Kashmir’s health department cracks whip on private nursing homes

Around 150-180 hysterectomies at Valley’s 40 private nursing homes every month alarms authorities

Riyaz Wani

Rafiqa, 50, from Qamarwari locality of Srinagar has had a massive weight gain and undergoes wild mood swings—a source of constant trouble for her family. The reason for such erratic behaviour, her doctors at the government hospital now tell her, was the hysterectomy surgery she underwent at a private nursing home six years ago. The surgery it turns out, was unnecessary. The consequent complications, she is told, will probably last for the rest of her life.

Rafiqa is not an exceptional case. Around 150-180 hysterectomies—a surgical procedure in which doctors remove the uterus—are performed at Kashmir’s 40 private nursing homes every month. The situation has alarmed the Valley’s health department, which is already battling the incidence of female foeticide in a state where the female sex ratio as per the 2011 census has plummeted to 859 females per 1000 males.

“We didn’t know that the situation is so bad. Then the complaints from the people and public quarters alarmed us,” director of health Dr Salim-ur-Rehman, who has recently taken over the functioning of the department, told TEHELKA. “We found that there was a tendency to prescribe hysterectomies as the only solution.”

According to a recent survey ordered by the health department, the total number of hysterectomies performed in the seven districts of the Valley over the past five years is 14,788. Most of them were done at private hospitals. For example, in Kulgam district, out of a total of 4,196 hysterectomies in five years, 3,546 have been done in the private sector and only 650 in the government sector. Similarly, in Baramulla district, out of a total of 280 such procedures, only one has been done at a government hospital. In Bandipore district, out of a total of 924, around 659 procedures have been performed in the private sector.

The easy recourse to the procedure in private hospitals can be gauged from the fact that a small nursing home in downtown Srinagar, according to the data of health department, has performed 28 hysterectomies in December 2011. As against this, Lal Ded, the Valley’s largest maternity hospital carried out only two hysterectomies in the same period. “The particular nursing home has only two surgeons and sees fewer patients, while Lal Ded with 66 doctors, sees more than one lakh patients at its OPD alone,” said a health official.

Rafiqa has had her hysterectomy at a private hospital in Srinagar. “I didn’t know what I was getting into. Doctors told me I would be all right and I had no choice but to believe them,” says Rafiqa. “Since the surgery, my health has become worse,” she added.

The incidence of the growing number of hysterectomies has forced the health department to crack the whip. Rehman has decided to hold the private nursing homes to account. At a meeting with the Association of Private Hospitals on 12 March, Rehman called on them to exercise a greater restraint in the prescription of the procedure and warned the cancellation of their license in case they didn’t follow the norms of medical practice. There are around 40 private nursing homes in the Valley.

Besides this, the health department is going for a more detailed survey of the incidence of hysterectomies in the Valley. “I have told chief medical officers to gather information on hysterectomies through Ashas. There is one Asha for 1000 people, so we will get a fair assessment,” assures Rehman.

The Federation of Obstetrics and Gynaecological Societies of India in a policy statement sent to the director of health underlined that only a gynaecologist can carry out a hysterectomy. “Surgeons cannot do justice to the removal of uterus since removal of uterus is not just a surgical skill and training for the same is primarily imparted to gynaecologists,” FOGSI says in the statement. “This (hysterectomy) can be done best by gynaecologists and the surgeons can be called in the event of involvement of other organs.”

However, FOGSI president Dr PK Shah, doesn’t think that the large number of hysterectomies in a particular area means they are all unnecessary. “It is very difficult to make a judgement. If there is a reason for hysterectomy, then it is okay,” Shah tells TEHELKA. “Numbers don’t matter much, but there are no two opinions about the fact that the hysterectomy should always be the last resort.”

The Valley’s well known psychiatrist Dr Mushtaq Margoob says he has seen more than many patients in distress following a hysterectomy, over the past several years. “I have seen women in their 30s who have undergone hysterectomy,” Margoob revealed adding that in most cases hysterectomy had not been recommended by a gynaecologist but by other doctors and sometimes even by quacks.

Another psychiatrist Dr Arshid Hussain said the “post-hysterectomy depression” is a familiar phenomenon. “I see a lot of these cases,” Arshid says. “Hysterectomy deprives women of hormones at a crucial stage in their life, which sends them into severe melancholic depression. There is a need for these women to keep replenishing these hormones.”

Pertinently, a study carried out by the Government Medical College has found the incidence of uterine rupture in the Valley at 0.2 per cent. The study, which carried over two years (March 2007-March 2009) studied 100 women and found that the prevalence of the uterine rupture was common in women with low socio-economic status.

Riyaz Wani is a Special Correspondent with Tehelka.

Breaking News – Peoples Peaceful Protest WINS in Koondakulum

Anti-nuclear activists, spearheaded by S P Udayakumar, today called off their 9-day- old fast launched by them after Tamil Nadu government gave the go-ahead for the controversial Kudankulam Nuclear Power Plant. Udayakumar’s decision came hours after a delegation of his supporters met senior district administration officials who assured them that their charter of demands would be conveyed to the government for consideration. “The officials promised to look into the seven demands placed by PMANE (People’s Movement Against Nuclear Energy).

We hope that the officials will talk to the government and meet our demands,” Udayakumar, who was on fast along with his associate Pushparayan and some others, told reporters here. Udayakumar broke the fast by accepting fruit juice offered to him by Madurai Bishop Peter Fernando. Besides Fernando, the 13-member delegation which included Rimond, Arivavalavan held talks with Collector Selvaraj, DIG Varadaraju and other officials and presented their seven demands for withdrawing their fast.

The Collector said he could withdraw prohibitory orders in all the areas except KNPP premises and had to convey their other demands to the government. The protestors demanded immediate withdrawal of cases filed against them, recognition of their struggle against nuclear energy and withdrawal of prohibitory orders in Radhapuram taluk. Other demands are release of all those arrested for organising protests, training for people in 32 villages in disaster management, an ‘open and frank’ nuclear liability bill and explanation to locals on how safely nuclear waste would be disposed. The anti-nuclear activists led by PMANE were on fast after Tamil Nadu government gave its go-ahead to the Indo-Russian nuclear project on March 19, clearing the decks for resumption of the work now in full swing. Udayakumar had yesterday said he was ready for talks with government provided cases against PMANE members were dropped.

The decision on actual details of where section 144 will be lifted, and release of prisoners, will only be confirmed by the DM tomorrow – presumably after consultations with high command!

 So until then the relay fasts will continue; kids will not go to school; boats will not put out to sea; and shops will not re-open, until the orders are final and the comrades return home from prisons where they are being held.

This is a victory for the people, for truth and nonviolence.

 there is a long battle ahead.

Forest dept burns 40 huts of Chhattisgarh tribals in Andhra

Forest dept burns 40 huts of Chhattisgarh tribals in Andhra

Dr Haneef from Andhra- Chhattisgarh border is telling us that today some forest officials came with more than 100 forest guards and burnt down 40+ huts of Interneally Displaced people ( IDP) tribals. These Chhattisgarh tribals are living in the reserve forest due to ongoing war in Chhattisgarh and they look for work in nearby areas for their survival. After the fire incident many women and children have run away in the forest and not tracable now. He requests all of us for helping these hapless people in trouble. For more please contact Dr Haneef at 09490353568


Listen to Dr Haneef

Immediate Release- “DEMANDS OF THE PROTESTING PEOPLE” in Koondankulum

March 27.2012

1. The cases filed against Struggle Committee members and other people must be unconditionally revoked. The people who have been imprisoned in connection with this struggle should be released from the prisons with no conditions attached.

Notwithstanding that Koodankulam Nuclear Power Plant is a Central Government undertaking, it is a fact that it is set up within Tamilnadu. Therefore, keeping in mind the safety and livelihood concerns of the people of Tamil Nadu, the Government of Tamilnadu has an immense responsibility to act on behalf of the people of Tamilnadu to make all efforts to ensure that the Central Government fulfills all its duties. On this basis, we request the Government of Tamilnadu to emphasise the following facts and actions to the Central Government.

2. The Government must assure that an independent team of experts will study the hydrology, oceanography and geology of the site and surrounding areas.

3. The secret  Agreement between the Government of India or the Atomic Energy Commission with the Russian company on the nuclear disaster liability must be made public. This is an important document that concerns the future of the people of Tamilnadu. We request that a copy of the same be provided to us as well.

4. The Tamilnadu Government should ensure that the Central Government implements the rule regarding emergency/disaster management training, as well as evacuation training for the people living within 30 km radius.

5. The Tamilnadu Government should ensure that full details about the nuclear waste management is made public by the Central Government.

6. Even as the struggle committee members give their word that they will not blockade the nuclear power plant or resort to any violent tactics for any reason, it is requested of the Government that we be allowed to voice our concerns and dissent in a democratic and non-violent manner, without disruption of law and order.

7. If these demands are accepted, we are prepared to end this phase of our struggle.

To emphasise these demands, we hereby appoint a team of four persons headed by Thiru Arimavalan on behalf of the people and the struggle committee.

Thiru. Arimavalavan. Age 47, S/o Mohan. Village Uvari
Thiru Pandi, s/o Thiru Velayutham. Village Koodankulam
Thirumathi Sundari, w/o Benton, Village Idinthakarai
Thiru Joseph, s/o Anthony Thommai, Village Koothankuzhi
People’s Movement Against Nuclear Energy

Original Document of demands in Tamil

Original Document of demands in Tamil

Anti-Nuke activists ask the Nation- Do we have a Right to Question Govt Policies peacefully ?

Idinthakarai Update, March 27, 2012
Greetings! Ayya Pazha. Nedumaran, Vaiko, Thirumavalavan, Seeman, journalist Gnani and many many more good hearts have been asking us to stop the fast unto death immediately. Pushparayan, 13 of our comrades and I have been very very tired; three women fainted and were hospitalized yesterday.  Rayan and I have some pain on our stomachs; and I have been feeling a bit dizzy. The government medical team checked on our health and found out that my pulse rate had come down. They wanted me to go to a nearby town for tertiary medical care but I refused to do that.
We have been asking the government to talk to us and this has taken 9 days for them to depute the District Collector for talks. People have chosen ten representatives from ten coastal and interior villages to go and talk to the Collector.
In the meantime, the police have charged all the 178 people from Koottapuli village with more serious case such as ‘waging war against the State’ and denied us the opportunity to take them out on bail.  Similarly, the other friends who are locked up in Cuddalur prison have also been re-arrested in more serious cases. The Indian State is hell bent on destroying us and sending a lesson to all the anti-nuclear, anti-globalization and other anti-government protestors around the country. The governments would pass all kinds of pro-foreigner and anti-Indian bills on crucial issues such as Food Security, Water, FDI on retail business and undertake dangerous anti-Nature and anti-Future projects and we all should keep quiet and fall in line.
The simple question we want to ask all our Indian brothers and sisters is this: do we, Indian citizens, still have the right to oppose the government’s policies, programs and projects peacefully and democratically? If so, why does the Indian State want to destroy us all with cases of sedition, waging war against the State and so forth?
We have been fighting nonviolently without even a single case of violence or terror. We have not harmed or hurt or killed anybody; we have not damaged any private or public property. Then why are we being treated like this by the Indian State? Is it because our people are poor, lower caste, or most of them belong to minority communities such as Christians and Muslims? Please think of this.
What kind of message is this brutal behavior of the State sending to our youth? They cannot use either violence or nonviolence to demand their rights and entitlements; they should not complain about anything and simply help the rich become richer.
Some 70 percent of our people are poor; more than 50 percent of our people do not have toilets and basic human dignity; and some 46 percent of our infants are born malnourished and under-weight. Most of the political leaders, bureaucrats, scientists, military leaders and businessmen are robbing the people mercilessly. They are hoarding their ill-gotten wealth in Swiss banks; and they steal not just in lakhs or crores but in lakhs of crores. The poor people of India do not have even two square meals, and safe drinking water.
It is high time we, the people of India, stood up and took our country back! Cooperatively, peacefully, nonviolently and democratically! Before it is too late and we are re-colonized by Russians, Americans, the French and others.
Please save us from the cruel grip of the Indian State. We thank all our brothers and sisters who are already doing this all over the country. We need more people and more actions.
Related articles

UN rapporteur arrives on fact-finding mission in Kashmir

The United Nations special rapporteur on extrajudicial, summary and arbitrary executions, Christof Heyns arrived on a two-day visit to Jammu and Kashmiron Monday afternoon.

This is for the first time that the special rapporteur has been allowed by the Indian government to visit the Valley.

Hayns told a news conference immediately after his arrival in SrinagarImages ] that his mandate was to visit different countries to asses the situation on right to life which is fundamental to all other human rights and report back to United Nations Human Rights Commission.

He said he will release the preliminary report in New DelhiImages ] on March 30 at the end his visit and submit the final report to the commission.

“During my stay I will be meeting government officials including those from the police, the Army, rights activists, victims and academicians etc.”

Chairperson of Association of Parents of Disappeared Persons, Parveena Ahangar met the special rapporteur after his arrival.

Senior advocate, Zafar Shah told the media conference “Kashmiri people and civil society have been demanding for the last two decades that UN should visit Kashmir and prepare a fact based report.”

He said, “Sweeping powers such as the Public Safety Act and the Armed Forces Special Powers Act were available to the authorities which made normal judicial remedies unavailable to those seeking judicial intervention against misuse of powers by the security forces in Kashmir.”

The coalition of civil society members also met the special rapporteur and submitted detailed reports about the human rights situation in the Valley.

He had a close door meeting with relatives of those killed in some highly controversial incidents in the Valley.

Mukhtar Ahmad in Srinagar, Rediff.com

Urgent Appeal from Koondankulam- Take action- Anti Nuke activists will be arrested soon

Dear Friends,

The hunger-strike in Idinthakarai, Koodankulam today has entered its 9th day. There has been no attempts on the part of the government to end the stalemate and start a process of dialogue with the people on hunger-strike. Even the routine medical check-ups and services extended by the govt in such cases are absent here. Yesterday, one of the 7 women on hunger strike in Idinthakarai, Melret (aged 48) had to be taken to hospital as her blood pressure became too low.

S P Udayakumar has expressed his apprehension that once he and other main activists are taken to hospital, they might be arrested and isolated from the local people. The govt then would use this opportunity to force people into compliance. The local administration has already started meetings with local panchayat (elected village bodies) leaders to distribute the 500-crore package which the PMANE has termed as ‘bribe’ to silence and divide people’s opposition.

The immediate demands of the protesters are simple and the government must be forced to listen to them at the earliest. They are demanding removal of prohibitory orders, adherence to AERB norms which stipulates safety drill before commissioning of reactors and revocation of criminal charges piled up against the activists supporting the Koodankulam movement.

The larger civil society and citizens of India must step in to stop this callousness and contempt of democratic dissent.

4 persons from Idinthakarai village are meeting the District Collector of Tirunelveli today to demand  earliest intervention to end the hunger strike.

Please call/fax/email the  Collector office of District Collector of Tirunelveli Dr R. Selvaraj at the following coordinates:

Phone: 0462-2500828 (O)
0462-2577655, 2577983 (R)
Fax: 0462-2500244

E-Mail: collrtnv@nic.in

Pl sign online petition which is sent to Collector also



More pics here

About 70 percent of India is poor: NAC member

New Delhi: Debunking the government’s claim that the number of poor in India has come down, a top adviser has claimed that around 70 percent of the country’s 1.2 billion population is poor, and stressed the need for a multi-dimensional assessment of poverty.

“The government claim that poverty has come down is not valid… there is a need for a multi-dimensional assessment of poverty as around 70 percent of the population is poor,” National Advisory Council member N.C. Saxena said in an interview.

According to Saxena, the various poverty estimates the government relies on to assess the impact of developmental schemes are faulty as they fail to factor in the lack of nutritional diet, sanitation, drinking water, healthcare and educational facilities available to the people.

The former bureaucrat, who now is part of the NAC that reports to Congress president Sonia Gandhi, claimed that not only the National Sample Survey Organisation data is faulty, the ongoing Socio-Economic and Caste Census, which is expected to throw up the latest poverty estimates, is highly flawed.

“The NSSO data is unreliable and the SECC is highly flawed,” said Saxena.

The National Advisory Council (NAC) was set up as an interface with civil society. The NAC provides policy and legislative inputs to the government with special focus on social policy and the rights of disadvantaged groups.

After the government faced flak over its latest poverty estimates, according to which anyone earning over Rs 28 per day in urban areas and Rs 26 per day in rural areas is not poor, Prime Minister Manmohan Singh said a multi-layered approach is required to assess poverty as the widely accepted Tendulkar committee report “is not all inclusive”.

The government now plans to set up another expert panel to devise a new methodology to assess poverty levels in the country, said the prime minister.

The government recently revised its poverty estimates from earlier Rs 32 per day in urban areas and Rs.26 per day in rural areas based on 2011 prices, to the current estimate which is based on 2009 prices.

Using the Tendulkar panel report, the Planning Commission pegged poverty at 37.5 percent of the population.

Saxena said in reality out of about 200 centrally sponsored schemes, only 5 or 6 are linked to the poverty estimates, pegged at 37.5 percent by the Planning Commission.

Having a realistic assessment of poverty in not only crucial for the government to ensure that around Rs 80,000 crore that it spends on various welfare schemes annually reaches only the genuinely poor, it is also important for the United Progressive Alliance which hopes to roll out the ambitious National Food Security Bill, which aims to provide subsidised rations to around 65 percent of the 1.2 billion population some time next year.


AFSPA has to go: Human Rights Watch’s Kenneth Roth

Human Rights Watch executive director Kenneth Roth, who has headed several human rights investigations and missions around the world, was in Mumbai to address an Observer Research Foundation talk on ‘Human Rights in the Changing World Today.’Yogesh Pawar caught him on the sidelines of his talk. Excerpts from an interview:

Some say that by voting for a US-backed resolution urging Sri Lanka to probe rights abuses in the war with the Liberation Tigers of Tamil Eelam (LTTE), India has only ended up pushing the island nation further into China’s arms?

Short term geo-strategic gains can’t be weighed against the long term right thing to do. We were quite confident India would come on board given the huge domestic sentiment in favour of such a move. In the last stages of the war, the Sri Lankan army indiscriminately shelled the Tigers trapped on a beach. Along with them, 40,000 civilians were also killed. These are substantial war crimes. Surely India wouldn’t have wanted to align itself with this brutality.

India has also been in a bind with other neighbours like Myanmar (Burma) as it has been unsure how much geo-strategic depth it can sacrifice for human rights concerns.

And to what avail? Today Chinese FDI in Myanmar is over 40% and India’s is a mere 2%. India realised the importance of engaging with the army since rebel groups in the North East were using Myanmar as a base. Having said that, creating pressure for a functional democracy, however, continues to remain important.

I would say current accelerated changes are being driven by the junta’s fears of an Arab Spring contagion. Mere gestures like releasing Aung San Suu Kyi will not help. The army just wants to change its clothes for civilian ones, leverage how Suu Kyi has reached the parliament and then demand for international sanctions to be dropped. India has a big role to play in the days to come if we want the change to be more than cosmetic.

How is that?

Already the junta has been unhappy about being under so much Chinese influence that Myanmar had almost become a Chinese province. The cancellation of the $3.6 billion China-funded Myitsonedam contract in September last year was the first sign of this change. India can use this opportunity to work with its neighbour and prevail upon it to accelerate the democratic process.

But many feel India’s own track record on human rights is not very good…

It is true that there are huge concerns in Kashmir, the North East, Central India and Gujarat. We continue to work closely with the Indian government on all these issues. This should not, however, take away from India’s role in the global human rights movement. We have seen India taking strong human rights positions in South Africa, in Myanmar, and now Sri Lanka and Syria, as well as for Tibetans. As a growing power it has emerged as a significant voice on the global stage.

You mention Kashmir and the North East. There has been a lot of criticism of the role of the armed forces in both these regions.

At Human Rights Watch we believe in working with both the government and those on the other side. There are human rights excesses from both sides which evoke concern. Having said that, there can be no two ways about the fact that the Armed Forces (Special Powers) Act (AFSPA) has to go. We continue in our efforts to persuade India and hope it sees our point.

What about the situation in Pakistan?

There is a lot to be concerned about in Pakistan which seems to be going through a state of flux. The honour killings and the blatant misuse of the anti-blasphemy laws against minorities is of grave concern and we want the government there to urgently address this.

There is a feeling in the sub-continent that the West has double standards on human rights. It raises this bogey as and when it suits its own interests.

It is a charge that is hurled at us often. Particularly by dictators who want to deflect attention from their own wanton disregard for human rights. It is very convenient to turn this into a North-South ‘us and them’ debate.

We have been, for example, very vocal in our opposition to the US’ policy of extraordinary rendition. We have got the European Union to back us on this opposition to picking up foreign nationals suspected of involvement in terrorism to detention and interrogation in countries where federal and international legal safeguards do not apply.

But the West seems to have no problems doing business with China despite its human rights track record…

This is exactly why so many dictators cite China’s model of development. Despite its magnificent rise as an economic superpower, there are huge problems with the way China has grown. There is a dark underside to the Chinese miracle. History has proven again and again that such model cannot be sustainable. In comparison, India represents a more accountable way of governance.As a vibrant democracy, India has demonstrably shown that its concern for human rights is not a western import.

What is HRW’s assessment of the current situation in Syria?

It is disastrous. Syrian forces are using military means against an opposition that is itself increasingly armed. A lot of the violence from the Syrian security forces is still directed at peaceful demonstrators. And much of the deaths are of peaceful protesters who want democracy.

Russia and China block most efforts by the international community, from the prosecution of the Assad regime by the ICC to a condemnation by the UN Security Council to the peacekeeping plan proposed by the Arab League. In light of the ongoing violence in Syria what would you say to Moscow and Beijing?

I find that those vetoes, which were really led by Russia and China followed up represent a callous indifference to the lives of Syrians. It is like playing global politics at their expense. Clearly Russia is concerned that the Assad regime is its last remaining friend in the Middle East and North Africa apart from being a major purchaser of Russian arms. Russia seems to look at the fight for democracy in the region through the lens of the Cold War. We hope Russia is widely condemned for this. This is not the way a permanent member of the UN Security Council should act.

DNA Article here


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