o

More substance, less fizz


The Joint Parliamentary Committee report on pesticides in colas reads like a charge-sheet on the functioning of many government ministries. Sudhirendar Sharma reports.




o

Understanding Schizophrenia


Dr.Judith Jaeger, an expert on psychiatric disorders was recently in Chennai. She spoke to Lalitha Sridhar on schizophrenia and the current state of knowledge in the world about the illness.




o

Competitive but inaccessible


Even as many Indian hospitals invite a foreign clientele to world-class treatment facilities, the poor have to contend with a different and unregulated private sector, says Abhijit Das.




o

Pyrolysis : dangerous but favored


As an alternative to incineration that is known to produce toxic pollutants like dioxins, India is leaning towards pyrolysis for disposal of medical waste. Ratna Singh of New Delhi based Toxics Link on the implications.




o

Sex ratio: the hidden horrors


Millions of males are falling victim to illnesses at much faster rates, skewing the demographic balance. Pavan Nair looks at the numbers.




o

Elections and Health


What plans and promises on 'health for all' have the NDA and the Congress offered to the electorate this election cycle? Abhijit Das takes a closer look.




o

New govt's population control thrust


Abhijit Das expresses concerns on the United Progressive Alliance's misplaced stress on population control targeting, taking the case of Uttar Pradesh.




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Crippling delivery to the disabled


Are tax-payer funded programmes for the empowerment of the disabled working? Until very recently, New Delhi has not even had reliable data to plan its programmes. Himanshu Upadhyaya digs into the 2004 Comptroller and Auditor General report.




o

The unfinished war on polio


As new cases of polio are reported in Andhra Pradesh and Karnataka, health departments scramble to respond quickly. Safia Sircar on a neighbourhood program in Shorpur.




o

The Census revelations


N P Chekkutty reports on several marked trends in the latest Census data.




o

Blowing back the smoke


Reducing tobacco consumption is a multi-dimensional and complex challenge. Varupi Jain reports on an organisation that is lending its VOICE with strong efforts.




o

The pressure for health care


These National Human Rights Commission's hearings on the Right to Healthcare are bringing out hundreds of poor citizens' experiences of being refused public health care. Gone are the days when citizens endured this with a fatalism born out of years of hopelessness, writes Abhijit Das.




o

The ABC's of fighting AIDS


The main message that is going out to the masses is: use condoms. But this overlooks a fundamental reality about the values contained in that message, says Mirra Savara.




o

Death knell for low cost medicines


Medicine prices nationwide are likely to go up soon, including at public hospitals and dispensaries. Domestic manufacturers will withdraw critical but cheaper medicines as India gets ready to fulfill WTO obligations. Devinder Sharma argues that this is the beginning of a scientific apartheid.




o

Rural Health Mission has promising goals


Rural public health care is choked nationwide for a number of reasons. To name two, provisioning of services is very top heavy and many major programmes continue to be conceived and run uncoordinatedly. But Abhijit Das finds promising prospects in the formation of the National Rural Health Mission.




o

Epilepsy: defogging the demon


Some studies estimate that roughly 10 million Indians may be suffering from epilepsy. But social stigma and economic barriers are keeping treatment out of reach for the majority. Unlike polio, which has a national eradication programme, epilepsy treatment has seen no such focus yet, finds Varupi Jain.




o

Clean hands, not soap sales


Who can object to washing hands regularly to improve hygiene? In Kerala, the World Bank found out that it isn't enough to promote sensible messages; it's also important that the messages do not appear to be based on ulterior motives, like sales for MNC products. Darryl D'Monte reports.




o

Global leadership, empty stomachs


Newspaper and television reports leave us thinking that India is poised to become a superpower, but a more wholesome measure of where the country is will paint a different picture. The problems are still immense, and India lags far behind the world in many ways; it is important to note this and begin tackling them, says Abhijit Das.




o

Snuffed out on screen


Smoking in the movies fosters a culture that encourages young people to smoke, whereas what is needed is that we actively develop antipathy to smoking! More than the health effects alone, it is this battle that has been engaged by the government's move to ban tobacco on screen, says Pankaj Chaturvedi.




o

Bringing hope to the rural disabled


Since 1988, SANCHAR has worked to improve the lives of the disabled in rural West Bengal. And with the increasing resources available by law to assist the handicapped now, SANCHAR is working to make sure panchayats tap into these to help their community. Rina Mukherji reports.

24 June 2005 - Sanu Ghosh was around one and a half years old when a visit to SSKM Hospital in Kolkata to treat an attack of pneumonia saw him diagnosed as a patient of cerebral palsy. But then, his daily wage-earning parents from the rural outskirts of the city could hardly have been expected to arrange for the necessary rehabilitation of their little son. Fortunately for them, the Society for Appropriate Rehabilitation for the Disabled (SANCHAR) traced him out when he was four, and even detected a hip dislocation that nobody had noticed until then. Today, not only does Sanu attend school, but can manage to seat himself there, thanks to a chair designed by SANCHAR. A similar contraption for his home enables him to manage his daily domestic chores. At school, he uses his mouth to hold a pencil to write, and can read and write nearly as well as any child of his age.

Arup Sani was struck with polio at the age of three, resulting in the impairment of his left leg and right hand. The son of daily wage earning parents belonging to Krishnarampur village in South 24-Parganas, Arup was adopted by SANCHAR when seven years old. The provision of calipers and crutches under the government's scheme enabled Arup to attend the village primary school. Arup is now 19, and studying at the higher secondary level. He is not only getting educated, but also teaching three hearing impaired children from the neighbouring village. Besides, Arup is helping a visually challenged child, Mafijul, studying in the second grade, as a writer during the latter's exams.

Very few people can identify 21-year old Sujata as a disabled young woman, given her confidence. And yet, Sujata could hardly move ever since she was struck with polio at one and a half years. Thanks to SANCHAR's home-based programme, Sujata not only helps her family make puffed rice for sale, but has taken advantage of the vocational training imparted to be able to stitch her own dresses. She is currently learning embroidery even as she broadens her knowledge of dressmaking to earn an income.

These are but examples of the work taken up by SANCHAR on behalf of more than a thousand disabled persons in rural areas. Starting in 1988, SANCHAR launched itself with field support from CINI (a non-governmental organization working in the field of health) to work with disabled children. At first, there were only three or four children that the organization worked with, in a couple of villages. Today, SANCHAR operates in 75 villages spread over 4 blocks - Falta, Bishnupur I and II, and Thakurpukur-Maheshtala, bringing assistance to 819 disabled persons and 774 families. It has been a long journey, but as Director Tulika Das concedes, "The Disabilities Act of 1995 has proved a shot in the arm. With so much being offered by the government now, it is not too difficult to convince communities and Panchayats to take the initiative and give a fairer deal to the disabled."

The organization works at three levels: the disabled individual, his/her family and the community. At the family level, SANCHAR personnel provide the necessary training to the parents and family-members as regards handling of a physically or mentally challenged child. Physiotherapy is provided for free by a professional to enable the child to handle his/her own chores. In cases where a child is unable to move out of the home to attend school, SANCHAR personnel actually arrange for the child's education at home.

"The Disabilities Act of 1995 has proved a shot in the arm. With so much being offered by the government now, it is not too difficult to convince communities and Panchayats to take the initiative and give a fairer deal to the disabled."


Editors' Note: The author has separately compiled a list of key facilities that can be accessed under the provisions of the Disability Act; click here to access this page. The community-based rehabilitation programme involves sensitizing villagers through villager education committees, members of which comprise Panchayat pradhans and members of the Panchayat, liaising with school authorities to provide the necessary facilities such as ramps and suitable chairs for the challenged and allowing clinics to be operated for their benefit. SANCHAR also facilitates the provision of identity cards, stipends and the like by getting Panchayat pradhans to apply and arrange for the same. Wheelchairs, hearing aids and appliances are given free by the government to all those whose incomes are below Rs 5000 a year. "All that we do is spread awareness among the persons in the village community about the facilities available", says Das. Tying up with Mobility India for the past two years has also helped Sanchar in this respect.

"We especially provide technical know-how for the building of school ramps. The incline should never be too steep, lest the wheelchair user rolls down." It is to the credit of SANCHAR that nearly all schools in the 4 blocks in which it works have ramps to cater to the disabled, whereas most educational institutions and libraries in Kolkata lacking these, despite government funds being available for the purpose.

Rehabilitation through vocational training is what SANCHAR has especially been working towards when dealing with the disabled. Here, training is imparted in vocations that complement the traditional occupations prevalent here. For instance, brush-making being a common cottage industry here, many mentally challenged youngsters have been trained in the vocation. The hearing or visually impaired youngsters interested in starting on a new enterprise have been imparted training in making packing boxes for these brushes.

Sometimes, interest and talent may also determine the kind of training given. Physically challenged Krishna, for instance, always showed an uncanny talent for needlecraft since childhood. After being given the necessary training, Krishna has been taking on embroidery jobs to cater to the market and is earning a steady income. He is also training some others in the village to help him in the business.

SANCHAR
Director: Tulika Das
A-2/6 Diamond Park, Joka,
Kolkata 700104,
West Bengal.
Tel: 91-033-24975625.
e-mail: sanchar@vsnl.com Not resting on its laurels thus far, the organization looks forward to changing the negative attitude of communities with regard to the disabled. The low priority to the disabled in national planning is also a matter of concern to SANCHAR. "It is important that disability figures on the agenda of all development plans formulated by the government in this country," emphasizes Tulika Das. For now, the organization is busy reaching out to prevent the occurrence of disability and help in rehabilitation of the disabled in as many villages as possible-including those outside its field area - through Open Day programmes. (Charkha Features)

Rina Mukherji
24 Jun 2005

Rina Mukherji is a freelance journalist, interested specifically in social and development issues.

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o

Living in a gray zone


Prem Kumar travels across the country, finding disabled children living in isolation and despair, carrying nature's cruel dispensation. But he is heartened as well by inspiring work that so many organisations carry out, and hopes that a brighter future awaits the children, thanks to their efforts.




o

Remote adivasis face health care chasm


Despite crores of rupees having been spent in name of tribal and other development programmes in one block of Palakkad district in Kerala, the region suffers from poor access to decent health care. 80 per cent of the adivasi population here are living in abject poverty. M Suchitra reports.




o

Wake up call for HIV/AIDS in U.P.


Official statistics are putting Uttar Pradesh firmly as one of India's low prevalence states for HIV/AIDS, even though stories from village after village show the disease making its way in. Abhijit Das finds holes in surveillance and reports that state authorities are not yet taking the penetration threat of HIV/AIDS seriously.




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Clubbing to combat HIV


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o

Cancer: The long fight


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o

A poor and unhealthy nation


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Who cries when mothers die?


The probability of an Indian mother dying during childbirth is roughly 10 times that of her Chinese counterpart. Reducing the Maternal Mortality Ratio (MMR) by three-quarters in 10 years is now a Millennium Development Goal. Why is MMR in India so high and how far are we from the goal? Arati Rao unravels the many challenges to saving mothers' lives.




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Are we ready for the avian flu pandemic?


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o

The silence around sex work


Planning Commission member Syeda Hameed and her colleagues made a presentation before Prime Minister Manmohan Singh a few months back on the HIV/AIDS pandemic. Health interventions for sex workers and homosexuals would progress if they were not regarded as criminals and accorded dignity and rights, they stressed.




o

A new plan for safe motherhood


It is certainly welcome that the government now recognises unsafe motherhood as a serious development concern. But the plans to tackle this are unimaginative, and ignore many realities of health care for women in rural areas, especially in the poorer states, writes Abhijit Das.




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Scientific interest surging in yellow magic


In India, we have known the magic of turmeric all along. An Indian kitchen without a can of turmeric is rare. The world today is discovering this member of the ginger family. Scientists worldwide as well as in India are validating the medicinal properties of the root, reports Ramesh Menon.




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White asbestos, a health time bomb


The Ministry of Mines and Minerals says it may lift the ban on asbestos mining. It is ignoring the views of exposure victims, informed recommendations of public sector medical experts, and mounting evidence of an asbestos disease epidemic emerging in developed countries. The rationale to permit mining is hollow, writes Gopal Krishna.




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Positive blip on HIV radar


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The doctor keeps away


Stressful apprenticeship in a system that is not geared to meet the medical needs of the majority makes junior doctors very different from the counterparts in other professions. Their strikes over questions of merit and reservation should not divert attention from this more important issue, says Abhijit Das.




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Iodised salt: The lesser known facts


The central government wants to ban the sale of non-iodised salt on grounds of rising iodine deficiency. However, states with notable rise in deficiency are those where a ban has already been in force for the past two decades – the north-eastern states and Uttar Pradesh. P Venu, an Assistant Salt Commissioner in Gujarat, connects the dots.




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Iodised salt: health or mere profiteering?


Recently, there has been renewed stress on compulsory iodisation, with the central government attempting to bring back a national ban on non-iodised salt. But the nature and comprehensiveness of research into iodine deficiency has never made a categorical case for a ban, finds Aparna Pallavi.




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Leprosy nearly eliminated, challenges remain


India has recently declared that it has achieved the tag of 'elimination' of leprosy as the number of cases is now just around one per 10,000 people. Still, a major challenge is to reach medicine to remote areas and tribal pockets which still battle with leprosy, and integrating the cured into society, says Ramesh Menon.




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When all joy leaks out


Women's gynaecological and urological organs share a close relationship, and disorders affecting one may give rise to symptoms in the other. Better care and knowledge can reduce the incidence of these problems, however, and many of the conditions are treatable. Fehmida Zakeer reports.




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Iodised salt: Health or mere profiteering? -- II


While it is nobody's case that iodised salt should be pushed out of the Indian market, what concerns many people's groups is the one-sided way in which iodisation is being imposed on the people of India. Aparna Pallavi concludes a two-part series into New Delhi's interest in banning non-iodised salt.




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Universal care - still miles to go


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Playing politics with AIDS


The Goan government wants to make HIV testing mandatory for marrying couples. But mandatory testing will drive some people, who are already sceptical about the health care system, further away from it. It is also unlikely to cause the changes in behaviour necessary to prevent the spread of HIV, writes Neerja Vaidya-Yadav.




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Making menopause easier


As the world marks World Menopause Day on 18 October, millions of Indian women over 45 are finding it difficult to smile through it - thanks to the lack of information and misunderstanding among them about this rather rough phase of life. Neeta Lal reports on the Delhi-based Indian Menopause Society.




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TB: gravest danger to India


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TB: gravest danger to India - II


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An opportunity to end health care slumber


The HIV epidemic has brought into focus multiple public health issues facing rural India today. In this respect, it presents us with an opportunity to deal with issues that have been neglected and even been actively ignored for too long, writes Supriya Kumar.




o

In the line of fire


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Will the Public Health Foundation be meaningful?


The proposed Public Health Foundation of India (PHFI), likely to be instituted soon, will establish five 'world class' institutes to train 1000 public health professionals every year. But just where will these new public health experts be employed? Padma Prakash on the unaddressed issues.




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In UP, the war on polio stumbles


In India's most populous state, with its low levels of sanitation, and high malnutrition rates, polio has made a dangerous comeback. The world is now looking at India to stem the spread as fears of the disease spreading to other parts of the world have come true. Ramesh Menon reports.




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Healthcare as a broad public challenge


The mounting cost of hospital care, increasing out-of-pocket expenditure, and its catastrophic impact on family finances demand an innovative and flexible risk-pooling mechanism to provide a security net for the poor. Merely transfering the costs to the public exchequer will land the nation in a no-win situation, writes Jayaprakash Narayan.




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Struck by fluorosis


Of 62 million Indians suffering from fluorosis, more than six million are children and young people. Among these young, nearly 20,000 are in Assam alone, and in Karbi Anglong, well known for its scenic beauty and thick forests, a tenth of the population is afflicted with dental or skeletal fluorosis. Nava Thakuria reports.