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New turn in Pak tangle
Widening disparities |
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The child stays hungry Rich state does not mean well-fed kids IT jolted the national conscience when the Prime Minister expressed concern over the severe malnutrition among children in the country, citing a report that said 42 per cent were underweight. As various agencies and experts set about finding causes and solutions, fresh reports of existing data are emerging, which suggest that the overall affluence of a particular state may not have a direct bearing on the health of its children.
Implications of Pak crisis
Remarkable Sardars
Age with grace
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New turn in Pak tangle IN the raging battle between the elected government in Pakistan on the one side and the army and the judiciary on the other, the nascent democracy seems to be safe. Political forces are upbeat after a special session of Pakistan’s National Assembly adopted a resolution pledging “full confidence and trust” in the political leadership on Monday. Even opposition leaders like former Prime Minister Nawaz Sharif and the latest army favourite, Tehrik-e-Insaf leader Imran Khan, have expressed their opinion against a military takeover of the government. Supreme Court Chief Justice Iftikhar Mohammed Chaudhry, known for his dislike for President Asif Zardari and Prime Minister Yousuf Raza Gilani, also does not seem to be creating difficulties for the survival of democracy. There are, however, indications that the three warring institutions may go in for a patching up exercise, resulting in mid-term elections. Both Mr Zardari and Mr Gilani appear to be in a tricky situation because of the court cases against them, but they are unlikely to leave the scene at this stage. Both are great political survivors. The Supreme Court has suspended the licence of former Law Minister Babar Awan, who had resigned to represent the government in the different cases it faces in the apex court. But the government has found a better replacement for Mr Awan, well-known legal luminary Aitezaz Ahsan. He has agreed to defend Mr Gilani in the contempt of court case that will be taken up by the Supreme Court today. Mr Ahsan was in the forefront of the campaign for the restoration of Justice Chaudhry as the Chief Justice of Pakistan. Mr Ahsan is of the view that Mr Gilani has not committed any contempt of court by not reopening graft cases against Mr Zardari and not writing a letter to the Swiss authorities to provide information regarding the Pakistan President’s secret bank accounts in Switzerland. The letter can be written even now, but it may not affect Mr Zardari’s position as he enjoys “complete immunity as President”. Mr Ahsan is expected to argue before the apex court on these lines. He is believed to be the best person to end the crisis involving the government and the Supreme Court. The army will be happy if this leads to the government announcing fresh polls. And this seems to be a clear possibility.
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Widening disparities INCOME inequalities have risen the maximum in Jammu and Kashmir followed by Madhya Pradesh and Bihar. A countrywide survey by the Associated Chambers of Commerce and Industry in India (ASSOCHAM) reveals that the consumption expenditure of the poor is either stagnant or declining, while that of the better-off is increasing. This means the rich are becoming richer — a phenomenon often attributed to economic reforms initiated about two decades ago. This also implies the benefits of social welfare programmes like the rural job guarantee scheme and Bharat Nirmaan are not reaching the targeted sections of society, thus raising a question mark on the implementation of such pro-poor schemes. However, the gap between the haves and the have-nots is getting narrower in Maharashtra, West Bengal and Haryana. Income inequality is different from poverty. Jammu and Kashmir along with Delhi and Nagaland has the least number of poor people in the country, according to a report by an expert group headed by Suresh Tendulkar. The group says every third Indian lives below the poverty line and the largest concentration of such people is in Orissa, Bihar, Jharkhand and Chhattisgarh. For the troubled state of Jammu and Kashmir implications of growing disparities are not hard to understand. In Kashmir feeble efforts to encourage inclusive growth can prove socially explosive as youth can be easily exploited by hardliners, militants and their patrons across the border. The lure of Naxalism also has its roots in poverty and economic inequalities. The governments will need to spend much less on the police and security forces if fruits of economic growth are evenly distributed. However, instead of relying too much on freebies as well as food/oil/fertiliser subsidies, which are becoming unmanageable, it is better to create employment by undertaking projects for strengthening infrastructure and invest more in health and education to make Indians fit for jobs thrown up by a fast-growing economy.
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The child stays hungry IT jolted the national conscience when the Prime Minister expressed concern over the severe malnutrition among children in the country, citing a report that said 42 per cent were underweight. As various agencies and experts set about finding causes and solutions, fresh reports of existing data are emerging, which suggest that the overall affluence of a particular state may not have a direct bearing on the health of its children. Haryana, otherwise among the top in the country in per capita income, has around the same level of child malnutrition as the worst 100 districts of the country had been found to have by the Hyderabad-based Naandi Foundation. This, when only last year Haryana had been found to be among the best in the administration of the Integrated Child Development Services (ICDS) — the country’s key programme against child malnutrition. Studies have found Punjab and Chandigarh no better, with 40-50 per cent children underweight. The improving economy and 8-plus growth rate seem to be having very little impact, which indicates an obvious distribution problem. And this is not only about distribution of wealth, but also, specifically, food. Rising economies often have high inflation, which leads to particular pressures on food prices, which rise even more steeply. This takes food out of the poor man’s hand even if he does earn some money. In the short term, thus, it is not economic corrections, but direct intervention that will save the children suffering hunger. India indeed has an extensive and specialised programme for that in the form of the ICDS, but that is not only inadequate (covering a mere 41 per cent of the eligible children), but also highly prone to pilferage. A Planning Commission review of the 2008-09 expenditure on the Supplementary Nutrition Programme under the ICDS found more than 40 per cent had been siphoned off. This is criminal, especially on the part of the system that allows it. Shall we say we are missing the end despite possessing the means?
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Those who deny freedom to others, deserve it not for themselves. — Abraham Lincoln
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Implications of Pak crisis THE appointment of Brigadier Sarfraz Ali as Commander of the Rawalpindi-based 111 Brigade on January 11, just after Prime Minister Gilani sacked Army Chief Kayani’s handpicked Defence Secretary Lt-General Naeem Khalid Lodhi, brought back memories of personally witnessing a newly appointed 111 Brigade Commander spearheading a coup to overthrow and arrest Prime Minister Nawaz Sharif in October 1999. That coup came after serious differences emerged between Mr Sharif and Army Chief Musharraf over who should take the blame for the Kargil fiasco. The 111 Brigade has executed virtually every overthrow of the civilian government by the military. It could play a similar role if and when the army decides to act to oust the present government. Conventional wisdom, however, suggests that the army would avoid direct or unilateral action, as in the past. While the 1999 coup was triggered by events involving relations with India, the roots of the present differences between the military and the elected government lie in the tensions in relations with the US, following the Abbottabad raid. That raid resulted in the killing of Osama bin Laden and shame and disgrace for the Pakistan Army, internally and internationally. The Musharraf coup was followed by a series of terrorist attacks across India, culminating in the attack on the Red Fort by the Lashkar-e-Toiba and on Parliament by the Jaish-e-Mohammed in 2001. But will it be wise to presume that just because circumstances are different, we can now be more relaxed and sanguine, ruling out any possibility of similar terrorist attacks on India? It would be the height of folly to relax our guard. On December 18, a number of jihadi groups and political outfits described as the Pakistan Defence Council staged a massive rally in Lahore, with speakers provocatively raving and ranting against the United States and India. Among the politicians present were representatives of Islamic parties like the Jamat-e-Islami and, more significantly, members of Imran Khan’s Tehriq-e-Insaf. Mr Imran Khan’s close links with the ISI and the military establishment are well documented. Former ISI Chief General Hamid Gul was a founding member of his party. While Mr Imran Khan professes his desire for good neighbourly relations with India and his abhorrence of jihadi violence, he still retains links with the Taliban. It would not be prudent to assume that he has had a “change of heart,” especially given his links with the military and the ISI. The Lahore rally on December 18 was organised by the Lashkar-e-Toiba under its pseudonym, the Jamat-ud-Dawa, (JUD). Both the Lashkar and the Jamat are designated by the UN as international terrorist organisations. The two most prominent slogans at the rally were “Permanently cut off NATO supply line”, and “Reject MFN (for India)”. India was accused of conducting a “water war” against Pakistan, to deprive its people of much-needed water. Speaking on the occasion, the JUD leader Hafiz Rehman Malik thundered: “Our men are trained to use rifles and Kalashnikovs. When they head towards India with weapons, no one can stop them.” Ever since Pakistan was compelled to move more troops from its borders with India to areas adjacent to the Durand Line, the army and the ISI have carefully calibrated the nature and extent of terrorist attacks on India. The NIA was told by Daood Gilani aka David Coleman Headley during his interrogation that though terrorist groups backed by the ISI were tasked a few years ago by the ISI to shift their jihadi energies to attacking the Americans in Afghanistan, their desire for jihad against India was still strong. Thoroughly discredited by the American helicopter-borne attack which exposed that it had provided haven for over five years to Osama bin Laden in the heart of the heavily fortified Abbottabad cantonment, the army hit back at the Americans, asking them to vacate bases and withdraw personnel. This also led to blocking supplies for the NATO forces in Afghanistan. It raised public passions against the Americans by accusing them of violation of Pakistani sovereignty. It used the infamous “Memogate” affair, involving indiscretions by Mr Hussein Haqqani, Mr. Zardari’s handpicked envoy to the US, to get an already hostile judiciary to further turn the screws on the besieged civilian government by issuing a contempt notice on Prime Minister Gilani. The military is playing for high stakes. It intends to get the Americans to quit Afghanistan, leaving the country open for a Taliban takeover. Domestically, it will work with the judiciary, to force early elections. Given the need to revise electoral rolls, elections in Pakistan can be held after six to eight months. In the meantime, General Musharraf has announced that he is returning to Pakistan this month, though he may be arrested on return. The military establishment is said to have arranged for its current protégé Imran Khan to quietly meet General Musharraf in London. The military evidently believes that the Americans are desperate to get supply routes to Afghanistan reopened. General Musharraf could serve as a useful interlocutor to get the Americans to accept Pakistan’s demands, especially with sections of the American political, diplomatic and academic establishment ever ready to give Pakistan a good conduct certificate, whatever its transgressions. Moreover, General Musharraf is liked by political outfits like the MQM in Karachi and his erstwhile Muslim League protégés like Chaudhri Pervez Elahi, who share his and the army’s antipathy towards Mr Nawaz Sharif. But he would require the army’s continuous backing, given the antipathy that characterises his relations with Chief Justice Iftikhar Chaudhry. Many in Pakistan will see the ouster of Mr Zardari as yet another conspiracy against a Sindhi leader, believed to be a Shia. India has done well not to offer any gratuitous comment on the developments in Pakistan. Unlike in the past, virtually no one in Pakistan is holding India responsible for the country’s present travails. The Americans now have the pride of place of being the external villains, responsible for all of Pakistan’s present woes. While Pakistan’s polity is in a mess, there does appear to have been a fall in terrorist attacks engineered by some of the military’s erstwhile jihadi protégés. This is so evidently because recent events have resulted in people like Mr Imran Khan powerfully voicing support for the Afghan Taliban on behalf of the military establishment. What India has to be prepared for is the prospect of having to face a new generation of Pakistani military men, fired up by their belief in the efficacy of jihadi terrorism as an instrument of state policy. We should, therefore, not have exaggerated expectations of any significant turnaround in our current virtually frozen
relationship.
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Remarkable Sardars MEETING two similar persons may not merit enough mention, but the two Sardars I met recently left me wondering about their past. Incidentally, both are octogenarians and flaunt white beards. Both are proud fathers. Both are retired. Both get adequate and due attention from their respective families. And both worked tirelessly in their youth to have them now emulated by those around them. One of them, Sardar Amreek Singh Sidhu, came in contact with me at a function at Chandigarh’s Tagore Theatre when a group of musicians organised a show in memory of his son, Manjit Singh. Uttam Singh of “Gadar, Dil to Pagal Hai” and “Pinjar” fame was there to pay his obeisance and be part of the event. Sidhu is a violinist and has worked with four generations of music directors of Bollywood, from the times of Anil Biswas till those of Bhappi Lehri. When his dexterous but strained fingers created magic on the stress-tuned chords, it made a near-bleeding violin moan — a treat to one’s ears. He groomed his son Manjit, too, into a very fine music composer, who made his mark in Chandigarh at a time when very few seemed to be interested in the genre of Punjabi renditions and recordings in the City Beautiful. Unfortunately, he died at an early age of 36. Life’s vibrant chord of the Sidhus got snapped so cruelly. On Amreek Singh Sidhu’s entering the theatre, Uttam Singh himself lunged towards the entry to lend a shoulder for the violin-maestro to lean while walking up to his seat. When Uttam Singh played a tune on Sidhu’s violin, the latter appeared to be feeling as if he had got a fresh lease of life. May be, he felt his note that had gone dead with his son’s departure from this mortal world had come alive once again. The other Sardar, Surinder Singh Bains, entered my office like my boss and straightaway offered to address me as “beta” unlike any boss. This burly man declared at the outset that I was like his son, and being eighty- plus, he deserved to be treated like an elder, with due dignity and honour. I had no option other than accepting him the way he offered himself to me. His presence was awe-inspiring. Though his suave manners were attractive and reassuring, he had a kind of intimidating influence on me. He informed me about his having retired as a senior functionary —not a journalist — from the oldest newspaper in the region. He proudly recalled his association with many stalwarts in the newspaper. On his leaving my office, I immediately called a friend, whose name the Sardarji had mentioned, to know more about the man since he had aroused enough curiosity in me because of his suave manners and the delivery of dialogues. My friend was upbeat and talked about him spiritedly. And lo! What I then learnt about the man left me with a desire to let him march in one more time to call me “beta”. Once when he went to Lahore, his colossus-like physique held everyone in awe and admiration. Now hold your breath! On purpose I withheld to mention the most interesting thing he told me. He had not come to meet an I.G. Sahab, but a friend. And guess, why? Surinder Singh is lovingly called by many of his friends and admirers as “I.G.
Sahab”!
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Age with grace Many get impressed by various advertisers’ claims about these products. It is important to get complete information about these products and procedures from experts. One must also be aware of one’s skin type so that there are realistic expectations and adverse reactions can be avoided. The time when the skin looks best is between 20 and 35 years, after which intrinsic and extrinsic factors start affecting it. But if one is aware of these factors, one can take precautions and maintain healthy skin even after the golden period of 20 to 35 is over. The skin is particularly vulnerable to the ageing effects of a number of environmental insults, especially ultraviolet (UV) radiation. In women, there are additional factors like hormonal changes during pregnancy, lactation and menopause. Stress, smoking, alcohol, lack of balanced diet and sedentary lifestyle, increasing exposure to electromagnetic radiations from computers, mobile phones and artificial light are some of the extrinsic factors, which contribute to the fast decline of the skin tone and alteration of collagen in skin. There have been increasing efforts by scientists, dermatologists, dermato-laser surgeons to disengage the role of these intertwined and contemporary processes and do research on various molecules with anti-ageing properties. Ageing is a complex process, which has been defined as the accumulation of molecular damage over time. Intrinsic factors that may be under genetic control include skin colour, antioxidant mechanisms to prevent free-radical damage, telomere shortening and mutations in the mitochondrial genome, hormone systems and the absolute length of the continuous cell cycle. Clearly, not all age-related changes are due to genetic factors alone. For example, both excess calories and lack of micronutrients may accelerate the physical changes associated with ageing. The ageing of most of the bodily organs has, however reluctantly, to be accepted, but even then, ageing of the facial skin appears to be a matter of widespread concern. More than 90 per cent of age-associated cosmetic problems are caused by UV radiation on exposed skin, which damages telomeres and generates free radicals. These UV-related DNA mutations result in specific signs of photo-ageing, such as wrinkles, increased elastin and collagen damage. The dermis diminishes in bulk, and in absolute terms, the collagen per unit area of unexposed skin decreases with age. The collagen bundles are well-organised during the younger years but with ageing, these bundles become fragmented and disorientated and elastin fibres get progressively reduced. In the later years, the whole epidermis becomes thinner with age and the cells become less evenly aligned on the basement membrane and less regular in size, shape and staining properties. The cell turnover rate is halved from 30 years onwards. The permeability of the skin also changes with age. Although foreign substances enter aged skin more easily as compared to young skin, these are removed more slowly into the circulation because of the changes in the dermal matrix and reduction in the vasculature. The most obvious age-related changes in skin are pigmentation irregularities. Yellow or brown macules, known as ‘liver spots’ or ‘age spots’ (lentigos), develop at the back of the hands and exposed parts of the face in more than 50 per cent of persons over 40. These consist of a localised proliferation of melanocytes at the dermal-epidermal junction. Some may consider these ageing changes to be abnormal and many with financial resources have become obsessed with the pursuit of acquiring an eternally youthful appearance. A major reason for this is that various pharmaceutical and cosmetic industries have invested heavily in the promotion of the concept that “young is beautiful”. A great deal of money is being, and will continue to be, devoted to the study of compounds that may arrest or reverse the visible effects of ageing. Medical research has led to the discovery of various new anti-ageing molecules, especially many new and latest serums. And with the introduction of nano-technology, more powerful anti-ageing molecules that stimulate the hydration of the skin, can be produced. These restore the barrier function and thus the permeability of skin, cell cohesion, cycling pattern and anchorage. Newer molecules are being tested and a lot of research is also being done on Indian herbs. Once one starts noticing age-related changes, one needs to adapt quickly and make required changes in diet and lifestyle, better management of stress, and do regular exercise to slow or delay the inevitable. One must be aware that ageing is a natural and inevitable process and medical advice should only be sought when skin changes are particularly troublesome or severe. One must try to control excessive exposure to extrinsic factors and age
gracefully. The writer is chief dermatologist and dermato-laser surgeon, National Skin Hospital, Panchkula
Pros of skin surgery Improved self-image
Cons of skin surgery Expenses Over-reaching expectations Sometimes a person tends to imagine a complete overhaul in his/her image and feels that the cosmetic procedure will make him or her look like their favourite actor/actress or what they have visualised. This kind of patient will always feel dissatisfied after the procedure. It is very important to talk to your surgeon beforehand to know the minimum or the maximum that can be gained from the cosmetic procedure being followed. Regardless of your situation, in the end, the person you see in the mirror each morning is you. So just do not go by the advertisements claiming a complete overhaul of your image. If you are considering some kind of cosmetic procedure, make sure you do it with an open mind, be aware of realistic expectations, complications, expenses and the downtime.
Skinsurance Every skin procedure, surgery and laser process from the most minor to the major treatment carries some type of risk. Patients may misunderstand or worse, disregard doctor’s instructions and complicate or halt their recovery time. Improper wound care or poor hygiene can lead to infections that can possibly be even life-threatening. Undertaking too many surgeries in too short a time can also cause the body to react to anaesthesia. Allergies can develop. Circumstances can change, leaving a patient in the middle of multiple-step procedure that cannot be completed. Because of unknown factors, it is important to think very carefully and follow guidelines strictly about any skin procedure, laser and surgery, especially when it is a cosmetic in nature.
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THE realisation about an ageing skin on an average starts at around 30-35 years, and then it grows by leaps and bounds. While the appearance of fine lines, deepening of under-eye and naso-labial folds and loosening of skin starts gradually in some people, in others, it is much more rapid. As nobody likes to lose their youth, some people tend to press the panic button quite early on and start using anti-ageing products. They even opt for various cosmetic procedures, without even knowing much about the effects of the particular procedure. 
Removal of scars, bumps or other symptoms of acne. For an acute sufferer of acne, it can be a major confidence-shattering factor; in many cases, it can become a devastating condition that leaves the sufferer with deep scars, red patches and ultra-sensitive skin. Micro-dermabrasion, laser therapy and other skin surgeries can remove some of these problems, leaving the skin smoother, more even in colour and less sensitive. For people in the glamour industry, wrinkles, creases or discoloration can sound a death-knell for their career. Models, actresses and others in the public eye have to maintain a certain level of youth and beauty, and, therefore, are more likely to opt for some cosmetic procedure. But by no means, they are the only ones who do so, as many more common people, too, opt for various cosmetic procedures. However, anything a person can do to make himself or herself feel better about their looks should be an individual choice.
In many cases, skin laser surgeries are deemed to be cosmetic and elective procedures and will not be covered by an insurance policy. If this is the case, the patient must factor in not only the cost of the procedure itself, but also the cost of the consultation and follow-up visits, the medicines and the time he/she will be expected to take off from work. In some cases, these can be outpatient procedures, but in others one can expect to be out of commission for at least a week or much more.