Presentation at the conference on “Science and Social Consciousness: Medicine in Rural India”

Joint Meeting of Indian Nuclear Society, Mumbai and International Cancer Center, Mahatma Gandhi Memorial Medical Trust

March 1, 2011    Bhimavaram, Andhra Pradesh

SUPPORT FOR THE INTERNATIONAL CANCER CENTER FROM THE  U.S.

James Bradbury, Ph.D.

Oppenheimer Institute for Science and International Cooperation;  Services and  Relief for the Poor

The International Cancer Center (ICC) of the Mahatma Gandhi Memorial Medical Trust (MGMMT) has now achieved many of its initial goals which is a tribute to the Government of India, some supporting activities in the U.S., and, most importantly, the dedication and perseverance of M.R. Raju and his wife, Devi, who conceived, created, nurtured, and brought the ICC to its present state of maturity.  The mission of the MGMMT is to provide medical and educational services to a rural, underserved, relatively poor region in Andhra Pradesh, the ancestral home of the Raju family.  Most of the people in this district cannot afford to go to major health centers in distant cities.   Medical services offered through MGMMT include radiation and chemotherapy treatments for a variety of common cancers, gynecological evaluations and treatments, and ophthalmologic  care.  More than 2000 patients have been treated and there are more than 1000 patients in the facility cancer registry.  The ICC has a well-developed infrastructure, ample  space and treatment facilities, and a highly competent staff that soon will soon need augmentation.  In addition to medical treatments the MGMMT provides education  through a formal preschool program and through awareness programs in the vicinity that emphasize early detection and prevention of health problems.

Core support of the MGMMT comes from the Raju family; additional,  direct assistance from America for the MGMMT has included modest financial contributions through the non-profit organization “Services and Relief for the Poor”, equipment donations, and more than 30 teaching interns, physicians,  and engineers who have provided volunteer services in India for extended periods.  More support can and should be made available.  It is estimated that to better serve regional needs in providing affordable health care there should be a factor of at least two increase in patients enrolled and a dramatic expansion in the prevention/early detection arm of the program. Further, it  is time to develop a plan for appropriate replication of this rural treatment  center in other parts of India. Some specific components of a vision  for the way  forward are listed below.   It is hoped that resources from the U.S. can help with the implementation of many of these activities.

*Staff and equipment to permit accessing more patients: Four additional staff members (surgeon, pathologist, diagnostic radiologist, medical physicist) are needed to double the number of patients treated.  Addressing additional cancer sites requires obtaining an  8-MeV electron accelerator,  a more  powerful Cobalt source,  and improved brachytherapy equipment; equipped rooms are already available for all of these appliances.

* Other clinic capabilities: In addition to cancer treatments, the MGMMT facility offers ophthalmological help,  gynecological  services, and  maxillo-facial surgery.  New directions could include providing dermatological services and  taking steps to ease the endemic tuberculosis problem.  TB is the leading cause of death for the Indian age group 15-45.  Relatively inexpensive DNA analysis equipment can be used to distinguish between latent and active TB and thus determine the most effective course of action for individuals.  This analysis and follow-up treatment could be performed in a rural clinic.

*Health education and awareness: New educational and motivational techniques can be instituted in the region to build health awareness, disease prevention, early detection of problems, and general good health practices including nutrition and hygiene.   Targeting children will pay huge dividends downstream.  Motivational technologies include child-accessible computer-based games, contests, health education programs, and individual handheld biomedical sensors.  Children could obtain and record their health data, remain strongly coupled to feedback and assessment activities, and enroll in study groups supported by the parents and schools.  Not only is long-term health improved but the children are introduced to the information age.  The village residents should assist in designing activities and participating in feedback and modifications and, at an appropriate time, take ownership of the program.

* Monitoring and tracking regional health parameters: Satellite data, surveys, and  existing records can be used to determine geographical parameters such as the regional demographics, socioeconomic characteristics,  health status, clusters of disease incidence, communication/transportation infrastructure, access to medical health care, clean water availability,  pollution and waste sites, etc.   These data can be used to establish baselines, rate of health improvement, and the region-specific health projects that cost-effectively satisfy community needs.

* Replication of the rural health clinic: The MGMMT will document its activities in terms of approach, problems encountered, and successes.   Replication of this rural clinic in other parts of India,  with facilities tailored to meet the particular regional needs, should be supported by local and national government and through community involvement and widespread volunteer effort.  The overall aim is to treat, on a region- by- region basis, existing health issues and create sustainable programs for achieving changes in behavior, health literacy, and health advocacy that will lead to demonstrably improved health in rural areas for the long term.

The above suggestions are all underpinned by science and technology. Good science and good scientific judgment are essential ingredients for developing solutions to the many daunting global  issues such as health, environment, clean water, food production, climate change, and reduction of weapons of mass destruction. However,  individual and collective social consciousness will be the attribute that drives the application of science to improving the condition of this needy planet.  Since national and international security are at some level dependent upon the well-being of the population there is a pragmatic component to dealing with the global issues. But there is also an altruistic component that modern research has shown to be embedded in our genes and leads to  selfless-ness and compassion, a wish to give to others with no thought of compensation.  This compassion and aid-giving is a major quality of being human.   The Raju team, husband/wife and their family, for the past two decades have devoted their time, energy, medical skills,  and scientific wisdom to making this rural medical clinic a successful reality.   They embody social consciousness in the highest manner.

Education is a necessary step on the way to developing a better, more egalitarian and prosperous society. It is, unfortunately, not a fast step and that is difficult for people who have suffered for a long time and are impatient for change.

The UK’s Institute of Physics (IOP) has programmes to help develop increased competence for physics and general science teachers in nine African countries. One of the newest such programmes has begun in 2012 in South Africa. In collaboration with the South African Institute of Physics (SAIP) the UK contribution is being by the Director of the Oppenheimer Institute for Science and International Cooperation, David Wolfe.

Our aim is to develop material for a new curriculum which will be instituted throughout secondary schools in the country. This will be used to help teacher development in both urban and rural schools. We will provide experimental and demonstration equipment as well. In addition, we will develop maintenance courses to ensure that the equipment continues to work.

The programme has been designed to run for three years in Gauteng Province, which contains Johannesburg and Pretoria. Besides the SAIP the collaboration includes the University of Johannesburg. If it shows progress then we hope to extend it throughout the country.

The initial efforts of the Oppenheimer Institute are centered in Russia and other countries of the Newly Independent States (NIS) and address the issue of reducing the threat of weapons of mass destruction while improving the economic situation in these countries. In the post- cold war era Russia and its neighbors are seeking economic, political, and Social coherence while fighting precarious internal situations, including fiscal indiscipline, corruption, and declines in personal and environmental health. A major problem, but at the same time an important resource, are the ten closed nuclear cities that contain some three quarters of a million people. Russia no longer needs and certainly cannot afford this gigantic nuclear complex; funding levels are down by more than a factor of five from a decade ago. Since incentives for proliferation of nuclear materials and technologies exist, it is important both for Russia and the international community to find ways of redirecting weapons scientists, who represent a tremendous capacity of skills and advanced technologies, into the private sector. These scientists are available at bargain rates and constitute an important opportunity for Russian and western business; however, it is necessary to develop the necessary brokering intermediaries. Thus, prevention of the proliferation of weapons of mass destruction, together with the longer term goal of eliminating such weapons, is a task with several dimensions; technical, political, economic, and social. The Oppenheimer Institute plans to work on all of these fronts.

 

The Oppenheimer Institute pursues its goal of reducing the threat of weapons of mass destruction through three fundamental activities: 1) sponsoring policy-relevant research on various issues relevant to the production and distribution of weapons of mass destruction, 2) arranging international scholarly and scientific exchange through conferences, workshops, and student/faculty exchanges, and 3) developing public/private partnerships to promote technology commercialization, thereby transferring weapons-related capacities to the civilian sector.

 

Since its inception the Institute has been engaged in collaborations with professionals from Russian nuclear centers and universities, representing a joint Russian-American effort to contribute to international stability and promote economic development by creating new opportunities for weapons scientists in the civilian sector. One form of this international collaboration is represented by the Institute’s public/private partnerships to promote technology commercialization, transforming facilities and human capital from weapons-related specialization to civilian sector development. The Institute acts as a “technology broker”, bringing together partners from private, public, and NGO sectors to facilitate new civilian uses of technology. Our efforts are leading to partnerships in computer tomography programs, automobile parts production, computer software development, shipment identification and tracking, remote sensing, and other areas.