Neurologists dwindling in numbers

Ankita Chakrabarty/ Zee Research Group/ Delhi

Ignorance is not bliss when it comes to neurological disorders. Indians, however, need to worry more as they face a double whammy. Not only they are miserably unaware of such ailments, but also the country is woefully short of neurologists who come in a highly uneven ratio of 1: 8, 50, 000 to the population. Add the rural-urban divide, the disparity becomes even more glaring with even lesser neurologists catering to the non-urban population where more cases are coming into light.

According to an article ‘Neurology: The Scenario in India’ published in the ‘Journal of Association of Physicians of India’ (JAPI) in January 2012, there are approximately 1100 qualified clinical neurologists working in India which is too less to cater the needs of 1.2 billion Indians.

While cases like a four-year-old boy from West Bengal suffering from Congenital Insensitivity to Pain with Anhidrosis (an inherited disease of the nervous system which prevents the sensation of pain, heat, cold, or any real nerve-related sensations called as CIPA) are rare, ordinary Indians are not even aware of common neurological disorders. The shortage of adequate neurology workforce hasn’t helped the matters.

Medical experts reckon the gap especially pertaining to rural-urban divide. Dr. Sanjay Kumar Saxena, head of neurology department at Fortis Noida, laments, “There are not sufficient neurologists to take care of the nervous disorders, whatever few which are available are mostly restricted to the metros so the needs of the rural and other cities are not met.”

Out of the 1100 neurologists, over 400 work in four large metros of India. Thus, many districts and rural parts of India have to be covered by single neurologists. As a result of this disparity, only a small proportion of neurological cases can find their way to the neurologists and it is believed that over 90 percent of the neurology is handled by the internal medicine specialists. Compared to this, in developed countries the ratio of one neurologist for population varies from 20,000 to 50,000. Further, approximately only 80 students are registered for neurology courses every year throughout the country.

Some of the common neurological disorders in India are Epilepsy, Parkinson’s disease, Dementia, Brain damage due to birth trauma, Nerve weakness, Neurological disorders consequent to nutritional deficiency and exposure to neurotoxic chemicals. Epidemiological indices of epilepsy in India are comparable to those from developed countries, with a prevalence rate of approximately five per1000 and incidence rate of approximately 50 per 100,000. The age adjusted prevalence of Parkinson’s disease is 71.6/100, 000. For the country’s greying population, dementia is a problem which has become a serious concern. Around 3.7 million people in India are affected with dementia and the figure is expected to double by 2030.

Congenital insensitivity to pain with anhidrosis (CIPA) is one of the rarest of its kind. The first case was reported in the year 1983. Till date, 84 documented living cases are there in the United States and there are more than 300 in Japan. In India, one such case had come up approximately 20 years ago in Bangalore and now the second case was reported from West Bengal.

Pointing out the measures needed to address the common neurological disorders in India, Dr. Manish Sinha, consultant neurology, Moolchand Medcity, New Delhi emphasises, “We should spread awareness about detection and prevention of neurological diseases. There is an urgent need to improve neurology care at all levels of the hierarchy of the health care pyramid. Health budget should be enhanced to increase manpower and meet the growing technology requirements. There is also a need to increase the number of neurology training institutes without compromising on the standards of training.”

Concurring with Sinha, Dr. Rajesh Kumar, consultant neurology at Rockland Hospital, reiterates, “Neurological disorders are neglected most of the time due to lack of proper awareness which acts as a hurdle in the further treatment of the disorders. So people all over should get aware of the common neurological disorders so that it gets addressed on time to check further complications.”

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