EDITORIAL
War cries,
Mismanagement...
If any evidence were
needed to show that the politics of this country is
diseased to the core, the fact that the politicians of
this country have not desisted from politicking over the
greatest threat to the nation today would prove it
overwhelmingly. But people do not need any proof; they
believe it for a truism that politicks here is grown
foetid to the core with this disease. But perhaps some of
this disease has rubbed on-this people, too. Or, how else
would they know all, be capable of assessing every actor
in the political arena and still not act to throw them
out. Not only do they not throw them out but the people
even suffer them to play out the antics to their fullest,
go witness their games of prevarication and falsehood,
and reward and punish them not for their work but for
this play-acting, this power to befool them the more.
Like bin Ladens sympathizers trying to justify
terrorism in a veiled manner, they seek excuses to
deflect the peoples attention from the most
pressing issue before the. nation.
A case in point is the
opposition to the POTO. We have Chief Ministers some even
in the beleaguered northeastern states, who are not able
to walk around their capitals without the security
agencies, telling the nation that they have enough
laws to deal with terrorism. Political parties act
as if there was nothing the matter with the World, as if
there were no terrorism around and see this very apt
ordinance as a sinister agenda of a particular party.
They have cleanly forgotten that they themselves had
brought in more draconian laws in their time, to deal
with a far lesser menace. None wants to think that when a
nation of Americas power, commitment and uniformity
of focus, needs a much more drastic law how would India's
worn-out laws help. Because none would. So it is with
other issues. From state to state, region to region, all
that the politicians are seeking is a political
advantage. In this state it is through the cries of
mismanagement. None would hold that Farooq
government has been a model one. It has failed on more
than one count. And, so have almost all the governments,
all over the country. Today, we have governments of all
formations coalitions and parties in theil country and
none has been able to deliver the promises they have
made.
But is that why there is
terrorism in this states? Much needless confusion has
been minted in this state and the nation by linking
administrative failure with the rise of terrorism.
Terrorism is a phenomenon that has little to do with
discomfituresover the distribution of Kerosene oil, or
rise in unemployment. Those who are positing these as the
causes of terrorism are misleading not only
the people of this state but the whole nation. Indeed,
the people who would collude with the enemy, over simple
administrative bottlenecks, or start pushing the
enemys agenda because they are not get enough
employments, for example, would be anti-nationals by
definition. But we are aware that this terrorism here is
sponsored, manufactured and exported into this nation
with agendas that aim at dismemberment even decimation of
this nation. How can that be attributed to simple
mismanagement, which is almost universal phenomenon with
political governance ? How can a war cry against this
menace be a deflection of public attention? This is a
threat to the nation here, and all the nationalists would
do better than deflecting attention from that threat.
...And Autonomy
If Farooqs opponents
have been trying to steel the thunder from his very apt
cry for a total war on terrorism by bringing in the
mismanagement of his Government over the past several
years, his attempts to play the autonomy card are no less
an attempt to keep sly agendas for politicking at hand.
Perhaps, no issue in this State has been so misconstrued,
misrepresented as the issue of autonomy. For a plain
fact, the nation is unable to understand the rationale of
a section of the people of this multiethnic state wanting
to have 'full autonomy' which the others vehemently
oppose. Within the state Jammu and Ladakh are dead
against autonomy of any sort. Their clamour, strong and
unmistakable, has been that the state should see more
integration with the nation as a whole, instead of any
further relaxation in this balance of power between the
union and the state. They validly ask why does half a
crore of people in Kashmir need a special power, special
status, if the other hundred crores, including crores of
Muslims, can do with the usual powers and status? They
see the home ministers assurance that there would
be a greater devolution of powers to all the states,
which would include this, state, as more than adequate.
But there lies a catch here. The state of Jammu and
Kashmir already enjoys more powers than any other state
in the union and more powers than any union...No, any
federation can give to its constituents. There simply is
no scope to enlarge the powers of this state.
But there is a more
sinister side of this devolution. It is the special
status, the demand for and pounding in of the notions of
distinctness that have provided fuel to the terrorist
mills. It is not the civic problems, or the discomfitures
over goods and services that have provided Pakistan a
fertile ground to sow its terrorism here, but the
insistence that this here is a place that is 'special',
this is a state that is somehow 'different' from the
other states other peoples of the country, that unless
special powers are granted here the people would not get
justice. By drilling in these dis-satisfactions the
powers and politicians of this state have, knowingly or
unknowingly, supplied ideological justification for the
terrorism. Politicians use many planks for politicking.
But some things are just not available for that game.
Foremost here is the integrity of the nation, its
oneness, its uniformity of treatment to all its citizens.
Politicking here is not allowed. It weakens the nation;
it gives ready excuses to the enemies and it deflects the
attention of the people, State and the nation from the
challenges facing it.
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Indian
Role in Anti-terrorism War Damages
National Interest
By
Balraj Puri
Whosoever
may be responsible, more than the other,
for recreating tension between India and
Pakistan, in particular over Kashmir,
India was none too pleased with the
advice it received from all world powers
to talk to Pakistan, including in
Kashmir.
But why
did India have to queer the pitch in its
relations with Pakistan and raise the
issue of Kashmir at this hour. Soon after
offering "unconditional and
unambiguous support" to the global
anti-terrorism fight, India started a
persistent campaign, for including
Kashmir in the fight against the
terrorists. India drew parallel between
the way terrorists struck at America on
September 11 and their attack at the
assembly in Srinagar on October 1. There
was a similar parallel between the way
Taliban provided safe heaven to bin Laden
and the way Pakistan harboured terrorists
who operate in Kashmir. India also warned
the anti-terror coalition against
inclusion of Pakistan in it in view of
its post record and its close collision
with Taliban. Fears were expressed that
withdrawal of sanctions on US aid to
Pakistan would be used by it to increase
its armed strength which would pose
threat to India. Our foreign minister
Jaswant Singh is reported to have
cancelled his meeting with Joseph Bidden,
head of the US foreign relations
committee, because he had supported the
US move to lift sanctions against
Pakistan.
India's
efforts to include Kashmir on
international agenda was responded by
Osama bin Laden's Al Queda which in its
video taped statement "ordered the
Americans to stop support to Hindus in
Kashmir." It, for the first time,
put Kashmir on international terrorist
agenda. It was almost a literal echo of
the voices of some naive Hindus who were
looking for an opportunity in what is
being perceived as a clash of
civilisations between the West and Islam
for settling score with the latter; in
particular with Pakistan by joining the
former camp.
The
official interpretation of Al Qaida's
threat attributes it to the influence of
the ISI. It is based on the presumption
that understanding between Pakistan and
Taliban has remained unaffected after the
former joined the American war against
the latter. The ban on SIMI, inter alia,
is being justified on grounds of its
links with the ISI and the Talban.
True, the
ISI had links with the Al Qaida, Taliban
and possibly SIMI. General Musharraf
himself was a patron of the Rabta Trust,
which is now banned in America and
Pakistan. The CIA and the ISI which had
jointly created the Taliban are jointly
trying to destroy them. If there are
doubtful elements in the ISI, they are
more a threat to Pakistan than to India.
Already to ward off such a threat
Musharraf sidelined the ISI chief and his
two army generals.
Even
Taliban pose a greater threat to Pakistan
than to India. According to a survey of a
Pakistan paper, Musharraf is the most
hated person in Afghanistan. With
Pushtoon community in Frontier Province
and Baluchistan virtually in revolt
against the Pakistan's Afghanistan
policy, prospects of revival of a
movement of an independent Pushtoonistan
are haunting Pakistan. In the rest of the
country also, jehadi forces are
threatening the pro-America government.
How the Pakistan government suppresses
this threat within the country and
supports them in Kashmir should become a
more serious problem for it than for
India.
At a time
when Pakistan is fighting a war for its
integrity and survival, why did India
started crying wolf and tried to divert
international attention from war against
terrorism to the threat it perceived on
its western border? Expectedly it just
succeeded in reducing its status to that
of parity with Pakistan and received
sermons for restraint.
Similarly
whatever be the outcome of the jehad of
terrorists against the government in
Pakistan, their jehad against India in
Kashmir is bound to receive a set back.
But why was India in a hurry to seek
priority for its fight against jehadis
and thus tried to shift undivided
attention of the anti-terrorism coalition
away from its first target in
Afghanistan? Notwithstanding India's
brave declarations of its capacity to
fight terrorism in Kashmir on its own,
why had the Prime Minister to rush a
missive to President Bush like a
damsel in distress telling him
that there was a limit to India's
patiance when the state assembly was
attacked by the terrorists. What
immediate relief we expected from
America? But why single out a single
world leader for such an appeal? If it
was a diplomatic move, to win
international sympathy, why not a similar
letter sent to the governments of the
other countries? Sole trust in America
and excessive expectations from it not
only was a national humiliation but also
an embarrassment to the super power of
the world.
Expectedly
we are advised to talk to Pakistan on the
Kashmir issue, keeping in view the wishes
of the people. The New York Times,
reminded India, more bluntly that
"it cannot crush Muslim aspirations
in Kashmir with the use of force".
Much more needs to be done at diplomatic
level and within the state to resolve the
issue.
How have
Kashmiri Muslims reacted to the latest
developments? Most of the Muslims
everywhere, including those who condemned
the terrorist attack on New York, are, in
varying degrees, swept by a sort of an
anti-America wave. Kashmiri Muslims have
not remained unaffected by it. There are
many reasons that have cumulatively
caused it. Without going into its causes
and merits, its effect on Kashmir,
includes marginalisation of the Muslim
leadership that Pakistan had recognised
so far. Anti-America slogans have
replaced anti-India and pro-Pak slogans.
Whether it turns out to be a loss or
gain, will depend upon how the popular
Muslim sentiment is interpreted and
channelised. That would also apply to the
Muslims in the rest of the country
its largest minority. Media has projected
Shahi Imam of Delhi as the most
representive voice of India Muslims;
without understanding the fact that his
status is no more than that of Imams of
thousands of mosques in the country. His
diatribes against America have been cited
as proof not only of fundamentalist,
fanatic and extremist character of the
entire Muslim community but also of their
lack of patriotism. Vociferous demands
are being made for his arrest and trial
for sedition and disloyalty.
Explanations
were sought from moderate and liberal
Muslims about their stand and that of
Indian Muslims. They have diowned Shahi
Imam and asserted that he did not
represent the Muslim mind. But a more
important issue is definition of
patriotism.
While
moderate and liberal Muslims have started
speaking out and media has starting
taking notice of them, it is necessary to
define the limits of patriotism. Shahi
Imam may be condemned for the type of
language he uses and for his views on
most of the subjects. But has he not
condemned Pakistan for being a traitor to
Islam and said, "common people there
will teach General Pervez Musharraf a
lesson for betraying the cause of
Islam?" Has he not condemned the Pak
sponsored jehad in Kashmir as un-Islamic.
On Kashmir, his stand is more
nationalistic than many liberal Hindus.
Condemnation of Pakistan and support of
Indian case on Kashmir are certainly very
parochial tests of patriotism. But if a
Muslim leader passes these tests, should
his loyalty be still doubtful? Even a
fundamentalist Muslim can be as loyal to
the country as any fundamentalist Hindu
can be. In no case anti-America
outbursts, however wrong, can be equated
with disloyalty to India. But six
students were asserted in Delhi on the
charge of sedition for distributing
anti-America leaflets. What could be a
better way of undermining the basis of
patriotism.
India's
stand on a post-Taliban policy is no less
uninformed about ground realities and its
national interest. Its insistence on key
role for the Northern Alliance in the new
regime would further alienate the
Pushtoons who comprise the most numerous
ethnic community of Afghanistan and are
totally unrepresented in the alliance.
Any regime without due representation to
the Pushtoon will be unstable. It is true
that they are the ethnic base of Taliban.
But it is equally true that they used to
rever Gandhi and Abdul Ghaffar Khan.
Urges of a community do take different
ideological expressions sometimes
from one extreme to the other
depending upon which ideology can give
them better expression. But on this
account no community can be written off
for ever. In their present anti-Pakistan
mood, they could be helped to assert
their identity through a
non-fundamentalist ideology instead of
diverting their hostility towards India.
In its
post September 11 role, India has neither
been able to promote its national
interest nor raise its moral and
political stature in the world. Within
the country Muslim and Hindu
fundamentalism got a new impetus. It
weakened internal unity and plural
character of the country which would
further undermine its international role
at this crucial turn of history.
A
re-assessment of the realities and
realignments in the world, its own
potential and strategic priorities is
called for by the leadership of India if
its aspires to play a role befitting its
size, strength, geo-political position
and civilisational background in the
interest of world peace and its own
enlightened self-interest.
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Concern
at Bank health
By K
Viswanatha Rao
One of the
steps favoured by the Reseve Bank o f
India (RBI) in its mid-term monetary and
credit Policy announced on October, 22
may appear to help the banks but will
harm them eventually. This is interest on
deposits at variable rates.
Interestingly,
the RBI zeroed in on this facility after
observing, rightly, of course, that the
banks have been able to mobilise huge
savings, as the saving public dont
have other risk free avenues.
True, we
have the Public Provident Fund
(PPF) operated by select banks and post
offices and various insurance policies on
offer from the LIC (now from private
sector players as well) besides some Post
Office schemes. But these are primarily
variations of the same recurring deposits
and can be tapped after a long wait.
Real
estate and gold are preferred
destinations for parking idle funds. But
both are often un-affordable, at least
the middle class vath limited sources of
income. These are prone to the market
moods and as such fluctuations in their
value is the norm, not the exception.
The
corporate sector is virtually closed as a
savings option these days, During the
three months from April to June this
year, only one company entered the
capital market to mop up just Rs. 10
crore. In the same period last year,
there were forty-one public issues for
Rs. 410.80 crore.
Merchant
Bankers and their ilk are aware of the
poor response that awaits them to any
invitation to contribute to the paid-up
capital. The root cause is not the
lacklustre performance of the corporate
sector. But the awareness among the
public that public contribution to the
paid - up capital is treated as a
non-refundable, interest free loan.
There is
also another aspect to the public apathy.
It has something to do with the window
dressing of the bottom-lines. By
different methodologies, a profit can be
shown as a loss. There is no law on the
statute book, which stipulates payment of
dividend at a minimum fixed per centage.
Since it is not compulsory, there is no
in-built incentive to offer dividend
either.
This is
not the case with bonus; in fact, the
Supreme Court has decreed that bonus is a
deferred wage and must be paid at the
lower rate (in the slab) of one
months wages. If the Apex Court had
not ruled thus, every enterprise covered
under the bonus act will certainly try to
wriggle out of the commitment by showing
a loss, yes, in a perfectly legal manner.
Given
these realities, banks have become the
preferred destination for parking funds
for varying periods. The depositor
naturally expects and gets a fixed rate
of interest at present to meet what can
be described as inevitable and
irreducible demands like rent,
insurance and unavoidable expenses,
which keep looking up north, simply by
efflux of time.
The RBI
credit policy aptly noted that the
holders of deposits in the banks
generally belong to the fixed income
groups. They expect a reasonable interest
in excess of the long-term inflation
rate. Well, rate of inflation, is, simply
put, increase in the cost of (a basket
of) consumer items over time. When the
apex bank decrees a cut the interest
rates, as happened now it causes disquiet
among the fixed deposit holders.
Many
avenues of parking funds today have
become risky propositions, where the
principal itself is not safe. The RBI
seems to be acutely aware of this and
hmce smugly suggested variable interest
rate structure.
The fact
of the matter is that the depositors,
despite their all-absorbing concern for
security of their savings cannot be
expected to take a raw deal. Certainly
not. The minimum they are willing to
accept and want is cushion against
inflation. As inflation continues, they
would love a return that would ease the
pressures caused by inflation.
The RBI
credit policy refers to this facet of
public deposits as a constraint on the
banking system in its ability to effect
further cut in the lending rates. If
there is more money with a bank it
can lend more. More money can come in if
the interest rate is attractive. To keep
paying this interest and to make a small
profit too alfter meeting all other
expenses, some body should pick up the
tab and that some body is naturally the
borrower from the bank. In other words,
the lending rates are dictated by the
interest rate on deposits. The question
is how to reduce the lending rate without
undermining the growth of bank deposits.
To help
the banks to gain freedom
from the above said cycle, the central
bank has mooted the new idea of variable
rate of interest on deposits. In a sense,
it is not a new idea, even in the Indian
context. The banks already enjoy the
freedom to offer variable interests on
long-term deposits.
That the
facility has not been popular with the
depositors is a different thing. For
various reasons, the depositors have
tended to favour fixed interest rate
regime. This tended to suit the
conservatives and status-quoists among
the bankers. Result? The flexibility that
banks have in lowering their lending
rates in the short run is effectively
reduced.
For public
sector banks the average cost of fund
mobilisation is over seven percent. For
many of the private sector banks, it is
even higher. The non-interest operating
expenses generally stand at around 2-3
per cent. This and the high level of
sticky loans (non-performing assets in
the banking jargon) push up the
bank-lending rate,
Recently,
the Vajpayee government has taken steps
to reduce the interest on Provident Fund
and National Savings Schemes (in the
official jargon these are contractual
savings schemes). Yet, an expert
committee set up by the government under
the chairmanship of RBI deputy governor Y
V Reddy has advocated a more sustainable
and flexible interest rate regime for
these savings instruments.
The RBI
now has veered round the view that the
Reddy prescription is good enough to the
banks as well for their long-term
deposits. There is a caveat. Depending on
the business cycle and inflationary
cycle, the interest rates could vary in
both directions. As a consequence, the
advisory doesnt necessarily imply a
poor yield on the deposit. Then where is
the catch? Why there are no suitors?
Even
according to the credit policy document,
the banks have parked a huge percentage
of their money (36.3 per cent) in
government securities. And it is in far
excess of the minimum prescribed under
the Statutory Liquidity Ratio (SLR) This
year (up to October 5, 2001) this
investment was significantly higher at
Rs.43, 664 crore. Around this time of
last year, the SLR need attracted Rs.25,
636 crore.
Whatever
be the reasons for the
attraction towards the government
securities, the fact of the matter is,
these fetch poor yields, an interest of
about ten percent or even less. Banks
should learn to make better use of their
funds and they should try to earn more.
In a general sense that is not the case
now. Under the latest RBI directive, the
banks have to keep a minimum of 5.5 per
cent of net demand and term liabilities
as cash reserve ratio. This will fetch
them an interest of 6.5 per cent
Let us
look at this issue more closely. If a
bank has a deposit of Rs. 100, the SLR
norm takes away 36.3 per cent and gets an
interest of Rs. 4. CRR requirement
impounds another 5.5 per cent and the
return (interest money) is Rs. 0. 3575.
Whatever the bank wants to earn either by
way of a profit or to pay for the
interest (on the deposit) it has to do
make up with the balance of Rs. 58.
Here in
lies the crux of the problem the new
variable interest regime will throw up. A
bank will put its best foot forward to
earn more if there is a compulsion to
pay. If there is no fixity on the
interest liability, the attitude is bound
to be different. They will offer an
interest they can afford. The looser is
the depositor. He belongs to the
unorganised sector unlike say a bank
employee, who has the protection of his
union.
So, what
would happen is most ordinary
deposits will tend to be for just a year
or less. Because, as things stand, the
variable interest regime is unlikely to
encompass such deposits. Also, because,
inflation as officially calculated is
much less than what it is actually.
Banks will
do well to remember that the depositor
makes sacrifices to save and naturally ,
therefore expects to get back his
principal with compensation for the
inflation. The depositor knows that the
money will not remain idle with the bank
and believes that it will be put to
productive use, benefiting him in the
process. There is bound to be a feeling
of being let down if there is no fixity
of interest even on long- term deposits.
While on
the issue of wage board recommendations,
the Supreme Court had observed thus: The
rates recommended by the wage board
should be paid as these depended more on
the capacity to earn, not on what is
shown as earned.
The
analogy applies to the Banks.
--Syndicate
Features
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Was
Pt Nehru an agnostic ?
By Babu Ram Sharma
Was the late Pt
Jawahar Lal Nehru, P M, an agnostic ? perhaps
not. He was an amalgam of materialistic
philosophy and ethos of Hinduism. He himself
acknowledges as being a queer mixture of the east
and the west due to the Impact of these two great
cultures on his personality. He was a true Janni
and Karam Yogi. He was also a staunch humanist.
To him inner
development of the individual and society was
conditional to their outer development as they
interact on each other. The visible world, wrote
pandit Ji, is undergoing change in time and space
and continually touching on the invisible world
which no thinking person can ignore. The modern
man is much more involved in himself and things
external. Religion, he said supplies deeply felt
need of human nature. Religion is a binding force
and not a divisive one. All the religious teach
brotherhood and service of mankind Pt. Jawaharlal
Nehru was keenly concerned and worked zealously
to better the lot of the poor and to make India
great. He acknowledged the influence of his birth
background and environment on him and gave
credence to the karma theory of cause and effect,
ethical valus according to Dharam Yuga. The Hindu
Religion as per its Great books, the vedanta
(upnishads) and the Bhagavad Gita went up in his
estimation, he wrote. He did not approve of
rituals. Interestingly, he compared some of the
latest conclusions of science with the
fundamental ideas underlying the Advaita vedanta
theory; ''These ideas were that the universe is
made of one substance whose form is perpetually
changing and further that the sum total of
energies remains always the same. Also that the
explanations of things are to be found within
their nature and that no external beings or
existences are required to explain that is going
on in the universe with its corallary of a self
evolving universe. Pt Ji was a great intellectual
and endowed with a logical and scientific bent of
mind. Indian religion divinifies all living
beings. It is based on Karma philosophy and
welfare of all the beings of the world; ''Sarva
Bhavanta Sukhina''. It is a fearless search
for truth: The Hindu prayer is: ''Lead me from
untruth to Truth darkness to light, ignorance to
wisdom and death to Immortality! Hindu religion
treats humanity as one 'Katumb Kam' one are
family. Pt Nehru considered religion as a
synthesising force and pitied people for
communalising it: Pt Ji was not only a votary of
materialistic Philosophy but also of truly
religions humanism. He loved the oppressed of the
world and fought for them. His temper and
approach was scientific He was intensely
religious in his quest for truth justice, fair
play and freedom from enslavement of mankind. He
was a patriotic Internationalist and loved human
life of sincere action and achievement. Such a
life is envied even by the angels as per our
scriptures:
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Investing
in Health
By Aarti
The mysterious
death of over 11 new-born babies in quick
succession on 3 and 4th November this year at
Lucknows King Georges Medical College
hospital is too poignant for words. Contrary to
the alleged shortage of oxygen cylinders in the
paediatric neo-natal unit by the bereaved parents
and resident doctors on duty, the hospital
Chiefs version that no single factor was
responsible for the tragedy and such deaths were
"routine" has evoked sharp reactions
from several quarters. Besides a two-member
expert team constituted by the Prime
Ministers office to make an on-the-spot
enquiry, apparently after one of the parents
faxed details of the episode, that the State
Government and the Medical College were also
forced set up their own inquiry committees
portrays the gravity of the matter.
The Lucknow
incident, a tip of the iceberg, is symptomatic of
a deeper malaise so dormant in our public health
system despite several efforts to stem the rot.
India perhaps has the worlds largest health
service systems to provide preventive,
rehabilitative and curative health care. Besides
some 146 medical colleges, over the past five
decades, primary health centres have grown from
725 to 1,63,181; hospitals/dispensaries from 9209
to 43,322; beds (private and public) from 117,198
to 8,70,161; allopathic doctors from 61,800 to
5,03,900 and nursing personnel from 18,054 to
7,37,000. But there are only 407 doctors and 214
nurses and 1,500 beds to serve every one lakh
people (ideally the doctor to nurse ratio ought
to be 1:3) when compared to 2,340 doctors, 3,204
nurses and 5,900 beds for the same number of
people in US. According to estimates, while less
than 20 per cent of the population seek out
patient services, less that 45 per cent avail of
the facilities for in-door treatment in public
hospitals. As such, about 300-million odd
unorganised casual workers, earning a meagre per
capita income of Rs 35 per day end up spending
around Rs 75 per capita expenditure on health.
The cause for worry is the plight of about 135
million people who do not have access to any
basic health services.
In the recent
past, the CP Singh Inquiry Committee(set up in
wake of the public outcry on the medical
treatment given to former Union minister
Rangarajan Kumaramangalam, who died evidently due
to wrong diagnosis) made some far-reaching
recommendations. Among others, the suggestion to
effect compulsory registration of all clinical
laboratories has been made compulsory. This is
aimed to check the growing complaints of wrong
diagnosis (resulting in wrong treatment and
death) and improving the monitoring the mandatory
provisions of public health care system in
secondary and tertiary hospitals in the country.
When the National
Health Policy was conceived in 1983, it had set
the goal of Health for All by the
year 2000, through the universal provision of
comprehensive primary health care services. This
objective could not be realised due to systemic
faults in the implementation of several
well-intended programmes. Resource crunch,
ignorance and complete lack of awareness of even
fairly common illnesses and their treatment
amongst a vast majority of our population coupled
with the uniformed medical approach to incurable
and dangerous diseases has compounded the
situation.
Various studies
indicate that infant mortality is declining.
Still, 1 in 15 children in India die before age
one. Primarily, over two-thirds of all infant
deaths occur in low birth weight category because
about 33 per cent of all babies born weigh 2500
grams or less at birth and vary dramatically
among major states, ranging from 16 in Kerala to
86 or more in Uttar Pradesh and Madhya Pradesh.
Government initiatives like reproductive and
child health care programmes have made inroads in
many areas. But with just 30-49 per cent of
births in India registered, as per an UNICEF
study, not only population statistics are
incorrect but also Governments plans for
the future often go awry. The percentage of
outlay provided for health and family welfare, as
a percent of the total outlay during the Ninth
Five Year Plan at 4.01, shows an increase when
compared to that of the Eighth Five Year Plan
when it was 3.24. Yet, our percentage of public
expenditure on health to total health expenditure
being significantly low and the aggregate
expenditure in the health sector hovering at 5.2
per cent of the gross domestic product, the
current annual per capita public health
expenditure is just about Rs 160.
Despite mobilising
external assistance from various bilateral and
multilateral agencies for implementing national
health programmes and for upgrading rural
hospitals in selected states, for a plethora of
reasons including rising population, the health
delivery services leave much to be desired. For
want of a systematic approach, coupled with lack
of public awareness and the apathetic attitude of
regulatory authorities, more and more people are
feared to get infected with deadly diseases like
AIDS, Hepatitis B etc, through toxic bio-medical
wastes produced and disposed unscientifically by
hospitals.
The condition of
several government hospitals in the country is
appalling - some are literally on the brink of a
collapse both, for want of sufficient funds and
lack of management planning. Dilapidated
buildings and poorly ventilated or leaky rooms,
rickety furniture, obsolete, inadequate, unusable
equipment and paucity of essential drugs are just
some of the many problems. The presence of
medical and para-medical personnel, often much
less than required by the prescribed norms,
coupled with the grossly inadequate facilities
have been responsible for overcrowding, leading
to a steep deterioration in the quality of
services. Many public health centres and sub
centres in the rural areas are either not visited
for months together by doctors assigned to them
or medicines allocated are sold off in the
market. Private nursing homes, corporate
hospitals and sophisticated medical institutes,
conforming to international standards, are
available only in the metros and few other cities
to those who can afford. But since the emphasis
is largely curative rather than promoting
preventive medicine, the costs are relatively
high.
With issues like
life expectancy at birth, infant mortality and
the causes of death still remaining the most
pressing health concerns in the country and our
health care system wilting under pressure, the
thrust of all efforts should be on long-term
plans and permanent solutions. The draft New
Health Policy-2001, hoped to be translated into a
reality soon, aims to create a beneficiary
interest in the public health system. The health
sector expenditure is to be hiked to 6 percent of
GDP, with 2 percent of GDP being contributed as
public health investment, by the year 2010. The
Central Governments contribution would also
rise to 25 percent from the existing 15 percent.
While envisaging a more effective supervision of
the public health personnel, through community
monitoring, the Primary Health System is to be
revived by providing some essential drugs under
Central Government funding through a
decentralised health system. By 2005, State
sector health spending is to be increased from
5.5 to 7 per cent of the budget; polio is to be
eradicated and leprosy eliminated. Zero level
growth of HIV/AIDS is to be achieved by 2007. By
2010, plans are on to reduce mortality by 50 per
cent on account of TB, malaria and other
vector/water borne diseases and prevalence of
blindness to 0.5 per cent. By improving
nutrition, the proportion of low birth weight
babies is to be reduced from 30 to 10 per cent
and infant mortality rates to 30/1000 and
maternal mortality rates to 100/lakh. While
utilisation of public health facilities is to
increased from the current level of less than 20
to over 75 per cent, health expenditure by the
Government as a per cent of GDP from the existing
0.9 to 2.0 per cent, share of Central grants to
constitute at least 25 per cent of total health
spending
Notwithstanding
well-intended plans, building faith in the public
health system by enhancing the efficiency of
delivery of basic health services is the first
step. Systemic flaws in the implementation of
several national programmes for the
control/eradication of diseases need to be
addressed effectively. Management planning and
control measures to periodically appraise the
existing health policies and the interventions
merit consideration. In spreading health
awareness through education, campaigns need to be
undertaken only after ascertaining the mind-set
or level of understanding of the target audience
to achieve the desired results. Empowering the
local bodies with the active participation of
women can enable them to play a greater role in
the day-to-day administration of such projects.
The approach to
health challenges, beyond reflecting concern and
compassion for the underprivileged, must also
deliver a comprehensive package that includes
primary education, particularly for women, to
fight poverty - a key determinant of health and a
major consequence for ill health. Investing in
health, being a social good must be looked beyond
an economic investment. Above all, it needs to be
recognised that the health of people is not only
a desirable goal but is also an essential
investment in human resources.
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