The Tribune, Chandigarh, India

PERSPECTIVE

On Record
Need to spread public awareness on diabetes,
says Dr Bajaj
by Vibha Sharma

ONE has to fight obesity to prevent diabetes, says eminent endocrinologist and Honorary President of the International Diabetes Federation Dr J.S. Bajaj. In an exclusive interview to The Sunday Tribune, on the occasion of World Diabetes Day being observed today, Dr Bajaj, presently the Chief Consultant and Director, Department of Diabetes, Endocrine and Metabolic Medicine at the Batra Hospital and Medical Research Centre, New Delhi, says that apart from greater allocation of funds for comprehensive health care, public awareness is a must to keep diabetes away. A former Member of the Planning Commission, he graduated in medicine from Panjab University in 1958. He was the Honorary Physician to the President of India and Chief Physician to the Prime Minister. He is also a recipient of Padma Shri and Padma Bhushan.

Excerpts:

Q: How did you zero in on the date of November 14?

A: In 976, the International Diabetes Federation (IDF) met in New Delhi. Former Prime Minister Indira Gandhi opened it. As the Secretary-General of the conference, I mentioned that Sir Frederick Banting, who had discovered insulin, shared his birthday with Pandit Nehru. November 14, therefore, needs to be commemorated. In 1991, the World Health Organisation and the IDF jointly decided to commemorate the day as World Diabetes Day.

Q: The number of those dying of diabetes or related complications every year is thrice more than those succumbing to AIDS/HIV. But why it does not share the same concern?

A: By 2025, as many as 330 million persons the world over will be suffering from diabetes. Of these, one fourth or close to 75 million will be in India. Of all the non-communicable diseases, diabetes is the commonest, others being heart disease, high blood pressure and cancer. But then, diabetes also leads to heart attack. So combined with heart disease, stroke and high blood pressure, in terms of total mortality, diabetes has a major impact. Why it does not evoke much interest is because it may remain undiagnosed and at times be considered as an individual’s problem without affecting society or economy, which is not true.

Q: How does diabetes affect society and economy?

A: The combined direct and indirect cost of diabetes in the US was to the tune of $ 20.4 billion per year (1994 figures). The cost would have doubled by now. The same year, at Kobe in Japan, we used a term that looked at morbidity and mortality from an economist’s point of view and recommended that the impact and outcome of diabetes be expressed as disability adjusted life years (DALY). DALY was calculated on the basis of premature loss of life combined with life lived with disability due to diabetes. Amongst developing countries, India, with a DALY of more than a million topped the list. Diabetes is the commonest cause of blindness and non-traumatic amputations in the West.

Q: How do you deal with a problem of this magnitude?

A: Awareness has to be generated among the general public on how they can recognise early symptoms and prevent the onset among health professionals, media and policy planners for quality health care planning. The effort has to be coordinated whether it is the food or agriculture industry. The food industry is a major culprit. Labels on the majority of food items available in the market are silent on calories and the type of fat of the product.

Q: By losing two kgs every month for five months, a person can gain five additional years of quality life. How?

A: Our theme this time is "Fight obesity, prevent diabetes". But this has to be done judiciously. Any rapid loss of weight irrespective of the device or drug can never be sustained on a permanent basis. It usually rebounds. Therefore, the lifestyle also has to change which is much more important than just losing weight. The Drug Controller of India should have a stricter control over devices used for treatment and in this case losing weight.

Q: Please elaborate on awareness among health professionals.

A: There are over 10 lakh qualified and registered medical practitioners of all systems of medicine. Surprisingly, most do not think of recording height and weight of their patients let alone calculating the Body Mass Index (BMI) of a patient. As per Indian standards, our BMI should be less than 23kg/m2 and not 25kg/m2 as in other countries. Based on the data generated in India, the International Obesity Task Force recommends a BMI in the range of 23 to 24.9kg/m2 as much of a risk equivalent of the Type II diabetes mellitus, hypertension and dyslipdemia as a BMI of 25 to 29.9kg/m2 in the European Caucasian population.

Even with a lower body weight, an Indian is predisposed to these diseases as a European with a higher body weight but similar height. Which is why every doctor should have the weight and height record of the patient, besides a record of the waist circumference. For a women, the waist circumference at the umbilicus should not increase beyond 88 cm and a man 95 cm.

The world of obese persons is divided into apples and pears. Pears with more fat around hips are considered safer than apples with more abdominal fat. But that is no consolation as excess weight is bad anywhere. Type II diabetes generally observed in adults is also prevalent in children and adolescents. Childhood obesity has crossed 10 to 15 per cent and is growing. There are no parks for children to play in cities. There are no cycle tracks for children to go to schools. TV and video games are also to be blamed. I would say "confiscate the confectionaries and ban the pan" but who would do it? When diabetes strikes at 40 years of age, its chronic complications may manifest when one has crossed the peak productivity. In younger age group, the complications may manifest when he or she is in the most productive age group.

Q: Would you not attribute lack of awareness among people to the government not allocating enough funds for the problem?

A: We have been caught in a time warp. We require money to improve comprehensive health care and prevent non-communicable diseases. If you do not have junk food and colas and do 100 skips thrice a day, you will remain healthy.

Q: What is your advice on World Diabetes Day?

A: Those who have a family history are overweight and obese, women who have delivered large babies, i.e. above eight pounds or four kg, those suffering from repeated infections of the eye or non-healing wounds and ulcers should be careful. Then symptoms like frequent urination, excessive thirst, marked fatigue should not be ignored, especially if the three are combined with obesity or family history of diabetes. These are reasons enough to go in for a check-up. If not managed well in time, diabetes can lead to impaired vision, even blindness, renal failure, peripheral vascular disorders. It also leads to high-risk pregnancies and increases the risk of abortion.

Overdue reforms in the criminal justice system
by R.R. Varma

The criminal justice system is under severe strain. Organised law invaders like terrorists, separatists, mafias and tax thieves are spreading their activities. Police investigations are poor and prosecution weak. Judicial delays and acquittals are also increasing. This is because of the inherent vulnerability of the criminal codes and malfunctioning of the police.

Archaic procedural laws and anachronistic investigative procedures have created a mismatch between law and justice. Apparently, there is little that a judge can do. In such a situation, the common objective of law and justice to uphold the truth, to protect the innocent, punish and reform the guilty becomes difficult. Some questionable omissions and commissions by the police add to queer the pitch.

The menace of planted and stock witness is too old to stress, but what is worrisome is that at times even a trying magistrate does not inspire confidence. This evil has become so endemic that in most criminal cases, including economic offences, witness tells lies in the court with no fear of the law. Punishment for such an offence is so mild and the procedure so cumbersome that the solemnity of administering the oath has become a farce. How witnesses behaved in the famous Best Bakery case and how the witnesses turned hostile in the Jesicca Lal murder case are common knowledge. This is a practice plaguing trials in most serious criminal cases.

Some legal provisions not only operate as insurmountable barriers for the trial courts to punish the guilty but also demoralise the brave and honest police officers. Consider Sections 24, 25 and 26 of the Indian Evidence Act and Sections 161, 162 and 163 of the Criminal Procedure Code. Section 25 of the Evidence Act lays down that no confession made to a (read any) police officer is admissible against an accused. This has wide ramifications.

If a person, after committing his wife’s murder, confesses voluntarily at the police station with the weapon used in the offence, it has no admissibility in the court, the tape recorded version notwithstanding. Professional criminals, mafia and organised gangs fully exploit this legal provision. To avoid harassment in police custody, they confess to the police and resile later in the courts, because police cannot take the signature of a criminal or witness.

Even if a person commits murder in Chandigarh and goes to Mumbai, discloses his offence there to a police officer, that too has no admissibility. This is about a criminal who has not yet been arrested. Section 26 of the Evidence Act, on the other hand, states that confession by an accused while in police custody is not admissible against the accused. In practical terms, it means that the existing legal practice to send an accused on remand in police custody is a wastage of time and mockery of law, because nothing confessed to the police or recorded by the police is admissible in courts. The use of third-degree, of course, is a barbarity.

Section 161 of the Criminal Procedure Code states that any person examined by a police officer is bound to answer truthfully except what may incriminate or expose him. Section 162, as if to negate what Section 161 states, says that a police officer shall not get a statement under Section 161 of witness signed by him or obtain in writing from him. These provisions help hardened and professional criminals and open flood gates for corruption because a dishonest police officer can resort to padding and fabrication.

Section 24 of the Evidence Act and Section 163 of the IPC lay down that no police officer shall offer any inducement, threat or promise to an accused. Even in the USA, a police officer may use inducement with a view to eliciting the truth. Our criminal jurisprudence, based on the English jurisprudence and adversarial system, is tilted in favour of the accused and tends to overlook the ground realities.

Grave threat to our territorial integrity emanates from Jammu and Kashmir and North-east separatists and outlaws like the People’s War Group. No witness will depose against these terrorists except police officers to whom they confess their crimes. Even in sensational criminal cases, a judge does not admit evidence on the prosecution record of a police officer if hit by Sections 24, 25, 26 of the Evidence Act or Section 161, 162 and 163 of the Cr PC. In such cases, there is no independent evidence and so, the cases collapse and criminals celebrate.

To reduce the backlog of cases, the practice that obtains in the US to amicably settle cases in bar courts at little cost can be examined. Various Law Commissions have recommended amendment to some of these criminal laws. The National Police Commission headed by Dharma Vira has made a useful recommendation to change the 1861 Police Act and to provide working autonomy to the police to improve efficiency and speed. It has also asked the government to rein in undesirable elements in the police by amending the key sections of substantive and procedural criminal law and the Police Act. As the police is a state subject, the states are showing little enthusiasm.

The Malimath Committee has recommended amendments to some key sections in the criminal law but these are gathering dust. Opposition to this is mainly coming from the legal fraternity—the central bar council, the state bar councils and some retired judges. It is hoped that the alarmingly deteriorating situation will evoke more creative responsive from these responsible circles.

It is time we shed our myopia and looked at the grim reality. There is need to assist, equip and discipline the police and make them people-friendly. The bar and the lower judiciary need to introspect. The priority is to confirm laws to the ground reality so that justice is dispensed without delay.

The Dharam Vira report contains all important and relevant recommendations to improve the working and efficiency of the police in areas like training, modernisation, recruitment, posting, transfer and punishment to erring officers and to improve police-people relations. It should be implemented in toto.

The writer, a former Director-General of Police, Himachal Pradesh, was also Chairman of the Himachal Pradesh Public Service Commission

OPED

Profile
Imran: Pak’s new generation leader
by Harihar Swarup

Imran Khan, who is known for his strikingly good looks, ostensibly, committed a faux pas at the recent Hindustan Times Leadership Initiative conference. Asked to name one woman in India that he would like to go on a blind date, he first hesitated and then zeroed on Sonia Gandhi as the one woman he admired for doing what few in the subcontinent would have done. Imran, evidently, evaded a direct answer to the loaded question and twisted his reply in a manner that made the TV viewers pause and ponder what this legendary cricketer was talking about. He then spoke the bitter truth: “I have just come out of a nine-year-old marriage and this is not the best of time to be thinking of dates”.

Nine years is a long time indeed in one’s life and one could make out pangs of separation and a wrecked family life writ large on Imran’s face. He had married Jemima Goldsmith, daughter of a multi-millionaire, in 1995. She was at that time only 21 and Imran 43 and the couple subsequently bore two sons. Jemima has taken along with her two sons, Suleiman and Qassim, to London.

Hailing from a proud family of Pathan landlords, Imran is now 52, but still retains his charismatic looks. His fans were more enthralled with his stunningly good looks and physique rather than his cricketing abilities. Reports say that before marriage to Jemima, he received many proposals for marriage and had “numerous affairs” with socialites all over the world but preferred to retain the tag of bachelorhood till he met the millionaire’s daughter. He now candidly admits “there’s no woman in my life and, frankly, I don’t know what I’ll do”. Imran may find one before long because as the age catches up with him, he needs more a trusted companion.

Imran’s married life might not have been successful, but he achieved his goal of becoming the best all rounder of the world. At the peak of his cricket career, he was considered the world’s fastest bowler. Having made his test cricket debut in England in 1971 when he was just 18, Imran was declared the international cricketer of the year in 1989-90. He was, possibly, the world’s only cricketer to have captained his country’s team for six years without a break. An outstanding all rounder, he became a national hero when he captained the Pakistan’s cricket team to a victory and brought back the World Cup in 1991-92 in Australia.

Cricket is, as if, in Imran’s blood. His family is known to have produced world class cricketers. His cousins, Javed Burki and Majid Khan, too had captained Pakistan’s team. As a student in Oxford, he captained the Oxford team in 1975. His classmate at Oxford was Benazir Bhutto; both were students of economics and politics. Benazir too was known to have become his fan. Imran decided to bid farewell to cricket in 1988 but the then President Zia-ul-Haq appealed to him to join the team as they needed his expertise and leadership. Imran changed his decision but finally hung up his boots in 1992 after winning the World Cup trophy for Pakistan.

Saying adieu to cricket, Imran plunged into the uncertain world of politics at a time when Pakistan was in the midst of turmoil followed by elections. He actively campaigned, heading the new political party “Tehreek-e-Insaaf”. He turned out to be a good speaker from the public platform, but to his surprise, his party drew a blank. He gradually and steadily made headway in public life, entering Parliament in 2002.

He is deeply religious and kind hearted, having helped people in distress. He has been devoting his time to politics. Even his critics say he has the interest of the people of Pakistan uppermost in his political agenda.

Imran’s yet another mission has been building the Shaukat Khanum Memorial Cancer Clinic into a world class institute. Built in his mother’s memory, the clinic has established its reputation in Pakistan. He has emerged as a new generation leader of Pakistan. As and when democracy is restored in his country, Imran has the potential to rise like a meteor as he had done in cricket.

Comments Unkempt
Sensitising youth on peace, cooperation
by Chanchal Sarkar

I used often to write to a friend of mine, Ijaz, that I was waiting for that evening to come when I could take a taxi to Delhi airport, but a ticket at the counter, and take the short flight to Lahore to go and stay with him in Shadman. Alas that will not happen now for he died a few months ago.

But in small ways the subcontinent is inching forward to come into its own. Flights to Sri Lanka are frequent, Bangladesh has this share but mainly from Kolkata. Buses are running between the two countries and the railway link has been partially re-established. With Pakistan the expressions of friendship are warm and often. The number of delegations, is on the up all the time mainly now through Wagah. By bus and train. But the way is not without thorns — visas are not there for the asking (except for legislators, judges and a few others). For the ordinary folk the gates are festooned with obstacles — personal appearances, nods from the Home Ministries of both countries aside from External Affairs and so on. Yet the meetings between people keep, thankfully, mounting.

Institutions, counterpart bodies and NGOs make valiant efforts, braving the tight-lipped negatives of consular potentates and using the telephone e-mail and fax to get over the hurdles. Whether the much-desired journey comes off or not invited notwithstanding hurdle after hurdle, a few of us have been over to Lahore by an NGO, Bargad, which interests itself specially in education and students, and, as a corollary to those two categories, to peace.

In the subcontinent, peace in the universities has become a rare commodity. Campuses like Dhaka and Allahabad have been ringed by police pickets and hostels have had large caches of firearms and one-time hostellers have stayed put in their rooms for years.

Burma has done without universities. Several Pakistani universities remained closed. A Vice-Chancellor of Allahabad University, speaking in a room in his residence not far from a police picket, told me “Without them we cannot possibly run the university”. Elections to students’ union have been blocked in old and distinguished universities where the only achievement of the union buildings have been the astronomic telephone bills that they have run up, paid by the university.

Institutions like Banaras Hindu University with widespread campus and buildings conceived by Malviyaji and with the Ganga running through, much more lordly than the Cam or the Isis, have been defaced with ugly posters. Rabindranath Tagore’s first love Visva Bharati’s stepping stone, the railway station and the small town of Bolpur is a sea of unlovely shops and winched-together buildings. And yet the other attractive little station, Prantik, will not be made the principal stop because Bolpur and its shops would lose business.

Other students who are expected at Lahore are from Afghanistan with wounds from the lashes of the Taliban still showing and from Iran where the conflict within universities like Tehran runs high and critical.

Lahore in its newly-minted winter should be an ideal place to put side by side the problems of Pakistan’s universities of which we do not know enough.

Karachi University is still apparently surrounded by Ranger troops. Peshawar University has rumours that the local government would like to ban coeducation. Kinnaird College and Government College University, Lahore, are still centres of excellence which were greatly admired in undivided India. Sindh University, Jamshoru, is where Sindhi students are sharply divided on class terms and Quaid-e-Azam University has been disfigured by murders of students.

On all these, Indian universities can match Pakistan one for one. What is most admirable is the effort by NGOs like Bargad to discuss the differences and clash of interests which conflict in Pakistani as well as Indian, Iranian and Afghan university.

Faculty members and students can discuss how to sensitise educational communities on peace and youth cooperation, build peace groups and from plans of action to pursue peace and youth cooperation in the region. This will not be easy. In both countries as well as in Bangladesh the younger generations are left with frustration, hopelessness and extreme religiosity. The process of liberation surrounded, as it is, by the political, ethnic and religious barriers within our countries will be difficult to confront. But if they are to be faced only young people can do so. We the older groups, have become incurable cases.

In the smarting cold of Lahore students and faculty members, if they can surmount the potholes and bumps carefully put in by well-trained mandarins and get there will be able to know one another and the problems that afflict their universities. Indian universities are hopelessly dependent on government, Central and State, autonomy is a thing of the forgotten past. Is it the same in Pakistan, Iran and Afghanistan?

At long last are the younger people, in countries which spend minute fractions of their GDP on education are trying to take matters in their own hands. Will they be able to make a strong start despite the years of bickering and sponsored hatred between the countries of the Indian sub-continent? If after centuries of war and hatred students from France and Germany can get together then why not Pakistanis and Indians?

Diversities — Delhi Letter
Arafat’s death a big blow to Palestinians
by Humra Quraishi

When the news of the passing away of Yasser Arafat came, I sat in nostalgia, thinking of the brief meeting I had had with him here about six years back. Keen on interviewing him, I got in touch with the then Ambassador of Palestine to India, Khaled Al Sheikh.

He suggested that I attend the reception he was hosting for his leader at New Delhi’s Taj Mahal hotel and together with that gave a subtle hint that Yasser Arafat wouldn’t be able to give a detailed interview because of health reasons.

And that evening this became clear as not just his hands but even his mouth was quivering and shaking and beyond a brief sentence at one given time, he couldn’t speak at a stretch. His large eyes were at their expressive best.

Though he spoke through an interpreter, what he had actually said in Arabic (a language beyond my grasp) would get relayed through the expression relayed through his eyes and, of course, the body language.

Arabs like us Indians throw about their hands and indulge in ample amount of gestures whilst talking. Though he was officially declared dead on November 11, ill health seemed to hold sway, together with the constant unleash of atrocities on his people by the US-Israel combine.

Then, as some Palestinian students hinted that within his own people, there were two opinions on how he should have gone about tackling the situation.

A growing segment was unhappy and critical with his approach. Anyway, now that he is no more, his people are at the mercy of the so-called superpower of today’s world.

Poor Teesta Setalvad

Sahmat hosted a press conference on Nov 13 where Teesta Setalvad was invited to speak. There is little point in going into the sequence of events after Zaheera Shaikh retracted from her earlier statements and put Teesta in a tight spot.

Having heard her speak earlier at two meets, I can comment that her commitment, sincerity and grit remain unmatched. Together with this footnote that in these decaying ill times, those really involved continue to occupy responsible positions.

No reduction in seminars

Yesterday a friend quipped that even if the petrol prices are further hiked, there wouldn’t be any lessening in the numbers of vehicles, commuters nor in the programmes. Quite true.

To this let me add there wouldn’t be any reduction in the number of seminars.

On Nov 22, the Delhi Peace Summit is organising a seminar on “Pathways to peace: transcending religious boundaries”.

Organising secretary Mohinder Singh informs that this seminar is a follow-up of their earlier Parliament of World Religions, with focus on what the mystics and sufis had to say about how to go about transcending narrow boundaries and religious divide.

On Nov 14, at the IIC, Rafia Hussain will organise a programme on her aunt, the legendary singer Begum Akhtar.

A documentary on her life and times would be screened together with some well known ghazal singers singing what Begum Akhtar had once rendered. Interestingly, Hussain is also related to the legendary Talat Mahmood and maybe another evening crops in his memory too.

On Nov 14, to celebrate the 115th birth anniversary of Jawaharlal Nehru, several programmes are lined up. Teen Murti House will host a Kuchipudi dance performance by young dancers, Yamini and Bhavana Reddy, daughters of the well known duo Raja and Radha Reddy.

On Nov 17, glimpses of Australia would get writ large through the works of three Australian writers. There would be a launch of the award winning works of three of Australia’s leading writers — “Three Dog Night” by Peter Goldsworthy, “The Idea of Perfection” by Kate Grenville, and “Cloudstreet” by Tim Winton.

As the invite states clearly, through their novels, the reader will “enter landscapes — urban, rural, the vast outback. You will also meet the complex, strange and familiar characters and families who inhabit these many layered stories and experience an Australia that is intriguing, confronting and expansive”. So let’s how much of Australia I manage to grasp that evening.