It’s Only a Transit Point

Once, an American man travelled to India to meet a Sufi Master. When he entered the master’s hut, he was surprised to find the great teacher sitting on a rugged mat. The place had no furniture; only books and notes scattered all over. The American looked around and said, “Where is your furniture?”

The master laughed and said, “Where is yours?”

I am just a visitor here,” replied the American.

“So am I,” said the master, “a visitor to Earth.”

The master meant that our stay on Earth is only a minuscule part of our journey as celestial beings. However, during our brief stay here, we get so engrossed in our daily affairs that we tend to overlook the impermanence of our very existence here. We tend to forget that of all that we have hoarded, nothing can be taken along on the journey beyond. It is only when we see our time on Earth as just a stopover and not the whole journey in itself that we realise the futility of being attached to material objects.

However, it doesn’t mean that we must give up all ambitions, cut off from the material world and live in solitude. We can lead a regular life and, at the same time, be aware that our being here is not just any chance but an essential part of the bigger cosmic plan. Hence, during our short lifespan, what really matters is not the things we accumulate but the impact we make on others’ lives, the experiences we undergo and the progress we make as spiritual beings in human bodies.

Source: Economic Times, 2/08/2018

Nearly as many farmhands commit suicide as farmers

Govt’s Relief Leaves Out Labourers

Government schemes meant to tackle farm distress have focussed on farmers — typically through loan waivers — but official data shows that almost half of all suicides among those working in agriculture is by labourers, not far mers.

Data from the National Crime Records Bureau, cited in the answer to a question in the Lok Sabha recently shows that of the 36,332 people “self-employed persons in farming/agriculture” who committed suicides between 2014 and 2016, 16,324 or about 45% were farm labourers.

At the level of individual states, a majority have seen more labourers than farmers taking their own lives. Particularly striking are the statistics of Tamil Nadu, Gujarat, Kerala and Rajasthan.

In Tamil Nadu, there have been 1,776 labourer suicides in these three years compared to 106 farmers taking their lives.

The corresponding figures for Gujarat are 1,177 and 132, for Kerala 1,205 and 133 and for Rajasthan 485 and 7.

Distress among agricultural labourers can also be gauged by the fact that West Bengal, Uttarakhand and Bihar have not witnessed any farmer suicides, but there have been suicides by labourers during this period.

Census data shows that labourers account for about 45% of the population working in agriculture, farmers constituting the remaining 55%. It might seem, therefore, that the pattern of the suicides is merely reflecting this reality.

However, at the state level this correspondence breaks down completely.

Several states in which farm labourers outnumber farmers have seen more farmers committing suicides than farmhands and the reverse is equally true. The NCRB has been providing disaggregated data on farm suicides only from 2014 and hence it is not possible to see whether the trend has changed from earlier years. Also, the 2016 data is provisional according to the answer in Parliament.

Experts have repeatedly pointed out that the biggest farmers are the major beneficiaries of loan waivers and marginal farmers and labourers, who hardly get formal credit and have to bank on moneylenders, are left out of the schemes.

The National Commission on Farmers (NCF) under the chairmanship of Professor M S Swaminathan had also recommended that agricultural labourers be treated as landless farmers and suggested several major nonfarm initiatives along with employment guarantee programmes for them.

Source: Times of India, 2/08/18

Layers of protection: on changes in anti-corruption law

Protecting honest public servants is important; so are anti-corruption efforts

The amendments to the Prevention of Corruption Act, 1988, adopted recently by both Houses of Parliament, are a mixed bag. Moves to make changes in this law, aimed at combating corruption in government, were initiated during the UPA’s second term in office and largely centred on the misuse of one provision — Section 13 (1)d. Former Prime Minister Manmohan Singh had criticised this section, under which public servants are culpable for securing a pecuniary advantage for another “without any public interest”, for ignoring a foundational principle of criminal law: mens rea. This resulted in many honest officials being prosecuted even when they gained nothing and merely exercised their power or discretion in favour of someone. Insofar as it had a chilling effect on governance and deterred bold decision-making, the amended form may have a liberating effect on honest officials. Besides, it is more concise and restricts criminal misconduct to two offences: misappropriating or converting to one’s own use property entrusted to a public servant or is in his control, and amassing unexplained wealth. There was concern initially with the wording, “intentionally enriches himself illicitly during the period of his office”, as it raised a doubt whether the ‘intention’ to amass wealth would also have to be proved. Now an explanation has been added that a person “shall be presumed to have intentionally enriched himself” if he cannot account for his assets through known sources of income.

By making citizens liable for offering a bribe to a public servant, the anti-corruption law has been brought in line with the UN Convention Against Corruption. The only exception to this rule is when one is forced to give a bribe. This exception kicks in only when the fact that one was forced to pay a bribe is reported to a law enforcement authority within seven days. The penal provision can empower people by allowing them to cite it to refuse to pay a bribe. At the same time, what happens when the police or any other agency refuses to register a complaint? People may be left in the lurch with no redress. Further, it may render them vulnerable to threats from unscrupulous public servants who collect money to speed up public services but do not deliver. The most unacceptable change is the introduction of a prior approval norm to start an investigation. When a prior sanction requirement exists in law for prosecution, it is incomprehensible that the legislature should create another layer of protection in the initial stage of a probe. Public servants need to be protected against unfair prosecution, but a genuine drive against corruption needs a package of legislative measures. These should contain penal provisions, create an ombudsman in the form of a Lokpal or Lokayukta, as well as assure citizens of time-bound services and whistle-blower protection. Laws to fulfil these objectives are either not operational or are yet to materialise.

Source: The Hindu, 30/07/2018

The public-private gap in health care

Policymakers have shown no inclination to provide equitable medical care

The recent controversy about transparency in the working of the cadaver transplant programme in Tamil Nadu has provided an opportunity to revisit the vexed question of medical rationing in India.

It is a hard reality that not all medical interventions are available to every citizen who may need it. The gap between what is technologically possible and what government hospitals generally provide widened appreciably after the technological leaps in medical care began, starting in the 1980s.

Covert medical rationing

The NITI Aayog’s document, ‘Three Year Action Agenda, 2017-18 to 2019-20’, has a section on health care. One of the recommendations is for the government to prioritise preventive care rather than provide curative care. The document also advises the government to pay attention to stewardship of the health sector in its entirety rather than focussing on provision of health care. Therefore, the system of private health care for those who can afford it and government care for those who cannot will continue in the foreseeable future.

Every government since Independence has stated egalitarianism as its goal in health care. The policies, however, have not matched the statements. Many interventions, especially those which are very expensive, continue to be provided only to those who can pay for them. This is medical rationing of the covert kind. Token provision of these interventions in a few government hospitals is merely an attempt by governments to appear fair.

The new Ayushman Bharat health scheme to provide secondary and tertiary care to those who are socio-economically deprived has a cap of ₹5 lakh per family per year. It is quite obvious that many interventions cannot be accessed for this amount, certainly not human organ transplants.

Transplanting a human organ is not a single event, but a life-long process. The actual act of transplantation itself needs expensive infrastructure and trained human resources. For the continuing success of the transplanted organ, expensive medication is needed. It is a sad truth that in India, out-of-pocket expenses for medical care are about 70% of all medical expenditure, and this particular intervention is only going to be available to those who can pay.

Inequitable medical rationing

Health care in India is obviously not egalitarian, but is it at least equitable? The evidence suggests otherwise. Governments have been giving subsidies to private players, especially to corporate hospitals. The repeated boast that India can offer advanced interventions at a fraction of the costs in the West does not take into account the cost of the subsidies that makes this possible. Since it is all taxpayers’ money, it is a clear case of taking from the poor to give to the rich. In an illuminating article, “Investing in health”, in the Economic and Political Weekly (November 11, 2017), Indira Chakravarthi and others pointed out that private hospital chains in India have entered every segment of medical care, including primary and secondary care and diagnostics. Most have large investors from abroad and some are effectively controlled by foreign investors. In short, taxpayers’ money is being used to ensure profits for foreigners.

Successive governments have been increasingly dependent on the private sector to deliver health care. The Ayushman Bharat scheme is a further step in this process. The benefit to patients is questionable but private players will see a large jump in profits. It will further institutionalise medical rationing by explicitly denying certain interventions — a “negative list” presumably of procedures which will not be covered, which is not yet in the public domain.

The problem of distrust

Besides being inequitable, medical rationing has other detrimental effects. One is a distrust of the public in government hospitals. The poor expect to get from them what the rich get in private hospitals. With present policies, this is simply not possible. Without a clearly defined mandate, morale among medical personnel in public hospitals is low. The perception that doctors in the private sector are much better than those in the public sector has a severe debilitating effect on the professional image of medical personnel in public hospitals. Attempts by doctors to provide these high technology interventions in public hospitals is bound to fail without continuing commitment from policymakers; it is quite clear from policy documents, which doctors and the public do not read, that such commitment will not be forthcoming.

Our hearts tell us that every possible medical intervention should be available to every citizen. Our minds tell us that the government is not committed to this. The only pressure group which can ensure at least equitable medical care is the electorate. Until such time as it demands this from governments, we will continue to witness the tragic drama of two levels of medical care in India.

George Thomas is Chief Orthopaedic Surgeon at St. Isabel’s Hospital, Chennai

Source: The Hindu, 1/08/2018

The Flow of a Stream

Sometimes we find that the streams of our lives can run into frozen winters. Yet, beneath the surface, the waters run deep. Klemens Tilmann found a profound symbolism in a little stream. The stream was only about four yards wide, but the water was in constant movement. Parts of the stream were frozen over and large areas of ice had become covered by the energetic flow of the water above. But the water flowing beneath the flat surfaces of ice was full of bubbles, dancing and vibrating.

The water of the stream sometimes encountered obstacles, and at other times flowed freely. Sometimes it ran in the opposite direction to the current only to later join the mainstream. All these different processes were observed by Tilmann who was impressed by the water’s obedience to its own essential being.

Tilmann saw in this little stream the symbol of his own life and the symbol of what all human life on this earth is meant to be. Every good action that we perform is determined by two factors: perfect obedience to our own inner being and perfect response to the situation in which we find ourselves. The stream responded everywhere — to the valley, to the bed of the stream, to the stones, the temperature and the weather.

Depending on circumstance, our lives can be like valleys, like stones or like dams that impede further movement. Yet, like the water in the stream, our lives are meant to run on, through choices in obedience to our own inner nature and quest and in obedience to the circumstances that may either expand or circumscribe our lives.

Source: Economic Times, 1/08/18

The Koshish That Paid Off

How TISS Team Blew the Lid Off Bihar Sexual Abuse Case

We spoke to them like a friend and they opened up to us: Team Leader

When a seven-member team of young psychologists of the ‘Koshish Project’ of the Tata Institute of Social Sciences (TISS) landed in Bihar last October for a social audit, they had little idea they would end up exposing a sordid tale of sexual abuse of the scale that has surfaced.

I am sure nobody, the Bihar government or us, knew that this scale of sexual abuse would be prevalent at the institutions in Muzaffarpur. We built confidence with children, spoke to them like a friend and they opened up to us,” Mohd Tarique, who headed the team, told ET.

The three women members of the team interacted at length with many of the nearly three dozen girls against whom sexual assault has been proven now. The team camped in Bihar for almost seven months, travelling to 110 institutions over 38 districts.

It was the report from TISS in May that blew the lid over the sexual abuse case. The team had also met main accused Brajesh Thakur. “One must credit the Bihar government for having this social audit, which is not compulsory under law...,” said Tarique.

“The most critical part is having a conversation, individually, and in groups,” said Tarique. “Sexual abuse is something that especially the children are not very vocal about. It wasn’t upfront that all the children spoke about it but there were some children who shared that this was happening. Some used another girl’s name saying that it happened with that person. It was indicating more like a pattern or the environment of the place.”

He said that the most important part how team members carry themselves in the institution. “Like if you sit in the superintendent’s office and two children bringing in tea for you notice you are comfortable with him, they take the message to the barrack that there is no point in telling these people anything. We avoided that – no refreshments were accepted,” he said.

Tarique said that when the TISS team spoke to the children in private, they strictly disallowed any institution member to enter the room on any pretext. “We had to warn the staff that if they come in on any pretext, we will have to complain to the government. This gave children the confidence to speak up,” he said. The TISS team would also never counter-check what children told them with the staff there immediately in front of them.

The key was to be realistic with the children. “We told them we may not be able to change everything, we did not make tall promises. But we assured them that whatever they would tell us, we would report it and it would go to the highest authority. Our mandate was not to investigate a crime – it is something we stumbled upon,” Tarique told ET.

Source: Economic Times, 1/08/2018

Record 55,000 clear UGC-NET

Over 55,000 candidates have cleared the University Grants Commission-National Eligibility Test to qualify as assistant professor and get a Junior Research Fellowship grant. This is the highestever number of candidates to have passed the exam. Last year, the number was around 38,000.

This time, the Central Board of Secondary Education (CBSE) announced these results in a record threeweek time. The exam was conducted on July 8 and the results were announced by the board on Tuesday. So far, the board used to take at least three months to do the same.

Although 11.48 lakh candidates had registered, 8.59 lakh appeared for the exam, around 6.5% of whom finally made the cut. For the first time, it was made into a twopaper exam (one general, meant for all candidates, and a subject paper) from the earlier three-paper one. The exam was conducted for 84 different subjects.

This year, the numbers of candidates registered (11,48,235) and appeared (8,59,498) are also the highest ever for the exam.

As per UGC norms, 6% candidates are allowed to clear the exam, but this time the number increased to around 6.5% due to the bunching of marks.

CBSE officials attributed use of more manpower to the early announcement of the results.

In the third week of July, the board uploaded OMR (optical mark resolution) sheet images and the answers, and invited challenges till July 27. According to CBSE sources, it received three kinds of challenges — some blackened two circles of the same question and requested the board to consider only one circle, others asked for subject change at the time of the examination and some candidates pointed out a few corrections in questions. While the first two challenges were turned down, the board put the third challenge before experts and implemented their advice.

Source: Times of India, 1/08/2018