Prof. A. Balas, Founder President of International Union of Angiology, Prof. Satish Khanna, President, Vascular Society of India, Prof. S.K. Khanna, Director, G.B. Pant Hospital, New Delhi, Distinguished Medical scientists, Ladies and Gentlemen,

I am very happy to be associated with the 3rd Annual Conference of Vascular Society of India.  I am glad that a galaxy of well known Vascular Surgeons, Physicians and Scientists from all over the world are participating in the Conference.  I extend a hearty welcome to them.

The Twentieth century has been described as the "Age of Anxiety" and the "Age of Extremes".  No wonder  that in the "Age of Anxiety" and "Extremes" the phenomena of vascular diseases are spreading far and wide reaching epidemic proportions and posing grave danger to the public health system in the world.  A new and significant assessment of the world's health by the WHO and World Bank shows that the plagues of the 21st century will not be dreaded Ebola virus or  bacteria or, indeed, even malaria, tuberculosis and AIDS, but heart disease, emphysema and motor accidents.  The implication for developing countries is that they have to fight both against the prevalent communicable diseases and the fast emerging vascular diseases that have serious socio-economic and public health bearings on their fragile and thickly populated societies.

With the growth in life expectancy due to relative availability of medical facilities, and food to a  large segment of our population, the diseases that accompany the extended years of life are becoming common.  Besides, the increasing stresses and strains of modern life combining with environmental degradation and poverty of the people, compound the problems of existence with crippling consequences.  It is estimated that vascular diseases are widely prevalent in India.  There are around ten million people in our country who are suffering from this disease.  I have seen reports in newspapers saying that "Indians are most prone to heart attacks", "India leads in heart attacks", and that "just being Indian is now considered to be a risk factor".  Indians are said to be four to five times more predisposed towards cardio-vascular diseases.  Even abroad, people of Indian origin, have a greater chance of suffering a heart attack.  In fact the high incidence of this disease among Indians has spurred research in London based Thrombosis Research Institute to identify the gene responsible for it. 

Indira Gandhi used to say that "If negligence is the cause of heart disease in affluent countries, ignorance is the cause of ours".  Therefore, we have to make people aware of the importance of modification of life style from sedentary one to a life oriented to exercise, physical work and low fat diet, cessation of smoking and effective treatment of vascular diseases.  The increasing materialistic appetite and voluptuous consumption must be  stemmed to contain the emergence of  life-threatening vascular diseases.  One famous American cardiologist once had said that "God does not give humans heart diseases before the age of 80.  If they get it before that, it is due to their own conduct and actions".

As you know, our cultural tradition is rich with prescriptions for good heath through exercise and balanced food.  Legend has it that once when some disciples of Sushruta approached him with the problems   of sweet urine, the sage advised them to search for the lost cows in the forest on an empty stomach.  The idea behind this advice could have been that through exercises the disciples would burn their surplus sugar, that  otherwise would have been deposited in their blood vessels.  Swami Vivekanand's approach to life was also  similar   He used to say that to understand the profound meaning of Bhagavat Gita, one has to play football.  The basis of existence, whether it be of physical or spiritual, rest on good health that is built, among other factors, on regular and modest exercise and  proper diet   The craze for fast food is spreading far and wide.  The high fat content and cholesterol amount, in such foods create fertile conditions for vascular ailments.

Combining this preventive aspect with science and technology we can achieve significant results to tackle these growing problems.  These problems accompany the extension of years of life.  As life expectancy grows the ageing population also swells.  The concomitant diseases of ageing are serious challenges for the scientists , doctors and physicians.  It has been very well said that "the society which fosters research to save human life cannot escape responsibility for the life thus extended".  Therefore, there should be a concerted effort to apply more and more science to tackle the vascular diseases themselves and solve the attendant problems.  We are now a developing country.  At this stage of development vascular diseases have assumed serious proportions.  These diseases are not the diseases of the rich only.  These have affected every strata of society.  The  need of the hour is to expand the application of our scientific knowledge.  I should like to say that, apart from prevention and cure, after-care following surgery is equally important.  I have a feeling that once the patient is safely out of the operation theatre, there is not enough attention to subsequent problems he may face.  There may be minor but disturbing after-effects and there is a case for co-ordinated attention by surgeons and cardiologists, including research into the after-effects of heart-surgery.

Whenever we talk about disease and public health there is almost a natural tendency to fall back on the western medical science, that is the allopathic system.  There is no doubt that this system is very effective in  providing  cure, but there are our indigenous systems of medicines Ayurveda, Siddha, Unani and Homeopathy which provide holistic treatment of diseases.  The world over, there is developing widespread interest in alternative system  of medicines.  London Economist reported  that at least one new purveyor of alternative medicine is opened every day in America.  America's National Institute of Health set up the office of Alternative Medicines in 1992 with a brief to integrate effective alternative treatments into mainstream medical practice.  The U.K. based Medical Research Council is studying the effect of meditation on people with stroke.  There is thus a renaissance of alternative medicines in the western countries.  American consumers are spending billions trying herbal or homeopathic cure.

These kind of approaches will reduce our cost of cure.  Particularly for the poor people it will be cost-effective, if they can get benefits from alternative systems of medicines.  The inference is that we need not necessarily depend on costly drugs and medicines or advanced life style to achieve significant results.  In my home State of Kerala it has been found that people's growing access to alternative system of medicines has contributed to the improvement of their health status.  Kerala has shown that we need not be very wealthy to be healthy.  The U.S. has achieved an infant mortality rate of 10 after spending $ 3,500 per capita per annum.  Kerala has achieved a rate of 17 after spending $ 20 per capita per annum.  This should provoke us to think.  I am sure that this Conference which is focussing on issues important to India will deliberate on such issues very deeply.

In a country like India with the dearth of medical facilities for an ever expanding population, "illness has become an industry" for some.  In this context we have to provide people with adequate medical facilities with less cost to save them from predatory commercial interests.  Dr. Ronald Ross, the legendary cardiac surgeon, who once appreciated Indian technology and expertize for heart treatment as one of the best in the world, had told the young doctors that there was no reason to keep grumbling and asking for more facilities and sophisticated theatres.  He had reminded that with team spirit and dedication they could even work in a shed.  This does not mean that we do not need modern facilities and equipments.  But sophisticated gadgets and five star facilities are not the answer to our health problems.  Thousands of years ago Hippocrates had said, "Wherever the art of medicine is loved, there also is love of humanity".  In fact, love for humanity must be the defining focus for  medical practice.  I am sure that the deliberations of this Conference will also be guided by this philosophy.

Thank you.