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Pinpricking by China
Still groping in the dark |
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Identification advantage
Oil, Islam and diplomacy
Too much of “Happy New Year”
Epidemic in the making
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Pinpricking by China
During
his recent Delhi visit Chinese Premier Wen Jiabao described the India-China border dispute as a “historical legacy”, which, in his opinion, “will take a fairly long period of time” to be resolved. Indeed, the way China has been raising it time and again inspires little hope of resolution. The latest from China is that its official Map World website, an answer to Google Earth, mentions India’s Arunchal Pradesh as a part of Chinese territory. Another objectionable entry in Map World is that it shows Aksai Chin in China’s Xinjiang province, denying India’s sovereignty over it. The Map World challenge came soon after China issued stapled visas to Indian sportspersons from Arunachal Pradesh wanting to visit China. This was on the lines of the Chinese practice of issuing stapled visas to visitors from Jammu and Kashmir. Earlier China refused to issue a visa to anyone from Arunachal seeking to visit China. Those in India who thought that there was some change in China’s policy have to revise their views, as Beijing has come out with an explanation that there is no change in its perception and it continues to consider Arunachal as South Tibet and a part of China. These are, no doubt, pinpricks which can lead to a major crisis between the two emerging global powers. There is need to take up these issues seriously through the “working mechanism for consultation and coordination on border affairs”, set up during Mr Wen’s December visit to India. China must respect India’s sensibilities and should avoid any demonstration of the border dispute in the manner it has been doing so far. Both have been gaining substantially in terms of rising bilateral trade for some time. The economic gains may get threatened if the border dispute is not kept aside to be settled in a spirit of give and take.
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Still groping in the dark
The
2010 Annual Status of Education Report is a grim reminder of the dismal state of school education in India. Brought out by an NGO called Pratham, it says half the students in Class V cannot read Class II texts. Students increasingly opt for private, English-medium schools. The enrolment in schools has jumped from 16.3 per cent in 2005-06 to 24.3 per cent in 2010. Although there is an overall decline in basic mathematics skills in the country, the situation has improved in Punjab where 70.4 per cent of the Class II students could recognise numbers in 2010 compared to 56.9 per cent in 2009. But this should not lead one to conclude that Punjab has entered the league of Karnataka, Tamil Nadu and Kerala. The improvement in the learning of mathematics skills in Punjab is at a limited level. Students of the southern states excel in competitive examinations for engineering and technology courses as also in sciences and the IT sector. Their dominance at the global level in IT companies is well known. Besides, the survey itself says that 70.8 per cent of Punjab’s Class III-IV students can read only Class I texts. Even this is seen as an achievement in comparison with the national average of 64 per cent. Punjab’s literacy rate is at a dismal 16th position nationwide. The Pratham survey reinforces the fact that schools lack proper infrastructure as is mandated by the Right to Education Act, which came into force in April last. Thirty per cent of the 16,000 schools surveyed do not have drinking water facilities and 50 per cent are without toilets. Teacher absenteeism is at a high of 45 per cent. The school dropout rate is alarming. The government has to increase education spending, ensure adequate infrastructure, appoint more teachers, improve their training and make them accountable, redesign curricula and initiate innovative and technology-based methods of teaching, and encourage private sector participation if school education is to come up to the rising expectations of parents.
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Identification advantage
The
Punjab Government is to be commended for being quick off the starting line and launching the Unique Identification Number (UID) project in the state. The project is appropriately termed Aadhaar and thus the UID would be the basis of all schemes for which the benefactors need to be identified. The UID card would be linked to the blue cards for BPL families, the ration card and the LPG connections, for starters. The state government has a major role to play in making sure that everyone is covered by the UID programme. Government officials at village level would have to ensure that everyone is identified, his or her data is recorded and the card issued. Obviously, precautions must be taken not only to ensure that everyone is covered in the scheme, but also that no fraudulent cards are made. The UID Mission has taken elaborate measures that included biometric information of the card holder, including iris scan, finger prints and photographs besides the name, address, date of birth, etc. The UID is envisaged as the Multipurpose National Identity Card which is to lay the foundation of e-governance. It will be on the basis of the information collected while preparing this card that the government schemes will be better implemented and will benefit those who need the most help. Thus all National Rural Employment Guarantee Act payments would be made to the UID card holders’ account, thereby cutting out middle men. If the UID card is extended to the banking sector, it can also have a significant role in controlling black money. It will also help in accurately identifying patterns of movement of various people from different parts of the state. The UID information can be of immense use and the Punjab government must ensure that the project is carried out accurately, transparently and according to its schedule so that the state is not only the first to start with the implementation of the UID programme, it also becomes the first to successfully conclude it.
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People rarely succeed unless they have fun in what they are doing. — Dale Carnegie
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Oil, Islam and diplomacy Over
the past two decades, India has crafted an imaginative “Look East” policy. This has resulted in growing economic integration with its economically dynamic eastern neighbourhood, while ensuring that it is a constructive partner and participant in evolving an inclusive security architecture for the Asia-Pacific region. Sadly, our horizons, as we look westward, appear to end with our “AfPak” neighbourhood, with little effort for pro-active diplomacy in the oil-rich Gulf region, where over 4 million Indians reside and work and from where we get over 70 per cent of our crucial oil imports. Moreover, with India’s trade deficit growing rapidly, our balance of payments is crucially dependent on the increasing remittances we receive from overseas Indians—$46.4 billion in 2008-2009. Our Persian Gulf neighbourhood contains two-thirds of the world’s proven petroleum reserves and 35 per cent of the world’s gas reserves. Moreover, as energy demands increase worldwide, it is these countries maintaining 90 per cent of the world’s excess production capacity, which alone can meet the growing demand of the rapidly emerging economies like China and India. Our major suppliers of oil from the Gulf are Saudi Arabia, Iran, Iraq, Kuwait, the UAE and Yemen. Iran provides 17 per cent of our oil imports, with some key refineries dependent on Iranian crude. Moreover, Iran remains our transit point for trade with Central Asia and through the Caspian, with Russia. With Pakistan denying us transit to Afghanistan, we have cooperated with Iran for reducing Afghanistan’s dependence on Pakistan, by development of infrastructure for Chah Bahar port. Iran is also providing political, diplomatic and material backing to the forces in Afghanistan which share our misgivings about the Taliban. At the same time, however, unlike their Arab neighbours, the Iranians have been unreliable in fulfilling signed contractual commitments with India, on supplies of LNG. The Persian Gulf remains the crucible for ancient civilizational and sectarian Shia-Sunni rivalries between the Persians and the Arabs. The depth of these animosities was exposed when, alluding to King Abdullah, WikiLeaks revealed the “King’s frequent exhortations to the US to attack Iran and put an end to its nuclear weapons programme”. The Saudi monarch reportedly told the Americans “to cut off the head of the snake (Iran)”. Riyadh has even reportedly offered over-flight facilities to Israeli warplanes, in the event of an Israeli attack on Iran’s nuclear facilities. Interestingly, even before Iran attacked the Osirak nuclear reactor in September 1980, the Director of Israeli Military Intelligence, Mr. Yehoshua Saguy, publicly urged the Iranians to do so. Less than a year later, on July 7, 1981, Israeli F-15s bombed and destroyed the Osirak reactor, after overflying Saudi territory. More than the Americans, the Israelis have astutely played on Arab-Persian rivalries to ensure that they remain the sole nuclear power in the Middle-East. Moreover, despite all talk of their solidarity with the Palestinians, a number of Arab countries maintain covert and not-so-covert ties with Israel’s Mossad. The sectarian dimensions of the rivalries in the Persian Gulf also cannot be ignored. Iran has consistently stirred up Shia minorities in Yemen and Kuwait and the Shia majority in Sunni-ruled Bahrain. This rivalry is also being played out in Iraq, where the Shia majority has accused its Sunni Arab neighbours of backing extremist Sunni groups. Paradoxically, after endeavouring to follow a policy of “dual containment” of both Iran and Iraq for over a decade, the Americans are now finding that their ill-advised invasion of Iraq has only brought Iran and Iraq closer together, with a number of Iraqi political and religious figures beholden to Tehran for the support they have received. While Arab regimes may be dependent on American support, the mood in Arab streets is distinctly anti-American a phenomenon the Iranians are cleverly exploiting. India’s relations with Arab Gulf States have shown a distinct improvement after the visit of Saudi Arabia’s King Abdullah in January 2006 and Dr Manmohan Singh to Riyadh in February-March 2010. India has received Saudi assurances of meeting of its growing requirements for oil. The desert kingdom and home of Islam’s holiest shrines appears to recognise the need to reach out to countries like India and China even as it maintains its strong security ties with the US. Moreover, our relations with Oman, the UAE and Qatar have expanded significantly, with Qatar emerging as an important supplier of LNG. We, however, seem to have run out of ideas in fashioning a new relationship with Shia-dominated Iraq even as China seals lucrative deals for oil exploration in a country that has the greatest unutilised capacity to boost global oil production. Our efforts to train Iraqi-professionals on petroleum-related matters could, however, serve us well in the long run. While a partnership with the US certainly has its merits in developing our relations with the Arab Gulf countries, we have given an impression of behaving like an American client State in dealing with Iran. This was evident in the unseemly and hasty manner in which we cancelled our partnership with Iran in the Asian Clearing Union——-an arrangement advocated and supported by ESCAP since 1974. This action seriously disrupted payments for oil supplies at a time when even American allies like Japan have ensured the continuity of their oil imports from that country. One sincerely hopes that the lure of World Bank and IMF patronage is not unduly affecting such decisions. Moreover, if we have reservations about the Iran-Pakistan- India gas pipeline because of legitimate doubts about the security of energy supplies through the volatile and violent Balochistan province of Pakistan, why are we hastily joining the proposed a Turkmenistan-Afghanistan-Pakistan-India gas pipeline? Is Taliban-infested Afghanistan a haven for peace and stability? Or is it because of the diktats of others? Our relations with Iran should be based on hard-headed assessment of national interest and calculations of Iranian reliability on issues of energy supplies and not on sentimentalism about the so-called “civilisational affinities”. Persian Emperor Nadir Shah did not exactly endear himself to the people when he invaded, pillaged and occupied Delhi. With Israel and the US now agreeing that Iran won’t be able to build a nuclear weapon till 2015, there is an opportunity for India to work with others in the International Atomic Energy Agency and the UN Security Council to craft innovative measures to deal with the Iranian nuclear impasse. Similarly, while our principled support for the legitimate rights of the Palestinians should continue, our relations with the Gulf Arab countries should not inhibit our ties with Israel. These relations should be determined and fashioned by the larger geopolitical
realities.
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Too much of “Happy New Year” Too
much of “Happy New Year” becomes a tiresome ritual. Now that the long distance telephone calls are inexpensive and many mobile telephony companies are offering attractive tariff, the tendency to phone your near (and not so near) and dear (and not so dear) ones is on the rise. My wife and I started receiving telephone calls early morning on the New Year day. The first call came at about five; it was from a cousin living in Seattle in the US. Luckily, the phone was in my wife’s bedroom, and she sleepily and somewhat irritatingly answered the phone. The cousin guessed that it must have been very early in India, and apologized for losing track of time zones. Then she wished us and our extended family “a very happy and prosperous New Year”. My wife was now wide awake and as polite as she could be under the circumstances. She was asked: “Where is Bhai Saab; give him the telephone”. Wisely, my wife said that he was asleep in his bedroom. “Why is he sleeping in a separate bedroom?” she queried. My wife had by now lost her equanimity, and answered that “I snore heavily and your Bhai Saab cannot sleep with all that snoring”. This was of course a lie; we have been sleeping in separate bedrooms for the past 15 years as a matter of convenience. Then the early morning caller from Seattle asked for the telephone numbers of six other relatives. My wife said that these were with your Bhai Saab and I could not dare disturb him. All this telephonic conversation awoke me too. My wife blamed me for this early morning call from “your cousin”. As I murmured an apology, the telephone rang again. It was my wife’s sister from Chandigarh wishing Happy New Year. It was not even six; but my sister-in-law explained that she wanted to be the first to call us. But here too she lost out to my Seattle cousin. The sisters chatted for about 15 minutes; thank God she didn’t ask to speak to Jijaji. Then our landline became active, and caller said, “Oh Raj tu halli tak sutta hoya hai”. I recognized the accent; it was that of a friend from Amritsar; another 10 minutes were spent on idle New Year gossip. To cut short this long story, we must have received close to 20 calls before we could dare do our morning rituals. My wife switched off her mobile and I took off the receiver from the landline. We took one hour getting ready and then made the mistake of switching on the mobile and putting the receiver back on the landline. Before we could think of breakfast, both the telephones came alive. The caller on the landline was furious. “With whom were you talking for so long”, he growled. Though the other caller was equally angry but she could not reprimand her elder sister; “Didi, I have been trying to call you for so long,” she muttered meekly. Now it was our turn to call our other friends and relatives. My wife and I divided the list between ourselves and started dialling. Most appeared engaged; some mobile companies exploited the opportunity by announcing that “the number you are trying to call is not answering. You may send an SMS.” For a change, both of us showed exemplary patience, and managed to complete most of the calls within the next three hours. Cooking the lunch was out of question. We had no choice but to go to the newly opened KFC for a quick bite. My wife had left her mobile at home. Thus the lunch was the only quiet time we had that
day.
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Epidemic in the making This year will mark a decade of the Erwadi tragedy in which 28 inmates of a private mental asylum in Tamil Nadu were charred to death in August 2001. They couldn’t escape the fire because they were chained. Ten years hence, mental health continues to subsist in the margins of general health services with the government not ready to treat it separately or give it the budgetary due it deserves. Currently, over two crore Indians need treatment for serious mental disorders and five crore for common mental problems. The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore which was recently declared an Institute of National Importance, says 35 lakh people need hospitalisation for mental illnesses at any given time. But there are just 29,000 beds available in all the recognised mental health facilities in India. The lesser said of private facilities, the better. The treatment gap is a whopping 50 to 90 per cent despite the Constitution guaranteeing access to services to all under Article 21. The judiciary has repeatedly interpreted this Article to mean “right to health” and even directed the National Human Rights Commission to keep an eye on the quality of services being provided by the 37 government mental health facilities in India. The first survey in 1997 revealed shocking facts — 38 per cent hospitals were built with custodial architecture, their average age being 84 years; 51 per cent had closed wards (in violation of the Mental Health Act 1987 that replaced the Indian Lunacy Act); 54 per cent offered balanced diets to inmates. Very recently, the NHRC commissioned another review to see if anything had changed. It wasn’t impressed as the study found there were no psychologists in 39 per cent hospitals, no psychiatric social workers in 50 per cent and no psychiatric nurses in 67 per cent hospitals. Clearly, no psycho-social inputs like individual therapies or psychological testing are available, states the study by Pratima Murty and K. Sekar though they found 91 per cent hospitals now had recreational facilities for the inmates. But the situation is far from satisfactory due to acute shortage of manpower in the sector. Current vacancy of psychiatrists in the government system is 116 (it was just 27 in the 1997 review); 44 per cent hospitals have no clinical psychologists. While in the 1997 investigations, 30 per cent hospitals said they didn’t have psychiatric social workers, today 38 per cent report the absence. The private sector is worse of with just 3000 registered practitioners with the Indian Psychiatric Society – that is one per three lakh people (Australia has 50 times this number). Another problem is their skewed distribution — 75 per cent are in urban areas, leaving rural India uncovered. And yet the government has failed to define optimal psychiatrist-to-population ratio so far though India roughly needs about 11,500 trained psychiatrists (has just 3000). Clinical psychologists are short by 9,000 and psychiatric social workers by 8,800. The gaps being huge, there’s a pressing need for medical education reform. Of the 211 recognised medical colleges offering PG courses in the country, only 101 offer PG in psychiatry. Very recently, the MCI added 125 seats to the pool by relaxing teaching norms. But dilution of norms is not the answer. Psychiatric training must be improved. Today an MBBS student, through the 142 weeks of his training, studies psychiatry for just two weeks (20 hours)! That means for one-third mentally disturbed patients (0.33 per cent) he sees, he has only 0.14 per cent exposure of the discipline. That’s shocking and must change. The MCI is now looking at revising the psychiatry curriculum and give it greater weightage in MBBS training. Results of this exercise will determine the future availability of manpower in the sector. Last year, the Health Ministry also uploaded on its website the revised Mental Health Act 1987. Stakeholders must respond to the draft now to push for changes, if any, considering the law would impact large sections of neglected people. More than 35 per cent Indians seeing general practitioners these days report some psycho-social condition that demands attention. The situation is therefore that much alarming.
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That brings us to a serious situation: In 2010, morbidity on account of mental illness overtook cardiovascular diseases as the single largest risk in India. Yet, the Health Minister made no mention of the looming mental health epidemic. Nor was the National Rural Health Mission revised to address psycho-social disorders.
It is high time mental health got the due it deserves. There is an urgent need to integrate mental health into the government’s cardiovascular disease
(CVD) detection programme which was recently launched. We must also provide mental health services in the Health Ministry’s Mother and Child
Care programmes in order to detect mental problems in babies born out of high-risk pregnancies. Such children, if left undetected, could end up facing severe problems like schizophrenia. Perinatal complications lead to brain disorders affecting child health. Therefore, we must detect disorders early enough to cure them. Also, 30 per cent of persons who suffer heart attacks and strokes report high chances of psychiatric illnesses. Integration of mental health with the CVD programme is hence critical.
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Major initiatives to reduce Maternal Mortality Ratio and Infant Mortality Ratio in high focus states through intensive implementation of
NRHM, Janani Suraksha and child care measures.
We really need to reposition our family planning strategy to reach our population stabilization goals. The fact is there’s a huge unmet need for contraception in India. There’s a huge demand and 18 per cent fertility is due to this unmet need. There’s no reason why a woman should have a child just because she does not have access to contraceptives. Access must be improved. Another major contributor to population is the population momentum caused by couple in reproductive age having children. This can’t be fully controlled. So we need to help such couples delay the first child birth and space children better. For that to happen, temporary methods have to be made available to advance fertility. To address the third issue of wanted fertility, we need better healthcare facilities so that newborns survive. In 2011, let us also remember that literacy is the best contraception and work towards the goal of literacy.
The Centre and states must focus on strengthening their public health cadres to eliminate infectious diseases. It is time we ensured no child died of measles. In 2011, the Government must also tighten the regulatory systems of education and training of health personnel. HR is our major constraint. I hope to see greater public investment in this and an end to crass commercialization of this sector due to private investment by non-interested actors. This year will also be critical to the formulation of protocols to provide medical and surgical treatment though third party payment systems without the ills of
over-medicalization and exorbitant feesGreater people’s involvement in the sector is the key. Do you think, for example, we can dream of a day when tobacco companies voluntarily shut shop and educate people not to buy their products? That should be our goal in 2011.