GUPTE: As more people from developing countries migrate to the West, has heart disease become a noticeable factor among them? SHARMA: Yes. Heart disease in immigrants is much higher than in native-born Americans. I notice this especially among [people] from South Asia. They are overambitious, under a lot of stress and very nervous about their prospects for success. So heart disease becomes a noticeable factor in their lives. There is also a cultural tendency to ignore signs of heart disease, a reluctance to seek state-of-the-art medical treatment.
Is heart disease the “hidden disease” within developing countries themselves? There is now increasing awareness of heart disease, especially as more and more medical institutions are springing up that specialize in coronary problems. But there is a dramatic difference in the decline of death rates from heart disease in the U.S. and in developing countries generally. While we have seen a significant decline in the U.S. over the last 20 years, deaths from heart disease are still rising in the developing countries. Traditionally, it hasn’t been fashionable to talk openly about heart disease in countries like India. Certainly you don’t see much informed coverage in the mainstream media of developing countries.
What made you decide to specialize in rotoblator angioplasty? Among various techniques of opening the blockages in the coronary arteries, the rotoblator is very unique and challenging and requires a great deal of technical expertise. At the same time, it offers sufficient confidence to open any kind of blockage–like very hard, calcified, long and chronic blockages. Because of all these qualities of rotoblator angioplasty, I got very interested in specializing in this technique so that I could tackle tough blockages and raise the field of angioplasty to a new high level.
What explains your “rags to riches” story? As I always say, “Only in America.” I have always felt that the United States offers an immigrant the chance to overcome his background and succeed through devotion, sincerity, confidence and focus. Those are the basic points of my rags-to-riches story. I think that my story also highlights that if you work hard you can achieve anything in life you wish and that you can go a long way in life irrespective of race, color and country of origin. But it’s not easy.
How do you personally encourage more physicians from developing countries to study in the West and then return home to serve their own people? Every year I bring a couple of physicians from India to be trained in angioplasty at Mount Sinai. The clear understanding is that after their internship they are to return home to serve their homeland. I’m also in the process of expanding the internship program to include other developing countries where heart disease is prevalent and where physicians need the sort of training we can offer in the U.S.
Are poverty and social underdevelopment major contributors to the incidence of heart disease? Traditionally, heart disease has been labeled as the disease of the rich and of urban development and migration. Therefore, poverty does not seem to be a risk factor in heart disease. But here’s a caution: poverty and social underdevelopment will cause higher incidence of death from heart disease because of late detection and unavailability of newer medical advances. Medically and morally, poverty isn’t ennobling.
How do you define a “healthy society”? A healthy society is one in which the citizenry takes care of itself and makes constant efforts to prevent disease by eating right, exercising, avoiding obesity and getting periodic medical checkups for early detection and treatment. But we’ve got to go beyond individual efforts. There must be a political will to incorporate health into wider policymaking. Health, as much as economic growth, is a sustainable-development issue. How many leaders of developing countries stress health in their political speeches? How much is allocated in national budgets of developing countries for health research? Not nearly enough is done in poor countries to address health issues. That must change. In this age of globalization, no society can afford to lag behind in its national health.
