The south Asian region consisting of India and neighboring countries namely Pakistan, Nepal, Bhutan, Bangladesh, Srilanka, and Maldives is one of the densely populated regions of the world. Approximately, 24% of the population of the world lives in this region. Historically and culturally, there are a lot of similarities between these countries. The socioeconomic status and genetic pool of this region are almost common, and therefore health problems being faced by the population are also similar. I have personally visited Srilanka, Bangladesh, Pakistan and Nepal and witnessed the similarities of problems being faced by the region.
The common problems affecting the maxillofacial region per se are high prevalence of oral cancer, load of patients with oral submucous fibrosis, cleft lip and palate and temporomandibular joint ankylosis. The trained manpower to deal with these problems in some of the countries is very less. The oral and maxillofacial surgery is a recognized dental specialty in this part of the world. India with more than 330 dental schools and 160 recognized postgraduate programs in Oral and Maxillofacial Surgery, with annual production of approximately 600 postgraduates is the leader in the region. Some of the countries in the region are establishing training programs in Oral and Maxillofacial surgery. First batch of MDS (Oral and Maxillofacial Surgery) in Nepal appeared this June, 2014, and I had the privilege to be an examiner for the first batch. Most of the teachers in Nepal dental colleges were visiting teachers from India going there occasionally to collect pay packet. Many other countries such as Bangladesh, Pakistan and Nepal are also opening dental and medical colleges mainly in the private sector and in rural areas with questionable infrastructure. Is this the spillover effect from India? India might be producing a large number of postgraduates, but quality and skills of many graduates are questionable due to poor training and facilities. These neighboring countries need not follow India in this aspect.
We look towards developed world to solve our problems. Based on the experience and health needs, these countries have developed protocols and solutions for their population. These protocols may not be suitable for our population because of cultural, geographic and socioeconomic differences. Therefore, we need to develop our own protocols and solutions for the common health problems of the region. There are differences in training and skills of postgraduates between developed and developing world. I was asked to train faculty at Nepal for orthognathic surgery and distraction osteogenesis. Can things be improved and common solutions developed to alleviate the suffering of poor people of this region? How can we achieve our common goals of alleviating the suffering and meeting the health needs of our population? There is a need for regional co-operation and pooling of the resources among the south Asian countries to bridge this gap.
Our national and regional professional associations and government sponsored programs for training and exchange of manpower in the field of health care in general and Oral and Maxillofacial Surgery in particular is the need of the hour.