Health & Life

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By Anjali Nambissan:

India is fast-becoming a strange country where we have the problem of both malnourished, as well as, obese children. A 2012 study by The Endocrine Society claims that childhood obesity in India has jumped from 9.8% of total obesity figures to 11.7% in the period between 2006 and 2009. Last month, the Washington Post reported that 80 per cent of the 65 million cases of diabetes in India are caused by obesity. In 2014, the number of weight-loss surgeries went up to 18,000 from 800, five years ago – The Post quoted the chief bariatric surgeon at New Delhi’s Max Healthcare Hospital as saying:

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Photo Credit

“Why are we becoming obese and unhealthy?”

It has a little to do with our growing middle class and a lot to do with what this growing middle class is growing up on.

Let me explain…

In 2010, the Centre for Science and Environment put under the scanner 23 junk food samples from seven food categories like potato chips, Indian snacks such as aloo bhujia, sweetened carbonated drinks, burgers, pizza, French fries and instant noodles. What they found might stick in your throat (pun intended):

1. The salt content in instant noodles (Masala Maggi has 4.2 gms of salt/100 gms of sample) and salted potato chips (Uncle Chips Spicy Treat has 3.5 gms/100 gms) overtakes our WHO recommended daily dosage of 5 grams per day.

2. Indian snacks (Haldiram’s Aloo Bhujia has 37.8 gms of total fat/100 gms), pizzas (Slice of Italy’s classic Margherita pizza has 55.6 gms of carbs/100 gms) and burgers (KFC’s Chicken Zinger burger has 16.9 gms of total fats/100 gms) are high in fat and carbs. So they can give you heart disease as well as, type 2 diabetes. A healthy adult should on average eat about 250-350 grams of carbs and 35-80 grams of fat, each day. Do the math.

3. Carbonated drinks and desserts from fast food chains such as McDonald’s and KFC have dangerously high levels of sugar. Both Pepsi and Coca cola have about 14-15 gms of sugar per 100 gms. If I’m not wrong, that means a 500 ml bottle of Coke/Pepsi has about 70 gms of sugar!

There are no regulations requiring take-away food and fast food available at major outlets to label their products and provide nutritional information.

Growing in the middle

Experts are pointing at a growing relationship between an expanding middle class and their expanding waist line. A 2013 study, titled The Rise of the Quick Bite, by management consultants, Technopak, claim that thanks to the ‘home-based consumer’ turning into an ‘indulgent Indian’, the food services market is set to grow to a whopping INR 408,040 crore (USD 78 billion) by 2018. Fast food chains alone are projected to grow by 75 per cent. Anyone noticed the new Burger King around the corner or the Taco Bell in the mall? Thanks to these international fast food giants, which are widely discredited in their home countries for making people sick, the fast food chain market grew to an approximate value of INR 5,500 crore in 2013.

What’s more? A 2008 Integrated Disease Surveillance report says that our rural population is catching up fast. Data from the seven states chosen for the survey showed that more people, across urban and rural areas, are consuming fast food.

Why are we ignoring our mother’s age-old advice of eating good ol’ ghar ka khana and moving towards a fast food future of death and diseases?

Doctors protest

By Gargeya Telakapalli:

In what seems to be a face-off between the junior doctors and the government of Telangana, lies a larger debate about the path the country is treading in both healthcare and employment.

The junior doctors in the state of Telangana have been on strike since September 29 on the issue of mandatory rural service on completion of education. They demand the scrapping of G.O. MS. No. 107, and that students who have to do compulsory service in rural areas after passing out be offered permanent employment and salaries at par with assistant professors and civil assistant surgeons. The government on the other hand was planning to send the passed out students only for a period of one year and that too on a contractual basis with low pay.

Doctors protest

Governments implemented mandatory service as part of tackling the lack of skilled professionals in the government owned primary health centres and to increase the doctor patient ratio in the semi-urban and rural areas of the country. The doctors have been urging the government to make permanent posts to achieve the goals mentioned in G.O. MS. No. 107 and solve the issues of high infant mortality and maternal mortality, thereby achieving the target of IMR at 18 per 1000 live births and MMR at 54 per 1 lakh live births.

The junior doctors under the banner of the Telangana Junior Doctors’ Association (TJUDA) have been the voice of the graduate and postgraduate medical students of the state over past decades. The Telangana Junior Doctors’ Association has its strength in the government medical colleges with limited presence in the private sector medical colleges. The same junior doctors were at the forefront of the struggle for statehood and are known for the spirit of struggle on issues pertaining to the society, along with issues bothering medical students.

In the last one month the postgraduate students lay siege to the office of the Directorate of Medical Education (DME), protested outside the state secretariat and have been carrying on various non-violent protests like dharna, rallies and meetings all over the state. The demand of the junior doctors is clear at the present stage where they are not against compulsory rural service, but demand that the pay be sufficient and that job security be provided by making the postings permanent. It is argued that the main motive of the government to increase the number of doctors in primary health care centres would be solved if it would recruit the doctors on a permanent basis rather than sending them on a one year basis. The evidence for it was that the past year’s recruitment saw an excess of applicants where thousands applied for the 1324 civil surgeon posts and the 350 specialist posts, however the recruitment was cancelled by the government due to unknown reasons.

The government on the other side has been accused of playing a mute spectator, criticized for the way the protests have been dealt where the students and the tents under which they were fasting were removed in police action post-midnight, at around 3:30 a.m. in the premises of Osmania medical college. The striking doctors have come under fire for boycotting their duties and participating in the strike .The government and some sections of the society have been blaming the medicos for not attending to health services and failing to serve the poor in the rural population, to which the medicos have replied again and again that protesting against injustice is their right and that they are not against serving in the countryside.

If we see the whole issue we would understand that the government seems to be very keen on sending the medicals students on a contractual basis as part of decreasing its spending on the health sector. This trend of the government is a phenomenon all over the country where the state governments have notoriously been cutting down their expenditure on healthcare services, healthcare providers and their recruitment. This trend of low expenditure on health and lack of permanent jobs can be attributed to the neo-liberal economic policies that are being followed in the country.

The present central and state governments should also understand that the country’s healthcare needs more funding than what is being allocated in the present budget. The answer to the problem would be nothing less than permanent recruitment of young doctors which would solve the lack of skilled professionals and healthcare providers on a long term basis.

 

5 days of dignity

By Youth Alliance:

Take a moment today. Here, right now, just stop. We, as a nation, in a much celebrating manner recognize childbirth as a woman’s domain. Why not then, can we embrace the fact that women menstruate? We rejoice and celebrate those nine months of pregnancy but what about the rest of a woman’s life journey where the significance of life flows out of her? Why is she then, a victim of myths and taboos? Instead of dreading their menses, early humans cherished the uterus and women’s cycles of menstruation, Pregnancy, birth and menopause and celebrated the uterus as the body’s center of Female power and creativity.

It is out of question then, that this periods’ related discrepancy is NOT perpetual and ancestral. What happened then? Where did we lose the way? Or rather paved new paths? Think about all those times when the shopkeeper wrapped up your sanitary napkin in a newspaper and put it in a black packet before he gave it to you as if it were some kind of a bomb. Think about the times where perhaps you or your female counterpart kept standing outside the temple or a mosque. These are the generalities. There are places where women have never went out and bought a sanitary pad on their own from the market, shying away from the male shopkeeper. There are cases, worse still, where women haven’t even used a sanitary napkin considering ‘wasting’ money on it to be irrelevant. Only 12% of Indian women have access to sanitary napkins. But today we are not here to deal with these issues. We are here to start slow but make it big. We are here to embrace womanhood. The moment’s over and now, today, we at ONUS, Youth Alliance are making an effort to eliminate the evil myths regarding menstruation that play in the shadow of our hearts.

Youth Alliance has collaborated with Goonj, the expert in the field with their initiative “Not Just A Piece of Cloth” to take the issue of lack of access to sanitary pads and menstrual hygiene to the university and proudly announces #Five Days of Dignity”, whereby we shall solemnly try to break the shackles which shackles woman every month. Our program is majorly centered at two colleges- Hindu and Jesus Marry College. Our initiative will involve sensitive street plays, a simulation drive where we will make sanitary napkins in our college campuses, dialogue with eminent personalities where people will get a chance to speak openly about menstruation through a discussion forum. It will also involve street interviews where we shall ask random questions about menstruation just to reach out to the discomfort on this issue. We vouch to make a change; do you care to be the change? Please be the support we are seeking. Join us in our campaign.

Our five days are our dignity. What are your five days like?

Join us on 3, 5, 7 Nov in Hindu and Jesus and Mary College.

Picture Credits: ventolinmono

Submitted Anonymously:

Last week, I was on a hospital bed getting my stomach washed. A few hours before I had taken a lethal quantity of tablets to end my life. Luckily, I survived to tell my story. Why did I take the decision to kill my own self? What compelled me to take such a fatal path? Had I failed in the exams? Had my partner ditched me? The answer is no. The more I interrogate myself with these questions, the more I find myself confounded. The truth is I don’t know why I wanted to die, but I know how I reached that dark corner of life where only hopelessness was my companion. The thing I called ‘dark corner’ was a panic attack I could not cope up with.

Picture Credits: ventolinmono
Picture Credits: ventolinmono

I am a depressed teenager with high dreams and lofty ambitions. I am a coolie carrying the burden of expectations of this society, my family and my own self. I have been fighting a war of nerves for many years now. I was 16 when the shrinks at the hospital declared that I was bipolar, which means I am suffering from manic-depressive illness. The disease has its own vicissitudes – I am happy sometimes, and often, I take a long trip to the valley of gloom. Mostly, I don’t have a yen for eating anything. I often feel like giving up everything and running away from my own self.

I have no qualms in saying that I am mentally unwell, but the society has. It was evening time when I was brought to the hospital by one of my friends. I was quivering while my abdomen was toxic enough to kill me. Here started the story of whispers and favourable lies. Except the medics, few of my friends and family, everyone was told a made-up story of how the tablets accidently entered my belly. Some were told I had gastro problems. No one was told the truth that in the surge of my stigmatized illness I had attempted self-murder. Why? Because had they known the real account of my doing, my future was doomed. In our society, mental illness is not treated at par with other illnesses.

We are the outcasts of this civilized world. People will show sympathy towards us but then talk ill behind our backs. Very few will understand. You can’t talk openly about your health because then they would have only one line for you — He is mental! He is a psycho! Wo Pagal hai! Yes, I am weak and suffer from a disease that is related to the mind. But I didn’t choose my illness, then why punish me for what is not in my control?

In a country where there is only one psychiatrist for a whopping 343,000 people, silence is the hallmark of any mental health disease. There is a silent majority which continues to suffer because of the stigma we have attached with mental health related disorders. There is a need for greater awareness to destigmatize mental illnesses. The National Mental Health Policy, launched this year, is certainly a first step towards that.

I survived to tell my tale, but there are thousands who succumb on that hospital bed without even knowing that their condition could have improved and there was no need to hide their condition. Let’s speak up and end the stigma that enforces this lethal silence.

The author is a student of journalism and wishes to remain anonymous.

Picture Credits: Rotary Club of Nagpur

By Saurabh Gandhi:

3 million units. Yes, that is the situation of blood shortage in our country, according to a 2012 World Health Organization (WHO) report. With a population of 1.2 billion, it is a shame that we are falling short of the required 12 million blood units annually, being able to collect only 9 million units. Lack of awareness and incorrect information or myths around blood donation in India are cited as the main reasons behind this shortfall.

Picture Credits: Rotary Club of Nagpur
Picture Credits: Rotary Club of Nagpur

With over 100 successful donor arrangements in Kolkata, it is this shortfall that an organization called “The Saviours” is trying to bridge. True to their name, it is a life saving registered organization which works towards providing blood donors when blood banks and all other sources are exhausted. Founded by a young college graduate, Kunal Saraff, the organisations’ vision is very simple: “To ensure that no body dies for the want of something that is abundant in everyone’s body.”

It works this way – People who are willing to become voluntary blood donors register with “The Saviours”; whenever there is a request for a particular blood group, they are contacted and if available, they donate. “You don’t need to be God to save lives… Be a Saviour” – That’s the philosophy that drives them. Anyone who voluntarily donates blood through the organisation is provided with the title of a “Saviour”, along with a certificate stating the details regarding their good deed.

In a free-wheeling chat with me, Kunal shares his motivation behind taking this initiative: “With over 3 million units of blood shortage in India every year, either people are dying for the want of blood or are paying exorbitant price for a single unit. This can range from 5000- 25000 INR, depending upon the availability or the blood type.”

When I ask him how does he plan to get more people sensitized to this reality of blood shortage in the country, he says, “With around 40-50 crore youth population, only if 1-2 % additional youth start donating, this shortage could be eradicated.” It is precisely for this reason that they are trying to get more and more youngsters to register themselves as a voluntary blood donor.

Already in touch with various colleges in the city, Kunal outlines the three ways in which you can help. First and foremost, you can register yourself as a voluntary donor by sending your details (which include your name, blood group, address, contact number, alternative contact number (if any) and your email id) at [email protected] You can also whatsApp the same to 9830148811 or message it to their Facebook page. At present, their operations are restricted to the city of joy, but they are building their database of donors all across the country and look forward to spreading their reach in other parts of the country.

The second level of engagement that you can have with them is by encouraging more and more people to register with them. As an extension of this vision, whenever there is a successful donor arrangement and the beneficiary thanks him, he requests them to ask three more people to register as a donor in order to keep the chain going till we reach a situation that no one dies for shortage of blood. The third level is the one where you can intern with them. They would be choosing a team from various colleges, which would be briefed and trained by them to handle the phone calls and requests. The team would be directly responsible for coordinating with the emergency requests and the donors in the database.

What would Kunal like to say to everyone who is reading this, I ask? “They say “making someone cry with a smile on their faces is the best feeling ever!” Please register with us and save a life. Be the change and belong to the 2% who can actually make a difference to people’s lives”, he says.

An android app named No More Tension has agreed to donate a generous amount of Rs.10 per download to this organization, and swears to bear all the other expenses borne by The Saviours. This is the reason they don’t accept donations from any third party! Are you a Saviour? Be one!

Diwali crackers

By Anshul Tewari:

Diwali crackersSo you had a great Diwali celebration with fire-cracker-bursting sessions with friends, didn’t you? Here’s what – according to a report by The Meteorology Department, Delhi has recorded the highest level of Respirable Suspended Particulate Matter (RSPM) pollution post-Diwali this year at 531 mg per cubic metre – more than five times higher than the normal level leaving many at risk of respiratory problems – followed by Kolkata where the suspended particulate matter level was 417 mg per cubic metre and Chennai at 320 mg per cubic metre.

Respirable Suspended Particulate Matter, you ask? RSPM is the microscopic solid or liquid matter suspended in the Earth’s atmosphere. The sources for RSPM can be man-made or natural, but with regards to RSPM suspended during Diwali, it is definitely man-made. RSPM can also lead to premature deaths and asthma, which are just a couple of the health issues that backpack themselves along with it.

According to the report, Punjabi Bagh in New Delhi registered the highest level of 194 micrograms per metre cube of nitrogen oxides.

Delhi had registered high levels of  carbon and nitrogen monoxides, and coupled with a wind speed of around 0.3 metres/second the city virtually choked with the escalated air pollution level. The Meteorology Department also added that humidity on Friday oscillated between 50 and 90 percent.

So what does all this mean? Earlier this year, Delhi was named the city with the highest pollution in the world by the World Health Organization. While many people try and justify bursting crackers on Diwali by stating that it is only a one day affair and cannot add much to the existing pollution by industries and cars, the fact is that even a day’s worth of pollution can turn deadly for the health of the city and the country. Just because someone else is doing more bad to health and environment, it does not excuse you to add to it, even if in small quantities.

According to health experts, a few health concerns that Diwali brings along include acute asthma attacks; chronic lung diseases; bronchitis in patients who are allergic, causing severe dry, irritating cough increasing in intensity while speaking and at night; apart from eye and nasal irritation and damage to the eardrums.

Firecrackers are something that many of us look forward to during Diwali. But remember, these few seconds of joy not just hurt the environment, but also cause serious health problems. From the gasses they emit to increasing air pollution (by nearly 30 percent), the toxic air during and post-Diwali is not just dangerous for those with respiratory problems and lung diseases, but also for others.

Well, now that the damage has been done, you might want to pacify yourself by thinking that the pollution levels this Diwali have been less than the 2013 Diwali celebrations, however, they have been equally (if not more) damaging.

So while you move on about your life and the next Diwali arrives, remember that a cleaner Diwali is indeed a happier Diwali for everyone.

body image Issues

By Tanuja Aundhe:

If you’ve been reading the news, you must have seen several pieces about how body image and loving yourself are important. If you’re like me, you may have dismissed it as some sort of hippy-dippy stuff — who on earth loves themselves exactly as they are? There are always details you want to change about yourself, little things you don’t like, like that tum you’ve got there, or that mole, that pimple, or that freckle. You may have issues with the colour of your hair, the size of your cheeks, your mismatched feet (guilty) or whatever. Obviously, each of us has a pet peeve. You simply say ‘different strokes for different folks’, brush it off, and move on.

body image Issues

But, you know, as it turns out, loving yourself isn’t as bad as it seems. It may actually be really good for you.

You’ve seen the advertisements and the videos — the Dove Self-Esteem Project is actually trying to drive that point into people. In a recent TED Talk, their Global Director, Meaghan Ramsey, provided some startling statistics:

1. Women who think they’re overweight, regardless of actual weight, have higher rates of absenteeism.

2. 17% of women would not show up to a job interview on a day when they weren’t feeling confident about the way they look.

3. People who give exams while thinking they don’t look good (specifically, thin) enough, score lower GPAs than those who are not concerned about this, regardless of actual weight. (findings consistent across Finland, US, China.)

4. 10,000 people every month Google ‘am I ugly’.

5. 6 out of 10 girls are now choosing to not do something because they don’t think they look good enough. ‘Something’ not being trivial activities, but are fundamental activities necessary for their development.

6. 31% of teenagers are withdrawing from classroom debate because they don’t want to draw attention to the way they look.

7. 1 in 5 (20%) is not showing up to class at all on days when they don’t feel good about it.

Additionally, as many as 10 million Americans are now struggling with eating disorders like anorexia and bulimia, according to the National Eating Disorder Association. Though no Indian statistics are available, a 2005 study conducted by the ICMR shows the prevalence of several significant psychosocial factors among Indian children and adolescents. A lot of these factors are triggers for future self-esteem problems and eating disorders.

1

Honestly, this is getting beyond ridiculous. Not looking good enough? Why on earth would you miss out because of that? But as these statistics illustrate, that is exactly what is happening. Let’s talk about why.

To begin with, “Self-Image”. I found this on Google:

self image

So, to say this again, the idea that you have of your traits, And I use ‘”traits” broadly — it can be your characteristics, your mannerisms, your habits — everything, including your looks – that’s where the trouble begins.

Because, when your self-image includes your looks, at some point of time, it may become exclusively about your looks. It may just be all about the way you look. And when you notice a blemish, or a fault, or a flaw, it seems more important than it actually is.

And that’s where the problem is! When you centre yourself on a flaw, you make yourself feel imperfect, you make your mind think that you’re an amalgamation of flaws with one or two nice bits. When, of course, it is the exact opposite. You have a few flaws — but who doesn’t have flaws? Who loves themselves for the way they are?

A Google search for ‘self-image’ reveals some utterly terrifying images. You can see some for yourself below:

google self image

See that girl there? Who’s looking in the mirror? You can just feel it. She’s terrified of what the mirror might show her.

And what are the slurs and comments thrown at women daily? They hear ugly/stupid/crazy/dumb/bitch — in short, not good enough. Try again next time. And why? Well, Meaghan gave us some reasons why.

She said that, in these times, during their teen years, admittedly the most vulnerable time of their lives, people start questioning their perception of themselves, whether they are pretty or ugly. But why?

She attributed it to the following reasons:

(a) Teenagers today are rarely alone. They are always available online, and this may be why they are over-connected, through posts, pictures, likes, comments, to people who are actually of no consequence.

(b) Obviously, this leads to no privacy for these teens and makes their life somewhat public. (Speaking of public lives, Keeping Up With The Kardashians, anyone?)

(c) It also makes them value or evaluate themselves based on the kind of feedback they receive from peers online, those oft-mentioned and oft-criticised posters, commenters, likers and viewers.

(d) This plethora of connectivity also means that for teenagers now, there is no separation between online and offline life.

(e) Thus, they cannot differentiate between what is real and virtual, authentic and digitally manipulated.

(f) They already have bad role models available online — trends such as thinspiration, pro-ana, bikini bridge — which are typically full of stereotyping and flagrant objectification of women.

(g) In an image-obsessed culture, we are training our kids to spend more time and mental effort on their appearance at the expense of all other aspects of their identities.

Some research suggests that it may start at even a younger age, when girls are given Barbie dolls to play with — Barbie as an ideal of a perfect young woman is seriously flawed. A study conducted by researchers at the University of Sussex in 2006 concluded that thin dolls like Barbie do affect young girls’ body image over time, and indeed, “may damage girls’ body image, which would contribute to an increased risk of disordered eating and weight cycling.”

A YouTube Video also shows how exactly Barbie affects body image. This video also talks about another bit of research, done in 2014, which shows how preschool girls want to be ‘thin’ so that they can look like Barbie. Come on, you’re in preschool!

And it isn’t just dolls and dudes — mothers, too, may play a more important role than they think. Research suggests that a same-sex parent is the most important role model for a child. So, when the kid comes home, and sees momma (or daddy, depends) working out like crazy, abstaining from eating certain foods, going through complicated beauty rituals or painful procedures just so that they look better, it is obvious that they’ll feel inadequate themselves.

In fact, one of the lead designers for Barbie has said that Moms are affecting the children’s body image issues more than their dolls (The whole interview can be found here). Things aren’t helped by people such as the Mom who put her 7-year-old on a diet, then wrote an article in Vogue about it.

And why is a positive self-image important? Obviously, the above statistics show how it matters, but also, it makes you confident, it makes your self-esteem go up, it gives your overall happiness a massive boost. As one HuffPost writer has pointed out, it gives you a glow and a special style of your own.

Well, okay then. We’ve established that people today are pretty screwed up about what they think about themselves — now what can we do about it?

Meaghan offers a range of solutions, grouped under the following heads:

A. Educate for body confidence

Help teens develop strategies to overcome image-related pressures and build their self-esteem. Ensure that programs which are trying to do this have both a positive impact as well as a lasting impact on kids. The best programs address six key areas:

(a) Family, friends and relationships
(b) Teasing and bullying
(c) Talking about appearance
(d) Media and celebrity culture
(e) Competing and comparing looks
(f) Respecting and looking after yourself

B. Be better role models

Challenge the status quo of how women are seen and talked about in our own circles. Start judging people on what they do and not on what they look like. Take responsibility for the types of pictures and comments that we post online. Compliment people based on their effort and actions, and not on appearance.

C. Work together

Communities, families, and governments should all get together to try and combat this problem.

The talk was mainly towards a group of older women, however. What can we do? Follow the above steps. Educate yourself. Be nicer to your younger siblings, to your peers, to your friends. Don’t make catty comments (this isn’t Mean Girls, you know) or unnecessary comparisons. Don’t draw ridiculous comparisons, period. It isn’t really helping either of you all that much. Eat well and eat all that you want. Rujuta Diwekar supports me on that.

And if you feel yourself having a problem, going down a spiral, or even if it’s just a bad hair day, talk. Open up to people. Give it a try. Seek help if you feel that you may be having an eating disorder or a weight issue. Nutritionists and therapists are not that hard to find, you know. A Google search is all it takes.

 

And you know those Barbies? Want to know how they’ll look like in reality? She’d be a crazy tall, crazy thin woman who’d be forced to walk on all fours and won’t be able to lift her neck.

Try the concept of Wabi-Sabi. It is a Japanese philosophy which believes in embracing your faults, taking in your flaws and accepting yourself just the way you are.

Photo Credit

By Deepa Padmanaban:

A 12-point checklist created for airline pilots to check human errors during flying inspired a similar list for Indian health workers, leading, in a test, to a drastic fall in the number of mothers who die during childbirth. The new health checklist, which includes simple procedures, such as washing hands and holding a baby close, is now being tested in one of India’s most backward states, a precursor to possible nationwide adoption.

Photo Credit
Photo Credit

Our story unfolds through nursing midwife, Ishrawati (she uses only one name), a registered nurse at a primary health centre, providing care before, during and after pregnancy. She plays a key role in the ensuring babies and mothers survive in the eastern Uttar Pradesh town of Baldirai in Sultanpur district, much as thousands of other healthcare staff does across India.

There is much experience that Ishrawati has gained in the field, but there were some important things she did not know about, until recently; for instance, the importance of checking the blood pressure of a mother at admission and after delivery. High blood-pressure is a sign of eclampsia. Left untreated, it causes seizures, convulsions and commonly kills pregnant women, and is responsible for 24% of all maternal deaths in India.

Now, thanks to the World Health Organisation (WHO) safe childbirth checklist, Ishrawati checks the mother’s blood-pressure before and after admission. There are other seemingly simple things on the 31-point checklist that have helped Ishrawati improve her efficiency and ensure fewer deaths: keep the delivery tray ready with thermometer, blood-pressure cuff, gloves and medications. It has taught her to provide skin-to-skin care to newborns immediately after birth; it helps keep babies warm and safe.

Ishrawati’s renewed skills are part of a trial programme called ‘Better Birth’, being conducted in about 120 primary health care centres and hospitals in UP, a state with high maternal mortality (MMR), a prime indicator of the state’s—and India’s—backwardness. The programme aims to improve maternal and infant survival rates by having healthcare providers follow a checklist.

The UP trial is led by Atul Gawande, surgeon and professor at the Harvard School of Public Health, author of three bestselling books and staff writer at the New Yorker. “Improving the quality of childbirth care in facilities is critical, but we have not known how to do it effectively. Classroom training does not produce behaviour change. We think onsite coaching and use of a checklist can make a major improvement and save lives. We are hoping to prove it,” said Dr. Gawande in an email interview to Indiaspend.org.

The trial is supported by the Gates foundation and run by the Harvard School of Public Health, in collaboration with the UP government, PSI, Community Empowerment Laboratory and WHO.

“UP is one of the most challenging states to work in,” said Atul Kapoor, CEO of non-profit Population Service International (PSI), one of the collaborators in UP, which has the second-worst record of mothers dying during childbirth of any Indian state. “If it works here, then it can be scaled up to the entire nation.”

In 2012, a six-month study conducted in Karnataka by Harvard, WHO and Karnataka’s Jawaharlal Nehru Medical College reported a dramatic decline in the MMR after a 150% rise in adherence to the checklist. The number of mothers who died for every 100,000 live births fell by more than 62%, from 203 to 126, according to results published in the journal PLoS ONE.

The practices, so successful in Karnataka and now being tested in UP, are modelled on a simple check list created for pilots and co-pilots. It includes step-wise instructions for use at four critical junctures in care during birth: at the time the woman is admitted, when the woman begins to push or before caesarean, within one hour after birth, and before discharge.

India has seen a significant decline in the MMR. It fell 16% on average across India in 2011-12, when 178 women died during every 100,000 live births, from 2007-09, when 212 died.

But this decline is considered inadequate, and—even if new techniques and practices, such as the checklist, are quickly implemented—there is little chance that states such as UP will achieve the United Nations’ millennium development goal (MDG) of 103 deaths for 100,000 live births by 2015.

Uttar Pradesh (and Uttarakhand) occupied second-last position on the list of states, with 292 deaths. The last position went to Assam with 328 deaths. It may be more realistic for the southern states, which saw their MMR fall to 105, to reach the UN’s targets.

Every year, about 70,000 women die during childbirth, and more than 1 million infants die during the neonatal period, nearly a month after birth, according to WHO estimates.

Between 1990 and 2012, the world neonatal mortality rate fell by almost a third, from 33 deaths to 21 for every thousand live births. However, the decline has fallen behind the rate of post-neonatal mortality. As a result, the proportion of deaths occurring in the first 28 days of life has increased, from 37% in 1990 to 44 per cent in 2012. In India, the infant mortality rate dropped to 37.7% in 2013 from 85.5% in 1990.

Kapoor said the UP programme is a “randomized control trial”, where researchers will observe up to 180,000 child births to see if birth practices can be improved through the check list.

The programme, currently rolled out in 30 facilities, will be completed by the end of 2015 after which it will be conducted in another 90 facilities, ending by 2017.

Kapoor said the trial will indicate if it is “impacting the birth attendant’s behaviour, and thereby improving maternal and newborn health”. In healthcare institutions where human resources are scarce, health workers are often burdened and unable to keep pace, as more women are now giving birth in institutional facilities. “The check list basically acts as a reminder, reducing the burden on the health care worker and helps offer better quality of care.” said Kapoor

This ground-up re-engineering of health practices is important because India does much worse than countries that are wracked by greater poverty, war and instablity. Mothers die giving birth in India at a rate that exceeds, among scores of others, Bangladesh, Cambodia, Guatemala, Iraq, Namibia, Fiji, and Botswana.

Globally, the MMR dropped by 45 per cent between 1990 and 2013, from 380 to 210 deaths per 100,000 live births. However, this still falls far short of the MDG target to reduce the maternal mortality ratio by three quarters by 2015.

Most maternal and newborn deaths in India are due to “usual causes”, said Mathews Mathai, coordinator of epidemiology, monitoring and evaluation at the WHO’s Department of Maternal, Newborn, Child and Adolescent Health. “For the mother, these are excessive bleeding, complications due to high blood pressure, infections, prolonged and obstructed labour and unsafe abortion, while for the newborn, these are birth asphyxia, prematurity and infection.”

Maternal and newborn deaths are more common in rural, remote, poor, disadvantaged and marginalised populations, where access to skilled care during childbirth and immediately after birth, the key to maternal and newborn survival, are unavailable or not satisfactory, Mathai said. Care during the first 24 hours after birth, particularly in labour, and delivery care with high-impact interventions for emergencies is important to ensure maternal and newborn survival.

So, it is important to UP and India that nurse midwives like Ishrawati get the basics right. The checklist continues: nurses experienced in all the techniques must train the newer ones, wear gloves, check temperature and—the simplest—wash their hands with soap and water.

About the author: Deepa Padmanaban is a Bangalore-based journalist)
Visualisations by Chaitanya Mallapur

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This article was originally published by IndiaSpend.

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By Katyayini Kabir Kakar:

A new movement is slowly taking over the beauty brigade of the world. It’s the era of theNo poo. The latest fad in the lives of natural product apologists, it’s all about ditching the shampoo and going au-naturel. Yes, they do wash their hair, not with store bought formulations, packed deceptively in shiny bottles, but with stuff picked up from the food aisle of grocery stores. The thought behind it being – if it’s good enough to eat, it will definitely be safe for your precious locks.

Incidentally, the word shampoo is derived from the Hindi word ‘champu’, which means ‘to press and knead’.The earliest known hair wash ingredients were not sulfate laden solutions, but plants and herbs picked from the nature’s lap. But the dawn of the 20th century brought with itself a society which promoted rampant consumerism and created a culture of luxury and consumption. Shampoos are said to contain chemical additives such as sodium lauryl sulfate, sodium laureth sulfate, fragrances, parabens, 1,4-dioxane, amongst others, which are known to be skin irritants. By stripping the natural oils (sebum) off the scalp, they cause the scalp to produce more oil to compensate for the loss. Thus creating a vicious cycle of shampoo-rinse-repeat.

shampoo info

The ‘no poo’ method uses baking soda instead of shampoo, and apple cider vinegar rinse as a conditioner. Baking soda removes grease and dirt, and the vinegar conditions and adds a shine. This inexpensive method is getting rave reviews as more and more people are waking up to the fact that their shampoos are doing more harm than good. There is also the ‘low poo method’, which is a fairly less adventurous method, for those who do not wish to give up on shampoos completely. ‘The low poo method involves the use of gentler shampoo bars, which are made from vegan ingredients and are sulfate free. These bars are prepared from an old-fashioned formulae, which makes these all-natural bath products safe to use. Some prominent shampoo bars are by the English companies – Lush and JR Liggett’s and the American ‘Chagrin Valley’.

no poo1

Proponents of the method have also formed support groups on social networking sites to help old followers and guide new converts. One such group is the No poo and low poo haircare group on Facebook. With over 12,000+ members, this community has people from all over the world, sharing problems, exchanging solutions and more. With tons of success stories being posted everyday, one can see that the no-poo family just keeps growing. If this is the beginning of a new era or just a passing fad, only time will tell. Till then, do try out and decide for yourself which side are you on. Poo or No Poo?

medicines

By Tanuja Aundhe:

Medication is, to put it simply, one of the most important things in life. Of course, it comes in many forms (in re: laughter is the best medicine), but, you know, we literally cannot live without it. Medicine, I mean. But laughter too, of course. India is one of the countries in the world with incidences of illnesses of all kinds, ranging from asthma, to diabetes to tuberculosis, increasing day by day. At last count, there were around 4.1 crore diabetes patients, 5.7 crore coronary heart disease patients, 22 lakh TB patients, 11 lakh cancer patients, 25 lakh HIV/AIDS patients and 6 crore blood pressure patients in India.

medicines

So, well, drugs and their prices in India have always been one of the most hotly debated topics (what’s that you say? No, not those drugs. Get your mind out of the gutter). Drug prices in India vary based on a number of factors, just as in any other country — the availability of the particular drug in the market, the state of the market itself at the time, whether the drug is classified as ‘essential’ or not, and so on. There is a National List of Essential Medicine (NLEM) published by the central government, which sets the maximum limits on drug prices, for essential medicines (obviously). The latest one was published in 2013 and contained 348 names.

However, the big daddy in this field, the regulatory body, is the National Pharmaceutical Pricing Authority (NPPA), set up in 1997. This authority has the power to set caps on drug prices, to limit and extend medicine sales, and so on, under the Drug Prices Control Order (DPCO) 2013. The DPCO also incorporates the NLEM stated above, with several more drugs added to the list. Some sources say that the number of medicines under DPCO are at above 600.

Additionally, under paragraph 19 of the DPCO, the NPPA is allowed to set caps on the prices of non-essential drugs, and has internal guidelines which allow it to do the same, which were put in place in May of this year. In July 2014, accordingly, it issued a list of 108 drugs which were non-essential, but now had price caps, in order to avoid competition and excessively high prices because of differences between brands.

Now, near the end of September 2014, the NPPA’s aforementioned power under paragraph 19 to set caps on certain drug prices was withdrawn, on the basis of advice reportedly given by the Solicitor General of India, Ranjit Kumar. How was this done? Remember those internal guidelines? Those had been set with the help of the central government, and were withdrawn on suggestions received from the same. It was said that the caps set in July 2014 would not be affected, though reports are suggestive that they are, and will continue, being affected. The drugs whose prices had been controlled under the July 2014 notification included a variety of medications, from a cancer drug (Glivec) to an anti-rabies drug (Kamrab), to a blood pressure medicine (Plavix).

Immediately, rumours started running around the Indian markets, going from maddening and terrifying, to much worse. One oft-quoted statement was that the price of Glivec, a cancer drug produced and marketed by Novartis, had risen from somewhere near Rs.8000 to something like Rs.1.08 lakh. Whoa! There was immediately a lawsuit instituted about this, in the Supreme Court. The lawsuit also stated that the decontrol in prices would negate the Indians’ Right to Life and Livelihood, a fundamental right granted by the Indian Constitution. (Oh yes, this is that Glivec, by the way. The famous patent lawsuit was about this one only. For more information, see: Novartis v. Union of India and Others)

How true is this rumour? We can’t say. But well, of course, the timing of this decontrol of prices was highly suspect, given that the new central government in India took over in May 2014, just a few days before the internal guidelines were set up. For some people, it feels like the moment it could, the government turned its attention to the NPPA, and went about maximising profit, keeping in mind the poor, needy pharmaceutical companies, rather than the very well-off but sadly sick electorate. Of course that’s how it happened. Seems like a Pyrrhic victory, doesn’t it?

However, this rumour is certainly questionable. For one, the NPPA is still allowed to regulate the prices of drugs. Only the internal guidelines have been withdrawn. For another, the central government still has the power to regulate drug prices, thanks to Section 3 of the Essential Commodities Act, 1955. It is worth noting here, though, keeping in mind the pending litigation, that it is unknown whether the NPPA can still use their power under paragraph 19 of the DPCO or not.

By the way, knowing Indian politics, there was immediately a bit of warmongering on the part of our favourite politicians. Rahul Gandhi got annoyed and said that it’s all a ploy by the Modi government, to which the BJP replied, ‘he’s disgruntled because he just lost the elections’. (I paraphrase. Forgive me, reader.)

What about the pharmaceutical companies, though? We’ve covered the other stakeholders, the government and the NPPA, the patients (the lawsuit), and now all we have left to consider is the sellers of these drugs.

The industry, in general, welcomed these proceedings (Do I even need to say duh here?). They said that they had always felt that paragraph 19 was erroneous (yep), and it wasn’t the appropriate provision to be invoked, and so on. To wit, a Mr Dilip G Shah, secretary general of the Indian Pharmaceutical Alliance: “We have always contended that the guidelines for Para 19 were erroneous. Para 19 is not the right provision for extension of price control as there is no public health concern which could have prompted the NPPA to invoke the provision.”

This same Mr Shah had also said  that “several companies have started withdrawing their products that are under price control, which means availability is going down.”

He cited the example of antibiotic drug Augmentin, whose price had been capped under the July 2014 notification. Under this cap, a lot of generic manufacturers had shut down production, which meant that the market share of its inventor, GlaxoSmithKline, had increased.

Another group of pharma companies under the head of the Organisation of Pharmaceutical Producers of India, said as follows:

“We appreciate the government’s decision to withdraw the guidelines on fixation/revision of prices of scheduled and non-scheduled formulations under Para 19 of the DPCO 2013. This welcome move tells us we are being heard and we look forward to working with the government toward a common goal.”

This above statement, along with a bit of common sense, offers the following meaning — that these companies can take this move as a chance to jack up R&D in India, to allow for more generic and unique drugs to be created, and thus, have a ‘common goal’ with the Indian government to have a healthy and happy Indian public (Yeah. And then we’ll all play with our pet unicorns and sing).

It was obvious that the decision made in July must have affected the profits of some big industry players such as Ranbaxy Laboratories Ltd, Pfizer Inc, Novartis, Abbott Laboratories, Sanofi SA, Merck & Co Inc, among others. The change in September was definitely much wanted (They could hear the pops of the champagne corks all the way to Macau, apparently). They had argued against the change at the beginning itself, by saying that most of these drugs were against lifestyle diseases, thus non-essential, and their price must not be controlled. That turned out to be a bit of a moot point because, well, their status as non-essential (as deemed by the Indian legislature and government) was never under question. The NPPA had the power to regulate their prices anyway too. They said it, regardless. Moving on, they had also used the argument that a regulator has no role to play in a free market (Capitalist economy zindabad).

The share prices of several drug companies shot up after the change in September. Sun Pharma and Ranbaxy gained nearly 2 per cent and GSK Pharma and Davis Lab gained 1 per cent each. Glenmark was also up around 1 per cent.

You know what? I get it. I get it, totally. All of this smells of a steaming conspiracy to help multinational drug companies earn massive profits off the poor ailing people while we rot in our poverty. This is totally not so that deregulation of markets, and free markets, can actually be a thing in India. This is definitely not going to help strengthen India’s international ties, so that it will be easier to lure more big players to enter our market. Of course it isn’t going to support the Indian home-grown pharmaceutical companies, or foster more grass-roots innovation, or allow our market to grow more easily. Oh, no. It’s all the Illuminati.

Picture Credits: Lian Chang

By Prakruti Maniar:

When was the last time you had a discussion about HIV/AIDS?

I had one in school. Sex education classes and a small chapter on the topic in textbooks were my last conscious interaction with the subject. And all somehow only preached abstinence and eventual monogamy as the only solution. Somehow, in our obsession with trying to curb sexual activity, we forgot to face reality. This article looks to provide a perspective regarding how one can target high-risk groups without coming across as a condescending breed of moral police.

Picture Credits: Lian Chang
Picture Credits: Lian Chang

It’s been 30 years since a case of HIV first emerged and recently scientists traced back to where HIV emerged — Kinshasa, the capital of the Belgian Congo. This was in 1920. One of the main reasons attributed to its spread was the colonial railway network to parts of central Africa. And the problem of mobility persists, in the form of migrants and truck drivers who are largely ignored and kept out of the focus of HIV intervention.

HIV or the human immunodeficiency virus, is the cause for AIDS, which is the last stage of HIV. Before any discussion of the subject is to be held, it must be remembered that, if checked for early on, one can live a healthy and long life with HIV and prevent it from growing into AIDS. With proper treatment, called “antiretroviral therapy” (ART), you can keep the level of HIV virus in your body low and in check through medication.

What’s new?

The problem again lies not with the amount of information available but our society’s acceptance of it, reaction to it and most importantly, the willingness (or lack of it) to bring a change in our collective attitudes. Basics continue to elude major chunks of the population whose first reaction at the mention of the word is to sit on the high seat of moral judgement.

India ranks third in number of people living with HIV and accounts for more than half the AIDS related deaths in Asia-Pacific. In 2012, 140,000 people died in India due to it. HIV and the high-risk populations included sex-workers, transgenders, men who have sex with men, and migrants.

But the problem of tackling the spread of the epidemic lies in the sociological understanding of people. The difficult part is that HIV has no symptoms, only many years later as it grows to AIDS, do signs show. Regular check-ups thus are essential to curb it at the first levels, and given the taboo surrounding the subject of sex itself, a routine of this kind is unlikely.

Yet India has a host of mechanisms in place — National AIDS Control Organization (NACO), State level AIDS Societies etc., to battle the problem. Their primary focus is sex workers and transgender communities. It has been observed that intervention levels are as high as 80% in these sections. MSM is a trickier issue, especially with the re-criminalisation of gay sex in 2013. Yet, if one has to look at the broader picture — these groups seem relatively better off. They roam in integrated communities and it is easier to target solutions at them. Chances are that 90% of say, sex workers, could be covered in one shot simply because they will be present in clusters which are easily traceable.

This is where migrants and truck drivers require special focus –

There are about 7.2 million migrants in India, with an HIV prevalence of 1 percent. Only 41.3 percent are covered in the HIV prevention activities. On the other hand, there are 2 million truckers with a prevalence of 2.6 percent according to Avert, and 4.6 percent according to some independent surveys, and HIV prevention coverage is 48.4 percent. An estimated 36 percent of the sex worker clients are truck drivers. It doesn’t take a lot to connect the dots. The migrants and truck drivers are hidden threats, looming in dark streets and being the harbingers of the virus, ravens who need to be attended to carefully.

“Truckers and migrants form what is called in AIDS intervention terms as a “bridge population” since they interact with the high risk groups like sex workers, and may risk to transmit HIV to their wives, partners and so on and from high-risk to low-risk areas” says Proshant Chakraborty who has worked as a field researcher for an independent monitoring and evaluation team for the Mumbai District AIDS Control Society (MDACS), between 2011-2012.

The prime destinations for the migrants include Maharashtra, Andhra Pradesh, and Karnataka, which are also states with high HIV prevalence. Maharashtra is also a destination for International migration. A research on Nepali migrants found that a lot of the male returnees had HIV or syphilis, infections presumed to have occurred during contact with Indian sex workers.

There is no one major problem in curbing this issue. Many small difficulties, as discussed below, weave together –

1. Limited data – Numerous surveys have been conducted to dig deeper into this problem. It has been a pattern that a good number of the sample population were hesitant to divulge if they had had sex with transgenders or indulged in MSM. The social stigma attached with the topic is high and not everyone comes forward to talk about it.

2. They have low risk perception of HIV. A study in Andhra Pradesh found that 60 percent of female sex workers acknowledged their risk to HIV as against 5 percent of the male migrants. This is glaring. It reveals how HIV prevalence has been restricted to just one side of the prostitution industry — the client-point of risk is hardly considered (sexism anyone?). This partial understanding of target groups needs stop.

3. General awareness of HIV in itself is a huge problem. By 2014, there were nearly 15,000 healthcare facilities offering HIV testing and counselling. Only 13% of people living with HIV in India are aware of their status.

4. Comments of new Health Minister notwithstanding, India has seen a steady increase in condom awareness, 60 percent on an average, truck drivers interviewed have reported inconsistent use of condoms with both paid partners and wives.

5. Drugs-Alcohol-Education-Working Conditions — Put yourself in their shoes. You’re staying away from home for days on stretch, you drive all day through all sorts of terrains, you hangout with guys your age. Cheap booze and cheap sex are readily available. Remember, you are from a background that is less educated and have even lower levels of awareness. It doesn’t take rocket science to connect the dots.

6. “Also, since the State AIDS Control Society are responsible for the activities within each state, it becomes difficult to coordinate between states when it comes to reaching out to migrants and truckers. Lack of information, stigma and the sense of “shame” associated with HIV acts as a hindrance to communication” adds Proshant.

7. A report on October 1 suggested that India could run-out of a critical medicine in its free HIV/AIDS programme in three weeks, thanks to bureaucratic incompetency, potentially risking lives of 150,000 patients. Forget targeting relief, even general measures seem to be in shambles.

What is being done?

Lack of medicines aside, NACO has started several projects to target high-risk communities. Project Kavach is one of them, reaching out to 21,000 truckers in a year in Panjabi Bagh and Magol Puri.

The specific objectives:

– Using Behaviour Change Communication (BCC), with the help of current and ex truckers, for adopting safer sexual behaviour and practice.

– Promoting use of condom among long distance truckers through improving access to clinic services.

– Reducing the incidence of various sexually transmitted infections (STI) through appropriate clinical intervention.

The results have shown — With the support of 20 transport companies, there has been a shift in percentage of drivers using protection — 5 to 60 in the last decade.

In 2012, there was a count of truck drivers in Chandigarh in the high risk group who can transmit HIV. National AIDS control organization (NACO) has given its consent as it believes that the truckers from all the three adjoining states have their transit here.

“So far, the most common way to reach out to truckers and migrants are IEC (Information, Education, Communication) strategies, like street plays in truckers junctions, construction sites and so on. Sex with sex workers is also normalised as a biological need, but one that needs to be done with protection” says Proshant. Many large construction sites collaborate with MDACS and NGOs, and give basic services to migrant workers.

However, it isn’t enough and a lot more can be done. It would seem that in curbing the spread of HIV, eventually we will need to acknowledge and accept several realities — people have sex, people pay for it too. Like Proshant said, normalising it is a crucial step in breaking the ice of taboo that makes all efforts to address it infinitely difficult. Clearly, sex should not be enough. Safe sex should.

Picture Credits

By Mannat Tipnis:

“The scale of maternal mortality is an affront to humanity…The time has come to treat this issue as a human rights violation, no less than torture, disappearances, arbitrary detention, and prisoners of conscience.” — Mary Robinson, former UN High Commissioner for Human Rights

While India is the 10th largest economy in the world, it is a pity that it continues to be within the category of some of the poorest nations in the world regarding maternal mortality rates and immunization. While Sierra Leone has the highest number of deaths related to pregnancy, India comes a close second with 50,000 deaths per year. According to the WHO, both India and Nigeria together were accountable for one third of the deaths the world over. There are greater nuances to the problem and solutions go far beyond an increase in the availability of hospitals and decreasing costs, though these in themselves continue to be far beyond the reach of a large section on women in the country, considering the fact that India only spends 4% of its GDP on healthcare.

Picture Credits
Picture Credits

As part of its study on maternal mortality, the Centre for Reproductive Rights, based in the USA, conducted a few case studies that sought to address the nuances of this problem.

July 20, 2006, Andhra Pradesh — Syeda Rizwanabi, a 15 year old girl, conceived a child three months after being married off by her parents. Due to a lack of information, she followed no dietary routine, her mother in law refused to admit her to a hospital when certain complications arose, she suffered convulsions, cardiorespiratory failure and died.

Source: Academy for Nursing Studies, Case Study: Syeda Rizwanabi (2006)

April3, 2007, Madhya Pradesh - Gita Bai, a member of the Banjara community, mother of 2 children. My hospital in Indore refused to admit her, when they discovered she was HIV positive. In pain and on the verge of delivering her baby, the doctors refused to even give her nevirapine to avoid the risk of transmission to her newborn. Gita delivered a baby girl outside the hospital, when admitted later, she continued to be ignored by the doctor. Gita Bai died due to sepsis and excessive bleeding.

Source: Human Rights Law Network, Gita Bai (2007)

December 15, 2007, Uttar Pradesh – Sumitra Devi, 28 years old, poor, illiterate, Dalit woman, a mother of three children, was going through a perfectly normal pregnancy till she proceeded to the Primary Health Center because of the onset of labor pains. There, she was given a total of fourteen injections by the ANM without any explanation. Sumitra’s body went cold, her family was forced to remove her from the bed, lay her on the floor and pay the medical fees, while she lay there dead.

India has a maternal mortality rate of 178 per 1,00,000 live births. This is an indication that the United Nations’ goal will be missed, say two reports – Dead women talking: a civil society report on maternal deaths in India drafted by CommonHealth and Jan Swasthya Abhiyan, and India infrastructure report – the road to universal health coverage”, released by the Infrastructure Development Finance Company.

Most maternal deaths that occur in India, one every 5 minutes, which is also 15% of the death for women of reproductive age, are avoidable. Even the leading causes like health and medical complications have to be looked at from a causative perspective. The National Family Health Survey stated that 55% of women in India are anaemic, in comparison to 24% men. This goes up to 85% pregnant women. This can be attributed to gender based discrimination in access to food, nutrition and healthcare. Thus, government policies should target the issue from the perspective of the background that influences women and their families into making certain health decisions.

9% of total maternal deaths are caused due to unsafe abortion, which is 15% higher than the global average. 6.7 million abortions occur outside government facilities. This is attributed to the fact that in most rural areas, there is a lack of information about safe abortions, and poorly trained doctors and nurses. Only a minuscule minority of women (some statistics say 9%) even know that abortion is legal. Women across class lines are forced into aborting female foetuses. This is done in unsafe conditions without legitimate medical authority, thus contributing to the list of reasons which can be avoided with greater government intervention that is not as generic, but targets each problem specifically.

The limitation of immunization and factors that are conducive to safer pregnancies are also restricted around cast and class lines. Caste continues to remain a social determinant regarding our access to education, and living conditions. Official policies to protect against discrimination haven’t percolated to the health sector.

Conflicts like armed insurgency and religious violence are cutting women off from essential pre and post natal health care services. “I have seen women trying to use home remedies like poultices to cure sepsis just because they don’t want to run into either an army man or a rebel.” — Daniel Mate, a youth activist from the town of Tengnoupal, on the India-Myanmar border, told Stella Paul of the Inter Press Service news agency. Families often stop women from receiving health benefits. In a household where there is a lack of funds, women will most probably be the last one’s to get these benefits. Often because mothers and mother in laws didn’t have access to medical facilities, women are discouraged and disallowed access to them.

There is a disturbing gap in the number of women who receive postnatal care. The NFHS reveals that less than only 36.4% of women across the country receive postnatal care and immunization within two days of delivery. One expert study contends that “half the [maternal] deaths could have been avoided if the health system had been alert and accessible”. While many factors affect the availability of care, studies show that in Indian primary health centers, absenteeism and poor quality of care are the norm. For example, in one part of Rajasthan, community health centers are closed during 56% of regular opening hours.

There is a great disparity in health care services in the north and the south. While 93% women receive antenatal services in the south, only 40% do so in the North. The east is plagued by a lack of communication and transport services, an effort by the government to improve the same has contributed to a steady decrease in the mortality rate but socio-economic and cultural factors require more detailed studies and evaluations.

Various NGO’s like Save the Children, Academy for Nursing Studies, Jaagori,Prerana, Sneha, Manmata Health institute for mother and child are working to spread awareness at the grass root levels and target specific problems. Its time the government wakes up to do the same.

Ebola virus

By Sourabh Harihar:

First things first. Ebola is a deadly viral infection that has recently taken deep roots in the West African Countries of Guinea, Liberia, Sierra Leone and Nigeria. The fatality rate of those affected with the virus is up to 90%. Medecins Sans Frontieres warns ‘Ebola can be caught from both humans and animals. Human to human transmission occurs through close contact with blood, secretions, or other bodily fluids of an Ebola-infected person’. Although the virus was discovered way back in 1976, there is no proper treatment or licensed preventive vaccination available as yet. If all of this is not alarming as it is, here are a few more reasons why it could snowball into a much greater problem in our country:

Ebola virus

1. Our Airport Checks:

New York’s JFK airport just started screening its arriving passengers for possible symptoms. While it may work there and in several other airports of the developed world, it seems to be quite a feat to be putting such machinery in place at Indian airports. And while the installation is one issue, the implementation would be another greater challenge, considering the apparent laxity and unpreparedness of our immigration and customs personnel. This only means that it could be highly possible for a person who has contracted the virus to pass into the country, totally unnoticed.

2. Our Healthcare System:

First of all, the diagnosis of the disease is quite difficult, given that symptoms may surface up to 3 weeks after actually contracting the virus. Our healthcare systems are clearly not sensitised to the extent of the danger this poses. To make matters worse, most healthcare facilities in our country are not equipped with appropriate space and infrastructure to quarantine patients. This could well imply that the disease would start spreading in the very places where it’s ought to be controlled – hospitals.

3. Our Government Machinery:

In spite of the enormous threat of the disease, the most our government has done so far is to issue guidelines and a series of FAQs about Ebola (which is practically available on the web anyway) via the Minstry of Health and Family Welfare. For fear of causing panic, the government may choose to be silent about the issue. But silence, coupled with inaction, would mean inviting a national crisis, which would be even more difficult to handle later.

4. Our Communities:

The WHO says that ‘Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.’ Far from taking any of these measures, our communities would rather not discuss the issue at all until it actually comes knocking at their doorstep. And then it could be far too late.

5. Our Attitudes:

Most of our culture actually encourages secrecy about being affected by diseases that spread. To add to that, the societal apprehensions and taboos associated with such pandemics will further delay proper care and prevention. This could all culminate in dreadful outbreaks and soon, situations could run out of control.

None of these points are meant to incite panic or malign systems. They are only intended so that attention is drawn towards the grave threat the Ebola virus presents and so that awareness is spread about how our country could tackle it better.

i touch myself

By Veda Nadendla:

In the year 1991, I Touch Myself– a song celebrating female sexuality, became a hit number for Australian band Divinyls. A decade later, when the band’s lead singer Chrissy Amphlett was diagnosed with breast cancer, she just knew that this song should be the new anthem for breast cancer awareness.

A year after Chrissy lost her battle with breast cancer, some of the best singers in Australia decided to make her dream come true. In a heart moving black and white video commissioned by Cancer Council NSW released over the weekend, ten women show their solidarity towards women with breast cancer around the world. The women in arms include breast cancer survivor Olivia-Newton John, ARIA female artist of the year winners Sarah Blasko and Megan Washington, Baby Animals singer Suze DeMarchi, ARIA Hall of Fame inductee and Amphlett’s cousin Little Pattie, Connie Mitchell, Deborah Conway, Kate Cerebrano, Katie Noonan and Sarah McLeod.

Christina Joy Amphlett passed away on April 21, 2013. After a mammogram and ultrasound initially failed to detect her cancer, she insisted on a biopsy in 2010 after self-examination. Amphlett’s husband Charley Drayton spoke to the Sunday Telegraph ahead of the one-year anniversary of her passing. “She would have wanted us to be more in touch with ourselves and to listen to what’s going on inside physically, and to be more in charge of our destiny and not wait for doctors or advisers to be in charge of us,” he said.

Cancer Council NSW declared the song the anthem for its #ithouchmyselfproject, which has a dedicated website here. This is Chrissy’s message to all women out there, be in touch with yourself and be aware, do not give life a chance to hang up a ‘The End’ board on you. Let Chrissy and her message reach every woman you know today.

Tea India

By Debanjana Choudhuri:

Life is busy as hell! My day starts at 7 AM (which by many is a late start), but for me, it’s quite an early start, because I sleep at 12, and wake up every 2-3 hours to check on my baby girl. Yes, I am a working mother and I love my work, and being a mom even more. My daily routine entails to get up, make food for my child, do the necessary chores, get ready, and scoot off to work (leaving my girl at the seasoned and doting care of my in-laws). And do you know what keeps me going? A good cup of warm adrakwali chai! But, lo behold! I cannot enjoy my tea anymore! Thanks to pesticides, which the tea companies have happily overlooked, and have been dishing out to us every morning/noon/night.

Tea India

Since the report Trouble Brewing has thrown light on the hazardous pesticides residues in tea, I can not get myself to drink the beverage I love, and need to keep me going. When I look back, not so long ago, around 8 months back, when my child would keep me awake the whole night (at times many nights in a row), I would quickly make some tea for myself, have a cuppa and get started to play with her or tend to her needs. Now, when I think the cups of tea I gulped down during pregnancy and post-natal, I shudder! I hope it has not left any footprints on either me or my daughter.

But now, I have to settle with not having tea, while the craving still remains.

And this is because one of my favourites, TATA Tea, has not yet committed to pesticide-free tea. While Unilever and Girnar, two of the industry majors have taken steps to clean up the supply chain, TATA Tea under TGBL (TATA Global Beverages Ltd.), a leading and well-loved brand has refused to take any constructive steps towards phasing out pesticides from their supply chain.

TGBL is sticking to an approach that could only help reduce pesticides. The outcome will be as good as the goal you set for yourself and the approach that you adopt to reach the goal. So, unless the goal is set as zero pesticides, one can never even reach close to it. As consumers, we simply don’t want pesticides in our tea and look forward to our favourite brands to adopt steps that will help achieve this. Non Pesticidal Management (NPM) has worked in other crops in erstwhile Andhra Pradesh, and with some research and commitment of companies and policy initiatives by governments, one can certainly make it work for tea. TGBL owes it to the consumers; it should work towards consumer safety. Like me, many associate the brand with reliability and sustainability, and I would want them to take steps, so that my faith in them is not lost.

As a tea buff, I would like the tea companies to provide pesticide-free tea to a nation that loves and knows its tea. Tea is a national pride, and the nation boasts of numerous tea connoisseurs. The brands owe it to us.

TGBL, please give me my favourite cup of tea back! Please clean chai now!

The author is Senior Media Officer at Greenpeace India

Aids

By Veda Nadendla:

According a World Bank report, as of 2011, an estimated 2.40 million Indian adults are living under the clutches of HIV. After the first ever case of AIDS in India was reported in 1986, the Government established National AIDS Control Program (NACP) which has developed into The Department of AIDS under Ministry of Health and Family Welfare.

Over the years the NACP has meted out AIDS prevention and awareness programs in three phases. During its first phase, 1992-1999, the primary focus was on increasing awareness about HIV and AIDS among the high risk population. Professional blood donations were banned by the Government and screening of donated blood was nearly universal by the end of this phase. During its second phase, 1999-2006, the NACP dispersed itself into the states with emphasis on interventions for high risk populations, preventive care for general population and increasing NGO involvement in carrying the word out there. Monitoring and controlling became a cause for concern. Despite the increase in awareness and interventions towards HIV/AIDS over the third phase, there was a realization that there is a need for more. Through the fourth phase the Government seeks to encourage and improve AIDS awareness, intervention, prevention, medication and control through participation of NGOs.

Increase what we may; we as a nation still lack the basic understanding of HIV/AIDS. We are still living in a world of half knowledge and assumptions, word of mouth and stigma which will prove most harmful in our fight against AIDS. If only we understood, and accepted reality as it is, we would throw caution to the wind, we would know the truth and we would be able to share it to enlighten others, we would be able to keep ourselves safe, and respect the dignity of the people who are positive. Here are some realities about HIV/AIDS that you and I must know as a citizen of this nation.

1 Ritesh

 

The Human immunodeficiency virus, commonly known as HIV, is known to cause AIDS, acquired immune deficiency syndrome. An AIDS diagnosed person’s immune system is weakened by the HIV virus to the extent that they may contract diseases which are uncommon to a person with a healthy immune system.

2  Kashyap

AIDS is not always the end result of an infection of the human immunodeficiency virus. HIV positive people can be treated with effective medication to slow down the progression of the disease and stop the development of AIDS. So, a person who is HIV positive should not ignore or lax medication because strictly following the medication prescribed can be the best way of protecting themselves from fast progressing symptoms of HIV and an AIDS diagnosis.

3 Sampath

When mosquitoes bite and suck the blood of one person, they do not inject that blood into another person they bite. There is no proof of transmission of HIV through mosquitoes even in areas where there are HIV infected people and lots of mosquitoes.

4 Binny

The strains of HIV can spread through unhygienic and unsafe use of needles which can happen at hospitals, tattoo parlours and with individuals who share needles when taking intravenous drugs. Further, the breast milk of a HIV positive mother can carry HIV to her newborn, when fed unknowingly. Also, very rarely, HIV can be contracted through deep, open-mouth kissing if the HIV positive person has bleeding gums or sores.

5 Vidya

All hope is not lost. People who are HIV positive can most definitely have children, but with the help of preventive and control interventions. The risk of the child contracting AIDS is less than 2%, as is the risk of other genetic diseases and disorders. Firstly, if you are positive, keep your doctor informed so that he/she can protect you and your baby. In the case of a father who is HIV positive, a procedure called ‘sperm washing’ can be done, i.e., separating the genetic material from the sperm after which the woman is impregnated using in vitro fertilization. Pregnant mothers who are HIV positive should take anti retroviral medication during the pregnancy, have a caesarian section and avoid breastfeeding the baby.

6 Ronit

Being HIV positive does not mean a miserable life and an imminent death. I have HIV positive friends who with the help of regular and effective medication, better lifestyle choices and family plus workplace support, have prolonged their life. Especially for people who are diagnosed early, the anti retroviral medication helps them lead a relatively normal and longer life.

7 Priyanka

If you think that you can spot an HIV positive person with ease, you are wrong. Do not discriminate because HIV/AIDS can affect anyone. In rare cases, this person does not necessarily have to be sexually active to be affected. As with the most abundant cases of AIDS in India, this person could have contracted HIV through sexual contact, they don’t necessarily have to be a prostitute. Shameful yet common stigma goes that gay people and drug abusers are AIDS patients. I implore you to put aside your differences because HIV positive people are none other than fellow humans who are in pain. They need your support, not your judgement.

8  Aseem

There aren’t too many ways of saying this so I’ll say it the best way possible- safe sex is the best sex. Not only does it protect from unexpected pregnancies and STDs but it is also one of the most effective ways of preventing the spread of HIV. If protection is worn during sexual intercourse as well as oral sex, HIV will not be transmitted. Even if the condom tears, there is medication available which if taken within 24 hours will prevent the spread of HIV. It is important to be aware of your sexual health and the sexual health of your partner.

9 Roshan

Yes, this young man wrote Genocide, because around the time when the first AIDS case was reported in Africa in the early 1980s, people believed that it was a ploy to wipe out the Black people. Since the epidemic left thousands of people dead in its wake with no cure to fall back on, the African people believed that it was an engineered ploy to bring an end to their population. There is still a minority in the population which held the belief until as recently as 2005, according to a study conducted by the Rand Corporation. AIDS is not genocide but ignorance definitely is. Being responsible and mature about AIDS is important in bringing about a positive mindset and preventing the spread of AIDS. It is important to improve self-awareness and practice safe sex, to not discriminate but appreciate and understand.

10 Ananya

The disease can only be contracted through exchange of blood, semen or breast milk and NOT through sweat, saliva and touching. HIV positive people are just that, people, suffering from a disease because of unfortunate choices or circumstances. We live in a post modern society and it is time to let go of ancient stigma and treat these people as one of us. We cannot catch HIV by

– Breathing the same air as an HIV+ person
– Hugging, kissing or shaking hands with an HIV+ person
– Using the toilet seat, or touching surfaces touched by an HIV + person
– Sharing food with someone who is HIV+

Why should they suffer judgement and discrimination when we can share our emotions with a person suffering from typhoid or cancer? Being accepted into society without judgement and blame is often the most difficult part of the life of someone who is HIV positive or diagnosed with AIDS. Support from friends, family and colleagues at work is the best way to improve the quality of life of this person, because they will feel loved, motivated and encouraged to prolong their own life.

11 Veda

Talk to your parents, your partner, your doctor or your friends; talk to them about HIV and about STDs. Talk to your school about the importance of sexual health awareness and accurate medical information about sexual health for young adults. Speak up because when you do, you’re breaking stereotypes and making it easier to discuss sexual health. It is your responsibility to yourself as an individual and your duty as a citizen of a developing nation.

clean chai

By Kanika Katyal:

In India, tea is not just a beverage. A sip of warm tea takes you on a trip down the Indian way of life. The numerous tea commercials time and again confer tea as the epitome of Indian hospitality. From Kashmiri ‘kahwa’ to ‘masala chai’ in Kerala; from Gujarat’s milky tea to Bombay’s ‘cutting chai’; from the tea brewed with ginger and bay leaves in Assam to the elegant Darjeeling tea, and to the health conscious’ green tea; it is a brew that transcends regional, linguistic, religious and class divides to become nothing short of a national drink. Thus, the importance of tea drinking in India cannot be confined to words.

clean chai

Breaking News: Your morning cup of Darjeeling tea could be lemon or honey flavoured. It could also be pesticide flavoured.

An investigation carried out by environmental NGO Greenpeace India titledTrouble Brewing has found residues of hazardous chemical pesticides in a majority of samples of the popular brands of packaged tea produced and consumed in India. Over half of the samples contained pesticides that are ‘unapproved’ for use in tea cultivation or which were present in excess of recommended limits. A number of these pesticides have been classified both as highly hazardous and moderately hazardous by the World Health Organization (WHO).

“We had carried out a study across many cities in India over the past one year to check the quality of tea leaves sold in cities. Our study has revealed the presence of residues of chemical pesticides in a majority of brands,” Neha Sehgal, senior campaigner of Greenpeace told reporters in Mumbai.

She claimed that out of 49 samples tested by the non-profit organisation, around 34 (94%) contained residues of at least one pesticide and 29 (59%) of the samples contained a cocktail of more than 10 different pesticides in them. Also 29 (59%) of the samples contained residues of at least one pesticide above the maximum residue limits set by the European Union (EU).

For the study, samples had been collected from different retailers from cities like Delhi, Kolkata, Bangalore and Mumbai over a period from June 2013 to May 2014.These included well-known brands of Hindustan Unilever Limited, Tata Global Beverages Limited, Wagh Bakri Tea, Goodricke Tea, Twinings, Golden Tips, Kho-Cha and Girnar.

Every tea lover needs to watch this video by Greenpeace. 11 August 2014: Greenpeace Activists took over billboards in Mumbai for over 50 hours to demand that the country’s drink – CHAI – be pesticide-free.

“Don’t say No to Chai, say yes to #CleanChai”

Key Concerns of the Campaign

– Firstly, the use of such a wide range of pesticides raises significant questions about safety for pesticide applicators and other workers in tea cultivation, and the possible impacts upon their health, as well as impacts on non-target organisms, on water and soil quality.

– Secondly, the “cocktail effect” of pesticides is thus a severe concern, and creates considerable regulatory challenges.

– Finally, many of the pesticides detected in the samples are not permitted for use on tea in India, raising questions about their origin in the samples and the legality of their use in tea cultivation.

Hazards

Pesticides have a chain of impact on human health and environment, right from the exposure to tea gardeners to the consumption by consumers. Sehgal said that there was a presence of the toxic DDT (dichlorodiphenyl trichloroethane) in 67% of the tea samples.“Use of DDT has been banned in India since 1989.”

Monocrotophos, termed as hazardous by the WHO, was found in 27 samples. Tebufenpyrad, a pesticide not registered in India and thus illegal, was found in one sample. “It can be very toxic for the liver,” she said.

Effects Of Pesticides On Humans

– Asthma
– Birth Defects
– Neurological Effects
– Cancer
– Hormone Disruptions
– Skin allergies

Effects Of Pesticides On Wildlife And Environment

– Chronic poisoning can sicken Wildlife.
– Acute Poisoning can be lethal.
– Adverse effects on reproduction cycles( especially in the case of birds).
– Colony Collapse Disorder (CCD) characterized by the loss of bees, affects plant pollination and cardinally, the environment.
– Loss of natural nutrients from the soil, making it unfit for cultivation.

1

Cocktail Effects Of Pesticide Mixtures

A major peculiarity that the Greenpeace survey threw light upon was the “cocktail effect” of pesticides. The regulation and permitting of pesticides is generally focussed on individual active substances and their toxic effects. As a result, the effects of toxicant mixtures, which are equally hazardous, are neglected. Greenpeace points out evidences that show how the components of a mixture of chemicals may be capable of interacting in a co-active manner.

Tea Industry in India and the Pesticide Trap

Today, India is the second largest tea producer in the world after China, and one of the largest consumers with over 70% of the tea being consumed within India itself. A number of renowned teas, such as Assam and Darjeeling, also grow exclusively in India. The tea industry in India is now over 175 years old, with the total area under tea cultivation around 9.8 lakh or nearly 1 million hectares.

Despite the importance of tea cultivation to the Indian economy, the sector has recently been facing a range of problems.

Pesticides: A Vicious Cycle

The farmers spray pesticides for higher production. They are aware of the dangers of pesticides, but they have no choice. The main aim is to produce a good quantity.

Harish C Mukhia, a consultant for the Specialised Agricultural and Industrial Consultancy on Tea and manager for six organic tea gardens, says , “Plenty of herbicides and pesticides are used on steep slopes to control weeds and pests. This greatly degrades the soil, leaving it barren.”

About 60 per cent of the bushes in Darjeeling are as old as 100 years, but no systematic and steady uprooting and replanting programme has been undertaken in the last 50 years. The innate immunity of the bushes has reduced. More and more pesticides have to be used to maintain the yield.

Moreover, Ramesh Chandra Gautam, senior scientist in the division of agronomy at the Indian Council for Agricultural Research, New Delhi, adds, “Overuse of pesticides has led to pests becoming immune.” The pesticide trap is, thus, a vicious cycle.

Failure and Confusion in the Regulation of Pesticides in India

The regulation of pesticides in India is complicated and confusing. The regulatory system is in crisis and that there are some serious flaws.

The responsible authority for registering pesticides for use on crops to control pests and weeds is the Central Insecticides Board and Registration Committee (CIBRC), which falls under the Ministry of Agriculture (MoA). In addition, pesticides are also regulated by the Food Safety and Standards Authority of India (FSSAI), part of the Ministry of Health and Family Welfare (MoHFW), which is responsible for setting tolerable residues of contaminants in foodstuffs.

With such a diversity of bodies making different recommendations on the use and applications of pesticides, the consequent overuse and misuse of pesticides is high.

There are inconsistencies between central registration, even between the CIBRC and the Tea Board (both government bodies), as well as differing regional recommendations like State Agricultural Universities (SAUs), the Tea Board and Tea Research Association.

2

The Demand

Greenpeace has embarked upon a mission to rid our beloved drink of all afflictions.

It has urged the government to move beyond their casual diminutive approach. Merely banning a few harmful ingredients would not solve the problem. Instead, policy and regulation needs to be made for the tea sector as a whole.

– Small tea growers need to be encouraged to shift rapidly away from the use of these chemical pesticides and thereby avoid the associated hazards and costs.

– The Big tea companies should work to move the tea sector away from the pesticide treadmill and adopt an ecological agriculture farming approach. In other words, they must care if the consumer ends up sipping pesticide laced water in the name of tea, and about the health of the 50,000 workers in the tea gardens of Darjeeling.

– Moreover, rather than investing in an expensive system to check for agro chemicals, tea-companies should invest the same financial resources in non-pesticide solutions, which are economically, ecologically and socially viable to chemical substance.

– The Tea industry should invest in ecological agriculture techniques that could prove to be both, a sound business choice for the tea sector, as well as a global market leadership opportunity for any given tea brand.

Need of the hour

It is a myth that harmful chemical pesticides are the only true way to rid gardens and crop fields from pests. We need to break the habit of using harmful pesticides and switch to rising organic ones that break down quickly in the sunlight and in the soil. The faster a chemical breaks down, the sooner the soil can return to a healthy state. The tea sector needs to become aware of ecological agriculture systems which already exist and to apply the same principles in tea cultivation.

India is not alien to the concept of Organic Farming and Pesticide-free production, even in the tea-sector.

The Case Of West Jalinga

When the bulk of the food production sector in India is contaminated with the continual practice of chemical methods in farming, the case of Jalinga Naturorganic Tea, in Assam, serves as a pioneer example for organic tea farming. Jalinga Naturorganic Tea, as the name suggests, is a natural organic tea that is cultivated upon the self-nourishment principle of plants, which not only replenishes the soil with nutrients, but also effectively controls pests.

3

Tucked away in a corner of Cachar district, West Jalinga tea estate looks like any of the lush plantations that dot the Assam landscape. Set over 1,200-hectare plantation, it is the largest organic tea garden in the world.

Tea Board Reacts

Because of Greenpeace’s report and the increasing public support, the Tea Board has called for a meeting between Greenpeace and tea companies. It has accepted that the Greenpeace report complies with the Indian laws and regulations and is in the interest of consumers.

The Tea Board also recently released a set of FAQs (Frequently Asked Questions) on their website, clarifying the concerns of the consumers regarding the issues.

Also, in an encouraging turn of events, two of the leading tea companies have come forward in support of Non-Pesticide Management (NPM) in tea. Hindustan Unilever has announced that it will be initiating a scientific research study to evaluate the environmental and economic feasibility of applying biological or non-pesticide methods for plant protection of Indian tea crops. Simultaneously, three Tata companies have announced an initiative – Sustainable Plant Protection Formulation (SPPF) Project – to develop and use ecological solutions for plant protection in tea. This is an initiative of Tata Chemicals, Tata Global Beverages and Rallis.

HUL (with brands like Lipton) and TGB (owning Tata and Tetley brands) are two biggest `packeteers’ of tea. This is a huge feat, in our struggle for health and well-being, which are after all, our fundamental rights.

You can also change the future of Indian tea for the better! Extend your support. There’s strength in numbers.
Sign and Share for #CleanChai

With the growing concerns over health and fitness, to know that our very own cup of tea that we have first thing in the morning to stimulate our senses and refresh ourselves is in fact poison, is cataclysmic! It poses serious questions as to the long-term sustainability of the tea sector in India. We need to demand from the government and all tea manufactures, the assurance that tea is safe from crop to crop and cup to cup.

Picture Credit: Ashley Rose

By Ayushi Vig:

Suicide, like many other crises, is an issue many of us often find convenient to think of as something “other people” deal with. We like to think that we and the people we love are somehow safe from it, until we aren’t any more. After all, we are all “other people” to someone else.

Picture Credit: Ashley Rose
Picture Credit: Ashley Rose

 

Suicidal tendencies are caused by depression, and the majority of us will experience depression at some point in our lives. Suicidal tendencies, which affect people of all genders, ages, and backgrounds, are not as rare as we like to think, and neither is suicide. According to government statistics, over 100,000 people commit suicide every year in India. That’s an average of one person every five minutes. Over a third of these 100,000 are youth.

Clearly, suicide is not an issue anyone can afford to ignore. Yet, scarily enough, not enough of us know what we should do about it:

1. Severe depression can be quite identifiable. Common signs of severe depression include:

– An increased dependence on drugs and/or alcohol.
– Loss of interest in activities previously enjoyed.
– Change in sleeping and eating patterns (sleeping too much/too little or inability to sleep through the night, eating too much/too little), and in weight (significant loss/gain).
– Isolation from friends and family.
– Mood swings.
– Difficulties with attention and concentration, and poor performance at work or school.
– Depression can often manifest itself as irritation in young adults as well.
– A recent, major life incident such as death of a loved one, unemployment, etc.

It is important to note, however, that severe depression is a relatively long-term predicament, and should not be confused with simply a hard week.

2. Although some attempts at suicide are undeniably impulsive, the majority are planned well in advance. Warning signs include:

– Giving away personal belongings.
– Not making plans for the short-term future.
– Taking care of affairs, such as by paying off debts or changing a will.

3. If you suspect that someone you know is considering suicide, talk to them about it directly. You will not be giving them any new ideas. Direct confrontation is the only way to deal with the issue.

4. Studies done by the US government have shown that more than 70% of individuals with suicidal tendencies mention their plans of suicide to a close friend or relative, often in an offhand, casual manner. If someone does bring up such an idea with you, take it seriously.

5. So what should you do? In short, you need to help them get the help they need. Statements like “you have so much to live for” and “suicide is selfish” are not helpful statements to someone who is considering ending his or her life. Do not judge them; instead, let them talk it out. Feel free to tell them that you may not be able to understand how they feel, but are there for them. Most importantly, enable them to get professional help right away. Contact a suicide hotline, or any mental health professional in your area.

6. Always remember that you are capable of helping.

The numbers for India’s suicide hotlines can be found at http://www.suicide.org/hotlines/international/india-suicide-hotlines.html

The pain of loss by suicide is often accompanied by the pain of regret. None of us want to look to the past and see the warning signs too late; none of us want an individual who deserves help to live a happy, healthy life to be unable to get it when we can give it to them. As human beings, it becomes our responsibility to help each other. So, stay alert, stay informed, and stay protective.

encephalitis

By Saparya Sood:

Acute Encephalitis Syndrome and Japanese Encephalitis are the recent problems added to the list of India’s miseries. Even though these diseases have always been common in India, especially during the monsoons, this year has been an exception. The outbreak of these diseases, usually most prevalent in Uttar Pradesh and Bihar, has spread further east to West Bengal and Assam, killing hundreds of people across regions.

encephalitis

Encephalitis is an inflammation of the brain, caused by any one of a number of viruses, says the World Health Organization. The disease is commonly called ‘brain fever’. Symptoms include high fever, vomiting and, in severe cases, seizures, paralysis and coma.

Prime causes of the disease include contaminated food or water, mosquito or other insect bites, or through breathing in respiratory droplets from an infected person. The first case of encephalitis suspected to be reported was around 1995 and yet so many years after, there is little known about the disease. Every year, it seems to worsen and the death toll only rises. This year has seen rapid spread of the disease to the eastern part of India. The victims are mostly children.

While ministers fighting in parliament seems to make it to the headlines on almost every news channel, it makes one wonder what could possibly be the reason for the lack of attention given to the rapid spread of this deadly disease claiming precious human lives everyday, both by the government and the media!

The apathy of the government towards this serious concern is shocking and disturbing. There aren’t enough hospitals with facilities to even diagnose AES or JE, and the hospitals which are equipped are largely over-strained in their capacity with multiple patients on one bed and a very skewed patient to doctor ratio. In interior places, people afflicted with the disease have to travel quite a long distance for treatment, which often is the cause of aggravation of their condition.

Vaccination drives started in the past have proved to be quite ineffective, since the JE vaccine requires multiple doses, which has been a significant barrier as a large number of patients from poor and remote areas are unable to return for subsequent doses.

However, a number of precautionary measures that can be taken to reduce the spread of this endemic haven’t been given their due regard. Even though the virus causing the disease is still unknown, its spread can be contained if the government took some preemptive measures. Environmental management of rice paddies by improving agricultural infrastructure in the country, access to clean water for consumption, improving health infrastructure, allocation of funds for research and surveys, increasing awareness about the disease are the basic measures the government should take to ensure that article 21 of the constitution isn’t merely a fundamental right in black and white!

Even though health ministers of the affected states have expressed concerns about the spread of the disease and the rising death toll, quick and adept measures need to be taken to control the rapid spread of this deadly virus. While there have been regional figures of death reported from various areas, it is strange and rather shocking that there are no national figures.

In India, media is the fourth pillar of democracy and is just as much a guardian of fundamental rights as the government in spirit! There is no better and more impactful a forum than the media to create awareness about encephalitis which is now an endemic in India. There is a responsibility on the press to reach out to people and inform and educate people about issues that most affect them. With little being done by the government to mitigate the impact of the disease, the media has the power to create pressure and make our politicians take a break from their petty political issues and pay heed to the large number of people who’s lives are at stake. Pressure from the media on the central and state government and in turn on health authorities to make the control of spread of this disease top priority is not only essential but immensely crucial now more than ever!

While on one hand, we are trying to build an international reputation in medical advancement in fields like commercial surrogacy, on the other, our inability to contain the death toll from encephalitis due to lack of medical infrastructure is a shame on India’s image as that of an upcoming medical tourism destination.

Prevention is better than cure, and though the situation has already gotten out of hand, it could worsen very fast in such a hugely populated country like ours. The media should at-least accord a ‘headline’ status to this issue as creating awareness to take basic precautions is the first step towards controlling the spread of any disease. However, creating sufficient medical facilities by deploying enough trained and specialized doctors in affected areas, along with opening clinics in remote areas is something that the government and heath authorities need to do and shift this issue a couple of notches higher on their priority list!

free healthcare

By Krishangi Singh:

A woman moans out in pain as her labor goes on. Her cries echo unheard, as she lays on the cot in a remote village as her economic conditions force her to bear with the torment. Suddenly, her death will become a phenomenon that will put the spotlight on everything that is wrong with the current healthcare system, but before the week ends, before her family can even mourn her death, it will all be forgotten. She is one more life lost among the 1,25,000 women who die in the process of bringing life to earth. As UNICEF reports, India stands responsible for about a quarter of all global maternal deaths.

free healthcare

Last year on July 16th, 23 children lost their lives due to poisonous mid day meal served at district school of Saran, Bihar. Food poisoning, a treatable condition, proved fatal for these children as they were referred to three different hospitals in a private vehicle instead of an ambulance. Here as well, government services proved inadequate and the rural residents could do nothing, due to economic constraints, to save these precious lives. Since this, numerous more incidents have taken place where children have died not only due to carelessness of government officials but also majorly due to lack of low-priced and accessible health care services. As WHO reports, India accounts for 1/3rd of world’s children who have no access to basic healthcare facilities.

We live in a country that is enchanted by the idea of progress and is going to great lengths to achieve it. Yet, I wonder how it is prudent to race towards development while a substantial proportion of our population still ends up losing their lives to treatable diseases. As we talk about holistic growth, the most basic necessity of the hour is certainly free and accessible healthcare in all rural and urban areas.

Free healthcare is essential for the entire country as the existing structure is too minuscule, and thus highly expensive. When our constitution grants equal right to life to each citizen of the country, then how can we deny them the right to a healthy life? India has approximately one doctor per 1700 people and with such a staggering ratio, comes along the extremely expensive treatment facilities. Business Today reports that about 70% of the 20 million blind people in India can be treated with a simple surgery, which remains unaffordable to them.

As we move to the topic of incurable diseases, the picture gets darker. India is one of the chief producers of high quality drugs and yet it’s own citizens fail to procure it at a reasonable price. Medicines for diseases such as those for cancer, diabetes and AIDS were sold at a price inflated by 6.3% in 2013, according to the National Pharmaceutical Pricing Authority (NPPA). With health insurance available to less than half the citizens as of now, the dream of sustaining a healthy or at least a tolerable life becomes a far-fetched reality. As if having healthcare options available was not an uphill enough task, procuring medicines at an affordable price becomes a larger challenge.

Preetha Reddy, managing director, Apollo Hospitals Group says, “The healthcare sector in India should be given national priority status. Our healthcare infrastructure needs huge augmentation, and the government should support this with multiple tax incentives. Improving primary and secondary care is crucial, but in addition, the new government must look into making quality tertiary care a lot more accessible and affordable to all in need.”

When we approach the idea of free healthcare services, it is not simply limited to opening a mere one story clinic that looks like an abandoned warehouse, but expanding to the notion of a well-equipped hospital with adequate staff, which is approachable to all sections of the society equally. Till yet, the available Public Health Centers in various rural locations are lacking the basic facilities of bedding and equipment mostly along with a reluctant staff that feels no obligation to attend to the incoming patients. As of now, according to the WHO, the public health expenditure by the government is a mere 4.1% of the national GDP. Needless to mention, this scanty amount can never sustain the healthcare costs of over a billion residents of this country.

Our healthcare system lies in ruins. Since National Health Mission in 2005, no major initiatives have been introduced to look over the health sector in the country. What further puts our entire system in a bad light is the fact that India ranked fifth in medical tourism for hosting 400,000 medical tourists from all over the world in 2012. Why is it that we are willing to provide cheap and effective healthcare to everyone around the world but not our own citizens?

For a developing country, a sound and healthy workforce is not optional. Free healthcare might seem like an extreme load on the country’s economy for the moment, but the return to this investment will be a hale and hearty population working all the more effectively to boost the economy.

Cheaper cellphones and shinier cars can wait, but the overhaul in our healthcare schemes cannot. As we move on to take our multivitamin pills, a few more of those 63 million children in India resign to their grievous fate.

ebola virus 1

By Mayank Jain:

The man alighting from the airplane at the Nigerian airport probably looked no different than others. Patrick Sawyer, a Liberian citizen might have been coughing or sneezing a bit but that wasn’t a good enough indicator of the havoc that was eating up his body from inside; Ebola virus disease. The infamous epidemic has come back to haunt countries of West Africa, this time with a furthered intensity and potential of crossing international borders and killing people outside the continent too.

ebola virus 1

Patrick Sawyer was tested positive for the lethal virus in the city of Lagos, Nigeria. It marked the arrival of the disease to the country. He was on a flight with almost 100 people who are being tracked right now. They need to be isolated from any contact before the virus spreads to anyone in the densely populated capital of Nigeria with over 21 million people on the streets.

Severe Outbreak

The current ongoing outbreak of the virus began in Sierra Leone just 4 months back in March and since then it has spread across 3 more countries. The virus has reached and claimed lives in Guinea, Liberia, Sierra Leone and most recently, Nigeria. The death toll is one of the highest ever seen. The outbreak is the most severe in recorded history.

140703085807-ebola-virus-map-story-top
Source

Over 1323 suspected cases have been recorded and the death toll has climbed up to 729 as of 29th July, 2014, which is substantially higher than previous outbreaks. It is of importance to note that the first outbreak of the virus was recorded in 1976 simultaneously in Sudan and Democratic Republic of Congo.

The first outbreak in Congo was in a village near the Ebola River and hence, the name of the disease.

The Silent Killer

The disease which appears to be an innocuous fever/flu infection at first, gradually develops in the body of the infected and turns deadly within a span of 2 days to 3 weeks. The infection is commonly mistaken for malaria or typhoid but symptoms like vomiting, diarrhoea and bleeding from the eyes and mouth aggravate quickly; the patient develops boils on the skin and the internal organs begin to shut down.

According to WHO, the viral illness reduces platelets and white blood cells in the body and elevates liver enzymes. The infection can last for a long time in the body and Ebola virus was once discovered in a man’s semen 61 days after the onset of the illness.

The Bad News: It might be in the cough of your co-passenger

The virus can be induced into the human body through multiple routes. Common ones include the blood, secretions, organs and other bodily fluids of those infected. The disease in Africa is said to be spread through monkeys (a popular choice for meat) and fruit bats which can carry the virus without getting infected themselves.

cases

Monkeys share almost 99% of their DNA with humans and hence, the ability of contracting infection from them is exponentially higher than other animals. Once a person is infected, the virus then thrives on human to human contact and spreads through hospitals, health care workers and even the mourners of those who died from the infection.

Deadly Sperms

The virus can’t be easily eliminated from the body even after the disease has gone and hence the phrase ‘deadly sperm’ has appended itself to the disease. Even after recovery, the disease can still transmit the virus through the semen of those infected for up to 7 weeks. Complete sterilization from the disease hence, is a long drawn process and isolation is one of the most crucial ways to stop it from spreading.

Mortality

During the first outbreak, the infection claimed a reported total of 280 lives from Congo itself with a mortality rate of 88%. The mortality rate usually hovered between 75-100% in further outbreaks in the continent and rarely went below 60%. The current outbreak is similarly high on death toll.

Doctors have estimated the current mortality rate to be around 70% at least, which makes it a highly dangerous killer if it spreads to other parts of the continent or the world. Containing the disease is the only option since no specific cure is available yet.

What Can Be Done

Multiple vaccines are under trials to contain the virus but none of those have made it to the ground yet. The disease usually spreads from animals and hence, proper cleaning procedures of pig and monkey farms can be carried out  to inactivate the virus.

The most important part is reducing human-to-human infection which can result by coming in contact with an infected person from the regions where the virus has already spread. Airports and the international community have a large role to play here. Isolation of those who seem sick and denying permission to board air planes for those who are infected, could help limit the spread of this virus.

In the end, talking about it, spreading awareness and building pressure on the international community of health professionals, organizations and governments to do their best to provide relief and rescue are the best ways to help while we wait for the cure to arrive from a laboratory somewhere.

To know more about this story and what I think, follow me on Twitter at @mayank1029

 

menstrualcups

By Archeeta Pujari:

menstrualcups

Periods. As if the pain, discomfort, swelling, acne and mood swings weren’t enough, there also comes the added dampness, messy leakage and stains associated with the use of sanitary pads. I only remember all too well the horror of my school days, surreptitiously asking female friends to check my backside for tell-tale signs of impending disaster, and inevitably during the most inconvenient moment possible, i.e. during an exam, discovering that my precautions had been to no avail and the back of my white PE skirt resembled the gory remains of a medieval battlefield. This was always followed by a shame filled slink to the filthy school loos, panicked washing of said skirt under the taps and a trip to the condescending school nurse who repeatedly admonished me for not behaving like a lady and allowing the same disaster to occur repeatedly. But try as I might, even well into adulthood, my clumsy school days far behind, I just don’t have the time, desire and mental togetherness to be singularly focused on stemming my menstrual flow throughout those 4 days, and the hassle associated with trying to balance periods with a normal working life has become no less challenging than it was all those years ago.

The problem with sanitary pads, for me, was that far too many things can go wrong. They can fill up, they can be in the wrong position, they can slip, they can be wet and messy and smelly. Until very recently, I wasn’t even aware that there existed even a single alternative, if not in fact several. My second foray into menstrual-related sanitary items was my short-lived tryst with tampons. I found that they solved none of the problems of pads, and in fact added a few extra dimensions of inconvenience to the whole sorry picture: they leaked freely and wildly on the days of heavy flow and had to be changed more often including in the middle of the night, they became fluffy and painful on days of light flow and couldn’t be used at all, and then there was the added risk of Toxic Shock Syndrome, a potentially fatal disease associated with leaving tampons in the body for too long.

It wasn’t until I was well into university that I discovered menstrual cups on some obscure online forum, and wasn’t until years later that I actually plucked up the guts to try it out! In fact, I am shocked that awareness of these products is so low, not only in India, but worldwide, despite the fact that the advantages of using cups over other forms of sanitary items are endless, while the downside is virtually non-existent. I have never met a woman who has had an unpleasant experience with the sanitary cup, and the online reviews are full of praise. I for one can definitively say that it solves all the problems associated menstrual hygiene that pad and tampons fell short on, and it makes periods an easier and less stressful experience overall.

The Basics: Nice and simple

What is a menstrual cup?

A menstrual cup is a reusable device, around two inches long and made from soft medical grade silicone.

How does it work?

It is worn internally a lot lower than a tampon but, while tampons and pads absorb menstrual fluid, the menstrual cup collects it. A light seal is formed with your vaginal walls, allowing menstrual fluid to pass into the cup without leakage or odor. This seal is released for removal, allowing you to empty the contents, rinse or wipe and reinsert.

How do I use it?

The menstrual cup is designed to be folded and inserted into the vagina, then removed, rinsed and reinserted up to every 8-12 hours. To remove, gently pinch the sides of the cup to break the seal and slide out. Since the cup is worn low in the vagina, it is easy to reach and remove. Although the prospect of inserting/removing a full-blown cup may be alarming at first, it is in fact quite easy if you follow the instructions carefully, and it gets easier over time. Additionally, since the cup holds up to 3x more fluid than a pad, you don’t need to worry about frequent removal/reinsertion.

How to clean it?

During periods, the cup only needs to be emptied 2-3 times a day, and can be left in all night. During periods, once removed, you can empty the contents into the toilet, rinse with plain water and immediately reinsert. Since medical grade silicone is used, this inhibits the growth of bacteria, ensuring the cup is always safe and hygienic. If you are in a public toilet, and too shy to go out of the cubicle and rinse in the basin, you can take a small bottle of water with you to rinse in the toilet. Or if you forget that, you can just wipe with toilet paper and reinsert immediately! Be careful not to use soap or disinfectant, as this can cause irritation.
At the end of the period, you may choose to clean your cup more thoroughly. You can either immerse in boiling water or use sterilization tablets. Again, don’t use harsh detergents/chemicals as this will damage the silicone.

Advantages

Where do I even begin?

No leaks, no leaks, no leaks!

When inserted correctly, the menstrual cup forms an airtight seal with the walls of the vagina. This means that as long as the cup is not full to the brim (this is unlikely), there is virtually no possibility of leakage and it cannot become accidentally dislodged.

Comfort and convenience

Since the cup is worn internally, there is no feeling of dampness or stickiness at all. It is also completely invisible from the outside. In addition, when inserted correctly, you should not be able to feel the presence of the cup within the body at all. While removing, all of the blood is contained within the cup, so it should be virtually a mess-free experience. It is painless to insert and remove.

Fewer changes

The menstrual cup contains up to 3x more fluid than other methods of absorption, which means it can be left within the body for up to 8-12 hrs. At any one time, a cup can hold up to a quarter of total monthly discharge, so you can avoid emptying in public toilets altogether. Medical grade silicone prevents the growth of bacteria/allergies/fungal infections. Since the cup does not absorb any fluid, it maintains the natural pH balance of the body. There are no known cases of Toxic Shock Syndrome associated with leaving menstrual cups within the body for too long.

Can use on all days of the cycle

The menstrual cup collects fluid rather than absorbing it. This means that it can be inserted before or after a period, or during days of very light flow without causing dryness or irritation.

Cheaper

On an average, a woman spends anything between Rs. 100 to 150 on sanitary packs every month. This amounts to Rs. 3,600 in two years and Rs. 9,000 in five years. The SheCup (an Indian manufactured menstrual cup) retails for Rs. 760, and can be re-used for up to 5 years! You do the math!

Environmentally friendly

Only 12% of the 355 million women of menstruating age in India can afford disposable sanitary napkins. Despite this, these 42.6 million women will throw 21.3 billion sanitary napkins into a landfill in their lives. Again, the menstrual cup is reusable for up to 5 years after a single purchase.

All sports/activities including swimming

The cup cannot be felt after insertion and cannot become dislodged easily, as it forms a tight seal. The seal is also completely water-tight. This means you can go about all every day activities while wearing it, including sports and swimming.

Discreet

For the shy people out there, most brands of the cup come with a discreet pouch. The cup can be placed in the pouch and left in the schoolbag/handbag between use. It can also be inserted before the period starts, to avoid any messy surprises! You don’t need to carry any spares or worry about disposal.

Healthy

The cup is made from soft medical grade silicone and is latex-free, hypoallergenic and contains no dyes, BPA, phthalates, plastic, bleaches or toxins. It is not associated with TSS or vaginal infections. It is non-absorbent, it will not cause dryness and does not disrupt your body’s natural pH levels (35% of the fluid tampons absorb is natural moisture!). The cup has measurement markings, enabling women to report menstrual blood loss to a doctor or gynaecologist. It does not contain any absorbency gels, additives or perfumes. Unlike some conventional cotton sanitary products, it is also free from pesticides and GM materials.

Any Downside?

These are few and far in between, but worth addressing none the less.

Takes some getting used to

As with any method, removal and reinsertion of the cup takes some getting used to (maybe 2 or 3 cycles). Always read the instructions THOROUGHLY. Also, take some time to practice and find positions that work best for you. However, you will most likely have no difficulty and be a pro in no time! If you are worried about incorrect insertion, use a pad simultaneously to catch any leakage until you get it right.

What if it gets stuck inside?

The menstrual cup cannot get stuck inside. The worst that can happen is that it travels too far up to reach. However, the cervix acts as a wall at the end of the vagina, so it cannot escape the vagina and get lost inside the body! If you can’t reach the cup, first of all relax! Tense muscles will send it higher up the vaginal canal. Sit down or squat and use the pelvic muscles to push the cup down till you can reach it. Then pinch the sides to release the seal and slide out.

Will I come into contact with blood?

The cup is actually un-messy to use. Yes, when you insert it you may come into contact with some blood, but no more than any other method. When you remove the cup, the outside of it is relatively clean, with the vast majority of the blood collected inside of it. It stays upright (and is rarely full anyway) until you tip it up to empty it down the loo. Then you simply rinse, or wipe, before re-inserting. You will see your blood, but you will not have much actual contact with it.

Hymen

The use of menstrual cups will stretch or tear the hymen. However, this is NOT the same as ‘losing your virginity’ (the definition of ‘losing your virginity’ is pretty tenuous, but it does hinge on having some kind of sexual contact). The hymen often breaks before adulthood due activities such as sports. However, if you or your family feel strongly about keeping the hymen intact, it is probably best to not use internal methods of menstrual sanitation.

Where Do I Get A Menstrual Cup?

SheCup is a menstrual cup manufactured in India. It retails online for Rs. 760. Mooncup, a UK distributer of menstrual cups also delivers to India. Other brands include DivaCup, FemmeCup and Lunette.

Useful links
shecup.com
mooncup.co.uk
menstrupedia.com

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