HEALTH

Implementation of PNDT Act — whose responsibility?
Shivani Bhakoo

Ludhiana, March 22
Doubts are being raised over the seriousness of the Punjab Government about the implementation of Pre-Natal Diagnostic Test (PNDT) Act as the implementing agencies have failed to ensure that the supporting staff attends meeting that periodically review and plan strategies for the proper implementation of the Act.

At recent meeting held in the office of the local Civil Surgeon, only a handful out of the dozen odd members attended the meeting. This is not the first time that such a thing has happened. Even in the past such meetings are held without any seriousness.

Besides, those who do participate in these meetings rarely exert themselves to effectively enforce the Act. A complaint with the Committee headed by Dr Rajinder Kaur, Civil Surgeon, was brought out that the Dayanand Medical College and Hospital possessed four sonography machines, whereas it had the licence for only one machine. But the committee chose to ignore the issue. However, Dr S.C.Ahuja, Principal, DMCH, when asked about it said, the objection raised in the meeting was not true and as the hospital had already submitted the papers for registration of all the four machines.

The Advisory Committee, headed by the Appropriate Authority i.e., the Civil Surgeon, constituted for the implementation of Act under the guidance of the Supreme Court has hardly come up with any results.

One of the members, on condition of anonymity, disclosed that most of the members did not attend the meetings. “There is no enthusiasm among the members. Some of the members take these meetings as a burden,” said the member.

In the recent meeting, it was suggested that the members who did not attend the meetings, should be relieved from their responsibilities so that new members start taking interest for the strict implementation of the Act.

A senior member of the Advisory Committee, when contacted, said that the Health Department was taking interest in the enforcement of this Act but the NGOs are little concerned. “It is not the duty of the Health Department alone. There is a need to change the thinking of society, especially the womenfolk. The NGOs should arrange talks and lectures on the subject at various ladies’ clubs so that the ladies should understand the sensitivity of the subject,” the person said.

Another active member of the Advisory Committee said that another major reason for the failure in the implementation of the Act was the political interference. This member said: “Recently one such case was reported in Hoshiarpur district but the culprits were not brought to the books as they were related to one former member of Parliament (MP).”

The member said that a senior male gynaecologist was removed from the Advisory Committee because a senior district official did not like him and the person who replaced him, hardly attended any meeting.

Dr Gursharan Singh, president of the local unit of the Indian Medical Association( IMA) and one of the members of the committee, said that Dr R.C.Garg, state secretary and elected president, took strong exception against the IMA doctor who before the raid had informed the doctor at Khanna that his diagnostic centre was being raided by the committee members.

Great need for palliative care
Asha Ahuja

Ludhiana, March 22
What is palliative care ? Palliative care is the active total care of patients whose diseases are not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Palliative care affirms life and regards dying as a normal process, neither hastens nor postpones death, provides relief from pain and other distressing symptoms, integrates the psychological systems to help patients live as actively as possible until death, offers a support system to help the family cope during the patient’s illness and in their own bereavement (WHO World Health Organisation 1990)

Dr Graham E Marlin, MBBS, MD ( Sydney), Consultant Physician in Palliative Medicine, Sydney Haematology and Oncology Clinics, Sydney, is visiting Christian Medical College & Hospital to start palliative services. He is on the invitation of Christian Medical Association that is running 300 hospitals in India and CMC is one of them. Actually, the services were provided in the CMC Hospital five years ago, but these lapsed and Dr Graham has come to reintroduce the service by training people through seminars. He says, “It is necessary to provide holistic care to the patients with incurable diseases”. These patients need management of psychological, social, emotional , physical and spiritual needs. Dr Graham says that a team comprising physicians, nurses, social workers, physiotherapists, occupation therapists, priest, dietician and volunteer co-ordinators is required.

He has built up a team that would start palliative care soon in the CMC. In India the major need is to extend palliative care services to homes as in India patients prefer to die at homes. Indian society offers support at home.

He said the concept of palliative services started way back in 60s but in India the concept reached in the 90s. The first centre was started in Calicut Medical College with the help of WHO Demonstration Palliative Care Unit. Later, the Indian Association of Palliative Care started quite a number of such services, but the number is inadequate.

Dr Graham said, “The main purpose of this care is to reduce the pain of the patient, to prepare him and his family members, including the children, of the impending death. Palliative care aims to allow the patient to die with dignity. Morphine is administered to patients to lessen pain and hence make life bearable. Morphine is not addictive. After the acute symptoms like breathlessness, vomiting, and intolerable pain is reduced, the patient has to receive palliative care in the homes. Needed are trained volunteers to assist families at home. These volunteers can perform simple tasks like giving physical and psychological support. In Australia, the story is different. There are well established allied health services, but in India a lot needs to be done. He said that the doctors in it should go for a short training course so that they can upgrade their knowledge”.

Dr Pamela Jairaj, lecturer in radio therapy of CMC said that there are many patients but the public has to become aware of hospices where pallaitive care has to be given. The core team tries to maintain contact with the bereaved family after the death of the patient to offer counselling to cope up with the loss. Palliative care is along the process of preparing the patient and family to help them fight despair and anguish and severe emotional distress.

Procurement arrangements ‘completed’
Tribune News Service

Ludhiana, March 22
A meeting to review the procurement arrangements for the coming wheat season was held under the chairmanship of Mr Anurag Aggarwal, Deputy Commissioner, here yesterday. The meeting was attended by all the SDMs, the DFSC, the District Mandi Officer, the Chief Agriculture Officer, the District Development and Panchayat Officer, the BDPOs and all officers up to the block level of all departments concerned.

Mr Aggarwal said that the government was committed to purchase every grain of wheat coming to the mandis. A total of 109 purchase centres had been set up for wheat procurement. Last year 8.9 lakh metric tonnes of wheat was procured by the government agencies. For this year the arrangements had been made for procurement of 9.7 lakh MT of wheat. All the government agencies were fully prepared for procurement and adequate arrangements of stock articles had already been made. The government agencies had been directed to position their procurement staff in the allotted mandis on April 1, 2002, and they would continue to procure the grains till the last arrival.

All the SDMs, and the Chief Agriculture Officer had been directed to ensure there is no harvesting during the night. This is to ensure less moisture content in the grains. The District Mandi Officer informed that 100 per cent arrangements had been made for cleaning of grains by power cleaners. Adequate arrangements had been made to provide water and shelter in the mandis. Commission agents had been directed to arrange for sufficient number of crates and tarpaulins in the mandis. The Deputy Commissioner directed the SDMs to ensure that auction should start at 10 a.m. and continue till 6 p.m. 

DC assures accessibility
Tribune News Service

Ludhiana, March 22
The Deputy Commissioner, Mr Anurag Aggarwal, held a meeting with local media persons to establish a smooth working relationship here today. After discussions, he said that it would be his serious endeavour to clear any misgivings that might have crept in about the functioning of the administration.

Assuring transparency and accessibility, the DC said that both the public and the media could expect full cooperation and coordination from the district administration. He also appealed to the media for cooperation for the smooth functioning of the administration.

Further speaking at this meeting, Mr Aggarwal and the Additional Deputy Commissioner (General), Ms Rakhi Gupta Bhandari, sought some time for settling down. The DC expressed his inability in dealing with some complicated issues and said it was not always possible for him to comment instantly on some important issues.