By Prashant K. Nanda
New Delhi, April 7 (IANS) From becoming a hub of medical tourism to having a sizable population deprived of basic healthcare, from bulging bellies in urban areas to stunted growth among kids across rural belts — the country remains a study in health contrasts.

India now stands at the cross-roads of improving health indicators and achieving the Millennium Development Goals (MDGs).

“We are at a difficult time. While millions of children are dying due to hunger and malnourishment, lifestyle diseases are on the upswing among urban populace,” said D.K. Gupta, president of the Federation of Association of Paediatric Surgeons in South Asia.

While states like Uttar Pradesh, Bihar, Madhya Pradesh, Chhattisgarh and Orissa are leading victims of malnourishment, more literate and rich states like Punjab, Kerala and Tamil Nadu are going the obese way.

According to the United Nation’s Children Fund (Unicef), nearly 2.1 million children die every year in India before reaching their fifth birthday. This accounts for 20 percent of children’s death across the globe, which means one out of every five children dying is an Indian.

The maternal mortality and infant mortality rate in India is even worse than in Sri Lanka and Thailand. According to an official data, 254 women die per 100,000 live births in India. A World Bank report puts the figure at 450.

Similarly, 46 percent of children in India are malnourished, a startling figure that has remained almost unchanged for the last seven years.

Tens of thousands of Indian kids are dying due to diarrhoea and pneumonia every year, which are largely preventable if water and hygiene conditions improve.

Even as it battles to control communicable diseases like Tuberculosis, India is increasingly falling in the trap of lifestyle diseases.

With economic prosperity has come unhealthy lifestyle and poor eating and working habits. Cardiovascular diseases, several forms of cancer, diabetes and hypertension silently kill millions every year.

India has already earned the dubious distinction of being a diabetes capital. For record, India is home to over 30 million diabetic patients. The World Health Organisation (WHO) has also warned that more than 270 million people, mostly from China, India, Pakistan and Indonesia, are susceptible to diseases linked to unhealthy lifestyles.

“Earlier they (lifestyle and chronic diseases) were called western phenomena but today India is facing both. Patients of chronic diseases in India have overtaken the numbers of chronic patients in the west,” said Sandeep Bhudhiraja, director of internal medicine at Max Healthcare here.

The argument has been accepted by Health Minister Ghulam Nabi Azad many times. “We are battling both forms of problem,” he says.

S. Sunder Raman, an independent advisor to the central government on health, said: “There are three major hindrances. Inadequate financial allocation, low level of priority to the sector and lack of due focus on fitness are the main culprits.”

Experts also said that there is another uneven field in medical human resources.

According to Azad: “Eighty percent of medical work force serve just 20 percent of Indians living in cities”.