सप्तरंग संस्था में आज अपने जीवन के अनुभव साँझा करने जा रहा हूँ । एक अजीब सी घबराहट महसूस कर रहा हूँ । क्यूँ ? शायद इसलिए कि चुनाव करना मुश्किल काम है शेयर करना तो आसान है । क्या व्यक्तिगत है और क्या सामाजिक है यह एक बड़ी कम्प्लेक्स चुनौती है ।
Saturday, 25 October 2014
ग्रेड 4 कुपोषण
एक बात सामने आई बात चीत में कि सरकारी ढांचों की रिपोर्टिंग में बच्चों में ग्रेड 4 का कुपोषण नहीं पाया जाता है । या यूं कहें कि रिपोर्ट नहीं किया जाता क्यूंकि यदि कोई बच्चा ग्रेड 4 कुपोषण से पीड़ित है तो उसकी वॉर फुटिंग पर इलाज करने की हिदायतें हैं जिनसे बचने के लिए रिपोर्टिंग न करने का मौखिक फरमान उप्पर से दिया जाता है । इसमें कितनी वास्तविकता है इसका पता तो कुपोषण पर निस्पक्ष सर्वे करके बताया जा सकता है या फिर जन पक्षीय बच्चों के विशेषज्ञ हमें समझा सकते हैं ।
रणबीर सिंह दहिया
हरयाणा ज्ञान विज्ञानं समिति
रणबीर सिंह दहिया
हरयाणा ज्ञान विज्ञानं समिति
Saturday, 18 October 2014
Contamination from depleted uranium (DU) munitions
Contamination from depleted uranium (DU) munitions
Tuesday, 14 October 2014 09:42 By Dahr Jamail, Truthout | Report
(Photo: Patty Mooney / Flickr)Contamination from depleted uranium (DU) munitions is causing sharp rises in congenital birth defects, cancer cases and other illnesses throughout much of Iraq, according to numerous Iraqi doctors.Iraqi doctors and prominent scientists believe that DU contamination is also connected to the emergence of diseases that were not previously seen in Iraq, such as new illnesses in the kidney, lungs and liver, as well as total immune system collapse. DU contamination may also be connected to the steep rise in leukaemia, renal and anaemia cases, especially among children, being reported throughout many Iraqi governorates.
There has also been a dramatic jump in miscarriages and premature births among Iraqi women, particularly in areas where heavy US military operations occurred, such as Fallujah during 2004, and Basra during the 1991 US war on Iraq.
It is estimated that the United States used 350 tons of DU munitions in Iraq during the 1991 war, and 1,200 tons during its 2003 invasion and subsequent occupation.
Official Iraqi government statistics show that, prior to the outbreak of the first Gulf War in 1991, the country’s rate of cancer cases was 40 out of 100,000 people. By 1995, it had increased to 800 out of 100,000 people, and, by 2005, it had doubled to at least 1,600 out of 100,000 people. Current estimates show the trend continuing.
The actual rate of cancer and other diseases is likely to be much higher than even these figures suggest, due to a lack of adequate documentation, research and reporting of cases.
“Cancer statistics are hard to come by, since only 50 percent of the health care in Iraq is public,” Dr. Salah Haddad of the Iraqi Society for Health Administration and Promotion told Truthout. “The other half of our health care is provided by the private sector, and that sector is deficient in their reporting of statistics. Hence, all of our statistics in Iraq must be multiplied by two. Any official numbers are likely only half of the real number.”
“Genocide”
“The world should know that Iraqi people were the victims of the aggression inflicted by the use of DU munitions by the American and British troops during these wars, and this is genocide,” Dr. Jawad al-Ali, a consultant physician and oncologist, told Truthout.
Al-Ali, an expert oncologist at the Basra Cancer Treatment Center, member of the Iraqi Cancer Board and a member of the Basra Cancer Research Group, estimates that there are 300 sites throughout Iraq that are contaminated with radiation from the DU munitions.
He attributes the extreme rates of birth defects in Fallujah to the US use of DU there during its two sieges of the city in 2004.
An epidemiological study titled “Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005-2009″ involved a door-to-door survey of more than 700 Fallujah households. The research team interviewed Fallujans about abnormally high rates of cancer and birth defects.
One of the authors of the study, chemist Chris Busby, said that the Fallujah health crisis represented “the highest rate of genetic damage in any population ever studied.”
The crisis in Iraq is bad enough that the country recently called for a global treaty ban on all DU weapons. At this time, it is unknown whether DU munitions are still being used in Iraq, but it seems unlikely they are as US attacks are presently limited to airstrikes, while most DU in the past was used in rifle rounds and tank shells.
In a report submitted to the UN Secretary General in August, Iraq “expresses its deep concern over the harmful effects of the use in wars and armed struggles of armaments and ammunitions containing depleted uranium, which constitute a danger to human beings and the environment (the air and the soil).”
In September, the Center for Constitutional Rights in New York submitted a Freedom of Information Act (FOIA) request to the US Department of Defense (DOD) and the State Department on behalf of itself and Iraq Veterans Against the War (IVAW), seeking the firing coordinates of weapons used in Iraq that contained depleted uranium.
According to a 2013 report by the Netherlands-based organization Pax Christi, Iraq has been subject to the largest use of DU munitions of all areas of conflict and test sites, conservatively estimated to be at least 440 metric tons – though the UN Environment Program has estimated an amount up to five times that based on satellite imagery.
Meanwhile, doctors in Fallujah continue to witness the aforementioned steep rise in severe congenital birth defects, including children being born with two heads, children born with only one eye, multiple tumors, disfiguring facial and body deformities, and complex nervous system problems.
Residents there have told Truthout that many families are too scared to have children, as an alarming number of women are experiencing consecutive miscarriages and infant deaths with critically deformed and ill newborns.
Dr. Samira Alani, a pediatric specialist at Fallujah General Hospital, has taken a personal interest in investigating an explosion of congenital abnormalities that have mushroomed in the wake of the US sieges since 2005.
“We have all kinds of defects now, ranging from congenital heart disease to severe physical abnormalities, both in numbers you cannot imagine,” Alani told Truthout at her office in the hospital last year, while sharing countless photos of shocking birth defects.
Alani also co-authored a study in 2010 that showed the rate of heart defects in Fallujah to be 13 times the rate found in Europe. And, for birth defects involving the nervous system, the rate was calculated to be 33 times that found in Europe for the same number of births.
In pursuit of answers, Alani visited Japan, where she met with Japanese doctors who study birth defect rates they believe are related to radiation from the US nuclear bombings of Hiroshima and Nagasaki. Alani was told birth defect incidence rates in Hiroshima and Nagasaki are currently between 1 and 2 percent. Alani’s log of cases of birth defects amounts to a rate of 14.7 percent of all babies born in Fallujah, more than 14 times the rate in the effected areas of Japan.
In March 2013, Alani informed Truthout that the incident rates of congenital malformations remained around 14 percent. Alani has had to flee the city due to bombardments from the Iraqi government, including shellings that targeted clinics and hospitals, as Truthout previously reported.
Basra
Iraq’s southern city of Basra was heavily bombarded with DU munitions by US warplanes during the 1991 war.
Al-Ali was heavily involved in working on two birth defect studies carried out in the wake of that war.
“The types of birth defects were hydrocephaly [an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain], anencephaly [the absence of a large part of the brain and the skull], cleft lip and phacomelia [loss of limbs],” al-Ali told Truthout. “Other consequences are the cancers which increased three-fold during the last two decades.”
He said that clusters of cancers occurring at higher incidence within the same family were another new phenomenon seen in Iraq only after the 1991 and 2003 wars.
“Other diseases related to effects of DU were the kidney failure of unknown cause and stone formation,” he added. “Respiratory problems like asthma and also myopathy and neuropathy are now very common as well.”
In Babil Province in southern Iraq, cancer rates have been escalating at alarming rates since 2003. Dr. Sharif al-Alwachi, the head of the Babil Cancer Center, blames the use of depleted uranium weapons by US forces during and following the 2003 invasion.
“The environment could be contaminated by chemical weapons and depleted uranium from the aftermath of the war on Iraq,” Alwachi told Truthout. “The air, soil and water are all polluted by these weapons, and as they come into contact with human beings they become poisonous. This is new to our region, and people are suffering here.”
According to a study published in the Bulletin of Environmental Contamination and Toxicology, there was a sevenfold increase in the number of birth defects in Basra between 1994 and 2003.
In addition, never before has such a high rate of neural tube defects (“open back”) been recorded in babies as in Basra, and the rate continues to rise. According to the study, the number of hydrocephalus (“water on the brain”) cases among newborns is six times as high in Basra as it is in the United States.
Childhood cancer also appears to be unusually prevalent in Basra.
“We have noticed bouts of malignant tumors affecting children’s limbs,” an Iraqi doctor who has worked in various parts of the country for 20 years told Truthout. He requested anonymity for security reasons. “These malignancies are usually of very aggressive types and in the view of the shortage of facilities we are running in our hospitals they usually have a fatal outcome.”
His prognosis was grim.
“The only help we can provide to those children is amputation, which sometimes does nothing but prolonging their suffering, in addition to the great psychological impact on both the child and the parents,” he said. “We know that it is possible to save most of these children in specialized oncology centers by advanced salvage surgery, with the attendant chemotherapy and radiotherapy. Unfortunately, this seems to be a kind fantasy for our government and health administrations, which are currently busy with the large amount of trauma overwhelming our hospitals’ resources.”
Other Struggles
Al-Ali, Alani and the anonymous doctor all agreed that the two biggest challenges they face today are security and the lack of adequate supplies and equipment.
“Since 2003 and just [a] few months after the American occupation of the country, we witnessed the emergence of gangs and mafias specialized in threatening and kidnapping for ransoms and assassinations,” the anonymous doctor told Truthout. “Most of these groups work under Islamic logos, yet their affiliations are ambiguous. Amongst the target victims were doctors and their families.”
He himself had to hide in hospitals and the homes of relatives for more than half a year after he and his family was threatened.
Al-Ali said the major challenge in the south of Iraq now is the difficulty in obtaining new medicines – things like equipment for PET scans – “and also the advanced centers for bone marrow transplantation.”
The anonymous doctor explained that the security situation has degraded from bad to worse.
He explained that when Mosul was under control of the Iraqi military, military personnel regularly threatened doctors.
Now, of course, doctors across the country are under a new security threat, with militants affiliated with the Islamic State now in control of many areas of Iraq.
“The greatest concern now is the future,” al-Ali said. “After the many blind airstrikes that destroyed civilian housing and sacrificed innocent lives, we believe that the war against ISIS is going to be a process of retaliation against Sunni people in an indiscriminate way. This is how things go on in Iraq, terrorism against terrorism, blood for blood, destruction for destruction, and the vicious circle goes on.”
Ultimately, he, like many Iraqis today, blames the United States and Iran for triggering and maintaining the chaos that is engulfing Iraq.
The violence contributes to an exodus of doctors from the country, as more than half of all medical personnel in Iraq have fled the country since 2003.
“Doctors are trying to escape outside the country to save themselves and their families,” al-Ali added. “Doctors that have remained in the cities are still there for humanitarian reasons.”
Copyright, Truthout. May not be reprinted without permission.
Dahr Jamail
Dahr Jamail, a Truthout staff reporter, is the author of The Will to Resist: Soldiers Who Refuse to Fight in Iraq and Afghanistan, (Haymarket Books, 2009), and Beyond the Green Zone: Dispatches From an Unembedded Journalist in Occupied Iraq, (Haymarket Books, 2007). Jamail reported from Iraq for more than a year, as well as from Lebanon, Syria, Jordan and Turkey over the last ten years, and has won the Martha Gellhorn Award for Investigative Journalism, among other awards.
His fourth book, The Mass Destruction of Iraq: Why It Is Happening, and Who Is Responsible, co-written with William Rivers Pitt, is available now on Amazon. He lives and works in Washington State.
Tuesday, 16 September 2014
HARYANA HEALTH MANIFESTO
HARYANA HEALTH MANIFESTO
September 16, 2014 at 3:46pm
Manifesto to promote health and healthcare in Haryana:
The right to health is a fundamental and universal right of all citizens and this will need to be respected and realized within a time frame. The Right to Health needs also to be located in the underlying determinants of health such as access to safe water and sanitation, adequate food and nutrition, housing, and secure livelihoods. Above all social inequities -- based on disparities along gender, caste, class and other lines – have a profound impact on the health of the poorest and the most marginalized.
The following concrete proposals are designed to reverse the present -- entirely unacceptable -- situation in the health sector, and to secure conditions of living and health care services that promote health in all its dimensions..
1. Act on the Social Determinants of Health: In Haryana this aspect is not taken seriously .This would include promotion of food security by universalization and expansion of the Public Distribution System (to also provide local cereals, pulses and oil)in an effective way; a national policy on Child Health and nutrition and universalization of ICDS with expansion of staff and services to effectively cover under-3 children; ensure universal availability of safe water in each village and habitation of Haryana ; and universal access to safe hygienic toilets in all habitations.
2. Address the Gender dimensions of Health: In Haryana gender bias is very predominant. This is reflected in sex ratio .Guarantee comprehensive, accessible, quality health services for all women and transgender persons for all their health needs which includes but is not limited to maternal care. Abolish all coercive laws, policies and practices that violate the reproductive, sexual and democratic rights of women; and regulate use of invasive reproductive technologies. Recognize gender based violence as a public health issue and ensure access to comprehensive health care (physical as well as psychosocial), screening, documentation, referrals, as well as coordinated, ethical medico-legal processes for survivors. Guarantee comprehensive, quality, accessible, adolescent-friendly health care, including for their reproductive and sexual health needs. Health Education in schools should be undertaken with pro gender orientation.
3. Immediately reverse Caste Based Discrimination: Haryana is having caste domination in our social life. Take immediate and effective steps to entirely reverse all forms of caste based discrimination, which is one of the most important social determinants of ill health. Immediate ban on manual scavenging. In the health care sector, special measures to promote priority access to discriminated sections of society.
4. Enact a Right to Health Act in Haryana which assures universal access to good quality and comprehensive health care for all the entire range of primary, secondary and tertiary services, and that makes denial or non-availability for reasons of access, affordability or quality a justiciable offence.
5. Increase Public Expenditure on Health to 3.6% of GDP annually (Rs 3000/- per capita at current rates) with the central government’s contribution being at least 1% of GDP (Rs 1000/- per capita). All public health expenditure to be tax financed. Public health spending to be increased to 5% of GDP in medium term.
6. Ensure quality and assured availability of health care: A lot can be said about the present infrastructure and staff in Haryana Health Sector. It should be updated as per laid down norms. Quality of care to be ensured in all health facilities, which would mean health care that is effective, safe and non-exploitative, provided with due dignity and respect to patient rights, and which aims at patients’ comfort and satisfaction. Quality norms and standards shall not mean conforming to infrastructure or other standards, which favor large corporate hospitals, or worse medical tourism, and make it impossible to provide low cost, rational and effective care. Every public health care facility would be required to provide guaranteed health services appropriate to their level in assured manner. Public health facilities to be entirely free of user fees and the entire range of services to be provided directly by government run facilities and not through Public Private Partnerships (PPPs).
7. Stop both Active and Passive Privatization of health care services in Haryana: Necessary measures to stop active privatization in the form of transfer of public resources or assets to private entities that provide services on a commercial basis. Measures to stop passive privatization by increasing investment in public health facilities, increasing number of beds and facilities in the public sector, and by expanding range of services available in public facilities. Public facilities to provide comprehensive health care services, not limited only to reproductive health care, immunization and a care for a few diseases of national importance.
8. Training of Health workforce in Haryana on war footing : Increase public investment in education and training of the entire range of health personnel. Ensure that government run colleges to train a range of health workers, nurses and doctors are located in areas where they are needed most. Training to be reoriented to impart skills that address the health needs of local communities. The trend of commercialization of higher education in medical and allied health sciences to be reversed, along with stringent mechanisms for regulation of existing private institutions in a transparent manner. The functioning of the Medical Council of India and the Nursing Council of India to be thoroughly scrutinized and revamped to weed out rampant corrupt and unethical practices in these institutions.
9. Well Governed, Adequate Public Health Work force in Haryana :Create adequate posts for the entire range of health personnel in the public health system. Regularize contractual employees and provide ASHAs, ANMs and all levels of public health system staff with adequate skills, salaries, and decent working conditions .The health and safety of workers, particularly of women to be assured. Act on available evidence from many states which show that the problem of the lack of doctors in rural areas is more a result of administrative incompetence and political failure than a matter of professional culture. Creation of a cadre of doctors, nurses and other paramedical workers who have training in primary health care, public health and in working as a team.
10. Secure access to quality assured essential medicines and diagnostic services in all public health facilities, free of charge in Haryana . This would be achieved by developing autonomous and transparent procurement and demand driven distribution mechanism (on the lines of Tamil Nadu, Kerala and Rajasthan). For chronic illness it would mean ensuring such access throughout the year from a distribution point most accessible to patients. Generic prescriptions to be made compulsory in all health facilities. The various schemes for benefit of patients should be implemented earnestly. Monitoring system should be there from top to bottom.
11. Participatory Planning, Community Participation and Community Based Monitoring of health services in Haryana to ensure accountability and responsiveness of services. Community Based Monitoring and Planning will be generalized and made a core component of all public health programs and health care services, to help effective delivery of services and ensure accountability and transparency.
12. Eliminate Corruption in the Public Health System. Deep rooted problem in Haryana . Can be contained through transparent policies for appointments, promotions, transfers, procurement of goods and services and infrastructure development – all of which are legislated through a Transparency Act (as in Tamil Nadu for procurement and Karnataka for transfers). Institution of robust grievance redressal systems, which are adequately financed and managed with some degree of autonomy from the management.
13. Reverse Exploitation by private hospitals and protect ethical private non commercial private providers in Haryana : The national Clinical Establishment Act would have provisions for: observance of patient's rights in all clinical establishments; regulation of the rates of various services; elimination of kickbacks for prescriptions, diagnostics and referrals;and establishment of government supervised independent grievance redressal mechanisms for patients. Standards would be designed in a manner that would prevent corporatization of health care. This would promote genuine not-for-profit and ethical health care providers and would contain costs of care in the private sector.
14. Absorb, over a period, existing publicly funded health insurance schemes (RSBY and different state health insurance schemes) into an expanded public health system publicly financed through general taxation .All entitlements available under these schemes would be made available through the public health system, suitably expanded and adequately resourced. This should include a comprehensive system for health care protection of unorganized and organized sector workers (providing primary, secondary and tertiary health care), linked with expansion and rejuvenation of the ESI.
15. Eliminate the role of multi-lateral and bilateral financing agencies from all areas of technical assistance or health policy formulation. Eliminate the influence of agencies -- such as the World Bank, USAID and Gates Foundation, as well as consultancy organizations such as Deloitte and McKinsey – in formulation of national priorities and approaches to health care provisioning and financing. Build international collaboration for generation and sharing of knowledge resources, especially with other developing countries. Exert pressure at the governmental level to free WHO, UNICEF and other UN agencies from dependence on corporate financing and influence. Critically examine the offer of advise and expertise from such agencies till such time as they continue to be influenced by corporations and private foundations.
16. Build National and State level capacity for Health research and development: The government would invest at least 5% of its public health budget on health research including health systems research. The government, for the purpose of promoting health systems research and research for domestic priorities, would develop institutions and strengthen existing institutions that are financed through public funds.
17. Ensure access to essential and safe Drugs & Devices :Cost-based price-control of all medicines, measures to ensure drug and device safety ,banning of irrational medicines and irrational combinations, opening of generic medicine outlets in adequate numbers, mandatory provision for doctors to write generic names of medicines ,use of the public health safeguards in the Indian Patent Act to promote access to medicines, and active promotion of indigenous manufacture of most drugs and devices.
18. Regulation of clinical trials and ethics in biomedical research: Develop a clear framework for the ethical conduct of clinical trials in India, combined with the regulation of all those that are involved -- sponsors of trials, CROs, ethics committees etc. Ensured that the CDSCO and the ICMR monitor the conduct of clinical trials at the trial sites and only permit trials at sites which are equipped to handle emergencies and adverse events. Fair compensation norms for trial participants who suffer from adverse events to be expeditiously developed and implemented. A charter of rights of clinical trial participantsto be developed and made justiciable.
19. Ensure access to treatment and care of persons with mental illness (PWMI) through integration of the revised District Mental Health Program with the National Health Mission. The rights of PWMI need to be protected by adoption of the Mental Health Act and action on the draft mental health policy.
20. Ensure facilities for estimation of residual effect of pesticides in human beings. Stop irrational and unethical use of Oxytocin in buffaloes and cows,
21. Stop Nuclear Plant in Gorakhpur . It will have many health hazards. Be more vpertinent about environmental issues related in development of Industry
September 16, 2014 at 3:46pm
Manifesto to promote health and healthcare in Haryana:
The right to health is a fundamental and universal right of all citizens and this will need to be respected and realized within a time frame. The Right to Health needs also to be located in the underlying determinants of health such as access to safe water and sanitation, adequate food and nutrition, housing, and secure livelihoods. Above all social inequities -- based on disparities along gender, caste, class and other lines – have a profound impact on the health of the poorest and the most marginalized.
The following concrete proposals are designed to reverse the present -- entirely unacceptable -- situation in the health sector, and to secure conditions of living and health care services that promote health in all its dimensions..
1. Act on the Social Determinants of Health: In Haryana this aspect is not taken seriously .This would include promotion of food security by universalization and expansion of the Public Distribution System (to also provide local cereals, pulses and oil)in an effective way; a national policy on Child Health and nutrition and universalization of ICDS with expansion of staff and services to effectively cover under-3 children; ensure universal availability of safe water in each village and habitation of Haryana ; and universal access to safe hygienic toilets in all habitations.
2. Address the Gender dimensions of Health: In Haryana gender bias is very predominant. This is reflected in sex ratio .Guarantee comprehensive, accessible, quality health services for all women and transgender persons for all their health needs which includes but is not limited to maternal care. Abolish all coercive laws, policies and practices that violate the reproductive, sexual and democratic rights of women; and regulate use of invasive reproductive technologies. Recognize gender based violence as a public health issue and ensure access to comprehensive health care (physical as well as psychosocial), screening, documentation, referrals, as well as coordinated, ethical medico-legal processes for survivors. Guarantee comprehensive, quality, accessible, adolescent-friendly health care, including for their reproductive and sexual health needs. Health Education in schools should be undertaken with pro gender orientation.
3. Immediately reverse Caste Based Discrimination: Haryana is having caste domination in our social life. Take immediate and effective steps to entirely reverse all forms of caste based discrimination, which is one of the most important social determinants of ill health. Immediate ban on manual scavenging. In the health care sector, special measures to promote priority access to discriminated sections of society.
4. Enact a Right to Health Act in Haryana which assures universal access to good quality and comprehensive health care for all the entire range of primary, secondary and tertiary services, and that makes denial or non-availability for reasons of access, affordability or quality a justiciable offence.
5. Increase Public Expenditure on Health to 3.6% of GDP annually (Rs 3000/- per capita at current rates) with the central government’s contribution being at least 1% of GDP (Rs 1000/- per capita). All public health expenditure to be tax financed. Public health spending to be increased to 5% of GDP in medium term.
6. Ensure quality and assured availability of health care: A lot can be said about the present infrastructure and staff in Haryana Health Sector. It should be updated as per laid down norms. Quality of care to be ensured in all health facilities, which would mean health care that is effective, safe and non-exploitative, provided with due dignity and respect to patient rights, and which aims at patients’ comfort and satisfaction. Quality norms and standards shall not mean conforming to infrastructure or other standards, which favor large corporate hospitals, or worse medical tourism, and make it impossible to provide low cost, rational and effective care. Every public health care facility would be required to provide guaranteed health services appropriate to their level in assured manner. Public health facilities to be entirely free of user fees and the entire range of services to be provided directly by government run facilities and not through Public Private Partnerships (PPPs).
7. Stop both Active and Passive Privatization of health care services in Haryana: Necessary measures to stop active privatization in the form of transfer of public resources or assets to private entities that provide services on a commercial basis. Measures to stop passive privatization by increasing investment in public health facilities, increasing number of beds and facilities in the public sector, and by expanding range of services available in public facilities. Public facilities to provide comprehensive health care services, not limited only to reproductive health care, immunization and a care for a few diseases of national importance.
8. Training of Health workforce in Haryana on war footing : Increase public investment in education and training of the entire range of health personnel. Ensure that government run colleges to train a range of health workers, nurses and doctors are located in areas where they are needed most. Training to be reoriented to impart skills that address the health needs of local communities. The trend of commercialization of higher education in medical and allied health sciences to be reversed, along with stringent mechanisms for regulation of existing private institutions in a transparent manner. The functioning of the Medical Council of India and the Nursing Council of India to be thoroughly scrutinized and revamped to weed out rampant corrupt and unethical practices in these institutions.
9. Well Governed, Adequate Public Health Work force in Haryana :Create adequate posts for the entire range of health personnel in the public health system. Regularize contractual employees and provide ASHAs, ANMs and all levels of public health system staff with adequate skills, salaries, and decent working conditions .The health and safety of workers, particularly of women to be assured. Act on available evidence from many states which show that the problem of the lack of doctors in rural areas is more a result of administrative incompetence and political failure than a matter of professional culture. Creation of a cadre of doctors, nurses and other paramedical workers who have training in primary health care, public health and in working as a team.
10. Secure access to quality assured essential medicines and diagnostic services in all public health facilities, free of charge in Haryana . This would be achieved by developing autonomous and transparent procurement and demand driven distribution mechanism (on the lines of Tamil Nadu, Kerala and Rajasthan). For chronic illness it would mean ensuring such access throughout the year from a distribution point most accessible to patients. Generic prescriptions to be made compulsory in all health facilities. The various schemes for benefit of patients should be implemented earnestly. Monitoring system should be there from top to bottom.
11. Participatory Planning, Community Participation and Community Based Monitoring of health services in Haryana to ensure accountability and responsiveness of services. Community Based Monitoring and Planning will be generalized and made a core component of all public health programs and health care services, to help effective delivery of services and ensure accountability and transparency.
12. Eliminate Corruption in the Public Health System. Deep rooted problem in Haryana . Can be contained through transparent policies for appointments, promotions, transfers, procurement of goods and services and infrastructure development – all of which are legislated through a Transparency Act (as in Tamil Nadu for procurement and Karnataka for transfers). Institution of robust grievance redressal systems, which are adequately financed and managed with some degree of autonomy from the management.
13. Reverse Exploitation by private hospitals and protect ethical private non commercial private providers in Haryana : The national Clinical Establishment Act would have provisions for: observance of patient's rights in all clinical establishments; regulation of the rates of various services; elimination of kickbacks for prescriptions, diagnostics and referrals;and establishment of government supervised independent grievance redressal mechanisms for patients. Standards would be designed in a manner that would prevent corporatization of health care. This would promote genuine not-for-profit and ethical health care providers and would contain costs of care in the private sector.
14. Absorb, over a period, existing publicly funded health insurance schemes (RSBY and different state health insurance schemes) into an expanded public health system publicly financed through general taxation .All entitlements available under these schemes would be made available through the public health system, suitably expanded and adequately resourced. This should include a comprehensive system for health care protection of unorganized and organized sector workers (providing primary, secondary and tertiary health care), linked with expansion and rejuvenation of the ESI.
15. Eliminate the role of multi-lateral and bilateral financing agencies from all areas of technical assistance or health policy formulation. Eliminate the influence of agencies -- such as the World Bank, USAID and Gates Foundation, as well as consultancy organizations such as Deloitte and McKinsey – in formulation of national priorities and approaches to health care provisioning and financing. Build international collaboration for generation and sharing of knowledge resources, especially with other developing countries. Exert pressure at the governmental level to free WHO, UNICEF and other UN agencies from dependence on corporate financing and influence. Critically examine the offer of advise and expertise from such agencies till such time as they continue to be influenced by corporations and private foundations.
16. Build National and State level capacity for Health research and development: The government would invest at least 5% of its public health budget on health research including health systems research. The government, for the purpose of promoting health systems research and research for domestic priorities, would develop institutions and strengthen existing institutions that are financed through public funds.
17. Ensure access to essential and safe Drugs & Devices :Cost-based price-control of all medicines, measures to ensure drug and device safety ,banning of irrational medicines and irrational combinations, opening of generic medicine outlets in adequate numbers, mandatory provision for doctors to write generic names of medicines ,use of the public health safeguards in the Indian Patent Act to promote access to medicines, and active promotion of indigenous manufacture of most drugs and devices.
18. Regulation of clinical trials and ethics in biomedical research: Develop a clear framework for the ethical conduct of clinical trials in India, combined with the regulation of all those that are involved -- sponsors of trials, CROs, ethics committees etc. Ensured that the CDSCO and the ICMR monitor the conduct of clinical trials at the trial sites and only permit trials at sites which are equipped to handle emergencies and adverse events. Fair compensation norms for trial participants who suffer from adverse events to be expeditiously developed and implemented. A charter of rights of clinical trial participantsto be developed and made justiciable.
19. Ensure access to treatment and care of persons with mental illness (PWMI) through integration of the revised District Mental Health Program with the National Health Mission. The rights of PWMI need to be protected by adoption of the Mental Health Act and action on the draft mental health policy.
20. Ensure facilities for estimation of residual effect of pesticides in human beings. Stop irrational and unethical use of Oxytocin in buffaloes and cows,
21. Stop Nuclear Plant in Gorakhpur . It will have many health hazards. Be more vpertinent about environmental issues related in development of Industry
Sunday, 14 September 2014
kuchh baten
दोस्तो कुछ चीजें ऐसी होती हैं जिसे हम जानते हैं कि हमें करना चाहिए पर फिर भी हम नहीं करते . उन्ही में से एक है . “अपनी सेहत पर ध्यान देना .” हमें पता है की अच्छे पौष्टिक भोजन से सेहत ठीक रहती है मगर पौष्टिक भोजन की जानकारी हमारी काफी कमजोर है और जानकारी है भी तो बहुत से लोगों के पास साधन नहीं हैं पौष्टिक भोजन खाने के । महज पौष्टिक भोजन खाओ यह सलाह कई बार कुछ परिवारों को छोड़कर ज्यादा कारगर नहीं होती । सुबह सैर करने से कई बीमारियों को दूरी पर रखा जा सकता है । जानते हैं पर ----
हम कहते हैं “Health comes first” , पर हकीकत में हम इसे last preference देते हैं .
हम कहते हैं “Health is wealth”, पर जीते ऐसे हैं मानो “Wealth is health”
हम कहते हैं “Health is wealth”, पर जीते ऐसे हैं मानो “Wealth is health”
हममें से 95% लोग ऐसा ही करते हैं ; और मैं भी उन्ही 95% लोगों में हूँ या कह सकते हैं कि तीन दिन पहले तक था ..जो अपनी health पर ध्यान नहीं देते …. पर अब मैं 5% ध्यान देने वालों के group में jump करना चाहता हूँ . शुरुआत तीन दिन पहले की है , पिछले तीन दिनों से मैं सुबह उठ कर exercise कर रहा हूँ … इसे जारी रख पाऊँ ऐसी उम्मीद करता हूँ , और आज publicly इस बारे में बता कर शायद मैं इस दिशा में और भी मजबूती से बढ़ पाउँगा … let’s see!!!
और ऐसा नहीं है कि ये पहली बार शुरू किया है … पहले भी कई शुरुआत कर चुके हैं पर कुछ दिनों बाद आप जानते ही हैं क्या होता है …. और कैसे नहीं जानेंगे आपके साथ भी तो यही होता आया है … 
पर मैं इस बार पीछे नहीं हटने वाला , अपनी daily routine में मैं exercise को ज़रूर include करूँगा और तब तक करूँगा जब तक ये brush करने या रोज नहाने जितना आम ना हो जाये …मेरी habit में ना आ जाये …
तो इसके लिए मैं क्या करने वाला हूँ ; इस बारे में बताता हूँ पर उससे पहले आइये समझने की कोशिश करते हैं कि हम अपनी health को ignore क्यों करते रहते हैं :
क्योंकि हमें प्यास लगने पे कुआँ खोदने की आदत है :
अधिकतर लोग बिजली बिल / टेलीफोन बिल कब जमा करते हैं ….last day पर … जब तक काम सर पर नही आ जाता हम उसे टालते रहते हैं … और यही health के साथ भी होता है ….. चूँकि अभी हमारी health normal है , इसलिए हमे इस और ध्यान देने की कोई urgency नहीं लगती , लगता है सब ठीक ही तो है , फिर अभी walk पे जाने की , jogging करने की क्या जल्दी है कुछ दिन बाद शुरू कर सकते हैं … but as we all know ऐसा हम कई सालों से सोचते आ रहे हैं, पर करते कभी नहीं .
हम सोचते हैं बुरी चीजें दूसरों के साथ ही हो सकती हैं :
Health के case में हम अपना बुरा कभी नहीं सोचते …. हाँ और चीजों में खूब बुरा सोच लेते हैं पर सेहत के मामले में हम अलग हैं …य़े जानते हुए भी की करोड़ों Indian diabetic हैं हम कभी नहीं सोचते की हमारी lazy lifestyle की वजह से हमें भी diabetes हो सकता है … हम इस ओर गलती से भी ध्यान नहीं देते कि अगर लाखों लोगों को young age में ही दिल की बीमारी हो रही है तो कल को हमें भी हो सकती है …मानो हम man नहीं superman हों !!!
हम सोचते हैं कि बाद में भी ध्यान दे दिया तो काम चल जायेगा :
पर ऐसा नहीं है , पहले तो ये “बाद ” जल्दी आता नहीं है , और दूसरा जिस वक़्त हम health को postpone करते जाते हैं उसी वक़्त हम bad health या बीमारी को advance करते जाते हैं . यानि हम खुद को समझा तो लेते हैं कि बाद में cover कर लेंगे पर जिस तरह school में शुरू से पढाई से जी चुराने वाला student कभी अंत में पढ़ कर 100% score नहीं कर पाटा , उसी तरह कोई इंसान सालों तक ignore करने के बाद अंत में ध्यान देने पर 100% health नहीं पा सकता , इसलिए हमे आज से ही इस direction में ध्यान देना चाहिए .
क्योंकि हमारा environment ऐसा है :
अगर आप सुबह walk पर जाएं तो आपको ज्यादातर old age people, या मोटापे से परेशान लोग ही दिखेंगे …ये वो हैं जिन्हे प्यास लग चुकी है , उनकी life में health issues आ चुके हैं …पर जो young हैं …अभी healthy हैं वो नदारद हैं … हमारा कोई दोस्त jogging पे नहीं जाता , gym के दर्शन नहीं करता इसलिए अगर हम नहीं करते तो क्या बुरा करते हैं ….friends, health पर ध्यान न देना दरअसल एक बीमारी है पर चूँकि 95% लोग बीमार हैं इसलिए इसे ही normal life मान लिया गया है …. पर as you know सच्चाई कुछ और ही है !
Well, अब मैं अपना plan बताता हूँ :
बड़ा simple है ; मैंने decide किया है कि मैं सुबह fresh होने के बाद का 30 minute exercise को दूंगा .
फिर चाहे मैं 6 बजे उठूँ या 9 बजे …ज़ब भी उठूंगा 30 minute health को दूंगा …. हम ब्रश के साथ भी तो यही करते हैं , isn’t it? क्या कोई ऐसा भी है जो देर से उठने पर brush नहीं करता …. सभी करते हैं … जब उठते हैं तब करते हैं … और वही मैं exercise के साथ करूँगा ….
इसमें क्या challenges आ सकते हैं ?
इससे मैं office के लिए late हो सकता हूँ …. मेरी आज plan की गयी blog post कल के लिए postpone हो सकती है …अखबार पढ़ने में gap हो सकता है …but let it be… हम हमेशा कहते हैं सेहत से बढ़कर कुछ नहीं , सेहत है तो दौलत है , and all that gyan … पर दिक्कत ये है कि सिर्फ कहते हैं practically कभी apply नहीं करते , इस बार मैं करने जा रहा हूँ …. मैं अपने आसपास मौजूद बीमार लोगों को देख रहा हूँ और मैंने इस बार अंदर से महसूस किया है कि “healthy” रहने से बड़ा और कोई asset हो ही नहीं सकता …
एक छोटी सी कहानी सुनाता हूँ …
एक सेठ था ,वो दिन- रात business बढ़ाने में लगा रहता था , उसका goal था कि उसे शहर का सबसे अमीर आदमी बनना है . धीरे -धीरे उसने ये goal पूरा भी कर लिया , इस कामयाबी की ख़ुशी में उसने एक शानदार घर बनवाया। गृह प्रवेश के दिन उसने एक बहुत बड़ी पार्टी दी और जब सारे मेहमान चले गए तो वो अपने कमरे में सोने के लिए गया .
वो जैसे ही बिस्तर पर लेटा एक आवाज़ उसके कानो में पड़ी ,
” मैं तुम्हारी आत्मा हूँ … और अब मैं तुम्हारा शरीर छोड़ कर जा रही हूँ !!”
सेठ सकते में आ गया और बोला , ” अरे तुम ऐस नहीं कर सकती, तुम चली जाओगी तो मैं तो मर जाऊँगा …देखो मैंने कितनी बड़ी कामयाबी हांसिल की है… तुम्हारे लिए करोड़ों रूपये का घर भी बनवाया है … इतनी सुख -सुविधाएं तुम्हे कहीं नहीं मिलेंगी … यहाँ से मत जाओ …”
आत्मा बोली , ” मेरा घर तो तुम्हारा शरीर था …. पर करोड़ों का घर बनवाने के चक्कर में तुमने इस अमूल्य शरीर का ही नाश कर डाला ,…तुम ठीक से चल नहीं पाते …ऱात को तुम्हे नींद नहीं आती … तुम्हारा दिल भी कमजोर हो चुका है …. तनाव की वजह से ना जाने और कितनी बीमारियों का घर बन चुका है तुम्हारा शरीर …… तुम ही बताओ क्या तुम ऐसे किसी घर में रहना चाहोगे जहाँ चारो तरफ गंदगी हो … जिसकी छत टपक रही हो …. जिसके खिड़की -दरवाजे टूटे हों …., नहीं चाहोगे ना !!! …. इसलिए मैं भी ऐसी जगह नहीं रह सकती ….”
और ऐसा कहते हुए आत्मा सेठ के शरीर से निकल गयी …और सेठ की मृत्यु हो गयी .
Friends, ये कहानी बहुत से लोगों की हकीकत है … मैं ये नहीं कहता की आप अपने goals pursue मत करिये , पर मैं ये ज़रूर कहूंगा कि जो भी करिये Health को सबसे ऊपर रखिये …. नहीं तो सेठ की तरह goal achieve कर लेने के बाद भी अपनी success को enjoy नहीं कर पाएंगे .
अंत में Swami Vivekananda के एक quote से अपनी बात ख़तम करना चाहूंगा …
“You will be nearer to heaven through football than through the study of the Gita.
तुम गीता का अध्ययन करने के बजाये फ़ुटबाल के जरिये स्वर्ग के ज्यादा निकट होगे .”
तुम गीता का अध्ययन करने के बजाये फ़ुटबाल के जरिये स्वर्ग के ज्यादा निकट होगे .”
… गीता पढ़िए …. पर फ़ुटबाल खेलना मत भूलिए …. अपने goal के पीछे दौड़िये पर अपनी health को पीछे मत छोड़िये ….
Tuesday, 19 August 2014
HARYANA SOCIETY AND HEALTH CHALLENGES
STATE CONVENTION
Topic:
Haryana Society and
Health Challenges
Date: 31.8.2014, Time: 10.30 AM
Venue: New Lecture Theatre (Near Anatomy Deptt.)
PGIMS,Rohtak
Main Speaker: Dr Amit
Sengupta ,
National Convener JSA & General Secretary of AIPSN
National Convener JSA & General Secretary of AIPSN
Amitava Guha, National Convenor JSA
Haryana Health Status: Dr. R. S.
Dahiya
Discussion and Comments: Audience
Future Planning: Satnam Singh
Vote of thanks and Remarks from the Chair
HEALTH CONVENTION
JAN SWASTHAY ABHIYAN HARYANA
STATE CONVENTION
Topic:
Haryana Society and
Health Challenges
Date: 31.8.2014, Time: 10.30
Venue: New Lecture Theatre (Near Anatomy Deptt.)
Venue: New Lecture Theatre (Near Anatomy Deptt.)
Main Speaker: Dr Amit
Sengupta ,
National Convener JSA & General Secretary of AIPSN
Amitava Guha, National Convenor JSA
National Convener JSA & General Secretary of AIPSN
Amitava Guha, National Convenor JSA
Haryana Health Status: Dr. R. S.
Dahiya
Discussion and Comments: Audience
Future Planning: Satnam Singh
Vote of thanks and Remarks from the Chair
Subscribe to:
Posts (Atom)