The modern thinking Indian

Swine Flu (or more correct, H1N1 flu) is now spread all over the world, declared a pandemic by the World Health Organization. It has been reported from countries all over the world, with people contracting the disease, and a majority of them recovering; for a small fraction of them, the disease worsens to the point that the afflicted person dies. One of the major factors that has helped prevent a higher number of deaths is the fact that the virus has not mutated into a virulent form. Currently, the virus is treated by the drug called oseltamivir or Tamiflu. However, like many other diseases, there will be a form of the virus that is resistant to this drug, and because they are more difficult to treat, this strain of the virus spreads.
Scientists are worried about a strain of the virus spreading that is resistant to the drug, and hence are tracking these cases. As an example, there are many forms of other bacteria caused diseases such as TB that have multi-drug resistant strains and which are of major concern to medical personnel the world over (link to article):

An increasing number of countries, including some in Asia, are now reporting Tamiflu resistant H1N1 virus. The worrying development, according to WHO, has seen 12 countries including China and Singapore. India has not reported the mutation in the virus so far. The changes in the virus reported in samples are making these strains of swine flu resistant to oseltamivir or Tamiflu - the antiviral of choice globally. Such cases have also been found in Japan, US, Hong Kong, Denmark and Canada.
Going by available data, majority of the resistant cases were reported where oseltamivir was given as preventive medication to people exposed to the flu but who had not tested positive themselves. Some cases were a result of treatment of mild illness as well as "immuno-compromised" patients or persons whose immune systems were working imperfectly.

This was the main worry in the case of earlier diseases where antibiotics were given for any problem, including treating the common cold. In the current case, health authorities are trying to prevent such a case by not allowing Tamilflu to be sold over the counter, and the dispensation of which has been restricted to either patients, or to those who are in high risk situations such as medical personnel, screening personnel.
Barring any mutation that causes the virus to become more virulent, the expectation would be that swine flu will be like any other flu, which spreads like the common flu, and patients recover after treatment. Initially, the media also went overboard, but now it seems like that there is some sense of responsibility and carefulness being exhibited by media all over the world.

Labels: H1N1 Flu, Health, Infection, Media, Medical, Swine Flu, Tamilflu, Treatment, Virus

Diabetes has been called a lifestyle disease, one that affects people who have moved onto a richer lifestyle (their food has got richer with more starch, more sugar, and lesser amount of direct physical work). As a consequence, the incidence of diabetes in countries (that are moving from a poor state to a state of rapid economic development) is increasing at a rapid pace. India is one such example - there is a huge section of the middle class and upper class that have more money than previously, have a more sedentary lifestyle, and also have aspirations to a richer living model. This would include stuff such as higher consumptions of fatty foods, colas, etc.
This increase in the number of diabetes affected people has many negative implications. Diabetes is currently a non-curable disease, and with a lot of potential complications all over the body. If the number of diabetes affected people in society increases, there will be a much higher need of diabetes treatment for all sections of society, and a much higher level of medical costs. The Government and other bodies should take a note of this trend, and try and educate society as to how to prevent this spread of diabetes from reaching alarming trends:

The fast transition of India to western lifestyle has made the country a hub for the disease and diabetes is fast emerging as one of the most common chronic ailment to affect children. Lifestyle changes and awareness of the disease can help many people to live safely with diabetes. “Obesity and inactivity among children have increased cases of diabetes among people of age 12-20 which was earlier prevalent only in those above 35 years of age,” says Dr Shailesh Lodha, senior consultant endocrinology, Fortis-Escort Hospital.
The incidence of juvenile diabetes caused due to genetic factors in children less than seven years is also rising by nearly 3%, whereas for mature patients it is rising by 5%. Meanwhile, the number of diabetes patients among grown-ups is also rising at a similar pace. Diabetes in itself causes less harm, but it can cause permanent damage to vital organs if remains undiagnosed for a long time.

Diabetes is a disease that has the potential of causing major long term harm to the health of society; and this will happen unless there are a number of measures taken to make society more aware of the need to prevent / control diabetes. The way forward should be to:
1. Educate people to reduce the current rate of people who are contracting diabetes.
2. For those who already have diabetes, they need to be properly aware of the normal safety measures to be taken, and follow them adequately.

Labels: Diabetics, Health, Medical

I read this article in a newspaper, and was shocked (and shocked is a mild word for what I felt). Read a few excerpts, and then we can discuss further:

Dr Harish Shetty, however, doesn't buy the logic. "Drinking with dad is just as bad as it can sow the seeds of alcoholism in adult life.'' He feels that there are some parts of the big bad world that parents should not get inside the homes. It's not just at house parties that alcohol is 'on the house. 'A Congress MLA's son from an elite school in the western suburbs celebrated his birthday party at Taj Land's End, where booze flowed freely until the wee hours of the morning.
For several city children, "beer and breezers aren't really alcohol.''Kids have often sneaked miniature bottles of vodka into the classroom and downed liquor in the loo. Some have even been caught for it, after falling asleep at school. Students at one south Mumbai school have openly gulped down vodka in Bisleri bottles during the school socials.

This is downright scary. Alcohol is not just a party drink; when drunk in moderation and under control, it can be accepted. However, there are many dangers to alcohol drinking that most people know about (and are outlined briefly). Please add more such stuff if you know about this:

1. Alcohol can be pretty harmful to the system. Regular drinking of alcohol leads to damage of the liver, and a craving to have a regular session with the bottle. Damage to the liver (enough to cause lasting damage) increases in probability due to the intake of alcohol.

2. During the formative years, children (or young adults as they would like to be called) are susceptible to peer pressure, and may be forced to join even when they would desire not to.

3. Similarly, in today's world, even with so many other careers available, the need for a good education is a significant factor in moving ahead in life; if children start to discover alcohol and spend time in such parties during this time, there will be a percentage of children who will be actually affected by alcohol.

4. Once a parent allows children to start consuming alcohol, it is one major moral point off; it will be much more difficult for a parent to try and prevent more 'social' drinking at parties / clubs.

5. Nothing comes for free. With an increasing proportion of population becoming obese, and coming down with the 'lifestyle' illnesses, such as diabetes, increased alcohol content just ends up causing more damage to the body.

6. Consider the case where you have given you almost adult child the keys to a vehicle (bike / car). He / she ends up at a friend's party where alcohol is served (you can maybe control going to clubs or other such places (how!!)), and drives home with a fair amount of alcohol in the bloodstream. Accidents happen, and in Mumbai, you stand the chance of having to get your child out of jail (where people caught drinking and driving are sent for atleast a day's imprisonment).

You can add many more reasons, and you could argue that this is a trend that one cannot stop, and you may be right; that does not mean however that one should accept this kind of behavior as normal. Out of readers, how many have faced such a situation, and do you know of things that will help out in this regard ?

Labels: Alcohol, Child, Health, Morality, Parents, Responsibility

There are a number of areas where modern science and problems clash with traditions. In such cases, a reasonable expectation is that there is a compromise between traditions and the needs of today; in some cases, there is a need that the tradition changes. Why did I suddenly think of this topic ? Well, I came across this article that describes how idol immersion, a joyful and integral part of many religious festivals, is actually helping in killing the river systems of the country. Now, there are many reasons why our river systems are getting killed - there is too much flow of effluents (both domestic and industrial), not enough cleaning of these effluents, not enough flow of fresh water to do a cleanup of the pollutants in the river. No one doubts that in many cases, the conditions of our rivers as they move past major cities is that of a sewer, with the water having very high percentages of pollutants.
For those who have taken part in Durga Pooja celebrations or those celebrating Lord Ganesha, the immersion of idols is an important part. This is repeated across the country. But how many of you have read the news articles that describe the dead fish found floating days after a major festival, with these fish poisoned by the chemicals form the immersion ? Read this article in more detail:

Elaborately painted and decorated idols are worshipped before they are taken during mass processions to rivers, lakes and the sea, where they are immersed in accordance with Hindu faith. Environmentalists say the idols are often made from non-biodegradable materials such as plastic, cement and plaster of Paris and painted with toxic dyes.
After the statues are immersed, the toxins then contaminate food crops when villagers use the polluted water for irrigation, said Shyam Asolekar, science and engineering head at the Indian Institute of Technology in Mumbai. Statue remains from festivities last year still float in rivers and water tanks in Mumbai, where the annual "Ganesh Chaturthi" festival culminate in the immersion of some 160,000 statutes -- some up to 25 feet high -- by millions of devotees. Traditionally, idols were made from mud and clay and vegetable-based dyes were used to paint them.

This is a tricky issue. Issues related to religious festivities are treated with care, with efforts being made not to offend the religious. However, there is no getting around the facts of a matter, and this is not an issue that has sprung up suddenly. Even on TV, you do see many times news articles about the importance of making statues with eco-friendly material, but somehow these items do not sink in.
Sometimes direct action needs to be taken, as for example, when the courts ordered the installation of tall fences on the bridges of the river Yamuna in Delhi in order to prevent people from throwing in flowers or complete garlands.
Rivers are the lifeblood of this country (or any country), with dependence on water requiring that water sources be protected. People know this, but somehow the relation with water pollution does not sink in, or maybe many people do not care. How does one ensure that such a message sink in ? You cannot use force to ensure that such a change happens across the breadth and width of the country.

Labels: Citizen, Community, Court, Environment, Health, India, River, Waste

Indian rivers are extremely polluted, and have been so for a long time now. It is all the more horrible since we consider many of these rivers as holy and worship them; the waters of the river Ganga find a very holy spot in Hindu culture. And yet, the waters of most of these rivers look hideous (unable to support marine life, unfit for human consumption, and so on). Various Governments claim to spend a lot of time and effort to clean up these rivers and have drawn up plans over the past 2 decades with big sounding names (all ending with the words of 'Action Plan') and the rivers remain dirty.
Over a period of time, even the courts of India have been unable to push the Governments to make an effective plan that is also executed well. All you get in the end is a lot of discussion about which method is the best for river cleaning (for those familiar with the discussions, the endless discussion in Delhi around where the sewage treatment plants should be, and how to stop the big drains from throwing their filth directly into the river would be funny if it was not so critical to public health). Otherwise, you would not get cases whereby drinking water to a city became critical when the filth content of the water available for drinking became too high.
What is required is for Governments to set up dedicated action plans that will ensure proper treatment of sewage (whether industrial or residential) so that no untreated sewage flows into the various water bodies that we have. Industries that violate this dictum need to be severely fined and punished (and that means that corruption levels in the environmental inspection area need to come down). Else we will end up with more cases such as the one in Punjab where millions of fish in a canal suddenly died due to release of untreated industrial waste. What we don't really need is for this kind of publicity generating measures such as this one:

With the state police coming to the fore to free the Gomti of pollution, now those caught red handed throwing garbage in the river will be severely dealt with. This announcement was made on Saturday by the director general of police (DGP) Vikram Singh, even as along with other senior officials of the department he took it upon himself to clean the city's lifeline.
In the morning the officials arrived at the banks of the Gomti for the cleanliness drive that is on to clean the river for the past few days. During the drive, the DGP made an official announcement that one company of river police will be deployed on all the banks of the river.

How will they prevent people from throwing trash into the river ? And will it stop if they patrol a few kilometers ? Would it not be more effective to have a proper education drive along with ensuring that people get a proper garbage collection facility ? Or am I hoping for an ideal world ?

Labels: Community, Development, Environment, Health, Police, Responsibility, River, Welfare

Recently I came across a situation that was terribly distressing. There was a school friend of mine (we are talking about the late 80's) with whom I had lost contact some years back. During the time that I remember spending with him in school, he was a good friend. However, as happens many times when you go out of school, and then go to different colleges, we lost touch (even though he was in the same city).
Then, while browsing through the friends list of a friend in Facebook, I came across his name. I promptly added him to my friends list, and within a couple of days, we had regained contact. In email through Facebook, I got to know what he had done after school. He had an interest in going abroad, and so, he did the usual software engineering route, joined a services company, and within a year got the chance to go abroad. He jumped at the chance, and moved with the software company to its US office; and after a year or so, jumped jobs and joined an American company.
All the time, his parents were at home, here, along with his younger daughter. Soon, when the daughter did her education and became a doctor, they found a good match for the daughter (another doctor settled in London) and the marriage happened; the daughter soon left with her husband to London. Now, the parents were left only to themselves in the house. Within a year, they found a suitable bride for their son, he came for the marriage, spent some time at home and then left back to the US. He was still devoted to his parents, coming once every year to visit.
However, and this is now the issue. I visited the parents a couple of days back, and found them to be in a bad position. They are growing old, and have only themselves to take care of each other. They are so used to the city and the circle around them that they are not taking up their son's offer to take them with him to the US, worrying about what they will do in a strange place, whether they will get along with their daughter-in-law (she is used to running the show in that house). The son is not willing to relocate back; he has a cushy life over there, children who are more American than Indian, and so on. And so, the have money (sent by their son), but do not have the moral support that is normally required. They also get testy when you talk to them about going abroad with their son, and I did not raise the issue again in visits. What is a good solution in such cases ?

Labels: Child, Community, Family, Health, Responsibility

A very sensitive subject indeed. Mercy killing, or allowing a person to take his own life (or a team of doctors to do so) is a dilemma that raises ethical questions all over the world. For a world that has derived many of its laws and regulations from religious backgrounds (Ten Commandments / The Gita / The Koran / etc..), mercy killing is something that raises the hackles of a large section of the world's population. It is only permissible in some countries, and that too under strict control. In many other countries (even one such as the United States), mercy killing has run against a moral hard rock and many physicians have been sentenced for helping in carrying it out. In a recent case of Terry Schiavo (Wikipedia), the case went through major conflict, with people at all levels (politicians, religious figures, family rights groups, etc) getting involved.
The basic premise for mercy killing is simple: There are many medical conditions that are terminal, and there is no established medical treatments that can cure the disease or prevent death. And unlike movies, people don't dance or sing till almost just before death, they go through horrible phases of steadily declining abilities - losing control of vital motor abilities, losing control of their mental faculties, unable to fend for themselves and being dependent on others, and a steadily increasing pain. In such cases, there has been the logic that given that their condition is terminal (that is, they have reached a condition where death is confirmed and they no longer have a life that seems meaningful in any way), they should be allowed an option to end their life when they still can command control of their life.

Taking the first step towards legalizing euthanasia or mercy killing, the Law Commission has decided to recommend to the government to allow terminally ill to end their lives to relieve them of long suffering. It allows those whose death is virtually certain to avoid their painful journey to the end.
The core of the recommendation to make euthanasia legal stems from several SC judgments which ruled that 'life does not mean animal existence’. "If a person is unable to take normal care of his body or has lost all the senses and if his real desire is to quit the world, he cannot be compelled to continue with torture and painful life. In such cases, it will indeed be cruel not to permit him to die," says the report, receiving final touches from Commission chairman Justice A R Lakshmanan.

However, aside from the moral and ethical problems that this issue comes up with, there are many other problems that arise when such a discussion comes up:
- There are a host of new treatments that are arising as we experiment more with genes and new areas such as stem cell technology, so is it right to assume that a condition that is treated as terminal now could not become one where a treatment is possible in a few years
- Who decides whether the condition is terminal ? If it is a team of doctors, who do you trust ? How do you prevent misuse, especially when we have seen so many new cases whereby elderly people are dumped because of the effort of taking care of them
- Will this become a poor vs. rich thing ? Suppose that a very expensive treatment is available abroad, and a poor person cannot afford to get this done for the terminal condition ?
- How will the actual logistics of carrying out the termination of a medically terminally affected patient be carried out ?
- In a country where there are many more needy people than hospital beds, would this become a misused thing ?
What do you people think ? Is India ready for something like mercy killing ?
I agree that we need to do this, subject to some stringent checks and balances.

Labels: Health, India, Law, Medical, Morality, Policy, Reform

Well, the real name of the amendment brought in by the Government at the urging of the DMK Health Minister Anbumani Ramadoss was actually the AIIMS Amendment Act; it should have been called the anti-Venugopal Act since though the law fixed the upper age of retirement of the AIIMS Director to be 65, based on which the noted heart surgeon had to resign. However, since Parliament, in a new low for the Government, actually spent time in passing a law that was directed specifically at one person; it was very easily challenged in court as being discriminatory and meant only to retire him. Venugopal challenged the Act, and even during the initial discussions, the SC had some strong words to say to the Government.

The Central Government on Thursday received a major setback with the Supreme Court striking down the law that enabled premature retirement of noted cardiologist P Venugopal as the Director of All India Institute of Medical Sciences (AIIMS) after a raging row with Health Minister Anbumani Ramadoss.

The net effect of the Supreme Court action has been that the health minister has suffered a severe reversal in his battle with the AIIMS Director. And of course, questions must be asked of the Prime Minister Dr. Manmohan Singh, this was after all the Bill of his Government and the Government has suffered the setback.
In other steps, the Health Minister has lead a campaign against drinking and smoking, and he is justified to that extent since these 2 are a cause of a large number of casualties. However, there are far more severe problems that the Minister and the Government don't seem too enthusiastic to tackle, since they are not glamorous. Take a look at this cover page article of TIME magazine that blows a hole in the quality of India's health services:

It's not hard to find people caught in the gap between India's dreams of greatness and the awful reality of its broken health system. Most of the country lives there. Sixty years after independence, India remains one of the unhealthiest places on earth. Millions of people still suffer from diseases and ailments that simply no longer exist almost anywhere else on the planet. Four out of five children are anemic. Almost one in four women who give birth receives no antenatal care.
The truth behind the glossy advertising is less incredible: India remains the sick man of Asia, malnourished and obese at the same time, beset by epidemics of AIDS and diabetes, and with spending levels on public health that even Prime Minister Manmohan Singh has conceded "are seriously lagging behind other developing countries in Asia." The sorry state of India's medical services might not matter so much if tens of millions of Indians weren't already so sick.

I would advise people to read the whole article, it is is no way complimentary and displays a state of health that a lot of us, who now depend on the private health care system, don't know about and don't care. And in the midst of this, we have successive Governments who care about things that make political logic; trying to spend the long time and effort to overhaul a broken health care system does not matter anymore.

Labels: BJP, Congress, Court, Development, Health, Medical, Policy, Reform, Responsibility, Welfare

India's public hospital and medical system is in a mess. Government hospitals are in a mess, catering to a massive number of patients, having doctors who are not exactly enamoured of the low salaries and bad working conditions (in fact, many doctors work to get a good experience and then parlay this experience to pick up much better salaries in the private sector), with funding constraints. One cannot even begin to compare the conditions at Government hospitals vs. private hospitals, although there are many Government hospitals that still retain a good name. However, no matter what are the reasons that have led to this condition, one expects Government hospitals to cater to the poor, the needy and not turn away anyone in need:

Twenty-seven-year-old Hemanti could not be saved but justice might still be done. Serious action has been taken against three doctors held responsible for the shocking case of medical negligence in Swami Dayanand Hospital on February 16. Hemanti, who was refused admission by the doctors on duty on Saturday night, passed away after she was forced to deliver outside the premises of the MCD hospital. Her baby, however, is reportedly in good health, a hospital source said.
Following a departmental inquiry, the Municipal Corporation of Delhi (MCD) has terminated the contract of Dr Mamta Tyagi, senior resident gynaecologist, on February 19. Two other doctors on duty at the hospital — Dr Deep Sikha, senior resident casualty officer, and Dr D K Padhy, emergency medical officer — have been handed show cause notices.

This is horrific news. Catering to a pregnant lady, poor, needy, bringing a new life into this world, is one of the most important objectives of the health system, and it has failed when such things can happen. One can only hope that the inquiry goes into the root of the matter, and also figure out what caused such an incident to happen. Typically doctors do not let such a thing happen, but the condition of doctors in Indian Government hospitals in pretty bad. They are forced to work for long hours, dealing with a number of patients that would make a doctor in the developed countries run away, and are many times man-handled by relatives of patients, and even by the support staff.
It is better that the health minister, Dr. Ramadoss focus on making sure that the health system is over-hauled, with better allocation of funds, making hospitals responsible for apathetic staff, bad maintenance and cleanliness, and the like rather than trying to make a name for himself in the newspapers.

Labels: Health, Medical, Punishment, Responsibility

For some time now, there has been a concerted push to get into the mid-day meal scheme for school children. The introduction of the mid-day cooked meal for school children has been a major factor in the increase of school attendance, especially in rural areas. Pushed and prodded by the courts and by large sections of educators, the Ministry of Education run scheme provides funds for meals in 9.5 lakh schools across the country. Overall, the scheme has been a great success in its stated objective of encouraging parents to send their children to school. Schools provide cooked meals to children as per the local diet, and this also enthuses children to attend.
However, every silver lining has a dark cloud behind it, and in this case, the money involved was too great to resist. And hence there was a concerted push by manufacturers of biscuits and pre-cooked meals to get into the scheme; what better way than to try and point out positives of not using cooked meals. There are logistical issues with the whole cooking process, there is scope for corruption in terms of the process of sourcing of material for the cooked meals being decentralized, and so on. Further, pre-cooked meals and biscuits would allow the exact concentration of nutrients to be served to children. Seem very convincing points, and all of these were actually enumerated in an article in a weekly that I read some time back.
And then I started reading some more, and found that there were many more issues with the proposal. There was a position by an institute that deals with nutrients that essentially blasted the proposal, claiming that biscuits were essentially empty calories and not capable of supplying the nutrients required. In addition, further opinion by experts were skeptical about how many children would be enthused by biscuits; further there was an easy likelihood of biscuits seeming to be strange food to many areas of the country or carried away and not consumed by the children. And then the ultimate; the industry actually got 30 MP's to write a letter to the Ministry of Education in favor of the proposal, and at that time, much more opinion started to come out against change of the cooked food scheme.
So, it is good that finally the ministry has decided against this proposal.

The biscuit manufacturers' and ready-to-eat food industry's attempt to make 12 crore children their captive consumers through the mid-day meal (MDM) scheme has come a cropper. The HRD ministry has shot down the proposal of the two industries to supply either biscuits or pre-cooked meals to more than 9.5 lakh schools under the MDM scheme.
"Replacement of the Mid-Day Meal programme through supply of biscuits would not be in the nutritional interest of children, since it does not fulfill the nutritional norms, dietary requirement and satiety of children and further it also deprives many intrinsic benefits that are being derived through the present pattern," the minister said in his letter to the MPs.

However, at one point of time, it seemed that the proposal was actually working its way through the approval chain. It required some pressure from educators, and from the few articles in the media that cared about the mid-day cooked food program (not too many did though, and this is a very important issue central to human development). One can only feel relieved that the proposal got terminated.

Labels: Child, Community, Corruption, Development, Education, Health, Politics

Gurgaon, just south of Delhi, is reported as the Millenium City, as a sample of growth. It has gleaming buildings, swanky malls, and plenty of BPO's, IT offices and many other such high-growth industries. It is seen as a self-sufficient township, with a large number of people now living there. However, there are many warts in this story. It suffers from infrastructure problems with poor water and electricity, lack of easy public transport, and sectors not involved in these sunrise sectors feel alienated from all this growth (one just needs to go and see 'Old Gurgaon').
And amidst all this, a heinous trade involving the removal of kidneys from poor people and selling to rich patients needing a kidney was going on (for a long time, maybe more than 8-10 years). Refer this news:

GURGAON: A Rs 100 crore kidney transplant racket that thrived on exploiting the poor and miserable with false promises and then removing their kidneys by force has been busted a few kilometres from the national capital.
The sheer scale of the racket — organized and brazen — that spanned six states and catered to the rich, including NRIs and foreigners, has left the authorities shaken. It was carried out right under the nose of the police in the Millennium City and could have been thriving for the past 15 years, according to one account, though Gurgaon police said it was eight years old.

What seems very clear that such a major operation could not have gone on without the complicity of authorities at some level, given the news that the main doctor involved, Dr. Amit Kumar (maybe not his real name) has been arrested many times earlier and yet was involved again in something of this scale. He is on the run, and even 2 days later, has not been caught. It may be very much possible that he had been tipped off before the raid.
One side-effect of this scandal was that the Government was thinking of making a change in the organ business, with measures to make it easier to get organs, including cadaver organ retrieval. However, the Government needs to ensure that even in such a case, the laws that rule against such organ selling and forcible removal are strictly enforced and maintained.

Labels: Community, Corruption, Governance, Health, Law, Morality, Punishment, Responsibility

Over the course of the past 2 years, there has been an immense amount of literature and news over the dangers of bird flu, especially the H5N1 variety that is extremely destructive, and has caused human losses elsewhere. There is a lot of worry over the fact that a pandemic has not happened for a long time now, and with the current movement of humans all over the world, any spread of a human version will be a much higher killer than previous pandemics. What can cause such a thing to happen ? Well, the bird flu is mostly restricted to avian creatures, and spreads to humans very rarely. In addition, even if humans are affected due to contact with infected birds, the disease does not jump from person to person. It is feared that if the virus comes into close contact with the human influenza virus, and exchanges genetic material with the virus, it is possible that this may cause the bird flu virus may be capable of becoming capable of getting transferred from humans to other humans. This is one of the most feared scenarios for health care personnel, especially because while humans do not take human flu seriously, the bird flu variety is a much bigger killer.
In such a scenario, it is even more necessary that any case of bird flu may be handled with the utmost seriousness. However, seeing the spread of bird flu in West Bengal makes one believe that the West Bengal government has been in a serious case of dereliction of duty. After all, it has been known for some time that many districts of Bangladesh have been affected by bird flu, and given the close interaction between districts of Bangladesh and West Bengal, there should have been a much better contingency plan. Given the close interaction between man and fowl in many areas of West Bengal, the districts and panchayats should have been sensitized about the seriousness of the issue and about the steps that they should take in this regard.
Instead, the disease was allowed to fester, with initial reports of birds dying being hushed up, culling operations being not adequately backed up by security and authority (even in a case where it seems clear that this is a health emergency), inadequate provision of compensation to people whose birds have been culled (leading them to try and hide their birds), and a general lack of seriousness among the state's politicians and leaders. This was to the extent that the Central health minister criticized the efforts of the state (although she was hushed up later, no doubt with the Big Brother CPM putting pressure on the Congress leadership).
Now the disease has spread to 13 districts, and is on the doorstep of Kolkata, and one wonders whether the inept State Government will be able to do something at all.

Birdflu on Sunday spread to two more districts of West Bengal taking the number of affected districts to 13 out of a total 19 even as the state government said it was fully prepared to face any kind of adversity if any human being is found afflicted by the dreaded disease.
Kolkata Municipal Corporation has formed eight teams to to keep the metropolis insulated from birdflu. The teams were moving in different parts of the city to monitor the situation. The fear that the disease might hit Kolkata has aggravated since the spread to South 24 Parganas, part of which form the city's suburbs.

One can only hope that the Government is serious. It has also been reported that part of the reason that the Government is abstaining from taking the strict (and also seemingly harsh measures) is the fear of offending voters; if such an attitude characterizes the Government response, then god helps up. Instead, panchayats are an ideal medium to spread the message about the harmful affect of the disease, and how cooperation will help all. Couple this with a strong media campaign and adequate compensation, and things would be much better.

Labels: Community, Governance, Health, Left, Politics, Responsibility

Ever since the concept of providing a cooked meal to school children as part of school came into existence, India's education system has seen a major improvement. The thought of getting a good nutritious meal has made children more eager to attend school, and at the same time, has made parents see more value in sending their children to school. Continuing this scheme, while making sure that the quality and quantity of food served remains good is an essential ingredient of making sure that India rural children attain more education, and India's targets of making sure that these children grow up into better adults is met. It would not too much to say, that in addition to having good educational facilities and good teachers, providing them good cooked food is essential.
And now enter the money-makers. The very size and reach of this cooked food program makes for an extremely large sum of money that is being spent. This money has attracted many corporates, who have launched a campaign to get biscuits to be served instead of food. The claim is that biscuits will be easier to manage than the logistics of cooking food, and the biscuits can be specially made to be as nutritious as the education program requires. The pressure by this lobby is so large that Members of Parliament have got involved, with many MP's having been swayed to sign a letter promoting this changeover into biscuits.
Hopefully, this latest statement by the National Institute of Nutrition should bring this debate to an end:

Children should not be fed biscuits as lunch under the government's mid-day meal (MDM) scheme. This has been stated emphatically by India's premier agency on nutritional issues, the Hyderabad-based National Institute of Nutrition, backing the contention of many states opposing the move to feed biscuits to children under the countrywide scheme.
In what would be the strongest indictment of the biscuit manufacturers' pitch for their products, the institute has written that it has “worked on the recommended dietary requirements for adults and children, and biscuits do not find a mention anywhere, nor is it recommended as a source of calories or nutrients, because biscuits (sweet or salty) are empty calories”.

This should really bring the debate to an end. Politicians really do not need to get involved in this debate. What is needed that the Ministry of Human resources stops this ridiculous attempt to move away from the cooked meal scheme. The cooked meals currently are region-specific, cooking the kind of meals required for that particular region; it is ridiculous to assume that serving biscuits will have the same kind of impression on parents and children.

Labels: Child, Community, Development, Education, Health, Politics, Responsibility

Everybody now knows about the ongoing dispute between the Health Minister Anbumani Ramadoss and the AIIMS Director P Venugopal (who is an eminent cardiac surgeon). This has been an ongoing dispute that has been going on and on, with a lot of discussions and dispute being parlayed through the media, and with the gutless Prime Minister not doing anything to rein in this dispute or to prevent the washing of dirty linen in public.
And now the Government has decided that it will show the AIIMS Director as to who exactly the boss is. The AIIMS Director in the past has won the various court cases where he was at loggerheads with the Health Minister, a move no doubt that would have enraged the health minister even more. And with the DMK being a reliable partner and one providing critical political support, the issues about autonomy of institutions and non-interference obviously do not count.
So, in an incredible law, the Government brought in a law that was primarily targeted at the AIIMS Director, setting an age limit of 65. The net effect of this law was that as soon the President signed the bill, the Government could then order the removal of Dr. Venugopal. And there has been almost no major protest against this law, which when seen in context, is an incredible attack on the autonomy of an institutions:

Hours after the Presidential assent to a Bill enabling his removal, the government on Friday night sacked eminent cardiac surgeon P Venugopal as AIIMS Director with whom Union Health Minister Anbumani Ramadoss was locked in a long-running turf war in the prestigious institution.
The dismissal of 66-year-old Venugopal came shortly after President Pratibha Patil signed the controversial Bill passed by Parliament two days ago fixing the age limit of 65 years for AIIMS Director, seen as a move to ease out the cardiac surgeon.

This action happened even after it was clear that the Supreme Court will hear a petition on Monday to whether this law is valid. In case the Supreme Court orders a reversal of the law or rules that it will apply only to future cases, then Government will face a humiliating reversal.

Labels: Congress, Court, Education, Governance, Health, Law, Parliament, Politics, Reform

How many times has it happened that you saw somebody throwing garbage on the streets and wondered as to why they did it ? Did you sometimes throw a wrapper on the street and felt guilty about it, or not even feel a twinge of guilt ? Take all these individual acts, put them together and you end up with a city (and this is about each and every city in India) full of garbage. Sometimes it is easily noticeable, for example, when the weather is humid, the smell of garbage is all around. But mostly, we criticize the municipal corporation (and rightly so) for the mess.
Surat, after the plague had gone, went through a government enforced cleanliness program with a lot of public support. That program was a good example of how a city can be made clean and kept clean. There are numerous other examples on a smaller scale that show how cleanliness can be kept. Private offices are a good example, where there are adequate facilities such as garbage bins and moral pressure to ensure cleanliness. The Delhi Metro is another example of cleanliness where the Metro ensures that people do not litter, and they also ensure that the facilities are always kept clean such that if anybody tries to litter, they will be seen as the first people doing the littering.
However, we also know that in addition to self-discipline, some amount of enforcement is also required. Singapore is one prime example of strict rules ensuring that no one tries any amount of littering, and people who do, suffer. And enforcement seems to be the measure that the Mumbai authorities are trying to use:

MUMBAI: Getting away with spitting, urinating in public, throwing garbage on pavements or any other nuisance which spoils the cleanliness of the metropolis will be harder and even costlier now.
To supplement the work done by the few nuisance detectors (NDs), the civic body today appointed five private security agencies to look after cleanliness and sanitation in the city with powers to impose fines ranging from Rs 100 to Rs 20,000 on offenders.

If you read the article, there is a lot of talk about not being heavy on the fines initially, but trying more education and getting people to be more aware of their responsibilities.
At the same time, it cannot be all enforcement. There is a crying need to have more facilities. One good example is the availability of garbage bins or dustbins and public conveniences. In our crowded cities, such infrastructure needs to be available at regular intervals and well maintained (and that is the killer nowadays many of them are not well maintained). It is easy to blame people for urinating in public, but in winter months, when there is no facility available for long distances, what can a person do ?

Labels: Community, Development, Environment, Health, Image, Neighbourhood, Reform, Waste

The separation of powers has the Government handling policy and day to day running of the country, and the Courts have interpretation of laws and the handling of civil and criminal disputes under these laws. So, normally you would not hear of courts getting involved in the matter of process of setting policy, or taking operational matters into their hands and providing directions to Governments. However, in India, the Governments have proved incompetent in so many matters that the courts have thought it fit to intervene using the basis of the rights of quality of life for citizens. Otherwise, who would have thought that a court would give directions to a municipal department to ensure that dengue protection steps are taken:

Delhi High Court on Wednesday ordered the city government’s health department and its civic bodies, MCD and NDMC to take all necessary steps to prevent the recurrence of dengue in the city.
A Division Bench of Chief Justice M K Sharma and Justice Sanjeev Khanna asked the agencies to comply with its previous directions to prevent mosquito breeding. At the same time, it directed the government to provide sufficient platelets in the blood banks in the city so that they are prepared to face any eventuality.

It sounded so strange when I read it; after all, these steps are something that a Government agency should be able to take on its own without having to be told to do so. But the situation is such that every year, one can see so many cases of dengue being reported that could be prevented through simple precautions by the municipal department that they do not do; and hence the court felt it necessary to order such steps. However, it still seems strange, and one can only hope that the Governments wake up.
We have had many cases in the past where court orders have forced Governments to take steps that have helped citizens, such as the implementation of CNG in Delhi and removal of polluting industries from cities (all policy matters but the Government was dragging its feet until the court intervened).

Labels: Community, Court, Development, Environment, Governance, Health, Judicial, Reform, Welfare

Ragging in Indian colleges is a given. It may be better than before, but there is no reason as to why a student, entering a college for higher education, has to obey the wishes of a person just because the person is a senior. There is no legal reason, and given the number of cases of ragging which turn ugly, there is no moral reason to have ragging exist. It is talked about as being a good way to bring about a closer interaction between seniors and juniors, but that is possible through more mentoring (assigning a senior to a junior as a mentor), or through more cultural and other such programmes where cross-year teams are encouraged. It is a bogus argument that forcing a student to suddenly start singing, or to go and propose to a girl, or to do other such things are okay.
An activity being okay is from the perspective of the person being forced to do it, and from my experiences in college, most freshers are happy at doing this because they are relieved that it was not something more. There is no basic desire to do such forced events. In fact, many students have a dread about the first days of college because they fear as to what ragging will bring to them. I remember from college of more than a decade past that college authorities had anti-ragging squads, but these would not reach the classrooms or inside the hostels, which is where most of the ragging had shifted to.
So, the Supreme Court implemented a set of measures in the current year which made ragging an offense, instructed colleges to take it more seriously, and file police cases. Colleges did not take too kindly to this intrusion, protesting that ragging was not so bad in their campuses, or that police cases would harm the careers of students who are affected, and so on. So, let us take a couple of cases from this year:

The ragging complaint rocked the Government Dental College and Hospital on Monday when the father of a student told the college authorities that his son had been subjected to physical abuse.
A committee member said, "We are going to question all the senior students in the college, who have been accused of brutal ragging sessions which include physical abuse. We will also look into the letter submitted by the student’s father to college authorities."

When a committee is setup, you mostly know that there's not going to be any action. And here's another one:

The parents of a first- year MBBS student on Wednesday alleged their son was driven to suicide after being "severely ragged" in Government Medical College and Hospital, Chandigarh.
They said Manjot returned home after being severely ragged by senior students at GCMH and committed suicide. Manjot joined classes on July 21, phoned home saying he was "upset" in Chandigarh and that he would come back as soon as possible. "The very next morning he returned," Milap said. When the parents returned after shopping on Sunday, they found him on the bed "motionless", he said, claiming the boy had ingested some "poisonous substance". "Later, friends of Manjot told us he underwent severe ragging in college and then went into a depression," he said.

It should be very clear that ragging is not an entitlement, and is a criminal activity. As long as it has social sanction, there will be people who will feel that they are entitled to torture their juniors and get away with it. They do not have any authority to do it, and should face the required action.

Labels: Child, Court, Education, Health, Law, Punishment, Responsibility

There is an old saying, 'Save the rod, and spoil the child'. It has a simple premise, that unless you teach a child the right and wrong and what to do / not to do, and actually implement these instructions with some punishment from time to time such that the lesson is imprinted. You would also have heard of teachings in Catholic schools where the nuns would imprint morals into a person, and make sure that these are properly learnt through the use of corporal punishment. What actually is corporal punishment? It is the using of some form of physical punishment in an educational facility as an aid to learning. Sounds simple, does it not; it worked in the past, did it not.
Well, guess what, in the past, society had no problems with the usage of such punishment as drawing and quartering, cutting of the head, and other barbaric forms of killing as a death sentence. As society evolves, it moves away from barbarism, and learns better ways of doing things. As a part of this, there is a realization that letting teachers use canes / rods / slaps as a means of punishing a student is no longer acceptable; in fact, for every 2 students who improve from this experience, there will be many others who get scarred with this experience, especially if it happens on a regular basis. There are other ways of making sure that students learn, and usage of such punishment is unwarranted, and in fact, is illegal in schools.
Why such a fuss ? Well, here's one experience:

In a shocking incident, the principal of a school in Andhra Pradesh gave electric shocks to a 10-year-old student. Police in Tuni town on Saturday registered a case against the principal of a residential school run by a Christian mission. Police were on the lookout for the principal, who allegedly justified the punishment before escaping to evade arrest.
"The investigations are on to find out as to how many students were given electric shocks," he said. The incident came close on the heels of another one where a school teacher allegedly pushed a five-year-old student so hard that he injured his tongue badly. Parents of five-year-old K. Devi Vara Prasad, a student of lower kindergarten at St. Mary School in Nallakaunta, lodged a complaint with the police in this regard two days ago. Last month, the head master of a private school in Mahabubnagar district was arrested for allegedly chaining a Class III student as punishment.

Corporal punishment is also a short-cut to try and discipline rowdy kids, or in the above case, to use one's own logic. Once corporal punishment is seen as an easy solution, in effect you are depending on the logic of a teacher to practise the restraint; and this can have fatal effects. In a recent incident, a student was beaten by the teacher with a stick, and ultimately his lungs collapsed and he died.
Secondly, when students are small, they are easily impressionable, and using corporal punishment can make them retreat into themselves, and avoid school.

Labels: Child, Development, Education, Governance, Health, Law, Morality, Punishment, Reform, Welfare

Our dear Health Minister, Dr. Ramadoss has 2 pet obsessions, one being to prevent tobacco from being displayed anywhere, the other being to prevent Dr. Venugopal to be there in AIIMS. The courts and now the cabinet have blocked the Health Minister from taking immediate action against Dr. Venugopal. No matter, he can still proceed on his inspired mission against tobacco.
Now, to make matters clear, I don't smoke, and I believe that cigarette smoking is harmful. The better objective would be to try and make the consumption of tobacco illegal, but that would harm political interests because of the supposed large number of people involved in tobacco cultivation (although the same argument could be be used if you had free-for-all opium cultivation; a large number of people would get involved in opium cultivation and you would not be able to ban it).
And of course, the Government is even less inclined to get proactive in the matter of beedis, which are more harmful than cigarettes.
However, having made my stand clear, I am even more inclined to also believe in the strength of privacy, and a man's/women's home being their castle; subject to no criminal activities taking place, a person can do what they want in their house. And so it seems ridiculous as to how easily a person inspired by the power of righteousness can take whatever action they want and not care about rights of other people:

Forget bars and restaurants, even smoking at home in the presence of a domestic help might invite action from the government. "We are going to take stringent measures against smoking in public places like hotels, bars and restaurants... in fact any place where there are employees," Ramadoss said, speaking at a ceremony here where he was awarded the World Health Organisation (WHO) Director-General's Special Award for Tobacco Control for the year 2007.
"Even at home, if you smoke and there is a maid present, action can be taken against you," he said. "If you have to smoke, then go to the roads."

This is crazy. To mandate more and more laws that control us, especially what we can do in our house crosses the line. And there is no end to what can happen if you use this law. Suppose you have a party in your house, you will then have to declare in the invitations whether the house is a smoking zone on non-smoking zone, so that you don't then get sued by some guest for the crime of second-hand smoking.
And following from what the minister said, suppose you smoked before the maid came; now smoke remains in the place of smoking for some time; so what would the law say about how often you should smoke before the maid or some other employee comes (maybe you can smoke 30 minutes before the maid comes, but if the weather is cold (<15 degrees) and there is no air circulation (less than 1 m/s) and your windows are not open for more than 5 cm, then you could be classified as still having second hand smoke in your house and hence the maid can get you to spend a night in jail.
This is written somewhat with a jocular nature, and smoking is a very serious issue. People die in large numbers, some in incredible pain due to cancer caused by long-term smoking or by direct tobacco consumption. However, the remedy needs to make sense. It reminds of Sanjay Gandhi's efforts to try to cut down population growth by trying forceful sterilization (a direct application of force that is not appropriate to achieve the direct results).
Western countries are more famous for anti-smoking measures, to the extent that the advocates are called anti-smoking nazis or health nazis, but even they stop at the entrance to a person's home. And of course, I never could understand why we create laws that are bound to fail (a trip in many trains and other means of public transport, especially in semi-urban areas could hell you understand as to how such laws are never followed).
Of course, this is not the first attempt. The Minister earlier tried to get all forms of smoking banned in films and TV, and even though there are chances of influencing youth with images of stars smoking; given the cinematic expressions and involved, and the need to show smoking when it happens normally in society, it is far better to have a voluntary restraint.

Labels: Family, Health, India, Law, Smoking, Welfare