Those who suffer, pay a big price — both physically and financially. Together, the four diseases affect about 30 per cent of Delhi’s population. Such is the scenario that in government hospitals, there are more patients than doctors and beds; in many cases, science has not offered easy answers. Beginning with COPD, a four-part Newsline series looks at these diseases, and how they affect Delhi.

For 29-year-old Sunil Kathuria, persistent coughing since childhood has brought him his present address: hospital bed. His mother Santosh, an employee at a Delhi museum, says Kathuria’s body swelled and he became unconscious after an uncontrollable bout of coughing two years ago.

Since then, he has ended up at the intensive care unit of Sardar Vallabhbhai Patel Chest Institute (VPCI) five times in the last seven months.

But doctors at the institute say it’s not bronchiectasis, his ailment from infancy, which has left Kathuria gasping for life today. Dr Rohit Caroli, who’s treating him, says packs of cigarettes for a decade has turned the lungs of the young tuition teacher into an old man’s decapitated organ.

“He is barely 30 but he has lungs of a 60-year-old,” Dr Caroli says, pointing to an oxygen tank Kathuria has been tethered to for over a week now. “He needs oxygen supply for 24 hours, and he has grown very feeble.”

Bronchiectasis, Dr Caroli says, did make matters worse but the real killer in Kathuria’s case is Chronic Obstructive Pulmonary Disease (COPD), a progressive illness that permanently damages the lungs and is usually caused by smoking. Once thought of as a disease of the old, the disorder has become a formidable medical challenge in the Capital, with COPD claiming a 10-15 per cent share in deaths due to respiratory diseases, say doctors.

“Among patients coming to our institute, 15 per cent suffer from COPD while 50 per cent of them come with bronchial asthma,” VPCI director Dr V K Vijayan says. “This may not be a dramatically alarming figure but it’s a chronic disease that increases over a period of time.”

‘Most dangerous’

Respiratory diseases — an umbrella term for diseases of the lung, bronchial tubes, trachea and throat — caused by factors like smoking and air pollution, among others, were responsible for 9,164 deaths in Delhi last year. In 2006, the fatality figure was 6,014.

But doctors warn that COPD may turn out to be the most dangerous. “It is associated with other core morbidities,” Dr Vijayan says. “COPD has higher prevalence of heart diseases, diabetes and hypertension; because of these morbidities, hospitalisation and mortality have increased.”

Indraprashta Apollo and Fortis Hospitals received more than a thousand COPD patients last year — and doctors say half of them are below 65. “The disease affects mostly people in the middle age, thus leaving the working-class too sick to work,” Dr M S Kanwar of IP Apollo Hospital says.

The expenses are also overbearing: an acute COPD patient spends about Rs 3,000 every month on treatment.

The treatment therapies vary but may include drugs, exercise programmes, dietary restriction, oxygen, and lung surgery.

While cigarettes are the major factor leading to the disease, a significant number of women are also getting affected with smoke from indoor fires that burn wood, coal, straw or dung for heating and cooking in the city’s urban villages. “Adequate treatment means drugs, usually inhaled, that open the airways and quell inflammation — these are preventive medicines that must be used daily, not just in emergencies,” says Dr Vijayan.

And, it is essential to quit smoking.

What is COPD?
A group of diseases characterised by pathological limitation of airflow in the airway that is not fully reversible. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other lung disorders.

Symptoms
Shortness of breath (dyspnea), wheezing, decreased exercise tolerance, cough with or without phlegm

Treatment
Antibiotics to fight lung infections, vaccines to prevent flu and pneumonia, and lessons on special breathing techniques. Some need constant oxygen supply.

Global killer
The Global Burden of Disease studies ranks COPD as sixth commonest cause of death worldwide.