt her. In September 2014, she underwent ASD device closure by Dr Smita Mishra through the fund. An open heart surgery was avoided. 

Since then, Nida has been regularly coming to us for follow up care.

She is now 14 years old and a student of class 9. She has friends and participates enthusiastically in all school extracurricular activities – drawing, poem recitations etc.; she enjoys sports like Kho Kho, Kabaddi and above all, she is doing very well academically.

Nida is another success story of the Samir Malik Heart Care Foundation Fund.

Using the device closure method avoided the trauma of open heart surgery, a more invasive procedure, to correct the congenital heart defect. It also meant a shorter hospital stay, quicker recovery. Undergoing the device closure also helped to remove the social stigma of living with a scar on the chest. 

Social gradient has been identified as one of the 10 social determinants of health. The others are: Stress, early life, social exclusion, work, unemployment, social support, addiction, food and transport. Social gradient means “people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged”. 

Social gradient needs to be addressed to eliminate the inequalities in health in the society.

To see Nida as a healthy and active child today only helps us to stay committed to our cause, which is to provide assistance to needy heart patients, young and old, so that they can live a healthy and productive life – “no person should die of a heart disease just because he/she cannot afford treatment”. 

Since it was first established in 2014, the Fund has successfully sponsored 279 heart surgeries such as valvular heart surgery, pacemaker implantation, surgeries for congenital heart diseases, bypass surgery and stents. It has also helped more than 1788 patients, both children and adults.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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