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EDITORIALS

Where is the change?
Punjab FM avoids hard decisions
I
N a departure from the past the youthful Punjab Finance Minister Parminder Singh Dhindsa has proposed in his maiden budget a 10 per cent cut in ministers’ allowances, a ban on the purchase of new vehicles and a reduction in fuel and office expenses.

Verdict shakes Pak govt
Judiciary-executive tussle deepens
I
N the ongoing battle for supremacy between the judiciary and the executive in Pakistan, the former appears to have gained the upper hand at this stage.

Toxic existence
Cancer in Malwa ignored too long
A
visit by the Parliamentary Standing Committee on Agriculture to Bathinda areas, particularly Jajjal village, has stirred high emotions among Malwa residents and activists raising their voice against cancer — a disease estimated to afflict 120-125 persons per lakh in the area, against the national average of 71.


EARLIER STORIES

Rescuing troubled EU
June 20, 2012
Greece poll outcome
June 19, 2012
Pranab – right choice
June 18, 2012
The naysayers
June 17, 2012
Think beyond paddy
June 16, 2012
Disgraceful power play
June 15, 2012
Siachen dialogue
June 14, 2012
Junking India
June 13, 2012
Violence-stained victory
June 12, 2012
Factionalism to the fore
June 11, 2012



ARTICLE

Discrepancy in Punjab figures
Ensure sanctity of the budget, at least
by Manpreet Badal
I
N his enthusiasm to pay profuse tributes to the Chief Minister and the Deputy Chief Minister, the new Finance Minister, Mr Parminder Singh Dhindsa, went on to describe the latter as “youthful and aspirational”. If a 50-year-old — twice the average age of this nation and state — is “youthful”, then by that token Mr Dhindsa, who I think is a good 10 years younger, should be in his adolescence.

MIDDLE

An early spiritual call
by Ravia Gupta
A
little chaos is needed in the soul to give birth to a dancing star…..”
Even before that alarming sound could wake me up from the deep slumber, I was up in the morning around 4 a.m. to promise myself a new me and had a word with the self that I shall shine today!

OPED — HEALTH

forgetful, not forgettable
The present number of 3.7 million patients suffering from Alzheimer’s and related disorders is expected to double by 2030. The cost of caring, estimated at Rs 14,700 crore, will increase three times. But new technology makes it possible to slow down the disease
Usha Rai
I
ndia has about 3.7 million persons suffering from dementia and this figure will double by 2030 to about 7 million persons. The number of persons with dementia doubles every five years and so India will have the largest number of elders with this problem. The cost of caring that has been conservatively estimated at present is Rs 14,700 crore.





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Where is the change?
Punjab FM avoids hard decisions

IN a departure from the past the youthful Punjab Finance Minister Parminder Singh Dhindsa has proposed in his maiden budget a 10 per cent cut in ministers’ allowances, a ban on the purchase of new vehicles and a reduction in fuel and office expenses. There are two more positives: fiscal deficit is tolerable and the outlay for greening Punjab has been raised four-fold. However, in keeping with the Akali-BJP politics of populism, the minister has left subsidies untouched. He has hinted at raising Rs 2,000 crore later in the year by slashing unproductive expenditure and ensuring better tax compliance. Cost-cutting and revenue raising efforts are unheard-of in Punjab, where ruling politicians commonly resort to borrowings and selling government assets to fund their lavish lifestyle.

Punjab’s major problems are slowing growth, low quality education in government schools and colleges, spread of debilitating diseases, mismanagement of water resources, freebies and fiscal indiscipline. All these have not been adequately addressed. Punjab’s growth rate is 5.68 per cent compared to Bihar’s 13.1 per cent. The state lags because industrial expansion is hit by poor power supply and a near absence of foreign direct investment. Agricultural growth is plagued by stagnation in wheat-paddy production. The budget has hiked allocation for agriculture by 52 per cent but more funds alone are not enough.

The government needs to take some really tough decisions: downsize the top-heavy administration and privatise or close down unwanted boards and corporations. The high cost of administration, political and bureaucratic profligacy and general fiscal mismanagement have placed the state under an unsustainable debt of Rs 78,236 crore, which will shoot up to Rs 87,518 crore by the end of this fiscal. The state needs to channel resources into three priority areas: health, education and infrastructure. But it refuses to adequately tax the rich, including builders, transporters, hoteliers, mall and marriage palace owners. Subsidies can be pruned by weeding out the undeserving. The budget does not reflect any enthusiasm to initiate change. Perhaps, the re-election has made the Akali-BJP leadership happy with the way things are.

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Verdict shakes Pak govt
Judiciary-executive tussle deepens

IN the ongoing battle for supremacy between the judiciary and the executive in Pakistan, the former appears to have gained the upper hand at this stage. Tuesday’s judgement of the Pakistan Supreme Court, disqualifying Prime Minister Yousuf Raza Gilani with retrospective effect (from April 26), provides fresh proof of this reality. As directed by the court, the Pakistan Election Commission has also formally declared that Mr Gilani has ceased to be a member of Parliament. Honouring the verdict, his party, the PPP, announced on Wednesday that a senior leader would replace Mr Gilani as Prime Minister in a day or two. This is in accordance with the wishes of the Supreme Court, which wanted the democratic process to remain unhindered.

Mr Gilani has suffered the loss of office for not implementing an order of the apex court, asking him to approach the Swiss authorities to reopen money-laundering cases against President Asif Ali Zardari. The disqualified Prime Minister’s plea was that he could not proceed against Mr Zardari as the later enjoyed immunity as President under the Pakistan constitution. The Supreme Court, however, refused to agree with the view and convicted Mr Gilani of contempt of court on April 26 and asked the National Assembly (parliament) Speaker to disqualify him. But the Speaker rejected the court directive and allowed Mr Gilani to continue as Prime Minister.

The Speaker’s viewpoint was challenged in the apex court by many, including Mr Imran Khan of the Pakistan Tehrik-e-Insaf party. The court judgement has jolted the government, but the latter cannot be expected to keep quiet. The PPP-led government must be busy thinking about how to make political capital out of the situation created by the judiciary. If the PPP goes in for an election before the present parliament’s five-year term ends next year, it may hope to get sympathy votes as most commentators in Pakistan see the powerful army’s hand behind Tuesday’s court verdict. Questions are being raised about the Pakistan Chief Justice not being as proactive in disposing of cases about thousands of missing persons involving the army and intelligence agencies as he ought to have been. There is the likelihood of the new Prime Minister also behaving in the manner Mr Gilani did — refusing to launch proceedings against Mr Zardari by approaching the Swiss authorities. What happens then will be interesting to watch.

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Toxic existence
Cancer in Malwa ignored too long

A visit by the Parliamentary Standing Committee on Agriculture to Bathinda areas, particularly Jajjal village, has stirred high emotions among Malwa residents and activists raising their voice against cancer — a disease estimated to afflict 120-125 persons per lakh in the area, against the national average of 71. These figures are disputed, as are the causes of the disease, as neither the state government nor the Centre have had any comprehensive study conducted on the subject. This gives rise to the suspicion the state government wants to hide the reasons, as those could be considered failings on its part — such as unscientific use of pesticides by farmers and inability to supply clean drinking water. Such allegations were levelled by some of the locals during the House panel’s visit. Various agencies have examined limited aspects of the issue and pointed at nitrates, uranium and pesticides in the water as culprits. However, none has offered a definitive cause, which provides the governments with a fig leaf to delay concrete action.

The immediate concern of the people is cancer treatment, which is hard to come by in Malwa. A few government treatment centres have been set up, but have failed to win people’s trust, who continue to go to Rajasthan for the purpose. A couple of large private cancer hospitals are also being set up on public land to provide low-cost treatment to the poor. But such charity arrangements have rarely worked in the past. This is one sector where the Centre will have to put in money. After all, Punjab has fed the country; its farmers are now in need of help.

One thing the state government has to work on is the prevention of cancer. While fundamental corrections such as cleaning up the state’s waters would take a while, the government has to ensure it starts providing filtered water to all affected areas immediately. Reverse osmosis is a technology found effective in filtering out most of the harmful elements. As it is expensive, the Centre needs to step in here too. No cost should be considered too much. People are dying.

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Thought for the Day

I would never die for my beliefs because I might be wrong.

— Bertrand Russell

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Discrepancy in Punjab figures
Ensure sanctity of the budget, at least
by Manpreet Badal

IN his enthusiasm to pay profuse tributes to the Chief Minister and the Deputy Chief Minister, the new Finance Minister, Mr Parminder Singh Dhindsa, went on to describe the latter as “youthful and aspirational”. If a 50-year-old — twice the average age of this nation and state — is “youthful”, then by that token Mr Dhindsa, who I think is a good 10 years younger, should be in his adolescence.

Actually his maiden budget speech was so full of verbal and numerical inexactitudes that it reminded me of a sweet-natured teenager exaggerating his family riches and status. He felt “proud” on Punjab’s average economic growth of 6.74%. The fact that this is less than national average of 7.86% should be sufficient to highlight the absurdity of this statement. Mind you, the national average is skewed by the growth rates of many under-performing states and there are states that have registered greater growth rates. Punjab’s performance vis-à-vis these states should lead to mortification and not to pride.

As someone who has been at the helm of affairs, I can say that the role of budgets has continuously lost significance. This is more so at the state level. With most of the policy measures being a continuation of the Centre’s schemes, there is precious little to speak of. Most of the new state policy decisions are anyway announced at separate forums by Chief Ministers; so there isn’t much in terms of novelty in a budget.

But what remains important is the Finance Minister’s duty to apprise the state government and its people of the true financial condition of the state. Any sophistry or equivocations here are unconscionable. Recognition and acceptance of a problem is a pre-requisite to solving it and Punjab’s politicians, I regret to say, have been often found wanting in this regard.

Look at the glaring discrepancy in the projected and actual revenue deficit figure. According to Mr Dhindsa’s own speech, the revenue deficit as per the budget estimates is Rs 3,379 crore. But in reality the revenue deficit has turned out to be Rs 6,838 crore. The fact that the actual figure overshot the estimated figure by two times shows that the estimate in the first place was disingenuous.

The actual tax collections and the actual receipts from the Central pool are almost always less than what they have been projected. This has to change and rather than making some sanctimonious references to the superiority of the ruling government, the Finance Minister should have done well to ensure the sanctity of the budget itself. In my assessment of the electricity subsidy figures that were mentioned in the last year’s budget, I had used The Tribune’s precious reading columns to show that how the actual cost of the subsidy is being grossly understated. The same remains true this year, which in turn means, that the fiscal deficit numbers, which Mr Dhindsa shows, are far from true. 

The Finance Minister mentioned that the Chief Minister and the Deputy Chief Minister have been forcefully pleading the case for a debt waiver with the Prime Minister and the Finance Minister. I wonder what is the significance of this statement because three years ago, the state government did achieve a breakthrough, when after relentless efforts, we convinced the Centre to consider Punjab’s case for a loan waiver. The Centre imposed certain conditions, which to be fair, were in the interest of Punjab and when I articulated the same, I was dubbed someone who was compromising the interests of Punjab. If the whole deal from the Centre was such an anathema to the state government then, I wonder, what is that they are trying to achieve now.

While it is heartening to see that there is a ban on the purchase of new vehicles and office refurbishments, it would be interesting to know how many fleets of cars were changed in the last two-three years and how many offices were refurbished.  Most of these changes are recent so chances of fresh expenditure are anyway remote.

I don’t want to sound unnecessarily skeptical here and appreciate the young Finance Minister’s effort in this direction and I am really keen that this injunction stays for the next five years and is adhered to across the government by everyone. An estimated saving of Rs 250 crore is too insignificant as of now and it would be important if it is increased significantly in the times to come.

 There is one particular statistic in the budget speech which causes me immense consternation. It is the fact that the primary sector constitutes only 23 per cent of the state’s GDP as compared to 45.5 per cent contribution made by the tertiary sector. Per se, this is an indication of an economy on the move. A higher contribution by services usually means that the economy is doing well.

However, what the figure doesn’t mention is that more than two-thirds of Punjab’s population is directly or indirectly dependent upon the primary sector (agriculture and allied activities) for their livelihood. When close to 70 per cent of your population has a share in barely 23 per cent of the state’s GDP, then it shows that there is something patently wrong in our economic set-up. It is time to address these wrongs and for that we need to start by calling a spade a spade, by being frank about the true state of the economy. Unfortunately, the government has chosen to live in denial.

The writer is a former Finance Minister of Punjab

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An early spiritual call
by Ravia Gupta

A little chaos is needed in the soul to give birth to a dancing star…..”

Even before that alarming sound could wake me up from the deep slumber, I was up in the morning around 4 a.m. to promise myself a new me and had a word with the self that I shall shine today!

All thanks to my Buddhist practice, which is helping me in the path of human evolution. It’s an amazing feeling to be a woman of the 21st century, as I have the freedom to decide the way I want to live on my own terms, define my own values and belief, and follow my own system and, even better, follow my spirit, follow my own path to find that connection with the higher being.

This “offbeat” career option is so happening, and I realised it only when I attended my first prayer meeting where I could hear many voices, but it was only one world, where the youth and spirituality were hand in glove with one another. Where the most talented, confident, young, techno-maniacs, shopaholics, party animals, call them by any name, but the so-called ‘different’ from the earlier generations, they were all there, chanting for the right wisdom to tackle their problems and report victory to their mentors, to their fellow beings and inspire one another.

The young battalion was deeply involved in various activities, exerting themselves in making good causes by sharing the grief of those in pain and showing them the light to bring out their true human potential into full bloom and earnestly trying to reach out to those in need or in low-life condition.

They all looked like being on a mission to transform their lives, to accumulate unlimited benefit and good fortune, which they feel and understand, could be found only by way of such unflagging efforts.

I was overwhelmed to see the young treading on the spiritual path. For some, it was ‘finding roots within’, for some it was performing their best in the competitive exams, for some it was outperforming the rest at the work place and for many others it was their faith in the concept which they believe would be able to help them attain peace and serenity.

After all, “Youth does not depend on the small number of years one has lived, but on the capacity to grow and to progress, and anyone who stops learning is old, whether at 20 or 80. The greatest thing in life is to keep polishing your soul and keep your mind young for learning!

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OPED — HEALTH

forgetful, not forgettable
The present number of 3.7 million patients suffering from Alzheimer’s and related disorders is expected to double by 2030. The cost of caring, estimated at Rs 14,700 crore, will increase three times. But new technology makes it possible to slow down the disease
Usha Rai

Thinkstockphotos/ Getty ImagesIndia has about 3.7 million persons suffering from dementia and this figure will double by 2030 to about 7 million persons. The number of persons with dementia doubles every five years and so India will have the largest number of elders with this problem. The cost of caring that has been conservatively estimated at present is Rs 14,700 crore. While the number is expected to double by 2030, the cost will increase three times. The study was done by Alzheimer’s and Related Disorders Society of India (ARDSI), a non-profit organisation established in 1992.

With a large number of people being affected by Alzheimer’s and related disorders and their numbers increasing at an alarming rate because people are living longer and have more stressful lives, the National Brain Research Centre (NBRC) at Manesar, Haryana, the Neurology Department of AIIMS and HelpAge India are collaborating for early detection and ‘treatment’ of Alzheimer’s. The good news is that thanks to the high field 3-Tesla MRI scanner, provided to the NBRC by the Department of Biotechnology, it is now possible to detect and diagnose early signs of the disease.

Early detection

Thinkstockphotos/ Getty ImagesAccording to Dr Pravat Mandal, an MR physicist and additional Professor at NBRC, a simple non-invasive magnetic resonance imaging (MRI) or brain mapping can track or detect changes in the brain. “Early detection can help in improving the quality of life of people suffering from Alzheimer’s and related disorders. Reliable biomarkers have been identified which could indicate mild cognitive impairment or early signs of Alzheimer’s.”

There is just a 3 per cent chance of Alzheimer’s being genetic. However, Dr Mandal has seen a 38-year-old patient of genetic Alzheimer’s. It was an unusual case where the parents as well as a sibling had the ailment.

According to Dr Manjari Tripathi, Additional Professor Neurology, AIIMS, and President of the ARDSI, when family members or relatives bring in patients with symptoms like forgetfulness, disorientation etc, these patients have already had Alzheimer’s for five to six years. Dr Tripathi said although 50 per cent of those over 85 suffered from Alzheimer’s and related disorders like dementia, 3 to 4 per cent persons over 65 also had Alzheimer’s. Under an arrangement between the AIIMS and the NBRC, based on her clinical diagnosis, Dr Tripathi refers patients to Dr Mandal. The NBRC then picks up these clients or patients and brings them to Manesar for the scan.

It is important for a family member or a friend to accompany the patient and share history and other information of those affected. To encourage a wider cross section of society to get the benefits of scanning, the poor are even paid Rs 500. Pick up and drop back home facility is provided for all those willing to undergo a brain scan. More than 115 persons have been scanned for Alzheimer’s over the past two years. The scans are analysed for changes in the brain and the results are sent back to Dr Tripathi for treatment. Certain chemical changes can be found on the left side of the hippo campus (the GPS of the brain) indicating pre-Alzheimer’s, says Dr Mandal. The chemical changes are much more in advanced cases.

“We are investigating what causes these chemical changes, and if they can be controlled,” says Mandal. Associated with the NBRC’s Alzheimer’s studies are half a dozen electrical engineers and IIT graduates.

Based on his two years’ of study at the NBRC, Dr Mandal has published scientific papers in the Journal of Alzheimer’s Disease, USA; the European Journal of Radiology and in the Biochemical, Biophysical Research Communication journal, USA. In India, the NBRC is the only institute involved in brain study for Alzheimer’s. It is also a leader in the world for such studies.

Dr Tripathi and Dr Mandal agree that an early diagnosis helps patients take medicines that can slow down the pace of the ailment. Last year, HelpAge, India, and ARDSI conducted memory tests on residents of many old-age homes in New Delhi and the NCR (national capital region). There are three stages of Alzheimer’s — mild, moderate and severe. In the last stage, the patients forget everything and there is no control over mental and bodily functions.

Silent epidemic

Because of the large number of cases now knocking on the doors of AIIMS, Dr Tripathi maintains Alzheimer’s is a “silent tsunami” for senior citizens resulting in chronic functional disabilities. There are different kinds of dementia. It is no longer just a problem of the elderly. Many suffering from hypertension had memory loss leading to dementia. This is a silent epidemic, said Dr Tripathi.

Dementia is not easy to diagnose. You may not realise the person has dementia until it is too late. However, the risk factors are preventable. Factors like hypertension, diabetes, smoking, stress, eating preserved food and alcohol consumption could be controlled. “We go out and buy diseases. If we look after ourselves, lead a healthy life, dementia can be prevented,” Dr Tripathi stated.

The Alzheimer’s & Related Disorders Society of India has been running a day-care centre for persons with dementia and AD (Alzheimer’s related disorders) at Tughlakabad on the premises of the Panchvati home for senior citizens. The other centre is in Faridabad. With the PICA (parents in India and children abroad) syndrome increasing, understandably stress levels for the seniors are high. So a 24-hour helpline and free medicines are also available for those with dementia.

Caregivers’ problems

Caring for those with dementia is really tough. One person with dementia is equal to 12 normal patients, says Dr Tripathi. To deal with the flood of cases being reported, a Chronic Care Facility for those with dementia has been proposed.

Mathew Cherian, CEO of HelpAge India and member of the Sub-Group that prepared the National Policy for Senior Citizens 2011, says the new policy has also recommended the setting up of a national centre for the older persons suffering from dementia and mental diseases at New Delhi. It also sought a budgetary allocation of Rs 120 crore in the Twelfth Plan for setting up such a centre. The policy is itself in doldrums because though it has been accepted by the Ministry for Social Justice and empowerment, it still awaits Cabinet approval.

Since older persons are often victims of abuse, ill treatment, exploitation, desertion and violence, to ensure their dignity and security, they need prompt and reliable support in times of need and distress, says Cherian. This is why the sub-group had recommended the:

  • Setting up of a national helpline for older persons based on the model of Child Line.
  • Setting up of Helplines in each state to provide different types of services by joint effort of an NGO and the local police department.
  • Helplines in old age homes set up under the Maintenance and Welfare of Parents and Senior Citizens Act, 2007.

The writer is a senior journalist who writes on development issues like environment, education and health

Case Study

Stave off Dementia

Poonam Natarajan, chairperson of the National Trust under the Ministry for Social Justice and Empowerment for the differently-abled, narrates the slow onslaught of Alzheimer’s in her mother, Nirmal, a vibrant, socially active woman who ran her own school in New Delhi for many years.

“Dementia begins with loss of memory. You get confused in a new place — then slowly you can’t find the toilet or the bedroom in your own four-roomed apartment,” she says.

A wonderful cook, Nirmal suddenly lost her ability to make tea. The family worried she may forget to switch off the gas or burn herself while in the kitchen. So her husband took on the responsibility of making tea in the bedroom.

The first signs of dementia were noticed when Nirmal was about 71. She wanted to go to the school she had set up. It was difficult to tell her that she was no longer in a state where she could run the school. Though she still remembered she was a teacher, in her fragmented mind she was back in her childhood and kept recollecting her family home in Amritsar, her brothers and parents. She wanted to go and meet that part of her family. She had no recollection of her 50 years of married life or the family she had raised. She thought she was still young and when Poonam introduced herself to morning walkers as her daughter, she turned around and told Poonam “You can’t be my daughter.”

She kept walking out of her house probably in the hope of finding her old home in Amritsar. Fortunately, she lived in an Army housing society and everyone knew Nirmal and her problems. They kept a watch on her and ensured she never strayed out of the colony or injured herself.

Over the next 12 years, Nirmal’s condition deteriorated. It was difficult finding care givers because it’s an extremely stressful job and Poonam, her father, sister and two other helpers shared the responsibility of watching over her.

Even taking Nirmal to the specialist was difficult. She refused the IQ test and either could not or would not write. At home, she could not find the toilet and incontinence set in. Slowly, she lost all her abilities. Her fine and gross motor movements started declining and with it ended her social circle.

She had to be taken everywhere on a wheelchair. Even in the residential complex, people, who wanted to talk to her, did not how to engage her. Friends and family stopped coming to see her. Poonam’s father was shattered to see his lively, dynamic companion of over 55 years reduced to this vegetable state and died 20 months before her.

Warning signs

Normal

Temporarily forgetting a colleague’s name

Forgetting placement of keys

Unable to find the right word but using a fit substitute

Forgetting for a moment where you are

Talking on the phone and temporarily forgetting the topic

Having trouble balancing a cheque book

Misplacing the wristwatch until the steps are retraced

Having a bad day

Gradual change in personality

Tiring of housework but getting back to it

Possible Alzheimer’s

Not being able to remember the name later

Forgetting that the meal was ever pre pared/burning of food on stove

Uttering incomprehensible sentences

Getting lost on known street

Forgetting topic with no recall at all

Not knowing what the numbers mean

Putting the wrist watch in a sugar bowl/spectacles in a glass for wash

Having rapid mood swings

Drastic personality change

Not knowing or caring about housework that needs to be done

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