to be made aware to be more responsible towards their childrens health. The other issue is of pollutionthe fumes and dust in the air which children breathe. These particles will aggravate pneumonia causing bacteria and virus if they are around. Overcrowding allows pathogens to spread rapidly, especially when ventilation is inadequate and sanitation is poor. There is a need of a lot of awareness in mothers about picking up pneumonia at an early stage. Professor (Dr) Rama Kant, an eminent surgeon and former Head of the Department of Surgery at Chhatrapati Shahuji Maharaj Medical University (erstwhile King Georges Medical College), Lucknow is passionately involved with social and public health issues. He is a recipient of the World Health Organization (WHO) DirectorGenerals Award for his contribution in tobacco control (2005) and is the Presidentelect of Association of Surgeons of India (ASI). He firmly believes that tobacco consumption is playing havoc with the lives of children as well as adults. According to him, There is an already established link between smoking and poverty. So children living in hutments and slums are more affected by the pollution of tobacco smoke which contains over 4000 chemicals, many of which are not only carcinogenic, but also reduce the childs immunity. These children are already malnourished, and deprived of proper ventilation and sunlight. On top of this, right from the time they are inside the mothers womb, they are exposed to the hazards of tobacco smoke, thus making them easy targets for pneumonia. In the opinion of Prof (Dr) Rama Kant, An important and worthwhile intervention is that facilities for tobacco cessation should be made available to people who are ready to quit smoking. Thanks to the efforts made by the government and NGOs, people are now more aware about the health hazards of tobacco. But they do not know where to go as facilities for tobacco cessation are very meagre in our country. Unless we have continuously available cessation facilities that can help people quit, many of the tobacco control efforts will go waste. The WHO did start such clinics, but gradually they are closing down due to paucity of funds and government indifference to manage them. So I want to emphasize two things people need to be aware that smoking should be controlled and never done inside homes, and secondly, cessation facilities will go a long way in preventing children from suffering from pneumonia related deaths. We have a jumbo system of public health system consisting of a large number of doctors, paramedics and other staff. But their services are underutilised, especially in the rural areas. So cessation facilities can be integrated with and piggy back on the existing public healthcare services. Dr Ajay Misra also agrees that Tobacco smoke is a major cause of respiratory diseases in India and is associated with pneumonia in adults. Second hand smoke does affect the childrens lungs, and reduces their immunity, making them more vulnerable to pneumonia. In order to reduce mortality from pneumonia, it is important to educate the public about prevention strategiesgood diet, proper cleanliness and a good environment. Improvements in health care, nutrition and the environment are interventions that can significantly reduce the incidence of childhood pneumonia. Access to cleaner fuels for cooking and heating can drastically improve the situation. In India, the national biomass cook stoves initiative launched in 2009, targets to distribute low
2|B r ea the I n Cl ea n Air To Ge t Rid Of Pn eum o nia
emission stoves in rural areas, and make them accessible to 87% of Indian households over the next 10 years, resulting in 240,000 fewer deaths from ARIs in children. Improving ventilation in houses and enforcing tobacco control policies, so that there is no second hand smoke in the house, will go a long way in preventing childhood pneumonia.
This article is part of a Citizen News Service (CNS) series in lead up to the World Pneumonia Day, 12 November 2011. The project was managed by Abhinav Bharat Foundation and funded by the 2011 Small Grants for World Pneumonia Day Advocacy Program. We are grateful to the International Vaccine Access Center (IVAC), John Hopkins Bloomberg School of Public Health, GAVI Alliance, Global Alliance for Clean Stoves, and Best Shot Foundation for their support. We would like to thank all those who were interviewed as part of this project and who took the time to share their views.
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