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Kick-starting
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Corporal punishment Stick is not the way to deal with agitating teachers THERE has been yet another violent putdown of protesting teachers in Punjab by the police. The fact that teachers — unemployed as well as those employed on different terms — have felt compelled to resort to agitating in the streets frequently is indicative of a serious flaw in the state’s education policy. The circumstances of the protest near a residential area in Amritsar on Sunday may have been such that police action was necessitated. But the government would do well to show compassion towards the teachers, as they have genuine issues that need addressing.
India’s objections at WTO valid
A delicate balance
The scourge of the eastern states Corruption & decline of ethics in medical practice
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Kick-starting ties Narendra Modi's diplomatic overtures met with an overwhelming response from Nepal as he became the first Indian Prime Minister in 17 years to visit Kathmandu. His address to the Constituent Assembly conveyed the warmth of his feelings, even as he propounded his inimitable HIT formula: “H for highways, I for information ways, T for transmission ways”. Calling the drafting of the nation’s Constitution a sacred process, he rightly stressed on its importance in a speech that has been widely lauded for its tone, tenor and content. By announcing that India can consider suggestions to review the 1950 India-Nepal Friendship Treaty, he had both removed a largely rhetorical irritant that had sometimes been seized by Nepalese politicians, even as he has brought into open what had often been discussed behind closed doors earlier. Naturally, such a revision will have long-standing consequences and will thus need to be calibrated carefully. The offer of $1 billion as a soft loan to Nepal is expected to strengthen mutual cooperation in the energy sector. Nepal needs the capital as well as expertise to tap hydropower. Three memorandums of understanding were signed — tourism development in Nepal, Goitre Control Programme in Nepal, and co-operation between the state-controlled television channels. However, only terms of reference on Pancheshwar Development Authority were exchanged. This is a major project and effort must be redoubled to come to an agreement soon since both countries badly need hydro-electric power, and Nepal has the potential to generate an estimated 42,000 MW, which it could sell to ‘power-hungry’ India. The two nations with a long history can gain much with more economic ties, especially in infrastructure, highways and the IT sectors. Indo-Nepal relations have not been a priority for New Delhi for a long time, but with the Prime Minister saying that he wants to see time-bound progress on important aspects, there is hope that momentum built up by the visit will be fructified in the form of genuine advances in various stalled projects.
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Corporal punishment THERE has been yet another violent putdown of protesting teachers in Punjab by the police. The fact that teachers — unemployed as well as those employed on different terms — have felt compelled to resort to agitating in the streets frequently is indicative of a serious flaw in the state’s education policy. The circumstances of the protest near a residential area in Amritsar on Sunday may have been such that police action was necessitated. But the government would do well to show compassion towards the teachers, as they have genuine issues that need addressing. This was a case of teachers employed by zila parishads asking to be taken under the Education Department because of restrictive service conditions and limited transfer options in districts. There are other categories of teachers with different problems. Then there is the unemployed lot of trained teachers. All of this has to be seen in the context of the state of government schools in Punjab, which are now only the last resort for the very poorest to get their children some education. The result is many schools have very few children on the rolls. To ‘rationalise’ the situation, the government has shut down many such schools. There seems to be no introspection on why parents prefer even poor quality private schools to government schools with relatively better infrastructure. Law and order, health and education are state subjects from which there is no getting away for the government. Education also has a bearing on the social health of the community, as only productive individuals can contribute to the growth of the economy as well as society. There is massive contribution coming in from the Centre for schools, which the state has failed to utilise properly and Punjab also makes very limited contribution of its own. At present there are disparate programmes and terms of employment in school education started at different times in the state. All of these need to be reviewed to arrive at a unified policy designed to ensure quality education for all.
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Thought for the Day
Once a woman has forgiven her man, she must not reheat his sins for breakfast. Marlene Dietrich, a German actress and singer
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A call for peace ON this the day of Raksha Bandhan — the day sacred to that noble chivalry which, on the receipt of a simple thread bracelet led even strangers to suspend hostilities and to rush to the relief of Rajput princesses in distress — the various sections of the great Hindu community should be closely knit in the silken chains of love and amity. But it is sad to reflect that, where there ought to be love, there should be hatred, that instead of peace there should be distraction, that the tongue of rancour should threaten to disturb the future relations of progressive and go-ahead sections like the Arya Samajists and the Sikhs, and which cannot fail in the long run to have an injurious effect on the whole community. Partisan feelings may get the better of communal interests for the time being, sectional sympathies may run strong at the sacrifice of national welfare and progress, but the spectacle cannot but give rise to sorrowful reflections in the minds of all thoughtful observers and well-wishers of the community. Is Austria-Hungary aggressive? THE immediate cause of the present disastrous war is the assassination of the Archducal pair at Serajevo in the last week of June. But over eighteen months ago when the late Archduke paid a flying visit to the German Emperor at Springe, the object of that visit was said to be "to solicit Germany's support beyond the obligations imposed upon Germany by the Austro-German Alliance." This Alliance was a purely defensive instrument and gave no satisfaction to the alleged aggressive impetuosity of Franz Ferdinand and his confidential friends and advisers. This fact was presumed to have promoted the Archduke to demand Germany's support for an aggressive attack on Russia.
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India’s objections at WTO valid India's stand at the WTO negotiations on signing up the Trade Facilitation Agreement (TFA) may have greatly disappointed the US and during his recent visit to New Delhi, US Secretary of State John Kerry said so. The WTO was established in 1995 under the Marrakech Agreement and replaced the General Agreement on Trade and Tariffs (GATT) that began in 1948 in Geneva.
While the logic behind setting up the WTO was to lay down rules of trade between nations, its main proponents — the US and the EU — wanted greater access to the markets of developing countries. The setting up of a ‘rule book’ unfortunately has been sabotaged by India but with perhaps good reasons. The WTO has claimed that with the TFA signed, there would be a big gain of $1 trillion for the world economy and 21 million jobs would be created — around 18 million jobs in developing countries. How such figures have been arrived at is not very clear. India has been objecting to the TFA on the ground that it has to stockpile food grains to provide food for the very poor at lower-than-market prices. It also has to give production subsidies to poor farmers. In Bali in December 2013, it was agreed by the EU and the US that India could go ahead and stockpile food procured at subsidised prices and no legal actions or sanctions would be imposed on it till 2017 by which time a solution would have to be worked out. The Modi government has rightly disagreed to sign the TFA on the ground that the 2017 deadline is too short a time for undertaking any significant adjustment. Basically, the whole TFA is tilted towards the rich countries and private sector traders. India's food security law binds the government to provide food to its vulnerable and poor population. In order to do so, it buys grains from farmers at minimum support prices. The US and others argue that since India buys food grains from Indian farmers at administered prices, which are above market prices, it leads to a trade distorting agricultural subsidy Under the WTO’s Agreement on Agriculture (AoA), the difference between the administered price and the market price is considered a subsidy and there is a limit on how much is permitted. The US has argued that India's expanded food security programme exceeds its limit and constitutes a trade distorting subsidy since the government could then dump its surpluses on international markets. India's support prices are only slightly higher than the current Indian market prices but they appear much higher because, according to the AoA stipulation, the administered prices should be compared to the average international prices in 1986-88. These are roughly one-sixth of the current market prices and so any procurement price that the government pays today looks like a huge subsidy. It is important thus to reopen the AoA and G33 (like-minded countries which now are 46 in number) has been asking for it since 2006 . The G33 has been asking for an update of the reference price on account of inflation in the past three decades. The US and others have refused and now even after Bali when there was a commitment to resolve the issue of the base price, India and G33 have seen no change in the food security issue, while the developed countries are pressing for trade facilitation measures. While the developed countries are keen to promote the TFA, which will involve high costs for the developing countries without the benefits flowing in automatically, the main issue of bias against the developing countries in the provision for food security has not been resolved. The costs will include the upgrade of infrastructure, change of customs procedures and port facilities. At present mainly the exporters from developed countries seem to be in the forefront, pressing for the TFA. Also when India signs the TFA, certain agreements on the reduction of import duties would have to be undertaken which could lead to a huge influx of imports, which could lead to a widening of the trade deficit, especially when in India's case, exports have been growing slowly. The US and the EU should understand the reason why India is trying to stick to its position of support to poor farmers. The EU spends 39 billion euros in giving direct subsidies to farmers and the US gives around $20 billion to its farmers in direct subsidies. The catch is that in developed countries, the direct subsidies are easy to give and administer as all farmers are literate with bank accounts. In India's case the scene is different and requires indirect subsidies which are seen as price and trade distorting. But giving huge amounts of cash subsidies in the developed countries is also a controversial issue and many economists have argued that by lowering the actual cost of production artificially, these countries have produced mountains of agricultural products which are then dumped in international markets which lower the prices. As Mark Mallock Brown, former head of the UNDP, estimated: “It is the extraordinary distortion of global trade where the West spends $360 billion a year on protecting its agriculture with a network of subsidies and tariffs that costs developing countries about US $50 in potential lost agricultural exports”. The US gives direct payment subsidy to farmers without regard to the economic need of the recipients or the financial conditions of the farm economy. This is because the US has such a strong farm lobby that the government refused to cut subsidies in 2006 at the Doha round of WTO talks, to a level where other countries' non-subsidised exports would be competitive, thus stalling the talks. India currently is under pressure and could be isolated in its stance and may relent by September 2014 and sign the TFA.
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A delicate balance Nine-year-old
Saachi Bani was perplexed. The only daughter of Indian parents settled in England, she had just read a book on the life of Mahatma Gandhi. “Mummy, wasn’t he just like Jesus Christ?” she queried. “Unarmed, they faced brutal armies so fearlessly.” Without waiting for a response, Saachi posed another question, and this left her mother speechless. “The story says that the British rulers were bad. I am British too. Am I also as bad?” And then came forth from the youngster's lips a clincher, which left the older woman flabbergasted. “Mummy, you are proud of your grandmother, just because she went to jail for her country. Am I from a family of law-breakers?” Helpless before an innocent onslaught, Mother realised how futile it was to justify to the new generation the doings of its forefathers. She tried to explain that not everything is totally black, or totally white; in real life there are only shades of grey. Sadly, her adult reasoning was falling flat. It merely pandered tired old clichés. So she sought to change the embarrassing topic. “But India and England are friends today, aren't they? See how sportingly they play a match of cricket at Lords in London! Come, let’s watch the game on television.” Saachi and her parents were avid sports enthusiasts. Saachi's dad was a die-hard supporter of England, whether at football or cricket. Seated in front of the TV screen, the three-member family presented a quaint picture. It was the last day of a Test match. With the best English batsmen at the crease eager to overhaul India's score, the match was finely poised. Each time the English team lost a wicket, Mum clapped excitedly, even as Dad was disconsolate. A boundary hit found Dad shouting and jumping. As for Saachi, the girl was intently observing the changing emotions of the adults, rather than the fortunes of the players on the picturesque green. “Whom do you root for, Saachi?” asked Dad. Saachi's reply was Solomon like in its wisdom. “My Mum and Dad disagree, so I take the middle path. I am for India, and with England too! In any case the better team will win.”
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The scourge of the eastern states TV channels repeatedly mentioned some time back about the admission of 315 new cases of Japanese encephalitis in the Gorakhpur hospital and death of 67 infants as victims of same disease in the Jalpaiguri and Malda district hospitals in West Bengal. Why does this happen year after year? Nearly 50 per cent of Indian children are underweight and more than 70 per cent of women and children have serious nutritional deficiencies, including anaemia, according to a report by UNICEF. India is at the bottom of the world's nutrition barometer, along with countries like Angola, Cameroon, Congo and Yemen. The report draws attention to India's ill-fed underbelly and the failure to address healthcare issues among the poor.
One of the primary reasons for the state of affairs is that India's spending on health is abysmally low. Only 1.67 per cent of the GDP has been earmarked in the 12th Plan. India is likely to miss the Millennium Development Goal on child mortality. The tragic consequences of such health deficiency are the large number of deaths of children in Uttar Pradesh due to Japanese encephalitis. It is a vector-borne disease afflicting a large number of children during the monsoon in eastern UP. Mosquitoes are the carriers of the virus, and they breed in stagnant ponds and are incubated in the underbellies of pigs. There are a number of piggeries owned by certain traditional pig owners who make a living by rearing them. There are also a large number of stagnant ponds, the largest of them is outside Gorakhpur town. The virus infection was eliminated in Japan many years ago, by systematically getting rid of the pigs by compensating the owners. The infection has also been completely eliminated in Thailand and Malaysia. The only effective way to prevent this virus is to vaccinate children under 10 years of age, and three doses are to be given during a period of 30 days. The total number of children in the 12 districts of Gorakhpur division were said to be around 75 lakh. Unfortunately, the laboratory at Kasauli, the only source of supply, can produce only 4 lakh vials. As a result, a large number of children remain without vaccination. Seeing the large number of deaths and admission of the afflicted children to Gorakhpur hospital, I visited the affected areas in July 2005 and held a meeting with officers, the local MLA and MLC, both paediatricians. I also visited the district hospital and saw the children under treatment. I was told by the doctors that about 40 per cent of the children who survived were likely to become mentally or physically deficient for life. What was more disconcerting was the fact that during my visit to hospital, I found a large number of pigs roaming in the compound of the hospital. Apart from the elimination of piggeries in the 12 affected districts of eastern UP and the filling up of shallow ponds in the region, the only way of tacking the annual occurrence of encephalitis was to vaccinate all the children well ahead of the monsoon. Once the children fall sick, they have to be treated properly and given nutritious food. The consequence of nutritional deficiency in India is fully reflected in the large number of cases of death due to Japanese encephalitis. The fact that this year too there were over 360 deaths due to the same virus infection shows that the preventive steps are not being implemented. It has been reported that the Union Health Minister Dr. Harsh Vardhan has called for a report from West Bengal regarding the incidence of Japanese encephalitis in the state. Apart from Uttar Pradesh and West Bengal, there are reports of some stray cases of the same disease reported from some of the coastal districts of Odisha. Preventive innoculation of infants in all the traditionally affected districts, as well as their neighbouring districts have to be dealt with on a war footing each year. Uttar Pradesh and other state governments should take steps to remove the piggeries as the pigs incubate the mosquitoes which carry some infection. Hopefully, the situation will be dealt with effectively with the cooperation of the state governments concerned. What is Japanese encephalitis? Japanese encephalitis is a viral disease that infects animals and humans. It is transmitted by mosquitoes and in humans causes inflammation of the membranes around the brain. Intensification and expansion of irrigated rice production systems in South and South-East Asia over the past 20 years have had an important impact on the disease burden caused by it. Where irrigation expands into semi-arid areas, the flooding of the fields at the start of each cropping cycle leads to an explosive build-up of the mosquito population. This causes the circulation of the virus to spill over from their usual hosts (birds and pigs) into the human population. How it affects people It is caused by a flavivirus that affects the membranes around the brain. Most JE virus infections are mild (fever and headache) or without apparent symptoms, but approximately 1 in 200 infections results in severe disease characterised by rapid onset of high fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and death. The case fatality rate can be as high as 60 per cent among those with disease symptoms; 30 per cent of those who survive suffer from lasting damage to the central nervous system. Where the JE virus is common, encephalitis occurs mainly in young children because older children and adults have already been infected and are immune. The virus circulates in ardeid birds (herons and egrets). Pigs are amplifying hosts, in that the virus reproduces in pigs and infects mosquitoes that take blood meals, but does not cause disease. The virus tends to spill over into human populations when infected mosquito populations build up explosively and the human biting rate increases. —The writer is former Governor of Uttar Pradesh and West Bengal
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Corruption & decline of ethics in medical practice THE issue of corruption in medical practice is not new. It troubled Hippocrates, Charaka and many others since then. Several codes of ethics have been suggested from time to time. The International Code Of Medical Ethics adopted by the World Health Assembly in 1949 (subsequently revised in 1968, 1983 and 2006) is the overarching international guideline. Most countries have formulated their own codes of conduct for medical professionals very similar to the International Code. However, in spite of the existence of regulatory bodies to ensure compliance with the prescribed standards of medical ethics, most countries have been periodically reporting concerns on the issue. Recent media concern, drawing attention to the scale of the problem in India is welcome; though any suggestion of a “discovery”seems misplaced since the practice is well within the knowledge of all stakeholders, including patients. No sting operations are necessary; the information is openly shared within the community; an open secret like none other. In addition, many formal publications in professional journals as well as the lay Press have referred to the issue from time to time building a substantial glossary by now. The Indian Journal Of Medical Ethics is specifically devoted to the subject. It is a pity though that the hallowed profession in the country is today precariously positioned, in danger of falling off the pedestal. Transgressions galore Unfortunately, the Medical Council of India (MCI) as the sole organisation mandated to ensure adherence to ethical standards in medical practice, as well as the quality of medical education, in the country. It has failed on both counts. Even when it did bare a tooth or two, the existing legal machinery failed to deliver. Consequently, occasional transgressions have coalesced over time to gain present scale of operations. Following developments have further contributed to the much-less-than-satisfactory scenario. The model of a free market economy adopted by the country espouses only a single measure of success in life, that of financial prosperity. It would defy logic if medical professionals remained unaffected by that pervasive mood generated in society. That aspirational drive, coupled with absence of any quality audit, striving for professional excellence alone no longer remains an endearing proposition. The notion that medical profession in India should be judged as a philanthropic profession is anachronistic considering that even social philanthropy is commercialised. Unrealistic constraints on earnings of medical professionals in the country have added fuel to the fire. The same argument applies to enforced rural service, when there is no such conscription for any other humanitarian activity in the country. Policies adopted by successive governments to deal with the shortage of manpower in healthcare industry have not helped either. Allowing RMPs, ayurvedic and Unani practitioners to freely practise the allopathic stream of medicine, for which they have never been trained, has been utterly short-sighted, with serious consequences for patients as well as professionals. That observation is no reflection on the benefits of any particular system of medicine, but only on the undesirability of practitioners over-reaching their own expertise. As is well known, cross-fertilisation between different species has the potential to produce monsters. Mismatched skills in this instance have predictably led to the compounding of undesirable practices. Although consequences to patients from this practice have never been measured, there is a strong perception within professionals that the practice has in a substantial measure, triggered the downslide. The suggestion for an abridged course for rural practitioners, that is currently doing the rounds in the corridors of power, is similarly flawed, and likely to contribute to further spread corruption. It is hoped that better sense prevails and the suggestion is shelved. The proposal is doomed to failure even otherwise for the present-day rural population is sufficiently informed to see through the undesirability of trusting their health to less than fully trained professionals. That the MCI is stated to have given its approval to the course speaks volumes about the professional commitment of the organisation. Marketing ploys & professional ethics The marketing practices of the drugs and devices industries have further contributed to compromises in ethical practices. Professionals with limited expertise are offered opportunities to increase their incomes by subtle and not-so-subtle means. The modus operandi varies with the type of business in question. For the more knowledgeable professionals there are other offerings. Likewise, business centres offering specialised services like diagnostic facilities, nursing homes or hospitals, big and small, offer a share in profits or incentives for business generated. Spectacular advances in the field of medical sciences have opened up equally spectacular opportunities for professionals open to persuasion. Having been personally witness to the steady deterioration in medical ethics over 50-odd years, the present slide is painful. There were chinks in the armour earlier also but the present slide is a sea change from the past. Failure of regulation, the scale of available opportunities together with mounting peer pressure, has led to more and more persons getting sucked into the “system.” We seem headed to a situation of institutionalised corruption such that a new graduate may well ask “Medical ethics! Whatever is that?” However, there are still many ethically alive professionals who have managed to keep professional ethics afloat in the country. Whether the situation is redeemed remains to be seen. There is still time, but the window of opportunity is slipping away. The problem is not as much of awareness as that of a will and the wherewithal to address the issues. Corruption in the medical profession is the symptom of a systemic social disorder calling for innovative management; mere changes in laws or any other coercive methods will not work. Having been complicit in the present mess, the MCI route will not work either unless transformational changes are introduced in that body first. To begin with, a transparent system of accountability needs to be introduced wherein the MCI is held answerable for under-performance or non-performance. A strong system that monitors public feedback in real time needs to be put in place with the proviso that it remains insulated from vitiation by pressure groups within the profession or outside. Fortunately, currently available technology is eminently suited to deliver such a mechanism. Although dramatic punitive interventions through the judicial route, notably in the USA, have aroused media interest these can only be a fall back option for a failed system; a better solution is to infuse correctives well before punitive measures become necessary.
— The writer is former Head of the Department of
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Mother was at pains to explain the complexities of history. How ambitious leaders throughout the ages had pursued power and glory through military conquest. How magnificent kingdoms were built all over the world by emperors like Ashoka and Akbar in India, and Generals like Alexander in ancient Greece and Julius Caesar in Rome. Mother began a narration of the violent conflict in the World Wars of the twentieth century. She intended to place the freedom struggle of modern India against British colonial rule in a neutral perspective. The child reads in an English school, she reasoned, so she must appreciate the position of both conflicting sides. Her attempt at astute diplomacy was nipped in the bud, for the child's attention had wandered. “The police arrest only those who commit crimes. Gandhi went to prison so many times, so was he a criminal?”