India's medical system offers lessons for Canada, according to South Asian Health Institute program director

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      The founder of the Canada India Networking Initiative, Dr. Arun Garg, sees tremendous potential for the two countries to help each other achieve better health outcomes.

      In an interview following CINI's conference last month in Surrey, the former president of Doctors of B.C. declared that Canada will never compete with India on efficiency and cost-effectiveness of medical services.

      Garg, who was born in India, used the colloquial Hindi and Punjabi word jugaad to highlight Indians' creative capacity to make things work with few resources.

      "India knows more about doing that than Canada will ever know," he said. "If you walk into a hospital in India, everyone in the line knows exactly where the costs are. Here, nobody knows."

      As an example of jugaad, Garg cited an Indian foundation that does cataract surgery with greater efficacy than Britain's National Health Service at less than one-tenth of the price per operation.

      "In British Columbia right now, two major health projects are coming up," he said. "These are billion-dollar projects. I think if there was a relationship already built, some of the jugaad, or cost-effective delivery, especially in high-tech, would have a positive impact on cost efficiencies, because some of the hospitals there are very well developed."

      But the Canada India Network Society founder and chair is also certain that Canada has a lot to offer in helping the Indian health-care system achieve higher levels of quality, professionalism, and ethics.

      According to Garg, India is hungry for the type of health-care leadership that Canada has demonstrated.

      However, he maintained that this is not being recognized by politicians in Ottawa.

      "The Canadian government has not done anything in that [area], whereas the French, Germans, and Americans are there," he said.

      Garg described Prime Minister Justin Trudeau's February trip to India as a missed opportunity to build bridges in health care. 

      The veteran pathologist noted that there is a large Indian diaspora in Canada, which includes many people working on various initiatives in India.

      "He should have taken 50 of these people, chosen carefully, who are making an impact," Garg said.

      Fraser Health is applying lessons learned from India

      Garg is based at Royal Columbian Hospital and works with Fraser Health to ensure that health services are offered in a culturally appropriate way to people of South Asian ancestry.

      As the program medical director of the Fraser Health's South Asian Health Institute, he is helping the community enhance its understanding of health conditions that it's vulnerable to, including adult-onset Type 2 diabetes.

      This was a major focus of the recent CINI conference, along with palliative care, mental health and wellness, and integrative medicine.

      Through CINS, Garg and other health-care providers are learning from experts dealing with similar populations in India about effective strategies.

      And when it comes to diabetes, Garg stated that a one-size-fits-all approach won't be very effective.

      "What works in a gurdwara will not work in a mosque," he said. "Or what works in a mosque will not work in a [Hindu] temple, so you need to recognize that."

      Part of the reason is that many Hindus are vegetarians. 

      "If you start talking about calories and protein in meat, you've lost them," Garg noted.

      He works with registered nurse and leader of the Sehat program with Fraser Health, Deljit Bains, at the South Asian Health Institute. She has played a leading role in educating some gurdwaras to use less sugar in meals served by the langar, or communal kitchen.

      "She's of Sikh faith," Garg said. "She's been very successful in connecting with gurdwaras because she understands them and she has earned their trust."

      Garg is a Hindu from the city of Agra, and he chairs the health committee at the temple he attends in Burnaby.

      There are also four subcommittees as part of the health committee promoting weekly yoga, better nutrition, seniors' health, and connecting with young people.

      He said people are eager to become aware of health issues and to engage, but only if it is shared in a collaborative and trusting way.

      Garg has a PhD in biochemistry from the University of Saskatchewan in addition to medical training at the University of British Columbia. And he also has keen interest in ayurvedic medicine, which is extremely popular in India.

      Ayurvedic practitioners focus on the whole person, whereas in western medicine, there's a tendency to zero in on the health condition or pathogen that's linked to a disease.

      He's particularly interested in new research into the microbiome, which is a term to describe the 100 trillion micro-organisms living in the body that, among other things, help digest food.

      "I think most of these chronic diseases are embedded in what we call common pathways of inflammation," he said. "And most of the plant-based materials are anti-inflammatory."

      By combining Indian and western approaches, he feels there are opportunities to achieve superior health outcomes.

      "Whatever we are doing is not exclusively South Asian," Garg emphasized. "It just happens that the population need is there, but it's applicable and scalable to any population."

      The Canada India Networking Initiative is a community partner of the Indian Summer Festival, which takes place until July 15 in Vancouver. As part of the festival and the 17th World Sanskrit Conference at UBC, there will be a presentation on the history of yoga by Sir James Mallinson on Thursday (July 12). For more information, visit the Indian Summer Festival website.