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Pragmatism on N-Bill
PM’s healing touch
On the trail of terror |
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US at crossroads in Afghanistan
Passions — sin or virtue?
Right to emergency health care
Medical colleges can transform Naxal areas
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Pragmatism on N-Bill THE passage of the Civil Liability for Nuclear Damage Bill is crucial for the operationalisation of the UPA-I’s 123 agreement with the US and in the light of this sensitivity, the government has shown pragmatism in accepting most of the changes suggested by the BJP. If it had not, it would have been forced to take several smaller parties like the SP, the BSP and the RJD on board — a far more unsavoury proposition. It has thus not only agreed to a three-fold increase in the maximum liability, raising it to Rs 1,500 crore, but has also extended the period during which victims can claim damages from 10 to 20 years. With the BJP’s Sushma Swaraj and Arun Jaitley saying that 90 per cent of their concerns and suggestions have been addressed, the Bill is likely to have an easy passage, possibly in this very session which may be extended for a few days if necessary, although Left parties are opposed to even the amended Bill. They have been calling for a single-tier liability system with a cap of an unrealistic Rs 10,000 crore and also a categorical mention that India would not become a member of the Convention on Supplementary Compensation. Another major compromise is that the government has agreed to keep private firms like L&T and Tata out of the reckoning for running nuclear power plants. These will be thus run only by the government or government-owned companies. That is a good starting point but as time goes by, it may become necessary to take private players on board, considering that the country aims to generate 30,000 MW nuclear power by 2030 – a target which government agencies may find too ambitious to meet on their own. The need for sufficient power generation cannot be overstressed. So far, foreign suppliers were reluctant to do business with India in the absence of a well-defined liability law. Now that this stumbling block is more or less out of the way, substantial progress on the nuclear power generation front may be made during US President Barack Obama’s visit to India in November.
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PM’s healing touch
IT was left to the Prime Minister to signal the nation’s resolve to rebuild Leh and keep hope alive among the people of Ladakh. On his brief visit to Leh on Tuesday, Dr Manmohan Singh said what needed to be said. All houses destroyed in the mudslide would be re-built before the winter sets in within the next three months, he asserted, and money would not be a constraint. What would have reassured people even more is the Prime Minister’s quiet assurance that he would visit Leh again later this year, just to ensure that targets are met. In times of crisis people look for reassurance and the Prime Minister did well to convey the determination of the nation and his own to stand by the unfortunate residents of Ladakh, many of whom lost their homes and also their loved ones in the unprecedented natural calamity that struck the cold desert in the early hours of August 6. The PM’s visit would go a long way in giving a sense of direction to relief and rehabilitation and would hopefully speed things up. The devastation in Ladakh could not possibly have come at a worse time. August is generally the peak tourist season for adventure sports in the region and the arid, bare but breathtakingly picturesque Ladakh has been drawing an increasing number of tourists. The all-too-brief tourist season in the region, marked by a blazing summer and freezing winter, provides the residents the income needed to survive the rest of the year. But although as many as 80,000 tourists visited Ladakh last year and as many as 35,000 foreign tourists were expected to arrive this year, tourism infrastructure remains poor. Health facilities and hospitals, drinking water and electricity supply continue to be inadequate. There may not be sufficient time this year to pay much attention to this aspect but policy-makers would do well to put in place a long-term vision for the region. While the Prime Minister’s visit will undoubtedly make a difference to the relief effort, lending it the urgency that is required, it is worth reflecting why the administration, and the disaster management system, are not yet well-oiled enough to be effective without such intervention.
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On the trail of terror
GOING by media reports, the recent arrests of some suspected terrorists and claims of the Punjab Police and the Centre, there is a distinct possibility of attempts being made by hardliners based abroad to revive terroism in Punjab. One shudders to recall the dark days Punjab had seen when so much innocent blood was shed in the pursuit of illusiory goals set by some misguided and disgruntled elements. That some of them are still around and active abroad is a matter of concern. Two hardliners from Punjab were arrested recently in Vienna on the charge of hatching a conspiracy to eliminate the Radha Soami Dera head. Media reports indicate that militants are active mainly in Europe, the US, the UK, Pakistan and Malaysia. The almost global spread of Punjabi terrorists has added a new dimension to the fight against insurgency. This requires, as Minister of State for Home Affairs Ajay Maken told the Lok Sabha on Tuesday, an integrated approach, sustained vigilance of the borders, better intelligence gathering and sharing, and modernisation of the police and the security forces. Is the Punjab Police up to the task? So far its track record has been commendable though only convictions in court of the suspects it has picked up will legitimise its claims of success. The Malaysian police has denied the reports that Punjab ultras are active on its soil and has asked for specific details. The recent media reports that some militants had attended the wedding of a son of the Delhi Sikh Gurdwara Management Committee president have raised doubts about the police findings and the claim seems politically motivated. The police, hopefully, will not be used again for settling political or personal scores on the pretext of fighting terrorism. The dangers of misuse and excesses of the police are too fresh to be forgotten.
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Like dear St Francis of Assisi I am wedded to poverty: but in my case the marriage is not a success. — Oscar Wilde
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US at crossroads in Afghanistan America’s
“Special Representative” for the AfPak region, Mr Richard Holbrooke, recently described Pakistan Army Chief General Ashfaque Parvez Kayani as an “enormously powerful political factor in the country,” adding that in keeping with his American training traditions, the good General was “smart” and a “remarkable strategic thinker”. This is not surprising, as in American eyes, the ambitious Pakistani Generals who have led their country to disaster in the past — ranging from Ayub Khan, Yahya Khan and Zia-ul-Haq to Pervez Musharraf and Ashfaque Kayani — have all been regarded, till their stars started to decline, as “smart” and “strategic thinkers”. Every US luminary visiting Pakistan, ranging from Mrs Hillary Clinton and Senator Johan Kerry to Admiral Mullen and Richard Holbrooke, invariably pays homage to General Kayani in Rawalpindi while ignoring his constitutional boss, Defence Minister Ahmed Mukhtar. It was National Security Adviser General Jim Jones alone who observed constitutional and democratic propriety by ensuring that General Kayani was present when he called on the Head of State, President Asif Ali Zardari. This fascination for “smart” Pakistani Generals has led the US to a situation where its Pakistan Army protégés arm and train jihadis, who kill American nationals in Mumbai and Afghanistan, and then demand an end to any criticism of their support for terrorists. General Kayani has been taped describing Taliban military commander Jalaluddin Haqqani as a “strategic asset.” There is no dearth of evidence, now in the public domain, about how the Pakistan Army arms and trains the Taliban on Pakistani soil to kill Americans, Indians and citizens of US allies and partners in Afghanistan. Why then do American officials mislead their own public about the professed qualities of head and heart of General Kayani? Is it because they are too scared to admit that they have been and are being led up the garden path by yet another “smart” Pakistani General? A vociferous section of the American public, the media and politicians is now demanding a speedy withdrawal from Afghanistan, amidst rising casualties in America’s longest war on foreign soil. A total of 1221 American soldiers have been killed in operations in Afghanistan since 2001. Casualties have gone up steeply in recent years, from double digits till 2005 to 521 soldiers losing their lives in 2009 and 423 already killed in the first seven months of this year. Costs of the war in Afghanistan are also steadily escalating. The Appropriations Committee of the US Congress approved a supplementary budget of $33 billion for the current financial year for the additional 30,000 US troops recently deployed in Afghanistan. This exceeds the annual budget for India’s entire armed forces! The Americans are now spending an estimated $84 billion annually for their military presence in Afghanistan when their budget deficit is rising. Apart from US spending in Afghanistan, the American taxpayer has paid $18 billion in military and economic assistance to Pakistan. Military assistance approved for Pakistan thus far amounts to around $13 billion. The bulk of this money has gone towards purchasing Chinese military equipment ranging from fighter aircraft to tanks and frigates, apart from American F16 fighters, air-to-air missiles and naval equipment — all of little use or relevance to fighting the jihadis operating from within Pakistan. The WikiLeaks revelations are only the tip of the iceberg on how Pakistan has milked, misled and double-crossed the Americans, primarily using US naiveté and gullibility to secure military assistance even as the ISI continues to arm, train, equip and harbour Taliban and other terrorists, who regularly kill American soldiers in Afghanistan. The American strategy of obsequious praise and respect for General Kayani in the hope that he can be sweet-talked into ending support for and taking on jihadi groups, including the Taliban, which have for years been nurtured by the ISI, is destined to fail. A hard-boiled Jhelum-born General Kayani, who comes from the heartland of groups like the Lashkar-e-Toiyaba, is hardly going to let American flattery and solicitude end his support for the assets he has nurtured for years. All this leaves President Obama facing a difficult dilemma. Growing American casualties in Afghanistan as a result of counter-insurgency operations will cast a shadow on his re-election in 2012. But, being seen to cut losses and run away from Afghanistan, he will invite ridicule, both domestically and internationally. The only wayout, in these circumstances, for President Obama would be to move towards a visible reduction of American forces in Afghanistan, together with moves to reduce casualties by disengaging from active counter-insurgency operations, particularly in Southern Afghanistan, by November 2012. It does, however, appear that the Americans will retain a reduced troop presence and air power in Afghanistan beyond 2012 to back up and train what is presently an ill- equipped, poorly motivated and inadequately trained Afghan National Army. India has to be prepared for a situation when the ISI-backed Taliban groups will gain increasing control over southern Afghanistan. How will this play out in the rest of Afghanistan, a country where around 56 per cent of the population is made up of non-Pashtuns, who would find any return of the country to Taliban rule totally unacceptable? Under Pakistani pressure, President Karzai recently sacked or sidelined the two most influential non-Pashtun officials in his government — Intelligence Chief Amrullah Saleh and Army Chief General Bismillah Khan. Criticising President Karzai’s efforts for “reconciliation” with the Taliban through the good offices of the ISI, Saleh asserted, “The ISI is part of the landscape of destruction in this country. So, it will be a waste of time to provide evidence of ISI involvement. They are part of it”. More ominously, Saleh alleged that President Karzai was “recklessly” pursuing a compromise and “reconciliation” policy with the Taliban, which he described as “a fatal mistake and a recipe for civil war”. If the Taliban, with ISI backing, establishes a strong presence in southern Afghanistan, non-Pashtun ethnic groups like the Tajiks, Uzbeks and Shia Hazaras will inevitably seek a loosening of ties with a weakened central authority in Kabul, with a reversion to the situation that prevailed in the mid-1990s. A number of Afghan leaders, including Presidential election candidates Latif Pedram and Abdullah Abdullah and regional leaders like Dostum and Muhaqqiq are now demanding greater regional autonomy. In any event, the stage appears set for what Pakistani scholar Ahmed Rashid described as a “Descent into Chaos” in our western neighbourhood. One, in the meantime, hopes the Americans will call the Pakistani bluff and deal firmly with their “major non-NATO ally”. This could be done after initiating measures to reduce American dependence on supply routes through Pakistan by routing supplies to Afghanistan predominantly through Russia and the Central Asian
Republics.
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Passions — sin or virtue? PASSIONS are an inherent part of man’s nature. But in their debased form they promote all the seven deadly sins: gluttony, anger, lust, avarice, pride, envy and sloth; which cause endless sufferings and humiliation to the man and the society. Gluttony turns into perversities in food eating, anger into hate and sadism, lust into debauchery, avarice into meanness and dishonesty, pride into aggrandisement, envy into contempt for others and sloth into levity. Persons overpowered by passions lose health, wealth, honour, peace of mind, esteem, and willpower. They become complete degenerates. Passions can turn positive in their higher forms of transformation and sublimation. Gluttony becomes identical with refined eating and culture, which social and community gathering represents. Anger manifests itself in revolt against injustice, religious indignation, against hypocrisy and cant. Anger brings revolutions, reforms and liberation. Lust brings love, romance and procreation. Pride brings respect, honour and enormous capacity to suffer and generates courage. Envy gets converted into critical appreciation and becomes a measure for progress. Sloth brings leisure and all the great gifts of culture which the latter brings with it. Once upon a time, Devil withdrew sins from the earth on man’s request and man thought that the earth will become heaven. Just the contrary happened. Disappearance of sin removed all that sustains man’s interest in life. It took away the motive for work, incentive to competition, longing for distinction, impulse for love and need for virtue. For example, with the withdrawal of anger the police and the law courts became irrelevant and non-functional. Man’s life became a mechanised existence. With sin also disappeared the noblest of human virtues — love, compassion, charity, repentance and forgiveness. Man had to say “Satan, give back the sins”. The wish was granted and the world resumed its usual course. Passions in their sublimated form have formed the theme of all art — architecture, poetry and literature. They become the love of Romeo, pride of Rama, ambitions of Alexander, compassion of Christ and the devotion of Radha. Passions, therefore, are like a huge water reservoir which if properly regulated, would serve as a flood-controlling element, generate electricity and irrigate the vast dry land and if let loose by a debased person, would cause devastation. Take away passions from a man and he is reduced to a mere corpse; for they are the index of his total personality, the sum total of the kinetic energy which his body, mind and soul possess. So why look only for the tempests in the sea and why not its mood of serenity as well? It is in this serenity that man can capture the higher truths, realise the true nature of self and have vision of Ultimate
Reality.
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Right to emergency health care A seriously injured and profusely bleeding soldier, Gulyani died in front of a clinic. The man was attacked by a gang of pickpockets while he was travelling in a bus. He managed to get off the bus and run homeward, but collapsed in front of a clinic. The doctor stepped out of his clinic, gazed at the bleeding man and returned to his clinic to attend to his patient. A couple who had come to the same doctor’s clinic got a stretcher from a nearby hospital, and pushed the bleeding Gulyani to the hospital where he was declared brought dead. Gulyani’s wife filed a case against the hospital and the doctor at the clinic in a consumer court and got an order for a compensation to be paid by the doctor at the clinic. The hospital was not implicated as Gulyani was not alive on arrival. The court reminded the doctor of the Hippocratic oath to render help to a dying man (human being). While Gulyani’s wife might actually receive the compensation amount from the doctor after two years of filing the case in a consumer court, the whole event reinforces that the onus of providing emergency medical attention and referral is undeniably the doctor’s calling. This ghastly vignette points to a few dimensions of the right to health care. The consumer forum’s contempt is clear for the doctor’s unpardonable indifference. The citizen’s right to emergency health care is also revealed. The third and the tricky dimension is the moral liability of a medical professional who is under the Hippocratic oath to provide emergency health care to a dying man, by implication, without any pecuniary returns. The difficulty occurs when the moral and the economic sides of the coin are analytically separated from each other. Health care provision, in popular perception is no longer viewed as a charity. It is a service like any other service that a consumer may buy, especially in the private health care sector. How is the doctor then obligated to provide health care without thought of economic returns? Does such a claim to health care become at once economic and moral because it involves human life? How does one decide when health care is a commercial service available on payment and when a moral service to be rendered without any pecuniary returns? This might depend on individual perception. In this case the perception of the doctor, the couple who took the injured Gulyani to a nearby hospital, Gulyani’s family and the consumer court differ in their perceptions about emergency health care provision. While the doctor’s response to the sight of injured Gulyani just outside his clinic’s turns health care provision as a commercial proposition, the consumer court has clearly taken a more moral than a commercial position, but the logic used to arrive at its moral stand is premised on health care being a commercial venture. And the couple that tried to help Gulyani reach a hospital, the humanitarian gesture borders on a mix of morality and civic responsibility. The affected family, of course, would wish emergency health care were a right. Reconciling the different perceptions and stakes is not easy. The frequency of such cases is on the rise, thanks to the media coverage in recent times. Let us see how the positive rights encapsulated in Article 25 of The Universal Declaration of Human Rights begins: everyone has a right to a standard of living adequate for health and well-being of himself and his family including food, clothing and medical care. While medical care needs vary a great deal among individuals in comparison with need for adequate food and clothing, provision of emergency medical care falls under a different category. Clearly, an Indian citizen can claim right to emergency medical care as the verdict in Gulyani’s case reveals. Why did the doctor then leave the injured Gulyani to die? What returns would the doctor get from handling a dying man? Private medical practitioners in Delhi work under varying conditions and many of the successful ones do not have time to spare for no returns. One researcher encountered several doctors who wished not to waste time talking to her. Instead, they would earn some money in that time if they saw patients. They had to earn a decent living and be judicious with their time. Also, the tedious legal procedures in medico-legal cases, can mean undue demands on doctor’s time and jeopardise their reputation and living. In such a politico-economic context, pragmatic State policies conducive for medical professionals’ honoring the Hippocartic oath are urgently needed, though their absence is no justification to let an injured man die at a clinic’s
doorstep. The writer is Professor of Sociology, Delhi School of Economics, University of Delhi
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Medical colleges can transform Naxal areas India currently has 320 medical colleges; according to WHO we need to add 500 more medical colleges in order to produce enough manpower to satisfy India’s healthcare needs. It would be unwise to let these colleges come up in the metropolitan cities since these are already filled with adequate number of medical colleges. But by starting these colleges in areas vulnerable to Naxalite influence we will be able to attract students with a service bent of mend given their backgrounds and also radically improve the healthcare delivery that is so deficient in these
areas. Manufacturing industries, on the other hand, will not be welcomed in these areas because people view them with suspicion for various reasons as we have seen in the past with the Nano plant or the Posco factory. But with the medical college and hospitals the citizens are able to see tangible benefits in their community firsthand. Teaching hospitals provide employment to all sections of the community; they empower women since they are so highly dependant on women. They will also attract a large pool of youngsters who will require housing, entertainment and transportation further adding to the economy of that area. As the hospital grows it will be able to bring in advanced healthcare to these once
inaccessible areas. The private sector cannot be involved in creating these colleges since most private colleges will require hefty capitation fees to keep their operations afloat; defeating the purpose of empowering poor villagers. These colleges must be started by the government sector with an investment of not more than Rs 70 crore in the already existing district hospitals. To illustrate my point I would like to tell about the history of a town called Manipal, around 7 km from my village in south Karnataka. The town was empty except for a few wandering tigers but in 1953 an avid educationist, Dr. T.M.A Pai, had the vision of starting a medical college there. The history of that town changed forever. I am a cardiac surgeon renowned
for my skill, but I started as a young impressionable youth in the village of
Kinnigoli, underwent my medical education in that college and that college has made me what I am. Believe me when I tell you I am a standing example that medical education alone can change the future of these Naxal-affected areas. Dr Shetty is an eminent cardiac surgeon and Chairman of the Narayana Hrudayalaya group of hospitals. He is also a governing member of the Medical Council of India. All opinions expressed are personal.
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WHEN a consumer court asked a Delhi doctor to pay a compensation of Rs 3 lakh to the family of Naib-Subedar K R Gulyani for not providing him emergency treatment at his clinic, an Indian citizen’s right to claim emergency health care was vindicated. The event took place two years ago in Delhi’s Janakpuri locality. 
ON April 6 the nation watched in terror, as a handful of Naxalites were able to ambush an entire CRPF battalion and kill 76 jawans. These Naxalites did not undergo any formal combat training. They are young impressionable youths brainwashed by propaganda. The government agencies estimate that nearly 140 districts in India have been infiltrated by the Naxalites. Their intention is to eradicate them by force. This is exactly how the Naxalite leaders expect us to react; instead we must overcome their influence on impoverished Indians by the power of education and employment.