Express View on women outnumbering men in medicine: Whole numbers, dark truths

 

As more women enter medicine, it is time to iron out systemic inadequacies, patriarchal mindsets.

One of the lacunae in the documentation of India’s medical history has been the fact that it covers little of the lives and struggles of women doctors. The journeys of Anandi Bai Joshi, Kadambini Ganguly or Haimabati Sen — some of India’s first female doctors — into popular consciousness might have been impeded by the fact that there were so few women who studied medicine in the late 19th-early 20th century that their stories got archived as exceptions. In the last decade though, this has shown a happy remedial tendency. Data from the All India Survey on Higher Education (AISHE) shows an upward graph in the enrollment of women in medicine. For every 100 men, there were 100 women enrolled in medical colleges in 2020-21. This was an increase from 88 in 2011-12 per 100 men to 110 in 2019-20, with a slight dip during the pandemic. There have been other significant — and welcome — departures. More women are opting for what have, for long, been male bastions — cardiology, oncology, neurology.

This upsurge is a welcome alignment of aspiration and opportunity and the work of generations of attitudinal shift. Women are no longer willing to be thwarted by societal expectations of marriage and motherhood or the premium placed on care work at home, notwithstanding their professional qualifications. The AISHE data bears this out. From just seven women against 312 men in 2012-13 in cardiology, the number rose to 78 against 220 men in 2020-21. In oncology, there were just 29 women against 95 men in 2012-13, but in 2020-21, the figures stood at 116 women against 123 men. In neurology in 2012-13, there were nine women against 118 men, but in 2020-21, this grew to 78 women against 173 men.

However, despite the projection that almost half of Indian surgeons in the coming decade will be female, and as the R G Kar rape and murder of a doctor in Kolkata has shown yet again, the system remains unprepared to receive women in its fold. Sexism in the classroom and the workplace, absence of basic facilities such as separate changing rooms and washrooms, inadequate security arrangements and little protection against violences large and small are all functions of a masculine imagination of the workplace. As more women enter medicine, this is an opportune moment to fix all that is broken. It could begin with more women in leadership roles who realise that it is not the late-night shifts that are the problem but the fact that women need to be worried about them in the first place.

Source: Indian Express, 17/09/24

What is helium and why is it used in rockets?

 Two NASA astronauts aboard Boeing’s Starliner will stay on the International Space Station for months because of a faulty propulsion system whose problems included helium leaks.

Back on Earth, SpaceX’s Polaris Dawn mission, which finally launched on Tuesday, was delayed because of helium issues on ground equipment.

Past missions that have been affected by pesky helium leaks include ISRO’s Chandrayaan 2 and ESA’s Ariane 5.

Why do spacecraft and rockets use helium?

Helium is inert — it does not react with other substances or combust — and its atomic number is 2, making it the second lightest element after hydrogen. Rockets need to achieve specific speeds and altitude to reach and maintain orbit. A heavier rocket requires more energy, not only increasing fuel consumption but also needing more powerful engines, which are more expensive to develop, test, and maintain. Helium has a very low boiling point (– 268.9 degree Celsius), allowing it to remain a gas even in super-cold environments, an important feature because many rocket fuels are stored in that temperature range.

How is helium used in spacecraft?

Helium is used to pressurise fuel tanks, ensuring fuel flows to the rocket’s engines without interruption; and for cooling systems. As fuel and oxidiser are burned in the rocket’s engines, helium fills the resulting empty space in the tanks, maintaining the overall pressure inside.

Because it is non-reactive, it can safely mingle with the tanks’ residual contents.

Is it prone to leaks?

Helium’s small atomic size and low molecular weight mean its atoms can escape through small gaps or seals in storage tanks and fuel systems.

But because there is very little helium in the Earth’s atmosphere, leaks can be easily detected — making the gas important for spotting potential faults in a rocket or spacecraft’s fuel systems. The frequency of helium leaks across space-related systems, some engineers say, have highlighted an industry-wide need for innovation in valve design and more precise valve-tightening mechanisms.

Source: Indian Express, 14/09/24

Quote of the Day September 2, 2024

 

“I object to violence because when it appears to do good, the good is only temporary; the evil it does is permanent.”
Mohandas Karamchand Gandhi (1869-1948)

“मैं हिंसा पर आपत्ति उठाता हूं क्योंकि जब लगता है कि इसमें कोई भलाई है, तो ऐसी भलाई अस्थाई होती है; लेकिन इससे जो हानि होती है वह स्थायी होती है।”
मोहनदास करमचंद गांधी (1869-1948)

What is Whitetopping Technology?

 The Ministry of Road Transport and Highways (MoRTH) in India is proposing a new policy to repair and upgrade old national highways using a method called Whitetopping Technology. MoRTH is asking for feedback on this idea from stakeholders by September 7. This policy is needed because many parts of India’s national highways, which cover about 1.46 lakh km, are aging and require improvement.

Definition of Whitetopping Technology

Whitetopping is a process where a layer of Portland Cement  Concrete (PCC) is placed on top of existing bituminous ( asphalt) roads. This technique is especially useful for roads that have ongoing problems due to poor drainage. Whitetopping has already been used successfully in various government projects, such as the Pradhan Mantri Gram Sadak Yojana (PMGSY), and cities like Bengaluru.

Benefits of Whitetopping

Whitetopping offers several advantages compared to traditional asphalt overlays:

Longer Lifespan: It can extend the life of a road by 20-25 years.

Less Maintenance: Roads require fewer repairs and less frequent lane closures.

Cost-Effective: Although the initial cost is higher, the long-term savings from reduced maintenance make it a smart investment.

Environmental Benefits: The lighter color of concrete reflects more light, helping to cool urban areas and reduce the heat island effect.

Better Performance: Whitetopping is more resistant to common road issues like deformation, rutting, and cracking, especially in hot climates.

Improved Fuel Efficiency: Vehicles use less fuel when driving on concrete roads compared to asphalt roads.

MoRTH is actively seeking input from various stakeholders to fine-tune the proposed policy and ensure it is implemented effectively. Gathering feedback is important to address any practical challenges and make this innovative approach to highway maintenance successful.

Economic & Political Weekly: Table of Contents

 

Vol. 59, Issue No. 35, 31 Aug, 2024

Editorials

For a Dignified Workplace

Comment

Bangladesh and South Asian Regionalism

From 25 Years Ago

From 25 Years Ago: Amnesty and Human Rights in the US

Strategic Affairs

The American Spy Agency and the Indian Subcontinent

Atul Bhardwaj

Commentary

Internalising Externalities - A Theoretical Analysis

Rachel Batra

E P Thompson (1924–93) - Religion and the Unmaking of the English Working Classes

Dilip M Menon

Closing the Gap - Prioritising Post-maternal Health Literacy for Working-class Women in India

Bidisha Banerjee, Archana Srivastava, Anandita Mitro

Book Reviews

Charting New Pathways for the Economy

Santanu Gupta

Pre-independence Consumption Expenditure Survey

Arun Kumar

Perspectives

‘Donkey’ Migration from Haryana - A Story of the ‘American Dream’

Reema Gill, Sneha Maji, Sanjeet

National Family Health Survey-5

Thirty Years and Five NFHS Rounds - What Next?

S Irudaya Rajan

National Family Health Surveys in India - A Reflection on the Journey

Tarun Kumar Roy

Data Collection and Quality Concerns for National Family Health Surveys in India - Insights from Five Waves, 1993–2021

S Irudaya Rajan, Sunil Rajpal

Violence against Women in India - Levels and Trends of Incidence and Reporting

Kanika Sharma, Aashish Gupta

Paternal Migration and Child Stunting in India - An Analysis of NFHS-5 Data

Aravinda Meera Guntupalli, Kirti Gaur, Edwin Amalraj Raja, Kunal Keshri

Social Determinants of Anaemia Speak - Are Policymakers Listening?

Sylvia Karpagam

Assessing Geographical and Contextual Vulnerability of Reproductive, Maternal, Child and Adolescent Health in North East India

Anchal Purbey, A J Francis Zavier, Punit Mishra, Rajib Acharya, Niranjan Saggurti, Subrato Mondal, Debendra Kumar Nayak

Current Statistics

Current Statistics

Letters

Citizens Speak Out against Brutal Cases of Sexual Violence

889 individuals and organisations against rape and cultures of impunity.

An environmental imagination

 

Is ‘flood control’ even possible in geographies like the Brahmaputra valley with such a potent monsoon? Must every flood be a disaster?

This year’s flood in Assam has been devastating, although not unprecedented. In fact, floods in Assam have become an annual event, leaving millions of lives shattered every year and costing the state dearly. The scenes on our television screens and the social media feed leave us with a sense of déjà vu. These events are being normalised either as a natural disaster or, increasingly, as a climate change-induced phenomenon. It is a familiar story in other parts of eastern India as well, with Bihar being one of the worst-affected states.

While flash floods, a recurring event across Indian cities nowadays, are largely the result of poor urban planning and inefficient municipal administration, a flood has to be understood in relation to ‘flood control’ and, by extension, control of the river itself which poses larger, philosophical questions. This calls into attention our worldview on rivers, raising questions about how we imagine our ‘hydro-sociality’. Of further importance is to examine what one might call the ‘governmentality of floods’ — that is the power that an entire apparatus of institutions, practices, and technologies exercises vis-à-vis flood risk management.

Central to the Indian State’s flood management system is the construction of embankments which date back to the colonial era (although pre-colonial embankments also exist). Enough has been written about the perils of embankments and I will not go into those in this piece. Not only writings but songs have also been sung and films made about embankment-induced catastrophes. Way back in 1929, the American blues singers, Memphis Minnie & Kansas Joe McCoy, composed “When the Levee Breaks” (later reworked by Led Zeppelin) in the context of the Great Mississippi Flood of 1927.

Be it the levees on American rivers or the colonial and post-colonial embankments on Indian rivers, research has shown that far from controlling flood, these embankments have aggravated the flood crisis, rendering traditionally flood-dependent communities flood-vulnerable. Critique of an embankment-centric flood control approach has, at times, emerged from within the State itself. The 1980 Rashtriya Barh Ayog report, for instance, noted: “Flood control should not be considered as an end in itself, rather it is the means to an end. Flood control has to be viewed within the broad context of the economic and social development in the country. Management of floods should be considered in the context of the overall plan for management of the water resources of a river basin… The approach, therefore, cannot be static, but should remain dynamic and flexible.”

Rural communities realise the risks posed by embankments very well. In my own research sites in Majuli, Assam, villagers have often referred to embankments as “mrityu-baan” (weapons of death). Clearly, neither research nor local knowledge has been given due attention by policymakers. Little wonder then that even as Assam was drowning recently — largely due to embankment breaching — the water resources minister of the state promised, ironically, hundreds of kilometres of new embankments.

Why this obsession with embankments?

In my view, the embankment fetish of the State is rooted in two factors: first, the modernist ideology, a hubris, of human’s mastery over nature, that nature can be controlled and disciplined; second, and more importantly, it highlights two interrelated things: first is what the anthropologist, David Graeber, said about bureaucracy, that it is a “dead zone of imagination”. Thus, the hydraulic bureaucracy cannot think beyond embankments or similar structures, as evidenced by the case of Assam ever since the Assam Embankment and Drainage Act of 1953 came to pass. Almost like an automated entity, the bureaucracy carries on with embankments year after year. Second, the embankments seem to have become part of the ecosystem of the hydraulic bureaucracy, with deep roots and rhizomes, entangling multiple actors with various stakes. So everyone loves a weak embankment that requires repairing or rebuilding.

What is to be done? Is ‘flood control’ even possible in geographies like the Brahmaputra valley with such a potent monsoon? Must every flood be a disaster? Going back to the Rashtriya Barh Ayog’s recommendations, we must seriously consider watershed management and floodplain management at the basin level (thus requiring cooperation among riparian states and nations) while also pursuing various non-structural measures such as flood forecasting and warning, flood proofing, flood defence education, and capacity building of local communities and institutions. Deforestation of the Himalayas and its foothills must be stopped in order to reduce the force of the rivers in the monsoon. What if we built and revived a network of channels (like the ones that existed alongside rural roads and fields) that could absorb the excessive water in the monsoon? How about regulations on the types of permissible dwellings in flood-prone areas? There’s much to learn here from indigenous communities inhabiting the riverine geographies of the Brahmaputra for generations. A robust crop and livestock insurance system will also go a long way in checking floods. In short, we need a new environmental imagination if we are to co-inhabit these floodplains.

A resident of a riverside village in Majuli once told me: “Nodikhon bor komal, moromere subo lage” (The river is too delicate, it should be touched with love). How about we commit to that: to love our rivers, again?

Source"The Telegraph, 31/08/24

Author: Mitul Baruah

Can India ensure that its elderly are taken care of?

 At a recent interaction with community service organisations (CSOs) working on longevity, I learnt that your answer would probably depend on how old you are. Younger respondents quickly conjure up words like walking stick, grey hair and nursing home. Financially secure seniors cite freedom from responsibility, travel, the joy of grandchildren, and spirituality. This difference in mental models is important to internalise as India turns from a young country with 50 per cent below the age of 25 years to a country with the largest population of elderly in the whole world.

We are still struggling to reap the demographic dividend of our broad youth base. Soon, we will have to figure out how hundreds of millions of senior citizens can contribute to and be cared for in our society.

Just recently, I turned 65. So did lakhs of other people in India. Sixty-five seems different to me — a new way of feeling old. The country’s average lifespan is 67.2 years. I am sharply aware of both my mortality and my privileges. I can access the best medical care, the best fitness options and nutrition. I can continue to write and work actively. I meditate, I pray. I stay positive with the blessing of many friendships, and a loving family. These are all things that global research has proven to produce better outcomes as one ages.

So, I am determined to make this the best decade of my life yet. To be part of a positive revolution in the mindset on ageing. To give at least as much as I receive; to cultivate and spread faith in human innovation and to nurture gratitude for the miracle of life.

This is what older people want to do for themselves and society — but not everyone gets to do it. In India, 40 per cent of older adults experience poverty, compared to less than 10 per cent of the general population. Only 14 per cent can use the Internet, and less than 5 per cent report being part of a social organisation. The elderly are more likely to be female, have much less education and live more in rural areas. More than one in three seniors still do not have the luxury of retiring, and many continue to do unpaid work, 65 per cent of those in agriculture and allied activities. Those who do retire can feel a sudden lack of purpose, a loneliness. With the rapid nuclearisation of families, in just 20 years, an estimated 80 million elderly will live alone or with just a spouse.

There are reams of data on how much will change in our demographics, and what we can reasonably predict about the quality of life and care, social security, and public amenities. We can share the estimates of mental health disorders among the elderly.

But data do not tell the whole story, or the only story. The good news is that samaaj-based institutions have been very active in India for decades. HelpAge India was set up in 1978 and works with two million elderly, actively advocating better state intervention. Since 1999, the Agewell Foundation has worked with a network of 80,000 volunteers across 768 districts to reach 25,000 seniors daily. Carers Worldwide aims to reduce the burden of 2,00,000 unpaid senior caregivers. The list goes on. These organisations do not just want to help seniors, they want to change the narrative on ageing. Grey Shades showcases many intrepid seniors who are giving back gracefully. Like army veteran and psychiatrist Rajinder Singh, 91, who is setting up a third mental well-being centre to address addiction in young people in Punjab. Like Harbhajan Kaur, 99, who realised her ambition to earn some income by becoming a cooking sensation at the age of 90. CSOs are trying to normalise these exceptions so that longevity and health spans are reimagined in a society that takes the elderly for granted. It shouldn’t. One in three seniors want to actively volunteer and contribute to their communities if they can find the opportunity.

Can India take the lead in redefining what it means to be an older adult? Can we do it in time for the seismic shift in our demographics? It depends. So far, the state is only just beginning to wake up. Less than 5 per cent of senior citizens get any reliable social security payments or services. Some policies, including the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 are simply unimplementable. There is a long way to go.

The private sector has still not tapped the potential of senior citizens to keep contributing productively. Nor has it stepped in to provide better living and recreational facilities, even though the “silver economy” is currently pegged at $7 billion. We have nothing like the American Association of Retired Persons (AARP), a strong advocacy body with 38 million members that markets must reckon with in providing senior citizen products and services.

It is the society that must lead the way. And private philanthropy is critical to kickstart the multi-sectoral innovation we need. At 65, I often turn to the Beatles song that captured the angst of a whole generation. “When I get older losing my hair, many years from now…Will you still need me, will you still feed me, when I’m sixty-four?”

The country will soon have to answer that question to hundreds of millions of folks, on whose shoulders it now stands.

Written by Rohini Nilekani

Source: Indian Express, 31/08/24