History & Background of Ladakh Institute of Prevention (LIP)
The Ladakh Institute for Prevention (LIP) was set up by a group leading citizens who were aware of the potential for health and educational benefits to the local community as well as the possibilities offered for research in Ladakh, one of the highest, and until recently, one of the most isolated, communities in India. The formation of the LIP was a gradual process and the need for this organisation was felt through the years of work carried out by Ladakh Action on Smoking and Health (LASH) formed in 1986. Dr Keith Ball (Physician and Co-founder of Action on Smoking and Health in Britain) originally mainstreamed the concept of preventative health in Ladakh and was one of the key founders of LASH along with Dr Tsering Norboo (Founder and Honorary Secretary for LIP).
Ladakh’s opening up to tourism and the influx of military, for reasons of security, is leading rapidly to major changes in the traditional life-style. While these changes pose potential problems their study offers opportunities for benefit to communities everywhere facing similar change.
By recognising the hazards posed by these changes, major, successful interventions have already reduced significantly smoking and, by reducing dust exposure, promoted a healthier environment in the home. We cannot become complacent as in spite of what has been achieved there is still much more to be done hence the need for and organisation like LIP.
Ladakh presents a unique opportunity to study a population who until recently followed a traditional agricultural life pattern but who are now exposed increasingly to modern day life with its diminishing physical activity, and a major change to the traditional diet. While there are opportunities for improvements in some aspects of nutrition these must be balanced by the potential for these changes to induce more heart disease, stroke and diabetes. Although aspects of change have been studied elsewhere in the world, the effects of change in a unique, high altitude community have not been studied. For example, we do not know whether the hazards of changes in diet and activity reported at sea level are modulated by the persistently low levels of oxygen (hypoxia) at high altitude.
There are conditions not encountered elsewhere, namely, the effects of environmental dust. As a result of the worldwide effects of global warming and the increased industrialisation in China and the Central Asian countries there has been an increase in dust related disease. Moreover, local changes in irrigation practice may also contribute to this. Some research has already been done on the nature and magnitude of the problem but there is a continuing need for research and the implementation of its results. This work can only be done effectively in Ladakh.
The opening up of the region to an influx of so many young men in the armed forces, as well as tourists from the overseas, has brought other health problems notably the hazards that lowlanders face when moving to life at high altitude. Moreover, wherever there is an impermanent population there is an important need for education for everyone to prevent HIV infection from gaining a foothold.
The local community has already published pioneering work in these fields showing the feasibility of carrying out such studies and emphasising their importance not only to the Ladakhi people but also to countless others in communities elsewhere. Thus it is clearly established by this work that there is an enviable opportunity to establish LIP as service to the local people and, at the same time, to offer a superb opportunity for internationally important research.
Government authorities have granted land for buildings adjacent to the Ladakh Heart Foundation and Hospital, whose facilities are being shared temporarily while funding is sought for buildings and laboratories for LIP as well as support for education and research activities. Local building expertise, and the scientific goodwill of visitors and post-doctoral fellows, will ensure a good start to the programme of building, education and research but there is already a real and increasing need for funding to sustain LIP’s objectives. With the help of number of charitable foundations, and by support from government sources, for all of which we are very grateful, a start has been made already on the programme but if we are to continue. It is anticipated research projects will gain funding from grant-giving authorities but additional core funding is needed for day-to-day support and specially to fulfil the aim of providing educational and health resources to isolated villages of Ladakh.