Saturday, May 6, 2000, Chandigarh, India
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Indias
LTTE crisis |
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Bharatpur
Blaze
Sunrise
in the mountains
What
is wrong with Indian hospitals
May 6, 1925
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Bharatpur
Blaze IT is common knowledge that most of the calamities occurring in our country are man-made. The recent blaze at the ammunition depot, Bharatpur, is no exception. Statistics would reveal that the artillery ammunition expended during the much talked about Kargil operation was not even 25 per cent of the ammunition destroyed in the Bharatpur blaze of April 28. This must give sleepless nights to our defence planners and the entire nation, because a would-be battle or war is already lost without fighting due to the quantum of ammunition gone waste in the aforesaid fire. This ammunition, if protected, could have been used as reserve/replenishment under such a situation. An experienced enemy always endeavours to destroy its adversarys ammunition and petroleum dumps and warlike resources and reserves during the course of a war. In this context, it is rather unfortunate that such a bulk of our ammunition (of all kinds) has been written off under peaceful conditions. It is a matter of great national shame to have sustained the loss of our precious war material due to sheer neglect and complacency on our part. The court of inquiry ordered in this case (headed by a Major-General) should not be considered be all and end all. It is to be taken as a procedural necessity, because the outcome of previous such enquiries, like the one conducted after our debacle in war with China in 1962 proved to be a futile exercise wasting time and money of the nation. Enquiries reveal nothing and, in fact, achieve nothing. The enquiry conducted regarding the 1962 war has not seen the daylight so far. The incident of accidental fire at Bharatpur ammunition depot must be instead reviewed in the light of the security of men, material, information (intelligence) and foolproof system of inter-communication between the sentries on guard duties, the Chief Security Officer and the Officer Commanding of the depot. A pertinent question arises. How come grass is allowed to grow and mature to dry near the ammunition-laden plinths, ammunition store-houses (magazines) and around the entire complex of the ammunition depot! For getting rid of the grass weedicides and anti-grass chemicals should have been used. Just pulling the blame on mechanical failures (as in railway accidents) or foreign agents (in case of explosions and fires) is taking the line of least resistance. The nation is no more interested in repeatedly cooked up and cock and bull stories. In this particular case, the blaze occurred due to some inadvertent intentional throwing of an unextinguished butt of cigarette or beedi into the standing crop of dry grass. The authorities right up to Army Headquarters and the Defence Ministry must share the blame for this fire. The incident confirms that no contingency plans have been chalked out and no rehearsal/practices of fire fighting ever carried out by all concerned. Even the visiting/inspecting officers also never bothered to carry out sample checks, although on paper everything would appear to be perfect in office files. It would be quite disheartening to realise that the god of fire is never propitiated by exhaustive paper work. He is to be satisfied by actual and sincere work done on the ground. Likewise short-circuiting of high tension wires should never be accepted as an excuse for the outbreak of fire. In this context proper and foolproof insulation of live high tension wires is the only answer to such happenings. The next fire in this depot could be due to the non-functioning of lightning conductors installed on the buildings of this complex. This also needs proper tuning up throughout the year. This should be food for thought for the authorities concerned: In view of the above, I venture to offer some practical suggestions for the safety of our army depots (of all kinds) and in the best interest of our country. Till 1983, the ammunition depot, Bharatpur, was protected by a barbed wire fencing around it. High ground (hills) towards its North-East was easily accessible to any intruder/saboteur, who could cut the barbed wire with a cutter easily and undetected. This calls for a protection wall around this complex if the same has not been constructed so far. * Safety against fire: The entire area up to a distance of 500 metres from the outer periphery of the plinths and ammunition magazines should be brick-floored. This would stop grasses from growing. Though the expenditure incurred would be colossal but it would be worth it. * Thickly insulated electric high tension wires should be used inside the ammunition store-houses. * Only diesel locomotive engines should be used for shuttling ammunition wagons inside the ammunition complex. Such depots must be located away from main railway lines. * Workers inside the complex should be subjected to surprise checks for possession of any inflammable material (matches etc.). Punishment for defiance of this order must be nothing less than dismissal on the spot. * Offices inside the depot must have a thick wall separating them from the ammunition magazines. Waste papers should be destroyed by burning in the vicinity of the cook houses. Only readymade tea should be permitted inside this complex. * Standing orders for fire and s.o.ps (Standing Operation Procedures) should be rehearsed periodically and that too religiously. * Roofs of the magazines must be made bombproof. * As far as possible only non-smokers be employed as workers inside the depot. Safety against saboteurs: * All worker, must be subject to the Indian Army Act for security reasons. This should not be made as a prestige issue from the workers side. * Issuance and checking of identity cards should be very strict. The staff employed to carry out such a check should also be fully trained. Identity cards should not be permitted to be carried by the workers to their residences. * Tenure of all the employees should be restricted to two years only. * No strikes/trade unions be permitted to the employees. Politicians should not be permitted to influence the workers. * Communication system inside the depot should be comprehensive. * No ammunition depot be constructed in low-lying areas because the floods can cause severe damage to the ammunition. * Empties of the ammunition expended should not be returned to the ammunition depots. This would reduce incoming/outgoing traffic inside the depots. * It will be worthwhile to invite experts from Israel for instructions and guidance for the ammunition depot staff because they have the bitterest experience in this regard. |
Forging
better Army-media ties ONE of the key recommendations of the Kargil Review Committee is that the Army should be trained for effective media relations. This recommendation stems from the non-existence of any relationship between the Army and the media until the early nineties so much so that the Army shunned the media. Even today, this relationship is far from effective. The background to the absence of any relationship between the two has a history behind it. And it is that during the Raj days, the defence forces were not brought under public gaze because they were considered to be a potent instrument to rule the country. Even after Independence, the defence continued to be regarded as a holy cow. The fallout of this was that our parliamentarians and the public remained ignorant about the defence forces. The result of this was that the defence issues were neither discussed in Parliament nor were they debated at public forums. This largely went to the disadvantage of the armed forces because even the important defence problems remained neglected. Mercifully, the defence forces have come to realise the value of media coverage. No wonder a former Army Chief, the late Gen B.C. Joshi, who was the architect of ushering in a cordial relationship between the Army and the media said in 1993: Media must be used by the services as a force multiplier. The innate goodness and efficiency of the Services makes such a relationship feasible. Otherwise the media will inevitably act as a force degrader. Since General Joshi was keen that the Army should become more open to the media, he got instructions issued by Army Headquarters to all Command Headquarters in this regard in the second half of 1993. This resulted in a number of seminars on Army-media interaction being held at various corps headquarters. These seminars acted as a catalyst to set off a new relationship and healthier understanding between the Army and the media. To begin with both the Army and the media were critical of each other at these seminars. The kind of criticism that the Army officers came out with can be gauged from what they said at one of the seminars: A rape by an Army jawan is flashed in banner headlines by the newspapers, whereas stories of heroic deeds of the defence forces and their casualties are relegated to the inner pages. Why is the Army given this kind of treatment by the press? The press on the other hand was critical of the Army for being too reticent and secretive even about the trivial defence matters. That things have changed was evident from the Kargil coverage which was the result of a better understanding between the media and the armed forces. But we should not sit complacent over it, for much more still needs to be done to close ranks so that an effective relationship can be developed between the two. Training, no doubt, is an essential pre-requisite to forge such a relationship. But then, this training should not only be imparted to the Army but also to the media in view of the peculiarities of the defence coverage. The defence coverage is different from the other coverage because of the sensitive security angle involved in some of the defence issues and for the reason that the Army Rule 21, which is a legacy of British rule, prohibits a military man from communicating directly or indirectly to the press on any matter in relation to a political question or on service subject or containing any service information without the prior sanction of the Central Government. There was a consensus at all the seminars that this archaic rule, which was not only discriminatory but also undemocratic in nature, must be changed. It was in this background that the Army Chief, Gen V.P. Malik expressed his opinion to this writer in September, 1998 thus: The Army is slowly opening to the media and adjusting to the new environment even though the government rules and regulations have not changed. Given the fact that some instructions from Army Headquarters have been issued in the past few years about the kind and level of interaction that can be carried out with the press, the restrictive nature of the coverage still prevails, thanks to the rules. The war coverage is trickier than the peace time coverage. In the former, the secrecy of operations, interest of the country, morale of the troops and morale of the public cannot be sacrificed for the sake of objective reporting. In this reporting, professional interest of a journalist often clashes with the professional interest of a soldier. A solution to this problem has to be found by striking a balance between the two but without jeopardising the interest of the country. And it is here that training will come in handy to both the Army officers and the media persons. Although a Media Communication Course for senior Army officers was started by the Indian Institute of Mass Communication (IIMC), Jawahar Lal Nehru University, New Delhi, in 1989, the frequency of this course was changed to two courses instead of one in a year, in 1995. This proved to be a useful training for the Army officers. Besides, various formations had also started including media training for officers in their annual training instructions by inviting media persons to such training events. But the enthusiasm seems to have petered out over the years. To train media persons to cover defence, a course of two weeks duration was run every alternate year at the College of Combat, Mhow, in Madhya Pradesh. This course too proved very useful. It was, therefore, planned to make this course a regular feature. But here again, the importance of this course was reduced by shifting it to the Military Intelligence School, Pune. Having realised that the course had lost its significance at Pune, it is, as Gen V.P. Malik said a few weeks ago, being shifted back to Mhow. In sum, training of Army
officers and media persons should be given more attention
to achieve the desired results in defence coverage.
Moreover, media persons should be attached to formations
and units for a short course so that they know about
their working and get an on-job training. |
Sunrise in
the mountains I WENT out to the balcony before dawn. In the semi-darkness the low, sweet chirping of several Ranikhet birds greeted me. From somewhere in the distance came the faint call of a koel. The early April air was a little too cool. My first impulse was to go back into the nicely warm room. But I decided to stay on. The hill near the resort I had come to the evening before and the mountains beyond looked like a painting on an immense canvas done in the most sombre of colours. At one place the sky flushed a light muddy brown. Around it were scraps of blackish clouds. Like tall, slim silhouettes stood the young pines near me. But I could discern the red of the sloping cottage roofs nearby. Low and sweet, the chirping continued. One or two other birds added to it their loud and different notes. An unseen dog also chose to join in. Or was it trying to bark the birds down? The farthest mountains were, as I had noticed in a picture in the dining room, all snow-clad. Of the many peaks, the tallest on my left was Trishul, named after the trident of Shiva. The light increased a bit. Now I found that the hill near me was covered with trees. However, they were blurred yet, and looked more black than green. I could also see patches of flat, cultivated land on my left. What had so far seemed two rows of mountains were actually more. Obviously the white peaks too were not of one row of mountains but of two or three. A couple of mynahs made screechy sounds. Perhaps disturbed by this, a pigeon, resting in a safe spot in the sloping roof of my room, fluttered. Then it flew out somewhere. The blackish scraps of clouds turned lighter. The muddy brown flush almost faded. Above the snowy peaks on my right the sky was turning a pale golden. The light showed a few more peaks. Though they were dim, they added to the length of the white row. On the hill near me the trees were now clearer and greener. A path running up it and a terraced field on top, as though uncurtained, came into view. The cultivated patches looked a soft, pleasing parrot green. Thick, off-white smoke rose from near there. It looked rather like clouds on a monsoon day. While I watched it, the smoke thinned and vanished. Some more birds had begun to chirp and twitter. One or two whistled and gurgled in between. Amidst the cute chorus appeared a patch of light on the Trishul peak. You'd say that a lamp had been lit in a window there. That pale gold on my right grew brighter. It imbued the pieces of clouds above and around. Those nearest me seemed small feathery heaps that had been coloured a silvery gold. A bird babbled. Another uttered what was like a funny sound made by a child at play. A small one flitted in and alighted on a branch of one of the pine trees. Two more patches of light came on the Trishul. I guessed that all its three "prongs" had caught rays of the sun, hidden though it was. The other peaks remained unlit yet. The golden glow on my right increased. While I looked, what seemed to be a red hot round edge rose above the mountains. Every half-second it grew in size, until it was a big ball. It was the sun, at once garish and glorious. But it was too bright to
stare at. Instinctively I turned my eyes this way and
that. |
What is
wrong with Indian hospitals I WRITE this week from a hospital bed in Mumbai. Quite a nice, hospital room really with a view of a sunlit, tour quoise swimming pool on the edge of the capuccino waters of the Arabian Sea. I chose to come to Mumbai for the surgery I required because, after consultations with friends and experts, it was agreed that Mumbai rather than Delhi, Chennai or Calcutta was the city most able to provide the best healthcare in India. And, had I not myself observed that in the six months of the year that our former Prime Minister, Vishwanath Pratap Singh, spends in India he prefers Mumbai to Delhi because he needs constant treatment for his kidney ailment and believes that the hospitals here are better. Not as good as London, naturally, where he spends his summers being treated at the expense of Indian taxpayers but definitely better than anything else available in India. Like V.P. Singh I too have observed, first hand, the standards of healhcare available in other parts of the world so although I am told that I am in the best hospital in India I notice that we are very far from world standards even when it comes to basic things like cleanliness. My room is cleanish but there are visible layers of dust encrusted on the venetian blind and the window panes and the bathroom is less clean than those you find these days even in five star hotels. There is also a disturbingly British Raj quality about everything from the nurses uniform, the equipment, hygiene standards and hospital systems which leaves me feeling that things have not changed much in the past fifty years. I notice particularly that there is not a computer in sight and find this worrying. Has nobody, noticed how computers have changed modern medicine? How much easier it would be to manage a large hospital by using them? No sooner do I get into critical mode, though, than I remembered how lucky I am to be able to afford to be here when only the week before I had seen how bad things can get in lesser hospitals. A friends mother had been taken to the intensive care unit of a smaller Mumbai hospital and I had gone to see her only to find myself in a place of dank, dirty corridors and wards that looked more like prison cells than places of healing. Garbage lay uncollected amid piles of old furniture in forgotten corners and, to my horror, anyone was allowed entry to the intensive care unit as long as you took, your shoes off. If this was happening at the lowest levels of Indian healthcare it would be bad enough, when you consider that this is the standard of private healthcare available to middle class Indians it becomes that much more horrific. I mentioned this to a doctor I met in that hospital and he said, I dont agree that there is no healthcare even for the rich and middle classes in India I believe we have some of the best doctors and nurses in the world. I pointed to the stained mattresses on which we sat in an empty ward, to the dirty linen that was drying out of the window, to the lumps of used cotton wool that had been dumped into flower pots and he conceded that when it came to standards of hygiene Indian hospitals did indeed have a long way to go. And, that is understanding the case. Before my surgery I had to have a series of tests and this provided me a chance to have a guided tour of several clinics in Mumbai catering again to the rich and the middle classes. Again, I was appalled. In one clinic I saw women carrying glass slides smeared with blood and other tests down several flights of stairs to a laboratory in which a girl with dirty finger nails collected them and placed them besides the telephone while she wrote out a receipt. Are accurate results possible in such conditions? Is hygiene possible? On one of the nights, I spent in hospital after my operation I discussed these things with a night nurse who admitted proudly that she had indeed been around since the days when the hospital had British management. She said standards had not dropped much since those days and that, in fact, there had been many improvements like air-conditioning and television. When I asked her why hygiene standards were not higher she seemed genuinely puzzled because according to her they were as high as possible. I explained, just as an example, that in countries with higher standards nothing that had been sterilised was touched by ungloved hands and that it was very high standards of cleanliness that ensured that people did not contract post-operative infections. She gave me the same answer that the doctor had in the other hospital. We have the best doctors and nurses in the world. It is our nurses from Kerala who go to the Middle East and our doctors who are working in America and England. Indeed. But, it is also true that you put your life at risk when you go into an Indian hospital for treatment. In Delhi I know personally at least two women who went into hospital for minor gynaecological problems and came out with hepatitis C. I know of a young boy who went into hospital with a broken arm and ended up nearly dying of septeicemia. I know of heart patients at the best hospitals in India who worry not about whether the surgeon will be able to perform their bypass properly but about whether they will survive the aftercare. Hospital beds are good places to think about these things and as I have lain in mine I have spent considerable amounts of time mulling over why even smaller countries like Thailand and Sri Lanka have better healthcare than we do in India. Did I come up with any answer? Any insights? Only this. Perhaps, what we have done wrong is to emphasise only the absence of healthcare for the poor and for rural Indians. This has led to the mistaken assumption that there is excellent private healthcare available for those who can afford it. The truth is that we seriously lag behind most other countries even where this is concerned and if we acknowledged this there would be more efforts to improve it. When things improve at the top there is some chance of a trickle down effect, some chance of models that can be emulated. Meanwhile, until our
governments are able to provide decent standards of
healthcare to the average Indian we should seriously
consider a ban on any politician or bureaucrat being
allowed to travel abroad for treatment at taxpayers
expense. When they and their families can no longer be
treated free at the best hospitals in the world we can be
sure that things will start to improve. |
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