A Winter in India

Yesterday, Dean Mahesh Verma had arranged an opportunity for us to meet with the Chief Minister of Delhi, a woman named Sheila Dikshit (as Dave Barry would say, “I am not making this up”). Delhi is actually a state, so the Chief Minister is comparable to a governor. She is a wonderful woman, very elegant, calm and quiet. She is the only politician I have met who actually said very little, and listened to what we had to say. We talked about how much Delhi had changed for the better since 1998. Considering that 1998 is when she was elected Chief Minister, a lot of these improvements are her doing: the Metro (subway), the conversion of all public transport vehicles to compressed natural gas, expansion and upgrading of the roads and bridges, revitalizing many parks and monuments, and providing the conditions in which private companies can flourish.

Mostly, though, we talked about public health. Oral health is not separate from the rest of health; the risk factors and risk behaviors for oral disease are the same as those for the other major non-communicable chronic diseases such as diabetes and cardiovascular disease. “Diet, dirt, alcohol and tobacco” (quote from the WHO) are the big four risks. Improving any of these helps improve health and prevent disease, and prevention is much more cost-effective than intervention. Dave also quoted the World Bank’s recent statement that monies spent on preventive public health should be counted as investments, not expenses. Economic development depends on having a healthy population, and not the other way around. In the past it was thought that a developing nation needed to produce wealth first and then spend money on health, but the thinking now is that without spending the money on health right up front, development will not succeed.

This is the basic strategy that Delhi, and India in general, is following. As she said, they are concentrating on two things: prevention and alternative medicine. In part the focus on alternative medicine is because the medicines are much cheaper, but it is also because the basic philosophy of medical systems such as Ayurvedic medicine, is to teach people a healthy lifestyle, and that really is the basis of preventive medicine. Yoga is one of the big strategies being emphasized. Indian politics is so rough and tumble, noisy and mean that it is amazing that Ms. Dikshit can safely occupy the Chief Minister’s office. For such a quiet, dignified lady to flourish in the world of politics, must mean that she outthinks her adversaries. In addition, her position on most controversies must be that of the maximum good based on the highest moral intent. If the population of the State of Delhi is 12-13 million and the population of the State of Maine is 1.3 million then Chief Minister Dikshit has ten times more people responsibility than Governor John Baldacci.