One-sided deal: Hospitals get but don’t give back


Hospital, Bandra

Hospital, Bandra (Photo credit: Wikipedia)

Grants, concessions and exemptions given to the hospitals far exceed the cost of free treatment they are asked to carry out

Jyoti Shelar and Lata Mishra, in Mumbaimirror

Posted On Thursday, April 26, 2012

The death of accident victim Reena Kutekar, whose husband Ram desperately hunted for a hospital that would save her life, has brought into focus how badly poor patients are treated in private medical facilities across the city.

Reena was first taken to Vile Parle’s Nanavati Hospital, where the authorities refused to take her into the ICU because Ram could not furnish the Rs 25,000 required for admission.

The story in most other hospitals in the city is alarmingly similar: though they are required by law to treat a certain number of economically backward patients, most people come away empty handed in their time of need.

The contention of the hospitals – from Jaslok to Breach Candy, from Lilavati to Hinduja – is that taking care of poor patients is a huge burden on them, and that they are asked to provide free treatment for nothing in return.

What these hospitals fail to reveal, however, is that the grants and concessions they are given by the government far exceed the cost of free treatment they are being asked to carry out. Running as charitable public trusts, their list of unaccounted-for exemptions is staggering:

1. Cheap land

If any charitable trust wants government land to build a hospital, it is charged only one-tenth of the market value in the island city, and one-twentieth of the market value in the suburbs. If the land is on lease, the price can be as low as Re 1 per square foot per year.

“Several facilities, such as Jaslok, Hinduja and Bombay Hospital, are on government land given to them on a Re 1 lease. Now they’re earning crores annually but still make excuses when it comes to treating poor patients,” said advocate Sanjeev Punalekar, who had filed a PIL on the issue in 2004.

2. Extra FSI

While the rest of the city’s commercial establishments have to make do with an Floor Space Index of 1.33 to 2, public trust hospitals get an additional FSI of up to 5.32 in the island city and up to 5 in the suburbs.

The FSI determines the height of the structure, which in turn translates into more room for patients, and more business. But the taller hospitals have hardly been of help to poor patients.

“The additional FSI and all other rebates come from the government. The rest of the money comes from patients. Ultimately, it is the government and public money that adds up to the surplus funds of hospitals,” said health activist Leni Chaudhary. “Then why not ensure that poor patients get treated?”

When contacted, Dr Pramod Lele, the CEO of the Mahim’s Hinduja Hospital, admitted that additional FSI proved beneficial in increasing the hospital’s “bed- strength”, but contented that they were asked to pay a premium for it. Not the best argument considering the demand-supply ratio of hospital rooms guarantees that this money is easily recovered.

3. Income Tax rebate

The exact rate of exemption varies from hospital to hospital, depending on how much money it makes. On average, however, 85 per cent of a public trust hospital’s income is exempt from tax. Even the remaining 15 per cent can be set aside as a corpus fund, ensuring that most hospitals have to pay no tax at all. The only catch is that anything accumulated above this 15 per cent in their account is taxable. Hospitals registered as research institutes are given similar concessions.

4. No Octroi

While Octroi rates in Maharashtra are inordinately high, hospitals are exempted from any additional tax for transporting equipment and machinery. In 2003, the BMC withdrew Octroi exemption from a few hospitals for not doing enough charity work. When contacted, a senior doctor from Lilavati hospital agreed that there had been several complaints made to the Charity Commissioner about norms being flouted, which had resulted in some rebates being pulled back for certain hospitals.

5. Duty free

All public trust hospitals are exempted from customs duty on imported machinery and medical equipment, as opposed to 10 per cent for all non-public-trust hospitals. When contacted, Customs officials said machinery and medicines from abroad were one of the most common items brought into the country. “As per the law, we clear them immediately,” an officer said.

6. Cheap Medicines

Hospitals procure generic drugs at nominal costs, and several medicines which are made available by the government under various programmes such as Tuberculosis and Malaria eradication are given to them at a fraction of the cost. However, health experts point out, that these drugs are then sold to patients at the market rate.

7. Low water and electricity rates

Despite being commercial establishments, hospitals are charged residential tariffs for water and electricity, which in itself is a huge benefit. The Residential rate for water per 1,000 litres, for example, is Rs 2.25 as opposed to Rs 38 for commercial use.

 What hospitals are supposed to do 

According to a Supreme Court judgment, charitable hospitals must admit a patient brought in an emergency and provide “essential medical facilities” until stabilisation. Transportation to a public hospital should be arranged, if necessary, and no deposit should be asked for.

Each hospital has to transfer 2 per cent of its income to an Indigent Patients Fund (IPF). The hospital has to reserve 10% of its beds for indigent patients (annual income less than Rs 25,000) who should be given free treatment.

A further 10% of its should be reserved for economically weak patients (annual income less than Rs 50,000) who should be treated at concessional rates. At the time of admission, all a patient has to provide is a certificate from the Tehsildar or a ration card or BPL card.

13 policemen will face trial for charges of gang rape in the case of Vakapalli tribal women #Rape #Vaw



 AP High Court orders that 13 policemen will face trial for charges of gang rape in the case of Vakapalli tribal women.

The Vakapalli rape case has been coming up for hearing in the Andhra Pradesh High Court since the last three weeks.

Justice Seshasayana Reddy of the AP High Court on Thursday directed a lower court to conduct the trial against 13 cops for allegedly raping 11 tribal women in Vakapalli village of Visakhapatnam district in August 2007. The judge told the judicial first class magistrate of Paderu to conduct an identification parade of the accused and then proceed against them. The judge gave the verdict after hearing the plea of 21 policemen who sought quashing of proceedings against them in the crime.

Justice Seshasayana Reddy ruled that eight policemen who were part of a Contour Party were outside the village at the time of the offence and could not have committed the crime. It was alleged that the 11 tribal women were raped by the armed cops when they visited the place during combing operations against Naxalites on August 8, 2007. Earlier, the Crime Investigation Department had investigated the case and closed it citing lack of evidence. The victims challenged it before the magistrate and he ordered an investigation. The HC stayed the probe and the victims then approached the Supreme Court. The apex court in November 2010 asked the High Court to hear the case within six months.
While discharging the eight constables P. Ravi Kumar, K. Purnachander Rao, P. Pavan Kumar, B. Gangadhara Rao, K. Ram Babu, Ch. Suresh Babu, G. Muthyala Raju and S. Venkata Rao from the case, the judge directed judicial first class magistrate of Paderu to conduct proceedings against A. Ravi Kumar, D. Ravi, B. Ravi Kumar, D.V.R. Suresh, R. Srinu, K. Devullu, T. Prasad, Ch. Vijaya Kumar, S. Tata Babu, D. Simhachalam, R. Chandrasekhar, R. Devanadh and S. Srinivasa Rao.

Contempt case on CID chief


The High Court will hear an appeal on Friday by the CID challenging an order of a single judge directing the Registry to issue suo motu contempt proceedings against the CID chief S.V. Ramana Murthy. Earlier, Justice Ramesh Ranganathan granted an order by directing the registry to issue contempt proceedings against the DGP V. Dinesh Reddy and Ramana Murthy for suppressing facts before the court in a plea filed by senior IPS officer Umesh Kumar.

It may be recalled that in August 2007 eleven tribal women belonging to the tribal hamlet Vakapalli, Paderu Mandal, Visakhapatnam district were raped by twenty one police men who had come to the village as part of combing operations. The local police station and several functionaries of the government denied the charges of rape. Large scale mobilization by tribal and women’s groups forced the state to order an investigation by the CB-CID. However, the CBCID conducted a lackluster investigation and filed a report that it was a false case. Its main contention was that there were no injuries on the women, no semen stains and that the women were unable to identify the accused. Despite the negative report of the police, a junior woman magistrate of Paderu believed the tribal women and took cognizance of the case. The Magistrate wrote that rape can be perpetrated without leaving physical injuries and semen stains.   Within a week of the cognizance taken by the Magistrate, the accused police men petitioned the AP High Court and obtained a stay of proceedings. This stay came in 2008 and all proceedings came to a halt. After four years, the case has now come up for final hearing before Justice Seshasayana Reddy. Both the public prosecutor as well as the counsel for the policemen repeated in unison the same arguments about absence of injuries and medical evidence of sexual intercourse.

Senior Counsel Tarakam who appeared for the tribal women vehemently contended that absence of injuries and semen stains can be no bar for prosecution. How can eye witness evidence be disbelieved just because there was no medical evidence? He insisted that the court should believe the statements of the women in toto. He also argued that the victim women should not be made to bear the brunt of a deliberately defective investigation. One was not sure about the outcome of the case. Clearly, except oral testimonies, there was no other evidence.

What little evidence that was available was wiped out by the investigation. Against all these odds, Justice Seshasayana Reddy ordered in the women’s favour. Of the 21 policemen, he held that the trial will continue against 13 policemen and acquitted eight others. The eight were acquitted on the ground that they were part of a contour party and outside the village.

The 13 policemen will now have to face trial for charges of gang rape and atrocities under the SC ST Atrocities Act. The trial will not start immediately. The policemen will surely move the Supreme Court for another round of litigation.   But, as of today, there is the satisfaction of having convinced one judge that such stuff happens and that a ‘judicial decision’ has to be rendered with minimal evidence.

Aadhaar card scam unearthed in Hyderabad #UID #Nandan Nilekani


200 px

200 px (Photo credit: Wikipedia)


Mahesh Buddi, TNN | Apr 27, 2012

HYDERABAD: Raising serious security issues over Aadhaar cards, an enrolment agent has processed 30,000 unique indentity cards (ID) within a span of just six months in the Old City. Also, among them 800 were enrolled under the physically-disabled persons category. However, a probe by investigating agencies revealed that the Aadhaar cards registered under the physically-disabled category were created with fake identities.

The civil supplies department, which is the nodal agency for rolling out Aadhaar cards in the state, had assigned the task of enrolling citizens to eight companies, including Infrastructure Leasing & Financial Services Limited. The fraud was committed by infrastructure major IL&FS’s data entry supervisor of the Old City, whose first name, according to civil supplies department sources, is Mohammed.

On April 20, the state government authorities became suspicious about the fraud as the agent had registered details of 30,000 people for Aadhaar card in a span of just six months, which would normally take two years. On scrutiny, they found that 800 enrolments were under the physically-disabled quota, where a person is without either fingers or eyes.

The uniqueness of Aadhaar card is inclusion of iris scan and fingerprint details in the card’s micro chip. However, to include those without fingers and eyes, an option has been provided in the enrolment process, where it would be declared that the candidate does not have fingers or eyes. As Aadhaar card would not have these details printed on the card, it would become easy for the fake user to utilize the card to get essential identification documents like a passport.

Based on the government’s directions, the Charminar police have conducted a probe into these physically-disabled Aadhaar card holders and found out that none of those candidates reside at the given addresses and their other details were also fake. After the probe, the civil supplies authorities were informed and they gave the go ahead to book a case against the supervisor.

On Thursday, police booked cases under sections 468, 471, 419, 420 and 120-B of the IPC against Mohammed. As police began probe into the activity, he fled from the city a few days ago.

However, a special team nabbed him in Mumbai. He would be brought to city soon. “We are looking into the possibility that all the 30,000 Aadhaar card registrations made by him could be fake and the main challenge is to know for whom he did it and what purpose,” a police officer said.

Immediate Release-US’ reaffirmation of visa denial to Modi welcomed by IAMC


Narendra Modi in Press Conference

Narendra Modi in Press Conference (Photo credit: Wikipedia)


FOR IMMEDIATE RELEASE

Tuesday April 26, 2012

The Indian American Muslim Council (http://www.iamc.com) an advocacy group dedicated to safeguarding India‘s pluralist and tolerant ethos today welcomed the US State Department‘s reiteration of its position on the issue of a US visa for Chief Minister Narendra Modi.
In a letter to Secretary of State Hillary Clinton, Congressman Walsh had called on the US government to lift the ban on issuing a US visa to Mr. Modi. On April 25, 2012, the State Department’s spokesperson Victoria Nuland responded to questions from reporters on Congressman Walsh’s letter. “Our position on the visa issue has not changed at all,” Ms. Nuland stated categorically, reaffirming the government’s position that Mr. Modi continues to remain inadmissible under current US law. Section 212 (a)(2)(g) of the Immigration and Nationality Act, makes foreign government officials ineligible for a visa should the State Department deem them complicit in severe violations of religious freedom.
Mr. Modi is the prime accused in a case filed by human rights organization “Citizens for Justice and Peace” and Gujarat carnage survivor Mrs. Zakia Jafri, where he is accused of conspiracy to commit mass murder, to influence the course of public justice and to destroy public records. An amicus curiae appointed by India’s Supreme Court has found sufficient evidence to charge and prosecute him for the carnage in 2002 that resulted in the killing of over 2,000 people and the displacement of over 150,000.

“Even after the horrific pogrom in Gujarat 2002, there has been no reprieve for the minorities in Gujarat. The continued violations of religious freedom in the state, in the form of extra-judicial killings, pathetic living conditions of people displaced since 2002, as well as economic discrimination against minorities reflect the culture of impunity cultivated by Mr. Modi and his administration,” said Mr. Shaheen Khateeb, President of IAMC. “The State Department’s refusal to reconsider the ban on Modi’s visa should also be seen in light of the ongoing struggle to secure justice and reparation for the victims of the Gujarat carnage of 2002,” added Mr. Khateeb.

IAMC has called upon India’s Supreme Court to look into irregularities in the functioning of the Special Investigation Team (SIT) appointed by the Court and to ensure that the masterminds of the Gujarat pogrom of 2002 are brought to justice.

Indian American Muslim Council is the largest advocacy organization of Indian Muslims in the United States with 10 chapters across the nation.

For more information please visit our new website at www.iamc.com.

RELATED LINKS:

No change in visa policy on Narendra Modi: US
US Department of State – Foreign Affairs Manual Volume 9

US lawmaker asks Clinton to reconsider decision on visa to Modi

http://www.indianexpress.com/news/us-you-will-have-to-give-him-a-visa/941328/

Gujarat 2002 – The Full Coverage

http://www.tehelka.com/story_main35.asp?filename=Ne031107gujrat_sec.asp

“We have no orders to save you” – Report by Human Rights Watch

http://www.hrw.org/legacy/reports/2002/india/

Concerned Citizens Tribunal – Gujarat 2002; An Inquiry into the Carnage in Gujarat

http://www.sabrang.com/tribunal/volI/index.html

 

Contact:
Zafar Haq
phone/fax:  1-800-839-7270
email: info@iamc.com

Address:
6321 W Dempster St. Suite 295
Morton Grove, IL 60053
phone/fax: 1-800-839-7270
email: info@iamc.com

Immediate Release-Shyam Benegal Sanctions 25 Lakh From MP Fund for Differently-Abled People


by Adapt (Able Disabled All People Together) on Thursday, 26 April 2012 at 19:38 ·

~ Innauguarates facility from the funds he provided at ADAPT, Bandra centre ~

Mumbai, 26th April, 2012: Every Member of Parliament in India is given Rs. 5 crores every year under the MPLADS – Member of Parliament Local Area Development Scheme for him/her to use for public welfare. Film director Shyam Benegal, whose 6 year term as MP ended on 15th of February this year, sanctioned 25 lakh from the MP fund for the procurement of aids and appliances for differently-abled people at the Able Disable All People Together (ADAPT, formerly the Spastics Society of India) centre at their Bandra centre.

Dr. Mithu Alur (centre), Founder Chairperson, ADAPT & Mr. Shyam Benegal helps to fix the harness of a child with disability from Dharavi, whose wheelchair has been brought by the fund provided by Mr. Benegal when he was a Rajya Sabha MP. He gave 25 lakh to ADAPT – Able Disabled All People Together (formerly the Spastics Society of India) from the MPLAD Fund – Member of Parliament Local Area Development Fund which got this child her wheelchair.

 

The funds provided by Mr. Benegal have been used to get equipments for the Greenstone Digital Library Unit; the Therapy Aids and Appliances Unit; the Audiology, Speech therapy and Communication Aids Unit and the Strengthening and Fitness Training Unit. These units were inaugurated by Mr. Benegal today as ADAPT celebrates its Annual Day. The chief guests for the occasion were Mr. Peter Beckingham, British Deputy High Commissioner and Ms. Sonal Desai, General Manager, CSR, HPCL.

Shyam Benegal and Mrs. Jill Beckingham, wife of the British Deputy High Commissioner Mr. Peter Beckingham, inaugurate the “Audiology, Speech Therapy & Communication Aids Unit” that has been made possible by the Rs. 25 lakh that Mr. Shyam Benegal gave to ADAPT – Able Disabled All People Together (formerly the Spastics Society of India) from the MPLAD Fund – Member of Parliament Local Area Development Fund while he was an MP of the Rajya Sabha.

 

“First of all I support all initiatives to do with children and adults with disability. Secondly ADAPT has been doing exceptionally good work for the last 40 years. So when the chance came to give them something back, I took it up. Unfortunately I could not give more than 25 lakh since that is the limit for NGOs,” Shyam Benegal said while inaugurating the centre today.

Dr. Mithu Alur, Founder-Chairperson, ADAPT said, “We went to Mr. Benegal with a request for funds to get some aids and appliances for our ADAPT centre in Mumbai. He told us to apply and send a proposal. When the need was confirmed, he sanctioned 25 lakh from the MP fund immediately. We didn’t even have to remind him about it. In a world where most of the MP funds meant to be used for welfare of the masses is rarely utilised by most MPs, it is heartening to see him being so proactive. If most of the MPs and MLAs were like him, this nation would be a much better place.”

Shyam Benegal & Mrs. Sonal Desai, General Manager, CSR-HPCL with Mrs. Jill Beckingham, (wife of the British Deputy High Commissioner Mr. Peter Beckingham) in the back ground inaugurate the “Therapy Aids &Appliances Unit” that has been made possible by the Rs. 25 lakh that Mr. Shyam Benegal gave to ADAPT – Able Disabled All People Together from the MPLAD Fund – Member of Parliament Local Area Development Fund while he was an MP of the Rajya Sabha.

 

The investment of the money done on the centre, will end up helping hundreds of children and adults with disability who avail of the facilities in the ADAPT centre.

About ADAPT:

ADAPT (Able Disabled All People Together), formerly ‘The Spastics Society of India, was founded by Padmashri Dr. Mithu Alur in 1972. From a special school with only three children, it has grown to become one of the foremost non-profit organizations in India providing services like assessment, therapy, counseling, inclusive education, skill training and job placement to thousands of children and young adults with disability and their families. Today ADAPT has evolved to become a seminal organization that interacts with national and international organizations, public & private sector bodies and government agencies at all levels to influence policy changes that impact marginalized groups across the country. In 2012 ADAPT is celebrating four decades of serving the nation through various programs.

For More Details  Please Contact: 

 

Bhavana Mukherjee: +91 9833179394

Madhavi Kumar: +91 9867661821

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Immediate Release on protest by blind workers


Press Release on protest by blind workers outside the residence of Minister of Social Justice and Empowerment

April 26, 2012

by Blind Workers Union
24.04.2012

Today, large numbers of blind workers collected outside the residence of the Minister of Social Justice and Empowerment, Shri Mukul Wasnik. These workers have met the concerned Minister, as well as officials in the Ministry of Social Justice and Empowerment on several occasions since November 2011. However, the deep rooted concerns of blind workers lay un-addressed. Today, when the blind workers initially gheraoed the residence of the Hon’ble Minister, he did not meet them, and left his residence in haste. This response once again convinced the blind workers that the Government is least concerned about providing adequate employment to the blind, as well as protecting the basic labour rights of blind workers employed in the private sector. However, undeterred by the Minister’s initial decision not to entertain a delegation, the blind workers continued to sit outside the Minister’s residence in the scorching April heat. The militant protest finally led to some dialogue as the K.M. Acharya met with the workers’ delegation. Following a lengthy discussion between Shri Mukul Wasnik and officials in the Ministry, the Ministry finally agreed to provide alternative employment at a government-supported institute, to all the blind workers retrenched by the NGO, National Federation of the Blind (NFB).

Since November of last year, the blind workers have been protesting the retrenchment of several blind workers by the NFB. This NGO retrenched the workers because they were speaking out against denial of minimum wages and other basic labour rights in the Training and Rehabilitation Centres (TRCs) run by the NGO. However, the struggle of the workers is not just against the NFB, but also against the overall exploitation of blind workers across the country by private companies and NGOs. In the interest of availing of certain benefits like tax exemption for employing persons with disability, the private sector is known to employ yet brutally exploit disabled persons. The arbitrary hiring and firing practices, unregulated working hours, etc. prevalent in the private sector, amount to a serious breach of social justice, which is why the bind workers have been approaching the Ministry of Social Justice and Empowerment. More importantly, the workers realize that the failure of successive governments to provide adequate employment to the blind community is the main reason why blind workers are dependent on the highly exploitative private sector. Hence, their struggle is based on the fundamental right to a livelihood—a right the Government is to protect and uphold. The three specific demands that the workers sought to discuss with the Minister were:

(i) Inclusion of a special section in the long pending Bill on the Rights of Persons With Disability (2011), which would safeguard the economic rights of blind workers employed in the private sector. For example, the Bill should include provisions to the effect that bodies violating basic labour rights will be penalized to the effect that NGOs indulging in such violation will face the cancellation of their registration.

(ii) That the Ministry of Social Justice and Empowerment tables a concrete plan of greater job creation for blind persons in the public sector. It is only with the provision of more government jobs that the dependence of blind workers on exploitative private companies and corrupt NGOs can be overcome.

(i) That because the Ministry has failed to curb the blatant violation of labour rights by the National Federation of the Blind (NFB), it should ensure that all the disabled workers employed by NFB be provided alternative employment by the Government.

As the situation stands, the Ministry of Social Justice and Empowerment has conceded the third demand of the blind workers. With respect to the first and second demand, the Ministry has asked the Blind Workers Union (BWU) to provide a concrete plan which can be subsequently discussed and implemented.

Thanking you,
Alok Kumar, Ramnath
(On Behalf of Blind Workers Union)

“I ran with my dying wife from Nanavati to Cooper to KEM to JJ “


I ran with my dying wife from Nanavati to Cooper to KEM to JJ

A poor man’s damning testimony of our emergency services

Lata Mishra and Jyoti Shelar

Cover story Mumbai Mirror

This newspaper has run a series of stories on the hit and run accident that led to the death of the wife and unborn child of a construction labour in Juhu.

The circumstances that led to the accident; the police’s hunt for the mystery man who dropped Ram and a bleeding Reena Kutekar to the hospital but fled soon after; and finally, his surrender ten days later at the insistence of his family after they had read about it in Mumbai Mirror.

But there is a larger story that still remains to be told.

Ram Kutekar’s desperate hunt for a doctor and hospital that would save his wife’s life, and his frantic 16-hour journey from Nanavati to Cooper to KEM to JJ Hospital across Mumbai puts the spotlight on everything that is wrong with emergency medical services in the city. And why its poor can never bank on them.

• First, Nanavati Hospital refused Reena the operation she so urgently needed because her husband, a daily wage worker, couldn’t put together a deposit of Rs 25,000 (He was falling Rs 10,000 short, which he promised to raise as soon as he could).

• At Cooper Hospital, the next stop, there was no CT scan facility which meant Reena had to be taken to a private clinic close by leading to precious loss of time. The results showed Reena had suffered serious head injuries and needed urgent surgery.

• But Cooper had no neurosurgeons on call at the time, so Ram was asked to take his wife, battling for her life, to KEM Hospital in Parel.

• At KEM, there were no beds available in the ICU. Ram was told to head to JJ Hospital.

• By the time Reena was put on a ventilator at JJ, it was 11 pm. The neurosurgeon that operated on her told Mumbai Mirror she was in critical condition when she was brought in – “her brain was swollen, her blood pressure had dropped alarmingly”.

Reena – five months pregnant – died three days later. The baby inside her, doctors said, had died one day before her.

“It’s not just that young man who killed my wife,” says Ram Kutekar sitting in a cramped room in a Vile Parle chawl. “The doctors are equally responsible.”

In the Hipporcatic Oath which all doctors have to swear by before their passing out, there’s a line that reads so: “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”

There is also a Supreme Court directive that says emergency patients must enjoy all the rights of a consumer even before they pay any money to hospital. Nanavati management, however, insists the hospital flouted no norms, as it was only at the second level of treatment that they asked for the deposit. “We admitted the patient, thoroughly examined her, and concluded she needed ICU care,” Dr Ashok Hatolkar, Medical Superintendent at the hospital, said. “Our policy clearly states that a deposit of Rs 25,000 has to be paid upfront for an ICU admission.”

The distinction between the first and second line of treatment is specious. Reena Kutekar was examined merely physically. There were no tests run to gauge the extent of her concussion. Tests she needed urgently and which, as later events proved, could have saved her time.

“I remember waiting nervously at the reception as Reena was taken for a preliminary examination. Then the doctors told me she would have to be shifted to the ICU. This was at around 8.30 am… the nurse came around and asked for a deposit of Rs 25,000.”

Ram had around Rs 200 on him, and Siddharth Pandya – the man who had been behind the wheel, and who had dropped them to the hospital – was his only hope. He spent 20 minutes looking for him… in the car park, in the washrooms. By this time, Ram was joined by his brother Sachin, and sister-in-law, who he had asked to rush to the hospital with as much cash as they could manage. “We were still falling short by over Rs 10,000,” he says, “I pleaded with the doctors to not stop the treatment, while I arranged for the money.”

Instead, Nanavati provided Ram with an ambulance – for which he paid Rs 600 – to take them to Cooper Hospital. “By the time we got there at noon, my wife’s condition was deteriorating, I was told that she was bleeding internally, and that the injuries to the head could prove fatal.”

Following the CT scan at a private clinic, which cost Rs 3000, Reena was put on a ventilator and Ram was asked to wait. At around 4 pm, the Cooper authorities said no neurosurgeon was available, and suggested Ram take his wife to KEM Hospital in Parel. “All this time, I kept telling myself that the doctors knew best; that my wife was in safe hands and that she would be alright. I followed their instructions, ran from Nanavati to Cooper to KEM. I told the doctors that they were like gods, and that they had the power to save my wife and our unborn child. They kept saying, ‘don’t worry, just take her to so-and-so hospital’,” he says.

By the time the couple reached KEM, more than eight hours had passed since the accident, and here they encountered the most common problem poor patients face in Mumbai: No beds. “I was told there was a long waiting list, that the ICU was packed beyond capacity. The authorities asked me to try my luck at JJ Hospital,” he says. Yes, the words emergency medical services and luck are closely linked in this city, and unfortunately, the Kutekars had none.

While Reena was operated upon at JJ, she passed away three days later. When Mumbai Mirror spoke to neurosurgeon Velu Varnan, he said she had been brought there in “extremely critical condition”.

Nanavati Hospital authorities say they “sympathised” with the victim’s family, but add that they were “helpless” under the circumstances. Medical Superintendent (Nanavati Hospital) Dr Ashok Hatolkar said, “We never flouted any directive. From our end, we did everything we could to help the victim. We only asked for the deposit at stage two, which is ICU treatment and surgery. It is unfair to blame the hospital for the death. We treat poor patients who ahve requisite documents but can’t treat everybody as we don’t get funds from the government.”

Ram, who earns around Rs 4,000 a month working as a daily labourer, says Reena supplemented the family’s income by working as maid. “Just a few days before the accident, I had told her to stop working as she was more than five months pregnant. In a matter of hours, my family was gone.”

On paper there are several schemes to enable the poor patients to take treatment at the private hospitals. The newest of them all is the Rajiv Gandhi Jeevan Dayi Yojna that promises free treatment for over 972 ailments. The problem is, none of the private hospitals want any part of it. These hospitals feel that the price list offered by the government is extremely low and they want a better price to be a part of the scheme. Medical superintendent of south Mumbai’s Jaslok Hospital, SK Mohanty, says, “We had agreed to be a part of the scheme assuming that the rates would be fair if not at par with our charges. But the rates are so low that we would have to bear huge losses if we agreed to be a part of this scheme.”

For instance, the state has set the cost for a bypass surgery at Rs 1.30 lakhs while packages at most hospitals are above Rs 1.65 lakhs. For an angioplasty, the state has set the cost to Rs 50,000 while the actual packages range from Rs 1 lakh and above depending on the make of the stent.

“We need a viable policy or else we won’t be able to run our hospitals with the new scheme. Also, the government should not force us to be a part of this scheme and it should be left to us to sign the agreement or not,” says president of Association of Hospital (AOH), Dr Pramod Lele.

The hospitals say that they already need to keep 10% of their beds reserved under the Bombay Public Trust Act (1950) for the poor. In addition to this, they have to set aside 2% of their revenue as an Indigent Patients Fund (IPF) for subsidising treatment for poor patients. If they are asked to be a part of this new scheme as well, they will not be left with any profits.

The IPF is yet another scheme aimed at benefiting those below poverty line which has hit a roadblock, again due to the negative response from these hospitals.

In this case, private hospitals claim that they were not properly explained the details of the scheme. “We were under the impression that the state will pay us some minimum amount under the scheme for the two per cent indigent patients that we already treat as per the charity commissioner’s rule. However it turned out that we were expected to treat yet more poor patients,” says a senior doctor attached to a private hospital on condition of anonymity. “We will suffer losses running into crores of rupees if we start doing charity this way,” he adds.

The government on the other hand had already collected a database of over 2 crore people across the state who will be benefited under the scheme. While earlier, the state had made it optional for the private hospitals to join the scheme, recently they announced a compulsory reservation of beds under the scheme. Early this month, health minister Suresh Shetty requested the chief minister to consider withdrawing the compulsion.

Last year, more than 14,000 people were benefited under the scheme and the state spent over Rs 110 crores. However, the scheme covered only four diseases and several hospitals complained about delay in payments.

(With inputs from Santosh Andhale)

Fake Kahaani to embrace motherhood! #Surrogacy


, TNN | Apr 26, 2012

AHMEDABAD: The artificial stomach Vidya Balan sported in the film ‘Kahaani‘ was the surprise element in the climax. In real life, the fake tummy is commonly used by women opting for surrogacy to have a child but want their families to believe they are the one’s carrying that bundle of joy!

Many women from traditional communities can’t tell their in-laws and extended families that they have employed a surrogate and instead walk around with strap-ons for nine months to simulate a pregnant stomach.

In an extreme case, a gynecologist couple chose to have an incision on the stomach of the wife with sutures so that it looked like a caesarean section. An artificial stomach would not have worked in their case as there were many doctors in the family who are more difficult to deceive.

Surrogacy expert from Anand Dr Naina Patel says an IIT-graduate couple from Chennai opted for an artificial stomach as the woman wanted to avoid the disapproval of her in-laws. “She did not have a uterus and her in-laws would never have accepted that the child was born through another’s woman’s womb,” says Patel.

Hema Inamdar, a soft toy maker, specializes in fake tummies. “A woman called from the UK saying she felt she was actually carrying a baby when she wore the tummy,” says Inamdar. One can get artificial stomachs in sets of three. The first set simulates three, five and seven months pregnancy. The other set simulates five, seven and nine months, with one set costing roughly Rs 1,000.

Fertility expert Dr Falguni Bavishi says NRI women too succumb to familial pressure. “A Gujarati woman in the US took artificial tummies with her after employing a surrogate, so that her in-laws would believe she was pregnant. She told them that she had to deliver the baby where the IVF treatment was done, got the baby from the surrogate and went back, her secret intact,” says Dr Bavishi.

Private sector censors- If business decides what’s ‘good’ and ‘bad’ speech what will happen ?


Private sector censors
If business decides what’s ‘good’ and ‘bad’ speech, it can lead to multiple interpretations and arbitrary decisions

Here, There, Everywhere | Salil Tripathi, Livemint.com

 In Milan Kundera’s 1967 Czech novel, Žert (The Joke), Ludvik Jahn sends a postcard to an intense classmate who takes herself too seriously. In the card, he makes sarcastic comments against the Communist Party. Unsurprisingly, others don’t see the joke. He gets expelled from the party, conscripted and has to work in mines.

While The Joke was a work of fiction, in the real Soviet era as punishment for such actions, many people lost jobs, sometimes their homes; some went to jail, often betrayed by those they trusted. In Czechoslovakia (as the country was then known), the state ran the postal service and those who read the postcard were party members. In India, the private sector provides Internet access and others don’t have the legal right to see what’s being transmitted, unless they are intended recipients, or if the material is broadcast publicly. The state now wants the private sector to police and censor the Internet.

 

 

 

Under the draconian Information Technology (Intermediaries Guidelines) Rules, 2011, any intermediary (a search engine, a website, a domain name registry, a service provider, or a cyber café) must take down the “offending” material from its website within 36 hours. The intermediary need not inform the person who posted the material, nor would the creator get the right to respond. As Apar Gupta points out on the Indian Lawand Technology Blog, in one recent case, based on these rules, an injunction has been granted. 

These rules go significantly beyond the existing restraints on speech. The Constitution limits speech and sections of the criminal code impose further restrictions. To that, add the IT rules’ vaguely defined terms of what can’t be said—content which is “grossly harmful, harassing, blasphemous, defamatory, obscene, pornographic, paedophilic, libelous, invasive of another’s privacy, hateful, or racially, ethnically objectionable, disparaging, relating or encouraging money laundering or gambling or otherwise unlawful in any manner whatever, harms minors in any way, or infringes any patent, trademark, copyright, or other proprietary right”. Who decides that? The intermediaries.

These rules make the private sector act like the state. Nobody elected business to play such a role; it does not have the expertise, capacity, legal training, or authority to act as the state. Censorship is bad; whether in state or private hands. If business decides what’s “good” and “bad” speech, it can lead to multiple interpretations and arbitrary decisions, without recourse to appeal. In a country where those who feel offended have often threatened violence, businesses will understandably take the cautious approach and not allow anyone to say anything that’s remotely controversial, even if it is an opinion about a film.

Decisions will be made on opaque criteria. Apple and Amazon have arbitrarily stopped some products from being sold on their electronic stores, citing “community standards”. Amazon stopped providing server space to WikiLeaks, even though no government had asked it to do so. Credit card companies stopped processing donations going to WikiLeaks, without any legal order. Even Google, which has admirably stood up to China’s bullying, has had to take down content when governments have required that it does so through proper legal channels. India’s record is poor: of the 358 complaints India lodged with Google, 255 were about content that was controversial or political, but not illegal.

To demonstrate the reach of the rules, the Centre for Internet and Society in Bangalore sent random notices to seven companies, asking them to take down content. Of them, six complied beyond what they were called upon to do—instead of the three pages that the centre asked for, one company blocked an entire website. A few legally worded letters were enough to get compliance from companies. The centre’s executive director, Sunil Abraham, told me recently: “Companies which have no interest in free speech are now taking these decisions. They have the power to do so and they are using it without any sense of responsibility.”

Aseem Trivedi knows this well. The cartoonist who ran a website called  cartoonistsagainstcorruption.com , found that his site had disappeared after a complaint from an individual that the cartoons violated laws. Since then he has been campaigning for freedom on the Internet. Everyone’s freedom is at stake—whether you want to see cartoons of Sonia Gandhi, Narendra Modi, Ramdev, Kisan Hazare, Binayak Sen, Arundhati Roy, Sachin Tendulkar, Poonam Pandey and even Mamata Banerjee. And yet look at what happened to Ambikesh Mahapatra, the professor who sent a cartoon mocking Banerjee to some friends via the Internet. He was arrested and later roughed up. These rules chill speech.

Last year, Kapil Sibal, minister for information technology, asked companies to screen content manually and censor the Web. The demand was audacious. It showed lack of understanding of how the Internet works and revealed fundamental ignorance of the state’s role: it has to protect the rights of the one who wishes to express and not the one who claims offence.

In Parliament, P. Rajeev, member of Parliament (Rajya Sabha), wants to annul those rules. Everyone should support him.

Salil Tripathi is a writer based in London. Your comments are welcome at salil@livemint.com

Female circumcision anger aired in India #FGM


By Rupam Jain Nair | AFP – Tue, Apr 24, 2012  AFP
  • A Muslim woman from the Bohra community ise seen outside a mosque in Mumbai. Over 1,600 Bohra Muslim women have signed an online petition calling for an end to the practice of female circumcision in the communityA Muslim woman from the Bohra community …
  • Ashgar Ali Engineer, a Bohra Muslim and expert on Islamic jurisprudence, poses for a photograph at his office in Mumbai. Ashgar has authored over 40 books proposing changes, particularly around the status of women in the community, in which female circumcision is commonAshgar Ali Engineer, a Bohra Muslim …

Eleven years ago, Farida Bano was circumcised by an aunt on a bunk bed in her family home at the end of her 10th birthday party.

The mutilation occurred not in Africa, where the practice is most prevalent, but in India where a small Muslim sub-sect known as theDawoodi Bohra continues to believe that the removal of the clitoris is the will of God.

“We claim to be modern and different from other Muslim sects. We are different but not modern,” Bano, a 21-year-old law graduate who is angry about what was done to her, told AFP in New Delhi.

She vividly remembers the moment in the party when the aunt pounced with a razor blade and a pack of cotton wool.

The Bohra brand of Islam is followed by 1.2 million people worldwide and is a sect of Shia Islam that originated in Yemen.

While the sect bars other Muslims from its mosques, it sees itself as more liberal, treating men and women equally in matters of education and marriage.

The community’s insistence on “Khatna” (the excision of the clitoris) also sets it apart from others on the subcontinent.

“If other Muslims are not doing it then why are we following it?” Bano says.

For generations, few women in the tightly-knit community have spoken out in opposition, fearing that to air their grievances would be seen as an act of revolt frowned upon by their elders.

But an online campaign is now encouraging them to join hands to bury the custom.

The anti-Khatna movement gained momentum after Tasneem, a Bohra woman who goes by one name, posted an online petition at the social action platform Change.org in November last year.

She requested their religious leader, the 101-year-old Syedna Mohammed Burhanuddin, ban female genital mutilation, the consequences of which afflict 140 million women worldwide according to theWorld Health Organisation.

Syedna Mohammed Burhanuddin is the 52nd Dai-al Mutalaq (absolute missionary) of the community and has sole authority to decide on all spiritual and temporal matters.

Every member of the sect takes an oath of allegiance to the leader, who lives in western city of Mumbai.

When contacted by AFP, Burhanuddin’s spokesman, Qureshi Raghib, ruled out any change and said he had no interest in talking about the issue.

“I have heard about the online campaign but Bohra women should understand that our religion advocates the procedure and they should follow it without any argument,” he said.

But over 1,600 Bohra Muslim women have since signed the online petition.

Many describe the pain they experienced after the procedure and urge their leader to impose a ban.

“The main motive behind Khatna is that women should never enjoy sexual intercourse. We are supposed to be like dolls for men,” 34-year-old Tabassum Murtaza, who lives in the western city of Surat, told AFP by telephone.

The World Health Organisation has campaigned against the practice, saying it exposes millions of girls to dangers ranging from infections, hemorrhaging, complicated child-birth, or hepatitis from unsterilised tools.

In the Middle East, it is still practised in Yemen, Saudi Arabia, Iraq, Jordan and Syria.

“It is an atrocity committed under the cloak of religion,” says Murtaza, who along with her husband was asked to leave their family home when they refused to get their daughter circumcised.

“My mother-in-law said there was no room for religious disobedience and we should move out if we cannot respect the custom,” she explained. “It is better to live on the street than humiliate your daughter’s body.”

Asghar Ali Engineer, a Bohra Muslim and expert on Islamic jurisprudence, has known the dangers of fighting for reform.

He has authored over 40 books proposing changes, particularly around the status of women, and has been attacked by hardliners inside a mosque in Egypt and had his house trashed by opponents.

While both France and the United States have laws enabling the prosecution of immigrants who perform female circumcisions, the practice remains legal in India and Engineer expects this to remain the case.

“Female circumcision is clearly a violation of human rights, the Indian government refuses to recognise it as a crime because the practice has full-fledged religious backing,” he said.

“No government has the courage to touch a religious issue in India even if the practice is a crime against humanity.”

He says many fathers are simply unaware of the damage they are doing by following the custom.

“I prevented my wife from getting our daughters circumcised but in many cases even fathers are not aware of the pain their daughters experience,” he says.

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