The Tribune, Chandigarh, India

Land acquisition
Time to amend the Central Act

THE western UP farmers’ violent agitation has renewed interest in the Bill to amend the 1894 Land Acquisition Act. It was passed by the Lok Sabha in 2010 but a stubborn Mamata Banerjee of the Trinamool Congress stalled it in the Rajya Sabha. The 1894 Act empowers the government to forcibly acquire land for public purpose. Farmers’ protests, first in Nandigram-Singur and then in western Uttar Pradesh, exerted pressure to make the land acquisition law farmer-friendly. Starting with the NDA regime in 2003, Bills moved to pacify farmers have collapsed in the absence of a political consensus.

Things have changed slightly. With her electoral ambitions in West Bengal nearing fulfilment, Mamata may no longer insist on having her way on the land Bill. The pending Bill allows the Centre to use force, if need be, to take over 30 per cent of the land after private parties have secured 70 per cent of it from the owners in a direct deal. Mamata wants the ratio to be 90:10. Rashtriya Lok Dal president Ajit Singh has also introduced a private Bill proposing a ban on government land acquisition for commercial purposes and profit-making.

Depriving a farmer of his land, which may be his only asset and source of livelihood, is an emotive issue, fraught with dangers. Haryana and Uttar Pradesh have passed laws, widely hailed as farmer-friendly. The UP law, passed after farmer protests first erupted over land takeover for the Delhi-Agra Expressway, has been upheld by the Supreme Court. Both UP and Haryana offer liberal rehabilitation terms, including annuity, to farmers. Disputes often arise over rates offered to land owners. Haryana provides the minimum floor rate, while critics of its policy seek market rates. In UP farmers down the road demand land rates offered in Greater Noida. Police brutality and politics have further complicated the issue. Hopefully, the amended Central law would take care of all ticklish issues with help from Mamata, lately on a political high, eyeing West Bengal’s chief ministership.

Army Chief’s comment
Need to be discreet on operational skills

A day after US Special Forces clandestinely flew into Pakistan and killed Osama bin Laden, the Indian Army Chief, General VK Singh, declared that the three services were competent to carry out a similar operation. Although the Army chief’s remark was in response to a question asked by journalists and was devoid of any mention of Pakistan, it was enough to evoke an excited reaction from the western neighbour which lost no time in warning India of a ‘catastrophic’ response against any such ‘misadventure’.

But the incident raises the question of whether the Army chief needed to make such a comment in the first place and whether he could have handled it more diplomatically. Few Army chiefs would like to admit that their forces do not possess such a capability, especially when it comes to India vis-a-vis Pakistan and, equally, vice versa. But more importantly, should a service chief be commenting on such capabilities considering that such operations require stealth, surprise and will forever be fraught with risk? For, if the US did record a spectacular success in taking out Osama bin Laden, then there have also been cases of abject failure. On April 24, 1981, almost 30 years ago, an attempt by a US Special Forces team to rescue 52 Americans held hostage in the US Embassy in Teheran resulted in a humiliating failure and contributed significantly to Jimmy Carter’s defeat in the presidential elections held later that same year.

The Indian armed forces would do well to study the success of Operation Geronimo, work to understand and acquire the required technology to make such operations successful and develop capabilities to conduct both covert and special operations. India’s security concerns are complex and not just confined to Pakistan. Considering that launching a war is neither easy nor a first option, the armed forces may be called upon to engage in similar operations in the future.

Thought for the Day

I have never let my schooling interfere with my education. — Mark Twain

ARTICLE

Uncertain future for Afghanistan
US-Pak tensions escalate
by G. Parthasarathy

WITH world attention focused on the spectacular American action to eliminate Osama bin Laden, there has been a tendency to forget the developments in Pakistan that preceded this event. Angered by American snooping on his jihadi assets, General Kayani launched a propaganda and diplomatic barrage to force the Americans to end their covert activities and drone attacks on the Haqqani network in North Waziristan. He claimed that the drone attacks were killing scores of innocent civilians. Cricketer-turned-politician and long-term Army and ISI protégé Imran Khan was commandeered to rent crowds and block US supply convoys to Afghanistan. Sadly for General Kayani, the GOC of Pakistan’s 7th Division in North Waziristan, Major-General Ghayur Mehmud, debunked his Chief’s strident propaganda, revealing that “a majority of those killed by drone strikes are Al-Qaida elements, especially foreigners, while civilian casualties are few”.

Undeterred by this fiasco and unfazed by the dressing down that his ISI chief Lieut-Gen Shuja Pasha got from CIA Director Leon Panetta during General Pasha’s visit to Washington on April 11, General Kayani roped in the army’s favourite politician in the ruling PPP, Prime Minister Yousuf Raza Gilani, to make some outrageous demands when Mr Gilani, accompanied by General Kayani and General Pasha, met President Karzai in Kabul on April 16.

According to Mr Karzai’s aides, privy to what transpired, Mr Gilani, whose intellectual abilities have not been known to match the sartorial elegance of his Saville Row suits, bluntly told President Karzai that the Americans had let down both of them and that Mr Karzai should under no circumstances agree to a long-term American military presence in Afghanistan. For good measure, Mr Gilani added that rather than look to a strategic partnership with the US, Mr Karzai should look to Pakistan and its “all-weather friend” China and strike a deal with the Taliban.

Having witnessed his father being killed by the Taliban in Peshawar and having learnt to balance adeptly between external powers, the wily Mr Karzai obviously has no intention of leaving his fate and that of his country to be determined by the ISI. The crude Kayani-led effort is to force the Afghans to accept an ISI-sponsored “reconciliation process” with the Taliban, which excludes the Americans. To demonstrate their clout, the Pakistanis have arrested the number 2 Taliban leader Mullah Abdul Ghani Baradar, who refused to accept Pakistani tutelage and was prepared to talk directly to President Karzai, who is a fellow Durrani Pashtun. The Americans, in turn, initially insisted that the “reconciliation process” should be initiated only after the Taliban renounced violence, surrendered arms and agreed to abide by the Afghan constitution.

Recognising that this was unrealistic, the Americans now say that what they had earlier demanded should be the outcome of the “reconciliation process”. In the meantime, busybodies like Turkey are working towards hosting an office of the Taliban despite the organization being banned as an international terrorist organisation.

The US and its NATO partners have announced that they will not further participate in active combat operations and hand over responsibilities to Afghan forces at the end of 2014. The million-dollar question is whether Afghan forces can take on the Taliban, armed, trained and operating from secure bases in Pakistan, from taking over the control of Pashtun-dominated Southern Afghanistan. President Najibullah held on to control his country till four years after the then Soviet Union commenced its withdrawal. He was forced to capitulate only because the Soviet Union collapsed. In these circumstances, the crucial question is what happens after December 2014. Will the Americans withdraw fully after December 2014, leaving a power vacuum to be filled up by the Taliban? There are no clear answers to this query, as yet.

President Obama declared on May 1 that killing Osama was a major objective, even as the US continued to “disrupt, dismantle and defeat” his network. The Al-Qaida, on its own, has not carried out a single significant terrorist attack after 9/11. The terrorist attacks in London, Madrid, Bali and New York’s Times Square were all largely by Pakistanis motivated by groups like the Lashkar, Jaish and HUJI, which are affiliated to Al-Qaida. It is also clear from the statements of Headley and Rana that it was Pakistani terrorist Ilyas Kashmiri, operating from North Waziristan, who was the mastermind of the efforts to stage a terrorist attack in Copenhagen. This makes it clear that despite the elimination of Osama bin Laden, the infrastructure of terrorism, established along the AfPak border areas, still remains intact, posing a threat to global security.

The elimination of Al-Qaida is not going to “disrupt, dismantle and defeat” terrorist networks bent on striking at cities in the US and its NATO allies. This would require relentless counter- terrorism action across the Durand Line. Given the heavy dependence of the Americans on Pakistan for logistical supplies through Pakistani territory, such action would be unthinkable just now. But with an estimated 50 per cent of supplies even now coming through Russia and Central Asia, this dependence on Pakistan will become much less important in the coming years, as American troop levels in Afghanistan are significantly reduced. In such a scenario, the US will be more open to effective counter-terrorism across the Durand Line, as US Vice-President Biden and others like Ambassador Robert Blackwill have advocated.

The US is negotiating a strategic partnership agreement with Afghanistan, which will enable a residual military presence even beyond 2014. Its provisions will be important in outlining long-term American objectives.

President Karzai’s enthusiasm for “reconciliation” with the Taliban is provoking a backlash in Northern Afghanistan, where non-Pashtun groups have noted that he no longer criticises Taliban excesses. There is scepticism about any possibility of the Taliban shedding its pernicious ideological beliefs. Given the composition of the Afghan Parliament, it would be difficult to get a consensus on any deal which Mr Karzai strikes with the Taliban.

If the Taliban overruns Southern Afghanistan, as the Americans commence their troop reduction, they will face serious resistance all over the Amu Darya region. We may then have a de facto partition of Afghanistan into Pashtun and non-Pashtun areas. It is not clear how the Pashtuns in Pakistan’s tribal areas, who have been relentlessly bombed and displaced from their homes by General Kayani’s actions, will respond to such a development. India will have to manoeuvre dexterously if it is to ensure that Afghanistan does not yet again become a haven for terrorism, threatening its security, as it did during the days of the ISI-backed Taliban rule in Kabul and Kandahar.

MIDDLE

The violin teacher
by Rachna Singh

One fine day my teenage daughter announced that she wanted to learn the violin. Considering no one in our family had ever attempted such a feat I was naturally taken aback. All my attempts to disabuse her were firmly rebuffed.

So began my odyssey for a violin teacher. We found the first violin teacher with surprising ease but alas he turned out to be nothing but a covetous fraud who took advance fee and disappeared after two classes. Somewhat disgruntled, I started to look around for another teacher. I soon found one who seemed sincere and devoted but unfortunately his repertoire was limited to the basic notes on the violin.

I was disheartened and ready to give up the search but decided to make a last-ditch effort. A music lover recommended a teacher but warned that he was a ‘fakir’. My imagination conjured a man with tangled locks and a ‘choga’. The reality, however, was shockingly different. I found a frail, lonely, old man living in near penury in an attic on the third floor of an old house.

He had an old pedestal fan in one corner of a bare room which he turned on only to provide me some respite from the heat of a scorching May afternoon. I almost fled the place but the sight of a beautiful violin in one corner lovingly polished to a fine patina gave me pause. So began the saga of the violin teacher.

Come rain or shine he would arrive with a smile on his face and a new melody he would lovingly play on the violin. Any offer of tea or eatables would invariably be met with a dignified “Nothing for me”. My hesitant offers of financial or material help were met with a steady “I have enough”. Soliciting help in any form seemed anathema to him.

I slowly learnt that he had been a music director in Bombay. He had directed music for several songs sung by Rafi but had left to create and play music on his own terms. In the pursuit of music he became a recluse and was able to earn only enough to keep body and soul together.

Today his vision is failing, his hearing is deteriorating, he has a cyst, the size of a cricket ball on his neck (malignant or not is anybody’s guess) and he is all alone in the autumn of his life. Yet, he soldiers on with a smile and the violin firmly tucked in the crook of his arm, an inspiration to the world. Such devotion to music is admirable and yet one sadly wonders at the exorbitant cost paid for such devotion.

OPED-HWALTH

Nursing education is a mess
Good nurses are essential for efficient delivery of health care services, but most of the private institutes opened for training them are no better than teaching shops
Radha Saini

This year the theme of International Nurses Day is “Closing the Gap: Increasing Access and Equity”. The theme primarily focuses on the contributions of the nurses towards efficient delivery of health care services even to the far-flung remote areas, including vulnerable communities, marginalized communities, rural communities and economically weaker sections of society with a view to promoting the utilisation of health services and health care resources by the people. However, India has been neglecting the education and training of nurses badly.

The country has 2,178 nursing diploma schools, 1373 nursing degree schools and 401 MSc nursing colleges and annually, the country produces around 60,000 nurses. According to Ministry of Health and Family Welfare (MOHFW) statistics the nurse-population ratio in India is 1:2,950 and hence among 133 developing nations we stand 75th in the nurse-population ratio even though we remain the biggest supplier of doctors and nurses to the developed world.

According to WHO, India will need 2.4 million nurses by 2012 to achieve the government’s aim of a nurse-patient ratio of 1:500. More than mere setting up of buildings and infrastructure or even complying with the norms set up to establish a new college as per the guidelines of the Indian Nursing Council (INC), the need of the hour is to give evidence-based and competent practical training to our new nursing graduates and also motivating them to build/develop interest and passion for patient care. Practices need to be highly skillful and competent based on a lot of practice to deliver holistic care to clients.

There are 150 nursing institutes in Punjab with more than 25 colleges offering MSc nursing course. Not even one MSc nursing college in the state has been able to comply with even basic norms and rules set out by Ithe ndian Nursing Council, New Delhi, and Baba Farid University of Health Sciences, Faridkot. Mainly there is lack of experienced MSC nursing faculty, lack of publications and independent published research work of high quality by MSC Nursing faculty, lack of independent research and development projects by college along with lack of resources and infrastructure for MSc Nursing course.

Furthermore, on the day of inspection especially by the INC, everything is shown on papers i.e. rented buildings, lab equipment and library books. So much so, even MSc and BSc nursing faculty is hired for just 1-2 days. After that nothing is there. Imparting nursing education is a mere business for the private businessman of Punjab. The relaxations given by the INC in opening /setting up BSc nursing and MSc nursing colleges have been grossly misused by the latter.

Teaching shops

In the race to be one-up on each other, these colleges indulge in all types of unscrupulous activities ranging from assisting students in cheating in examinations to allowing students to do non-attending MSc nursing course which is totally illegal, unprofessional and unethical. Teachers are made to work by making them kill their conscience and are left on the whims and fancies of their respective managements.

Student nurses while pursing their training often lament inappropriate practical training. Nursing procedures ought to be practiced by students many times on dummies before being administered independently on patients. Yet, a majority of nursing institutes do not even have dummies. Even if a dummy is present, a student hardly gets a chance to practice on it as student-dummy ratio is 50:1 or even 75:1.

Students are forced to try out procedures directly on poor patients, making the latter guinea pigs for carrying out simple to complex nursing procedures. Often nursing students end up harming the client in one way or the other.

Nurses are always caught in a dilemma between their accountability to patients in terms of nursing care and professional duty to doctors and other health care professionals in terms of obeying their orders and hence assisting the latter by all means. So much so, while assisting physicians in clinical trials they never question the doctor regarding the authenticity of these trials in terms of the bioethics involved.

Lack of ethics

They rather blindly follow physician’s orders and hence equally contribute to unscrupulous medical practices which make poor patients guinea pigs in pharmaceutical company-sponsored clinical trials. The good reason is that there are no defined nursing ethics in our country.

The difference in the care rendered to a patient by a locally trained illiterate girl/quack nurse and a diploma/degree holder or postgraduate nurse is not appreciated. Hence there is no motivation for increasing one’s qualifications.

The modus operandi of private nursing homes and hospitals is to train local illiterate young girls and boys in basic nursing care which primarily includes changing IV bottles and administering medications, including injectables, and subsequently making the latter don nurses’ dress and hence giving a vague and fraudulent picture of nurses to the entire society.

In the government sector, till date there is no post of Professor or Assistant Professor/Reader. Nurses in all the private nursing institutes, including mission hospitals such as CMC Ludhiana, and CMC Vellore, use self-proclaimed designations of Professor and Assistant Professor/Reader, which is totally unprofessional! Till date nurses have not been able to create a separate directorate of nursing and still are governed by Director Health services at the state level and Ministry of Health and Family Welfare at the central level. With the population of our country exceeding one billion, it is shocking that we have only one nursing advisor at the Centre.

Need of the hour

The need of the hour is to strengthen the inspection criteria of the INC and the university. It has two main components: one, checking of credentials of MSc nursing teachers in terms of published papers of high quality, conducting independent research projects or involvement in ongoing/current research project of government or any other international UN body or NGO, and secondly evaluating the academic performance of a college in terms of conducting national level workshops and organising conferences on an annual basis along with taking research grants from national bodies like the ICMR, the MOHFW, NACO and WHO, UNDP Geneva etc at the international level.

More rigorous evaluation criteria for practical and theory examinations of students, along with starting a common exit exam for all nursing passouts, thorough investigation of Masters and Bachelors nursing students’ dissertation thesis, recruitment of special nurse researchers by the university are a few things needed urgently. Above all, nursing students must be continuously motivated for “selfless service” and “significance of empathy” while caring for patients.

Nurses of India need effective training and ought to acquire skills necessary for effective implementation of the government’s programmes and policies, especially in relation to the Reproductive and Child health Programme (RCH-II), Universal Immunisation Programme (UIP), Adolescent Health programme and Geriatric Health Programme run by the Ministry of Health and Family Welfare at the Central level and the Directorate of Health and Family Welfare Programme at the state level. Both these programmes are being run under the auspices of the Director-General Health Services (DGHS).

The writer is Vice-Principal, Rayat-Bahra College of Nursing, Distt Mohali