Friday, July 11, 2003, Chandigarh, India





National Capital Region--Delhi

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EDITORIALS

PM’s dialogue mantra
Harking back to the past won’t do

P
RIME Minister Atal Bihari Vajpayee’s call for a “culture of dialogue” could not have come at a more opportune time. His appeal should not be seen as an empty platitude articulated on the occasion of the international conference on “Dialogue Among Civilizations”. It came a few days after one more effort to find a solution to the vexed Ayodhya issue through dialogue failed.

Outrage in Andhra
Make AIDS campaign more effective
T
HE report about the recent stoning to death of an HIV-infected woman at Kuppam in Chittoor district of Andhra Pradesh is shocking for two reasons. One, that such a heinous act should take place despite a massive blitzkrieg in the media spreading awareness and dispelling myths about AIDS. Two, it should happen in a progressive state like Andhra Pradesh.



EARLIER ARTICLES

THE TRIBUNE SPECIALS
50 YEARS OF INDEPENDENCE

TERCENTENARY CELEBRATIONS
Run with your wife
The secret of keeping ale and hearty
T
HE world is not coming to an end. How can it with men having discovered the secret of keeping “ale and hearty”? The women too are not complaining. In fact, they seem to be having more fun than their spouses if reports about a unique wife-carrying race are not exaggerated.
OPINION

Focus on population stabilisation
Time to ensure high-quality health services for all
by Vichitra Sharma
T
HE challenge before the health sector today is to make standard quality of primary healthcare services easily accessible to the masses, especially the poor. On this World Population Day, when the focus is on population stabilisation, the need for reforms in the management and governance of the decades’ old existing facilities can hardly be over-emphasised.

MIDDLE

Downsized!
by S. Raghunath
T
HE year was 1999 and after a decade of acute financial stringency, I found myself in the clover and a cash surplus position. I was awash in ready liquid cash and gobbles of it.

Do we have a direction as a country?
The political system is not responsive to problems of people
T. R. Ramachandran interviews V.P. Singh
F
ORMER Prime Minister Vishwanath Pratap Singh, 73, bemoans that people are losing faith and confidence in politicians and politics. This country was built on the dream of freedom and thereafter vision of India, the frail Mr Singh observes in an exclusive interview at his Rajaji road residence in New Delhi.

NGO takes film star, kids for a ride
by Krittivas Mukherjee
A
high-profile NGO, working with thalassaemia patients, is being investigated for fraud after two children it introduced to celluloid star Hrithik Roshan during a promotion complained they didn’t have the disease.



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PM’s dialogue mantra
Harking back to the past won’t do

PRIME Minister Atal Bihari Vajpayee’s call for a “culture of dialogue” could not have come at a more opportune time. His appeal should not be seen as an empty platitude articulated on the occasion of the international conference on “Dialogue Among Civilizations”. It came a few days after one more effort to find a solution to the vexed Ayodhya issue through dialogue failed. Of course, it can be argued that he was referring to the absence of a culture of dialogue in the present-day India. The absence does not square with the rich traditions of India Mr Vajpayee himself referred to that facilitated persecuted people from all the over the world to seek a sanctuary in the country. Obviously, it was with great pride that the Prime Minister described India as a meeting point of faith routes and called upon the rest of the world to accept the principles of secularism as enshrined in India’s Constitution.

History bears ample proof of Mr Vajpayee’s contentions. However, it is equally indisputable that the country has not been able to find a solution to a man-made problem which has been offsetting its progress. The nation has been paying a heavy price for keeping alive the Ayodhya issue. It should have been a plaything to solve it for a nation which takes pride in religious tolerance and the fact that Zoroastrians are now celebrating the 3000th year of their religion in India. The reason why it has failed on this count is not far to seek. There are powerful political and religious forces within the country, which have not yet reconciled themselves to the principles of secularism the Constitution upholds. Worse, they have been systematically trying to undermine the very Constitution through ways that can be described as deviant, if not barbaric. With the government unable to control them, they have become a law unto themselves. Under these circumstances, harking back to the past glories will not take the country any further unless it is able to push the ominous forces to the sidelines of the polity.

Unfortunately, intolerance has now assumed global dimensions. Efforts are underway to change the world order to suit the convenience of the mighty as has been exemplified by the recent Iraq war. And to compound the atavistic fears, academicians like Samuel P Huntington come up with blood-curdling theories of clash of civilizations. When even institutions like the UN allow themselves to be bulldozed, Mr Vajpayee’s appeal for a culture of dialogue will strike a sympathetic chord with all right-thinking people.
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Outrage in Andhra
Make AIDS campaign more effective

THE report about the recent stoning to death of an HIV-infected woman at Kuppam in Chittoor district of Andhra Pradesh is shocking for two reasons. One, that such a heinous act should take place despite a massive blitzkrieg in the media spreading awareness and dispelling myths about AIDS. Two, it should happen in a progressive state like Andhra Pradesh. Chief Minister Chandrababu Naidu's model of e-governance and IT initiatives are appreciated both inside and outside the country. The state government often boasts of being the first to take the computer to the village. Yet it has failed to use the latest in technology to change the village mindset, which is still steeped in superstition and reacts so violently to something based on hearsay.

Obviously, the AIDS campaign has failed to reach the village level where it is needed the most. Whether such outrageous incidents happen in Andhra Pradesh or elsewhere, one thing is quite clear: unless the benefits of the advances in technology percolate down to the masses, such contradictions emanating from imbalanced development would continue to send shockwaves. There is a general perception even among the enlightened sections of society that the AIDS menace is confined to the urban areas in states like Maharashtra and Tamil Nadu, where maximum HIV positive cases have been detected. The truth is that even the rural areas are within the reach of the epidemic. The AIDS virus is carried to distant places mostly by migrant labourers who have unsafe sex.

The killer virus spreads fast in villages due to lack of awareness and timely medical help. Instead of seeking immediate treatment, the identified victims tend to hide the disease due to the social stigma attached to it, spreading the disease in the process. There are additional risks like the infusion of blood untested for AIDS. As The Tribune report on Thursday indicates, many blood banks and nursing homes collect blood from professional donors like rickshaw-pullers and drug addicts without getting it screened for the HIV virus. There is an urgent need to bridge the loopholes at the preventive and curative levels. Information given out as part of the AIDS awareness campaign must be simple and free from technical jargon so that it is understood by the targeted sections.
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Run with your wife
The secret of keeping ale and hearty

THE world is not coming to an end. How can it with men having discovered the secret of keeping “ale and hearty”? The women too are not complaining. In fact, they seem to be having more fun than their spouses if reports about a unique wife-carrying race are not exaggerated. The gods must have come down from their divine abode for a ringside view of what sounds like a fun race that was run across a 250-metre obstacle course. Estonia’s wife carriers had come with a secret strategy to a resort in Finland for this year’s world championships. The event is rooted in a Finnish legend about a wife-stealing gang. What happened to the gang? It would have been in great demand in this age of redefined liberties.

Getting a wife on your back is as difficult an art as getting that damn monkey off your back. The first requires expertise and the other loads of patience. The teams from Estonia evidently had both in abundant measure. The prize for the winners was the wife’s body weight or 45 litres of ale, whichever was less. The winning tactic was hailed as “Estonian Carry” — where the woman squeezes her thighs on the sides of the man's face while hanging upside down on his back. The event certainly deserves wider participation and publicity. In India potential champions can be found among members of certain tribes who encourage boys to physically carry away the girls of their choice as part of the marriage rituals. There was just a minor flaw in the rules. The champion hubby was made to carry 4.5 kg of sand to bring his wife to the minimum regulation weight. Had the winner been given gold, instead of sand, Indian women would have forced their men to join the race. They may even have gone on a starvation diet because the less they weighed the more gold their men would have got to carry for the race.
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Thought for the day

Culture may even be described simply as that which makes life worth living.
 — T. S. Eliot

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Focus on population stabilisation
Time to ensure high-quality health services for all
by Vichitra Sharma

THE challenge before the health sector today is to make standard quality of primary healthcare services easily accessible to the masses, especially the poor. On this World Population Day, when the focus is on population stabilisation, the need for reforms in the management and governance of the decades’ old existing facilities can hardly be over-emphasised.

Despite the large network of public health providers and establishments, spending on health is around 1 per cent of the gross domestic product (GDP). This figure, in a World Bank study, puts India among the bottom 20 per cent of the countries. It is also far below what is needed to provide basic health care to the population.

The picture is further distorted with unequal health financing among the different states. The large variance in public resources for health between rich and poor states is widening the gap for achieving the replacement level of fertility and addressing the issue of a high maternal and infant mortality rate that is an important factor preventing population stabilisation. Kerala, Punjab and Tamil Nadu, for example, have doubled the per capita public health spending as compared to Bihar and Madhya Pradesh. In fact, states like Kerala, Tamil Nadu and Maharashtra have nearly uniform spending on health across different income groups.

In contrast, private health expenditure accounts for more than 80 per cent of all health spending, one of the highest proportions found anywhere in the world, according to the Bank study. Most of the private spending on health is out- of- pocket for the service use, an inefficient way to finance healthcare, leaving people extremely vulnerable. Poorer families are unable to pay for the curative care and, therefore, try to avoid hospitalisation as far as possible, that is, if it is at all available.

For them, hospitalisation leads to financial disaster, for the rest about 58 per cent of the annual expenditure goes towards hospital costs. More than 40 per cent of hospitalised people borrow money or sell assets to cover expenses. One conservative estimate finds that one-fourth of those hospitalised were not poor when they entered the hospital, but became so because of the expenses. The extent to which their financial status falls varies from state to state.

Even at public hospitals, which are intended to protect the poor they continue to be vulnerable. In fact, in states like UP, West Bengal, Madhya Pradesh, Rajasthan, Haryana and Bihar, the poor are more likely to borrow money. Though the poor depend on the public sector facilities, these are not always available or functional. Therefore, even those below the poverty line have to ultimately fall back on the private sector in small towns and rural areas for 79 per cent of the outpatient care, that is of low quality and often provided by untrained practitioners.

Further, despite widespread information and economic compulsions, the poor are unable to plan a family because of continuing high maternal and child mortality. With the infant mortality rate hovering over 70 per/1000 live births, population stabilisation cannot be achieved without first providing for an improved health status of women and children.

Medical and technological development has led to a rapid fall in the crude death rate, but this does not include maternal mortality resulting out of complications during pregnancy or childbirth. It is estimated that every six minutes a woman dies giving birth to a child. The figure on an yearly basis would be staggering. This should be unacceptable for any civil society, especially when having a baby is a very natural and normal part of a woman’s life. But due to poor and inaccessible services this simple act continues to be life-threatening.

The Tenth Five-Year Plan has rightly noted some of the major areas of concern that should be taken up as a priority in implementing health-related strategies by the states. Other policy documents, the National Population Policy (2000) and the National Health Policy (2002), have also recognised that the critical gaps in infrastructure, equipment and a de-motivated, often poorly matched manpower in the primary health centres (PHCs), community health centres (CHCs), district hospitals, and a lack of both diagnostic and referral services require immediate attention. The metropolitan hospital services that are being used for routine advice are no longer in a position to meet the pressures from the countryside.

The urgency to introduce reforms in the health services cannot be stressed more, given the fact that India, the second most populous nation, is sustaining 16.7 per cent of the world’s population on 2.4 per cent of the world’s area. The population growth rate continues to be high, firstly, due to the population size in the reproductive age group, accounting for almost 60 per cent of the total increase in numbers. Secondly, it is because of the unmet need that is also due to the inaccessibility of contraception. This contributes to around 20 per cent of population growth. Finally, we have to blame a high wanted fertility due to high infant mortality and other socio-economic reasons, contributing another 20 per cent rise.

The nation-wide population replacement stage continues to be elusive. Most population projections have been too conservative leading to corrections and revisions. According to the Technical Group on Population Projections constituted by the Planning Commission, the country would achieve the replacement level (total fertility rate) of 2.1 by 2026. However, the most populous states of Bihar, Rajasthan, Madhya Pradesh and Uttar Pradesh will achieve the replacement level of fertility by 2039, 2048, 2060, and after 2100 respectively.

Tamil Nadu and Karnataka have attained replacement levels of fertility while Andhra Pradesh has shown a remarkable drop. However, the marked differences among the states in the size of the current population, projected population growth and the year by which the TFR may be achieved shows that these will have a major impact on other development parameters. These are health and nutrition, education and skill development, appropriate employment with adequate emoluments, rural-urban and inter-state migration and other socio-economic developments.

The Tenth Plan document on sectoral policies and programmes in family welfare endorses that high quality services will have to be provided during the next two decades to break the vicious cycle of poor performance, poverty, low per capita income, low literacy and a high birth rate in most populous states. Urgent steps have to be taken to ensure that the gap of disparities among the states doesn’t widen further and a drop in the quality of life is prevented. An Empowered Action Group has been set up to provide special assistance to these states.

The Plan document has focused on a paradigm shift in health care. Though change had started in a few pilot areas during the Ninth Plan, more and more states have come around to seeing merit in changing the traditional way of running health services and bringing in elements of modern management practices. The Government of India’s Sector Investment Programme (SIP), supported by the European Union, is a step in this direction.

The key elements of the reforms are decentralisation, community participation and public/private partnership as well as “attitudinal changes” and improving programme abilities and managerial skills within the system itself. This means that the stakeholders at the panchayat, bloc, district and state levels are involved in micro-planning. As a result, the responsibility of programme implementation will ultimately rest with the community, to address its specific local-based health issues. It will also eventually lead to the decentralisation of the management of the day-to-day running of health facilities.

Ultimately, the challenge is to ensure that the health system improves the health of the people in an accountable, equitable and affordable manner.

The writer is a senior journalist specialising in development issues

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Downsized!
by S. Raghunath

THE year was 1999 and after a decade of acute financial stringency, I found myself in the clover and a cash surplus position. I was awash in ready liquid cash and gobbles of it.

The benign Union Finance Ministry had sanctioned the 11937th instalment of DA and I had hoodwinked the Reserve Bank and the Enforcement Directorate and stashed away a Nizamesque amount of Rs 2.25 in a secret, numbered Swiss bank account. Then the grimy bus ticket I was clutching grimly won me a Croesus-like Rs 1.75 in the Bangalore Transport Service Passenger Incentive Scheme draw and I had promptly stashed it in an offshore account in a Cayman Islands bank after laundering it in Panama and the Bahamas. In a fitting climax to my unremitting run of good luck, I swept the Himachal Pradesh Heera Panna Grand Baisakhi lottery draw and pocketed a whopping 75 paise and I sequestered it in a Jersey bank.

I decided that it was time to draw out and indulge in nawab-like opulence and live the life of Riley.

I put in an expansively worded ad for a butler-cum-major domo and I appointed as my executive chef a chap who had worked as a temporary cook in a roadside dhaba and chaat stall. I appointed a couple of chamber maids, assorted understudies and even a boy to clean the knives and boots and several bell captains and the domestic staff pandered to my every whim and fancy.

Then one fateful day, without due advance warning, the shoe dropped and the cookie crumbled. The Finance Ministry, kowtowing to the high handed “diktats” of the World Bank and the IMF impounded the next instalment of DA and credited it to my PF account causing a severe liquidity crisis. The bank unilaterally foreclosed my overdraft limit of Rs 3 leaving me fiscally stranded. In a desperate bid to make ends meet, I even slyly raided the “hundi” kept in the worship room and desperately prayed out of it 5 and 10 paise coins.

It was time to trim the fat, let go the surplus staff and emerge lean and fit and taking a leaf out of private sector managements, I set in place a Voluntary Separation Scheme (VSS).

The first to feel the pinch was the cook because he had been the first to be hired and natural justice (and my version of VSS) required that he should be the first to go.

I called him into my study for a cosy tete-a-tete. I told him that I wanted him to leave me, pronto taking a day’s salary in lieu of notice and a bonus of 20 paise — 10 paise for each month he had served me.

The cook conked me on the head with a coconut grater. My VSS, hardly a day old, had already sprung a leak.

It was the maid’s turn to take the heat. “Ma ‘m”, I said warily eyeing the broomstick she was carrying belligerently,” it’s about time you scrammed and I saw the last of you. You may go and seek greener pastures elsewhere and to sweeten the kitty, I’m giving you this blouse piece.”

The maid dumped a bucketful of rubbish on my head.

The crunch came when my wife summoned me to her dressing room for a dressing down. “I took you on board when we were in boom times,” she said brashly, “and now that the bottom has fallen out of the market, I find that I can no longer afford to pay my beauty parlour and dress expenses with your pittance of a salary. I find you redundant and for heaven’s sake go!” and she handed me a shiny 25-paise coin.

My golden handshake has turned out to be a golden shakeout.

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Do we have a direction as a country?
The political system is not responsive to problems of people
T. R. Ramachandran interviews V.P. Singh

FORMER Prime Minister Vishwanath Pratap Singh, 73, bemoans that people are losing faith and confidence in politicians and politics. This country was built on the dream of freedom and thereafter vision of India, the frail Mr Singh observes in an exclusive interview at his Rajaji road residence in New Delhi.

Excerpts of the interview:

On prevailing political environment.

In which direction is the country going? Do we have a direction as a country. All the parties don’t make the country? Discussing data does not make the country. Dreams do. In our childhood we had faith in the leaders. We could see it in villages. Canals came up, schools were being constructed and roads being made. The political system was sensitive and responsive to the problems of the people. Over a period of time Gandhiji’s consensus has withered away and a certain new situation has arisen. There is no crystallisation of consensus and a dream. We have to redream India. This is the malaise. India has been equated to elections and government. Ask a common man what he thinks of the political system. His first sentence is most important about politics and politicians. Earlier, politicians commanded respect. Now it is great credit if the first sentence does not contain abusive language. It will be of great grace. There is a certain decorum in public life...certain commitment to the people and element of patriotism has to be there. That leads to clean politics. The population of 100 crore is not taking any part in the government.

On why politics has degenerated?

Politics is a power game. There is no denial of that. The government is a sword and it has to be used in favour of the people. Power is good but when certain things have to be achieved at any compromise or ideology, then most of time is spent making or unmaking governments. Nobody has time to make the country. Khan Abdul Ghafar Khan once told me "factory aur sadak ban rahe hein...lekin insaan ko kaun banayega." No one wants to answer or make a commitment to the issues of shelter, food, clothing, healthcare, education, clean drinking water, good governance and respite from the bribe taking machinery. Politics get diverted to emotional issues and clouds the main ones.

In the last decade or so, religion and caste have become money and muscle power. This has become the main mix of politics. During the last election in Uttar Pradesh, I told the farmers that if they are going to vote on caste basis then how are their problems going to be resolved. Issues have, therefore, become irrelevant to any party. Peoples’ issues have to be brought into focus and made the mainstream of politics. This correction is necessary. The effort of evolving national consensus should not involve political parties but also writers, labour, farmers and various sections of society. The unity and freedom of the country is imperative. Freedom is seriously imperilled because we are divided. It opens up to inimical forces.

On religion and Ayodhya tangle

We have come to a very controversial issue which is affecting the unity. Again dealing with this matter has gone down in priority. The ruling party has to harmonise the differences on many controversial issues. We have imprisoned God in buildings and edifices. We have come to a stage to rethink on religion. Many people reduce religion to a ritual. That is where the conflict arises. Religion is a deep experience and can’t be propagated on a loud speaker. When a child is born how is religion imposed on the new born without his/her consent? There is social imposition on the individual of which the child knows nothing. One should declare one’s religion at the age of 21. Truly each person has to find his/her own religion as per one’s conscience.

There are many good aspects to religion. There are many humane aspects. Now Hindu philosophy says all living beings are the same. Christianity is a religion of forgiveness. Islam has the message of brotherhood and Buddhism and Jainism has the message of non-violence. The Sikh Panth has embaraced everyone. We have the most important religions of the world. Each religion develops in a certain social context. One should see the common humane message.

On Godhra carnage and aftermath

The backlash of Godhra was the outburst of systematic cultivation of hatred over decades. This is the stream coming along before independence. A section of people cultivated hatred against the minorities. Taking revenge for what happened in the past.

On transparency and foreign policy

We had a consensus on foreign policy for a long time. Now transparency in public life is good. The amendment to the Official Secrets Act awaiting the assent of the President will be a powerful instrument in the hands of the people. Transparency is also required in tackling political funding.

On J and K and Pakistan

The government has done quite a few U turns. There must be firm action against militants. There has to be a message that militants cannot succeed. At the same time, politically the people of J and K have to be taken into confidence. This ought to be the policy. The Kashmir problem cannot be solved by any government overnight. This is the cumulative impact of various governments. I supported the May 1998 Pokhran II (peaceful testing of nuclear device). The BJP took the decision on nuclear testing as in every previous government the device was being developed. J and K chief minister Mufti Mohammed Sayeed has good relations with the Centre. Tackling insurgency always takes time. We must have the patience. India has suffered the most. There is no readymade solution. It has to be through a process of time. India and Pakistan have to communicate with each other.

When I took over as the Prime Minister in December 1989, Punjab was aflame and there were disturbances in J and K. Indian forces were in Sri Lanka and I expedited the withdrawal of forces from the Island country. I wanted to avoid having two fronts. Inspite of cross border terrorism, we should open a dialogue with Pakistan. Finally we have to talk to Gen Musharraf. Dialogue does not mean trust blindly. Trade should be opened up with Pakistan. This will help in cooling down matters between India and Pakistan.

About the US, any country will expand its political interests. It is not necessary for us to toe any line. India must have its policy and act as a sovereign country. We can’t prostrate ourselves by equating with Pakistan. I am for friendship with the US. We have several interests including a large Indian presence in the US. I am not for (Tony) Blair’s type of friendship with the US. We must explain our position to the US. While I was Prime Minister, the US wanted me to visit Washington on a working visit but I did not agree. There is a difference between a friend and a slave.

On political vendetta

Political vendetta is bad for the system. When there is a change of government, it will also carry on the same way and the bureaucracy gets distorted. There is no sense of justice in this. During my Prime Ministership, there has not been one case of political vendetta.
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NGO takes film star, kids for a ride
by Krittivas Mukherjee

A high-profile NGO, working with thalassaemia patients, is being investigated for fraud after two children it introduced to celluloid star Hrithik Roshan during a promotion complained they didn’t have the disease.

The police has arrested Smile Earth chief Sonali Chowdhury, who has been seen posing with celebrities like Amitabh Bachchan, Rahul Dravid and Steve Waugh.

According to police officials, she could have collected millions in charity from famous personalities using healthy children as thalassaemia patients.

But the real brunt of the fraud is being borne by the two children whose lives have become miserable after newspaper photographs of them with Hrithik Roshan were published.

Saba Salim (12) and her brother Vicky Salim (6) suddenly found themselves being boycotted by people and even their school.

The authorities told the children that they should stop coming to school until they were cured. Their father, Sahzada Salim, even received a letter reiterating the condition on July 3.

“We were stunned when we learnt that the world thought our children had thalassaemia. They are perfectly healthy and don’t suffer from any disease,” Salim told IANS.

He filed a police complaint against Smile Earth and Chowdhury after receiving the letter.

According to Salim, it all started on June 27. Chowdhury, whose office was near Salim’s home, picked up the children saying they were going to a function.

She gathered two more children and went to meet Hrithik Roshan at a city hotel. The four children were introduced to him as thalassaemia patients. Roshan called the children to him and posed for photographs with them. He also interacted with them for sometime. The photographs were published in newspapers the next day.

In its defence, Smile Earth said it had been framed. Chowdhury sought to prove her innocence by blaming the media for a mistake with the photographs of Hrithik Roshan’s promotional event.

Smile Earth has been supposedly working for the rehabilitation of poor children suffering from thalassaemia for several years. She has befriended several prominent personalities with her cause.

Thalassaemia is a hereditary, genetic disorder transmitted through symptom-less parents. There is a one-in-four chance that a baby born to two carriers of the disease would inherit the abnormal gene from both parents and suffer from severe anaemia, resulting in premature death.

Continuous blood transfusion is the only effective way to combat the disease. But the high cost involved in the entire process is beyond the reach of many.

West Bengal, which has the highest rate of thalassaemia among children, is contemplating a novel law that would make a blood test mandatory for marrying couples.

The state has about 65,000 thalassaemia-affected children. About 13 per cent of the state’s population are carriers of this disease. — IANS 
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