Three of every four companies found guilty of misbranding or selling adulterated food products get away without any punishment, according to health ministry records, even as Nestle India and the instant-noodle industry continue to suffer what now appears to have been an exaggerated scare over contaminants.
Canada, UK, Hong Kong and Singapore, Australia and New Zealand have all found Maggi two-minute noodles to be safe, as have many Indian states, and while legal proceedings continue, the controversy is a reflection of how food-safety procedures unfold in India.
Over the past seven years, about 25% of 53,406 companies against whom prosecution was launched for violating food safety laws were convicted. As many as 72,861 companies were found guilty of misbranding and adulteration during the period.
Experts say that the low conviction rate is one of the primary reasons for the rise of adulterated food in market during the past five years. The percentage of adulterated food tested by government has risen from 8% in 2008 to about 18% in 2014.
Adulterated food can cause cancer, insomnia and other neurological problems, and adulteration is a growing concern across India, as IndiaSpend previouslyreported.
Who will analyse suspect food?
Officials blame the low conviction rates on a shortage of food analysts. Last year, as this Times Of India report said, Rajasthan closed seven public-health laboratories because it could not find such analysts.
“There are only about 200 food analysts in the country, so it becomes really difficult to prove charges in the court,” an official with the Food Safety and Standards Authority of India (FSSAI) told IndiaSpend. He spoke on condition of anonymity, since he is not authorised to speak to the media.
There are many states that are yet to establish appellate tribunals, as mandated in the Food Safety and Standards Act (2006), to quickly conclude cases where the adjudicating officer has already passed orders, thus leading to trial delays, said the official.
State food-safety officers pick random samples and send them to government laboratories for testing, a process monitored and regulated by the FSSAI.
A scrutiny of the past three years’ records show that except for a few state authorities, such as Uttar Pradesh, Maharashtra, Jammu & Kashmir, none of them have convicted offenders. Bihar, Rajasthan and Haryana are among the worst performers.
Chhattisgarh, Uttar Pradesh and Himachal Pradesh were among the states where every third sample tested was found below standards.
Patil is a New Delhi-based freelance journalist. He has worked with The Economic Times, DNA and The New Indian Express.
This article was previously published on IndiaSpend.
“Abortion is murder.” “Only selfish women have an abortion.” “Abortion is used as birth control.” “Women who have an abortion regret it later.”
For many people, an image of a distressed, aggrieved, and remorseful woman comes to mind when they hear the word ‘abortion’.
The issue of abortion in India is very stigmatized, thereby limiting an open discourse around it and reinforcing the stigma. Myths and misconceptions, fabricated by culture, dominate people’s perceptions about abortion. These myths further strengthen the regressive patriarchal norms around women’s sexuality, bodily autonomy and integrity and negatively impact their health. CREA’s campaign #AbortTheStigma seeks to provide a platform to raise awareness, enable open conversations around abortion and address the stigma and shame associated with abortion.
Despite all of our claims to progress, have things really changed when it comes to the condition of women? Have we really started having the difficult conversations on gender equality and sexuality? Or do we still cave in to the problematic norms and misconceptions around abortion? Watch this video to find out what young India thinks about abortion.
The disbelief gets credence because less than four months ago Nadda told Parliament it would take five years to immunise 90% of India’s children. Only 65% of children are now immunised, the best rate achieved in 38 years since the Universal Immunisation Programme (UIP), as it is officially called, was started. It targets 27 million new-born children and 30 million pregnant women every year.
In India, 500,000 children die of vaccine-preventable diseases because one in three misses the benefits of full immunisation, according to government data.
“The government has launched Mission Indradhanush on December 25, 2014 with an aim to cover all those children who are partially vaccinated or unvaccinated. The mission focuses on interventions to rapidly increase full immunisation coverage of children by approximately 5% annually, and to expand full immunisation coverage to at least 90% children in the next five years,” Nadda said in reply to a question in the upper house of Parliament, Rajya Sabha, on March 10, 2015.
Here’s how the rate of immunisation has grown over the years:
The current rate of immunisation has risen to 65.2% (2013-14) from 35.5% in 1992-93. The programme started in 1978. In 1985 it got its present name and was taken to all districts by 1989-90.
Under UIP, the government provides free vaccination against nine preventable diseases: diphtheria, pertussis (whopping cough), tetanus, polio, measles, a severe form of childhood tuberculosis, hepatitis B, meningitis/pneumonia due to haemophilus influenza B and Japanese Encephalitis.
Uttarakhand Does Well, U.P Lags
Uttarakhand with 79.6% coverage is the best-immunised state, according to the Annual Health Survey (AHS) 2012-13 while Uttar Pradesh with 52.7% is the worst.
“Eliminating transmission of a virus is one of the greatest public health achievements possible,” said Margaret Chan, WHO director-general adding that it was an important step towards having an AIDS-free generation.
WHO’s Pan American Health Organisation (PAHO) started an initiative in 2010 in Cuba and other countries of the Americas to eliminate mother-to-child transmission of HIV and syphilis. With the help of the government of Cuba, it provided early access to prenatal care, HIV and syphilis testing for both—pregnant women and their partners, treatment for women who test positive and their babies, and substitution of breastfeeding. These services are provided as part of equitable, accessible and universal health system in which maternal and child health programmes are integrated with programmes for HIV and sexually transmitted infections.
“Cuba’s success demonstrates that universal access and universal health coverage are feasible and indeed are the key to success, even against challenges as daunting as HIV,” said PAHO director, Carissa F Etienne.
Every year, globally, an estimated 1.4 million women living with HIV become pregnant. Untreated, they have a 15-45 per cent chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. However, that risk drops to just over 1 per cent if antiretroviral medicines are given to both mothers and children throughout the stages when infection can occur. The number of children born annually with HIV has almost halved since 2009—down from 400,000 in 2009 to 240,000 in 2013.
The secrets of great sex and satisfying relationships unveiled! Secrets of the world’s most sexually satisfied countries! The internet knows your darkest secrets! These news flashes and more in this week’s Sex in the Press.
In Search For That Ultimate Secret
People are always looking for easy answers when it comes to having great sex and satisfying relationships.
“Countries that are more socially liberal and have relaxed attitudes toward sex tend to have lower rates of STDs, teen pregnancies and abortions, and much more satisfying sex lives in general.” This is certainly the case for countries such as Switzerland, the Netherlands and Germany.
A general openness to sexual matters seems to drive the sexual satisfaction of traditional Latin lover countries such as Spain, Italy and Brazil.
A willingness to openly discuss their sexual desires seems to drive the Greeks to have the most sex on average in the world (164 times per year).
Then there’s the winner: “Nigeria is rated the number-one sexually satisfied nation in the world with 67 per cent of its population claiming sexual gratification. Perhaps it has something to do with the fact that Nigerians also take the longest time having sex, at 24 minutes per average session.”
“Now imagine it is Saturday evening, you’ve been playing upbeat songs all day via Spotify, then around 7pm you play some dinner music and at 9pm you switch to some Barry White. It doesn’t take a genius to know what you’re doing.”
“If you are wearing an Apple Watch (at all times, right?), FitBit or Jawbone UP then those companies have that intimate data too. Every time you turn around, or move that arm up and down, and up and down, and… well, you get the idea.”
“You check Facebook every 2 minutes, right? So when you and your date get together and for exactly 43 minutes don’t check anything, and then at the same time check back in again? Yep, Facebook knows.”
A group of students at the Isaac Newton Academy in Essex, England, have invented a ‘smart’ condom to detect sexually transmitted infection (STI) in the wearer. Called S.T.Eye, the latex condom is covered with antibodies that would react with the bacteria found in STIs, triggering a change of colour. This would occur on both sides of the condom. In the presence of STI, the condom would turn green for chlamydia, purple for genital warts, blue for syphilis and yellow for herpes.
The idea, which is still at the concept stage, is the brainchild of Daanyaal Ali (14), Chirag Shah (14) and Muaz Nawaz (13), who won the TeenTech award this week for their proposal. The competition encourages 11-16-year-olds to create “technology to make life better, simpler or easier“, and includes prize money of £1,571 and a trip to Buckingham Palace.
The winners told BBC Newsbeat that they took inspiration from an HIV testing method called Elisa which utilises colour-changing technique. “Once the bodily fluids come into contact with the latex, if the person does have some sort of STI, it will cause a reaction through antibodies and antigens hanging on to each other, which triggers an antibody reaction causing a colour change,” Ali explained. They wanted to make detecting harmful STIs safer and easier, in the comfort of one’s home and without the embarrassment of going to a clinic. “We noticed how big the condom market was—there were over 4,50,000 STI cases in England in 2013 alone,” Ali said.
The young students have already been contacted by a condom company who is keen on developing the concept further. “The technology for colour change in the presence of an antigen is certainly something that does happen. It normally requires some additional chemicals in that process and with a condom you would obviously need to make sure that those chemicals are not going to be harmful or toxic or in any way cause irritation,” Mark Lawton, a consultant in sexual health and HIV at the Royal Liverpool Hospital, told BBC.
So while the MDGs along with their 21 targets and 60 indicators were designed particularly to address the needs of the world’s “poorest and marginalized citizens”, it is ironic that they failed to address the one group that is most susceptible– people with disability.
While the MDGs provided governments a reference point on which they could focus their policies to end poverty, they have also been criticized for being too narrow and for not focusing on the element of human rights in their design. Although the MDGs were goals to be achieved globally, in reality they were more for the poorer countries to accomplish with overseas aid.
The world then began to talk about what would happen once the MDGs would expire. The Post-2015 is a process designed to help define a future global development framework that would succeed the MDGs, with a target date of 2030. It was in 2010, at a United Nations summit called by the UN Secretary General to review the progress of the MDGs and also to think of a future course of action beyond 2015, that the idea of a Post-2015 agenda was born.
In 2012, during a United Nations Conference on Sustainable Development (Rio+20), Member States agreed to launch a process to develop the next set of goals- Sustainable Development Goals (SDGs). Subsequently, in 2013 an Open Working Group assigned by the UN Secretary General was assigned the task of preparing a proposal on these goals, which was completed in July 2014, and was presented in the General Assembly.
Since then multiple consultations have taken place globally, both online and on the ground. Many civil society organizations have come together to participate in the process and contribute to the development of the new agenda.
As of this year, in September 2015, the MDGs will expire and the General Assembly will adopt the 17 SDGs. While the magnitude of involvement of the disability movement in this process is much higher than what it was during the MDGs, the results speak otherwise.
Groups working around the issue seem to celebrate the fact that disability has mentions in the new framework, but what is ironic once again, is that Goals 1 and 3 on ‘Eradication of Poverty’ and ‘Ensuring Healthy Lives’ have no references to disability – neither in the goals, nor in the targets. When one talks of health, if there is one group of people that needs health care services and are vulnerable, it is people with disabilities.
During a recent visit to the UN Headquarters in New York as part of a disability group delegation, I learnt many new, hard-hitting things. We lobbied with Permanent Missions to make some noise about the exclusion of disability. But it seemed it was too late. The Goals and targets will remain as they stand. The only few strands of hope were that disability was to be included in the provision for disaggregated data, but this may or may not remain once the indicators of these goals are finalized.
Another insightful learning was that the G-77 countries were adamant against any change in the Goals and targets. Their reason, which I personally empathize with, was that they have worked very hard to get certain targets and groups included in the process and these might get taken away if the so-called Pandora ’s Box is opened. Other marginalized and ignored groups may also then begin to question the process vis-à-vis their own inclusion (or exclusion), which then risks this becoming a never-ending battle.
As things stand now, the world of disability hopes for a miracle when the Indicators and the Political Declaration are adopted. Only time will tell.
The UN Secretary General called for ‘Leaving no one behind’ in the Post-2015 development agenda. But the way I see it, history might just be repeating itself.
With the Disabled Left behind, yet again.
Parul Ghosh has worked with a global disability rights organization for over three years and these are her personal views. While she writes about the Global development process, she also questions the direct impact of the agenda, if any, on the grassroots.
Sanitation in Jammu & Kashmir (J&K) is among the worst in India, with more than 54% of more than 1.2 million households without toilets and the 2014-15 target for household latrines falling short by 86%, according to government data.
While J&K is ranked third, the two worst states are Odisha and Bihar, according to the Baseline Survey 2012 of the Union Ministry of Drinking Water & Sanitation.
“The sanitation programme is at a preliminary stage in the state,” said Khurshid Ahmad Shah, Secretary, Rural Development. “We are taking measures to fulfil our objective, and it will be done very soon.”
That does not appear immediately evident.
Prime Minister Narendra Modi’s much-talked-about sanitation programme, Swachh Bharat Abhiyan (SBA), is largely unimplemented in J&K, which is partly ruled by the Bharatiya Janata Party.
In J&K, 6,351 schools lack toilets for girls and 8,098 lack toilets for boys, according to data from the state’s Unified District Information System for Education (DISE Survey 2014-15).
More than 71% of schools have no basins or taps to wash hands near toilets and urinals.
“Sanitation facilities in the state are very poor, and this is not only limited to villages,” said Dr Nisar ul Hassan, a senior doctor at Shri Maharaja Hari Singh Hospital in Srinagar. “The situation is similar in cities and healthcare institutions as well. Hepatitis A and diarrhoea, particularly in children, caused by rotavirus are common among patients where sanitary facilities are poor.”
40 cases of viral hepatitis, caused by unsafe government-supplied drinking water, were reported from a village in northern Kashmir last month, according to the Union Ministry of Health & Family Welfare.
Successor to an earlier sanitation programme called the Nirmal Bharat Abhiyan, SBA seeks to eliminate open defecation in rural areas of the country by 2019.
Slow toilet construction increases health threats
The state has done little to mitigate health threats from improper sanitary facilities for households and school children.
J&K constructed 42,239 individual household latrines during 2014-2015 against the annual target of 0.3 million, a shortfall of 86%.
The government was to construct toilets in 1,264 schools last year, but it did so no more than 87. Only 17 of 300 anganwadi centers (creches) saw construction of toilets.
The state has constructed only about 0.13 million household toilets in the state since the survey was conducted.
This is not the first time J&K has faltered in meeting the annual objectives of sanitation schemes.
Official data since 2010 shows the state never completed its annual objectives in construction of household toilets. The best it did over the past five years was in 2010, when it fulfilled about 60% of its objective.
That was the first time the state constructed more than 0.1 million household toilets in a single year.
The annual implementation plan for the year 2015-2016 of Swachh Bharat Abhiyan was approved by the state on June 9, setting a target of 0.2 million latrines to be constructed in rural areas during the year.
Of J&K’s three regions, Jammu, Kashmir and Ladakh, two districts, Kargil and Leh, in the mountainous Ladakh region, did better in household toilet construction than Kashmir and Jammu divisions, the data revealed.
J&K has also lagged in the implementation of the National Rural Drinking Water Programme, with Rs 310.15 crore unspent in 2014-2015, with more than 60% of the target unmet.
Senior personnel from the Union Ministry of Drinking Water and Sanitation, in an official meeting held in February, reported there was “very low” implementation of the programme in J&K.
Schools lack toilets, wash-basins, drinking water
More than 71% of schools have no wash-basins or taps available near toilets, according to government data and 9.18% schools have no drinking water.
This article was originally published on IndiaSpend.
Within 4 months of a strike following the incident at the Guru Teg Bahadur Hospital, 2000 resident doctors have gone on an indefinite strike, starting Monday morning, in the national capital. Their demands are pretty clear: they want adequate supply of life-saving and generic drugs, better security at their workplace, drinking water, timely salaries, as well as time-bound duty hours. They claim that they had written to the concerned authorities expressing their grievances, and expected a reaction before June 21st, but carried on with the strike owing to lack of response.
The healthcare services in Delhi naturally have been affected, because the 2000 doctors protesting belong to 20 different hospitals, including major ones such as Safdarjung Hospital, and Lady Hardinge Medical College.
We need to remember that this is not the first time that doctors have gone on strike. Horrible working conditions have been reported in the past too. These doctors are public servants but that doesn’t warrant sidelining of their basic rights. The welfare of patients lie in the welfare of doctors too, and thus, ignoring their grievances would mean disregard for public health. Delhi CM Arvind Kejriwal seems to have grasped this point well, and promptly tweeted, acknowledging the demands of the doctors as “genuine”. He also mentioned that the government is “committed” to providing the “best health facilities” to people. On the other hand, he alleged lack of cooperation of the doctors, and said that they were invited for talks on Saturday, Sunday, and Monday (at 3 pm), but did not show up.
There is a need to place such strikes that have far-reaching consequences, in a political context too. Ever since Kejriwal’s landslide victory in Delhi, the national capital has been the center of action for months together now. Political parties have tried their best to make use of opportunities to attribute issues to faults in governance. The congress has been quick to react, with the Delhi Congress’s chief spokesperson expressing the party’s support to the doctors’ demands, and at the same time accusing the Kejriwal regime of poor administration. One can only hope that this strike culminates into proactive measures to address the concerns being raised, and does not become propaganda for warring political parties.
There is a shortfall of 73% and 55% in inspections of sonography centres in the western states of Gujarat and Maharashtra, two of India’s richest.
The child sex-ratio (number of girls under six years per 1,000 boys) in the states are among the lowest in India, especially in backward districts, such as Beed in Maharashtra’s Marathwada region (807) and Surat district (831) in Gujarat. The national average is 914.
Verdicts have been pronounced in 23 cases of 603 reported cases of child marriage in Maharashtra with 580 cases pending for 2013-14.
No one has been convicted in Gujarat under the prohibition of Child Marriage Act, although 659 cases are registered.
A wealth of laws and programmes instituted to protect girls are failing them in India’s two most economically-developed states, Maharashtra and Gujarat, according to recent reports by the central government auditor, the Comptroller and Auditor General of India (CAG).
Both states are failing to implement the Pre-Conception and Pre-Natal Diagnostic Techniques Act (PC & PNT), which prohibits sex selection, before or after conception, and regulates diagnostic techniques to prevent misuse for sex determination used in female foeticide.
Strong laws that work on paper, fail on ground
On paper, the Act provides for robust implementation state-wide through a supervisory board and an advisory committee including an officer of or above the rank of joint director of Health and Family Welfare as chairperson; representatives from women’s organisations and an officer of the law department.
The chief medical officer or civil surgeon is designated the appropriate authority at the district level.
These authorities can monitor the sonography centres that help abort the female fetus.
In Maharashtra, there was a shortfall of 55% in inspections (averaged across all districts) in 2013-14, up from a shortfall of 43% in 2011-12, the CAG found. The highest was in Amravati district at 54%.
In Gujarat, the shortfall was higher at 73% in 2013-14.
“The joint secretary, health and family welfare department, stated that the state government had assured to increase (sic) rate of conviction by meticulous paper work, evidence gathering and proper submission, and strong pleading of PC & PNDT cases,” the report said.
Maharashtra registered 481 cases under the PC & PNDT Act as of March 2014.
While 181 offences were registered in Gujarat under the PC & PNDT Act as of March 2014, only 49 cases were prosecuted and only six offenders were convicted, the CAG report said. The punishments include imprisonment, cancellation of licences and fine.
In violation of Supreme Court directions to prosecute cases within six months, cases continued from one to 12 years.
The failure to implement the PC & PNDT Act is responsible for the falling child sex-ratio in these states, the report said.
Child sex-ratio in Maharashtra is the lowest in Beed, Marathwada with 807 girls per 1,000 boys followed by Jalgoan in Khandesh (north Maharashtra).
In Gujarat, Surat has the lowest ratio of 831:1,000 followed by Gandhinagar.
The child sex-ratio in four districts (Chandrapur, Kolhapur, Sangli and Satara) in Maharashtra rose between 2001 and 2011 but it declined in 31 districts over the same period.
Sex ratio improves in India, not in Maharashtra, Gujarat
Maharashtra’s overall sex ratio declined from 920 to 919 over a decade (2001 to 2011) although the all-India ratio improved from 933 to 943, according to census 2011.
For Gujarat, the overall sex ratio declined from 920 to 919 from 2001 to 2011. However, there was some improvement in the child sex-ratio from 883 to 890 between 2001 and 2011.
Another important finding of the report is that the child sex-ratio is lower in urban areas than in rural areas in both states.
The report explains that this could be due to the availability of sonography centres in urban areas.
“The availability of genetic clinics in urban areas and awareness of literate people about usage of sex determination techniques could also be attributed to declining child sex-ratio in urban areas,” the report said.
The child sex-ratio in urban India stood at 902 as against 919 in rural areas, the report said.
In Maharashtra, the child sex-ratio in urban regions stood at 899 and 890 in rural areas.
In Gujarat, the child sex-ratio in urban areas is 852 and 914 in rural areas.
Children forced into marriage under-reported by both states
Child marriages, meaning girls/boys aged 10 to 19 years getting married, are common across Maharashtra and Gujarat, the report said. The audit found that both states were under-reporting child marriages.
There are almost 17 million children in India who were married between the ages of 10 and 19. Maharashtra ranks 5th with 1.5 million children married, while Gujarat is 7th with 0.9 million children married in the 10-19 age group.
Almost 73% of children married are girls in Maharashtra while it is 66% in Gujarat.
In 2013-14, Maharashtra’s per capita income (at current prices) was 45.6% above the Indian norm (Rs 117,091 annually), while Gujarat‘s was 33% above (Rs 106,831 annually at current prices). India’s average annual per capita income (at current prices) was Rs 80,388.
While Maharashtra grew at 8.7% in 2014-15, Gujarat grew at 8.8% in 2014-15.
This article was originally published on IndiaSpend.
It comes unannounced, greets you like an old nemesis, and then consumes you whole. Depression is perhaps one of the most terrifying of disorders to affect people. That seemingly content stranger standing next to you on the bus stop could have it. So could your closest friend. Globally, more than 350 million people of all ages suffer from depression. And often, it leads to suicide.
Many wonder what the fuss is all about. After all, can happiness really be all that elusive? This powerful performance by a woman will show you how glimpses of depression can be found in ordinary moments throughout life. She writes her depression a letter, and with that, lays bare her struggle against it.
To know more about what I think of this video, follow me on Twitter at @im_sanskriti.
Having a baby in a remote village of eastern Bihar, India means being pregnant with anxiety and a sense of helplessness. Without access to health infrastructure to monitor pregnancies and provisions for emergency care, it is a life threatening situation for both the mother and the unborn child. In cases of abortions, women who approach state-run health facilities are turned away due to lack of infrastructure and are forced to approach private practitioners. Most of them, cannot afford their services.
Last year, 24-year old Masuhsun Khatun from Fulvari village of Bihar’s Kishanganj district was expecting her fifth baby. She was five months pregnant in June 2014, when she tripped and fell in the front yard of her house.
Later that night, Masuhun woke up writhing in pain and bleeding profusely. Her husband tried calling a government ambulance but to no avail. He then hired a private vehicle to get Masuhun to the nearest government hospital. They found no doctors there and Masuhun was taken to a private practitioner, who informed her that she needed to undergo an abortion.
Two weeks after the abortion at a private health facility, Masuhun started bleeding again. This time she was taken to a state-run hospital, where she was told she had foetal remains in her womb. Masuhun was forced to undergo a remedial procedure at her home, under the supervision of an auxiliary nurse midwife (ANM), because the hospital lacked adequate medical facilities. Although, ANMs are not qualified to perform surgical procedures. Her condition worsened over the next five days before she passed away.
For three weeks, Masuhsun shuttled between private practitioners and state-run medical facilities. Her husband, a daily wage labourer, spent nearly Rs 40,000 on her pregnancy and the subsequent termination, including Rs 17,600 on eight bottles of blood required for transfusion.
Community Correspondent Navita Devi’s report reveals that due to lack of proper abortion facilities, trained medical personnel and access to public health facilities, several other women in Fulvari village of Kishanganj district in Bihar suffered the same fate as Masuhun’s. The ones who survived, live with financial burdens and a trauma that never leaves them.
This, however, isn’t just the story of the women of Fulvari.
India Has The Highest Number Of Maternal Deaths
56,000 women succumb to pregnancy related complications in India every year — the highest across the world. Rajasthan, followed by Assam, Uttar Pradesh and Uttarakhand, has the highest maternal mortality rates—the number of women aged 15-49 dying due to pregnancy related complications per 100,000 live births—in India, according to a report by the Registrar General of India.
Madhya Pradesh, Chhattisgarh, Odisha, Bihar and Jharkhand are other states with critical numbers. Infections due to non use of a sterile kit during delivery, home births without trained providers, eclampsia, postpartum haemorrhage, early pregnancies, anaemia and unsafe abortions are the leading causes of maternal deaths. However, these deaths are entirely preventable. According to government data, although India’s maternal mortality rate has come down considerably in the last two decades, urban-rural disparities continue to exist.
In 2005, the Ministry of Health and Family Welfare launched the Janani Suraksha Yojana (JSY), a cash transfer programme, that incentivised institutional deliveries, in order to reduce maternal deaths in India. Women are awarded Rs 1,400 in rural areas and Rs 1,000 in urban areas to give birth in public health facilities, under the scheme. It also makes provisions to reduce out-of-pocket expenditure, providing free antenatal check-ups, IFA tablets, medicines, nutrition in health institutions, provision for blood transfusion, and transport from health centres and back. The scheme, however, makes no provisions for medical intervention in cases of accidents, and women like Masuhusn are left to fend for themselves.
While the scheme’s focus remains on reducing maternal and neonatal deaths, by providing free institutional care, ground reports by Video Volunteers’ (VV) Community correspondents reveal that access to prenatal and postnatal care, nutrition and timely medical intervention remain dismal in several parts of the country.
These reports are first in a series of VV’s project on Community Monitoring of Maternal Health in India. Through its network of over 180 community journalists from marginalised communities, VV seeks to report violations, produce stories, take action and devise solutions to improve the state of maternal healthcare in India.
Women continue to give birth in deplorable conditions at unhygienic and ill-equipped health facilities. While Bharti Kumari reports on how dangerous it is to deliver at the Telmocho sub-health centre in Dhanbad district of Jharkhand, Meri Nisha Hansda’s report reveals how pregnant women wait for hours to receive medical attention and are charged not just for medicines but also for using the toilet at the Primary Health centre in Godda. According to the health ministry guidelines a Primary Health Centre is supposed to have two doctors. However, no doctor was present at the time when Paku Tudu was brought in to the hospital. Her delivery was conducted by an ANM.
Missing Infrastructure And Health Workers
While India’s public health system grapples with a dearth of health facilities, shortage of human resources is one of the biggest impediments to the functioning of existing public health facilities in India. The absence of a health centre nearby also means that pregnant women have to travel long distances to avail medical services.
In interviews to Reena Ramteke, several women from Khatti village in Chhattisgarh say that ANMs hardly ever visit the village, and that the sub-health centre in the village always remains locked. A sub-health centre is a state-run first care provider staffed by an ANM who is responsible for administering antenatal care to pregnant women.
One Frontline Health Worker For 14 Centers
Frontline health workers are often blamed for dismal healthcare in rural India. However, they are spread too thin and are forced to work under inhuman conditions. According to the ministry guidelines, one ANM is supposed to look after eight sub-health centres. However, in Jharkhand’s Dhanbad district, two ANMs look after 23 centres in Baghmara block. Ahilya Devi looks after 14 of the 23 centres. “There is no water and provisions for emergency light in cases of power failure. In such a case we have no choice but to use a flashlight, lantern or candle. How do we put stitches in such a case?” she asks. She admits that because of the workload, she often can’t make it to some sub-health centres.
Gyanti Kumari reports from Bihar’s Siwan district on the shortage of medicines at the Rajapur Primary-health centre and instances where women were forced to spend money on medical facilities they are entitled to under the JSY. “The ANM charged Rs 50 per injection and Rs 500 to cut my daughter’s umbilical cord,” says Muni Devi’s mother.
In testimonies to VV’s community correspondents, women say that the lack of infrastructure, support from healthcare providers and high out of pocket expenditure discourages them from seeking care at state-run facilities. Unavailability of or delay in the arrival of an ambulance is another deterrent.
In August this year, the health ministry plans to send voice messages delivering advice to pregnant women to increase health awareness amongst them. The government plans to make use of India’s network of 950 million mobile connections to combat maternal and infant mortality. This might prove to be a cost-effective way of spreading awareness but what about safety of women who choose to deliver at public health institutions? How far will awareness campaigns take us at a time when the public health system is in complete disarray?
While New Delhi is all-out preparing for the showpiece event of the inaugural International Day of Yoga, the All India Muslim Personal Law Board (AIMPLB) on June 7 decided to launch a nationwide campaign against making Yoga and Surya Namaskar (requiring a person to bow to Sun God) compulsory in schools. Several Muslims in Mumbai got infuriated when the Maharashtra government recently passed a diktat for schools to open on Sunday, June 21 to compulsorily celebrate and promote the importance of yoga.
According to many Muslims, yoga is anti-Islam. Education secretary of Jamat-e-Islami Hind Mohammed Zahoor Ahmed told Indian Express, “It is detrimental to our religious freedom. Islam being a monotheistic religion, the followers cannot bow before anyone except Allah, and it is wrong to impose such things on Muslims.”
Dr Zahir Kazi who is the president of Anjuman-I-Islam, which runs a chain of schools and professional colleges in Maharashtra, called the move as “undemocratic”. He says, “The order is undemocratic and amounts to infringing on the rights of a group of citizens who don’t worship anyone except Allah who is formless and omnipresent”.
Members of All-India Majlis-e-Ittehad-ul Muslimeen (AIMIM) consider promoting and making yoga compulsory an indirect way of promoting a ‘Hindu rashtra’ by the BJP government. “This really shows that they want to impose the hindutva ideology on the throats of people and we are definitely not going to follow”, says AIMIM chief Asaduddin Owaisi.
“The government should develop a sense of confidence among the people of the minority communities that they can practice their religion without any problem but it is seen that Hindutva forces are carrying out their agenda against minorities after Narendra Modi became Prime Minister,” AIMPLB assistant general secretary Abdul Rahim Qureshi said. AIMPLB also alleged that communal forces wanted Muslim youths to break laws so that they can get a chance to isolate the community and justify atrocities against them.
Having seen all the incidents of unacceptance by minorities, making yoga strictly compulsory might be a wrong choice by our PM and state governments in our democratic country. However, promoting the importance of yoga pertaining to its health benefits is not wrong as well. Although Vedic chanting and surya-namaskar are not required to perform yoga, chanting “Om” can be replaced by “Allah”, “Jesus” or any syllable to help focus during meditation. It is true that yoga’s origin is linked to Hindu scriptures and rituals but in reality it has traveled across many countries and has evolved into a sport and a recreational activity to achieve a healthier lifestyle.
There are 47 Islamic nations among the 177 countries of the United Nations General Assembly (UNGA) that officially co-sponsored–with India–a resolution to establish June 21 as “International Day of Yoga”.
Yoga is a 5,000-year-old physical, mental and spiritual practice rooted in Hindu tradition, a religious origin that has caused disquiet among some Indian Muslim clerics.
This is the highest number of co-sponsors ever for any UNGA resolution, according to the Union Ministry of External Affairs (MEA). The resolution was passed unopposed without a vote.
Prime Minister Narendra Modi has promoted yoga as a means to project India’s soft power. Some critics accuse him of subtly furthering a Hindu agenda, while some representatives of Indian Islamic organisations support yoga day, saying that namaz includes yogic postures.
Pakistan, Saudi Arabia, Malaysia, Brunei, Mauritiana, Cameroon, Libya and Burkina Faso were among the 8 members of the Organisation of Islamic Cooperation (OIC) that did not co-sponsor the proposal for the yoga day.
The Non-OIC members that did not co-sponsor the resolution were North Korea, Estonia, Namibia, Swaziland, Switzerland, Monaco, Solomon Islands and Zambia.
More than 35,000 people will gather at Rajpath, New Delhi, to mark yoga day. Among them will be the Prime Minister, his cabinet ministers and diplomats.
In addition, more than 1.1 million National Cadet Corps cadets nationwide will perform a “common yoga protocol”, established by the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH). So, too, will about 0.9 million policemen and women.
Some of the yogic postures under the common yoga protocol:
The word “Yoga” is derived from the Sanskrit root ‘Yuj’, meaning to join or to unite and dates to 2,700 BC, and according to this government document, considered an “immortal cultural outcome” of the Indus-Saraswati Valley Civilisation.
The government and yoga: close links
Yoga and naturopathy are widely promoted by the government of India, specifically by the AYUSH ministry.
There are two National Institutes, the Morarji Desai National Institute for Yoga (MDNIY), New Delhi and National Institute for Naturopathy (NIN), Pune, and one Central Council for Research in Yoga & Naturopathy (CCRYN), New Delhi. Granted Rs 101.5 crore over the last four years by the government, they hold exhibitions, seminars and conferences.
MDNIY recently started a B.Sc. in yoga science, and there are 18 colleges in eight states imparting a five-and-a-half year Bachelor of Naturopathy & Yogic Sciences degree and more than 50 stand-alone yoga colleges offering B.Sc., M.Sc., diploma and certificate courses.
The government has also proposed an All-India Yoga Institute.
This article was originally published on IndiaSpend.
Having a baby in a remote village of eastern Bihar in India means being pregnant with anxiety and a sense of helplessness. Without access access to health infrastructure to monitor pregnancies and provisions for emergency care, it is a life threatening situation for both the mother and the unborn child . In cases of abortions, women who approach state-run health facilities are turned away due to a lack of infrastructure and are forced to approach private practitioners. Most of them cannot afford their services. Here’s one such case:
A 24-year old woman in labour was kept waiting for the doctor for 6 hours. The doctor on duty did not turn up and she delivered in the presence of a nurse. She was forced to pay INR 400 for her delivery and even, to use the toilet. She neither received free medicines nor nutrition. This is despite the provisions of the Janani Suraksha Yojana, the Indian government’s scheme to bring down maternal deaths, which makes provisions to reduce out-of-pocket expenditure for women below poverty line —providing free antenatal check ups, IFA tablets, medicines, nutrition in health institutions, provision for blood transfusion, and transport from health centres and back. Mary Nisha reports from Godda district, Jharkhand.
A series on community monitoring of maternal health in India is being produced by IndiaUnheard, a network of 174 community journalists trained by Video Volunteers. VV is a community media organisation that empowers marginalised communities to produce stories, take action and devise solutions.
There is a silent epidemic going on before the eyes of the general public. Millions of people are suffering from anxiety, depression, fear, panic attacks, and many other diseases related to the daily stress of life. As a society, we all wear a mask that projects to others that we have good control of our life. If we show our pain, we are considered weak and not able to fit into societal expectations. The pressure of fitting in leads us to wear this mask, more so for people who are suffering and cannot handle their pain. Desperately wanting help, many turn to Internet Support Groups because then they can create an alias and openly express their problems.
I went through this same route myself. I wore the mask, hid my problems, and participated in many Internet forums. Having done that, now I see the time has come for me to bring these issues to the attention of everyone and remove the social stigma associated with them. Awareness is essential to the process of healing. In most cases this is not a disease, it is rather due to people going through a life transition process that often occurs in midlife. A spiritual awakening has common symptoms.
Here is my journal of experiences based on the notes I took while applying my new insights that I received in daily life.
Being truly alive means being filled with love. Only when we are fully alive and filled with love will we feel complete and be free of suffering, fear, and pain. If our life isn’t like this, then how can we get there? Everyone is born in this state but very few continue to live in that state. As part of growing up in the name of learning and gaining knowledge, we lose the essence of love. It is inherent in today’s culture with its increasing levels of stress and distractions of sustenance, survival, and the everyday worries of life. Our natural state is suppressed even more.
I was leading a normal life with everyday challenges, struggles, and stress, with occasional happiness. I would rate it as an average life, not only for the material success but also for the quality of life I experienced. In the eyes of others, I would be seen as a typical man with a happy family, decent job as software engineer, and having the necessities to lead a comfortable middle class life. I was content with this self-image.
But things turned interesting…
It was May 6, 2010 and it’s hard for me to forget that day, it was the day when the US Stock Market crashed about ten percent during the intraday trading and later recovered most of the losses. It was a wild day in the stock market and later the wild swing in the market on that day was called the “Flash Crash”.
I was very active in trading as I was looking for ways to get more money in my life. I did not make big trades but I would make one or two trade per week. On this particular day, I had high hopes. I had heavy bets on a single company that was going to release its quarterly release that afternoon after market close.
A typical day for me then was to wake up around 6 AM before the market opened, browse the news, and check my emails and then go for a run. I had my smart phone with me all the time so checking the stock ticker was kind of a natural instinct every ten or fifteen minutes. In between the commute to work I was tuned into the business radio shows, which give a running commentary on the market. I was very hooked all day long through the smart phones, computer, radio show, or television shows and my mood would be in accord with what was happening in that world.
On that Thursday, the market was not looking good. It was going down in the morning and then there was the huge crash around noon. The anxiety and the stress that came with the crash compounded by a very poor quarterly report from the company, in which I had invested, put me into a deep depression. Compounding that situation was a rehearsal for a community event in the evening. In the middle of the show rehearsal, I felt faint and kind of dizzy. Without attracting anyone’s attention, I slowly sat down on a nearby chair. From nowhere, an intense fear came over me with heavy breathing and a feeling of total loss of control. Initially I thought it was a heart attack but somehow knew this was something different. Even though I had minor attacks like that before, this attack was full blown almost incapacitating me from doing anything. But I knew that I wanted to be alone. I slowly managed to walk to my car in the parking lot and sat down for a while. The attack lasted for almost an hour and the remnants continued for an hour afterwards. I did not know how to react to the attack but it was a real shock. Losing total control of yourself for a few minutes with fear fully taking you over is very scary. It was a serious wake up call in my life.
I did not know what happened to me that day, but I had to understand what initiated the attack. After checking with the doctors I figured out it was a panic attack. After more research and searching on the Internet, I learned quite a bit about these attacks. Doctors advised me to stay away from stressful situations to avoid a recurrence.
But the attacks randomly persisted and I felt I had to drastically change my lifestyle habits, diet, and exercise so that they could be brought under control. The attacks could be triggered when I was outside in public places, so I had nowhere to hide. A couple of times the attacks were totally out of control and I had to check in to the emergency room, only to find out that everything was normal. The medical world treated it like a disease and they prescribed anti-depressants to bring it under control. I decided not to take the medication. I wanted to heal myself holistically. I would also suggest to others that they be very wary of the placebo presented by the medical community through medication. I encourage you to research and find possible alternative solutions as opposed to just taking the easy way out with pills that mask the underlying cause.
Having grown up with the belief that people can achieve anything, I was not going to swallow the anti-depressant pill as my first option. From my upbringing, I was aware of two choices. My father, who had inspired me throughout my life, healed himself of recurring asthma attacks by practicing breathing exercises and learning yoga. He did this by religiously practicing it while he was in his seventies. On the other hand, my mother who was depressed could not get out of it, even though she tried to heal herself with yoga, meditation and walking. She finally let anti-depressants be her only savior. She did get better and her depression lifted, but her dependency on the anti-depressants did not go away. Given this background and being a spectator of the lives of my parents, it was natural to choose the route my father took. I started to look for healing through meditation, yoga, physical exercises and diet. I was ready to make every change needed in order to heal myself.
I altered my lifestyle to focus and maintain control, however the attacks did not abate, instead they began to recur more frequently. I had to make some drastic changes; I did not have a choice. I decided to stay away from the stock market, switching the radio away from the business news. Instead of running daily, I did slow walking to bring the adrenaline rush under control. I changed my diet to eating lighter foods so that I never felt heavy. I also dropped all the distracting habits that made me lose conscious control, including alcohol. I read a book that would give me peace before going to bed which became a habit. These changes gave me better control over my life but there was no reprieve from my panic attacks.
The challenge during these attacks was the flight or fight response which was naturally triggered by my body. I did not have the control of this mechanism. I felt like a passenger in a car driven by a mad driver. The symptoms of heavy breathing, fainting, losing control of myself and feeling that something terrible was going to happen, scared the hell out of me. After a few attacks I realized I was not going to die and I would survive. After facing many attacks, I figured out that they were illusions created by the mind and the attack was temporary from which I would recover. Some days I would wake up early, go for a walk or run 5 miles and have a typical breakfast. All would seem perfectly normal, and then bam! it would hit me again. Often when I was about to go out somewhere, I would fall victim to the symptoms and get into the panic anxiety mode.
I chose to fight the occurrences with will power and this played a key role. However, having tried this repeatedly, it didn’t help me cross the bridge to the other side. One of the best advices I had was to integrate the attacks into my life and let them happen without fighting against them. It sounded very simple but my automatic fight or flight response and conditioned mind never let it happen that way. The struggles continued for months, but the trust that I would overcome it helped carry me through those tough days.
Everyone Switched Countries, I Switched To A Different State Of Being
In May 2011, I was going through the naturalization process to become a United States citizen. The day to officially take the oath arrived. I had the usual jitters wondering whether a panic attack might strike me during the ceremony. That day, I settled in my seat amid thousands of people in the auditorium. As soon as the lights were switched off and the video presentation started, the butterflies in my stomach started to fly. Was this the beginning of another panic attack?
This day was unique. I had no choice but to fight the panic attack due to the circumstances. My seating arrangement meant I could not escape and if I had left the hall it would have made it more painful to go through the process again. However, even with these considerations something that never happened before happened that day. My nervous system, which normally went into the autonomic fight or flight response when the attack started, did not. Therefore, what the system usually perceived as an attack changed and let it go without responding. This happened as soon as I stopped fighting it.
It was a unique experience of feeling a sudden rush of energy through the body while externally looking calm sitting with other people. I realized I had undergone a major shift in my handling of panic attacks internally while externally I underwent a change of citizenship. Both the internal shift and external milestone happening on the same day was a significant turnaround for me. At this time it was not clear to me why this happened, but later I saw how it worked. I understood there was an energy that was activated in my body and my natural instinct to fight it caused my nervous system to treat is as a threat and put my body in the fight or flight response. This response created a variety of symptoms in my body, which scared the hell out of me, and it was very hard for me to break the attack.
Due to the way I had conditioned my mind and body; my natural response mechanism couldn’t handle the additional energy that was generated. On that day, it was the very first time I had experienced it fully. The energy started to shoot from my hip and it went to my heart, circled around the heart and then came back to the point where it started. The feeling of the energy flow was immediate and with so much fear, I could not enjoy it much. But, once you let the energy flow without blocks, the energy started to go from the hip to heart and circled back. The lesser resistance offered the higher the energy flow was smooth.
Here Is The Synopsis Of My Healing Process In Stages
This was my process to heal panic attacks, but my understanding is they are generic and you can apply them to any part of your lives. This is because the root of all challenges are the same. Whatever you do involves your mind and body and if you have a way to handle and understand that better, then anything external to us is easy to solve. If you win the war with yourself then outside reality reflects the inner victory. Whether you have a serious illness, a challenge in your relationship, financial hardships or bankruptcy in the business, all these can be solved with the following understanding.
1. Initial Fear: Why me?
When life throws a challenge at us the first response that we have is: “Why me“?
What actually happened to me was I had disconnected myself from being part of a universal being and lived as a separate entity possibly for a long time. So when it looked like I had a disease, my first reaction was: “What did I do wrong“? Instead of looking at the real problem I started to look at why I had been singled out to suffer this condition. That was a very natural reaction for my belief system from younger days was constructed that way. By relating to this challenge and finding the root cause it became my stepping-stone to major breakthroughs and led me to the next stage of life. It provided me choices to enter new routes that I had not explored before. It gave me choices of new exercise regimen, diet, and reading habits that impacted my life for the greater good.
Life’s challenges often cause a shock to our system when we first encounter them, but it’s important not to let them drag us down too long. Anyone who goes through a sudden shock in life whether it is a cancer diagnosis or a lottery win returns to normal life after a period of anxiety, excitement, pain or happiness. If we are a sad person even after we win a lottery we will return to that state after our initial excitement goes away. Others have the opposite default state of happiness and a shock like death of a loved one will cause a short span of sorrow after which they will return to their happy state. Therefore, it’s the internal being that we set as base that forms the state of our lives and dictates how we live for the majority of the time. What these shocks offer us is the chance to change the priorities in life and get more aligned with our inner self.
2. Blessing in Disguise
Whether we accept it or not, every challenge is a blessing in disguise. It was very hard for me to accept this fact when I was going through the challenge. Irrespective of how painful it was I now see the wealth of lessons learned about life, about myself and about the understanding of the people involved. After you get through the initial shock to the system, look to see what was the blessing in disguise was offered to you. In order to find this you need to dig digger to find the blessing. When you first start this might take years to determine, but after some time it is obvious and you see it sooner.
3. Embracing the Change
The turnaround happened for me after I accepted the challenge and started to see things as they were. In life everyone is susceptible to all the challenges of life. However we try to protect ourselves, we are always exposed. This is acceptance of the problem. It helped me to handle the issue without much guilt or pain. This understanding meant I didn’t have to blame the situation, blame another person or even worse blame myself. I accepted it as reality. The challenge was there for me to face head on. I thought this is what I had signed up for and this is not the end of the world for me.
I ride a bicycle every day from daybreak till the roads become full of automobiles. It has a basket that carries my phone, wallet and camera. On this day, I decided to haul the bike up a walk bridge, to cross over to the other side where a tree lined avenue awaited me. The two men on the bridge were apparently regular walkers and there was this wonderful play of sunlight on one side of the wire mesh so I thought, let’s shoot this from the bike with one hand like Zen monks clapping.
It all fell in place while editing. I thought it would be a good time to officially come out about my mental illness and all I had was one and a half minutes. The bit from the Syd Barret tribute was an obvious choice; also it was the music I grew up with never knowing it would make sense this way. Most memories and anecdotes of my illness are shocking, humiliating and cringe worthy despite my best efforts at compensating. The spotlight invariably shines on them all the time. As a survivor, I would like to move the spotlight towards other areas and maybe piece together a story that sheds more light on my illness and changes the way people see us.
John Thekkayyam was an officer in the merchant navy in the 1980s and 90s, and is now a writer, radio professional and weather junkie who also makes YouTube videos.
The Agri-Food and Veterinary Authority of Singapore has allowed India manufactured Maggi to be sold in markets, reports said, after it declared it to be free of health risks. While Nestle has hired APCO Worldwide for rebuilding its image and is seeking a judicial review and revocation of the orders of food safety regulators banning Maggi in Maharashtra , it was interesting to note a Wall Street Journal article highlighting what the United States’ FDA found in Indian snacks.
Some number crunching done by WSJ found that “half of all the snack products that were tested and blocked from sale in the U.S. this year were from India. Indian products led the world in snack rejects last year as well.” FDA’s import refusal report which lists among other things the name of the manufacturer, the place of manufacturing, and the charge(s) for refusal, is likely to ruffle snacks consumers in India if the response to the Maggi fiasco is anything to go by. While Haldiram’s snack products had the highest refusals among snack products between January and March 2015, Bikaji, Bikanervala Foods Pvt. Ltd., Jhaveri Industries of Badshah Masala fame, Hindustan Unilevers Ltd., Britannia, MDH Ltd., Adani Food Products Pvt. Ltd., Heinz Pvt. Ltd., and Mother Dairy are some of the popular manufacturers whose products- ranging from whole grain, bakery products, and snack food items to spices, flavors and salts were refused by the FDA. Some of these products had a labeling problem or did not mention their ingredients properly, while others contained pesticides, were sometimes charged as simply “FILTHY”. Some of these were rejected for containing Salmonella – whose permissible limit in India too, as per Food Safety and Standards Authority of India, is very small – which Mayo Clinic says can cause “diarrhea, fever, and abdominal cramps within eight to 72 hours.”
A high concentration of lead can cause serious troubles and authorities are always likely to crack down on lead exceeding permissible limits. However, the case of MSG is different. It is usually considered safe (although it can lead to health problems in the long run) and the Food Safety and Standards Authority of India has limits prescribed for it (in the list of permissible limits of MSG) only for table olives and frozen fish fillets. That’s why perhaps the FSSAI, Bengaluru Centre, is confused whether to suggest a ban because it found lead content to be well within the permissible 2.5 ppm. Maggi defended itself by saying that it does not add MSG, although naturally occurring MSG might be present. An Economic Times article said, and it appears, that FSSAI had only “admonished the company for labeling the pack with the line ‘No added MSG'”.
However Maggi fares in the long run, we Indians do need to discuss what the implications of our fast food and snack habits can be. It is already said in media that big multinationals adhere to the strict regulations of developed countries while food products containing contaminants or excessive additives are shipped to developing countries. Take for instance MSG, which is popularly known as ajinomoto. It is a flavor enhancer and can make inferior quality food taste better. There is profit to be made there and it is probably being made, that too, at the risk of the health of the people of developing countries. “Chinese” and other foreign noodles are already being smuggled to the North Eastern states, a report in the Hindu said.
It is imperative then that regulatory bodies buckle up. Limiting this to Maggi or Nestle would be a short-sighted measure and would hardly do anything for the general health of the nation. A senior-vice president at Haldiram’s defended his company saying that “a pesticide that is permitted in India may not be allowed there (the U.S.)”. But given the response to MSG in Maggi, perhaps the regulatory bodies may want to re-consider what they allow and what they don’t in our food. Pesticides have no business inside human bodies whether Indian or American.
Breathing doesn’t come easy to Asgar Ali Siddique, 45, a Mumbai resident, especially if he walks fast or climbs stairs—all because at the age of 15, he and his friends started to experiment with smoking.
One cigarette led to another and soon, Siddique evolved into a chain smoker. Cigarettes, beedis, Siddique tried them all. At 35, he first saw a doctor for his breathing troubles.
“I quit as soon as I realised smoking was causing my breathing difficulty,” said Siddique.
His volte-face was too little, too late because Siddique had developed chronic obstructive pulmonary disease, or COPD.
People with COPD breathe as if something were obstructing the flow of air. Toxins in smoke inflame and narrow the airways of the lungs and gradually damage the alveoli, tiny air sacs at the ends of the airways where oxygen is deposited.
Asthma, the second most deadly chronic respiratory condition, involves a sudden allergic response of the immune system to a trigger—anything from vehicle exhaust to peanuts—causing inflammation and construction of the airways. Asthma is marked by breathing difficulties, wheezing, chest tightness and coughing.
Chronic respiratory diseases, with COPD and asthma in the lead, killed 1.25 million in 2012, up 115% from 0.58 million in 1998.
Since the turn of the century, respiratory diseases have stayed at second position in India’s list of top killer diseases. In this time, however, COPD has become a bigger threat, individually overtaking neonatal diseases, a major communicable disease listed third in the rankings.
As a result, more people than ever before are living with the discomfort inflicted by blackened lungs, many more in rural India than urban.
Living with weak lungs in the Indian countryside
As a young bride, Ranjana Vahile never thought twice about cooking on a wood fire. That was the way of life in rural Pune in the 1980s.
She did not know the hearth smoke was quietly making its way into her lungs. Vahile first got wind of the trouble ten years ago, at the age of 45.
“I started to experience breathing difficulties. Coughing spells, with expectoration, followed. Now I also experience fatigue that simply refuses to go away,” she said.
Switching to cooking on a gas stove has made no difference to Vahile’s suffering. She has now developed COPD.
Roughly three times the number of rural people suffer from COPD than urban people. Between 1996 and 2011, the rural prevalence of COPD increased from 9.54% to 14.19% while the urban prevalence rose from 3.46% to 5.15%.
COPD is predominantly a disease of the poor, according to an Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis (INSEARCH), funded by the Indian Council of Medical Research.
“A staggering 62.9% of persons with chronic bronchitis were from socio-economically less-privileged backgrounds versus only 3.2% from privileged families,” said Surinder K Jindal, INSEARCH study leader and former head, Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh.
About 2.05% of adults suffer from asthma, according to INSEARCH. However, asthma is predominantly a children’s disease.
In Asthma: The Biography, Mark Jackson, professor of the History of Medicine at the University of Exeter, UK, says its prevalence in India has grown from 2% to 15% between 1960 and the late 1990s. Asthma has a current prevalence rate of 10% to 15% in the 5 to 11 age group in India, according to the World Health Organisation.
A one-way street to slow death
Smoking cigarettes and beedis are the biggest cause for COPD in men. Smokers face a threefold risk of developing COPD as compared to non-smokers, according to INSEARCH.
Roughly one in four adult Indian men smokes. They pose a danger to themselves and to those around.
“Passive smokers have twice the odds of developing chronic bronchitis as those with no such exposure,” said Padma Sundaram, respiratory medicine specialist at Manipal Hospitals, Bengaluru.
Indoor air pollution is the biggest cause for female COPD in India.
“In Asia, female COPD is predominantly household air pollution induced,” said Pune-based pulmonologist and chest physician Arvind Bhome.
Outdoor air pollution, such as smoke from traffic effluents, fire crackers, industrial fumes and mining dust, can also cause COPD and set off asthma.
Other asthma triggers are strong odours as from paint and air fresheners, smoking, suspended pollen and dust, sudden climatic changes like entering an air-conditioned room straight after being in the sun, eating cold food and exposure to dampness and cold. Intense emotion, expression and stress also provoke asthma.
Certain foods can bring on asthma. Popular triggers are eggs, milk, peanuts, soy, wheat, fish, sulfites and sulfating agents occurring naturally and used in food processing, some preservatives and food additives.
A global study, the International Study of Asthma and Allergies in Childhood (ISAAC), based on the experience of half a million children and teens, draws a connection between fast food consumption and asthma.
In study centres across the world, researchers found that eating fast food at least three times a week increased a teen’s risk of developing severe asthma by 39% and children’s risk by 27%.
Another common asthma trigger is sudden exertion.
Weak-chested Indians shouldn’t tax their lungs
Indians have weak lungs, which compounds the respiratory malaise sweeping their country.
“Our forced vital capacity (a measure of lung function) is low vis-à-vis Caucasians and even other Asians like the Chinese. Indians have shorter chests in comparison with those races,” said Parvaiz A Koul, head of the Department of Internal & Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar.
Research shows Indians have about 20% less lung capacity than Caucasians.
Koul is investigating the role of genetics in developing chronic bronchitis, driven by its high prevalence in non-smoking men and women in Kashmir.
“Here, nearly 1 in 5 men and 1 in 7 women above the age of 40 suffer from lung function abnormalities consistent with COPD,” he said.
Breathe easy: How you can get back your life
Asthma is the lesser evil of the two major chronic respiratory diseases, it is both reversible and preventable.
Medication and inhalants can help control asthma flare-ups. But drugs are expensive and progressive, in that successively higher doses are needed to manage symptoms. So after recuperating from an attack, it makes sense to control exposure to triggers and work on other preventive measures.
Healthy eating helps cut the risk of asthma. This includes restricting salt intake and eating a lot of fruit.
Fruits are rich in antioxidants like Vitamin A/betacarotene, vitamin C, vitamin E and selenium, which help repair the damage caused to the epithelial lining of the lungs by inhaled oxidants or inflammatory processes. Also antioxidants boost the immune system as does exercise.
Asthmatics who exercise experience fewer flare-ups, and they recover faster. But working out during an attack and pushing comfort limits are not good ideas. It takes time to build up stamina for aerobic exercises.
Nikhil Anand, 19, will always remember his first asthma attack. While playing cricket with his friends in Muzaffarpur, his hometown, at the age of 5, he suddenly felt breathless.
Things have gotten much better since his preteens when he would experience a flare-up every couple of months. Today, Anand swears by his workout but is careful to stick to a certain set of exercises.
“I can sense my body protesting if I try to overstep this limit,” he said.
Breathing exercises help improve lung function, affirms Tarun Saxena of the Department of Internal Medicine, Mittal Hospital, Ajmer, and lead investigator of a study to gauge the effect of pranayama in patients with bronchial asthma of mild to moderate severity.
“Since patients of asthma (and COPD) struggle with expiration (breathing out), we taught patients breathing exercises and expiratory exercises,” said Saxena. “In particular, bhramari, making the sound of the honey bee while exhaling and performing a high pitch/forceful prolonged omkara helped patients to maximise the expiration of trapped air.”
Pranayama works on the physical level, by aiding deep breathing and controlled breathing, as well as on the mental plane by helping to de-stress.
Unlike asthma, COPD develops gradually.
“It takes 20 to 30 years to develop COPD,” said Sundaram.
Moreover, there’s no turning back the clock once COPD develops.
“Lungs afflicted with COPD are damaged beyond repair, and severely starved of oxygen,” said Anurag Saxena, internal medicine specialist at Primus Hospital, New Delhi.
Medication can help partially alleviate COPD symptoms. Vahile continues to suffer despite taking three tablets daily, since being “officially” diagnosed with COPD three years ago.
Oxygen therapy is an option, but it is out of the reach of the poor, as is intensive care, when COPD gets exacerbated.
“In case of COPD, exacerbation warranting hospitalisation, the median out-of-pocket costs are as high as Rs 44,390,” said Koul.
It’s a hard life for less privileged people who fall prey to chronic respiratory diseases.
Siddique couldn’t have been given a worse life sentence for smoking. A blacksmith, he’s out of work because breathing in front of a furnace is impossible.
Hardly a day goes by when Siddique does not brood over the government’s approach to curbing tobacco use.
“Of what use are written warnings on cigarette packets for illiterate people like me who can’t read?” asked Siddique. “Pictures are good, we need more pictures. Why doesn’t the government just stop making cigarettes and beedis available?”
A few days ago, we learned Siddique had traveled to Hyderabad to swallow a fish as a miracle cure.
The UNICEF Total Sanitation television commercial called ‘Dulhan’ converges two of India’s most prominent social issues – the suppressive patriarchal idea of keeping a woman in a veil and the public health issue of inadequate sanitation in rural India. On watching the commercial, it is clear that the latter wins out over the former. It promotes development through better sanitation but backslides by encouraging ideas of keeping women in their rightful place, at home in their ghoonghats. Is this prioritizing of social issues justified?
The need for sanitation facilities in rural India became a political priority in 2013 when Narendra Modi said, “Pehle shauchalaya, phir devalaya” (toilets first, temples later). The Planning Commission conducted an evaluation study for the Total Sanitation Campaign, which found that 72.63% of all rural households practiced open defecation. This unsanitary practice leads to diseases, malnutrition, sexual violence and various other hazards. To combat this issue the Nirmal Bharat Abhiyan (now Swacch Bharat Abhiyan) was set up which aims to build 11 crore toilets across the country in 5 years, many of which have already been constructed.
However, this project is not completely successful as villagers are apprehensive to actually use the toilets constructed for them. In 2014, another survey showed that over 40% of households with a working latrine have at least one member who still defecates in the open. In an interview with Bloomberg, Sunita, a resident of Mukimpur, a north Indian village said, “Feces don’t belong under the same roof as where we eat and sleep.” “Locking us inside these booths with our own filth? I will never see how that is clean, going out there is normal.” She added pointing to the field.
The surveys also indicate that the reasons for the unused toilets are ‘lack of awareness’ and ‘established age-old practices’. Since defecating in the open is the only way the villagers know how, they refuse to accept why it can’t continue regardless of health hazards. Many women preferred open defecation because it gave them an excuse to leave their houses to socialize and ‘exchange gossip.’ These ideological hurdles make it necessary to explain the issue in a context that can be understood by the rural population.
Therefore, since respect for a woman in rural and traditional India correlates to her modesty and dignity, these are important tools to explain her health and sanitation needs. The campaign in Nal Beri, in Bikaner, overcame age-old beliefs by raising questions about the community’s pride and dignity like “A woman has to wear a veil to protect her dignity, but what about her dignity when she lifts her skirt to squat in public spaces?” In spite of being regressive, this campaign was successful in creating a demand for more toilets.
To make up for hindering the ‘socializing’ opportunity women enjoyed with public defecation, many campaigns promoting sanitation involve social interaction among rural women. Also, to ensure women’s empowerment in some village campaigns, households that construct a toilet get a ‘beautiful home’ nameplate for their home where the name of the female family member is mentioned ahead of the male member. This is a matter of great pride for the women.
Although suppressive patriarchal notions must be actively battled for women’s upliftment, sanitation is an important women’s issue too and could be potentially life threatening if ignored. The priorities in the lifestyles of rural and urban India vary greatly. In keeping with this, patriarchal messages may be regressive, but provide a necessary context for villagers to understand the issue.
When Hyderabadi filmmaker Deepthi Tadanki set out to research the subject of corrective rape for her upcoming film Satyavadi, she learned about shocking practices which took place in Bangalore. In one instance, a homosexual boy was forced by his family members to engage in sexual intercourse with his own mother, apparently to “cure” him of his “deviant” sexual behavior. The victims have decided to remain silent because they choose to delete memories of such incidents where their own family members have conspired to push them in the throes of lifelong trauma. At least 15 such cases were reported to an Indian LGBT organization over a period of five years.
Before one pounces on this opportunity to brand corrective rape as an “Indian problem”, let us take a look at the origin of the term “corrective rape” and at horrific examples from around the world. Corrective rape is defined by ActionAid as “a way of punishing and curing women of their sexual orientation” (I want to emphasize here that men too are victims of corrective rape as illustrated by cases in India and Zimbabwe).
The term was coined in South Africa in the early 2000s when charity workers first noticed an influx of such attacks. It was also during that time when, following a United Nations report, South Africa was repeatedly described as the “rape capital” in the world, having one occurrence of rape in every 17 seconds. The brutal gang-rape and murder of Eudy Simelane, a soccer player training to be a referee for the 2010 FIFA World Cup who identified as a lesbian, brought extensive press attention to this phenomenon of corrective rape, resulting in a few survivors finally speaking up about their ordeal.
Pearl Mali was raped by a priest almost every day for nearly four years since she was 12. When she was impregnated, she was also deprived of her parental rights by her own mother. Mvuleni Fana was gang-raped by four men and was beaten up by them until she passed out. Simphiwe Thandeka was raped by a male relative. When the bleeding girl complained to her mother, the latter dismissed it as a “family matter.” All these incidents were accompanied by verbal abuse. The victims were derided with centuries-old patriarchal remarks, such as “This is what a man tastes like”, “I’ll show you your place”, and “Act like a real woman”. Knives, stones, sticks, and other sharp objects are routinely used during the rape. Apart from psychological trauma, the victims suffer from unwanted pregnancies and HIV infection.
While the world looks up to South Africa for some of the most progressive LGBTQI laws—it is the fifth country in the world to legalize same-sex marriage, and its Equality Act (2010) outlaws hate crimes, the country’s social and criminal justice systems are lagging far behind. 31 lesbians were killed, resulting in only one conviction. According to a support group, more than 10 lesbians are raped every week. The Telegraph reports that out of 25 rapists, 24 will be acquitted. It further notes that in 2013, UNESCO revealed that schools in the country were failing with regards to gender rights. It appears that homophobic religious sermons have replaced inclusive sex education, inspiring schoolboys to “jack-roll”, a colloquial term for gang-rape in the country. “Homosexuals can change,” said Reverend Oscar Peter Bougardt to journalist Clare Carter. What’s more? 61 per cent of South Africans believe that society should not accept homosexuality; that it is in some way “un-African”.
The situation is no better elsewhere. Angeline Jackson, an LGBTQI activist in Jamaica and a rape survivor who identifies as a homosexual woman, tearfully tells me that she was advised by police to “leave this lifestyle and go back to church” when she went to report the crime. Due to a string of similar attacks in the country, the complaint was eventually accepted and the case moved to court. The perpetrator was handed down a sentence of 27 years, but Angeline felt “victimized all over again” because majority of the charges against the rapist related to possession of firearms and kidnapping. At most four years of imprisonment was ordered for rape because “the legislation in her country did not count forced oral sex as rape.” In 2014, the sentence was overturned on appeal, and Angeline was not even notified about it by the court.
United Nations Secretary General Ban Ki Moon aptly said, “Violence against women and girls continues unabated in every continent, country, and culture.”
To fight corrective rape, many citizens are taking it in their own hands to act. Deepthi Tadanki is adamant in making the film which is only 40 per cent complete due to financial struggles (and in the face of blog comments accusing her of “conniving with Westerners to defame India”). Angeline Jackson is sharing her experience globally and is battling homophobia through the organization Quality of Citizenship Jamaica. An online petition on Avaaz.org has already collected 947,750 signatures. Before corrective rape threatens any more of your near and dear ones, read about it, create awareness, and act now to criminalize this violent practice.
Uterus and vagina owning people, we know as well as you do that there’s half a pile of underwear in your cupboard that you reserve for the red ninja’s visit and a fast depleting supply of “good” underwear you can still wear out, because mass-market undies just aren’t cutting it, with their flimsy and hard to clean fabrics. What if there was a safe, smart and stylish alternative that you could buy with the knowledge that the company is making menstruation that much less daunting for you and also for women in Uganda. THINX underwear, created by Antonia Dunbar, Radha and Miki Agrawal, is aimed not just as buyers’ comfort, but also addressing a serious problem women in developing countries face today. Without proper resources to use during their period, missing one week of school for every month that a woman has her period puts her at a grave disadvantage. In Uganda, THINX and its partner AFRIpads are providing those resources not through hand-outs but by giving Ugandan women the tools to be self-sufficient.
Combining four technologies, THINX underwear provides the ‘perfect backup’ to couple with your tampons or menstrual-cups, keeping the stress of stains and leaks at bay. One of the styles can even hold up to 2 tampons’ liquid, so you don’t have to punctuate busy days with frequent trips to the washroom.
THINX Co-Founder, Miki, and Director of Marketing, Veronica del Rosario spoke to Youth Ki Awaaz about the company’s journey, vision and the taboo of menstruation.
Shambhavi Saxena (SS):Why did you think of designing THINX underwear?
Veronica (V): Let’s just say we had our fair share of underwear mishaps; there’s stories about three legged races, swimsuits, business meetings, yoga classes…all of those experiences we’ve all had! It was more than clear that women everywhere needed something better; new and improved underwear seemed like a no-brainer. Then, the idea really got its legs when Miki travelled to South Africa in 2010 (yes, for the World Cup). Miki asked a 12 year old girl from a rural area, “Why aren’t you in school?” and the girl quietly responded, “It’s my week of shame.” 100 million girls around the world miss school just because they lack the sanitary supplies they need to manage their periods. They knew that they could somehow use the innovative idea of magic period underwear to support these girls. And BOOM. THINX was born!
SS:The product is pretty high tech. What was the 3 year long development process like for you?
Miki (M): The reason why it took 3.5 years to develop was the intense trial-and-error process. We had to work with 4 different technologies (anti-microbial, moisture-wicking, breathable leak-proof, absorbent) that had to all work together and also function properly during the care process. After a couple of years, we finally put together a pair of underwear that we thought would do the trick but then when we threw them in the dryer, one layer shrunk at a different level than another layer which made the garment buckle. We had start over with new fabrics entirely. And! It has to all work in the most sensitive area of a woman’s body.
SS: Has your product met with conservative reactions because of its focus on menstruation? How do you respond to the general attitude of silence or stigma attached to the female body?
V: Menstruation is a huge taboo; it’s our biggest challenge and our greatest one. At first, we thought we would pursue stores and boutiques to have them sell THINX, but we quickly realized that we are the only ones who can tell our story wholly and properly at this juncture (and that’s why we only sell direct from our site). People are also grossed out by blood, even their own, which makes it a hard concept to grasp. We’ve seen some adverse reactions to wearing bloody underwear all day, and the best thing we can do is just have an open dialogue about it, and explain what wearing our product really feels like (hint: it feels clean and dry). If our mission is to break the taboo, we’re doing it— we’ve never seen more women openly discuss their hygiene regimens than now, on our own social media accounts, articles, and advertisements.
Another difficult bit of our business is getting across that THINX is something that you use as you choose. Products before ours have very rigid and specific instructions that come with them, and ours is a much more flexible experience. THINX is most commonly used as backups to tampons and cups, but some women do opt to use them as a replacement on lighter days— and it’s not at all something that we can dictate, because we simply don’t know every woman’s cycle. Every single woman is different, and handles her period differently. What’s cool is, as soon as people actually get to use THINX and see how it works for them, most of the time, can’t imagine their periods without our underwear. That’s a good feeling.
SS:As a company you’re taking your social responsibility very seriously. Tell us about your partnership with AFRIpads?
V: Our giveback is an integral part of our business, and it’s been there since day one (even before that, really). The co-founders did a lot of research on a number of organizations to find the appropriate partner, and fell in love with AFRIpads’ model. It empowers local women and girls in a big way. Miki visited Uganda earlier this year and talked to some of those women who either sew, sell, or use the menstrual kits that we fund, and it’s no exaggeration when they tell us that their lives have changed. The rate of attendance in school just skyrockets when they have access to the materials they need, and the women that AFRIpads employs now have sustainable careers. The whole system is fantastic.
SS:Is it true you spent some time in India? What was your learning experience here? And what pressing concerns did you come across, with regard to feminine hygiene and opportunities for women?
M: My father is from India (mom is from Japan) – I’ve been to India 6 times and each trip is equally more eye-opening than the next. I was 11 years old when I first went to India and it was the first time I saw extreme poverty. I will never forget giving a meal to a 6-year old kid who was homeless and living alone in a train station with elephantitis on his feet. While he walked away dragging his feet, it was the first moment that I realized how LUCKY I was to be born where I was. I won the lottery of life. I had two loving parents, a roof over my head, a school to go to and opportunity to be whoever I wanted to be. When you think about this at age 11, a lot changes. With regards to feminine hygiene, it was never brought up when I was there, it just wasn’t something that people talked about. It was only after I went to South Africa did I start asking around, and it was clear that it was a massive problem in India too that held women back.
SS:Will the company play a role in safe sex and health education for the girls in developing countries it already has a presence in?
M: Our partner organization AFRIpads is doing a lot of health education work in Uganda and we plan to work with other similar organizations all over the world (India, Nepal, West Africa, South America etc) so YES, we do plan of really helping spread health education far and wide.
SS:Putting an inadequate product on the market and making it the only widely available option is a profiting technique. Is THINX aiming to or projected to challenge that system?
V: We absolutely don’t intend to sacrifice quality for profit. Our #1 priority has always been our product and technology, so we’re doing our best to make it the best it can be.
SS:Do THINX come in various colours, styles and sizes for every type of body?
V: When it comes to style, we’ve really put the majority of our focus on perfecting our technology rather than on putting out a ton of styles and colours. Right now, THINX comes in three styles and two colours––black and beige, from size XS – XXL. As soon as this summer, we’ll be expanding our size offering to go from XXS – 3XL, and we’ll be releasing two new styles, which we’re super excited about! Stay tuned!
SS:How can you buy THINX now? And will we find THINX in local supermarkets across the world soon?
V: THINX can only be purchased online via shethinx.com (unless you’re lucky and run into us at an event or something!). We ship internationally, too. Again, selling in stores in general is a long time down the road for us, and selling in stores internationally is even farther down. One day at a time!
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