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Strike: What for?
Antony’s visit to Arunachal
Reviving Indian hockey |
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Much ado about nothing
In another world
Relief for renal patients
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Strike: What for?
Tuesday’s
countrywide strike organised by 11 labour and employee unions met with partial success, unsettling transport and banking services in particular. One can understand if low-paid workers protest against rising prices or excesses of the management or demand better wages and working conditions. The labour laws recognise the right to strike under certain conditions. Dissatisfied workers have the right to take their dispute to labour courts. But what is it that is common among factory workers, bus drivers, postal employees and bankers? Some are fairly well paid and they have joined hands only to show their disruptive power. This was the 14th general strike since the economic reforms began in 1991. The Left and others opposed to reforms are free to voice their dissent in a peaceful way. India as a democracy allows them enough space. Elections provide the voters an opportunity to overthrow a government whose policies they disapprove of. But a minority cannot dictate terms, disrupt normal life or indulge in unlawful activities to forcibly have its way. There is almost a political consensus on economic reforms, which have pushed India’s growth rate from 2-3 per cent to 7-9 per cent. If the agitating workers and employees have rights, so do people at large – the right to free movement to carry on with their day-to-day life. A shutdown brought about by the use or threat of force is illegal and courts have ruled against road/rail blockades. Times have changed. A vote is seen as a more reasonable weapon to bring about change than a strike. Companies, banks and institutions compete not only among themselves within the country but also with rivals outside. A whole new generation has emerged which is furiously working to raise living standards and is intolerant of disruptions and dislocations. Given the cost of agitations and loss of productivity caused by a disgruntled workforce, managements have to strengthen their internal dispute settlement mechanism and make their work culture congenial for growth. It is important to adopt global management practices. Rules of the game have changed and the socialist era is over.
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Antony’s visit to Arunachal
IT is condemnable that China continues to raise objections over the visits of Indian dignitaries to Arunachal Pradesh. Defence Minister A.K. Antony has done well to forthrightly describe China’s stand as “most unfortunate.” Visits of Prime Minister Manmohan Singh and President Pratibha Patil had in the past evoked similar responses and India cannot but be concerned over Chinese imputation that India is “complicating” the border dispute with such visits. Arunachal is an integral part of India and it is preposterous for Beijing to describe it as “southern Tibet.” Mr Antony had recently gone to the State to celebrate a quarter century of its statehood. That was as it should have been. The two sides had signed an agreement in 1993 on maintaining peace and tranquillity along the Line of Actual Control, as the frontier is termed, an agreement on confidence building measures in the military field in 1996, a protocol on the modalities for implementing these in 2005 and a memorandum of understanding in 2006. In such circumstances, it is wrong for China to take a threatening position when the channels of communications are wide open between them. Significantly, the latest Chinese statement has come on the eve of the Chinese Foreign Minister’s visit to India for bilateral talks. If anything, India has reason to be aggrieved with China over the manner in which it has been positioning its troops in the Gilgit-Baltistan region of Pakistan-occupied Kashmir. That it has taken de facto control of the region is a measure of how the Chinese are making insidious attempts to establish bases at our doorstep in collusion with Pakistan. Not only must India be on its guard, it needs to make it clear to China that India views this as an unfriendly act. It is apt that of late India is engaged in strengthening its defences and infrastructure in Arunachal bordering China. That process must continue on a solid footing so that the Chinese are deterred from indulging in any military misadventure.
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Reviving Indian hockey
Seemingly
the fittest Indian team in a long time, the men’s hockey team has restored some of the country’s lost pride by qualifying for the London Olympics, scheduled for July this year. India in any case was the favourite in the qualifying round and was expected to sail through. But the authoritative manner in which the team played was certainly unexpected. After a long time, an Indian team was seen playing attacking hockey, scoring field goals and converting penalty corners. Although the opposition was weak, the Indian team admirably did not lose its focus and scored as many as 44 goals in five matches. Even more creditably, 23 of those goals were field goals. In the final against France, the two teams earned seven penalty corners each. But while France failed to convert a single one of them, the Indians succeeded in converting six into goals. However, the Indian coach has rightly sounded a note of caution. It is at best a good beginning and the team has a long way to go, he said. Preparing a team for the Olympics takes several years but the new coach and his team were allowed barely 10 months to deliver. It would, therefore, be unwise to expect a miracle in London. European players have a bigger build and are speedier than the Indians. They are also able to think better on their feet and switch strategies during the run of play. Their ability to launch swift counter attacks and bottle up the Indian forwards by tight marking can hardly be under estimated. The decision, therefore, to prevent the probables from playing in the World Series Hockey, the ambitious tournament fashioned on the lines of the Indian Premier League in cricket, is possibly the right one. Clearly, the coach and the support team cannot afford to lose more time or risk injuries to players. But having said that, the unhealthy rivalry between Hockey India, recognised by the Federation of International Hockey, and the Indian Hockey Federation, backed by the sports ministry and which is organising the World Series, needs to be quickly resolved. Players like Arjun Halappa and Rajpal Singh, banned for favouring IHF, should not pay for the ego clashes between administrators.
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Imagination is the wide-open eye which leads us always to see truth more vividly. — Christopher Fry
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Much ado about nothing TWO “crises” that rose to a crescendo of Opposition and media fury last week concerned the government’s alleged “decisions” to curb the powers of the Central Election Commission and further to “undermine federalism” by moving to establish a National Counter Terrorism Centre. These are prime examples of national frivolity with sections of the media setting up a bogus agenda by reading all manner of sinister conspiracies into “facts” that could have quite easily been investigated and put in perspective for rational consideration and debate. First, on February 21, leading 24x7 channels and newspapers got hold of a secret Agenda note for a GOM (Group of Ministers) meeting the following day “to consider measures that can be taken by the government to tackle corruption”. How did this confidential Cabinet committee paper leak and who leaked it and to what end? Everything seems to leak selectively with impunity and immunity -- CAG reports, commission of inquiry reports, SIT reports, you name it –and is published/broadcast with a bias that grabs the headlines, often out of context, and focuses debate on non-issues or side issues at the cost of the main thrust of the document at hand. Initially subjective pronouncements in turn tend to thwart objective debate as the facts are not as sensational as the myths created around them. This kind of media-Opposition hype tends to feed on itself and hijacks cool deliberation and stymies decision-making. The cry of freedom of expression is then mouthed to justify discussing complex and delicate issues in the marketplace through the intermediary of all manner of busybodies. This is a dangerous tendency that could make India ungovernable. The GOM agenda note in question suggested that the Law Ministry “may also look into (and report on) aspects where executive instructions of the Election Commission were required to be given statutory shape”. Further, was the CEC’s model code of conduct an “excuse” to stall development projects? The GOM, let alone the Cabinet, were yet to discuss the issue. Yet, the Law Ministry was charged with seeking to curb the powers of the CEC which, among other things, bars new policy pronouncements by incumbent governments in the form of populist freebies or “bribes” to woo the voter once elections are announced. No decision had been taken or implied that the grant of statutory powers would curtail the CEC’s jurisdiction in favour of the government. These statutory powers could well be exercised by the CEC itself, an option supported by T.S. Krishnamurthy, a former CEC. Consider an example. In Punjab, as many as 201candiates who stood for election in the January 30 Assembly poll have responded to Election Commission notices admitting having paid broadcast channels or newspapers for election coverage. They have now reportedly agreed to file these “paid news” outlays as part of their election expenses. Other cases are being investigated. Is this sufficient punishment to stamp out a rampant evil in which the media, election candidates, political parties - and still others in other cases – subvert elections, the law and freedom of expression to undermine democratic governance? The only other power the CEC has is to refer such cases to the tax authorities to follow the money trail on both sides and take action in case of default. However, were the model code to have statutory backing, exemplary punishment could be awarded both to the guilty candidate and his/her party and to the channel or newspaper concerned. Penalties could extend by law to disqualification of the candidate for seven years, a fine on both the party and the media outlet equivalent to 10 times the outlay on “paid news”, and a public apology printed and broadcast at prime time or on page 1 for commission of a public crime both by the media house and the party concerned. Specious pleadings can be made about vicarious liability and lack of proportionality; but the murder of democracy demands no less a sentence. Will the CEC be weaker and the elections less credible for such a reform? Why is this not discussed in editorials, 24x7 panel discussions and in party councils? Next, take the bogey about the threat to federalism from the government’s move on the NCTC? The NCTC was sought to be established by an executive order under the Unlawful Activities Prevention Act, 1967, and made a wing of the Intelligence Bureau. It is possible the government did not consult all concerned or early enough. After “federalist” protests by seven Chief Ministers, the PM asked the Home Minister to conduct a fresh round of consultations to establish a broad consensus. The essential point, however, is that countering terrorism cannot be left to individual states. Intelligence gathering and analysis, investigation and liaison with foreign agencies in cases of cross-border crime must be coordinated and calibrated across state jurisdictions. The case for a Central authority is patent as virtually all CMs have admitted. The existence of a NCTC will not militate against the police powers of the states. Even in dealing with the Naxal movement and insurgencies, it has been found necessary to have a unified command by whatever name so that dangerous elements do not slip through discrete and, sometimes, discordant jurisdictions. This arrangement can perhaps be tidied up but basically has no bearing on federalism. A number of CMs have in this case come together in a misalliance, based on mistaken premises, in order jointly to confront the Centre. This is a manifestation of partisan politics for collateral gain and not a cogent platform for better governance in the name of injured federalism. Strange that an astute lawyer like Arun Jaitley reportedly argued that India has a federal structure and is not a Union of States! He needs to re-read Article 1 of the Constitution. Three others issues last week merit attention. First, the Supreme Court had harsh words for the Centre for unconscionable delays in disposing of mercy petitions. An 11-year delay in one case had led to the condemned prisoner suffering a “slow death” every day. A norm should be laid down that any mercy petition not decided in three months should be taken as affirming the death sentence. Delay has politicised the matter in cases such as that of Afzal Guru. The second relates to the former Civil Aviation Minister’s daughter and family demanding to fly business class Bangalore-Male-Bangalore by Air India. The airline thereupon felt compelled to switch to a bigger plane both ways to accommodate these VIP passengers, resulting in over 100 seats remaining unfilled. AI Board members and civil aviation top brass and their families have cost this highly pampered national airline dear even as its losses mount. Such freebies must end. Pomp must yield to performance. Finally, the Kakodkar Committee has castigated the Railway Ministry’s unwillingness to raise fares in order to avert bankruptcy of this vital PSU and upgrade its services and safety standards. A string of irresponsible and populist Railway Ministers must own prime responsibility for the mess. As argued earlier, it is time to scrap the Railway Budget and subject the Indian Railways to the purposes and discipline of the national
exchequer.
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In another world
I
confess to feeling some pride when people ask me how one felt to be a student at Trinity College, Cambridge. It was in the late nineteen eighties that I was both overwhelmed and daunted by the prospect of studying at Trinity. Nothing had prepared me for the distinction of the place as I crossed rooms which had once been occupied by Nehru, Byron and Wittgenstein or sauntered by Newton’s famous apple tree. The list of Trinity Nobel laureates and prime ministers, poets and historians is endless. Such is the ambience that ghosts of great men and women can never quite be shaken off. My first year at Trinity exposed its opulence: I was lucky to be allotted rooms at the Blue Boar Court that had recently been raised at the staggering cost of 30 million pounds. Alongside this, came the beneficence of the Trinity bed makers—kindly ladies who cleaned bathrooms, vacuumed rooms and, of course, made your beds. Such luxury was rare in other Cambridge colleges. I remember a birth anniversary when my “bedder” baked me a cake and decorated my staircase, gestures I will always cherish. Would such kindness be ever part of an Indian hostel, I wonder. Then, there were the omnipresent porters—certainly not to be compared with the Indian “coolie”. They were posh gentlemen, always in formal suits, who kept a strict vigil over the college and had the prerogative to prevent even the Master from entering the gates. The porters never used your first name: it was always “Miss Sethi” unless, in a moment of bonhomie, they would boom a “Hello Darling” to your pleased ears. In the year 1990, as I cycled across New Court, I was signalled by the porter on duty to immediately dismount as cycling was prohibited on the premises. It amused me that Prince Charles (who also went to Trinity) had been reprimanded in the same fashion by a porter in 1967 but refrained from getting off his bike, continuing to ride at breakneck speed into Queen’s Avenue which is owned by his mother. Alas, I had no such royal lineage to protect me. I often had the opportunity, however, to meet British royalty. Not only was Trinity regularly visited by the Queen, Prince Edward, Princess Anne as well as the late Princess Diana (who arrived magnificently in a bright red helicopter as I was jogging one morning), my next door neighbour also happened to be the Prince of Jordan. One evening, during ramadan, on finding my sink full of dishes (we shared the same kitchen), he did all the washing up. Such was his etiquette towards a “commoner”. Studying at Trinity was indeed an experience: one still reminiscences about the May Balls, punting on the river Cam, the music recitals by the Trinity College Choir amidst the serene Backs, and the Great Court Run which is performed by students in tune with the chiming of the seventeenth-century clock on the day one matriculates. When I later moved to the University of Oxford as a Fellow, I was a victim of divided loyalties. On the occasion of standing on Putney Bridge in London watching the famous boat race between Cambridge and Oxford, I was in a dilemma who to cheer. It dawned on me then that no matter which team I supported, I would always be on the winning side. The stories are endless and experiences myriad. Many years later, at a social gathering in India, I came face to face with Mani Shankar Aiyar, to whom I was introduced as a “Trinity Woman”. When he said that he too had studied at Cambridge, it was natural to ask him: “Which college?” to which he replied: “That shack next to yours.” He was obviously referring to Trinity Hall, by no means a “shack”, but certainly not as prosperous as its affluent
neighbour.
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Relief for renal patients
Laparoscopic surgery Laparoscopic surgery is also known as minimally invasive surgery (MIS), or keyhole surgery. It is a modern surgical technique in which operations in the abdominal area are performed through small incisions as opposed to larger incisions needed in laparotomy. Laparoscopic surgery is performed using most modern specialised surgical instruments in which the surgeon puts in a camera in the patient's abdomen and operates upon the different organs situated inside. Laparoscopic operations are performed through very small incisions, hardly five mm to 10mm, which result in minimal scarring, and are extremely comfortable for the patient. This technique involves placing a small, high-definition camera through a small incision, which is used during the entire operation. The scar of this incision fades away in six months. The advantage of using a high-definition camera is that it gives an immensely crystal-clear view inside the body so the operation is done with extreme precision and can also reach areas, which are difficult to reach during open surgical operations.
Advantages Laparoscopic surgery evolved during the 1990s. Gall bladder and appendix operations were the earliest to be done by this technique. Before this technique came into being, most gall bladder operations were done using traditional open surgery method in which there was a long incision over the front of the abdomen. The greatest advantage of laparoscopic surgery is that it requires a very small incision for complex high-end surgeries. This becomes specially important in urological operations. A traditional open surgical incision in the kidney requires cutting open of the strong muscles of the back as well as of the stomach on the front. Since this incision stretches from the back on to the front, the length of the traditional incision is usually between 20cm to 30cm. Since it requires muscles being cut open, it is very painful for the patient. The traditional method also requires cutting of the 12th rib to expose the kidney, which makes it even more painful. In laparoscopic urological surgery, all these problems are avoided since the incision is usually 2 cm-3 cm in most of the kidney and ureter operations. After laparoscopic surgery the patients require fewer painkillers and the incision heals nicely. Since the incision is small, it never leads to development of hernia in future. Another advantage is that the patient starts eating early after the operation and there is less bleeding, so usually blood transfusion is also not required in almost all cases. After the surgery, the patient usually goes back home in two days and can resume his routine or can join work after a week. In open surgery, since the incision is long, it took more time to heal, so usually the patients were discharged after four to five days and could not resume work even after two weeks. In fact, the actual healing of the incision takes around six weeks to six months. In case of laparoscopic surgery, the main advantage for the surgeon is that with the help of the high-definition camera, the vision is clear and the field of vision is extensive. In open surgical operations, vision gets limited in the peripheral areas, so laparoscopic surgery is better in that respect, too. Today, almost all leading specialist centres such as the AIIMS, New Delhi and PGIMER, Chandigarh, are using laparoscopic surgery for most kidney operations.
Other operations Nowadays, most of the abdominal operations are done laparoscopically, with the removal of the gall bladder being the most common. Almost all abdominal operations, which were earlier done by open surgery such as removal of the uterus, ovaries, intestinal operations, stomach, liver, spleen etc, are now done laparoscopically at most specialist centres. Surgery of kidneys is a super-speciality surgery and requires high-end laparoscopic instruments and expertise.
Treatment for other
diseases Treatment for almost all diseases of the urinary system such as the kidneys, ureters, urinary bladder, prostate and the urethra can be done by using either endoscopy or laparoscopy. Hardly five per cent of ailments of the kidney require open surgery in the present scenario. Various operations of the kidneys, which are done laparoscopically, include removal of kidney tumours or cancers, removal of kidney, ureteric or bladder stones, all kinds of obstructions in the kidney such as pelvi-ureteric junction obstructions and strictures, all kinds of kidney cysts, including the infective Hydatid cysts and removal of the hydronephrotic or non-functioning kidneys due to stones, obstruction or infections. Similarly, operations of the removal of the prostate can also be done endoscopically or laparoscopically.
Common symptoms Symptoms include poor flow of urinary stream, urine coming in drops, not able to empty the bladder completely, feeling of straining while passing urine, going for urination again and again and getting up several times in the night to pass urine. Many a time, patients may have a strong desire to pass urine but they are unable to do so. At times, they may even have a severe urgency to pass urine but they pass only a few drops. They may also have blood or pus in urine and can feel pain when they are voiding. Other symptoms suggestive of kidney diseases include pain in the sides of the abdomen, fever with burning in urine or passing less amount of urine. Usually a healthy person should pass around 1.5-2.5 litres of urine in a typical day. The urine output may start going down slowly and the patient may be completely ignorant about it until it falls to less than half a litre in a day. Other features of advanced kidney failure include swelling of the body and the eyes and difficulty in breathing.
Kidney diseases
in India A variety of urological problems occur with rising incidence in this part of northern India, especially various kidney cancers. Most of the kidney tumours detected now-a-days are in asymptomatic healthy individuals. The tumour is detected incidentally when people undergo
an ultrasound routinely for some other purpose. The other most prevalent disease is kidney stones. Due to a variety of lifestyle changes, the incidence of kidney stones is on the rise. Even many children are getting affected by kidney stones. If stones are formed in individuals less than 30 years, they have a high chance of stone formation even after the
treatment. Such patients should undergo detailed blood and urine tests to find out why stones are being formed repeatedly.
Treatment of
kidney cancer The treatment of kidney cancer has undergone a sea change in the last decade due to various advances in imaging, laparoscopic surgery and medical management. Now about a third of kidney cancers are detected during routine ultrasound but only incidentally. Most of the early kidney cancers can be radically treated by minimally invasive methods such as laparoscopically or retroperitoneoscopically. The patient's recovery is hastened and he/she goes back home with a minimum scar. Laparoscopic surgery provides the best cancer control, gives minimum discomfort to the patient as the patient becomes ambulatory the same day surgery is done.
Retroperitoneoscopic
surgery Reteroperitoneoscopic surgery is the most modern technique of laparoscopy, utilised mainly to treat kidney diseases. In this type of operation the discomfort to the patient is even less than traditional laparoscopic surgery. In this operation, the patient can get up from the bed on day one and can start eating right from the first day after the surgery. In this technique the kidneys are approached directly so there is enhanced patient comfort after the surgery.
Transplant operation Since the person donating his/her kidney is an absolutely healthy
person, so doctors prefer to do the operation laparoscopically to avoid problems in future. The
incision heals relatively smoothly and since no muscles are cut the donor can do whatever he/ she wants after a week of surgery.
Recovery time The recovery in most cases is usually fast. The scar of surgery is barely visible after a year of the surgery. The writer is Endourological, Laparoscopic and Kidney Transplant surgeon, Fortis Hospital, Mohali
Advantages of laparoscopic surgery
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Reduced haemorrhaging, which reduces the chance of needing a blood transfusion.