In your interest.
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No beating about the bush.
Medical malpractices and related corruption are rampant but the truth rarely comes out. And that is why it would be great if the IMA sues Aamir Khan
I recently came across a news item in The Hindu which stated, “The Indian Medical Association (IMA)…demanded an immediate apology from actor Aamir Khan, accusing him of having defamed the medical profession in the 27th May episode of his TV show Satyamev Jayate, and warned him of legal action if he didn't do so. IMA secretary general Dr DR Rai told journalists: ‘Every profession has its black sheep. …But it can safely be claimed that the white sheep will always outnumber the black ones in every field. …It was extremely wrong on the part of a responsible citizen of the country and a public figure like Aamir Khan, whom most of the citizens of the country might even consider as their role model, to put the rotten eggs over the good ones,’ he said.” (IMA demands apology from Aamir)
There is an interesting parallel here and associations, irrespective of the industry, seem to be more oriented to claiming that the black sheep (in their industry) are far and few. Folks, you may remember that in June 2010, about three months before the height of the Indian microfinance crisis (October 2010 onwards), the then chairman of MFIN said almost the same thing and I reproduce his quote:
“Unfortunately, recent headlines have focused on some aberrations in microfinance that have then spread misconceptions about the industry as a whole…We want to emphasize that the sector should be judged by its median and best and not by the black sheep that damage our cause and the cause of the people we wish to serve. Every industry has its bad apples and we are committed to expose and expel them.” (MFIs as engines of inclusive growth by Vijay Mahajan, The Economic Times, 28 June 2010).
What happened thereafter is well known and it is another matter that neither MFIN nor other actors in the Indian microfinance industry did little to stop the black sheep—some of whom were members of MFIN. Part of the reason as to why the Indian microfinance industry and MFIN were unable to act on the black sheep was perhaps because of the fact that some of the so-called black sheep MFIs were themselves part of the overall governance structure at MFIN. Therefore, it became slowly clear that huge conflicts of interest prevented the association from acting in public interest and in accordance with its original mission. I wonder if such a situation prevails at the Indian Medical Association as well.
That apart, I am really looking forward to the day when the IMA will sue Aamir Khan and I hope that they do so immediately. I am sure that given the disenchantment with the medical profession in India over the last few years, many Indians (myself included) would be willing to implead themselves into the case and provide tangible evidence in support of Aamir Khan’s views.
Without question, there have been many good doctors who have provided yeoman services to this country.I do not think anyone is disputing that. However, what needs to be squarely recognized is the fact that medical malpractices and corruption cases are indeed increasing by the day. I report a few such instances here:
Instance # 1: A 30 year old acquaintance underwent spinal surgery to remove a disc. During the operation, his nerves were damaged. In spite of additional surgeries done by the hospital, he could not be cured and he now lives with acute back pain.
Instance # 2: In another instance concerning a friend’s 52-year old mother, during a back surgery, the spinal canal was supposedly accidentally punctured and the patient suffered a serious disability and now lives with long-term pain.
Instance # 3: A maid servant, working in a friend’s house, aged about 57 years, had complained of muscular type of pain. On her way back home, she went in search of a doctor. She saw a clinic and entered by mistake—as she could not read/write she did not realize it was a dental clinic. When she walked out she was poorer by almost Rs912 (almost 20% of her salary)—which had been taken by the clinic for a whole range of unnecessary tests and medicines that in no way would have alleviated her original (muscular) pain.
Instance # 4: A friend’s uncle (about 79 years) was admitted to a large private hospital a couple of years ago with gall bladder related problems. According to the family, negligence in treatment, unhygienic conditions and lack of standard care during the 1st three weeks of hospitalization led to respiratory complications and the patient had to be put on a ventilator. After a harrowing five months, by when the family had to cough up close to Rs1 crore for hospital and other medical expenses, the man finally breathed his last.
These instances are but a tip of the iceberg. India is replete with examples of medical malpractices and related corruption. From wrong diagnosis to unnecessary and repeat tests/procedures to inadequate/wrong treatments, poor standard of overall care, gross negligence and the like, medical malpractices indeed appear to be burgeoning over the last few years. We certainly need to take stock and set the record straight. And that is why it would be great if the IMA sues Aamir Khan as then, the people of India, who have been traumatized by the medical malpractices and corruption could step forward to recount their own stories and happenings in a telling manner.
Without question, the commercialization of medicine (without necessary checks and balances) has perhaps resulted in medical ills, frauds and malpractices being perpetuated on the people. Therefore, it is time to build safeguards including the creation of an effective and easily accessible network of medical ombudsman who can take strong, severe and swift action against the (errant) black sheep in the Indian medical fraternity.
(Ramesh Arunachalam has over two decades of strong grass-roots and institutional experience in rural finance, MSME development, agriculture and rural livelihood systems, rural and urban development and urban poverty alleviation across Asia, Africa, North America and Europe. He has worked with national and state governments and multilateral agencies. His book—Indian Microfinance, The Way Forward, is the first authentic compendium on the history of microfinance in India and its possible future.)
Former power and finance secretary EAS Sarma says that the Vishakhapatnam Steel Plant continues to release toxic pollutants because the state pollution control board is not taking any action
Former power and finance secretary EAS Sarma has said that due to inaction from the Andhra Pradesh Pollution Control Board (APPCB), the Visakhapatnam Steel Plant (VSP) is continuing to spew out pollutants into Appikonda Vagu that drains into the sea.
Mr Sarma, in a notice sent to Ravi Chandra, member secretary of APPCB, said,"...the toxic pollution caused by VSP is adversely impacting traditional fishing activity in the sea adjacent to the plant. APPCB which is the statutory authority to enforce the relevant environment laws has not cared to proceed against VSP".
"If anyone can visit the Appikonda Vagu and see the black colour of the water and its turbidity, he or she will understand how VSP is releasing effluents in a highly undesirable manner. The confluence of the stream with the sea has changed the colour of the sea water, discouraging traditional fishing which used to take place in the past," said Mr Sarma, who is also the convener of the Forum for Better Visakha (FBV).
According to the former power and finance secretary, the Centre for Science and Environment (CSE), has given a poor environmental rating to the steel industry in general and to VSP in particular. CSE has also observed that VSP's poor record in containing pollution is primarily on account of APPCB's inaction, he said.
In his previous letter sent on 1 February 2011 to the then member secretary of APPCB, Mr Sarma said that the Visakhapatnam chapter of the Indian National Trust for Arts and Cultural Heritage (INTACH) had collected a sample of water from the channel draining waste water into the sea from VSP near Appikonda village. Here are the results of the lab testing:
According to Mr Sarma, the presence of lead in the waste water is worrisome, as the place where this water joins the sea is a site used by the local fishermen for fishing. Lead ingested fish can cause carcinogenic diseases. An independent water sample analysis carried out at this site not only confirmed the presence of lead and other solid pollutants, especially the presence of chromium, nickel and copper. I am not sure whether VSP's waste treatment plant is fully operative, he said.
Earlier in September 2001, the former secretary to the government of India sent a letter to the secretary in the ministry of environment and forests, complaining that the state level APPCB has neglected its responsibility to conduct public hearings on the basis of these environment assessment reports, apparently because officials have vested interest. (Companies procuring false environment impact reports, ministry overlooks fraud, says former top bureaucrat)
Will the concept of the point-to-point AC bus service help in getting motor car users to move to buses? Will it be useful in actually addressing transportation woes of the Mumbai as a whole or merely going to serve a small segment and to what extent?
The Mumbai Transformation Support Unit (MTSU) and Brihanmumbai Electric Supply and Transport Undertaking (BEST) are working to get a Point to Point AC Bus Service Scheme (P2PACBS) put in place. The scheme is to provide services from certain highly populated cooperative housing societies (CHS) to central business districts (CBDs). It is hoped that with such home to office trips in AC comfort provided, most members of the CHSs will opt not to take their personal motorcars out for their daily commute.
The concept is not new at all but then the buses used were the non-AC ones and were being operated by private bus operators. This system is still in vogue. It is interesting to go into details to compare with BEST staged services. A non-AC ‘contract’ bus with capacity of about 50, charge a monthly sum of Rs900 per person for a 10 km trip length twice a day. Since most offices open between 9am to 10:30am, and also close between 5:00pm to 6:30pm, the bus operators have to make as many trips as possible within the given peak periods. These buses then idle around.
Before the stricter norms for school buses came into vogue under the School Bus Policy, these buses were also being used on school trips. To enhance its income, the contract bus operator would try to reduce travel time by often bypassing traffic safety norms, which only a pedestrian or cyclist is able to observe as they are the most vulnerable groups affected by such flouting of safety norms. Also idle time parking is done wherever the contract bus operator finds place and narrow lanes become such parking places. They then keep the space reserved for themselves. Maintenance work is also carried out on these streets and footpaths if any get encroached upon to cater to the needs of drivers, washers, etc. The bus and the road/footpath space becomes dwelling for the bus staff.
From the commuter’s perspective, Rs900 per month of say 25 working days a month means the commuter pays Rs36 per day. For the same trip by BEST, it would cost Rs36 a day (latest Express bus service fare). But the BEST buses are loaded to 70 to 90 persons during peak period and frequency not necessarily to every commuter’s need or liking. These are also not from the gate of their CHS. Contract bus thus scores over BEST from fare as well as comforts point of view. “Organized corporate commuters” will find the P2PACBS scheme a great boon.
Basic operational costs of BEST buses are (i) driver’s and conductor’s salaries, (ii) fuel expenses (iii) maintenance of buses and (iv) depots for stabling buses. If the contract bus operator matched his driver’s salary with BEST bus driver’s, bus maintenance was as good as BEST’s (although lately that has been deteriorated too) and they paid for the parking too then surely for the level of service, the fare structure would significantly surpass the BEST fare structure as the private operator’s profit too has to be added to the overall costs. By parking on roads, there is a social cost citizens pay and usually these locations are rarely near residences of people who are affluent. Therefore, it is the less affluent who are providing facilities to the more affluent without in return receiving any facilities of improved general public transport; on the contrary they are subjected to greater hardships.
Only 2.8% of Mumbai citizens use motorcars. This number comes to 3.5 lakh. If the point-to-point AC bus service is hypothetically provided for all the personal motorcar users, it will benefit only 3.5 lakh people. This is because those not opting to take the new bus service will be driving in less congested road and the rest will be using buses. Since the suburban trains carry 75 lakh people daily in miserable peak period loading and the current users of BEST bus services are in perpetual traffic jam during peak period, their plight does not get addressed by this P2PACBS. Since P2PACBS will be like the contract bus service, it will be a fixed time service, providing no flexibility in terms of time. People do not like to lose their independence of travel. This constraint is not acceptable to the affluent in general. When in 1974 the petroleum products overnight became three times costlier, car pooling was resorted to initially, but practically within three months, people using personal motorcars returned to earlier independent use of own motorcars.
With the P2PACBS scheme in place, two scenarios could be visualized. (i) people in CHSs take the view that it is in their interest to be restrained by discipline imposed by the P2PACBS and travel in comfort or (ii) drop off the P2PACBS scheme as it is not being used adequately because non adherence to time by the commuters and thereby return to use of personal motorcars.
In my opinion it is the latter scenario that will emerge, with personal motorcars driven by employing a driver. Since a car is available and is being driven by the driver, it will be used by the family for dropping and picking up children going to school and college and spouses attending social events and shopping and host of other things, adding to the prevailing road congestion. Even if the former scenario emerges, personal motorcar shall get used for all other purposes mentioned thereby providing no respite from the road congestion.
Besides P2PACBS not providing independent mobility, it will also be subject to the normal delays of everyday traffic. All in all, I do not see any benefit from P2PACBS scheme but one.
What is that benefit I foresee by P2PACBS? People who try out the scheme and find life adequately comfortable will suggest or demand (i) shortening of journey time by asking for dedicated bus lanes and (ii) increase such services so that if they miss one bus they could board another. Since this will be demanded by people who are affluent, the suggestion will be given greater weightage. Bus Rapid Transit System (BRTS) fulfils dual purposes. Firstly it will delink the fixed time boarding requirement of the P2PACBS scheme by providing frequent services. Secondly, BRTS will have significantly excess carrying capacity that will facilitate general public in using this service as an alternative to the overcrowded railway and existing BEST services.
Whichever way MTSU, BEST or BMC proceed in addressing the transportation woes of Mumbai, it is hoped that they will put up an efficient and effective BRTS in place soon even if they initially look at addressing excessive personal motorcar usage aspect only.
(Sudhir Badami is a civil engineer and transportation analyst. He is on Government of Maharashtra’s Steering Committee on BRTS for Mumbai and Mumbai Metropolitan Region Development Authority’s Technical Advisory Committee on BRTS for Mumbai. He is also member of Research & MIS Committee of Unified Mumbai Metropolitan Transport Authority. He was member of Bombay High Court appointed erstwhile Road Monitoring Committee [2006-07]. While he has been an active campaigner against Noise for more than a decade, he is a strong believer in functioning democracy. He can be contacted on email at [email protected])