Gauri Healthy Heart Mission A run up to the Next Destination-Kakching Dist

Prof (Dr) Upendra Kaul
Gauri Healthy heart team after covering 5 districts in Jammu and Kashmir is moving to areas of North East now as a part of our plan to cover other remote areas of the country where we have an access. First on the list is Kakching district of Manipur. It is one of the 16 districts of this wonderful part of the country. This district came into existence on 8th December 2016. Manipur (Mani = jewel, Pur = Abode), “Jewelled land” with Imphal as its capital, has Nagaland to its north, Mizoram on South and Assam to its west. It shares an international border with Myanmar on its east. Manipur is mentioned in historic texts as Kangleipak or Meeteileipak.
The State is blessed with 4 major river basins. The Barak River is the largest river of Manipur. It originates in the Manipur Hills and is joined by several named tributaries, Irang, Makru and Tuivai. After its junction with the Tuivai, the Barak River turns north, forms the border with Assam State and enters Cachar Assam just above Lakhipur. Manipur also has a number of lakes but the most known one is the Loktak Lake which is the largest freshwater lake in North East India and is famous for the phumdis (heterogeneous mass of vegetation, soil and organic matter at various stages of decomposition) floating over it. The lake is located at Moirang. One of this phumdis with an area of 40 kms is famous for Keibul Lamjao National Park, the only floating National park in the world. It is the last natural habitat of the endangered Sangai, the Manipuri brown-antlered deer, (Cervus eldi eldi), one of three sub-species of Eld’s deer
The State covers an area of 22,327 square kilometres and has a population of almost 3.5 million, including the Meitei, who are the majority group in the State along with the Meitei Pangals (Manipuri Muslims) constituting around 52% of the  population of Manipur. They speak Meitei language, a Sino-Tibetian language with an ancient script.  Naga tribes, Kuki/Zo tribes and other communities, who also speak a variety of Sino-Tibetan languages constitute the remainder with Nagas outnumbering others.
Manipur traditionally had a king or monarch ruling it from times immemorial. There were however times when the country was in turmoil without rulers and long historical gaps in between 1129 BCE and 44 BCE. In 1891 CE, after the defeat of the Meiteis by the British in the Anglo-Manipuri war of Khongjom, the sovereignty of Manipur which it had maintained for more than three millenniums, was lost.
After the war, British India moved towards independence, and the princely States which had existed alongside it became responsible for their own external affairs and defence, unless they joined post-independence India or the Pakistan. The Manipur State Constitution Act of 1947 established a democratic form of Government, with the Maharaja continuing as the head of State. Maharaja Bodh Chandra was summoned to Shillong, to merge the kingdom into the Union of India. He is believed to have signed the Merger Agreement under duress. Thereafter, the legislative Assembly was dissolved, and in October 1949 Manipur became part of India. It was made a Union Territory in 1956. and a fully-fledged State in 1972 by the North-Eastern Areas (Reorganisation) Act, 1971. Some similarities in what happened to Jammu and Kashmir
Manipur has had a long record of insurgency and inter-ethnic violence. Several opposition groups received arms and money from the neighbouring countries. Their slogan was independence from India and form Manipur as a new country.
For these reasons Manipur was declared as a disturbed area from 1980 to 2004. This had to be lifted from some Municipal areas of Imphal under a mass uproar following the rape of a Manipuri woman,Thangjam Manorama Devi, by members of the Assam Rifles. This led to wide protests including a nude protest by the Meira Paibis (women’s association). Episodic unrest continues to occur. However recent years has seen improvement in law and order and new development plans.
 One of the grouses of Manipuris is that people of mainland India are not aware of this area and their problems in general are not highlighted in the Indian media. The medical facilities in general need lot of attention. The capital city, Imphal has 2 medical colleges with very crowded hospitals attached to them. Specialized treatment is difficult to get. Private hospitals are beginning to come and one of them SHIJA hospital a multi-speciality modern Hospital, has a good standard and reputation.  Like-wise some other entrepreneurs have smaller set ups, like the SKY Hospital for heart diseases, of Dr Shyam Kishore Singh. In general, the paying capacity of most people of the State is very poor and except for a miniscule rich population which moves out to Kolkata or Delhi for specialized treatment cannot afford it. The healthcare of the State needs a revamp.
Nurses from Manipur are very efficient in their profession and they can be found working in several parts of the country and like Kerala nurses are very sought after because of their dedication and the missionary spirit.
Kakching District: We have decided to go to the Kakching town of this district through one of the doctors from that district working in Delhi, Dr Ibethoi Yengkhom on 16th of March 2021. This district is about 45 kms from Imphal and 75 kms from the border of Myanmar.
Kakching is known as the granary of Manipur. Its workers produce the highest percentage of food grains in the State. The availability of proper irrigation and canal facilities has allowed farmers to practice double cropping. rice, pulses, cereal and potatoes are the important production of this sub-division. Hand-loom and handicraft products are also made in high volumes there. It has also been declared as the cleanest city in North East India and has a high literacy rate of 89%. It has a famous beautiful garden situated at Uyok Ching, to the south of Kakching Bazar and has been developed as a tourist centre.
Kakching, used to have an aerodrome during the 2nd world war which has now become a paddy field and farmers still find used shells while tilling.
The population of Kakching town is around 45,000 based upon the last census. That would mean around 13500 patients of high BP, 4,500 diabetics. The number of patients with heart disease would also be around 5,000.
The district authorities have been informed about the camp by Gauri Kaul foundation and around 100 previously screened patients with high blood pressure, diabetes with or without heart disease will be seen by a team of doctors under my supervision. The activity would be done under the guidelines of WHO, COVID protocol. Every patient would have general examination which includes, weight, height measurement, BP recording by a validated machine, point of care blood sugar, lipid profile, in suspected cases with heart failure nt Pro BNP and an ECG. A questionnaire designed for our camps would be used to get all the data.
 The medical treatment would be optimized using cost effective drug combinations and all the patients would be counselled regarding the importance of a good life style. New drugs for managing diabetes and heart failure would be prescribed and starter kits would be provided free of cost to the needy subjects. Patients needing specialized care would be guided according to their needs and affordability.
At the end of the camp a report will be prepared and submitted to the health authorities and we would also compare it with the reports of the previous camps done by our foundation. The writer is MD, DM, FCSI, FACC, FAPSIC, FSCAI, FAMS, recipient of Dr BC RoyAward and Padma Shri and Chairman of Batra Heart Centre