As a cancer surgeon, I would focus on things pertaining to my field wherein Meghalaya can grow by a change in behaviour.

Meghalaya, in its golden jubilee year, has the dubious distinction of topping the country in the proportion of cancers caused by tobacco, with 70.4% of cancers in men and 46.5% of cancers in women of East Khasi Hills District attributable to tobacco.

 Meghalaya tops the country in the incidence of esophageal cancer(cancer of the food pipe) with ten times the incidence seen in other states. This is also one of the diseases attributed to tobacco. It is sad to note that while tobacco has no beneficial effect to humanity(apart from the profit it brings to those who trade it), yet it is one of the most abused substances.

So what can the church do to ensure the health of the society apart from running hospitals?

While the missionaries did well to build mission hospitals, it was in the era when even primary health care was not available in India. People were dying during child birth, of diarrhoea, malaria and other infective diseases.

 The standard of healthcare has improved much today(though there is scope for much improvement!) and so has our understanding of disease. This is reflected in our National Health Policy(NHP) which was revised in 2017.

 This NHP 2017 emphasises on ‘well-being’, and stresses on the preventive and promotive aspects of health services and not just the curative aspects. This is where the church can play its role, without any major investment whatsoever.

Where I grew up, it was considered a ‘sin’ for a church-going person to smoke. Even the few who used tobacco, did so in private, taking pains to ensure they are not seen in the act. But sadly, it is probably not so in Meghalaya.

A few years ago, I was surprised to see the ‘No Smoking’ board outside a prominent church, on the wall of the parish hall. I wondered as to why such a board was necessary in a church where none (I thought) would smoke.

 Later, inside the church, to my shock, I could smell tobacco on the person who was leading the service. This was at a time when face masks weren’t mandatory.

While some may argue that it is not a ‘sin’ to smoke, I am sure that none can deny the fact that tobacco harms the body, which is considered the temple of God.

As per the Global Adult Tobacco Survey (GATS 2016-17), 47% of people in Meghalaya use tobacco, as compared to the national average of 28.6%. This means that more people in Meghalaya use tobacco, as compared to the rest of the country.

Since this is a state with a Christian majority, the church can play a major role in changing this. If the pastors in our state can preach (both from the pulpit and off it) on the need to curb tobacco use, it would go a long way. If tobacco use is looked upon as a ‘sin’, it would sure discourage its use among the faithful.

A major fallout of the high prevalence of tobacco use in the state is the impact on children.

 The Bible lays a lot of emphasis on parents teaching children the right things and it is to be remembered that kids learn a lot by observing. I usually buy fruits from a van parked on the road near my house and the fruit seller is usually accompanied by his son, aged about 7 years. Sadly, oblivious of the fact that the vehicle is parked in a public space and that his young son is watching him, he is invariably seen smoking. Now it is obvious as to what this boy would do once he grows up.

 Unfortunately, he would probably not even wait to be an adult to take to smoking-as data from the Global Youth Tobacco Survey 2019 shows. This is a survey done among children aged 13 to 15 years of age, commissioned by the Ministry of Health and Family Welfare, Government of India(GoI).

 In Meghalaya, 34% of 13–15-year-olds were found to be using tobacco.

The Government of Meghalaya, through a joint effort by the departments of health and education, has successfully implemented the ‘Tobacco Free Educational Institution’(ToFEI) program to curb use of Tobacco by school students.

As part of this program, the school is expected to ensure that no tobacco product is sold in and around schools (upto a radius of 100 metres), no teachers (or other staff) use tobacco in the school and activities such as pledge against tobacco are taken up on a regular basis by the students. The students have participated in rallies to spread awareness around the state and have conducted a signature campaign to this effect too. The government of Meghalaya has been commended by the GoI for this program.

 But such an initiative of the government would be fruitless if the same students go home to see their parents use tobacco.

World No Tobacco Day is observed on the 31st of May every year, since the year 1987. An initiative of the World Health Organisation (WHO), this year, the theme is ‘Poisoning our Planet’ with the hashtag #TobaccoExposed. The focus is on the impact tobacco has on the environment. The tobacco industry uses a lot of natural resources for preparing the finished product and also leaves behind a lot of waste, apart from the contamination the smoke produces. This again is something which should be of concern to the church.

A few months ago, a patient with esophageal cancer was brought to my outpatient clinic by his brother, who introduced himself as a church leader. After explaining in detail about the patient’s condition, I encouraged him to teach his congregation about the ill-effects of cancer-causing substances such as tobacco, betel nut and alcohol. It was heartening to see a video clip sent by one of his congregation members, wherein he was seen preaching from the pulpit on this issue, exhorting his congregants to desist from these substances.

How I wish many more church leaders(and lay leaders alike) would be like this person. It would go a long way in ensuring a healthy church, healthy society and a healthy Meghalaya.

These are extracts from an article, written by Dr. Caleb Harris, a cancer surgeon. It first appeared in The Shillong Times. Though the focus is Meghalaya, the message is universal.

(The writer is M.Ch.(Surgical Oncology)Surgical Oncologist [email protected] views expressed are personal)

  Christian, Church, Meghalaya, naked truth, Northeast, World No Tobacco Day