The missing E’s in medical education: Dr. K. Srinath Reddy

The Chairman of the Public Health Foundation of India, Dr. K.Srinath Reddy has written in The Hindu today, another piece on the parlous state of health — this time on medical education in the country. His earlier pieces in the newspaper dealt with the need for the entire Union Cabinet to function as a strong pro-health force.

Now that Dr. Manmohan Singh has undergone a coronary bypass, perhaps he will be more receptive to the concerns of public health advocates and the average citizen, and ask his Finance Minister to sharply raise the public expenditure on health, which currently stands at about 1.3 per cent of GDP (Economic Survey, 2008) or, in Dr. Srinath Reddy’s assessment, 1.1 per cent (pers communication, 2009). Indians spend out-of-pocket to meet nearly 80 per cent of their health expenditure, arguably the highest in the world.

This article in The Hindu deals primarily with health education deficiencies. A quote “Despite effective generic drugs being available, costly brand name drugs are prescribed by the young doctors whose choice is more influenced by what drug industry representatives tell them than by the consideration of a patient’s purchasing capacity”.  A worthwhile read for anyone interested in the issue of health, which is engaging Barack Obama, the UK, China and India. http://bit.ly/dDgmU

BSNL employee’s organ donation helps four lives – MOHAN Foundation

The Multi Organ Harvesting Network has been working hard to garner public support for donation of kidneys, heart and liver from brain dead donors.

MOHAN has just released information on the selfless act of the family of Rajaiah, a 48 year old employee of BSNL in Warangal. He met with an accident on the evening of 10th June, while traveling on his two-wheeler near Kakatiya Medical College. As he suffered serious head injury, he was rushed to MGM Hospital, and later shifted to Krishna Institute of Medical Sciences in Secunderabad, where he was on life support system until the night of 11th, when the doctors declared him “Brain Dead”.

Rajaiah’s family was counseled by Dr. Purna and the members agreed to donate his organs. MOHAN Foundation facilitated the process of organ retrieval. On 12th, Rajaiah’s kidneys were retrieved and used for transplant for two patients, and his heart valves were retrieved by doctors from Innova Hospital. They will be used for two patients. Rajaiah, survived by his wife and three children, continues to live on in four people. The family finds solace in the thought that Rajaiah continues to live on in four people.

The development mandate for the UPA – will it deliver?

The UPA needs to deliver on its promises in the core areas of development — free and compulsory education for all, universal healthcare, affordable housing and access to water and sanitation. This article appearing in The Hindu by Dr. K.Srinath Reddy, the president of the Public Health Foundation of India provides a fine base on which the new government of Manmohan Singh can build. It would be a pity if the special interests in these sectors successfully raise a cacophony of diversionary voices to distract the UPA.

Why Tata Sky is losing the game

Vikram Kaushik, Managing Director and Chief Executive Officer, of Tata Sky has apparently spoken to the media in Chennai asserting that Tata Sky would always strive to acquire ‘quality customers’.  He has also said that his service is not interested in the ‘bottom of the pyramid’.

This is a euphemism masking the contempt that Tata Sky has for the vast number of people who bought its service — its self-reported base is 3.7 million customers as on date.  It is also strange business logic, going by the strategy of the mobile phone industry in this country — where bigger subscriber numbers lead to profits.

It would have been interesting to hear what Tata Sky had to say about High Definition broadcasting, which their rivals like Sun Direct DTH have already announced. National Geographic, Animal Planet and Discovery are seeking permission to beam HD in India, we hear, and it is not clear if Tata Sky will offer them because they have been speaking of lack of capacity on satellites (They don’t have NDTV Hindu yet for that reason, it appears). Hi-Def also requires new STBs, and Tata has lost that advantage to rivals already.

I am a Tata-Sky customer, and it is my experience that they don’t offer all the channels available in the market; they club channels, particularly in sports and films, in such a predatory manner as to ensure that value offerings are not part of their base packages.

The DTH market is very messy right now with no regulatory controls. Now that the TRAI is out of the stranglehold of Ministers-cum-broadcasters-cum-distributors, it should devote itself to regulation of DTH. There can be no delay in introducing a la carte pricing for DTH channels, with regulatory cap on the price of individual channels and controls on anti-competitive behaviour.

It is also difficult to imagine that Prasar Bharti, which launched DTH from Doordarshan, has been banished from the scene. There is no augmentation of the DD DTH platform, on which many broadcasters would be happy to be seen. It is also possible that DD will broadcast HD. It has been kept out of the reckoning by disallowing use of modern technology such as Digital broadcasting, both terrestrial and satellite. AIR is also in a moribund state, unable to use such advancement as Digital Audio Broadcasting. Truly a shameful situation for Indian broadcasting, compared to the progress made by public broadcasters such as the BBC.

Poddala Jayantha, Sri Lankan journalist, is attacked

This press statement issued by the Committee to Protect Journalists based in New York adds to the feeling of a systematic purge of the media being pursued in Sri Lanka, over the issue of eliminating armed resistance. The LTTE for their part were never in favour of a free press; their enemies in the Sri Lankan government seem to think no differently.

New York, June 1, 2009—The general secretary of the Sri Lanka Working Journalists Association, Poddala Jayantha, was abducted in Sri Lanka today, beaten, and dropped by the side of a road in a Colombo suburb, according to a release by the association and two colleagues who spoke to him.

The attack came on a busy road during rush hour at 5:15 p.m. Jayantha’s colleagues said witnesses at the scene told them six unidentified men in a white Toyota Hi Ace van with tinted glass windows grabbed Jayantha as he was walking home in the well-to-do suburb of Nugegoda. The same type of vehicles have been used to pick up anti-government figures in the past, CPJ research has found.The journalist was left on the side of the road about half an hour later.

Jayantha declined to speak directly with CPJ, but two colleagues who asked not to be identified for fear of retribution told CPJ by phonethat he was beaten with an iron bar and wooden poles—weapons similar to those used in other recent attacks on journalists. Jayantha has a broken ankle and is reportedly severely bruised over much of his body. In an apparent attempt to humiliate him, his abductors shaved the hair on half his head and the other half of his beard. News reports say his injuries are not life-threatening.

”The attack on Poddala Jayantha is part of a trend,” said Bob Dietz, CPJ’s Asia program coordinator. “These attacks are a chilling reminder that journalists remain under attack in Sri Lanka even after the end of the government’s battle with Tamil separatists. We call on authorities to ensure a thorough and immediate investigation into this assault.”

The Associated Press reported that police spokesman Ranjith Gunasekara said that “authorities don’t know who was behind the attack on Jayantha, who had long accused the government of using threats to silence criticism in the media. No arrests have been made.”

Sri Lankan journalists came under increased attack after the government decided to pursue an all-out victory of the secessionist Liberation Tigers of Tamil Eelam in 2006. Despite the end of the country’s decades-long civil war in May, the climate of intimidation has persisted for journalists. During much of the fighting, foreign and local reporters were prohibited by both sides from covering the front line, a policy the government is continuing.

Binayak Sen speaks out on life in prison

“Another revelation I had was of the widespread corruption in the judiciary. We’re simply not looking at it…” — Dr. Binayak Sen.

Binayak Sen and his wife Ilina addressing a press conference in Kolkata on Friday.

The great Indian middle class, journalists included, never has a serious brush with the law, and therefore cannot fully appreciate what Dr. Sen says. Not surprising that no newspaper bothers to go into this vital aspect of electoral democracy. Can Manmohan Singh and Sonia Gandhi change this shameful dimension of our vaunted democracy?

The UPA Government is set to have a full term from 2009, and it has the opportunity to ensure justice delivery to the masses of this country.

It has to start with implementation of police reforms, which all the States have resisted. The Soli Sorabjee-drafted Model Police Act is still in limbo, so far as the States are concerned. (An earlier draft Act by C.V.Narasimhan is here.)

Accountability and transparency in the lower judiciary, which hears most of the cases, has to be ensured immediately, with penalties and dismissal of judicial officers found to be corrupt. This serious approach will bring sufficient pressure on the High Courts and the Supreme Court also to function as per the letter and spirit of the law and the Constitution.

The appointment of judges has to be painfully transparent. There is nothing wrong in this, since that is the procedure followed even for the US Supreme Court.

Here is the report in The Hindu today (Saturday) on Dr. Binayak Sen’s press conference held in Kolkata after his release from prison in Raipur, on bail.

Now, Dr. Manmohan Singh and UPA Co, get down to work !

The Prime Minister Dr. Manmohan Singh paying floral tribute at the Samadhi of Mahatma Gandhi, at Rajghat in Delhi on May 23, 2009. - Photo: PIB

Now that the 79-member Ministry of the UPA is in place, Dr. Manmohan Singh and his colleagues would do well to get down to work. Such is the level of degradation and non-performance in various Ministries, that it would take his Ministries 22-hour work days to even get the various policies initiated during the last UPA government going.

Dr. Singh and his colleagues have outlined in their last iteration, many policies in key areas. While Education and Health already had national policy documents issued in the past, he put out policies on Housing, Sanitation, Transport, Urban Development and so on.

Now it is imperative that the Prime Minister persuade the State Governments to deliver. Most government policies depend on the response of State Governments, and experience shows that they are unwilling to let go of their rent-collecting methods when it comes to welfare and empowerment. This will be a major challenge for Dr. Singh to overcome.

It remains to be seen who will steer key areas in the new Government on Education, Health, Housing and Sanitation. All these subjects are being eyed by the private sector to skim off profits from the Middle Class, threatening to leave the lower rungs of Indian society behind. They may not be very amused with the interpretation of Rahul Gandhi, that this is a verdict for the ‘aam aadmi’ for the poor and so on.

If there is a single factor that challenges India’s efficiency today, it is the absence of rule of law and justice delivery. To rein in bad government, the legal machinery has to be effective, accessible and willing to punish authority. Can Dr. Singh and his mentor, Sonia Gandhi ensure that justice delivery becomes affordable and efficient during this term of the UPA?

Massive investments are also called for to expand public schooling, collegiate education and vocational training. These are as important to India’s future as roads and bridges. This is the foundation on which India’s capacity will be built in coming decades.

And lastly, Dr. Singh has the monumental challenge, which he seems destined to fail, of providing affordable and good medical care to India’s vast population, on the principle of free and universal access. The insurance industry, which is screaming for greater profits in the country, has been positively gleeful about the verdict, because it can expand its activities. This is a supreme irony, because President Barack Obama has been trying to fix a health insurance system in the US that ran amok during the Bush years, and ensured that Republicans got little sympathy.

There are other important deliverables that the UPA must focus on — strengthening of the Right to Information Act and the National Rural Employment Guarantee Act, raising agri productivity, modernising transport systems for the 61 million-plus cities, providing sanitation in all urban and semi-urban agglomerations, protection of the natural environment, climate change mitigation and adaptation and so on.

So Dr. Singh, your hands are full. Let’s get cracking in the first 100 days. And if there are people who are coming in the way of these pro-poor, anti-fat cat policies, please shout out loud to us. State elections are due in coming months and years, and the public will smoothen the path for you.

Three day CBI custody for Sumathi Ravichandran, Passport Officer and husband

The Hindu reports that a special court for CBI cases has granted CBI custody of disgraced Regional Passport Officer Sumathi Ravichandran and her husband for three days from May 1. There is no word on whether the DMK-controlled Chennai Corporation has taken action against Dr. Ravichandran,  a senior medical officer at the local body.

Such action is mandatory in the case of government servants when they are arrested and detained. Perhaps the ruling party is not treating service in Chennai Corporation separately, or the rules do not require action

Remarkably, the major newspapers and television channels have not thought it newsworthy to visit the Regional Passport Office and see whether the Augean stables have been cleaned, after the arrest. The Times of India’s report on a second case against this officer is here.

An earlier post on this subject is here. The mystery continues on why this officer has been hauled up despite her powerful connections to the DMK. We can only speculate that she has upset someone within the party, or someone very high up at the Centre.

Sumathi Ravichandran, Regional Passport Officer, nabbed

It is not everyday that one finds a top government babu, outside whose office people normally have to wait for hours to get an audience, being marched off to judicial custody. That small satisfaction is available today, when one reads of the arrest and remanding to judicial custody of Sumathi Ravichandran, the politically connected and influential Regional Passport Officer of Chennai. The report of the arrest is here and an earlier post of mine here.

I once tried to contact Ms. Ravichandran on her office landline telephone for very bonafide reasons. After I had fully identified myself, I expected to hear a question from the other side about the reason for my call. Instead, I got the following response, before the call was terminated unilaterally “Wrong Number.”

It was evident to me that someone who said something like that on her work telephone had to be absolutely deceitful, and today’s arrest of the official by the CBI seems to confirm that for me.

In any case, it was a story that was plain as daylight to anyone who bothered to look at the RPO in Chennai. Strangely, the Chennai media was completely disinterested in this story.

Although it is impossible to catch all crooks in India by the collar, as the corridors of power are swept, mopped and waxed by them day-in and day-out, it is satisfying whenever that happens.

Tamil Nadu farmers organise against Monsanto

The quiet “research sponsorship” diplomacy pursued by Monsanto in India has failed to wash with farmers. On April 3, many farmers’ organisations got together in Coimbatore to consider the gravity of the threat posed to hu

Dr. M.R.Sivasamy, farmer leader, addressing a meeting on Monsanto field trials at TNAU, Coimbatore, April 3, 2009

man health, agriculture, food safety and biosafety by Monsanto’s genetically modified crops. The verdict: catastrophic.

The senior farmer leader Dr. M.R.Sivasamy urged the farmers to destroy the open-field trials of  crops launched at the Tamil Nadu Agricultural University in Coimbatore, as a proxy for Monsanto.

This call is perfectly valid, considering that the GM companies have, in different instances, obdurately insisted on going ahead with open-field growing of crops (violating the permissions given to them), clandestine distribution of illegal GM cotton seeds (unearthed recently at Attapady in the Coimbatore-Palakkad forest border by Kerala government), and refusal to subject their crops to proper safety testing. Finally, Monsanto and its ilk does not have any liability for any damage that they cause in India under existing laws for biosafety.

Greenpeace has issued a statement on the impending arrival of GM food crops. Evidently, the entire p0pulation of Tamil Nadu is sought to be turned into lab rats by Indian subsidiary Mahyco-Monsanto, by plying its untested GM seeds for vegetables.

Do you know of any method to determine which brinjals in your local supermarket or green-grocer are Bt and which are not? Obviously not.

That makes you a lab rat for Monsanto, the same company that produced Agent Orange, a chemical used to destroy Vietnamese forests and vegetation (see this report in the BBC), rendering people seriously ill. It also dumped so much toxic Polychlorinated Biphenyls in Anniston, Alabama, US, that the local population fell sick and sued it. The company was asked to pay heavy damages — 700 million dollars — as a result. Read the full story here.

Generally, Monsanto tries to hide its past behind the screen that its chemical operations were under the charge of a new company, Solutia Inc. But the Washington Post reveals that the original Monsanto company had filed judicial papers undertaking to pay any damages that Solutia could not. (”Officials at Solutia Inc., the name given to Monsanto’s chemical operations after they were spun off into a separate company in 1997, acknowledge that Monsanto made mistakes…” says the Washington Post).

So if you get sick by being force-fed the Bt vegetables by Mahyco-Monsanto, you know what to do.  Get together and sue them. But why wait? Why eat them at all? Protest to the DMK government demanding an end to all GM agriculture and the declaration of Tamil Nadu as a GM-free state.

Also write a letter to Pasumai Vikatan at this address pasumai@vikatan.com if you feel strongly moved by the issue. This magazine from the Vikatan group has been opposing GM and advocating organic agriculture, through detailed articles by and on the organics evangelist, Nammalwar.