Monday, 13 October 2025

CHC



गुमनाम वीरांगनाएँ

आदिवासी नंगेलीः जो 'स्तन कर' के खिलाफ लड़ी

(हमारे इतिहास में बहुत सी गुमनाम महिलाएं हैं जिन्होंने अपने समय और सदी में अपने तरीके से इतिहास बदला।
लेकिन नंगेली की कहानी सबसे अलग जान पड़ती है। ये वो साहसिक आदिवासी महिला थी जिस ने केरल की निचली जनजाति की महिलाओं को स्तन ना ढाकने देने के क्रूर नियम को हटवाने के लिए सत्ता में बैठे लोगों के खिलाफ आवाज उठाई और अपनी जान की कुर्बानी दी।)

यह करीब 150 साल से भी पुरानी घटना है। उस समय केरल के बड़े भाग में त्रावण कोर के राजा का शासन था। यह वो दौर था जब जातिवाद समाज पर बुरी तरह हावी था। निचली जातियां शोषित थीं और उच्च जाति वाले खुद को उनका मालिक समझते थे। छुआ-छूत, सामाजिक बहिष्कार जैसी चीजें आम थी। इसी जातिगत भेदभाव के तहत निचली जाति की महिलाओं को स्तन ढकने का अधिकार नहीं था। यानि उस क्षेत्र में उच्च वर्ग की महिलाएं ही स्तन ढक सकती थीं, निचली जाति की महिलाओं को सार्वजनिक स्थलों पर भी स्तन ढके बिना ही काम करना होता था। यह नियम कई तरह के आदिवासी समूहों और जनजातियों के लिए बनाया गया था। अगर निचली जाति की महिलाए अपना स्तन ढकने की इच्छा रखती थीं तो उन्हें राजा को टैक्स के रूप मे कुछ रुपये देने पड़ते थे, जिसे 'स्तन कर' या 'मुल्लकरम' कहा जाता था। यह कर क्षेत्रीय आर्थिक विकास के मामले देखने वाले अधिकारी के पास जमा करवाना जरूरी था। यह कर न दे पाने की स्थिति मे इन महिलाओं को स्तन ढाकने की इजाजत नहीं थी। हम जिस दौर की बात कर रहे हैं, उसमें निचला वर्ग बहुत गरीब था इसलिए इस वर्ग की महिलाओं ने इज्जत को दाव पर रखकर स्तन ढके बिना ही जीना स्वीकार किया।




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बहिना बाईः भारत की पहली आत्मकथा लेखिका


(प्रायः विद्वानों ने भारतीय आत्मकथाओं के विकास का क्रम सन 1900 के बाद निर्धारित किया है। किन्तु गांधी युग से कई साल पहले 1700 में मूल मराठी भाषा में लिखी गयी बहिना बाई की आत्मकथा को भारतीय भाषाओं की पहली आत्मकथा माना जा सकता है। उस समय जबकि भारतीय स्त्री में खुद के बारे में सोचने की चेतना नहीं के बराबर थी. बहिना बाई ने शब्दो के माध्यम से अपनी बातों को अनजाने ही लोगों तक पहुंचाने का प्रयात्त किया। उन्होंने अपनी गृहस्थी की घुटन और अपनी लगन द्वारा ज्ञान प्राप्ति की छटपटाहट को सीधे-सीधे सरल शब्दों में बाधा। मूल मराठी भाषा में लिखी गयी यह आत्मकथा सन् 1914 तक पाण्डुलिपि के रूप में ही रही। सन 1914 में इसे प्रकाशित किया। आत्मकथा हाथों-हाथ विक गयी। सन् 1926 में इसका दूसरा संस्करण प्रकाशित हुआ। मराठी जगने वाले अंग्रेज पादरी जस्टीन अबोट ने आत्मकथा का अंग्रेजी में अनुवाद किया और 1929 में ॐ यह रचना प्रकाशित हुई। अंग्रेजी संस्करण के प्रथम 1 पृष्ठों में बहिनाबाई की आत्मकया है पुस्तक के उत्तरार्दध में उनके द्वारा रचित अभंगों का अंग्रेजी अनुवाद है तथा अतिम भाग में बहिना बाई द्वारा मूल मराठी में लिखी गई आत्मकथा दी गई है।)
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गुमनाम वीरांगनाएँ

पार्वती बाई अठावलेः जो विधवाओं के हक के लिए लड़ी

(हमारे भारतीय समाज में ऐसी अनेक महिलाए हुई हैं जिन्होंने अपने जीवन की अधेरी राहों को तो रोशन किया ही, पूरे समाज की महिलाओं को भी प्रकाश का रास्ता दिखाया। ऐसी ही गुमनाम वीरागनाओं में पार्वतीबाई अठावले का नाम अगली कतार में आता है. जिन्होंने मराठी भाषा में अपनी आत्मकथा लिखी जिसका अंग्रेजी अनुवाद 1923 में 'द ऑटोबायोग्राफी ऑफ एन इण्डियन विडो' शीर्षक से प्रकाशित हुआ तथा 1986 में 'हिन्दू विडो-एन ऑटोबायोग्राफी शीर्षक से पुनः प्रकाशित हुआ। इस हृदय विदारक आत्मकथा का अनुवाद मराठी का ज्ञान रखने वाले एक अंग्रेज पादरी 'जस्टीन अबोट ने किया।)

      पार्वती बाई का जन्म सन् 1870 में कोंकण के रत्नागिरि जिले के देवरुख गाँव में हुआ। 14 वर्ष की अल्पआयु में उनका विवाह गोवा में सरकारी नौकरी करने वाले अठावले से हुआ। 20 वर्ष की उम्र में ही उनके पति की मृत्यु हो गई। उस समय वे एक वर्ष के शिशु की माँ बन चुकी थी। अठावले के निधन से उन पर विपत्ति का पहाड़ टूट पड़ा क्योंकि वे अपने पीछे पार्वती की जीविका के लिए कोई आधार नहीं छोड गये थे। उन्हें मजबूरन अपने मायके लौटना पड़ा, वह मायका, जहाँ उनकी दो बड़ी बहनें पहले से ही वैधव्य का दुःखद जीवन जी रही थीं। परम्परागत हिन्दू विधवाओं का अभिशप्त जीवन जीते हुए भी वे अपने एकाकीपन और दुःख को मन की गहराइयों में छिपाकर बनावटी मुस्कान ओढ़े रहती थीं। उन्होंने अपनी आत्मकथा में लिखा है 'माता-पिता की उपस्थिति में मैं हमेशा खुद को खुश दिखाने की कोशिश करती।' पार्वती बाई के बड़े भाई, नरहर पत, सुधारवादी विचारों के समर्थक थे। उन्होंने अपनी एक बाल विधवा बहन, बाया को, मुंबई पढ़ने भेजा था। नरहर पत के घनिष्ठ मित्र थे आचार्य 'कर्वे' जिनसे बाया के पुनर्विवाह के लिए किसी विधुर वर की तलाश के लिए पत ने आग्रह किया। कर्वे स्वय इस कार्य के लिए तैयार हो गये। विवाह के बाद इस दंपत्ति ने पार्वती बाई को पूना में रखकर पढ़ाने का विचार किया। पार्वती बाई की सास को इस पर सख्त ऐतराज था क्योंकि वह नहीं चाहती थी कि उनकी बहू पर भी सुधारवाद की छाया पड़े।


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फातिमा शेखः प्रथम मुस्लिम महिला शिक्षिका

(फातिमा शेख एक भारतीय शिक्षिका थी, जिन्होंने 19 वीं शताब्दी मे समाज सुधारक ज्योतिबा फुले और सवित्रीबाई फुले के साथ शिक्षा के काम को आगे बढ़ाया। फातिमा शेख मियां उस्मान शेख की बहन थी, जिनके घर में ज्योतिबा और सावित्रीबाई फुले ने उस समय शरण ली थी. जब फुले के पिता ने दलितों और महिलाओं के उत्थान के लिए किए जा रहे उनके कामों की वजह से उन्हें घर से निकाल दिया था। उस्मान शेख ने फुले दम्पत्ती को अपने घर में रहने की पेशकश की और परिसर में एक स्कूल चलाने पर भी सहमति व्यक्त की। फातिमा ने हर संभव तरीके से ज्योतिबा और सावित्रीबाई फुले के साथ मिलकर शिक्षा के प्रचार प्रसार के साथ साथ, अन्य कई तरीकों से समाज सुधार आदोलन में साथ दिया।)

Sunday, 12 October 2025

Thursday, 9 October 2025

b eqbal

Prioritizing Public Health Over Patent Rights: Spinal Muscular Atrophy Treatment Crisis
Dr. B.Ekbal
The ongoing debate in India over access to treatment for Spinal Muscular Atrophy (SMA) highlights a fundamental conflict between public health imperatives and intellectual property rights. SMA is a rare autosomal recessive genetic neuromuscular disorder caused by mutations in the SMN1and SMN2 (Survival Motor Neuron 1, 2) gene, leading to insufficient production of SMN (Survival Motor Neuron) protein, essential for the maintenance of motor neurons. Degeneration of motor neurons results in progressive muscle weakness, respiratory failure, and, in severe cases, early death. In India, SMA is among the leading genetic causes of infant mortality, underscoring the urgency of ensuring equitable access to treatment.
The Cost Barrier: A Matter of Life and Death
Recent breakthroughs have made disease-modifying treatments for SMA available. However, their exorbitant costs render them inaccessible to most patients. Zolgensma, developed by Novartis Gene Therapies, is a one-time gene therapy costing approximately ₹18 crore. Risdiplam, marketed by Roche as Evrysdi, is an oral therapy requiring lifelong administration, priced at ₹6.2 lakh per bottle, amounting to about ₹1.8 crore annually for a 20 kg patient. 
These prohibitive costs deny patients their constitutional right to life and health under Article 21 of the Indian Constitution and drive families into financial ruin. The National Policy for Treatment of Rare Diseases (NPTRD) 2021 provides financial support up to ₹50 lakh, covering only a fraction of SMA treatment costs. Kerala Health Department’s  United against Rare Diseases (KARE) program, and crowdfunding campaigns are attempting  to bridge the gap. However, such efforts are not sufficient to address a systemic problem rooted in patent-protected monopolistic pricing.
Legal Interventions: The Case for Compulsory Licensing
India’s Patents Act contains robust provisions to protect public health, notably Section 84, which empowers the Patent Controller to grant compulsory licenses in cases of unreasonable pricing or non-availability of essential medicines. India has successfully utilized this mechanism before. In 2013, a compulsory license was granted to Natco Pharma to produce Sorafenib Tosylate (marketed by Bayer as Nexavar), a cancer drug priced at ₹2.8 lakh per month. Natco’s generic version brought the cost down to ₹6,000 per month, setting a global precedent for using public health safeguards in TRIPS-compliant patent law.
The Roche vs. Natco Pharma Battle: A Turning Point?
Building on this legacy, Natco Pharma sought to manufacture a generic version of Risdiplam, offering to sell it at ₹15,900 per bottle, a 90% reduction from Roche’s price. In response, Roche filed a patent infringement suit in the Delhi High Court, claiming exclusive rights under its patent. Natco countered that Roche’s pricing was excessive and exploitative, violating public interest, and that denying affordable treatment to SMA patients amounted to infringement of the fundamental right to life. On March 24, 2024, the Delhi High Court (single bench) dismissed Roche’s petition, emphasizing that public health considerations override patent monopolies when essential medicines are priced out of reach. The court observed that monetary compensation to the patent holder cannot substitute for the loss of human life due to lack of treatment. However, Roche has since appealed to a division bench, stalling Natco’s ability to supply the generic drug. This episode underscores how prolonged litigation can be weaponized by multinational corporations to maintain market exclusivity at the expense of human lives.
The Ethical and Policy Imperative
The SMA crisis illustrates a broader ethical dilemma in pharmaceutical patenting: Should profit-driven intellectual property regimes take precedence over human survival? The SMA context presents a, moral obligation. The central government must proactively invoke compulsory licensing for Risdiplam and similar high-cost therapies. State governments, patient advocacy groups, and public health professionals should collectively push for legislative and executive action to ensure affordable, uninterrupted access to life-saving SMA therapies, prioritization of public health over patent monopolies, and a sustainable framework for rare disease management in India.
The SMA treatment crisis is not merely a question of drug pricing; it is a test of India’s commitment to health equity and justice. The Constitution enshrines the right to life and health, and the state bears the responsibility to uphold these rights over corporate profit motives. The compulsory license is not just a legal tool; it is a moral imperative. By deploying it decisively, India can reaffirm its position as a global leader in affordable medicines and ensure that no child dies for want of treatment that exists but is priced beyond reach. Large multinational companies, with their immense financial power, can use the complexities of court proceedings to obstruct attempts to produce essential medicines at lower prices. In this situation, the central government must be prepared to use compulsory licensing under the Patents Act as needed. 
A resolution should be unanimously passed by the Kerala  state assembly urging the central government to use compulsory licensing for expensive, life-saving drugs like Risdiplam and grant other companies the right to produce their affordable generic versions.

Wednesday, 24 September 2025

Palliative care in Haryana

Palliative Care Status Update in India
We are excited to inform you that the IAPC has drawn upon this year’s World Hospice and Palliative Care Day (WHPCD) theme, ‘Leave no-one behind – equity in access to palliative care’, to put together a special feature with an update on the status of palliative care services from every State in the country.
The idea of this special feature is to generate awareness on how palliative care is being delivered in different parts of the country and to facilitate a cross fertilisation of ideas by encouraging networking and collaborations to improve the overall momentum of palliative care across the country. With this special feature, we also wish to draw your attention towards the inadequate integration of palliative care within the healthcare system and the subsequent inequity in access to Palliative care. 
This humble effort of the IAPC, with the immense support and cooperation from all the contributors, is an evolving project and only a start towards creating a database for the status of palliative care in the country.
To begin with, we are thrilled that palliative care services, in some capacity, are now locally available in all of India’s States and Union Territories, with the exceptions of the Andaman and Nicobar Islands, and Daman and Diu and Nagar and Haveli. It is also heartening to see the development of institution-based palliative care across the country, which was lacking in the past 3-4 decades. Several institutions of national importance now offer, or are beginning to offer, post graduate courses in palliative medicine; the cumulative efforts leading towards an improvement in the status of palliative care in the country.
While compiling this report, several interesting highlights came to the forefront. To name a few, the differing perspectives on whether a separate State palliative care policy is now actually needed in light of the NPPC’s implementation across the country, the ability of some States to provision care using only locally available resources, the adaptability of a State to continue providing virtual trainings for centers to receive RMI status despite the pandemic imposed limitations, the innovativeness of a State to integrate a cancer registry staff to be a part of their team to ensure statistics were collected, stood out. This list goes on.
It was also delightful to observe that palliative care provisioning in a few States was primarily led due to the initiatives of the respective State Governments’ in comparison to the commonly observed NGOs or private practitioners-led service provisioning.
We would like to reiterate that this report is only a step towards creating a concrete evidence base and that our contributors have done their best to share the information accessible to them despite their various limitations. The report will be available permanently on our website and will be converted to a more evidence based resource over time. We invite those interested to please connect with us and contribute towards making this database more robust and evidence based.
We once again extend our deepest gratitude to all the contributors for their enthusiasm, efforts, timely support and cooperation, without which this project would not have been possible. Thank you dear contributors!
With warm regards,
The Editorial Team, Indian Association of Palliative Care

palliative care

Palliative Care Status Update in India
We are excited to inform you that the IAPC has drawn upon this year’s World Hospice and Palliative Care Day (WHPCD) theme, ‘Leave no-one behind – equity in access to palliative care’, to put together a special feature with an update on the status of palliative care services from every State in the country.
The idea of this special feature is to generate awareness on how palliative care is being delivered in different parts of the country and to facilitate a cross fertilisation of ideas by encouraging networking and collaborations to improve the overall momentum of palliative care across the country. With this special feature, we also wish to draw your attention towards the inadequate integration of palliative care within the healthcare system and the subsequent inequity in access to Palliative care. 
This humble effort of the IAPC, with the immense support and cooperation from all the contributors, is an evolving project and only a start towards creating a database for the status of palliative care in the country.
To begin with, we are thrilled that palliative care services, in some capacity, are now locally available in all of India’s States and Union Territories, with the exceptions of the Andaman and Nicobar Islands, and Daman and Diu and Nagar and Haveli. It is also heartening to see the development of institution-based palliative care across the country, which was lacking in the past 3-4 decades. Several institutions of national importance now offer, or are beginning to offer, post graduate courses in palliative medicine; the cumulative efforts leading towards an improvement in the status of palliative care in the country.
While compiling this report, several interesting highlights came to the forefront. To name a few, the differing perspectives on whether a separate State palliative care policy is now actually needed in light of the NPPC’s implementation across the country, the ability of some States to provision care using only locally available resources, the adaptability of a State to continue providing virtual trainings for centers to receive RMI status despite the pandemic imposed limitations, the innovativeness of a State to integrate a cancer registry staff to be a part of their team to ensure statistics were collected, stood out. This list goes on.
It was also delightful to observe that palliative care provisioning in a few States was primarily led due to the initiatives of the respective State Governments’ in comparison to the commonly observed NGOs or private practitioners-led service provisioning.
We would like to reiterate that this report is only a step towards creating a concrete evidence base and that our contributors have done their best to share the information accessible to them despite their various limitations. The report will be available permanently on our website and will be converted to a more evidence based resource over time. We invite those interested to please connect with us and contribute towards making this database more robust and evidence based.
We once again extend our deepest gratitude to all the contributors for their enthusiasm, efforts, timely support and cooperation, without which this project would not have been possible. Thank you dear contributors!
With warm regards,
The Editorial Team, Indian Association of Palliative Care

Wednesday, 17 September 2025

आजाद

आजाद सिंह सिवाच 
जन्म दिन 24.03.1950
1975 फार्मेसी
1976 सर्विस सतनाली
23.06.1976
चिलानी 1977
महम   1978
 फरीदाबाद 1981..
1981..87 पुठी सैमन पीएचसी
1987 फरीदाबाद
1987 डिस्पेंसरी शिवाजी कॉलोनी
1991 डिस्ट्रिक्ट जेल भिवानी

1992 पीएचसी बनियानी
1992..1994 लिटरेसी कैंपेन
1994 पीएचसी बीरोड 
1995 सीएचसी खरर 
1996 पीएचसी लाखन माजरा

1998 डिस्ट्रिक्ट जेल रोहतक
1905 पीएचसी मोखरा
31.01.2007 vrs