In the morning I met with Dr Dilip Nadkarni, a campaigner for Spit Free India. I used Dilip’s anti-spitting video, that I came across on YouTube, in my lectures as an example of the nature of public health messages in India but also how messages can be relayed with humour. Dilip’s video uses a popular song reframed with anti-spitting lyrics. Take a look – it actually encapsulates how spitting is an act of the wealthy as well as others, quite well. Needless to say the angle is not a sympathetic one and Dilip and I chatted for a while about the use of paan at weddings, and ceremonies, in expensive hotels and the like, and also about what might be possible regarding changing spitting cultures in India.
At the clinic (an NGO called PATH [People’s Association for Training in Health] which has a tuberculosis check-up dispensary, we met Dr Marian Gomes (medical practitioner) and Mr K.T. Chacko, the founder Director of PATH – shown here in the depths of the Cheeta slum colony.
The clinic specialises in containing the spread of tuberculosis – of which there is an extremely high prevalence among the slum dwellers – and spitting is a major concern of theirs. Spitting is seen as an important factor in the spread of TB and other diseases and viruses through airborne particulates. Because the clinic is faced with frontline priority health issues, on a daily basis, including trying to prevent spitting in a population that spits all the time and the challenged conditions in which they have to carry out this invaluable work made me self-conscious about musing to them about the ways and wherefores of public spitting more generally and unsurprisingly I was met with some scepticism about the value of the research. What followed was a long and involved discussion around whether there is much reliable scientific evidence (simply assumed usually, but poorly evidenced in reality – about spitting being a significant threat for the spread of TB and other diseases, followed by various depth cultural examples and a friendly exchange the nature of spitting in different cultures.
Here’s a Shanghai Public Health clip claiming to depict the way spit spreads disease.