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CORE ISSUE

India, the world’s largest democracy, has a very diverse population, geography, and climate. It is the world’s second most populous country having more than 1.21 billion population, and the world’s seventh largest country in area. As the population keeps increasing the government machinery for health care is unable to cope with the rapidly expanding demands placed on health care. The quality of medical care also varies considerably and it becomes a great challenge to provide adequate tertiary medical care to everyone.

Congenital heart disease is primarily seen in the newborn, infants and children. But in our country it’s not uncommon to see uncorrected congenital heart disease in adults. The burden of congenital heart disease in India is enormous because of the very high birth rate. The reported incidence is 8 – 10/ 1000 live births. Nearly a third to half of these are critical requiring intervention in the first year of life itself. Unfortunately majority of children born in India and afflicted with congenital heart disease do not get the necessary care leading to high morbidity and mortality. Going by a crude birth rate of 27 per 1000 population the total births per year in India is estimated at 28 million per year, if we apply an 8/1000 incidence of CHD, nearly 180,000 children are born per year with congenital heart disease per year. Of these 60 to 90000 suffer from critical CHD requiring early intervention. Approximately 10% of present infant mortality may be accounted by CHD alone. In this way a large no of children are added every year to the total pool of cases with CHD. We also have a large no of adult patients with CHD primarily because of lack of health awareness and inadequate health care facilities.

We may find it hard to imagine how much these children and their parents suffer. There are lots of socio economic factors that prevent them from reaching for better and timely treatment of these diseases. Realizing their desperate situation many parents choose to lose their beloved ones in front of their eyes, which is so heartbreaking.

Cause of problem

The scientific investigations bring to light a number of factors that forces the innocent children to be victims of congenital heart disease

The prominent among them are :

  • Maternal malnutrition during pregnancy
  • Maternal illness during pregnancy
  • Genetic transmission because of consanguinity
  • Older parent
  • Teratogenic (drugs that can cause abnormal development of the foetus) medication during pregnancy

Intensity of the problem

Recent Health Data indicates that the incidence of heart disease is increasing rapidly that soon it may reach epidemic proportions. It has emerged as the number one killer in both urban and rural areas of the country.

Given below are some of the revelations in this context

  • Over 1.4 million Indians need critical heart surgery annually. Currently about 55,000 surgeries are done, largely because the rest cannot afford it. They die a slow painful death.
  • More than 1,50,000 children are born with congenital heart disease. Only about 25,000 manage to get treated mostly with sponsorships and government aid.
  • Incidence of valvular heart disease requiring surgery is as much as CHD. But very few get the surgery done because of the high cost increased further by the phenomenally high cost of the artificial heart valves.

Our experience has brought to light that many such cases drop in to the hospital and leave sadly accepting the fate and to depend on prayers. The sad aspect is that many have not even come to hospitals because of economic crisis and succumb to slow death. The fact is that many are innocent kids. The situation demands our intervention in whatever way possible to save these lives and bring smiles on the faces of the innocents.

 
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