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Pathribal killings
Afghans depend on India
Online and vulnerable |
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The unhappy Indians
Reasonable anger
UNDERSTANDING AIDS
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Pathribal killings THE Supreme Court has asked the Army to decide in eight weeks whether it wants to court-martial its officers and jawans involved in the killings of five civilians at Pathribal in Jammu and Kashmir or let them be tried by a criminal court for which the CBI would seek the Centre’s sanction in four weeks. According to the CBI charge-sheet, five Kashmiris were picked up randomly in Anantnag and killed in cold blood by the accused a few days after the massacre of 36 Sikhs by terrorists at Chittisinghpora in March 2000. The setting of the deadlines shows the Bench of Justice B.S. Chauhan and Justice Swatanter Kumar does not want the case to again get caught in procedural delays. The fake encounter took place 12 years ago and justice has still not been delivered to the families of the victims. Given the gravity of the case, the Army itself should have conducted an inquiry and proceeded against its soldiers, if found guilty. However, the CBI had to do the job and expose attempts made to cover up the crime and mislead the investigation. The CBI, which filed the charge-sheet in a Srinagar court in 2006, maintained that no sanction was required to prosecute the accused under the AFSPA (Armed Forces Special Powers Act) as the murders were not committed in the discharge of their official duties. The Supreme Court has not accepted its argument and directed that Central permission would be necessary for a judicial trial. It is true the security forces work in a hostile environment. In the fight against terrorism innocent blood too gets shed. This has happened in Punjab, the North-East and Naxalism-hit states apart from Jammu and Kashmir. The AFSPA has been imposed in militancy-affected states to enable security men to carry out their difficult operations without being hauled up for every deviation from the approved practices. But the Army cannot condone deliberate violations of laws. A fair and fast justice system sends across the larger message that, barring aberrations, the innocent are not targeted and the rule of law is upheld, regardless of the enormity of the challenges.
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Afghans depend on India THE Hamid Karzai government in Kabul is leaving nothing to chance about how to manage the situation that will emerge after the US-led multinational forces withdraw from Afghanistan in 2014 as scheduled. The war-torn country has an army of over one lakh troops and officers, besides a big police force, but they are neither properly trained nor well-equipped to take on the Taliban. That is why Afghanistan has been keenly looking for India’s assistance to prepare the Afghan forces for the post-2014 scenario. India, being an all-weather friend of Afghanistan, entered into an agreement with Kabul in October last year to set up a strategic partnership council to help it in security-related matters. The council has now formally come into being with Afghanistan asking for not only training facilities for its forces but also the required equipment to make the Afghan troops confidently fight the extremists. India is already helping Afghanistan in infrastructure development, including the laying of power transmission lines, construction of hospital and school buildings, etc. India’s Border Roads Organisation has constructed a strategically significant highway in Nimroz province, connecting Delaram to Zaranj. The road connects Afghanistan to Chabahar port in Iran. The Delaram-Zaranj road is part of a strategy to make Afghanistan less dependent on Pakistan for its economic growth. While New Delhi’s assistance to Kabul in the latter’s rebuilding programme has endeared India to the Afghans in general, various Taliban factions have been trying to mislead the ordinary Afghans about India’s role in their country. These extremist forces may try not only to challenge the writ of Kabul in the insurgent-dominated areas but also pose a security threat to the nearly 4,000 Indians engaged in various infrastructure projects. Thus, it is in India’s own interest too to ensure that the Afghan forces are properly trained and well-equipped to meet any challenge that may be posed by the Taliban. Training the Afghan troops and equipping them with the latest weapons is, in fact, the responsibility of not only India but also the rest of the world in the interest of peace and stability in the region. It would be good if the Afghan troops are in a position to defeat the enemies of peace without taking the help of any third country.
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Online and vulnerable THE arrest of a five-member group of technically sophisticated criminals who used electronic equipment to skim and clone credit and debit cards of people in various parts of the country has again exposed the need for more security in the execution of electronic financial transactions. The latest scam, for which these persons have been arrested from Hyderabad, is one in a growing number of such cases seen in different parts of the country. Many involve credit cards, others even debit cards used by customers to access their bank accounts. Sometimes, phishing attacks are used to lure customers to various websites where they give out their credit card details, which are then used to take money from the users’ funds. Union Communications and IT Minister Kapil Sibal only recently informed Parliament that cyber crimes were on the rise in India with a total of 966 such cases reported under the Information Technology Act in 2010. Of course, many other cases that involve cyber crime are booked under various sections of the Indian Penal Code, and, as such, the number of such crimes is much higher than these figures reflect. Union Home Minister P Chidambaram recently quoted the US-based Internet Crime Control Centre which puts India at No 5 in the number of cyber crimes. Cyber crime in India is going up at the rate of 50 per cent per year. While people at large have been slow to adopt technology in their day-to-day lives, there is no doubt that technology in general and information technology in particular is a great enabler. However, what is done with its help depends entirely on how people use it. Criminals have shown a great propensity to adopt it for their nefarious activities. In doing so, they especially target the technically challenged and thus most vulnerable sections of society. There is no doubt that the government needs to take proactive steps, like setting up more much-needed cyber labs, sensitising the police to cyber crimes, and providing information with which the general public can remain vigilant and protect itself. People who use credit cards and other financial instruments that involve computers too need to be careful, and to remember that they are the first major of the line of defence against cyber criminals.
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The real problem is not whether machines think but whether men do. — B. F. Skinner
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The unhappy Indians
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recent Gallup poll has revealed that 240 million or 30 per cent Indians are unhappy with their lives and are ‘suffering’ instead of ‘thriving’ or ‘struggling’ as compared to 24 per cent last year. Gallup ranks people according to how they view their current and future lives on a scale of 0 to 10. Those who rate their present life at 7 or higher and their lives five years hence at 8 or higher are ‘thriving’. People who view both dimensions at 4 or below are considered ‘suffering’. In between ratings are termed ‘struggling’. Most people who are suffering are also the least educated. Education undoubtedly holds the key to prosperity and people thriving. People with a low level of education obviously feel insecure as they cannot switch jobs easily and are stuck in a vicious cycle of poverty. Moreover, burdened with rising food prices, bringing up children becomes more cumbersome. Thus, even though the Right to Education Act ( 2009) has been one of the best reforms so far and, according to the government’s Economic Survey, has resulted in 95 per cent enrollment in schools, the problem arises regarding the quality of school education. India has a much smaller number of students going from primary to secondary education, and gross secondary enrolment is 57 per cent which is less than many countries with the same level of development. Even fewer students ( 13 per cent) go for tertiary or college education. It is difficult for children from poorer families to go even for secondary education because they face problems in primary schools doing home work and getting books, and as they also fall sick more often, their attendance falls. There is lack of incentive to attend school also because with an average of 40.7 pupils per teacher, there is hardly any individual attention. Hence once the child starts falling behind studies, he or she drops out. Children’s attendance declined from 73.4 per cent in 2007 to 70.9 per cent in 2011. Most children start helping as agricultural labour in villages or find menial jobs in towns. As compared to the semi-literate agricultural workers, blue-collared workers’ who are better educated have more options and better wages. Their suffering, according to Gallup, has increased by 4 per cent and white-collared, college-educated workers’ suffering has risen only by only 2 per cent. It is clear that to reduce the suffering, there is no better investment than education, specially the quality of school buildings, teaching and other facilities which are not improving at an even pace in all the 28 states. Since education is a state subject, many states have invested well and have achieved a good standard of teaching in primary and secondary schools. Unless primary schools are improved, children cannot go to the secondary level. Both primary education and secondary education are important for skill training of workers in the future, otherwise the demographic dividend that India is enjoying over China may turn out to be a big problem instead. Currently around 35 per cent of the labour force is not literate and by 2030, around 426 million youth will be looking for jobs in the labour market. They all will require employable skills and at least secondary education. A big incentive for children to go to school especially at the primary level is the mid-day school meal which is often their only square meal of the day. Also having girls’ toilets in the school premises is important for retaining girl students. Other attractions can be a playground, library, and computer training in the school premises. All these are important for encouraging children to go to school regularly and not to drop out. Regular attendance of teachers is also essential and separate classrooms for different classes. Putting two or three grades together leads to teachers not being attentive and children learning nothing and parents withdrawing children from schools. More than half the classes in rural India are multi-grade or mixed. Contrast the present state of primary and secondary education sponsored by the state governments with the private schools for the well-to-do children in towns and cities. They often have airconditioned class-rooms and school buses, holidays abroad and high school fees ranging from Rs 10,000 to Rs 14,000 a month. Private schools are flourishing all over the country despite the high fees they charge. From these top class private schools, students enroll into foreign universities easily. Even in rural areas across North India, 30 to 50 per cent children go to Private schools. Income inequalities in India are most prominently manifested in the way the rich educate their children. Indian students studying abroad are one of the largest in the world from any country and they spend Rs 5.9 billion or $ 113.5 million per year. Students with foreign degrees often get high paying jobs in the private corporate sector or in private universities when they return home. Service sector jobs, though lucrative, are accessible only to those with a secondary school education and who have a working knowledge of English. Low end service sector jobs like plumbers, janitors, guards, carpenters, construction workers and electricians are also growing but many require skills. Even with skill training, there may be a dearth of jobs because industrial expansion is not happening at a rapid pace and most of the expansion involves capital investment with fewer jobs being generated. Most job seekers who are without college education will have to be in the informal sector where they will be without a social safety net and will have to fend for themselves in the case of accident, illness or job loss. The future looks bleak for many such workers. No doubt, their angst about their life’s prospects and uncertainty about the future of their children is currently rising. It is indeed an inflammable situation and could trigger another
‘Arab Spring’. As long as the standards of school education differ by a wide margin between government schools and private schools, the elitism embodied in private school education will continue which will perpetuate income inequalities unless students from low-income families also have access to such schools. In this regard, the recent Supreme Court judgment, making it mandatory for private schools to have a quota of 25 per cent of students from the weaker sections even in state-unaided schools, is important and worth watching regarding its effective implementation. The state government is supposed to reimburse the private schools and also provide the students mid-day meals. This may bring about some amount of equity in the education system and reduce the future ‘suffering’ of millions of people. Meanwhile, the standard of education in government schools would have to be greatly
improved.
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Reasonable anger
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am notorious for my temper, and I know that most of the time my anger is unreasonable. Then last week I was angry with, what was definitely, reasonable anger. I returned home after a month and the bumpy potholed road almost caused my little Alto to break down. The other local roads that I travel on are just as bad. I reached home to find the house and all the surrounding area plunged into darkness. This is an everyday occurrence and I cope with it by ensuring that I have a plentiful supply of candles. There had been no water supply for the last 20 days – also a regular occurrence which compels me to buy tankers of water. Most of the time I live with these problems without protest. But today something snapped within me. I was consumed by an intense, burning anger. I was angry with the government for its failure. I was angry with the opposition for concentrating on Mr Bindal’s alleged misdemeanours and not making an issue of the difficulties in the life of the common man. I was angry with the Press which carried endless stories about the wedding of an old Sanawarian girl to the King of Bhutan and not a word about the woes of people like me. I was angry with the officers of the administration whose approach to these issues was a helpless shrug of their shoulders: the roads were not repaired because the centre had not released funds, the electric supply was erratic because the transformer at Garkhal was old and constantly broke down, the water supply was non-existent because the old pipe line burst at least once a month. They smiled indulgently; it was all beyond their control. Most of all, I was angry with the statisticians who unfailingly listed Himachal Pradesh as one of the most developed states in the country. Then I realised that all these individuals probably had their town tube-wells, their own generators and vehicles with suspensions so good that they felt no bumps or jolts when they rode over our terrible roads. For them these problems did not exist. I had met Anurag Thakur a couple of times and knew him to be a well-meaning young man. Unable to sleep, I lit a candle and sat down to write to him — he would do something. When the morning light filtered through the windows, the floor was littered with crumpled sheets of paper — incomplete letters to Anurag. My simmering anger had turned into a cynical realisation: no purpose would be served through this letter. It would find its way into an obscure file which would afterwards be misplaced. But I also knew that I had to do something. I couldn’t get a generator or a bore. So I did what I was most competent at doing: I wrote this middle. I know nothing will come of it, but at least my anger has been stilled and I can live again with packets of candles and tankers of
water.
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UNDERSTANDING AIDS
Exactly how the HIV was first transmitted to humans is not definite but a commonly accepted explanation lies in the African practice of hunting and butchering chimpanzees. Probably a form of virus not harmful to these non- human primates, simian immunodeficiency virus (SIV) was transferred to humans while hunting or dressing a kill, or by eating uncooked contaminated meat and then by multiple mutations over a period of years, it became infectious to humans and is now termed as Human Immunodeficiency Virus (HIV).
HIV is different from AIDS HIV infection generally progresses through various stages and weakens the immune system significantly. The most severe stage is termed as Acquired Immunodeficiency Syndrome, or AIDS (the condition of lowered immunity caused by the virus). HIV is the virus that causes AIDS but this progression to AIDS may be preceded by a period during which the person may or may not have symptoms (average around eight to nine years for adults). The introduction of highly active antiretroviral therapy (HAART) halts the progression of HIV infection to AIDS stage. And it is now possible for someone with HIV infection receiving HAART to live for years without developing full-blown AIDS. The success of HAART has helped to destigmatise the HIV, and it has now come to be recognised as a chronic manageable disease.
How is it contracted The highest concentration of the HIV in the body is found in blood, semen and vaginal secretions. So, any contact with these bodily fluids from an infected person may be a route of transmission. This includes heterosexual or same-sex contact with an infected person, as well as sharing of used needles. HIV is also present in sweat, saliva and tears but in very small concentration and there is no documented evidence of transmission through these body fluids. The most common modes of transmission of HIV are: unprotected sexual intercourse with an infected person, injecting drug (sharing needles), blood transfusion and mother-to-child transmission
Affects on the body Patients recently infected with the HIV may experience symptoms of acute retroviral syndrome. Some of the common symptoms during this phase are fever or flu-like symptoms, rash, mucocutaneous ulcers, oropharyngeal candidiasis etc which will later settle down. The mean time from suspected exposure to appearance of these symptoms is two to four weeks. After this there is a long asymptomatic phase where a person may be totally healthy or may have certain mild illnesses. As the HIV infection progresses, it weakens a person’s immune system and the person starts falling ill with diseases that a healthy person will be able to fight.
Diagnosis A person has HIV if there are detectable levels of the virus on a blood test, or (with the exception of babies born to HIV-positive mothers) a positive blood test for antibodies (infection-fighting proteins) against the virus. The criteria for HIV diagnosis is slightly different in infants because HIV antibodies can be passed to the baby from mother before or during birth, but the infant may not actually be infected with the virus. The earliest time when the HIV status of a person can be ascertained is between seven and 12 days from the suspected date of exposure by fourth-generation enzyme linked immunosorbent assay (Elisa) test but should again be confirmed at three months through a rapid HIV test kit.
Symptoms It is possible to live with HIV infection for years, without any significant related symptoms. Some of the more frequently seen symptoms are significant weight loss, prolonged fever, unexplained fatigue, recurrent diarrhoea in the absence of any other illness that may cause these symptoms. The two factors that indicate the severity of infection are; a decrease in the CD4 ((cluster of differentiation 4) cell count and the presence of one of the AIDS-defining illnesses. The most common are cryptococossis (fungal infections), TB, pneumonia, candidiasis, herpes etc.
Treatment For HIV treatment, a combination of three or more antiretroviral drugs (ART) is given and the therapy is called highly active antiretroviral therapy (HAART). These drugs prevent the virus from multiplying inside our body. As a result, fewer CD4 cells are destroyed and the body’s immune system is maintained. However, the virus also mutates quickly and becomes resistant to medicine. It is, thus, essential that the treatment regimen for HIV contains three or more drugs. Besides this, the adherence of more than 95 per cent is essential for the drugs to act optimally and prevent the emergence of resistant strains of HIV in the body. These drugs only contain the multiplication of the virus, and hence minimise the attack on the body’s immune system thereby improving longevity and quality of life but not cure the HIV as the virus is known to persist in certain sanctuaries like lymph nodes and brain.
Side-effects Some common side-effects of HAART are nausea, vomiting, diarrhoea and headache. Some drugs may also cause abnormal dreams and difficulty to concentrate. However, most of these are not serious and improve in the first one or two months.
First-line & second-line ART The initial combination of ARV drugs taken to treat HIV is called first-line ART. When this combination of drugs is not able to contain the multiplication of the virus, then another combination of drugs is started (from different class) and this is called second-line ART. A person can be stable on first-line regimen for around eight to 10 years if taken as per instructions from the doctor (primarily adherence >95 per cent).
Post-exposure prophylaxis for HIV Post-exposure prophylaxis (PEP) for HIV refers to measures taken to prevent infection in a person, who may have been exposed to HIV infection. The various measures include first-aid care, counselling and risk assessment, followed by initiation of short-course ART, if required. The PEP is a combination of two or three ARV drugs and should be initiated as soon as possible but definitely within 72 hours from the suspected time of exposure. The treatment has to continue for 28 days. During this period, the person may suffer from various side-effects like diarrhoea, vomiting, headache and
myalgia.
Government initiative The Government of India has set up around 9,500 integrated testing and counselling centres (ICTCs) across the country where free of charge HIV testing is done with confidentiality. Besides this, there are 340 ART centres (HIV treatment centres) across the country where investigations and ART is provided free of charge to all the patients. Currently 4,87,000 patients are receiving free ART at these
centres. — The writer is Senior Lecturer, Public Health Foundation of India, and Technical Consultant
(Care, Support & Treatment), National AIDS Control Organisation, Government of India Dr Sudhir Srivastava, writer of “When robot plays surgeon”, is the Chairman, CEO and Managing Director, International Centre for Robotic Surgery, New Delhi. He is not the Chairman, CEO and Managing Director, Fortis Healthcare, as was inadvertently mentioned on April 25, 2012.
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IGMC, ARTC , Department of Medicine Opposite Blood Bank, Shimla