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Editorials | Article | Middle | Oped — Health

EDITORIALS

Judicial overreach
PM sounds a note of caution
Prime Minister Manmohan Singh’s observations at an interaction with newspaper editors in New Delhi on Monday that the Supreme Court should not go into matters relating to policymaking — which is the exclusive domain of the executive — has once again brought to the fore the question of judicial overreach.

Battle for Bihar
A virtual referendum on Nitish Kumar
T
HE Election Commission has exercised abundant caution while announcing the dates for the next Assembly election in Bihar. Although the last election was relatively free from violence, at least by Bihar’s standards, the Commission has chosen to err on the side of caution by deciding to hold the election in six phases and that too spread over almost a month.


EARLIER STORIES

Doping mess
September 7, 2010
Say ‘no’ to Maoists
September 6, 2010
The caste conundrum
September 5, 2010
Unchallenged Sonia
September 4, 2010
Mounting tax arrears
September 3, 2010
Food for thought
September 2, 2010
Wasted opportunity
September 1, 2010
All eyes on the verdict
August 31, 2010
Farooq formula for J&K
August 30, 2010
Law, society and emotion
August 29, 2010


Students’ voice
Unions can play a vital role
I
F young people have to make their presence felt in Indian politics, perhaps there is no better training ground than student council elections. In fact the culture of debate and discussions prevalent in many universities has often given birth to political leaders. Closer home, for years Panjab University, Chandigarh, has been a hotbed of politics.
ARTICLE

Make Games a grand success
India’s honour is at stake
by Lt-Gen Vijay Oberoi (retd)
T
HE mess that the organisers of the 10th Commonwealth Games have made of it has sullied the honour and image of India. Unfortunately, while the Organising Committee (OC) has been in the eye of the storm, the mess is not confined to it.

MIDDLE

Fun at forty, is it?
by Gitanjali Sharma
F
ORTIES have a way of announcing their arrival. Before you realise it, you find yourself saying pardon at least once a day. Nah, that has nothing to do with etiquette, just the first sign of hearing loss! Then, the eyes that you took for granted suddenly lose sight of the 6/6 claim you held so dear.

OPED — HEALTH

Medical education is in poor health
Most medical colleges in the country, both in government and private sector, have failed to keep abreast of technological advancements and new teaching methods
Rakesh Kochhar
A recent newspaper report suggested that from next year there will be a common all-India entrance test for MBBS and postgraduation (PG) as well. This news comes as a relief to lakhs of medical aspirants but it does not solve the whole problem.

Only lip sympathy for the physically challenged
G. N. Karna
T
HE recent reprimanding of the Union Government by the Supreme Court on denial of jobs to two disabled candidates has sparked off a wider national debate on the pace of implementation of employment-related provisions of the existing Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995.





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Judicial overreach
PM sounds a note of caution

Prime Minister Manmohan Singh’s observations at an interaction with newspaper editors in New Delhi on Monday that the Supreme Court should not go into matters relating to policymaking — which is the exclusive domain of the executive — has once again brought to the fore the question of judicial overreach. While issuing a directive to the Centre to distribute foodgrains among the poor on August 31, the court was perhaps guided by the fact that it was its duty to protect the citizens’ right to livelihood as mandated by the Constitution. Even as the hearings have started on the Centre’s affidavit in response to the order, Dr Singh’s remarks have added a new twist to the controversy.

Of course, the Prime Minister shares the apex court’s concern over the huge stocks of foodgrains rotting and the need to distribute them among the poor. At the same time, he has expressed difficulty in implementing the court directive because of the huge magnitude of the problem. When, according to the Suresh Tendulkar committee, 37 per cent of the country’s population lives below the poverty line, how would it be possible for the Centre to distribute foodgrains free to such a large number of people?, he legitimately asked. He also referred to its adverse effect on the farmers who, he said, would lose the incentive to produce more food.

The Prime Minister’s comments reinforce the cardinal principle that the judiciary should not be seen as interfering in the executive’s legitimate role in policy formulation and day-to-day governance. In the constitutional scheme of things, the tasks of each organ of the state — be it the legislature (making laws), the executive (policymaking and execution) or the judiciary (dispensation of justice) — are cut out. They should function in conformity with this basic spirit of the Constitution and in accordance with its provisions. This relationship has been clearly defined and demarcated in purpose, intent and areas of activities. The centrality and supremacy of the Constitution should prevail at all times to help the system work smoothly and efficiently. If any one organ encroaches upon the other’s domain, the delicate constitutional balance would be disturbed leading to avoidable friction. Clearly, judicial overreach in the sphere of policymaking will not be in the interest of parliamentary democracy.

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Battle for Bihar
A virtual referendum on Nitish Kumar

THE Election Commission has exercised abundant caution while announcing the dates for the next Assembly election in Bihar. Although the last election was relatively free from violence, at least by Bihar’s standards, the Commission has chosen to err on the side of caution by deciding to hold the election in six phases and that too spread over almost a month. Renewed Maoist activity in the state and political fortunes of a large number of political heavyweights being at stake, both mark it as one of the toughest elections conducted by the Commission in recent times. After losing out in the last election, the Rashtriya Janata Dal and the Lok Janshakti Party ( LJP) had found in the Election Commission a convenient scapegoat, blaming it for preventing their supporters from casting their votes. Over the years , however, the Commission has steadily devised better ways of preventing poll-related irregularities and protect itself from allegations of bias.

The election will be a referendum of sorts on the claims of development by Chief Minister Nitish Kumar, and determine the level of his dependence on the BJP. While Kumar would be hoping to secure a majority on his own, which would require a virtual landslide in favour of the JD(U), BJP’s unspoken compulsion is to ensure his continued reliance on it. It remains to be seen how the contradiction in the coalition plays out in the election. The Bihar Chief Minister is credited with restoring the rule of the law in state. Infrastructural developments in the state, speedy trial of criminal cases and ensuring a bicycle for every school-going girl. are some of his achievements that emboldened him to predict that the election would be contested on the plank of ‘Development’ and not on ‘Caste’. But then the left-leaning socialist has also done his bit of social engineering by stitching a coalition of the Extremely Backward Castes ( EBCs) and the Pasmanda or Backward Muslims.

Lalu Yadav and Ram Vilas Paswan’s regional parties had fared poorly in the general election also last year and, therefore, next month’s Assembly poll will be a battle for their political survival in the state. The Congress, which along with the mainstream Left, has been reduced to a marginal political force, would be content to increase its tally of 10 in the House of 240 members. Bihar appears headed for a two-horse race, with Congress bringing up the rear.

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Students’ voice
Unions can play a vital role

IF young people have to make their presence felt in Indian politics, perhaps there is no better training ground than student council elections. In fact the culture of debate and discussions prevalent in many universities has often given birth to political leaders. Closer home, for years Panjab University, Chandigarh, has been a hotbed of politics. While there is nothing wrong in students nursing political ambitions they must realise that as representatives, their first and foremost responsibility is honing of academic skills and ironing out academic roadblocks if any. Not only should the platform provided by students’ elections be used for furthering the interests of students, student leaders must learn to abide by rules.

Unfortunately, the election campaigning has in recent times come to be ruled by money power and all too often students violate Lyngdoh Committee rules, especially with regard to the campaign expense cap. The recently held Panjab University elections were not only marred by minor clashes but also threw Lyngdoh norms to the winds. While rules about taking out rallies were blatantly ignored, printed material like posters and pamphlets were openly used. Besides, there were reports of parties being organised by student union bodies cancelled at the last minute for fear of police reprisal. The Lyngdoh committee regulations may have brought about a change in the way student politics is being practised today, but the student community needs to look within and make the election process more transparent and fair. Besides the unions could play a more constructive role rather than being preoccupied with trivial issues.

In fact, they could take a cue from student unions across the world. Among the achievements listed in the Oxford University Student Union’s website are representation of students voice on the University Fees Committee, an accommodation workshop to ensure that students can deal with landlords and a safer Oxford. Instead of being mired in petty politics, student unions across India could become an effective voice of the student community and a significant bridge between students, universities and society at large.

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Thought for the Day

Believe me! The secret of reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously!

— Friedrich Nietzsche

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Make Games a grand success
India’s honour is at stake
by Lt-Gen Vijay Oberoi (retd)

THE mess that the organisers of the 10th Commonwealth Games have made of it has sullied the honour and image of India. Unfortunately, while the Organising Committee (OC) has been in the eye of the storm, the mess is not confined to it. Here is a world class event, bid for by the country, for which ample time was available to the OC as well as to the entire Delhi Administration, and yet we find ourselves in such dire straits that neither the Games venues nor the infrastructure facilities in Delhi are ready. One should also not forget that the worthies of the Central government, who were supposedly keeping a close watch, continued to be somnolent till they were jolted by revelations in the media.

The media needs to be congratulated for bringing to the public domain how officials associated with organising the Games have misappropriated government funds and lined their own pockets. There is no end to such revelations, hoodwinking and passing the buck, but the culprits are either posturing or in a permanent state of denial while delays continue in all fields of activity, from infrastructure to what are euphemistically called “overlays”.

The latest are the gag orders issued to the coaches after the chief hockey coach, a Spaniard, in great anguish commented lucidly on the systemic failures of the nation in the field of sports, saying, “I have lost; your ‘system’ has won. I tried my best to change it; I pleaded, I cried, I did everything; but it won’t budge.” What a monumental shame!

The mess is not confined to the so-called world class infrastructure relating to the Games, but even in getting Delhi organised for the purpose. Let me mention just a few — the road communications within Delhi and the Metro extension; the grossly incomplete beautification drive undertaken by various agencies and not meeting even the targets of hotel rooms and other accommodation; all at such monumental costs. There can only be two reasons for this state of affairs — officials sitting over sanctions till their personal “demands” are met, and an abysmal lack of pride in the nation’s achievements. With every new revelation, the nation comes down another notch in the eyes of the world as well as our own people. It is not corruption per se that bothers the citizens, but the rampant loot of their hard-earned money, for public funds are after all created by numerous taxes which we all pay. Apparently, corruption no longer bothers us because it has now become a way of life in our country. There is no facet of India that is corruption-free.

In areas where a particular action may not be described as corruption, there is filching of public funds, again by both the high and the mighty as well as the officials who occupy the lower rungs of the bureaucracy, the police, etc. We seem to be so completely affected by our proverbial fatalistic outlook to life that we continue to withstand this onslaught of government officials and elected representatives without any major and collective backlash.

Reverting to the Games, once the media had exposed the skulduggery of the OC and the grossly inadequate preparations, it is to the credit of the Prime Minister that he moved fast, set up a Group of Ministers (GoM) as well as a Committee of Secretaries (CoS) to oversee all aspects of the preparations of the Games. A number of senior-level bureaucrats were also coopted to oversee each venue and expedite completion. It may well be a case of “too little too late”, but at least attempts are being made to retrieve a dismal situation.

At the same time, we have fallen into the trap of having “too many cooks.…”. So, there is a great danger of not meeting the aims and objectives.

In the Army, we cater for contingencies when the officer in command may become unavailable; his deputy takes over automatically and continues with his task. The advantages are obvious, but our political leaders as well as bureaucrats are loath to learn from the Army. So, we have a situation where the man in charge of the Games must be replaced, but we are unable to do so either on political grounds or because such a contingency was not planned for, and control could not change seamlessly.

There are also other major disadvantages. Besides diluting responsibility, we have managed to reduce accountability too. Resultantly, though the powers at the highest level have promised a full enquiry after the Games and severe punishment for those responsible, no one seems to believe it. Such is the loss of confidence of the “aam aadmi” in our leadership. Undoubtedly, a tragic situation! However, that is still in the future and such speculations at this time are unlikely to help in conducting the Games with a view to retrieving at least some of our image.

A few years back, the Army had conducted the World Military Games at Hyderabad, which were at a grand scale, with participation by over 70 nations. These Games were conducted flawlessly and earned kudos for the country. Luckily, some senior military officers who had played major roles in organising the military games have been coopted in the present games. They will undoubtedly do a stupendous job. One of them could have been made the deputy and we could have avoided the pitiable situation we are in. While on the subject of the military, how churlish it is on the part of the organisers to ask the serving personnel of the military who have been coopted for the most important tasks to do so gratis. Is this being suggested as a desperate measure to balance their books, although the paltry honorarium asked by the military is so minuscule that for the OC and the GoM to even suggest it is shameless, to say the least? It is only these military personnel who with their dedication and discipline will pull the chestnuts out of the fire for the OC and in doing so restore some of our lost image. Do pay them well.

At the end, it must be said that enough dirty linen has been washed in public. We need to end this now and concentrate on making the Games a grand success despite what has happened till now. There will be plenty of time and opportunity for recriminations and bringing the culprits to book after the Games. For the present, let us strive to put up a good show, for the sake of the country’s honour and reputation. In the long term, the nation will benefit. Once the Games are over, the media can go hammer and tongs after all the guilty and set examples for the future.

The writer is a former Vice-Chief of the Indian Army.

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Fun at forty, is it?
by Gitanjali Sharma

FORTIES have a way of announcing their arrival. Before you realise it, you find yourself saying pardon at least once a day. Nah, that has nothing to do with etiquette, just the first sign of hearing loss! Then, the eyes that you took for granted suddenly lose sight of the 6/6 claim you held so dear. What goes inside the shampoo bottle or that pasta sauce was once an easy read, now no more!

Coming to the knees, you continue to be proud of them but with 40 years of wisdom behind you, you couldn’t agree more with that health expert that walking is a better bet than whatever little jogging you struggle to do with those piling-up pounds. And, that brings you to the perpetual problem called weight!

You can hardly open the door to Forties with a welcoming smile when you realise they are walking into your life hand-in-hand with a monster called ‘expanding middle’. Just as the forties are impossible to dislodge from your life so are the inches that get quilted on your waist.

The forever-optimistic health experts may promise a trick to undo the damage, but their to-do list is rather long, intimidating and, simply put, hard to do: Have six to seven small meals; banish colas and sweets; quit fried stuff; don’t go near burgers; give up tea and coffee; abstain from alcohol; avoid red meat; reduce quantity of carbs; and on it goes.

By surviving on water and half a dozen miniscule meals, you may succeed in driving out ‘expanding middle’ from your house but it will call for the will of a supermodel or the stubbornness of a mule. And, unfortunately or fortunately, you are neither.

Physical failings apart, the emotional quotient too takes a serious dip upon kissing goodbye to the thirties. When the first time you are addressed as aunty or uncle, it hits you hard. But now when even a thirty plus call you such and that too with a dose of reverence thrown in, it pierces deep, smashing your fragile 40-year-old ego to smithereens.

Forty, our socio experts may claim, are the new twenties. And, their assessment may not be off the mark if you go by the exuberance levels, jetsetting lifestyles, gym visits and almost teenage-ish wardrobes maintained by 40-somethings. The vigour and enthusiasm they display for their health, career and relationships could undoubtedly put to shame the youth of twenties. But at the end of the day, yoga or no yoga, botox or no botox, Viagra or no Viagra, forty remains forty. If men are known to turn naughty and women bold and daring at forty, it is more for a cover-up — to mask insecurities that come with age.

Fun begins at forty! Does it? It surely does when you accept there is no getting away from Forties. They’ll land up at your doorstep when they have to. They may be an uninvited guest for many, but they’ll come and, God willing, they will even stay for a decade. Forties will only leave when the room has to be aired for Fifties. And, I can lay a wager that the day Forties beg leave of you, you wouldn’t want to part company with them – and fun!

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OPED — HEALTH

Medical education is in poor health
Most medical colleges in the country, both in government and private sector, have failed to keep abreast of technological advancements and new teaching methods
Rakesh Kochhar

A recent newspaper report suggested that from next year there will be a common all-India entrance test for MBBS and postgraduation (PG) as well. This news comes as a relief to lakhs of medical aspirants but it does not solve the whole problem.

Of the 32,000 MBBS seats in India, less than half are in government colleges. The rest are in private colleges affiliated to state universities or deemed universities. The fees in most private colleges which are run by trusts headed by politicians are 1000-1500 times higher than in the government colleges.

In the private institutions some seats are allotted by the governments on the basis of the state level entrance test. The rest are under management quota and NRI quota which are priced higher. This year's MBBS admissions in private colleges in Kerala have been mired in a controversy which sums up everything that is still wrong. The private colleges admitted students on 50 per cent seats on merit but the state government had allowed the colleges to fill the rest of the seats as management quota, with no specified fees. The matter is with the state high court.

Some years ago the apex court had tried to rationalise fee structure in private colleges but with no countercheck, it's back to the old days. It is noteworthy that whatever regulatory procedures are in place, they have been forced down the throat of private colleges by the judiciary. They are followed not because of any respect for the philosophy or logic behind them, but under the threat of litigation. The private institutions make every attempt to subvert the norms imposed by the government or judiciary.

Over 7000 medical seats have been created in the country during the last five years with 75 per cent in private colleges. A medical college affiliated to a state university, has some semblance of state control but a college under a deemed university, has a free hand at admission or fixing its fees. About the faculty the less said the better. The arrest of MCI head, Dr Ketan Desai, and some MCI inspectors from New Delhi recently is just the tip of the proverbial iceberg.

Over the past decades we have devalued education in humanities, science and in engineering. Now it is the turn of medical. It is partly due to the poor infrastructure in most of the private colleges, especially the ones started in the last decade. They get recognition from the MCI despite lack of adequate faculty and equipment. The Tribune has recently exposed how a college can hire medical faculty just for the duration of the high powered shut-eye inspection team.

The government colleges also do not have enough faculty because of poor infrastructure and poor remuneration. A state health service allopathic/ ayurvedic/dental doctor, a medical teacher in a medical college and a superspecialist who trains DM and MCh students get the same salary. The government could form an all-India health services cadre with a three tier system to compensate the extra training and inputs of medical teachers.

Most medical colleges in the country, both in government and private sector, have failed to keep abreast of technological advancements and new teaching methods. A train-the-teachers programme at the AIIMS or the PGI or other similar institutes would help the teachers.

Lack of faculty in some government colleges has forced the MCI to cut down on MD/MS and even MCh seats allocated to them. Medical students in such colleges are never exposed to specialities like neurosurgery or cardiac surgery because there are no such posts in them. Many colleges do not have even have echo-cardiography or endoscopy equipment. A large proportion of students thus do their MBBS and even MD/MS without ever seeing coronary angiography or bypass surgery.

On the other hand private and corporate hospitals have the latest equipment and expertise. For example, no government teaching institution has a successful liver transplant programme in the country whereas a number of private hospitals are offering this treatment to the needy.

To make matters worse there is a talk of public-private partnership to provide services in government institutions. Some government colleges, including Chandigarh Medical College and SMS Medical College, Jaipur have gone in for installation of CAT scan/MRI scan by private entrepreneurs thus denying postgraduate students hands-on training on the one hand and preventing generation of revenue on the other hand.

The newly constituted board of governors of the MCI has suggested that India needs 100 more medical colleges instead of improving the basic infrastructure and enticing more faculty with better remuneration. The MCI has for years been far removed from ground reality with. Constitution of the new board of MCI had generated some hope but even the new board does not have representation from state medical colleges; it is top heavy with experts from institutes and private sector; some are long retired.

If the scene at the graduate level is scandalous, the one at the post-graduate level is pathetic. There are only 30 PG seats for every 100 students doing MBBS. More than half of these PG seats are in private colleges. While the government college fees is a few thousand rupees, the private colleges charge 3 to 7 lakh rupees per year. The capitation fee ranges from Rs 40 lakh to Rs 2 crore depending on the specialisation.

The Health Ministry, some years ago, had started a DNB course parallel to MD/MS to compensate for shortage of PG seats. Private hospitals, private imaging centers/labs and even nursing homes have been allowed to run the course. However, there is virtually no teaching and no training as the consultants have no time from their practice. The MCI does not seem to be doing anything in this regard.

We had learnt at some cost how detrimental license, permit and quota-raj can be to economy. Its role in medical education can only be worse. There is an urgent need to revamp medical education in the country with uniform infrastructure, uniform minimum standards,uniform fee structure, a common all-India entrance test for the MBBS and PG, and re-evaluation of both the private and government colleges.

The writer is Professor of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh

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Only lip sympathy for the physically challenged
G. N. Karna

THE recent reprimanding of the Union Government by the Supreme Court on denial of jobs to two disabled candidates has sparked off a wider national debate on the pace of implementation of employment-related provisions of the existing Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. These judgments delivered by the Supreme Court with regard to providing jobs to Ms Pritilata Nanda (a physically disabled woman of Orissa, suffering from paralysis of lower limbs) against Class III post under South Eastern Railway (SER) and Ravi Prakash Gupta (a visually impaired candidate) as an IAS Officer are, indeed, quite historic in disability rights movement in India.

Significantly, despite clearing a written test conducted by the railways 21 years ago, Pritilata was denied job by the railways on flimsy ground that her candidature was not sponsored by employment exchange. The Supreme Court has directed the South Eastern Railway to appoint Ms Nanda on a Class III post within two weeks with the entitlement to the actual monetary benefits retrospectively with effect from August 5, 2008 as also a sum of Rs 3 lakh as compensation for harassment by the SER.

The same illogical ground was adopted by the UPSC in denying job to Ravi Prakash Gupta, notwithstanding his qualifying the Civil Services examination and fulfilling the eligibility conditions. The contention given was quite vague--that there was only one post meant for disabled persons, which included persons with other physical disabilities.

Finally, the Supreme Court has directed the Centre to grant him posting in eight weeks. Both the judgments of the apex court are historic and like a slap on those defiant administrators/officials who, though are entrusted with the responsibility of implementing and ensuring the provisions of the existing Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995; they stoop to any means to nullify the implementation of job-related statutory provisions, especially in central and state universities, public sector undertakings and autonomous bodies (which normally skip away by citing technical reasons under the excuse of autonomy and excellence. Hence, these trendsetting judgments must be an eyeopener to all such errant officials who deliberately violate the statutory provisions meant for the disabled and disadvantaged sections.

While in the case of Ms Pritilata Nanda, despite her being on the merit list, the authorities showed callousness and dereliction of duty in not issuing her the appointment letter, the appointment of Ravi Prakash Gupta was kept blocked unduly for three years despite his qualifying the civil services examinations.

There could be innumerable such cases where, despite clear- cut provision of 3% job in all government establishments ranging from Class I and II to Class III and IV posts, the employment rights of disabled candidates are brazenly violated routinely because of insensitivity and deep- seated prejudice on the part of those babus who are legally mandated to ensure justice to the actual beneficiaries. Such victimisation of the disabled candidates in depriving job avenues has become the order of the day.

Hence, there is greater imperativeness of amending or reshaping the job related provisions of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995, so as to extend the reservation facility to all category posts. Some strict and punitive provisions for overhauling misuse in selection/recruitment process must be put in place to deal with cases of victimisation of the persons with disabilities in selection/ appointment process.

Given the scope for such discriminations, it is necessary that at every selection committee, there should be one member/expert from among the disability sector (preference be given to the expert who himself or herself is afflicted with disability) with vast knowledge and experience as representative of the Chief Commissioner for Persons with Disabilities (in case of Central establishments) and state disability Commissioners in case of state establishments. Especially with regard to selection of the candidate(s) against the reserved posts/vacancies, these designated representative should have the authority to submit a dissenting note to the Chairman of the Selection/Appointment Committee as also his/her immediate boss; which could be deterrent to flagrant violators.

The recently constituted Committee for Drafting New Legislation for Persons with Disabilities (by the nodal Ministry of Social Justice & Employment/Government of India) must take special note of these pro-active historic judgements delivered by the judiciary while finalising the draft legislation.

Dr Karna, Honorary President of the Society for Disability and Rehabilitation Studies, is also a Member of the Committee for Drafting New Legislation for Persons with Disabilities

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