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Neglected migrants
Medical education blues |
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Civic politics in UT
Don’t neglect nuclear plans
Waiting for Godot
Master gland of metabolism
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Neglected migrants
The
admission of the Union Labour Ministry that it has indeed no clue to the number, trends or status of migrant workers in the country, is shocking indeed. Although the Centre had enacted the ‘Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Act’ way back in 1979, like many other laws, this too apparently remained on paper.
While principal employers and contractors employing migrant workers are required to be registered and obtain licences, in the entire country, it seems, only 240 employers have cared to register themselves and just 285 contractors have taken the trouble of securing the licence from the appropriate authority. What is worse is that in several states, notably in Punjab, Haryana, Uttarakhand, New Delhi and Jammu & Kashmir, not a single employer or contractor appears to have bothered about legal niceties. That, of course, does not mean that migrant workers are not employed and exploited in these states. Far from it. But what it means is that these state governments too have been largely indifferent to the plight of the workers and utterly callous in implementing the law. Migrant workers contribute enormously to economic activities around the country, from coffee plantations in the southern states to paddy fields in the north, indeed from the tea gardens in the North-East to the mines in Chhattisgarh, the shipyards in Gujarat to industries in Maharashtra. But they often do so at enormous personal cost too. Entire families are often uprooted and forced to settle in areas where they may not even be familiar with the local language or customs. The education of children suffers and the necessity of sending remittances back home generally means that the workers take little care of their own health or their own needs. They are often paid poorly and employers frequently hold back their due so that they find it difficult to leave. Sometimes, families are separated and the women subjected to sexual exploitation and worse. The casual admission smacks of bad governance and poor supervision. If a 32-year-old law has been allowed to remain only on paper, the least the government can do is to fix responsibility and take stern action against errant officials and steps to implement the law.
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Medical education blues What the Medical Council of India ( MCI) announced with a bang, has ended up as a whimper. The ambitious plan to hold a common entrance test for MBBS, which was scheduled in a hurry for May 2012, will have to wait for a while. For, the government agencies and institutions like AIIMS (All-India Institute of Medical Science) expected to conduct the test have expressed their inability to do so due to lack of time for preparation.
As a result, both NEET( National Eligibility-cum-Entrance Test) for both undergraduate medical courses as well as for postgraduate courses have been deferred. The well-meaning plans of the MCI began by preparing a roadmap to meet the urgent demand for more medical colleges and to plug the deficit of faculty in medical colleges, that is reported to range from 25 to 33 per cent, according to its own report. To plug this, the government announced plans to create an additional 7000 MD seats to tide over the crisis of faculty shortage by 2014. Then came the proposal to introduce a common MBBS entrance test. In a notification filed in 2010, the MCI had announced the common tests would be conducted from the academic year 2012. With the benefit of hindsight, it can be said that the MCI needed to do its home-work well before embarking upon such bold plans. To begin with, a nationwide common entrance test would require mega-scale logistics to be in place, as also a well-thought-out curriculum, which would do justice to aspirants from all states, without compromising on the demands of this profession. The reality is that for the tests to be conducted in May 2012, the MCI unloaded the course content only in Nov 2011. This caused many states to protest on grounds that students required more time to prepare for the new examination system. Rightly so, the apex court has rapped the Central government, which, despite cautions raised by several quarters, had assured that the NEET could be implemented in 2012. Their callousness has further slowed down the speed required for improvement in the medical education sector. |
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Civic politics in UT The list of nine councillors nominated to the Chandigarh Municipal Corporation by the UT Administration has stirred a major storm in the tiny cup of civic democracy that is still on the brew in the city known for its beauty. Nearly one-fourth of the councillors in the city come through nomination, obviously a concept aimed at keeping development ahead of politics.
That’s one purpose that may have been defeated by the Administrator nominating some councillors who are believed to have an affiliation to the Congress, a party that had one councillor less than the BJP-SAD alliance, its major rival in the corporation. At first sight, this is the same old minor political indiscretion that we have learnt to ignore, but it cannot be overlooked, for the civic elections — held for the first time in 1996 — are part of a larger shift towards democratic administration of the city. Chandigarh has long been a unique island of bureaucratic rule in the midst of a democracy, and its residents didn’t seem to mind that either! The voter turnout in this election was nearly 60 per cent, which in the previous polls had hovered between 30 and 45 per cent. To sustain the increased interest in civic politics, it is important that the trust of the city’s highly-educated residents is not lost. Another reason why healthy politics is important in this particular case is that the civic body currently has only a small role to play in the running of the city. Most weighty responsibilities remain with the administration run by bureaucrats. However, each year a few more responisiblities are handed over to the corporation. This is a process that is likely to be hurt if the council functions in a chaotic manner, which is inevitable when there is petty politics. The administration claims it has nominated people from all walks of life without bias. But is that credible? All that the Administrator needed to do was name nine people of distinction with absolutely no shadow of political affiliation, and there is no dearth of such persons in the city. |
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There is no conflict that cannot be resolved. Violent conflict is created and sustained by human beings, and it can be ended by human beings — George Mitchell
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Don’t neglect nuclear plans
Now that the Lokpal logjam looks like ending one way or the other and the controversial Food Security Bill is already on the Lok Sabha’s anvil, the time has come when the Central government should concentrate on the country’s nuclear power generation programme. In recent months it has been sadly neglected even though it is facing several obstructions, most notably at Kudankulam in Tamil Nadu but not there alone. In the circumstances it is entirely understandable that the nuclear cooperation was on the top of the agenda when Prime Minister Manmohan Singh held his annual summit meeting with Russian President Dmitry Medvedev and Prime Minister Vladimir Putin in Moscow (December 15-17). The Kudankulam Nuclear power plant (KNPP), costing Rs1,400 crore, has been built by Russia. Ironically, it is ready for being commissioned but its two reactors of a 1,000 MW capacity each are lying idle because of the virulent and protracted agitation against it in the surrounding areas. Dr Singh assured his hosts that the first reactor at Kudankulam would be made operational within two weeks and the second six months later. But judging by the sharp and angry reaction to this of both the agitators at and around the project and Tamil Nadu’s feisty Chief Minister, J. Jayalalithaa, this appears doubtful. A prime ministerial promise that is not kept would be an acute embarrassment internationally. In his statement on the decisions taken at the summit, the Prime Minister had declared that the Kudankulam agitation had been “overdone” because the plant was “absolutely safe”. Experts of the atomic energy establishment, he had added, had answered all the doubts and misgivings of those that feared for their safety and livelihood. To this the response of the protestors was to intensify their agitation. At the time of writing, they have extended the agitation to the entire state at least for a day. They are also demanding peremptorily that all uranium should be removed from the KNPP site before the year’s end, or else. More importantly, Ms Jayalalithaa, in her terse letter to the Prime Minister, has expressed her “amazement” that he should have decided to commission the reactors at Kudankulam even before the 15-member team of nuclear experts had interacted with the people worried about their future. For reasons unknown, the Minister of State in the PMO, V. Narayanswamy, took this opportunity to chastise the state government for its failure to “act” against the obstreperous agitators who are blocking entry into the plant even though the Union government has been urging it to do so. Does this worthy seriously believe that the Tamil Nadu Chief Minister would act against those she is sympathetic with? The problem at Kudankulam is primarily political and can be resolved only politically, not through presentations by nuclear technocrats. To put it more bluntly, the problem can be got out of the way only with the cooperation of Ms Jayalalithaa, and New Delhi should know that she wouldn’t talk to mere ministers of state or functionaries of the Atomic Energy Commission. Top leaders at the Centre have to engage themselves in talks with her. If the kerfuffle at Kudankulam goes on, a stage could be reached when the Russians would start worrying about the future. For, it is no secret that they were expecting that contracts for the construction of Kudankulam 3 and Kundankulam 4 would be signed at the summit. They had to be content with the joint declaration to the effect that the “terms and conditions” for the additional two reactors at Kudankulam had been “agreed to”, and that a formal agreement would be signed soon. In the current situation, the Indian side could not have gone beyond that. Left to them the Russians would like to install not four but eight reactors at Kudankulam. Even with the best of will on India’s part, that would not be possible. So, they will have to be given alternative sites acceptable to them. Haripur in West Bengal was one but Chief Minister Mamata Banerjee does not want any nuclear power project in her state. Jaitapur in Maharashtra, where six French reactors are to be put up, is for the present free from agitation. But the opposition to the project in the area remains strong. Meanwhile, the Indo-Russian understanding on two more reactors at Kudankulam has an important repercussion with much wider significance. No one has announced it explicitly but the Russian position that the two new reactors at Kudankulam are under the original agreement of 1980s has been accepted. Consequently, these reactors would not attract the Indian law on nuclear liability that was enacted much later. This is an issue on which the United States is much more perturbed than the other two nuclear suppliers, Russia and France. For, the American suppliers who were waiting anxiously to partake of the highly lucrative Indian nuclear market are dismayed. They argue that they cannot invest in India because of the law that places the responsibility for paying compensation to the victims of a nuclear accident on both the operator and the supplier. This is indeed so even though, under the Indian law, the supplier becomes liable only if the accident occurs because of a defect in the equipment. Moreover, under the rules and regulations framed under this law, the suppliers’ liability has been limited to five years only. Thus, it happened that while the Prime Minister was in Moscow, the US Under-Secretary of State, William Burns, was in Delhi discussing the nuclear liability law with high officials. He was courteously told that this country’s laws had to be obeyed, especially after New Delhi had tried to accommodate the suppliers’ concerns to the extent possible. American advocacy on behalf of suppliers is rather odd because the US has itself wriggled out of its categorical commitment, under the Indo-US nuclear deal, to extend to India “full nuclear cooperation”. It has since taken recourse to an escape hatch. Through the Vienna-based Nuclear Suppliers’ Group, it has got fresh guidelines issued, prohibiting the transfer of technologies for nuclear enrichment and reprocessing (ENR) to countries that haven’t signed the NPT. Of these, India is certainly one. The Russians have finessed this restriction neatly. They would, they say, enrich India’s uranium and reprocess its spent fuel on “Russian soil”. This would enable them to honour their bilateral commitments to a “special friend” and also observe their international
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Waiting for Godot
Last
week while waiting at the barber’s shop amid a liberal sprinkling of “Stardust”, “Femina” and “India Today”, I was reminded of what Ravi Dayal, the late Editor and founder of Ravi Dayal Publishers, told me once. He said the success of magazines was partly connected with the Indians having to wait all the time — you go to a government office, you have to wait. You catch an aeroplane, you’ve to wait. To pass your time, you pick up a magazine. Paying a tribute to him, Amitav Ghosh, the celebrated writer, said, “Dayal was one of the greatest editors of his time: the sort of expertise he brought to the printed word simply doesn’t exist anymore, not just in India but anywhere.” Once I asked Dayal which of his titles had been doing well that year. He said Ghosh’s “Shadowlines” and Khushwant Singh’s “Short Stories” had done very well. “I’ve had to reprint Firdaus Kanga’s ‘Trying to Grow’ within eight or nine months. Khushwant Singh’s ‘Train to Pakistan’ goes on moving. So, someone there is interested in good things. And I’m really just a part-time publisher.” On why he had resigned from the OUP when he was at the zenith of his success, he said, “I left the OUP because I wanted not to be obsessed by work. Partly, it is great fun doing it. But I thought I had done it now long enough---must travel, must be a human being, must look and think a little more rather than just work all the time. It (publishing) is a source of my income and that pleases me. It has done all right. But I’m not thinking of publishing all the time. I’ve time to go out.” When I asked him if there was enough interest in fiction, what with a glut of niche publishing, Dayal said, “Fiction has a better future than in the past. I think it’s a function of the growing intelligence. It’s mixed. Nowhere in the world does everyone read high-level James Joyce or Iris Murdoch and so on. Most people read rubbish. And the serious, thinking, critical minds are always comparatively few. So we’re not unique in this. As literacy grows, as economy grows, I think, it’s bound to increase.” He added, “I think certainly part of the magazine writing has got much more engaging than it used to be and there’s a new crop of journalists who’re amusing and quite crisp in their articulation.” He didn’t think it was eating into books. “I think it is perhaps the starting point for people to begin reading books. It’s a sort of halfway house. If you can go through a fairly sophisticatedly written magazine, it means your language is good enough to read a book, by and large. Isn’t it?” Dayal concluded that afternoon’s discussion with his comment, “I have a feeling we haven’t published or written enough good, light reading over here which is a skill also. We’ve people attempting major literature. I think Shobha De is attempting reasonable, light literature. In all societies, we’ve got satirical writing. We don’t have too much of that in English. Some of it possibly exists in Hindi.” His parting shot was, “I don’t think people should behave as if reading is penance. It’s a source of delight basically.”
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Master gland of metabolism The thyroid gland, which is located below the voice box, is the largest endocrine gland. It primarily secretes two hormones, thyroxine and triiodothyronine, commonly known as T4 and T3. Secretion of these hormones by the thyroid gland is controlled by Thyroid Stimulating Hormone (TSH), which is secreted by the pituitary. The net result of thyroid hormones is a generalised increase in functional activity throughout the body. So, it increases the metabolism of carbohydrates, fat and protein and decreases the body weight. It also increases the heart rate and blood pressure. Disorders of the thyroid gland can result in either production of too much (overactive thyroid disease or hyperthyroidism), too little thyroid hormone (under-active thyroid disease or hypothyroidism) thyroid nodules, and/or goitre, cretinism (a usually congenital abnormal condition marked by physical stunting and mental retardation and caused by severe hypothyroidism), myxedema (a condition associated with severe hypothyroidism and lack of thyroid hormone in adults), thyroid cancer and rarely thyroid storm (also referred to as thyrotoxic crisis, it is an acute, life-threatening, hypermetabolic state induced by excessive release of thyroid hormones (THs) in individuals with thyrotoxicosis (hyperthyroidism). Various types of thyroid problems are more common in women than in men. Diagnostic tests and treatment: Sometime a transient thyroid problem can occur due to viral illness or any other illness, which is self-limiting. A blood test for thyroid hormones (like free T4 and free T3 which are high with a suppressed TSH) are usually sufficient for diagnosis. Sometimes a nuclear scan ( Tc99thyroid scan) is needed . Tests in hypothyroidism give opposite results that is - elevated TSH with normal or low thyroid hormone levels. To find out the cause of thyroid illness - thyroid antibodies (antibodies destroying the thyroid gland) are estimated. These are usually high in both hypo and hyperthyroidism and confirm the autoimmune nature of the disease. Treatment of hypothyroidism is to simply replace the thyroxin hormone slowly in doses as prescribed by the doctor and taken empty stomach in the morning. Growing children and pregnant women should always be treated with target levels of TSH in the essentially normal range. Treatment of hyperthyroidism includes oral anti-thyroid drugs (carbimazole, methimazole, PTU) or radioiodine ablation of thyroid gland and sometimes surgery is also required. Risk factors for thyroid disorders Gender/age: Women face a greater risk of developing thyroid disease than men. While experts vary in estimates, many studies say that women are six to times times more likely than men to develop a thyroid condition. Being 50 and above increases the risk of thyroid disease in both men and women. Personal history: A personal history of thyroid disease increases your current risk for developing thyroid disease. For example, in women, if after a pregnancy she had postpartum thyroiditis that resolved itself, she is at increased risk of developing a thyroid problem again after pregnancy or later in life. A personal history of any autoimmune disease slightly increases your risk of developing an autoimmune thyroid disease such as Hashimoto's disease or Graves' disease. Family history: A family history increases a person's risk for developing thyroid disease. The risk is slightly greater if you have a first-degree female relative (mother, sister, daughter) with the disease. Thyroid emergencies Thyroid disease may present emergencies due to thyrocardiac disease (heart disease resulting from hyperthyroidism), which includes thyroid storm and cardiac arrhythmias for e.g. (atrial fibrillation) and sometimes as severe pericardial effusion (cardiac temponade). The patient needs immediate hospitalisation in case of thyroid storm and thyrocardiac disease, as it needs very prompt treatment, otherwise delay in treatment could lead to high rate of mortality. Myxedema coma Myxedema coma is a loss of brain function as a result of severe, longstanding low level of thyroid hormone in the blood (hypothyroidism). Myxedema coma is considered a life-threatening complication of hypothyroidism, and represents the far more serious side of the spectrum of thyroid disease. It is seen more frequently in elderly patients and in women. It usually occurs in winters, the body temperatures falls abnormally low as 26.6°C and the patient requires immediate hospitalisation and may require ventilator support. Myxedema coma carries a very high rate of mortality. Thyroid cancer Growths on the thyroid are usually called nodules. Thyroid nodules can be benign (non-cancerous) or malignant (cancerous). It is more common in women than men. It can occur due to exposure to radiation, family history or any other unknown cause. The malignant cancer spreads from thyroid to other parts of the body and can lead to death if not diagnosed and treated at right time. Types of thyroid cancer l
Papillary and follicular thyroid cancers l
Medullary thyroid cancer (usually family l
Anaplastic thyroid cancer (rare and one of the most aggressive cancer of the human body) l
Treatment includes surgery, radiodine ablation and rarely chemotherapy.
The writer is senior consultant, endocrinology, Fortis Hospital, Mohali
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