E D I T O R I A L   P A G E

EDITORIALS

W(i)LL talk
Need for a level-playing field
THE Group of Ministers has, for the first time, categorically asserted that the judgement of the Telecom Disputes Settlement Appellate Tribunal on limiting the operation of the Wireless in Local Loop services to a particular short distance charging area would be implemented. 

‘Phoren’ craze
Human trafficking in different guises
ILLEGAL immigration of Punjabi youth has been going on for years and with disastrous consequences for some as the Malta boat tragedy had amply revealed. Of and on there has been a police crackdown on unauthorised travel agents too, but the problem has not been tackled with the seriousness it deserves. 

Hail Hayden
Another great from the Bradman country
MATTHEW Hayden could have made a name for himself in so many other high profile careers had he decided not to play cricket. His height and muscular body would have made him an ideal candidate for the slot vacated by Arnold Schwarzenegger after being elected Governor of California. 

• Thought for the day

OPINION

Weak response to Israeli attack
Arab anger may lead to chaos in the region
by S. Nihal Singh
THE dominant neoconservatives in the George W. Bush administration might not have won a victory in their social engineering exercises in Iraq but they remain undeterred in taking their experiment further afield. That is the meaning of two recent significant moves on the West Asian chessboard: the Israeli bombing of a target in Syria for the first time in 30 years and Israeli Prime Minister Ariel Sharon’s determination to go ahead in building an inhuman wall on Palestinian land, robbing Palestinians of more territory.

MIDDLE

Star struck
by Nirupama Dutt
REMEMBER the old fable in which the benign spirit granted three wishes and no more. If a foolish choice were made, the next wishes would be lost in rectifying it. A modern-day parallel for an adolescent would be a hundred bucks to spend and three things to buy.

IN FOCUS

The state of medical institutions — 2
IGMC fails to meet required standards & expectations
Patient care at Snowdon suffers due to frequent shifting of faculty
by Pratibha Chauhan
HEAVY inbreeding, shortage of faculty and ill-equipped departments have become the bane of the Indira Gandhi Medical College, Shimla, the first medical college of the state. The IGMC has failed to give a lead in quality health services in the hill state where the private sector is still dormant.

REFLECTIONS

EDITORIALS

W(i)LL talk
Need for a level-playing field

THE Group of Ministers has, for the first time, categorically asserted that the judgement of the Telecom Disputes Settlement Appellate Tribunal (TDSAT) on limiting the operation of the Wireless in Local Loop (WLL) services to a particular short distance charging area (SDCA) would be implemented. This clears the air, even though no time-limit has been given for the implementation of this order. WLL came in as a service that would offer limited mobility. It is like a cordless phone extended to cover cities and metropolitan areas. It was envisaged as a no-frills cellular service that would increase the teledensity in a nation that is still woefully underconnected.

Though there is no technological limitation with WLL, the service was shackled by the licensing regulation. There is no such thing as "limited mobility"; you have either mobility or fixed landlines. The bone of contention between the WLL operators and their rivals using the GSM (Group Spécial Mobile that now stands for Global System for Mobile communications) technology is that WLL service providers were not required to pay high licence fees since their service was restricted to SDCA. Now WLL operators are giving feature-rich service at rates that are competitive, in fact, often lower than those of GSM operators, who also accuse WLL operators of trying to make a backdoor entry into the mobile market.

There is no doubt that now there is a window of opportunity in what has become a protracted battle between two powerful groups. The GoM's stand that it will press for unified licensing for the telecom sector is to be welcomed but beyond these assertions will be the hard part. The devil is in the details on how telephone companies will give access to one another and the financial implications of the move. With powerful vested interests on both sides, only a strictly impartial and transparent process will resolve the issue and give the consumers the stable and cost-effective service that they want. This will also allow concerned companies involved to make long-term investments and plans to upgrade the network. The goal has to be a smooth transition to a unified licence regime in which a single licence would allow telephone companies to offer a range of services — cellular, basic and long distance. Till such time, the government must implement the TDSAT judgement promptly and make concerted efforts to level the playing field for all the telecom players. The Indian consumer now expects a cheap and reliable telephone facility, including mobile services, and it should be available promptly.

‘Phoren’ craze
Human trafficking in different guises

ILLEGAL immigration of Punjabi youth has been going on for years and with disastrous consequences for some as the Malta boat tragedy had amply revealed. Of and on there has been a police crackdown on unauthorised travel agents too, but the problem has not been tackled with the seriousness it deserves. Of late, a new class of facilitators of human trafficking has emerged. It comprises agents who arrange foreign visits of cultural, sports and religious troupes. How many “kabootars” (pigeons), as immigration applicants are referred to in the local language, have flown out of Punjab illegally is anybody’s guess. The problem surfaces only when the promised immigration does not take place and the applicants approach the police as agents fail to send them abroad or return the money charged for the purpose.

The issue has once again attracted public attention as one of the agents arrested by the Patiala police is a brother of the famous Punjabi pop star Daler Mehndi. The singer himself has sought anticipatory bail as his name had also figured in some complaints. There had been similar complaints in the past against highly placed public figures, including two Punjab ministers and a theatre personality of Patiala, but no one has heard of any follow-up action. Earlier this year, a few members of a girls cricket team of a Jalandhar college had disappeared in England and their relatives told the police that they had paid hefty amounts to the club that had organised the trip to the UK, though some of the girls returned home later.

It is natural for people to try for a better quality of life and seek greener pastures. But the resort to illegal means is uncalled for, especially when many have suffered heavily for their misadventure. The reports of youngsters paying up to Rs 20 lakh to unauthorised travel agents for US immigration indicate the extent of their desperation to get out of their home state. Anybody having that much money should be able to maintain a reasonably good standard of living and even start some business. But lack of education, particularly training in entrepreneurship, forces them to move out and take up left-over jobs in Western countries. All this points to a disturbing economic and social trend. Imparting skills in demand to youth and giving a boost to economic development by attracting private investment can ease the situation to some extent.

Hail Hayden
Another great from the Bradman country

MATTHEW Hayden could have made a name for himself in so many other high profile careers had he decided not to play cricket. His height and muscular body would have made him an ideal candidate for the slot vacated by Arnold Schwarzenegger after being elected Governor of California. He could have been rich and famous as a member of the "fixed fight" network of the World Wrestling Federation. An extremely unlucky Hayden would still have managed a decent living as a night club bouncer. It is the game's good fortune that he chose cricket and gave it all that he had to take both to new peaks of glory. The news is not that on Friday he wiped out Brain Lara's highest individual Test score of 375 by picking up 380 runs at Perth in the first Test against Zimbabwe. The news revolved around the awesome power he put behind the shots that saw him claim the title that was won for the first time for Australia by the incomparable Don Bradman.

The 334 by Bradman against England at Leeds in 1930 was the first triple century in Test cricket. Mark Taylor, another Australian could have had a shy at Lara's 1993-94 record in Peshawar in 1998-99. But he chose to declare the innings on equalling Sir Don's record! Taylor wanted to stand next to the game's greatest player and not ahead of him. Hayden's record-setting knock was certainly not a purist's delight. At times, he uses the bat like a sledge-hammer, that kills the flies around him and bowlers' confidence. But he will now stand tall because of his towering height and the power that he puts behind each of the shots that saw him sail past Lara.

Objective scrutiny of the game's greatest knocks should not ignore the quality of the bowling attack. Of the three living record-breaking triple century makers, none could claim to have tamed a particularly nasty bowling line-up. Len Hutton's 364 had come against an Australian attack that consisted of Stan McCabe and Bill O'reilly. Gary Sobers went past him while facing Fazal Mahmood and Mahmood Hussain of Pakistan, who were adequate but not as good as, say, Sobers as a bowler! When Lara ran into England at St John's in the West Indies in 1993-94 the nursery of international cricket had surrendered its popularity to soccer. The present Zimbabwe team is struggling to establish itself in international cricket. It is only marginally better than Bangladesh. Except for captain Heath Streak no bowler deserves notice as a Test cricketer. But this should not diminish the importance of Hayden's achievement.

Thought for the day

A constitutional statesman is in general a man of common opinion and uncommon abilities. — Walter Bagehot

OPINION

Weak response to Israeli attack
Arab anger may lead to chaos in the region
by S. Nihal Singh

THE dominant neoconservatives in the George W. Bush administration might not have won a victory in their social engineering exercises in Iraq but they remain undeterred in taking their experiment further afield. That is the meaning of two recent significant moves on the West Asian chessboard: the Israeli bombing of a target in Syria for the first time in 30 years and Israeli Prime Minister Ariel Sharon’s determination to go ahead in building an inhuman wall on Palestinian land, robbing Palestinians of more territory.

Israel would not have risked a “pre-emptive” bombing of Syria a figurative stone’s throw from the capital Damascus if it did not have the implicit blessing of America. And sure enough, the White House lifted its objections to a House committee discussing sanctions against Syria. The Israeli bombing was, in effect, a warning to the Syrians on Washington’s behalf to be more cooperative in fulfilling American aims in Iraq.

The Syrians, in no shape to give a military answer to Israel, were redared to issuing a belated warning to Tel Aviv, asking it not to repeat its exercise. Apart from taking the issue to the UN Security Council, of which it is a non-permanent member, Damascus’ riposte was to throw the Israeli wall issue into the UN’s lap to embarrass Washington. American vetoes in support of Israel in the Security Council come at a price the Bush administration would rather not pay, with Iraq in turmoil and the Palestinians’ plight getting worse by the day.

It is clear as daylight that the United States has no intention of restraining Israel in its efforts to complete the wall, which is dividing Palestinian lands and homes, creating more checkpoints and Bantustans and gobbling up more Palestinian land. Mr Sharon knows he is sitting pretty because President Bush cannot afford to displease the powerful American Jewish lobby with elections knocking on the door. In any event, the neocons are not averse to seeing the emergence of a Greater Israel. What happens to the poor dispossessed Palestinians will be attended to later.

It is one of the many ironies of the West Asian tragedy that while relations between the US and Old Europe hit rock bottom by Washington’s unilateral intervention in Iraq with the fig-leaf of a “coalition of the willing”, the European Union has largely remained a spectator as Israelis drive a coach and four through the so-called road map to peace. The latest peace plan was ostensibly a “Quartet” effort of the European Union, Russia and the UN, in addition to the US. Yet Israel is merrily going on building the wall while the UN tut-tuts as does Old Europe, with Russia remaining on the sidelines. So confident has Mr Sharon become on having his way that Tel Aviv has announced the enhancement of Jewish settlements on occupied land.

Palestinian leader Yasser Arafat has been declared an outcaste and all blame is heaped on the altar of terrorism, with the Israelis now having the excuse of not having a credible Palestinian interlocutor to talk to. President Bush has called Mr Sharon a man of peace and famously answered Israel’s air strike in Syria by granting Tel Aviv the right to safeguard its security. Mr Sharon is content to bask in the glow of President Bush’s praise and, having been greatly encouraged by the downfall of Saddam Hussein and the large US military presence in Iraq, is seeking to frighten both Syria and Iran into submitting to Tel Aviv’s dictates.

Arabs are, of course, in no position to fight America or even Israel’s might, collectively or otherwise. Between Syria and Iran, the former is viewed as the softer option and hence the Israeli pressure on Damascus to forswear any support it gives to the Hezbollah or other Palestinian militant groups. Understandably, Syria’s indirect answer to Israel has been to activate the Hezbollah along the Lebanon-Israel border.

The United States on its own is pursuing the Iran question, maintaining its pressure on Teheran through the International Atomic Energy Agency and has even won over the European Union in asking it to come clean on its nuclear activities. But Teheran is likely to prove to be tough in fighting military intimidation although there have been signs of Iran’s flexibility on the nuclear question and even on building bridges to the United States. Turkey, the other important neighbour of Israel, has now agreed to send troops to Iraq for its own geopolitical reasons, spawning an entirely different set of problems. Turkey has somewhat close diplomatic and military relations with Israel.

The neoconservatives’ plan for West Asia is, of course, well known — to remould the region more in line with American and Israeli interests, beginning with the regime change in Iraq. Since the neocons have lost some steam in the erosion of domestic support they have suffered, Tel Aviv is coming to their help by keeping the larger picture in focus by hitting Syria even as it precludes the emergence of a viable Palestinian state by all means it can.

Two questions remain to be answered. How far will the American difficulties in Iraq hamper the achievement of the neocons’ dream, even with Israeli help? Second, when will the Arab anger, building up in proportion to Israeli and American moves and to Iraqi fatalities in US policing operations, burst the banks of restraint?

Americans are finding out that the form of guerrilla war they are facing in Iraq makes their military intervention in other countries and regions more difficult. Admittedly, the declared American scheme to maintain its world supremacy has run into such problems as an army overstretch and the need for others’ support in stabilising Iraq. America’s decision to go it alone into Iraq with those willing to sign on has had the disadvantage of the dissenting nations now dragging their feet. Somewhat belatedly, the Bush administration has realised that not even the most powerful country — a hyperpower to boot — can run the world alone entirely on its own terms.

Despite the rhetoric, the Syrian response to the Israeli air strike has revealed in all its ugliness the Arab weakness. Most countries in the region are beholden to the US in one form or another. Egypt, the traditional leader, has been living on an annual American subvention of some $ 2 billion since the Camp David accords came to be implemented and cannot chart out its own course. Others have military protection agreements with the US and can pay only lip-sympathy to the Arab cause.

But the United States is overlooking a latent danger that is building up. There will arrive a time — the tipping point in the American idiom — when the regimes of the Arab world (whatever their system of governance), squeezed between US power and their people’s anger, would be unable forcibly to suppress the anger on the street. Or perhaps the neocons believe that chaos in other countries of the Arab world, in addition to Iraq, will set in motion a whole series of regime changes. We shall have to wait and see.

MIDDLE

Star struck
by Nirupama Dutt

REMEMBER the old fable in which the benign spirit granted three wishes and no more. If a foolish choice were made, the next wishes would be lost in rectifying it. A modern-day parallel for an adolescent would be a hundred bucks to spend and three things to buy.

“So what,” I told her, “one doesn’t stop liking someone or something just because one is not going to get it.” I got another bored look from her. I wanted to launch off on a treatise that the ultimate in romance was the unrequited. But I stopped myself. None of my outdated fundas were required. She had to sort out all this for herself. Maybe she would do better than her Mama!

IN FOCUS

The state of medical institutions — 2
IGMC fails to meet required standards & expectations
Patient care at Snowdon suffers due to frequent shifting of faculty
by Pratibha Chauhan

HEAVY inbreeding, shortage of faculty and ill-equipped departments have become the bane of the Indira Gandhi Medical College (IGMC), Shimla, the first medical college of the state. The IGMC has failed to give a lead in quality health services in the hill state where the private sector is still dormant.

The historic building housing the IGMC at Snowdon, once the residence of Lord Kitchner, Commander-in-Chief of the British army in India, though awe-inspiring, unfortunately doesn’t seem very inspiring for patients. Perhaps that explains the beeline of patients from Himachal wanting to shift to the PGI at Chandigarh at the slightest of complication. It is also a comment on the patients’ confidence in the quality of health services at the IGMC.

The state’s politicians, eager to grind their own axe, have contributed to the woes of the IGMC by setting up another medical college at Tanda in Kangra district. Ironically, instead of lessening the burden of the IGMC, the Dr Rajinder Prasad Medical College at Tanda has hampered the normal functioning of the IGMC itself as the faculty has to routinely go there to sustain a struggling medical college, which has run into serious trouble with the Medical Council of India (MCI).

Already facing acute staff shortage, the IGMC faculty feels the second medical college was proving to be the biggest stumbling block in the functioning and growth of the IGMC. “It is not just the patient care which suffers due to frequent shifting of faculty, at times for just a week’s time, but it also creates problems for the medical college students,” says a faculty member, adding that the college could have done without this albatross cross round its neck.

“As far as the faculty position is concerned, I admit that the problem is there in some of the non-clinical departments like anatomy and pharmacology, but then this is due to an overall shortage of doctors in these streams all over the country,” explained Prof Kapoor, Principal of the IGMC.

The Centre and the MCI were now considering a review and downsizing of the faculty requirements as per the laid down rules for these non-clinical departments due to the consistent shortage of doctors, he added.

Set up in 1966, the IGMC has a 850-bedded hospital with 34 departments. The medical college, known as Snowdon earlier, was rechristened as IGMC in 1984. Post-graduation courses in radiotherapy and dermatology have been introduced this year while two new specialities of psychiatry and pulmonary medicine will be started shortly.

Interestingly, the IGMC, instead of strengthening and consolidating the present infrastructure and facilities, is craving for expansion into new departments. The point was underscored by the MCI while turning down the IGMC’s request to increase the number of MBBS seats from the present 65 to 100 as the council wanted the college to consolidate the existing infrastructure.

The stunted growth of the institute is partially blamed on the heavy inbreeding. Despite its existence for over four decades, the IGMC has failed to come up to the required standards. It has meant that few talented doctors from other medical institutes are ready to join here, says an old faculty member. Rather, the brightest lot from the college tend to get jobs in prestigious medical institutes outside the state. Naturally, lack of new talent has failed to infuse any fresh idea or approach to the functioning of the institute.

Himachal Pradesh may boast of having two medical colleges, but there is not even a single Magnetic Resonance Imaging (MRI) machine in the whole state, be it in the government or private sector. Patients have to go to Chandigarh, Ludhiana, Pathankot or Jalandhar to get an MRI done before the diagnosis can be done.

“The government has committed that it will give us Rs 5 crore soon for installing an MRI machine,” says an optimistic senior functionary, knowing very well that such commitments could take several years to be fulfilled.

The IGMC is still struggling to overcome certain teething problems in its functioning despite its four decades of existence. The Gynaecology Department of the IGMC is still functioning from the Kamla Nehru Hospital, 4 km away, causing inconvenience to both patients as well as students. Though a neo-natology wing and a nursery have been set up at the Kamla Nehru Hospital, there are occasions when the newborn has to be shifted to the IGMC, while the mother is kept in the far-off gynaecology wing.

Because of shortage of space, there is hardly any possibility for further expansion of the IGMC. With the ever-increasing number of patients coming to the hospital, it could have done with some new buildings and parking lots. There is an acute shortage of space for wards and often patients have to share beds.

At the time of outbreak of the “mystery fever”, three patients had to share a bed at times. The newly constructed block with new wards has not been made operational, for reasons best known to the hospital administration.

The hospital authorities say the Phase II Block, a five-storeyed building with a basement, is nearing completion. “This will help in bringing all the OPDs under one roof. This will also help us in segregating the indoor and OPD patients. Some of the OPDs are still functioning from shed-like structures.

The casualty ward at the IGMC exists just in name. Till date it has no X-ray facility and patients have to be wheeled to the ground floor of the old block, where the lone radiology unit is located. Moreover, simple MBBS doctors are deputed as Casualty Medical Officer and in case of an emergency a specialist has to be summoned from the department or wards, resulting in loss of precious time.

Shortage of faculty is another problem area. The Neurology Department has been without a specialist for the last few years. The departments of urology and gastroenterology too are facing a shortage of doctors.

The shortage of para-medical staff like nurses, technicians and ward boys is affecting patient care. Despite more than a dozen deaths this year due to mystery fever, which was diagnosed as “scrub tyhpus”, the IGMC is still not equipped to handle a similar situation and undertake sample tests of patients despite the recurrence of the disease for the past four years. Most of the samples have to be sent to the Central Research Institute at Kasauli, though the Microbiology Department here should have been adequately equipped by now to handle the situation given the grave risk to life the disease poses.

The medical college students too face a lot of problems. Hardly any new books, publications and medical journals are being bought for paucity of funds. The library is open till only 4 p.m, thereby making it practically impossible for students to make use of it, as they are busy in the college and hospital till late in the evening. “It is not possible for us to buy all the medical books as they are so expensive. We need to have a well-stocked library, which should be open at least till midnight, if not for 24 hours,” say students.

There are some silver linings despite the gloomy scenario at the IGMC. The IGMC is probably the first state medical college in the region to have been given the status of a Regional Cancer Centre a few years back and has a full-fledged Nuclear Medicine Department, which not many medical colleges in the country can boast of.

“By the end of this year, the IGMC will perhaps become the only state medical college where open heart surgery will be performed. Orders have been placed for all the expensive equipment and the senior cardiology faculty of the AIIMS and the PGI have been involved,” informs Professor Kapoor.

Biggest accolades for the IGMC will, however, come in the form of a better faculty, infrastructure and increased patient confidence.

REFLECTIONS

— Guru Nanak