PROJECT PREPARED

By

Dr. PS. Prasad, MD,MPH,Ph.D.

Institute of Public Health

Professor of Sports Medicine &

(EOHS)Occupational Medicine and

Public Health and Preventive Medicine

Public Health meaning is Peoples Health in the community. This focus is overall Health of the Population.

Health is Wealth, Prevention is the best cure. Every person want to be Healthy and not to get sick. Living Healthy is the Boon to that person but the irregular life styles makes one to get sick. Wellness centers and the Life style change are the main concepts for better health now all over the world. This unique project clubbed with Medical Tourism is the best bet for the present health care where the cost of Health care is sky rocketing.

Countries like India with 1.26 billion population is not having a single full pledged Public Health Institute but countries like USA  with far lesser population{( 350 million( 35 crores)} have more than Ten Public Health schools.

The time between in any person’s life who gets up early morning and  Going to bed in the night is considered his/her Life style.  In this Life style we have sleep, we have body movements, Exercise, Diet, Hygiene, Thinking positive, Day to day organized work, maintain the stress, Relaxation, Meditation, Yoga Exercises etc. have tremendous impact on individuals Health.

Public Health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, communities, individuals day to day public and private conditions. Public health is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of a couple of continents. There are two distinct characteristics of public health. One deals with preventive rather than curative aspects of health and the second one deals with populations rather than individuals. The subfields of public health are environmental, social, behavioral and communicable diseases, Health related hygiene, preventive medicine. Preventive cardiology, occupational health amongst others are also included in the public health domain (see the sub components below).

Preventive Medicine is the important medical discipline whichfocuses on preventing diseasesandpromotingageneral state of health and well-being. Preventive medicine is a board specialty, meaning that physicians can focus on preventive medicine while they get their medical degree and use the skills they learn in school to reduce the outbreak of disease epidemics, to improve public health, and to increase the general quality of life for individuals all over the world. In the western world, preventive medicine is practiced as an arm of public health and is applied to the whole population, while in eastern medicine many doctors currently practice individual preventive medicine. Individual western doctors are sometimes criticized for not practicing preventive medicine on a patient by patient basis, because insurance companies often feel that it is too expensive and time consuming and it will not compensate doctors for preventive measures. As the cost of health care is sky-rocketing in USA, many hospitals are now focusing to adopt preventive measures by using alternate medicine as well as lifestyle change counseling.

Lifestyle change.Another aspect of public health improvement is the lifestyle change and wellness forhealthy living which is directly proportional to the establishing and practice of preventive medicine. Lifestyle change not only is mandatory to prevent the one disease but a series of diseases which will be altered by changing the lifestyle.

Swachh Bharath. This presentation would not be complete without discussinghygiene, vaccinationplans, lifestyle change and the need of wellness centers which are the backbone of preventive care.The Honorable Prime Minister of India Sri Narendra B. Modiji correctly called for Swachh Bharath plan which is nothing but the hygiene part of health what we are practicing since past

many years. But in public Health there are other important items as fitness and nutrition which are too often ignored by the population. Awareness in these disciplines is very important from the public health point of view. Hygiene is simply called cleanliness, though we simply call cleanliness the procedures adopted and maintained in various hygienic conditions which may vary and use lengthy procedures.. The supreme star cricketer SachinTedulkar played all his life (25 years) because of correct fitness and nutrition.

Public Health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society,  communities, individuals and public &  private organizations,. Public health is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people   or as large as all the inhabitants of several continents. There are two distinct characteristics of public health. One it deals with preventive rather than curative aspects of health and the second one it deals with population rather than individuals. The subfields of Public Health are Environmental, social, behavioral, , Communicable diseases, Health related Hygiene, preventive Medicine, Preventive Cardiology, Occupational health etc.etc  also included in the public Health. ( See the sub components below)

Preventive Medicine, is a medical discipline which focuses on preventing diseases and promoting a general state of health and well being. Preventive medicine  is considered to be a board specialty, meaning that physicians can focus on preventive medicine while they get their medical degree, and use the skills they learn in school to reduce the outbreak of disease epidemics, improve public health, and increase the general quality of life for individuals all over the world. In the West, preventive medicine is practiced as an arm of public health, and is applied to the whole population, while in Eastern medicine, many doctors practice individual preventive medicine. Individual Western doctors are sometimes criticized for not practicing preventive medicine on a patient by patient basis, because insurance companies often feel that it is too expensive and time consuming, and will not compensate doctors for preventive measures.  As the cost of Health care is sky rocketing in India and many western countries and in  USA many Hospitals are now focusing to adopt Preventive measures by using alternate medicine as well as Life style change.

Another aspect of Public Health improvement and is the Life style change and wellness for Healthy living which is directly proportional to preventive medicine. Life style change not only to prevent the disease but Many disease will be altered by changing the life style. 

This presentation is not completed without discussing Hygiene, Vaccination and Life style change and wellness centers which are the back bone for preventive care.  The Honorable prime minister Sri. NarendraBhaiModiji Called for Swachh Bharath which is nothing but of Hygiene part of Health, but in public Health the other important items are Fitness and Nutrition what should be ignored by the population. Awareness in these disciplines is very important in public Health point.  Hygiene is simply called  cleanliness, though we simply call it cleanliness the procedures adopted and maintained in various Hygienic-conditions vary and having lengthy procedures(Dental and Industrial Hygiene).

Our Honorable Chief minister Sri. Nara Chandra Babu Naidu Garu walked nearly 3000 kilometers at the age of sixty four because of his Life style and in-turn he is in perfect fitted Health. The supreme Star Cricketer SachinTedulkar played all his life ( 25 years) because of fitness and Nutrition.

Since a decade I am asking AP Government to commence School of Public Health and its importance in the Health of the population particularly Rural Poor who cannot afford costly corporate Health care.

Middle class persons admitted into corporate Hospitals and by the time he/she discharges they become poor(corporate Hospital charges are sky rocketing in India).

My Discussions with the Present proponents in Hyderabad in the last three months scored mileage &movementum.   In this Regard I have invited two eminent scientists to India, Professor Heresh , California, USA and the second one is Professor Staderini M. Enrico  from Switzerland.

These two Scientists gave presentations on two different subjects where India is not yet started. The first one is Telemedicine (Part of Public Health) presentation by Professor Staderini

The second Presentation was given by Professor Ved about BIOCURIOUS PROJECT. This was appreciated by one and all that attended the presentation.

The Public Health is the great Subject to Provide the Health care with Minimum cost. This is more beneficial to the Poorer Population in the rural areas where India’s 75% of the population is living in Rural villages.

TO START THE SCHOOL OF PUBLIC HEALTH MCI PERMISSION IS NOT NECESSARY.

The School of Public Health Focus  on the following:

1. About preventive care(  Primary, secondary and tertiary care)
2. Academics
3. Research

The above three major components are addressed below.

As mentioned above Prevention is the best cure.  In this prevention measures we have three subsections, one is Fitness, Second one is Nutrition and Balanced Diet, third one is the Hygiene(Swatch Bharath what Our prime minister is Calling for the country).

These sub components are addressed in the academics as part of the course Curriculum.

Preventive Health care (alternately preventive medicine or prophylaxis) consists of measures taken for disease prevention, as opposed to disease treatment. Just as health encompasses a variety of physical and mental states, so do disease and disability, which are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primary, secondary, and tertiary prevention.

Each year, millions of people die preventable deaths. A 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. In India we didn’t have any statistics? Leading causes included cardiovascular disease, chronic respiratory disease, unintentional injuries, diabetes, and certain infectious diseases. This same study estimates that 400,000 people die each year in the United States due to poor diet and a sedentary lifestyle. According to estimates made by the World Health Organization (WHO), about 55 million people died worldwide in 2011, two thirds of this group from non-communicable diseases, including cancer, diabetes, and chronic cardiovascular and lung diseases. This is an increase from the year 2000, during which 60% of deaths were attributed to these diseases. Preventive healthcare is especially important given the worldwide rise in prevalence of chronic diseases and deaths from these diseases. There are many methods to prevention of disease. It is recommended that adults and children aim to visit their doctor for regular check-ups, even if they feel healthy, to perform disease screening, identify risk factors for disease, discuss tips for a healthy and balanced lifestyle, stay up to date with immunizations and boosters, and maintain a good relationship with a healthcare provider Some common disease screenings include checking for hypertension (high blood pressure), hyperglycemia (high blood sugar, a risk factor for diabetes mellitus), hypercholesterolemia (high blood cholesterol), screening for colon cancer, depression, HIV and other common types of sexually transmitted disease such as chlamydia, syphilis, and gonorrhea, mammography (to screen for breast cancer), colorectal cancer screening, a pap test (to check for cervical cancer), and screening for osteoporosis. Genetic testing can also be performed to screen for mutations that cause genetic disorders or predisposition to certain diseases such as breast or ovarian cancer. However, these measures are not affordable for every individual and the cost effectiveness of preventive healthcare is still a topic of debate.

The following programs should be conducted

1. Bio Statistics– Not many Bio statisticians in the country(India) but each discipline in the Health care sector needs Bio Statistical analysis .
2. Epidemiology: In my opinion India need more Epidemiologists to do studies in communicable and tropical diseases, without this study it is practically impossible to control the disease patron.
3. Health promotion and Health Education : will play great role in educating the rural population and younger generation . It is the great subject where the society in general will get benefitted.  The Telugu Desam Founder NTRamaRaogaru tried to this through his then Health  secretary Sri. P.L. Sanjeeva Reddy IAS, but they failed as the State have no School of Public health.
4. Women and Child Health: This is very important for the Inda as there are so many mortalities in the
5. Global Health: As the entire world is a global village now and the travel from one part of the globe to another part is easy and as a result the disease carrying also very possible ( example Ebola Virus disease, Swine Flue, Bird Flue etc.)
6. Health Behavior and Modification: This is the key subject particularly for addictions. Our Honorable Prime minister asked to write to him how to control the addictions. Addictions of Cigarette smoking, Alcohol, Illegal drugs, Dope in the Athletes, Gambling also an addiction.
7. Environmental Health and its Impacts on Human Health: A great subject have no boundaries. The diseases of Air pollution, Indoor air pollution, Radon Gas, molds, Water Pollution, and solid waste hazards are few to address. To add more to this Ozone and its impact on human Health, ozone hole, Tsunami related Health Hazards, Recent HUD -HUD cyclone, Recent gas leaks from the fertilizer companies and ONGC  gas leak accidents, are the major hazards to address
8. Medical jurisprudence or legal medicine (Health Criminology.) is the branch of science and medicine involving the study and application of scientific and medical knowledge to legal problems, such as inquests, and in the field of law.^[1] As modern medicine is a legal creation, regulated by the state, and medico legal cases involving death, rape, paternity, etc. require a medical practitioner to produce evidence and appear as an expert witness, these two fields have traditionally been interdependent.^[2]
9. Forensic medicine, which includes forensic pathology, is a narrower field that involves collection and analysis of medical evidence (samples) to produce objective information for use in the legal system.
10. Sports Science and Applied Medicine, – what we have now at  JNTUK, as MS,PG
11. Environmental Occupational Health, –   what we have now at JNTUK as MS PG
12. Industrial Hygiene  to be added to this School of Public Health. This discipline is totally lacking in India

Research:Bio Curious Project- This is completely the Health Research: Health Research is very slim in India. My aim is to produce 100 scientists in the next five years with International reputation.  The Research in the Indian Universities are very poor compared to the Western countries and the USA Universities.  Because of the Research and in turn invention & Innovation the USA Universities are remarkable and giving the leading role to their country where we failed in India.

These above mentioned courses are very important for Health care Developments in India.

Who will Join: The students who fail to get MD, MS seats will come and join.  The degree offering is MPH, Masters in Public Health, a Two year or four semester program with 85 credit hours.

Job for Graduates:Where is the job Market: In India ? WHO projects  all over the world need these graduates.( The pay will be U$D 60,00 to 80,000 per year.)

 At Present most of these jobs are taken by USA and Western countries graduates. African countries and Asian countries have many job opportunities. In this discipline.In India itself we can create 100,000 jobs in the health care.

Apart from the above there are several opportunities for this School of Public Health to do international projects by associating with many western institution .

In India average life expectancy for both sexes have shown significant improvement from 2000 to 2012.  In 2000 average life expectancy was 62.5 where in it 53.5 years are healthy life expectancy at birth for both the sexes. The male healthy life expectancy shows that 52.7 from the average life expectancy of 61.7 years and female healthy life expectancy shows that 54.4 from the average life expectancy of 63.4 years. In 2012 average life expectancy was 67.3 where in it 58.3 years are healthy life expectancy at  birth for both the sexes. The male healthy life expectancy shows that 56.9 from the average life expectancy of 65.9 years and female healthy life expectancy shows that 59.7 from the average life expectancy of 68.7 years.

The United Nations Millennium Declaration, signed in September 2000, commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women. The Millennium Development Goals (MDGs) are derived from this Declaration. Each MDG has targets set for 2015 and indicators to monitor progress from 1990 levels. Some of these are indicated in the India’s: WHO statistical profile.

• The under-five mortality is the probability (expressed as a rate per 1000 live births) that a child born in a specific year or time period will die before reaching the age of five, subject to current age specific mortality rates. It is expressed as a rate per 1,000 live births. Since 1990 a rapid decline was seen in the U5MR and from an estimated level of 126 in 1990, it fell to a level of 53 in 2013.

• The MMR in India has dropped from 560 per 100,000 live births in the period 1990-13 to 190 per 100,000 live births .
• HIV related deaths accounted by 10.5 in 2000, and it was increased to 10.9 in 2012 (per 100 000 population) 
• Deaths due to malaria during the period 2000-2012 have fallen by 3.5 to 2.3.
•  Deaths due to tuberculosis among HIV-negative people (per 100 000 population) was also declined from 39 to 19 during the period 2000-2013.

Utilisation of health services*

India has utilized health Services very effectively. It is indicating that 92 to 100 percentage services are utilized in the country as set by the WHO in various categories like Contraceptive,Antenatal care(4+ visits prevalence) , Births attended by skilled health personnel, Measles immunization(1-yr-olds) , Smear-positive TB treatment-success

According to the 2008 data adult risk factors raised blood glucose for the age group of 25  and above it shows that 11.1% in male and 10.8 % in female., where as WHO region was 9.9 in men 9.8 % in female.

Raised blood pressure for the age group of 25 and above it was 23.1% in male and 22.6% in female. The WHO region was 25.4% in male and 24.2% in female.

Obesity for the age group of 20 and above shows that 1.3% in male and 2.5% in female. WHO region was 1.7 in male and 3.7 in female.

Tobacco usage from the age of 15 onwards, it was 25% in male and 4% in female. WHO region it was 34% in male and 4% in female.

Use of improved drinking water and sanitation as per the MDG target in 2015, and percentage point change from 1990 to 2015.

WHO-STAT

There are many leading causes of deaths in India, and Ischaemic heart disease was the top killer that has affected both urban and rural population. Ischaemic heart disease deaths account for 12.4% of total deaths in the country.

Deaths due to Stroke (9%), Self-harm (2.6%), Falls (2.6%), Road injury (2.4%) are increased from 2000-2012

Deaths due to Diarrhoeal diseases (6%), Lower respiratory infections (4.9%) are declined from 2000-2012.

Deaths due to Preterm birth complications (3.9%), Tuberculosis (2.7%) are moving constantly.

Death by broad cause group:

Cardiovascular diseases and diabetes , Chronic respiratory disease are the leading causes of death, followed by other infectious diseases, other NCDs, Maternal, neonatal, nutritional, Acute respiratory infection, Cancer and Unintentional injuries. HIV/AIDS,TB,malaria,Suicide, homicide and conflict are the ninth  and tenth most common causes of death respectively.

NATUROPATHY AS APPLIED PUBLIC HEALTH:

Another latest trend of Public Health is Yoga, Meditation and Naturopathy which are playing great role in the Health of each individual person.  The best cleaning mechanism of human system is the Naturopath and its related treatments which are now included in the Public Health syllabi.

Naturopathic medicine is a distinct system of primary health care  WHICH IS THE PART OF PUBLIC HEALTH that emphasizes prevention and the self-healing process through the use of natural therapies.  It is an ancient and traditional science which integrates the physical, mental, and spiritual aspects of our natural constitution.

The main principles of Naturopathy are astounding. First, the reasons and remedies of all diseases are the same; ailments develop due to the presence of intoxicants which are removed. Second, the intoxicants cause diseases, which may be weaken immune system and giving bacteria and viruses invade which damage more. Third, nature itself is the best ‘doctor’, the patient is cured, not the ailment.

The principal aim of Naturopathy is to teach people the art of healthy living by changing their daily routine and habits—this not only cures the disease but makes the bodies strong and glowing. 

There are four classifications: food, mud, water and massage therapies. In food therapy, the idea is to consume what we eat in its natural form as much as possible as it is by itself a medicine.

This mainly includes fresh fruit, fresh leafy green vegetables, and sprouts; and there are different combinations of purifying, strengthening, or pacifying foods. These must be consumed in the correct proportion, and the stomach left a little empty. To extract intoxicants from the body, both mud baths and mud packs are used, particularly for ailments such as high blood pressure, tension headaches, anxiety, constipation, plus gastric and skin disorders. There are several main types of water therapy using clean fresh and cool water; and after this type of a treatment, the body feels refreshed and energized. The methods we use have efficacious results for a wide variety of ailments a hip bath improves the efficiency of the liver, large intestine, stomach, and kidneys a full steam bath opens the skin’s pores drawing out harmful intoxicants; a hot foot bath helps with asthma,

knee pain, headache, sleeplessness, and menstrual irregularities in addition, there is a full body water massage, a spine bath, hot and cold wraps, and enemas, all of these to get rid of the toxins we do not  want.

Finally there is a massage therapy which increases the blood flow, removing stiffness, weariness, and pain from muscles and this can work in conjunction with some of the other naturopathic therapies. 

YOGA

Yoga is a discipline to improve or develop one’s inherent power in a balanced manner. It offers the means to attain complete self-realization. Yoga can therefore be defined as a means of uniting the individual spirit with the universal spirit of God. According to Maharishi Patanjali, Yoga is the suppression of modifications of the mind.

SALIENT FEATURES OF YOGA:

All paths of Yoga (Japa, Karma, and Bhakti etc.) have healing potential to shelter out the effects of pains. However, one especially needs proper guidance from an accomplished exponent, who has already treaded the same track to reach the ultimate goal.

TYPES OF YOGA:

Japa Yoga

To concentrate one’s mind on divine name or holy syllable, mantra etc. like ’OM’, ‘Rama’, ’Allah’, ’God’, Guru’ etc. through repeated recitation or remembrance.

Karma Yoga

In this sadhana, a Yogi considers his duty as divine action, perform it with whole-hearted dedication but shuns away all desires.

Gyana Yoga

Teaches us to discriminate between self and non-self and to acquire the knowledge of one’s spiritual entity through the study of scriptures, company of Saints and practices of meditation

Bhakti Yoga

Bhakti Yoga, a system of intense devotion with emphasis on complete surrender to divine will. The true follower of Bhakti Yoga is free from egoism remains humble and unaffected by the dualities of the world.

Raja Yoga

Raja Yoga popularly known as “Ashtanga Yoga” is for all-round development of human beings. These are Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana and Samadhi.

Swara Yoga

Swara Yoga is the Science which is about the realization of cosmic consciousness, through the awareness/ observation then control/ manipulation of the flow of breath in the nostrils. Swara Yoga involves the systematic study of the breath flowing through the nostril (or Swara) in relation to the prevailing phases of the Sun, Moon, time of day and direction. It is the association of the breath in relation to the activities or phases or positions of the Sun, Moon, Planets, Seasons, Time of day, with the physical and mental conditions of the individual and then taking the appropriate action according to these subtle relations.

Kundalini

Kundalini Yoga is a part of Tantric Tradition. Since the dawn of creation, the Tantrics and yogis have realised that in this physical body, there is a potential force residing in Muladhara Chakra, the first of seven Chakras. The seat of Kundalini is a small gland at the base of the spinal cord. In the masculine body it is in the perineum between the urinary and excretory organs. In the female body its location is at the root of the uterus in the cervix. Those people who have awakened this supernatural force have been called Rishis, Prophets, Yogis, Siddhas and other names according to the time, tradition and culture.

To awaken the Kundalini, you must prepare yourself through yogic techniques such as Shatkriya, Asana, Pranayama, Bandha, Mudra and Meditation. Awakening of Kundalini results in an explosion in the brain as the dormant or sleeping areas start blossoming like flowers.

Nadi As described by Yogic texts, Nadis are flow of energy which we can visualize at the psychic level as having distinct channels, light, colour, sound and other characteristics. The entire network of nadis is so vast that even yogic texts differ in their calculations of the exact number. Reference in the GorakshaSataka or GorakshSamhita and Hatha Yoga Pradipika place their number at 72,000; emerged from the navel center- the Manipuri Chakra. Of all the thousands of nadis, Susumna is said to be the most important. The Shiva Swarodaya enumerates ten major nadis which connect to the ‘doorways’ leading in .

Wellness Centers in Public Health:

• Health is the real Wealth
• Prevention is the better than cure was the old saying
• But the new dictum is PREVENTION IS THE BEST CURE.

As there are several definitions of Health given by various countries and organizations like WHO, CDC,NIHetc.but the simple definition of Health I have invented from my experience is

“ Fitness, Nutrition with Balance diet, Hygiene, and Spirituality” Constitutes best Health for any person.

Keeping the above philosophies in Health I developed new concept which is beneficial to the Indian Population, particularly to the rural and tribal Indian population.The new concept of  Health in the 21^st century is Fitness, Nutrition and Balanced diet associated with Hygiene is called the real Health. Once these parameters are added with Spirituality the

true Health is achieved. As the cost of Health care skyrocketing every day, it is better to have complete curative system which is nothing but of integrated approach(combination of different approaches  to get good health).

It is practically impossible to any government to provide the corporate level high-tech medicine to all the 75% rural population in India. Therefore a better method, a curative method, a rejuvenating method and a fully keeping fit procedure and preventing many health care problems come into the picture what I Call“Integrated Health and Medicine” or Alternative Medicine or Complimentary Medicine. In My approach I am not neglecting the Conventional Medicine which is used for Medical Emergencies. Therefore I am fulfilling the American Cancer societies’ approach.

Medical disciplines that integrates the therapies from all the Medicines of Health care with those practiced by mainstream medical practitioners.Any therapy that is typically excluded by conventional medicine, and those patients use instead of conventional medicine, is known as “Alternative Medicine.” It’s a catch-all term that includes hundreds of old and new practices ranging from Ayurvedic Medicine to Homeopathy to Naturopathy to iridology ( Eyes are the windows of  the Mind). Generally Alternative therapies are closer to nature, cheaper and less invasive than conventional therapies, although there are exceptions. Some alternative therapies are scientifically validated, some are not. An alternative medicine practice that is used in conjunction with a conventional one is known as a “complementary” medicine. Example: using ginger syrup to prevent nausea during chemotherapy. Together, complementary and alternative medicines are often referred to by the acronym CAM.

Integrative Medicine as defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine “combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.”

In other words, integrative medicine “cherry picks” the very best, scientifically validated therapies from both conventional and CAM systems. In his New York Times review of Dr. Weil’s latest book, “Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being,” Abraham Verghese, M.D., summed up this orientation well, stating that Dr. Weil, “doesn’t seem wedded to a particular dogma, Western or Eastern, only to the get-the-patient-better philosophy.”

So this is a basic definition of integrative medicine. What follows is the complete one, which serves to guide both Dr. Weil’s work and that of integrative medicine physicians and teachers around the world:

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

The principles of IntegratedMedicine (IM):

• A partnership between patient and practitioner in the healing process

• Appropriate use of conventional and alternative methods to facilitate the body’s innate healing response
• Consideration of all factors that influence health, wellness and disease, including mind, spirit and community as well as body
• A philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically
• Recognition that good medicine should be based in good science, be inquiry driven, and be open to new paradigms
• Use of natural, effective, less-invasive interventions whenever possible
• Use of the broader concepts of promotion of health and the prevention of illness as well as the treatment of disease
• Training of practitioners to be models of health and healing, committed to the process of self-exploration and self-development

IM combines mainstream medical therapies with non-conventional complementary therapies. However, IM only uses complementary therapies for which there is some high-quality scientific evidence of safety and effectiveness. In short, IM utilizes all appropriate, evidence-based therapies to achieve health.

This common sense but scientifically rooted concept is catching on with the American public, who now partner with their family physicians to include evidence-based, non-conventional treatments (IM) in their healthcare regimes. Practice of IM has become so credible that the American Hospital Association states that more than 16% of hospitals, including leading medical facilities at Harvard, Mayo, and Duke, feature IM centers as part of their institutions. Among hospitals not currently offering IM, 24% stated that they planned to do so in the future.

So are there distinct differences between this “new medicine” (IM) and its forerunners, alternative or complementary medicine?

Yes. The National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine (CAM) as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.” While some scientific evidence exists regarding some complementary and alternative therapies, many still require well-designed scientific studies to definitively answer questions about safety and efficacy.

NCCAM also offers the following key difference between complementary and alternative medicine:

• Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.
• Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient’s discomfort following surgery.

So although IM utilizes complementary therapies, the stringent requirement that these treatments have a solid scientific basis exists, making it “once removed” from complementary or alternative systems. However, many practitioners and patients look forward to the day when the practice of using all evidence-based methods becomes commonplace and the IM designation is no longer required.

It’s also important to note that IM, like most healthcare systems, is more than simply a list of treatments or therapies. IM values all aspects of a person’s health – mind, body, and spirit – and reaffirms the importance of an open relationship between practitioner and patient. Those who practice IM consider a patient’s overall satisfaction with life, pointing to irrefutable proof that stress management and good mental hygiene positively affect healing and health. Finally, instead of focusing solely on curing disease and illness, IM also emphasizes preventing disease and/or living well with chronic disease.

Integrated Health and Medicine is an art of different disciplines incorporated to fulfill the need of the patients for a successful relief, cure and well being of an individual. This new concept of different disciplines of Health measures what are available are incorporated what we call an ALTERNATE MEDICINE. As conventional Medicine is used widely in the present world and its stoppage limiting to cure for some diseases and the sufferers are looking for alternative avenues where Alternative Medicine or (complimentary) Medicine emerged into the present world. Alternative Medicine emphasis that disease is due to the result of physical, emotional, spiritual, social and environmental imbalance and should be corrected to attain the final result what we call THE CURE.This integrated Medical disciplines are now widely used in the present world.  40% of the world population is looking into these disciplines after the limited result achieved by the conventional ( allopathic) medicine.

Disciplines of Integrated Health and Medicine has its roots in several ancient healing traditions that stress healthy living and being in harmony with nature. In this aspect this sounds like Holistic medicine but the concept may look same but the approach of treatment modalities are different. In this Alternative or Integrated Health system the above said Fitness, Nutrition and Hygiene with Health education and Promotion are focused mainly and lacking in Holistic Medicine.  In the Holistic approach like the conventional medicineit is costly matter for the person who is suffering in length as well as burden on the Government, family and the insurance companies.  The main idea of introducing the integrated Health is to Give better and quick cure as well as to Reduce the Health care cost.  More over the scientific evidence is more in Integrated Health system/Alternative medicine rather than Holistic approach.

Socrates promoted a different approach. Plato was another advocate of completeness, advising doctors to respect the relationship between mind and body. Hippocrates emphasized the body’s ability to heal itself and cautioned doctors not to interfere with that process. All these great persons are right when they Spoke in the BC(427, 460 and 467 BC.)  I am not debating the basic principles what they observed and worked in their epoch. From those olden days to now majority of science is changed and new Technologies are developed in Health care sector which is easing the identification of the disease process and at the same time the treatment part also changed for the betterment.

In spite of new methods applied in Medicine many disease are not completely cured because one discipline of Medicine is not able to cure all human suffering, whereone of the other discipline having the capability to cure that Particular disease.

In Integrated Health and Alternative medicine is THE COMBINATION OF HEALTH DISCIPLINES are incorporated what are totally different from Holistic Medicine.

The above two words appears similar but the difference may be recognized before one can look into Integrated Health.

• Alternative Medicine and Holistic Medicine look alike but not. 
• There are differences between the two entities.
• In-depth studies proved that these two disciplines are different by practice.
• In Holistic Fitness, Nutrition and Hygiene are not discussed.
• Holistic Medicine opposes Conventional Medicine, but Alternate Medicine utilizes conventional Medicine when ever needed and part of it.
• In Holistic Medicine the procedures varies from doctor to Doctor but in Alternative Method the procedures are almost same.
• In Alternative Medicine these three components, Fitness and Nutrition and Hygiene are mainly focused along with Therapy procedures, but in Holistic Medicine the procedures are different as by the Physician can think.
• Alternative Medicine is Practiced by qualified persons, but Holistic Practice is by Quakes without proper degree or with Fake Degrees.
• Alternative Medicine is not much bothered about spirituality and leave this to the discretion of the person but Holistic medicine is more spiritual approach than scientific.
• In Holistic majority treatments are not proved scientifically but in Alternative Medicine most of the proven treatments are established.
• In Holistic certain planned programs or methods are followed irrespective of the outcome because of this the cure rate is delayed or the final goal may not be reached, but in Integrated medicine if the response is not appropriate the direction of the treatment plan  is changed to another discipline without wasting time.
• Alternative medicine is more preventive and curative, but in Holistic preventive measures are zip to zero and  curative basis by applying medicine from the very beginning.
• In holistic approach is aimed at cure but outcome is uncertain, where in integrated system the outcome of cure is eminent.
• Dangers Often holistic healers will convince their patients to forgo proper medical care, usually combined with misrepresentations of studies or emotional appeals, to undergo holistic therapies. Since there is no valid evidence to support holistic therapies being capable of curing deadly ailments, this kind of malpractice is dangerous to offer patients.
• In some of the disciplines of Integrated Health  the treatments are not yet proven scientifically and this mission aim is to do research in such disciplines of particular cases. Though scientifically not commenced the proven work, but in practical these remedies proved. Such kind of one medication I have tested in US Lab and proven for HIV/AIDS, and further studies needed on human clinical trials.

In the Integrated System of Health Medicinal part comes in the latter stage than in the starting phase.   Human body have the capacity to RE JUVINATE once the system itself is allowed to remove the etiological factor or factors and restore the normal Physiological functions. As India touched 120 billion Population and most of them are living in the rural villages, so they have no proper Health care system as well as this population cannot afford the corporate hospital treatments.  The middle class Family person admitted in the corporate Hospital and once he/she came out of the hospital, the Middle class family turns to poor.  The corporate Hospital are increasing the price tag day after day and it is practically impossible for most of the families to afford once they are sick. In his Recent Speech his Excellency Governor of AP state Sri. Narshiman, commented about the charges collected by the Hospitals and the Doctors.

Fitness plays an important role in the Human Health. This truth everyone agrees but to implement this program in the schools, colleges and Universities there is no mandatory rule Therefore I urge the authorities and Law makers to make the Law that sport and game and in turn fitness should be make mandatory in all the educational institutions. President Dwight D. Eisenhower was the 34th president of the United States who made mandatory law for school physical fitness program immediately after he was elected president of USA in 1957. This kind of Legislation is needed in Indian school system that all our school going students are fit and having good Health. Fitness is the part of Health. But Unfortunately the Private schools are not caring physical fitness and limiting the students for their class rooms and grinding them for their institutional ratings.

Apart from the above my plan is to set up one Integrated Health centre in Each Mandal

( Population 50,000 ) with all the needed infrastructure.

This Health Scheme Have Few components given Below:

Disciplines of Alternative Medicine includes

1. Health Education and Health Promotion from the elementary schools to all the colleges
2.  Fitness programs, sporting activity and games
3. Balanced Diet and Nutrition.
4. Hygiene( personal and surrounding).
5. Allopathic Medicine for (Emergences, Trauma, accidents, surgeries etc.)
6. Naturopathy to detoxify the human system, Yoga, Meditation,
7. Ayurveda ( Pancha karma, and other medicines)
8. Homeopathy( Using medicines for certain proven diseases of cure but not for emergencies)
9. Unani ( medicines, same like above)
10. Acupuncture( For Immediate relief of pain)
11. Herbal supplements( medicines)for strength
12. Massage Therapy for better circulation.
13. Energy products consumed are to Enhance cell Energy.
14. Prevention is more focused here
15. Finally Women and child Health what is very poorly developed in the Rural India.

These above components all together form Integrated or Alternative Health Care system.

1. Land of Three acres
2. A Fitness centre with proper equipment.
3. A senior Citizen Home to accommodate 10 persons in each centre.
4. All the disciplines of Health Care are incorporated in this centre with needed infrastructure..( all 15 items written above).

Alternative medicine

In alternative medicine, it is believed that the spiritual aspect should also be taken into account when assessing a person’s overall well-being.

Some of the practices of alternative health include, but are not limited to:

Description

Few items focuses on how the physical, mental, emotional, and spiritual elements of the body are interconnected to maintain wellness,  When one part of the body or mind is not working properly, it is believed to affect the whole person, but what discipline of medicine should be adopted is not known before but This Integrated Health specifies the selection of the sub sect of the list mentioned in this presentation.  This approach differs from  Holistic approach in treatment point of view.

Overview

Available scientific evidence does not support claims that IM, when used without mainstream or conventional medicine, is effective in treating cancer or any other disease. However, many health professionals promote healthy lifestyle habits such as exercising, eating a nutritious diet, not smoking, and managing stress as important in maintaining good health. Alternative Medicine methods are becoming more common to adopt into the mainstream care and may be used as complementary therapy or preventive care.

In Mainstream Medicine, an Alternative approach generally means a more inclusive approach to a person’s health by Life style, one that includes the patient’s social and cultural situation as well as his or her illness. This term Alternative is used to reflect a focus on a person’s overall health, a focus that includes prevention, fitness, Nutrition, rehabilitation, and other approaches, rather than illness alone. Nurses, for example, may speak of the “bio-psychosocial sphere” of a patient. This means that a person’s health includes the mind, body, and spirit, as well as the surrounding culture and environment. This can include one’s family situation, housing, employment, insurance, and more, since these all have an impact on the patient and his or her health. If all these factors are taken into account when a person is treated for cancer, it may make treatment easier and improve chances of success.

How is it promoted for use?

Alternative medicine approaches health and disease from several angles. The approach suggests that a person should treat not only the illness but the whole self to reach a higher level of wellness. For example, practitioners may treat cancer by changing diet and behavior and adding social support groups and counseling. Others may suggest taking botanical supplements and using complementary therapies, such as art therapy, hypnosis, imagery, meditation, psychotherapy, spirituality and prayer, and yoga. These approaches can be used with conventional medical treatments such as chemotherapy, surgery, radiation therapy, and hormone therapy. Combining these different methods can help a person take control of his or her situation and attain a feeling of total wellness –Fitness, Nutrition, Cell energy enhancement, spiritually, and boosting Psychological strength.

Some supporters of holistic medicine claim, however, that conventional medicine does not work, and that only the holistic approach to cancer and other diseases is effective. In my opinion both are wrong and an Alternative measures and combination of an Alternative measures are focused.  They may offer a “cure” based on individual stories of success or personal experiences, which are very hard to prove. Some of the types of cancer that they claim can be cured by holistic methods include cancers of the bone, breast, tongue, liver, lung, throat, skin, testicle, prostate, ovary, uterus, stomach, intestine, colon, brain, pancreas, spleen, kidney, and bladder, as well as leukemia, lymphoma, and melanoma, but scientific evidence in this regards is slim.  I differed with conventional Medicine and Holistic approach and Introduced Alternative Medicine and Therapy where I got excellent improvement.(eg:Supra Teritorial Brain Atrophy?), Muscular Dystrophy etc.)

What does it involve?

The field of Alternative Medicine is very diverse and broad. Some providers define it looks like Holistic  as including emotional and spiritual care, but none of them are not in the reachable in the range of Alternative methods of treatment.while others focus on these aspects to the exclusion of the physical. There are many different techniques and approaches in holistic medicine, depending on the practitioner, the person, and the illness, however, stress the use of treatments that encourage the body’s natural healing system and take into account the person as a whole.

The use of conventional and alternative therapies but focuses mostly on lifestyle changes.  In this approach to stomach cancer might include reducing sodium intake, increasing intake of antioxidants through food or vitamins, eliminating Helicobacter pylori (type of bacteria found in the stomach), quitting smoking, improving oral hygiene, avoiding foods that contain geno-toxic agents, and increasing the amount of vegetables and fruits consumed.

In this Alternative Medicine Therapy we can also include natural supplements that cause the same changes as conventional drugs. For instance, synthetic interferon is currently used to treat some people with cancer, but to take high doses of intravenous vitamin C instead, in an attempt to stimulate the body’s production of its own interferon.

The Healthy lifestyle habits will improve a person’s energy and vitality. Those habits might include exercising, eating a nutritious diet, getting enough sleep, learning how to breathe properly, taking antioxidants and supplements, and using acupuncture, acupressure, healing touch, craniosacral therapy, yoga, qigong, and other methods.

Role of the Practicing Physician:

The Physician in this system recognizes that our discomforts or pains are merely symptoms of an imbalance. The imbalance from the external Environment and internal Environment.  This Imbalance is Balanced the person should not get any disease. could be a physical issue, the result of abusing the physical body through an unhealthy diet, lack of exercise, or too little sleep. Or, the imbalance may be the result of mental, emotional, or spiritual needs not being met. No aspect (mind, body, spirit, or emotions) of a person is overlooked when this treatment is sought.

What is the evidence?

Although there has been research on various Alternative methods that may be considered part of a holistic approach, scientific research generally does not focus on holistic medicine by itself as a cure for cancer or any other disease. Available scientific evidence does not support the idea that alternative practitioners are more effective than conventional physicians in persuading their patients to improve their lifestyle. Nor have available scientific studies shown that any of these approaches are effective or cost-effective against any disease if holistic methods are used without conventional medical treatment.

Some health care professionals suggest that cancer pain and some side effects of treatment can be managed with a holistic approach that includes the physical, psychological, and spiritual factors involved with each person. Increasingly, the health care team comprises a diverse and varied group of health care professionals. Members of this team are drawn from the specialties of medicine, nursing, surgery, radiation therapy, oncology, psychiatry, psychology, and social work. In addition, the team may call on dietitians, physical therapists, and the clergy for support. Health professionals realize that a person’s health depends on the balance of physical, psychological, social, and cultural forces. However, available scientific evidence does not support claims that holistic medicine alone can cure illness.

Are there any possible problems or complications?

Some substances may not have been thoroughly tested to find out how they interact with medicines, foods, or dietary supplements. Even though some reports of interactions and harmful effects may be published, full studies of interactions and effects are not often available. Because of these limitations, any information on ill effects and interactions below should be considered incomplete.

Adopting healthy habits related to diet, exercise, emotional, and spiritual well-being is considered important to maintaining good health. In fact, studies have shown that certain dietary changes and regular exercise can reduce your risk of some kinds of cancer. However, relying on healthy habits or holistic measures alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

Guidelines for Using Alternative Medicine Methods

Alternative are terms used to describe a number of products, practices, and systems that are not part of mainstream medicine. They can include things like herbs and dietary supplements, body movement, spiritual approaches, pills, extracts, and creams or ointments. Some are done by a person with formal education and training, such as art or music therapy. Others may be recommended by the person who is selling the product in a store or online, such as botanicals and exotic types of juice. The methods can involve everything from enemas, like colon therapy, to no-touch “energy work”.  Some take a lot of time or cost a lot of money, such as strict diets or travel to another country for special treatments. Others are fairly cheap and easy to use, like vitamins or homeopathy. Some can be done at home on your own, such as meditation and prayer, and others require another person to give them, like massage or acupuncture. Some almost never cause harm, while others can be dangerous and have even caused deaths.

You may hear about one or more of these treatments from friends, family, co-workers, salespeople, and others. The treatment may be something you’ve never heard of before, and it can be hard to get good, unbiased information about it. Here we will go over what you need to know before you decide to try one of these unconventional treatments. We will give you some ideas about how to look at these methods and what questions you might want to ask as you think about what might be best for you. It may also help you find out more about the treatments that interest you.  In this Medicine More Research should be accomplished in the coming months and years.

The American Cancer Society considers complementary and alternative medicine to be different from each other:

Alternative medicine is used instead of standard or mainstream medical treatment, often with serious outcomes for the patient.

Complementary medicine is used along with mainstream medical care. If carefully chosen and properly used, some of these can improve your quality of life without causing problems with your regular cancer treatment.

People with cancer might think about using alternative and complementary methods for a number of reasons:

To relieve the side effects of mainstream cancer treatment without having to take more medicine

To find a less unpleasant treatment approach that might have few side effects

To take an active role in improving their own health and wellness, because they prefer alternative theories of health and disease, as well as alternative treatments

The decision to use alternative methods is an important one, and it is yours to make. We have put together some guidelines to help you think through the issues and make the most informed and safest decision possible.

How Alternate Medicine is Helping What’s the Latest Development?

Clinics that offer alternative medical treatments like acupuncture and homeopathy are now eligible to receive federal funding in USA if they combine those treatments with traditional medicine. Some M.D.s are up in arms, decrying practitioners of alternative treatments as hucksters and con-artists. Such treatments, they say, have never been proven to work more frequently than the placebo effect whereas traditional medicine is supported by evidence from clinical trials. Author David Freeman says the picture is not so black and white and that even some highly respected traditionalists are reevaluating alternative medicine.

What’s the Big Idea?

The success of the medical establishment cannot be denied in its ability to combat infectious diseases. But the illnesses of today that pose the biggest threat to patient health are not easily remedied with vaccines and surgeries. Afflictions like heart disease, cancer and Alzheimer’s often respond better to lifestyle changes—ones that alternative medicines incorporate directly into their regimes—than to traditional medicine’s most sincere attempts at a cure. Procedures offered by traditional medicine typically respond to disease only after it has set in while alternative treatments can reduce risk factors associated with disease before they form.

Explaining the demand for naturopathy in rural health: affinity with rural patients and populations

The participants explained how their practice constituted a popular treatment option attracting good numbers of local and regional patients. As the quotes below illustrate, the naturopaths often made reference to what they perceived as the ‘open-minded’ and/or ‘independent’ outlook or approach of rural patients as a factor for demand for their services .

I think country people are generally more open-minded and less cynical about things than city people… so I think they’re more willing to give things a go.

I don’t think they’re exposed to as much of the negativity as city people, you know they’re not bombarded with media or advertising so they have to make up their own minds.

These perceptions were further explained by some naturopaths in terms of the stoic approach of rural patients not just to health but also to life generally. As the quotes below illustrate, this stoic approach is often associated with a preference for preventive measures and self-care – a preference that naturopaths’ claim fits comfortably with their perspective and practice

Rural people brought up with this idea that you don’t seek help until the last minute and I think they enjoy the fact that you teach them to look after themselves rather than telling what to do.

I really think that that preventative role of naturopathy can really help country people… they work themselves into the ground so much until… they die  and they aren’t often able to get away from their farms to see you. So if you can teach them to look after themselves.they really appreciate that aspect.

As this last quote suggests, the constraints and logistics of rural work and life may also be instrumental in establishing a convenient affinity between the preventive and empowering tenets of naturopathic care and the needs and abilities of rural patients with regard to accessing health services.

Some naturopaths pointed to the extensive time commitment and support provided by naturopathic consultations as another ‘pull factor’ for rural patients in seeking their services. As the following quotes illuminate, these claims referred to logistics and the commitments associated with accessing health care in rural locations:

‘Some of these people are driving seven or eight hours to see a healthcare professional… [if the consultation only lasts for] 15 minutes and [costs] 200 bucks they get very disappointed… I think that’s why they like coming to see someone like us… we try to make the trip worthwhile.

Rural Population  have a larger sense of commitment. I’ve found that if I… include their family members and include their story… that’s half their healing…. They don’t get heard in the medical establishment because it’s 5 minutes, 15 minutes if they’re lucky, I’ve found that country people want to talk first.

Likewise, the quote below pointed to the affinity with closer personal relationships among rural populations as cementing the demand for their naturopathic services.

‘They’re more inclined to see me because I listen and because I remember the story the next time they come or if I meet them down the street they will tell me and I have to remember those little pieces.it’s very different [from patient-practitioner relationships in urban communities].

Others suggested that another key factor driving rural patients to seek complementary therapists was the fact that complementary therapists, more so than conventional health practitioners, were often originally from the areas they practiced in, with deep cultural roots in the community. Practitioners not originally from the area often mentioned that they were only accepted after they had become ‘locals’. This connection to and understanding of the culture of the community may help deeper therapeutic relationships with their patients, as illustrated in this quote:

‘I definitely think that the fact that I’m originally from here made a huge difference… patients automatically feel more comfortable because they know you’re aware of issues that arise from living in the area. I think if I was someone coming up from the city they wouldn’t have been anywhere near as open to start with.

This connection to the community was perceived to be more important than the type of practitioner they were. The community perception of who is a ‘foreign doctor’ could apply equally to a medical graduate from Brisbane, Sydney or Melbourne as it could to an international medical graduate. However, international medical graduates (who make a significant proportion of the Australian rural medical workforce) may present issues of their own in relation to local Alternative Medicine use that disconnected them from their patients, as the following quote illustrates:

Not only do close therapeutic relationships serve as significant pull factors for naturopathic consultations, in some patients they also serve to differentiate the naturopaths from conventional medical practitioners, as this quote from a participant illustrates:

‘It’s always “she doesn’t listen” or “he doesn’t listen” or “they’ve always got their face on the computer”, or “how do they know me if they don’t talk to me”… There’s always a bit of a hinge first  how the doctor treated them last time. people come to see me because I’m not a doctor.

Meanwhile, other naturopaths appeal to a notion of historical affinity to explain the high use of naturopathy in rural populations. As one participant suggested:

Western people are far more open… natural therapies have always been a part of their lives… some of the founding fathers of naturopathy started out in places like this… that culture is still alive here… it never died out.

I think people in the country still have access to all those old grandma cures.( The Tennis Legend Pete Sampras was cured his Shoulder pain from the Herbal Treatment from His Grandmother from Mexico)

 I mean they haven’t lost that part of their culture like people in the city have.

Linked to this notion of rural communities as characterized by closer personal relations, some naturopaths highlighted how both rural patients and naturopaths share a broader conception of health and illness, one that places emphasis on family, community and social ties and acknowledges the relationship between health and wider environment. This conception of health is characterized by these practitioners as holistic and supporting a version of holistic practice:

The naturopaths’ explanations of this pragmatic attitude towards the complex interactions and inter-connections affecting health seems to stem more from lived experiences and attitudes in rural areas than from new age or esoteric philosophies often attributed as pull factors for CAM in the broader community:

The people here are much closer to nature and the natural cycle, they believe in the power of it… they see things  get sick and die they’re just more earthier people

However, not all explanations of naturopathic practice in rural communities were couched in entirely positive terms and as the next section of analysis outlines, there were a number of perceived challenges associated with providing naturopathic services to the wider rural community.

 Barriers and challenges to use Alternate Medicine in Rural Population:

Despite their overall presentation of Alternative Medicine and its sub sections as well suited to rural patients and populations.

Several practitioners outlined how the resourcefulness and independence of rural people may produce challenges in providing timely treatment – a difficulty acknowledged as facing both conventional and complementary practitioners but were particularly a problem for working in the competitive private sector where treatment costs are entirely out of pocket and borne solely by the patient.

As one Alternative Treatment Physician  explained.

I found people were much happier paying for the service Similarly, another Physician described how rural people are proud and how their self-reliance can be a challenge to providing care. This can be seen as the flip side to the positive affinity between a patient’s self reliance and a  preventive approach as illustrated earlier by Alternative measures applied.

Another informant explained how in her experience rural patients need to feel in control and be central to decision-making in their healthcare, and how this influences her approach to providing care.

Rural population is very strong, they do prefer their own counsel you can’t push them very muchIf they feel as though they are doing this themselves then you have their compliance. If you keep telling them what to do they don’t really want to know. So This population need Health Education and Health Promotion give them reading matter… handout sheets, they have a chance to go and think about t, seems to be a need to be in self-control.

Conclusion: In conclusion the Alternative Methods by clubbing with Conventional Medicine and also with Health Education and Health Promotion are important to give better Health by adopting Fitness, Nutrition and Hygiene to the Rural Population.

Purpose of the integrated health center

To provide a health care centre that has integrated multi specialty and multi disciplinary approach to different formats of medicines with a win – win approach providing health with fewer burdens on the pockets of the patients.

The amenities expected from the health centre are

1. The needed land ( with 30% to 40% from the owners and others from government and FDIs)
2. The structure (building for the center)with construction cost of Rs 1500/- per square yard
3. Elevators and pathways
4. The beds for old age patients for their care center(20Nos)
5. The ambulances (2Nos)
6. The doctors for allopathic, naturopathy, homeopathy,  experts and consultants
7. The sub-staff( Helpers)
8. The equipment required to do the needed diagnostic study
9. Canteen/ cafeteria
10. Medical dispensary
11. Generators
12.  Miscellaneous.

Establishment costs

One Time Cost:

Total Land is : 3 acres

This unit Have 15,000 Square Feet construction in  two stair Building in ¼ to ½ acre area The remaining is left for Medicinal Plants.

S.No	Factor under consideration	Cost per unit	Total cost
1.	Land  3 Acres
2.	Building cost (15000 sft) Rs 2000 per SQ.Ft
3.	Lifts and pathways(if any) 2
4.	The beds for the old age patients 20 rooms  20/20
5.	The ambulance, one in number
6.	Equipment costs – X –ray machines Blood Testig and Urie testing etc, scanners and other diagnostic tools, oxygen cylinders,	15,00000
7	Canteen	OUT SIDE contract
8	Medical Pharmacy	OUT SIDE contract
10	Generator 1
11,	Fans, AC’s, TVs, Water purifiers and other facilities.
12	Tele Medicine unit	3,000000
13	Big data Servers	10,00000
14.	GIS/GPS

Monthly Maintenance costs:

S.No	Factor under consideration	Cost per month	Cost per year
1.	The doctors recruitment(allopathic, Ayurvedic, Naturopathy, Homeopathy,  Acupuncture expert, nutrition specialist, Physiotherapist etc.,) 7 members each one have 25,000 rupes per month.
2.	Salaries of sub – staff (nurses, paramedics, attenders, Pharmacist, Lab Tech drivers) 15 members   ( Each one have 12,000/month
3.	Maintenance of the premises security  need 3 persons
4.	Electricity , Phone and Water charges
5.	Diesel for ambulances and generators
6.	Canteen maintenance costs
7.	House keeping 3 persons Rs. 10000/ person per month
8.	Basic amenities and medicines cost

Patients who come for various treatments: Insurance payments, and AArogyyasri

Patients using Alternate Medicine Treatments

Persons who are using Physio Therapy

Seniors citizens who stay in the clinic for care = 20X5000 per month = Rs.100,000

Tele Medicine

What is Tele Medicine?

Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through the phone or the Internet and sometimes other networks for the purpose of consulting, and sometimes remote medical procedures or examinations.

Services SLIDE

Tele Medicine Participants

Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries. Telemedicine generally refers to the use of communications and information technologies for the delivery of clinical care.

Types of Telemedicine

Telemedicine can be broken into three main categories: 

store-and-forward, remote monitoring and interactive services.

Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignalsetc) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time. Dermatology (teledermatology), radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured Medical Record preferably in electronic form should be a component of this transfer. A key difference between traditional in-person patient meetings and telemedicine encounters is the omission of an actual physical examination and history. The store-and-forward process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination.

Remote monitoring, also known as self-monitoring/testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective. Interactive telemedicine services provide real-time interactions between patient and provider, to include phone conversations, online communication and home visits. Many activities such as history review,

physical examination, psychiatric evaluations and ophthalmology assessments can be conducted comparably to those done in traditional face-to-face visits. In addition, “clinician-interactive” telemedicine services may be less costly than in-person clinical visits.

What is Tele Rardiology?

ECG or electrocardiograph can be transmitted using telephone and wireless. This was done by Barr (1958) who transmitted ECG tracings to about 40,000 feet.

• New technology called Tele-cardiology allows our cardiologist to run tests and perform check-ups on patients here at Hillcrest Hospital Henryetta instead of driving several miles to another city for the same service. When using the Tele-cardiology service, the cardiologist is shown on a monitor where he or she can see and hear the patient at a different location. Assessments and tests can be performed, even when the cardiologist and patient are miles apart. The cardiologist receives the results of the tests immediately, as if he or she were sitting in the office with you.Along with cardiology services, our specialty clinic offers many services such as:
• General Surgery
• Ophthalmology
• Podiatry
• Orthopedics

What is Tele Radiology?

Tele radiology is the ability to send radiographic images (x-rays) from one location to another. For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving / image review station.

 The most typical implementation are two computers connected via Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. Sometimes the receiving computer will have a printer so that images can be printed for convenience.

The Tele radiology process begins at the image sending station. The radiographic image and a modem or other connection are required for this first step. The image is scanned and then sent via the network connection to the receiving computer.

Remote patient monitoring

• including home Tele health, uses devices to remotely collect and send data to a home health agency or a remote diagnostic testing facility (RDTF) for interpretation. Such applications might include a specific vital sign, such as blood glucose or heart ECG or a variety of indicators for homebound patients. Such services can be used to supplement the use of visiting nurses.

Consumer medical and health information & Education  

• includes the use of the Internet and wireless devices for consumers to obtain specialized health information and on-line discussion groups to provide peer-to-peer support. Medical education provides continuing medical education credits for health professionals and special medical education seminars for targeted groups in remote locations

  What Are the Benefits of Telemedicine?

Telemedicine has been growing rapidly because it offers four fundamental benefits:

• Improved Access – For over 40 years, telemedicine has been used to bring healthcare services to patients in distant locations. Not only does telemedicine improve access to patients but it also allows physicians and health facilities to expand their reach, beyond their own offices. Given the provider shortages throughout the world–in both rural and urban areas–telemedicine has a unique capacity to increase service to millions of new patients.
• Cost Efficiencies – Reducing or containing the cost of healthcare is one of the most important reasons for funding and adopting Tele health technologies. Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
• Improved Quality – Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations. In some specialties, particularly in mental health and ICU care, telemedicine delivers a superior product, with greater outcomes and patient satisfaction.
• Patient Demand – Consumers want telemedicine. The greatest impact of telemedicine is on the patient, their family and their community. Using telemedicine technologies reduces travel time and related stresses for the patient. Over the past 15 years study after study has documented patient satisfaction and support for Tele medical services. Such services offer patients the access to providers that might not be available otherwise, as well as medical services without the need to travel long distances.

HEALTH CARE IN RURAL INDIA

1. 70% of India’s populations live in rural area
2. 90% of secondary & tertiary care facilities are in cities and towns

Secondary Health Care

Secondary Healthcare refers to a second tier of health system, in which patients from primary health care are referred to specialists in higher hospitals for treatment. In India, the health centres for secondary health care include District hospitals and Community Health Centre at block level.

Tertiary Health Care

Tertiary Health care refers to a third level of health system, in which specialized consultative care is provided usually on referral from primary and secondary medical care. Specialised Intensive Care Units, advanced diagnostic support services and specialized medical personnel on the key features of tertiary health care. In India, under public health system, tertiary care service is provided by medical colleges and advanced medical research institutes.

• Low penetration of Health care services
• Lack of investment in Health care in rural areas
• Inadequate medical facilities in rural areas
• Problem of retaining doctors in rural areas   specially the specialist doctors
• Rural and remote areas continue to suffer from absence of quality Health care services.

Benefits to the Patients:-

1. Access to specialized Health care services to under served rural, semi –urban and remote areas
2. Access to expertise of Medical Specialists with out Physical referral
3. Reduced Physician’s fees and cost of medicine
4. Reduced visits to specialty hospitals
5. Reduced Travel expenses
6. Early detection of disease
7. Reduced burden of morbidity

Benefit to Health care Professionals:-

1. Improved diagnosis and better treatment management
2. Continuing education and training
3. Quick and timely follow – up of patients discharged after palliative care
4. Access to computerized comprehensive data of patients, both offline & real time

HOW TELEMEDICINE WOULD HELP RURAL POPULATION AND OUR HOSPITAL:-

1. Increased patient satisfaction
2. Remote Monitoring
3. Keep Medical talent
4. Positive patient outcomes
5. Increased Access to specialty care
6. Patients can consult with Specialists
7. Decreased cost

Benefits for Healthcare Delivery System

Significant reduction in unnecessary visits & hospitalization for specialized care at tertiary hospitals

Earlier discharge of patients leading to shorter length of stay in hospitals

Increase in the scope of services without creating physical infrastructure in remote hospitals

Improve monitoring facilities at the rural based centres

Increases stuff productivity

Training

CHALLENGES

1. Patient’s fear and unfamiliarity
2. Financial unavailability
3. Lack of basic amenities
4. Literacy rate and diversity in languages
5. Quality aspect
6. Government support
7. Perspective of medical practitioners

Software &Hardware SLIDE

• Desktop PC platform with Laser Printer
• IP Video Conferencing Kit
• Tele medicine soft
• Digital ECG
• A3 Film Scanner
• Digital Microscope & Camera
• Glucometer &Haemogram analyzer
• Non-invasive Pulse & Blood Pressure unit
• Connectivity device & Router

GIS & GPS IN PUBLIC HEALTH:

GIS Mapping as a Public Health Tool

What Is GIS?

Geographic information systems (GIS) are “automated systems for the capture, storage, retrieval, analysis, and display of spatial data”. Using GIS – a technological tool for comprehending geography and making intelligent decisionsis basic to human thinking.GIS is able to process geographic data from a variety of sources and integrateit into a map. Some data is gathered in the field by Global Positioning System (GPS) units that attach a locationcoordinate (latitude and longitude) to a feature or place such as a primary health centre in a village.

GIS for Early Detection and Responseto Infectious Disease

Successful understanding and response to infectious disease outbreaks depend greatlyon the ability to consider the surrounding context. Disease spreads geographically, and interventions occur in relation to human, institutional, climatic, and other kinds of landscapes.

Because GIS technology relates many kinds of data to geographic location, it excels in tracking not only disease spread but also laboratory specimen and medical supply where abouts, hospital bed availability, testing facility proximity, vulnerable population locations, and medical personnel distribution. Built-in GIS analysis tools provide effective early warning systems and preparedness programs that generate meaningful information that public health officials need to make effective decisions—at the community, national, and global levels.

During an outbreak, GIS provides tools that speed the collection of accurate field data. Complex statistical and other analyses applied with GIS technology provide relevant information to support sound decisions. GIS analysis can, for example, locate a potential disease hot spot and calculate a nearby hospital’s ability to handle the expected increase in service demand if an outbreak should occur. Public health emergencies are not of short duration. Effects of a disease outbreak have the potential for long-term impacts on the health and well-being of a community. Organizations like Institute of Public health rely on GIS analysis tools to assess data collected in the process of monitoring long-term health effects.

Health professionals can use geospatial technology to

• Discover geographic origins of symptomatic populations.
• Identify specific locations of vulnerable at-risk populations.
• Identify congregate groups targeted for preventive measures.
• Create maps to help organizations establish field clinics and locate medical supplies.
• Provide information relevant for community leadership planning and response.

GIS in Non-Communicable Disease

Non-communicable diseases share several risk factors that present interactive, addictive, and synergistic effects. Thus, upon preventing one risk factor, it is possible to help prevent several NCDs simultaneously. The following classification made by the World Health Organization (WHO) is useful for population-based assessment and surveillance:

In individuals

• Background risk factors, such as age, sex, level of education, and genetic composition.
• Behavioural risk factors, such as smoking, unhealthy diet, and physical inactivity.
• Intermediate risk factors, such as serum cholesterol levels, diabetes, hypertension, and obesity.

In communities (contextual factors)

• Social and economic conditions, such as poverty, employment, and family composition.
• Environment, such as climate and air pollution.
• Culture, such as practices, norms, and values.
• Urbanization, which influenceshousing and access to products and services.

The uses of GIS in non-communicable diseases have been shown by its relation with the environmental components as indicated above for individuals and also for communities. The ability of GIS to assimilate all the relevant data and aid analysis makes them an ideal tool for public health departments and other organisations assigned with the task of disease surveillance.

GIS Empowers Emergency Response and PublicHealth Awareness

Government health departments regularly deal with issues that require large amounts of data to be processed, integrated, analyzed, and distributed to many different end users. End users comprise a diverse internal and external group including concerned citizens, community organizations, health care workers and administrators, university researchers, and other government agencies. Within each group, technical capabilities and needs vary. With limited resources, these agencies need to determine the most appropriate way to make information available. Time and budget constraints, agency cooperation and collaboration, enterprise architecture, legacy processes, privacy concerns, and existing infrastructure are some of the issues. To facilitate most of such data processing geographic information system (GIS) technology is only a viable solution.

As an example, maps showing infrastructural facilities: Sub-centers, Primary Health Centers, Community Health Centers, District Hospitals, Health Rank, Mandal-wise bed strength in Andhra Pradesh is shown in figure below

Conclusion:  Once Established this Institute of Public Health is an asset to the state. The Institute of Public Health is a Must for the new state of Andhra Pradesh as well as  for India. This Institute is going to improve the general Health conditions and take care of specific disease prevention and cure It gives abundant input for the Health of the poor people as well as cost cutting health care provider. Apart from the above the tremendous research will be commenced in this discipline of school Public Health where India is very poor in the Health care research

Therefore I request the Andhra Pradesh State Government to provide the requested Land and other amenities such that I will start this mega Project at Amravati.