It was a moment of glory for two doctors and pride for the medical fraternity in Vidarbha and Nagpur as national honours were conferred on Dr Vikram Marwah and Dr Prakash Amte.

Dr Marwah, ex-professor of surgery and dean of the government medical college, Nagpur, is a crusader of sort, having immersed himself in teaching and applying independent thinking and indigenous method to surgical and orthopaedic specialities. He was the driving force behind the artificial limb centre which was started along with the physiotherapy school in the 1970s. He was known for developing below-knee prostheses from simple bicycle stands; these were hugely popular. After his retirement he devoted himself to corrective surgery for polio-afflicted children and along with his team has performed nearly 10,000 surgeries. A man of literature, he has contributed to Hindi prose and poetry and is actively involved in the Hindi literary movement. He is also a recipient of the BC Roy award.

Dr Prakash Amte, alumni of GMC Nagpur, along with his wife Dr Manda took inspiration from his illustrious father and Dr Albert Schweitzer and started Lok Biradari Prakalp, a project for tribals in the remotest forests of Gadchirolli district in 1973. Despite the lack of roads, electricity and equipment, and despite being cut off from life in the city for six months of the year, he and the local people have been working relentlessly to improve health and educational services for tribals in this district. He is a simple man who takes his principles seriously and applies them rigorously to himself and his work.

These doctors have different personalities, attitudes and methodologies but they have a common goal -alleviating suffering of the poor. Both of them have been immensely successful in their efforts; the honours may have been conferred a shade late.

Another important event was the annual conference of the Academy of Medical Sciences, Nagpur, on January 19 and 20. This conference gives its members a platform to present their research work. The award and free paper sessions generated a good response from speakers and audience alike. In all, 20 papers were presented. Interestingly, the jury bypassed some highly technical papers to choose a simple paper meant to judge specialists’ knowledge. Fifty obstetricians – the first contact for new mothers — were interviewed by a paediatrician on their knowledge of current breast-feeding practices.

The results of analysis were quite interesting. Perhaps all specialists should be evaluated at regular intervals on their awareness of appropriate health care practices. This could be produce some very interesting analyses, besides becoming an ongoing education programme.

I reproduce, below, Dr Meenakshi Girish’s paper on the “breast feeding promotion programme: right policy, wrong target”: Though the medical fraternity has been bombarded by costly technological advances, none of these so-called sophisticated interventions have had as great an impact on morbidity and morbidity as have low cost interventions. A classic illustration is the oral rehydration solution which has transformed mortality statistics in children in the last few decades.

Another low cost intervention is the policy of promoting exclusive breast feeding till the age of five months, and its continuation till one to two years. Unfortunately, this policy has not realised its true potential. Who is to blame? Should we point a finger at the pharmaceutical companies for aggressively promoting formula fees, or should we hold a mirror to ourselves? To address this issue, a study was conducted with the aim of assessing the knowledge of breast-feeding management among obstetricians. About 50 obstetricians were asked to respond to questions which were based on several popular misconceptions held by the general public which were detrimental to successful breast milk secretion and feeding.

While 100 per cent of obstetricians agreed that breast milk is best for the baby, the percentage of obstetricians with a good knowledge of the various aspects of breast-feeding management was appallingly low. Only 20 per cent of respondents knew that the baby should be allowed to suckle in the first hour after delivery, 86 per cent of respondents believed that since mothers need rest after undergoing a Caesarean section, breast feeding was not a priority for these women. There was almost universal lack of awareness of the adequacy of colostrum for an uncomplicated, full-term, appropriate for date baby. Most obstetricians (72 per cent) would supplement breast milk with top milk in the first few days of life. While 72 per cent believed that water supplementation was not needed even in the peak summer months, there was still an unacceptably high figure of 29 per cent who believed that water must be given to quench the baby’s thirst. Use of nipple shields in retracted nipples increases the risk of infection in the baby and also causes lactational failure. Yet 72 per cent of respondents advocated nipple shields for the treatment of retracted nipples.

Among all the mammalian species, only Homo Sapiens require breast feeding education or management. No other species needs it because they don’t have an alternative. Popular misconceptions, the availability of alternative nutritional sources and the impact of advertisements combine to make the topic of breast feeding management mandatory for all prospective mothers. It is disturbing to note that even medical professionals who have the greatest influence on these prospective mothers need to be educated about various issues pertaining to breast feeding.