Do Doctors Inform Patients about Effects of Environmental Pollution and Adulteration in Food: Scenario in Bangladesh

Author(s): S. K. Chanda*1, K. R. Bhowmik1, M. H. Molla2
Affiliation(s): 1Research and Training, SARPV Bangladesh, 2ISSPH- Bangladesh, Dhaka, Bangladesh
Keywords: Health effects, pollution, adulteration, information gap
Background:

Pollution and adulterated food has a detrimental effect on health, on emerging and re-emerging disease pattern and on medication as well. Ailment is very much linked to changed natural environment, adulterated foods, poor living conditions and life style. Medical records show alarming increase of hypertension, diabetes, renal diseases and carcinoma among Bangladeshi population in last decades. Bangladesh is facing enormous degradation of environment, witnessed massive deforestation in the name of urbanization and industrialization. Also adulteration in food and adding up carcinogenous substances such as formalin in fishes, Copper Sulphate solution in vegetables, even in adulteration in life-saving medicines are a big issue now-a-days. Doctors are accomplished in communicating with people directly through treatment and advice regarding all health and associated issues. It is their responsibility to inform patients about the ill-effects of pollution on health and how to save them from these effects. Providing such information to patients is also a part of medical ethics and proper service delivery.

Summary/Objectives: Objectives of this study were to explore doctors’ attitude towards patients regarding the conveying of information and to examine the awareness level of patients about the adulterated food and pollution issues, their effects on health, and sources of information.
Results: Cross-sectional data have been obtained from a face-to-face interviews by a structured questionnaire with patients (n=624) and doctors (n=41) in six public hospitals and twelve private facilities. Environmental pollution, adulterated food issues, source of information, and amount of education received from their doctors were questions answered by patients. Almost all patients expressed high level of concern for adulterated food and environmental pollution, 23% of patients mentioned doctors as source of information while 26% of doctors said that they really talk about this issue. 65% of patients said that they should know more about air and water pollution, effects of adulterated and genetically modified food, related diseases, etc. It has come out in discussions that majority of the doctors never consider themselves as part of the environment while in practice, just providing treatment based on clinical diagnosis. Many patients said that it is the doctor’s responsibility to inform them about these issues. And it is a fact that the patient always tries to follow what the doctor says. The main source of information and education about environmental pollution and insecure food has come from media and NGOs working on these issues, true for both doctors and patients. Some of the doctors are very much up-to-date about medical and scientific literature on these issues; still they very seldom discuss this with patients.
Lessons learned:

There is a huge information gap between doctors and patients regarding health impact of pollution and food adulteration, and doctors have major responsibility to minimize the gap. By discussing these issues, people would be able to understand the need for behavioural changes in order to protect them from many ailments. Doctors would be able to help people to overcome their avoidance, denial and confusion and to motivate them for good practice in everyday life. It is essential to inform patients on implication of changes on health and therefore many tend to take the issue appallingly seriously and doctors should take time and have patience to pass this message, which is a part of their ethical practice and providing good quality of health service as well.

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