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Significance of October Revolution Action plan for promoting
health care in states |
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On Record
Profile Reflections Diversities — Delhi Letter
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Significance of October Revolution
The Russian Government’s decision not to observe the November 7 holiday marking the October Revolution is a sad reminder of how much US-led, pro-capitalist sentiments have spread around the world. I am neither a communist nor an ex-communist, but nevertheless, one felt inspired by those events, and the spirit of sacrifice and commitment described in John Reeds’ Ten Days that Shook the World. Of course, one was horrified by Stalinism, the murders, and the events from 1939 when Russia decided to oppose freedom in the name of people’s war. But still, November 7 is too important to forget. Karl Marx’s Communist Manifesto put into action in the Communist Revolution during the 19th Century was short-lived. Many then had doubts as to whether they were merely the hair-brained ideas of a small time pamphleteer, or were indeed the most Revolutionary doctrine since decades. One had read Tolstoy who had described the plight of Russian Peasant, “I sit on his chest choking him. I wish him well. I want to do everything for his well being and health. But I will not do one thing which will make the peasant breath easily and live — that is get off his chest”. Then there was the famous ironic fling by Anatole France about the attitude of the bourgeois towards the homeless when he said “we treat rich and the poor equally and without discrimination. Both of them have the same right to sleep under the bridges”. One most overwhelming thing about the October Revolution is that common citizens came together to throw out an oppressive regime in an attempt to usher in an egalitarian society. It does not matter that the dream was not fulfilled. Nor does it matter that Russia became a Gulag as described by Alexander Solzhenitsyn or Boris Pasternak in Doctor Zhivago. It was shown that there could be an alternative to the capitalist system of society where everyone will enjoy equal dignity and respect. Of course, there are many reasons why Russian Revolution failed. Violence can never be the midwife of a Revolution — rather it eats its own children. An open, peaceful and Gandhian method of resistance for change of society is the only alternative. The real contribution of the October Revolution was to show that an exploitation free society was possible. One may regret that those like Stalin to whom this opportunity was given failed us. The fact that the Russian Revolution turned on its own children is no reason to deny the contribution and the victory of that idea even for a short period. If one was to go by Russian President Putin’s logic, the French Revolution and the Bastille Prison break-in should be forgotten because it was followed by Robespierre and later on by Napoleon Bonaparte’s crushing of the workers’ movement. The French Revolution nevertheless and in spite of these later distortions remains an inspiring idea to millions of
people. The author is a former Chief Justice of the Delhi High Court. |
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Action plan for promoting health care in states
Surprisingly, even after 58 years of planning, we have no separate health policies for the states. After the introduction of the National Population Policy 2000, some states like Andhra Pradesh, Kerala, Uttar Pradesh did prepare state population policies but did not work on them. Despite instructions from the Union Ministry of Health and Family Welfare, some states like Punjab, Haryana and Himachal Pradesh never bothered to prepare their own population policies. As a result, all health institutions, particularly rural, continue to excessively focus on immunisation and family planning activities, ignoring the curative aspects of health care. It is time curative aspects of health care were given due care along with preventive aspects, through effective state administration. Health planning must start from the bottom (state level to begin with, if not the district or village level). Framing health policies for individual states is one such step towards decentralisation. Though we have a national health policy, states too need to have such a policy as health care requirements differ from state to state, district to district and individual to individual due to socio-economic differentials. A national health policy would help establish broader national goals such as determining public health investments, bringing about innovations in health equipment and drugs, establishing an integrated system of surveillance at the national level and earmarking different national programmes for health. A state health policy would help ascertain properly all aspects of health care (including preventive, promotive, curative and rehabilitative) at the district or block level. Despite many rural and urban health institutions at the all-India level, only 20 per cent population uses the government health services for outdoor treatment. In states like Punjab, the situation is worse, with only seven per cent rural and six per cent urban households using public health care facilities for non-hospitalised illnesses. There is an urgent need to revitalise the public health system in the states. The costs of public health care are indeed revealing. For instance, in Punjab, there are 1,465 allopathic rural dispensaries (each with a medical officer and a pharmacist besides other support staff). When one works on the costing pattern and the number of patients visiting these dispensaries, he will be embarrassed. For each patient visiting the dispensary, the government spends nearly Rs 700, without dispensing any medicine to the poor visitor (based on a rough estimate of 35 patients visiting the dispensary a week which is rather rare). State health policies are needed to work on viable alternatives to meet such situations. State health policies are needed to ensure optimal utilisation of existing health resources including manpower and equipment. Alternatives are needed for making health care affordable for the masses, bringing about viable health insurance plans to meet rising health costs in public and private sectors; improving reproductive health, nutrition, control of HIV/AIDS; promotion of Indian systems of medicine and homoeopathy; promotion of mental health; improving availability of diagnostic facilities; coordination of public-private sector besides marking area-wise prevalence of tropical and other diseases. All these warrant in-depth research, with experts’ help. At present, we are totally non-committal on establishing a strong health management information system (HMIS) for immediate access to information on different health indicators such as birth rate, death rate, neo-natal, peri-natal, infant and child mortality rates, method-wise contraceptive prevalence rate, prevalent disease patterns, etc. at the district level. An effective information system will ensure planning area-specific and need-based policies and programmes for future. Our information network should be so strong that a child should be registered at all levels as soon as he is born. When we can have ATM machines, an online share market at the all-India level, why cannot we have an online system for instant registration of births and deaths? Thus, state health policies should focus on a health information system, which is user- friendly and online. During this writer’s 17-year fieldwork in different northern states, he has come across many incidents of mismanagement. For instance, he could see eye and skin specialists or a gynaecologist at a rural dispensary without the required medicines or instruments. They simply mark their attendance and go away. In some hospitals, pharmacist is deputed to the post of a staff nurse. There are many private hospitals in Haryana, Himachal Pradesh and Punjab, which are usually run by a husband-wife team, where one is a government practitioner, and spends most of his time in the private clinic rather than at the place of posting. In the districts, one cannot get the exact number of private practitioners/clinic from the district health authorities. Removing such anomalies and ensuring regulation of private sector by way of mandatory registration, service monitoring, fees regulation, and rating are some of the biggest challenges to be solved through state health policies. In addition, state health policies should focus on developing a new work culture, rewarding performance, fixing accountability for failures, removal of malpractices such as absenteeism, reluctance to live at the place of posting, etc. It would be very difficult to bring about any further improvement in institutional deliveries, obstetric care, antenatal and postnatal care unless some of the measures mentioned above are taken care of. Adequate monitoring and supervision, induction training, refresher courses, at least six monthly inspections of all the health institutions are a few steps which are required on an ongoing basis to take stock of the situation and mark periodic changes in the health policy. The policymakers are very much aware that production of such documents by the respective state governments is a challenging task. But the execution of the action plan so suggested would become difficult without a strong political and administrative will. Given the current scenario, it is imperative for the respective governments to take steps for overhauling the existing health systems, and suggesting action plans for setting up immediate, medium-term and long-term priorities. It is also necessary to ensure that such documents do not become a one-time experience but remain vibrant, flexible, and need-based by way of continuous inputs. The writer is Senior Research Fellow, Population Research Centre, Centre for Research in Rural and Industrial Development, Chandigarh |
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On
Record
Excerpts: Q: What are NDA’s prospects of victory? A: From reports available so far, we will make it this time with a comfortable majority. When the ballot boxes are opened on Nov 22, the mandate may surprise many. Q: Why did you miss the bus last time? A: Oh, we were close to power. The people wanted a change and to end the domination of the RJD and its allies, but they were not clear about the alternative. Consequently, they voted for the NDA and the LJP as the two combinations represented change. But Ram Vilasji was not prepared to take the plunge and dragged his feet for over two months when his legislators revolted and broke away. The LJP chief was keen to sail in two boats as he wanted to remain in power at the Centre and have a stake in Bihar also. His attitude disillusioned many of his committed supporters. Over two thirds of his MLAs decided to extend support to the NDA but before we could stake claim, the Centre in a midnight operation imposed Central rule and dissolved the Assembly dashing the hopes of millions to have a non-RJD government. Q: How is it different this time? A: There is no confusion now. The NDA has projected its chief ministerial candidate much in advance and there is no confusion in the people’s mind. The contest is between the NDA and the RJD-led front and all other parties are marginal players. The people want change and are prepared to come out of their casteist and religious mindset. The electorate is beginning to see the ill effects of 15-years of casteist divisions in the state which has ruined the administration and brought a bad name to Bihar. Q: How do you see the Election Commission’s role? A: It has been playing a stellar role and has emboldened people to come out and vote fearlessly. It has restored the prestige of the voter and has considerably eliminated the role of booth managers and musclemen who used to rig the election. The EC has substituted violence and terror with peace and fearlessness. Voters are coming out to stand in line to exercise their franchise. Bogus votes have almost been eliminated. The present Assembly election is the fairest poll in the recent past. Q: What ails Bihar? A: A demoralised bureaucracy, almost non-existing law and order machinery, misgovernance resulting in non-development and a divided people. Flight of talent from the state and the absence of job opportunities resulted in large-scale migration of labour. Deteriorating law and order led to closure of many industries as capital fled from the state. Q: If voted to power and elected as Chief Minister, what would be your priorities? A: Effective governance holds the key to the state’s problems. Governance ensures delivery. The delivery system has collapsed and we will restore it. We would first restore law and order and provide a feeling of security. We would not use the law enforcing machinery, i.e. the state police for partisan ends. It was used by the Laloo-Rabri regime to harass and harangue good people and protect bad and criminal elements. We shall reverse that practice and instruct the administration to restore people’s confidence in the state machinery. The role of middlemen who siphon off money from the people’s welfare schemes will be eliminated. They are the real culprits as they thwart development schemes by pocketing the funds which come from the Centre and other agencies. Roads, water, schools, hospitals, employment generation and stepping up of investment are obvious objectives and priorities. Q: The NDA has been running a campaign against tainted ministers. How would you avoid being accused of a similar offence as there are such elements among your ranks too and you would be under pressure to include them in your cabinet? A: Don’t
worry on that count. You would see that we would not be accused of
that. The role of criminals is being reduced because of free and fair
election which has encouraged genuine voters to exercise their
franchise. This in itself is a guarantee against such elements. |
Profile
Mr Kofi Annan expressed anguish at what he called the “Oil-for-food scandal”, which had cast a shadow over the United Nations and asserted, “I am determined to get to the bottom of it, and to get the truth”. Perhaps, unwittingly he observed, “that was why I set up the panel headed by Paul
Volcker”. Volcker had by that time submitted two reports and, as Mr Kofi Annan, disclosed: “We expect the final report in June which will deal with the broader issue — smuggling of oil by Iraq outside the programme, the role of the companies and others”. The programme was devised to assist the Iraqi people, because it was felt that as long as sanctions were there, they would not be able to sell oil and they were going to suffer. Little did the elite audience in the hall and Virendra Dayal, in particular, realise at that time that the Volcker report would rock India’s political scene and he would be the man entrusted with the task of looking into allegations against Union Minister Natwar Singh relating to irregularities in the Oil-for-Food programme during the Saddam Hussein regime in Iraq in 2001. This is the toughest assignment given to Dayal in his 28-year-long association with the UN. It comes at a time when he has already hung his boots. He is now 70. Success of his fact-finding mission depends on the cooperation of the Volcker Committee and its staff, many of whom have nothing to do with UN. Dayal says: “It all depends on how cooperative people are. I have to use the diplomatic means to perform my functions…let us see how the world reacts and how forthcoming people are”. India’s Permanent Representative at the UN, Nirupam Sen, has been quoted as saying that under-secretary dealing with the Oil-for-food investigation had told him that his office has no document relating to the inquiry. Though mandated by the UN, the Volcker panel was an independent inquiry and, therefore, all papers remain with the committee. Hopes are now pinned at Dayal’s diplomatic skills and drive. Known as “an officer and gentleman”, he has always been “first” — from his school days to the IAS and to his long association with the UN. Two successive Secretary-Generals of the UN — Javier Perez de Ceullar and Boutros Boutros Ghali — had reposed full trust in him. Dayal describes de Ceullar as one with “absolute impartiality and a determination not to be discouraged. He quotes the Secretary-General as telling him at the end of a difficult day: “Viru, I don’t have the right to be discouraged”. Boutros Ghali too had full confidence in Dayal and asked him to serve on mission to South Africa twice. The achievement of the first mission led to “a very healthy present of the UN in South Africa”. At the time of second mission, Nelson Mandela and the then President De Clerk were not on speaking terms because of the violence that had broken out in the township. Dayal met Mandela a few times and also called on De Clerk. As a result, the ice was broken and the two met. Dayal says: “I was very happy because I think the support and encouragement of the UN was what greatly helped in bringing this about”. Allahabad-born Dayal was the first rank IAS officer of 1958 batch. His ambition was to serve in his country and he had no plans of going overseas. He had served in Naini
Tal, Rampur and Moradabad districts of his home state, Uttar Pradesh. Subsequently, he moved on to Delhi. Destiny took another turn as he got an offer from the UN. Dayal joined the office of the UN High Commissioner for Refugees
(UNHCR) and served in Geneva. Since then, there was no looking back for him. Dayal returned to India in 1992 and asked to serve on the Indian delegation to the World Conference on Human Rights in Vienna. He was appointed member of the National Human Rights Commission of India in October 1993 for a five-year term. Now he has been given the status of Special Envoy of the Indian Government to liaise with the UN and its member countries to go into the depth of the allegations made by Volcker and find out the truth. On his report hinges the future of Union Minister Natwar Singh and those allegedly involved in the Oil-for-food
scam. |
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Reflections
I was a guest speaker at the Founder Day’s celebrations of New Delhi’s Lady Irwin College, known for its prestigious Home Science Graduate courses besides many others. While the Principal was reading out the annual report, I had the opportunity to go through the college brochure. It triggered my thinking. Some curious thoughts started to trickle into my head. As I started to jot them down, Mrs Gursharan Kaur, wife of Prime Minister Manmohan Singh and the chief guest of the function, asked me if I was preparing my speech. I said, “In a way yes. My mind has got charged with some interesting ideas”. I told her that I was going to tease the audience and the institution a bit when it was my turn to speak. But while I was still collecting my thoughts, I was called out to speak. And here are some of the highlights of my interaction with the audience: First, I asked the audience comprising the faculty and students of the premier Home Science College in the country what they thought about the concept of a Home Science College exclusively for men/boys? Uproarious laughter filled the auditorium. I wondered aloud if the boys would have sought admission. Would it have been as popular a course as it is for women? And what difference would it have made in these male students in their approach to various issues of life and living? For the emerging trend amongst working women is that marriage is an added homework and therefore, why should they ask for more? Beyond companionships, marriages are additional work with extended responsibilities. Well placed career women are no more seeking financial security or a roof on their head through marriage. They only want intelligent companionship and trusting friendship against the traditional patriarchal control of a husband who demands care and nurturance similar to the kind they received
from their traditional mothers. I further wondered if the studying of Home Science by men would make a difference to their mindsets. Would they make better companions for career women? My second teaser question to the audience painted the following scenario, “What if marriage advertisements have parents seeking grooms who are educated in Home Science for their daughters? My third teaser posed the question, “Is it not time we renamed the subject Home Science altogether”? For the whole subject of Home Science had gone beyond the boundaries of “home”. This thought triggered a large applause. Obviously, it resonated with the entire audience! The Prime Minister’s wife too endorsed this thought in her speech. My final observation at the Lady Irwin College revolved around how insensitive we have historically been towards male education. Our society actually has kept men away from many avenues of sensitivity. How can we then complain that they are not as sensitive as we would like them to be? In another experience, I was driving down to a school annual and struck up a conversation with the teacher who was with me in the car on my way to the school. She had been teaching for 18 years. I asked her if she had noticed any changes in the children as students over the years. She said, “Plenty”. On further probing about sharing the most obvious and visible changes she had experienced, she said most of all “awareness”. Today’s children are much more aware of their surroundings and environment. Besides this, respect towards elders has declined considerably. They are becoming adults a little too soon. Parents do not spend quality time with their children. Children today prefer indoor activities rather than outdoor activities. I asked her if, as teachers, they came together for training to address the changing environment? Should we not accept certain matters now as realities so that we focus on what can be done rather than on something that is out of our control? So that we are better prepared to deal with the changing environment? She replied, “No, we do not train for this. It depends on each of us how we handle these changes. But it would help if we do assess and upgrade our skills at regular intervals”. I further asked her if teachers and parents came together to communicate or share trends or observations beyond the parents’ teachers association (PTA) meetings. I asked if parents shared their experiences with their children at home while teachers did the same about their experiences at school. She again replied, “No”. We arrived at the function and our conversation ended. But it was not the end. For me this is a matter of grave concern. Why do we not think through such simple solutions? It costs nothing to do so. But left unattended, these issues can extract a very heavy price from our society and nation at
large! |
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Diversities
— Delhi Letter
What I could term as quote of the week is what Mahatma Gandhi’s grandson Ramu Gandhi said at a meet here. Words along the strain… It’s time we Indians took on the West and asked them to explain the criminal role they had played during the Partition! Let them explain…make them realise what they have done. Yes, if there had been no Partition, then lesser problems for those living in this part of the subcontinent. Once divided, there seems an ongoing saga of tension and human plight. Together with internal turmoil. I know I am not being very original in stating that verse is the best (and I suppose the safest way in today’s times) to hit out. Many such verse rendered at the Mushaira Jashn-e-Bahar held here this weekend by the Indian Council for Cultural Relations and Urdu activist Kaamna Prasad. The list of poets is long and they came from all over, Zhang Shixuan from Beijing, Omar Salim Al-Aidroos from Jeddah, Fahmida Riaz, Zehra Nigah from Pakistan. Besides, a large contingent from home territory like Shahryar, Nida Fazli, Gauhar Raza and several others. Just before the take-off, I asked Nida Fazli what he thought of present-day tension ridden atmosphere. He spoke of something or everything going completely haywire because of the great religious divides. “The minute one stops thinking in terms of being a Hindu or a Muslim, the situation will improve. As far as I am concerned, I consider myself just a simple human being with no religious prefix!” What about the name which holds out so much? “That’s not my doing, my parents”! He quipped and spontaneously came out with some intense poetic lines, which though went into my head but well past it. Nida is definitely one of our best shayars but too engrossed in Mumbai. Having moved there all the way from Uttar Pradesh, his native land. This brings me to write about another of best poets — Gauhar Raza who also happens to be a scientist presently on a year’s sabbatical. Moving away from New Delhi to set up an educational institution in Jahangirabad, which lies beyond Lucknow, in the very heartland of Avadh. The nazm which Raza rendered at this Mushiara meet is hitting. It focusses on the disasters. Before I write the nazm, I must quote this: “It was on June 26, 2002 and I was visiting the Gujarat-situated dargah of Sufi Wali and seeing the way it lay destroyed and ruined during the communal riots left me feeling so upset that immediately these lines came out: “Kahan thai tum? /Wali mai aaj mehfil mein nazar neeche kia, sar ko jhukai, haath baadhai/nidamat, sharam se bojhal saa ek dil laikar aaya hun /nazar neeche hai meri /kyunki woh aurat jiski shaan mein tumne ghazal se rang di duniya /ghamon ka ek paickar hai /tumhai maloom hai kya /ab zina bhoj hai us par /kai us ke pairahan se khoon ke dhabbe nahin dhulte/kharashain hain badan par jo kisi surat se nahin mitteen /Mai kaise sar uthaun /saamna kaise karun unka /ki jinki nanhi aankhon nai / wohsab hotai hua daikha ji sai sunke /faqat sunke / badai bhi kaap uthai /woh aankhain phoonchti hain — kyon hua, kaise hua wohsab.” Translated it goes this way: Wali, today in your presence I come with my eyes lowered, bowed head, folded hands…embarrassed and a heart full of shame. My eyes are lowered because the woman in whose glory you painted the world with ghazals is sorrow personified today. Do you know it is now burdened with rape? Her attire has blood stains that cannot be removed. Wounds on her body refuse to heal…how do you expect me to raise my head? How do you expect me to face those young eyes who saw that happening about which if the elders hear or just come to know would shiver. Those eyes keep asking me why and how did all this happen…
Continuing with the poetic mood, there is more coming. On Nov 22, the forum ‘Hindustani Awaaz’ is hosting a talk at the India International Centre on Ghalib’s ghazals. The speaker is coming all the way from the Columbia University — Professor Frances Pritchett. He is Professor of Indian Languages in the Department of Middle East and Asian Languages and Culture.
At his forthright best I am not a traveller, in the sense I am not too happy travelling. Yet ironically I have the latest issue of Excel’s which besides carrying the timetable of air services within the country has other inputs too. This copy was sent to me by Lt-Col Sankar P. Barua. As part of his management skills, he has come up with some offbeat remarks together with this backgrounder on himself. Educated at the City of London School, the Council of Legal Education, he was in the Indian Army for 17 years. He was an Instructor at the Indian Military Academy, Dehradun, and on the Military Staff of the Indian High Commissioner in London. He quit the Army in 1967. Coming to his views, there are many and each rather bold especially those related to Kashmir — an area where Burua had been posted when he was in the Army. He was also the presiding officer in the court martial of some soldiers accused of raping a Kashmiri girl.
Professor’s mission
for togetherness Delhi IIT Professor V.K. Tripathi has not just formed the Sadhav Mission but actually practises it. Last fortnight, he and his colleagues from different faiths held a day-long fast at Mahatma Gandhi’s samadhi and prayed for those perished in the earthquake and the blasts. He is one of those who is worried that communal twists would further add to the anguish
around. |
A verbal abuse is one, but responding to it will cause many more. Do not respond to an abuse and keep it isola ed. —
Kabir Whatever we are, whatever we have made of our lives, is the result of our thoughts. —
The Buddha It is by His will that we come and go. —
When the help of God comes, and victory and you have seen the people enter the religion of god in droves, praise your Lord and seek forgiveness of God; for God is most forgiving. — Islam It was the cowards who died many times before their death. —
Mahatma Gandhi Accursed is the life which is lived only to fatten one’s belly.
— Guru Nanak |
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