In your interest.
Online Personal Finance Magazine
No beating about the bush.
The donation numbers look strange, the actual terms and conditions are not so clear and the show is flagging
On 20th June, Moneylife wrote how Satyamev Jayate (SMJ), the do-gooding show that was to redefine prime time and claimed to reach a massive 40 crore Indians (over just five episodes) had collected just Rs1.7 crore for seven NGOs so far. Of this Rs85.25 lakh has come from Reliance Foundation (numbers provided by them), which had offered to match the donations received from others.
While I wrote to Reliance Foundation, I also contacted SMJ’s official PR agency (Hanmer MS&L) listed on its website and asked for the donation numbers. Late that night, after our report was published, a Hanmer executive wrote to say that she didn’t have the numbers, but the Rs85.25 lakh that Reliance Foundation had paid reflected only the first five days of donation and that Snehalaya had in fact received Rs70 lakh. She promised to get me the exact numbers by 21st June afternoon.
This was after seven episodes had already been aired. We sent a reminder on 23rd June and also pointed out a mistake in the “terms & conditions”, which said that the exact donations received would be announced on Asar, a programmed aired on Aaj Tak channel every Friday night. In fact Asar is aired on ABP News, formerly Star News. This gross mistake was corrected on 25th June along with certain other changes.
Finally on 25th June (seven weeks after the show went on air), five days after our report, the Hanmer PR person wrote to say SMJ has received Rs1.9 crore through Axis Bank and another Rs25 to Rs30 lakh through text messages (so much for precision and disclosures), which means “Rs3 crore plus” of donations after adding “Rs85 lakh donated by Reliance”. She writes, “Reliance only doubles the amount collected in the first week (after telecast date). From a legal perspective, there needs to be a cut off date for Reliance to double the amount”.
But hasn’t Aamir Khan been looking us in the eye (through our TV screens) and telling us that Reliance Foundation will match the donations received? Then why is its contribution less than half the total received? As always, Reliance Foundation seems to have bargained a phenomenal deal—a big dollop of publicity for Nita Ambani’s plans to change the world, being economic with the truth (in terms of what it would match) and coughing up just Rs85 lakh over six weeks, when advertisers have been paying Rs8-Rs10 lakh for a 10 second spot! Bharti Airtel, the presenting sponsor, is understood to have paid Rs17-Rs20 crore while associate sponsors (Skoda, Coca Cola, Axis Bank, etc.) have paid Rs6-Rs7 crore each for far less visibility than Reliance. Why don’t the terms and conditions mention that Reliance Foundation only matches donations of the first week?
Naturally, we found this breezy obfuscation unacceptable and demanded a break up. By now, Star India officials had corrected the terms and conditions and updated the website. They have finally updated the website to say that the show had yielded—630,298,439 connections, 8,839,494 responses, 2,778,984 community members and Rs30,160,678 in donations. There was still no clarity about how these figures were arrived at and who got how much. On asking for a detailed break-up, we received an email from them.
The numbers are interesting (see table). Data for the first two episodes indicates that nearly half the donations were received in the second week after the telecast, despite the flutter on social media caused by the programme’s first episode. Secondly, Snehalaya, the NGO featured in the first programme garnered Rs1.3 crore or nearly half the total donations generated by the first six shows. Yet, barely 2.2% were through sms. Digital marketing experts may explain why sms-happy Indians were so reluctant to donate through texts, but apparently donated through more cumbersome online contributions to Axis Bank, that too a week after the episode. It will be interesting to see how many of the Axis Bank donations came from overseas transfers.
Childline and Himmat managed to attract the next highest number of donations (around Rs40 lakh each) while The Humanity Trust, West Bengal which has been subject of nasty innuendo because it was confused with another trust of the same name (finally corrected and explained by SMJ’s website only on 25th June) had the third highest collection of Rs27 lakh. But given the fact that it is this show that probably had the maximum impact on public consciousness, the amount collected was strangely too small.
What is however evident from the numbers, is that SMJ is fast losing steam. Only two episodes have really made waves—the first on female foeticide, mainly because it startled people and the second on medical malpractices, because it affects us all. Also, the massive clout of the pharmaceutical and medical equipment manufacturers ensures that we get to know so little of the sleazy underbelly healthcare sector. In fact, media reports on medical malpractice rarely go beyond doctor’s negligence.
The political class, which was wary after the first episode, has now begun to ignore the show. SMJ still has the potential to pack a punch for social transformation, but it needs some changes. For one, many viewers say that 90 minutes is far too long on a Sunday morning and there is no follow up action from the producers. They and Aamir Khan Productions obviously expected to just sit back and rake in the moolah and the glory. If activism could be reduced to show business, India would not need drastic transformation 65 years after independence.
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Aamir Khan has stirred a hornet’s nest, by exposing the malpractices in India’s healthcare services. Personally I am surprised by the sharp reaction of the medical associations and their intention to sue him or to boycott all his programmes. I thought he presented a rather balanced picture; the cut-practice, unnecessary investigations and operations, etc are issues that are discussed almost everyday by the media. What is more important is to find out what is ailing our healthcare services and what can be done about it. As a doctor, I feel that the least we could do is to stop the “blame-game” and the clamour to “punish doctors who misbehave”. Are they really guilty? If so, to what extent?
Even the most well-informed and well-placed intellectuals have not understood the complexities of our healthcare system. There are two distinct streams to this service. The state provides “public healthcare” for essential services to benefit the maximum population. The importance given to public health services and the amount of money spent on it by the state varies from country to country. India spends hardly 0.5% of its GDP (gross domestic product) on health, which accounts for just around 26% of the total amount spent on healthcare; the remaining 74% comes from the pockets of Indian citizens. Even though the importance given to this section is enormous and primary health service is so neglected that a survey by some social institutions found that 80% of the people opted for private services for their primary health—despite abject poverty. Moreover, it found that less than 20% of the MBBS doctors were involved in primary health care—private or public. This is because the union and state governments seem to be inclined to leave health services primarily in the hands of the private sector.
While the private sector dominates healthcare services in India, barring a small section of general practitioners, it consists of nursing homes, hospitals and specialists. The hospitals are turning high-tech and people end up spending three times of what the state is the spending for their health. Unfortunately, the private sector offers only the lucrative ‘cold’ work and modern high-tech services and thrusts all uncomfortable or non-profitable services on to the public sector—the poor, destitute, old people, tuberculosis, leprosy; even emergency services are a headache to them. “Health is the responsibility of the state” is a convenient argument.
WHY? Though George Bernard Shaw warned society a hundred years back, the people have steadfastly refused to accept that the (private) healthcare sector is an INDUSTRY—a highly profitable industry because of extremely low consumer resistance. Worse, now it sells attractive healthcare ‘products’ at profitable rates. Profit gets priority and healthcare becomes a subsequent objective. Hence, actual “health service” becomes a by-product and the proportion of its availability depending on the moral concepts of individual doctors. In just around 10% of the cases one gets miraculously good results and the patient is gifted with some extra and valuable years of good life. By then, the remaining 90% suffer so much economic loss that nearly a crore of Indians are being pushed below the poverty line every year because of crippling medical expenditure. Who is at fault and what needs to be done to correct this situation?
The medical industry is virtually run by “big money”, “ably aided” manufacturers of modern equipment and by big pharmaceutical companies. The media is cleverly used, first to create panic about every illness and then to glamorise new technology or a new ‘miracle’ drug/ invention which will save you from a ‘deadly’ illness. Doctors are mere pawns in their hands. The cost of research, PR and advertisements needs to be covered and the doctors must then earn money for the industry chain to make a profit. How can all this come cheap? The overuse of costly investigative and treatment modalities is further increased by:
a) lack of knowledge and expertise in specialist doctors
b) ever-increasing expectations of patients and
c) growing intolerance in society towards any untoward consequences during the management of treatment.
Earlier, there was a lot of emphasis on close observations and other clinical methods for diagnosis but now, due to the need to avoid ANY MISTAKE, the trend is towards “Objective Diagnosis”. Less you know, more you depend on technology. Less your expertise, more you need precision equipment to perform. The costs escalate, doctors are blamed, “internal trading” is suspected—and confirmed even without any evidence. But the fact is that many doctors are now totally dependent on these costly modalities; they are crippled without these aids for reasons mentioned. “Cut-practice” is but a small aberration for additional gains and merely indicates the same degree of corruption as is prevalent in the society in general. Totally unindicated misuse just for making money is an unpardonable crime. It does exist but I cannot judge the percentage of such unethical practices—could be 30% or so!
But overall, are you better off than previously in terms of your health-care? Facts are stranger than fiction. Average life expectation at birth is a useful indicator of the health of the community. Sri Lanka and Thailand have a much better lifespan than for Indians (more than 71 years compared to 64 for us). Reason? Those governments depend more on public healthcare, spending more than 50% of the total health expenses. And there is more attention to primary (and secondary) healthcare needs as indicated by a much better ratio of nurses in those countries, despite less number of doctors per 10,000 population. Mumbai fares the worst. It has 20 doctors, all sorts of specialists and all sorts of modern facilities, yet a Mumbaikar lives just around 58 years. This is universal; small town people have a much healthier life than those in metropolitan cities, all over the world. MODERN TECHNOLOGY DOES NOT OFFER YOU A BETTER HEALTH CARE EXCEPT SPORADICALLY. Mr Aamir Khan, don’t blame the doctors, blame the market, blame faulty medical education.
(Dr Sadanand Nadkarni, 80, is the former Dean of Sion Hospital, author of several books, a serious thinker of medical issues and hugely respected for a series of path-breaking ideas on improving the delivery of medical services to the aam aadmi. His book “Management of the Sick Healthcare System” is among the first to speak out about medical malpractice and other issues).