The Chacha Nehru Health Scheme, under which free medical check-up and treatment will be provided to all the school children, will be launched by the Delhi Government on Children's Day, November 14. At a meeting chaired by Chief Minister Sheila Dikshit on Friday, it was stated that to begin with the scheme will cover 100 schools.

The scheme had been announced by the Delhi Government in the Budget speech for the year 2011-22 that was made by Ms. Dikshit, who also holds the Finance portfolio. The Delhi Government has since then completed the formalities pertaining to the scheme and is now prepared to implement it.

In the meeting, Ms. Dikshit instructed the Health Department and the Education Department to work in tandem to ensure proper implementation of the scheme. She directed the Health Department to see to it that the proposed health check-up was comprehensive and included all diseases while also taking care of the immunisation gaps.

The Chacha Nehru Health Scheme intends to address the deficiencies and symptoms of disease in children right from the beginning to ensure that they remained healthy.

Ms. Dikshit said it has been decided to launch this scheme on the birth anniversary of first Prime Minister of India Pandit Jawaharlal Nehru and to begin with the scheme would be launched in over 100 schools.

It would later be expanded in a phased manner to cover all the 954 Delhi Government schools. She said the scheme would be closely monitored to prepare a comprehensive computerised health profile of school children.

To implement the scheme, that would ultimately cover about 14 lakh school children, around 117 teams consisting of a doctor, primary health nurse and computer data entry operator will be required. Each team will be able to screen 60 children for all diseases including general check-up in one day.

Since the total number of working days in a year is about 200, each team would be able to cover about 12,000 children in a year. So to meet the target of reaching out to about 14 lakh students, 117 teams would be deployed.

Delhi Health Minister A.K. Walia said apart from providing free general check-up to school children, the Delhi Government will also provide free medicines to them and will their treatment if they are diagnosed with any disease. He added that the Health Department will also ensure that all bottlenecks, if any, are cleared immediately so that the scheme could take off smoothly.

The meeting, which was also attended by Chief Secretary P.K. Tripathi, Principal Secretary Health Anshu Prakash, Principal Secretary Finance D.M. Sapolia and Director Health Services Dr. N.V. Kamath, also discussed the spade work that has been done and the infrastructure that has been created to ensure that the scheme succeeds in achieving its goal of having healthy children for a healthy society.

An inquiry into the 11 crib deaths at BC Roy child hospital has cleared the hospital authorities of negligence, but the incident spurred the health department to take steps to prevent a recurrence.

Another baby died on Thursday, taking the number of deaths in a 72-hour period to 12. Seven deaths had been reported between Monday evening and Tuesday night, and four died on Wednesday morning.

"We are studying the inquiry report. The deaths are unfortunate but they don't seem to have resulted from negligence. It's true that critical patients, who have very little chance of survival, are brought to the hospital. So, we plan to curb this system of indiscriminately referring patients to BC Roy," said Susanta Banerjee, director of medical education.

The 12 children who died were aged from a day to three months. While the hospital claimed all of them were underweight and had serious heart and respiratory ailments, some of the families feel the doctors were slow in treating them.

It's not the first time the hospital is caught in such a controversy. Eighteen babies had died in a 48-hour period last June. Then, too, the hospital had argued that the children were critically ill and couldn't have been saved.

Patients' relatives aren't convinced. "This has been happening far too often. Parents would obviously be scared to admit their children at BC Roy. Since this is the only specialized hospital for infants, where else will they go?" asked Kanailal Panda, whose five-day-old granddaughter died at the hospital on Wednesday.

On Thursday, news of another baby's death sparked panic among parents. Rumours of more deaths started floating around. Some families immediately arranged for their babies to be shifted out although hospital authorities tried to pacify them. A trader from Dum Dum said that the doctors had recommended a series of tests for her daughter, who has a leg injury, but nothing has been done in the last three days. "I have no idea if the tests will be done or if she needs them at all. Whenever I ask doctors, they tell me to wait," he alleged.

"We can't wait and watch when babies are dying like this. It could be your child next so we were already planning to move out. But now it seems the situation is under control," said Benoy Kumar Das, whose niece has been admitted for the last five days.

The hospital authorities maintain that the deaths had not resulted from negligence. "About five-six babies die every day. They cannot be saved because they are brought to us in an irretrievable state. Often, the number of such critical cases shoots up, leading to a sudden spike in the casualty figure. This is exactly what has happened over the last 48 hours. We have already carried out an enquiry and have found nothing to suggest negligence on our part," said hospital superintendent D K Pal.

He, however, admitted to a "communication gap" between parents and doctors at the hospital. "Doctors don't always interact properly with parents, which often leads to an impression that they are not treating the children. This is not the case. Every patient is being attended to, though we have our constraints," Pal explained.

The health department wants to stop the practice of referring critical cases to BC Roy Hospital. "It has become the norm to refer patients. The infrastructure at the hospital makes it impossible to take care of such a huge number of serious patients. From now on, every hospital or nursing home must cite specific causes and justify why the patient was shifted. It will be assessed by doctors at BC Roy before admission. Also, we shall revive a care unit at the hospital by the first week of November. This will raise the number of beds and lead to a few additional facilities," said Banerjee.

The World Polio Day is being observed today. Union Health Ministry said, India is closest ever to eradicate polio from the country.

In a statement, the ministry said that only one polio case has been detected this year making it the longest polio-free period ever since eradication programmes were launched.

Health and Family Welfare Minister Ghulam Nabi Azad said that the government has also decided to treat any fresh case of polio as a public health emergency in order to achieve complete polio eradication at the earliest.

He said, the Health Ministry has also prepared an Emergency Preparedness and Response Plan to intensify measures to build the immunity of children against polio in all high risk areas.

Mr Azad said, efforts will be further intensified to stop any residual polio virus circulation and to prevent any polio case in the most vulnerable populations including the newborns and the migrants.

Every second woman and fourth man above 50 years in India has suffered a fracture due to osteoporosis, a bone disease that causes weakening of bones. Estimates say that around 40 crore Indians would have this disease by 2013. It is also known as a silent disease for it has no detectable symptoms until the damage is done. On the occasion of the World Osteoporosis Day on Thursday, orthopaedic surgeon Dr Kiran Shete spoke to DNA on ways to avoid surgery and improve quality of life for patients suffering from the ailment.

Why is osteoporosis called a silent disease?
It is called a silent disease as bone loss occurs with no symptoms until one actually suffers a fracture or pain due to the disease. Osteoporosis is basically a bone disease caused due to weakening or brittle bones that become prone to fractures. It is supposed to happen in old age but these days I have seen patients, especially women in late 30's or 40's, having osteoporosis.

What are the risk factors and how can the disease be avoided?
Women above 50 years who are post menopausal or have had hysterectomy are especially at risk. Many other factors like taking steroids or anti-seizure drugs, smoking, alcohol, family history, very thin people with low body mass index and poor nutrition could lead to brittle bones. Proper nutrition and smoking can be avoided to ensure optimal health while other factors like thyroid problems or menopause cannot be controlled.

When should people consult a doctor?
As a rule, people above 50 years who fall in the category of risk factors should consult a doctor and if one does not have any visible symptoms then go for a check-up once you turn 65 years old. Some visible signs like stooped posture, loss of height, fracture of vertebra, wrist, hip or bone and back pain due to collapsed vertebra are other indicators for consulting a doctor.

Is surgery required to treat osteoporosis?
Surgery is done if the disease has progressed and renders a person immobile due to fracture. However, in my practice, we believe in non-surgical intervention and have observed that 95% to 99% surgeries are avoidable.

What is the treatment for osteoporosis?
The first step is to start calcium and vitamin D supplements. Second is to give appropriate medication depending on the medical condition. Besides medication, we make dietary changes and regulate intake of food items rich in calcium, magnesium and phosphorus. Physiotherapy and light exercising at home is incorporated to build bone density.

We also offer fall prevention therapy in which seniors are recommended lifestyle modifications like avoiding wet floors and slippery carpets. We also ask patients to stay away from alcohol and tobacco.

Osteoporosis is no longer a 'woman's disease'. Men are also at risk. On this World Osteoporosis Day, observed on October 20, the city doctors advise men to improve their peak bone mass by adhering to a healthy lifestyle by including regular exercise, brisk walk, balanced diet with adequate calcium and Vitamin D intake. With changing lifestyles, this silent killer, which has no sign or symptoms and is diagnosed only when a person suffers from a fracture of the bone, has also put men at risk.

Dr Mahesh Bijjawara, consultant spine surgeon at Sri Bhagawan Mahaveer Jain Hospital, says that in the past few years the prevalence of men suffering from osteoporosis has increased and now doctors are also recognising it.

The two interesting features about this disease in India are: The higher incidence among men and the low age of peak incidence as compared to western countries. The ratio of osteoporosis hip fractures is one woman:1 man in India, while in the west it is 3:1.

Besides, in most western countries, while the peak incidence of osteoporosis occurs at about 70- 80 years of age, while in India it afflicts those between 50 and 60. Although the overall prevalence of fragility fractures is higher in women, men generally are recording higher rates of fracture related mortality.

"Though there is no specific research on the cause of the disease in men, it is known that about 20 to 24 per cent of hip fracture are suffered by men and it is estimated that the lifetime risk of experiencing an osteoporosis fracture in men over the age of 50 is 30 per cent," he adds.

In aging men, wrist fractures carry a higher absolute risk for hip than spinal fracture in comparison to women. Doctors also observe that osteoporosis is largely under-diagnosed and remains untreated in the country.

Dr Upendra, a consultant spine surgeon, says that early diagnosis and treatment helps reduce the disease burden along with significant improvement in the quality of life of those who suffer from osteoporotic spinal fractures.

What is osteoporosis?

Osteoporosis is a disorder characterised by a decrease in the density of bone and bone mass resulting in fragile and weak bones. The bones become extremely weak or porous and prone to multiple fractures even on a slight fall.