Why is Mumbai abandoning its civic hospitals? #Healthcare


 

 – Rediff.com India News

By deserting public hospitals we are dismantling our public health-care system, says Dr Sanjay Nagral. | Why is Mumbai abandoning its civic hospitals?

Read entire article >

Why is Mumbai abandoning its civic hospitals?

May 09, 2013 10:56 IST

By deserting public hospitals we are dismantling our public health-care system, says Dr Sanjay Nagral.

The recent story of babies with heart defects dying in Mumbai’s [ Images ] civic hospitals while the procurement of a heart-lung machine was delayed is tragic and shocking.

The heart defects in these toddlers were eminently correctable by timely surgery, which not only would have saved lives but also lead to a normal quality of life.

Unlike bypass surgery, which may add a few years to life, surgery for repairing congenital heart defects can translate into a normal healthy life span. Many readers are likely to have dismissed it as yet another chapter in the now familiar media exposes on the crumbling systems in Mumbai’s public hospitals. And we will all soon if we already haven’t forgotten about these babies and their cruel fate.

Mumbai’s civic hospitals boast of some of the oldest and finest cardiac surgery departments in the country. A lot of the early pioneering works in cardiac surgery in India [ Images ] –including the earliest successful heart operations — were performed at KEM Hospital‘s cardiac surgery department. Many of us who have trained in KEM’s surgery department have been beneficiaries of this great legacy.

Even today Mumbai’s civic medical colleges and hospitals are considered amongst the best in the country, both for undergraduate and postgraduate studies. Mumbai’s civic budget for health is one of the highest in the country and the teaching hospitals get a lion’s share of this.

So why is it that the purchase of a lifesaving heart-lung machine gets delayed for so long and it takes a newspaper expose for the authorities to respond?

Is it all about bureaucracy, red tape and indifference of some officials?

It is indeed tempting to think so for this is an easy, simplistic explanation. We can then momentarily feel sad, perhaps a little outraged, rationalise it and go back to the comfort zones of our daily lives. But there is more to it.

And that bit is not about some inefficient civic official, it is about you and me.

Public hospitals in Mumbai were once the heart of health-care in the city. Except for the few super rich who would seek services in a fringe private sector a large majority of the population including the middle class were treated in these hospitals.

Check with your parents and grandparents, and they will tell you this. Over the years a burgeoning private sector started attracting larger and larger sections of the population.

Today most people including the poor seek health care in the private sector which is perceived as ‘efficient’ and of ‘better’ quality. The middle classes have largely abandoned these hospitals and even the poor seek their services only for major illnesses often after being bankrupted in the private sector. Thus, these hospitals have essentially moved out of the imagination of those who shape public opinion.

A majority of the doctors trained in these institutions seek careers abroad or in the private sector. They have largely become training grounds for nourishing the private health- care industry. And finally no bureaucrat or politician now seeks treatment in these institutions, preferring to get their treatment funded at private institutions.

At the Bhabha hospital in Bandra — one of the largest civic peripheral hospitals where I work part time as a surgeon — there is a predictable pattern to patients brought to our casualty with accidents. Those who are well to do will often be whisked away by their family and friends to nearby private hospitals, whereas the poor will continue to be treated with us.

Thus in the bomb blasts of 2006 most of the victims including those with serious injuries were transferred to private hospitals since they were from the first class compartment. In the previous year’s riots and floods we managed the victims.

Many years ago when I was at KEM I would treat a large number of friends and their family; people like you and me. Now I treat a large number of maids and drivers of friends at Bhabha, whilst I treat their employers in the private hospitals I work with.

A few years ago when a senior journalist friend chose to get himself operated at Bhabha a large number of common friends expressed surprise and even admiration for his act of ‘courage’.

In a subconscious collective act we have abandoned these institutions to those ‘others’ who inhabit a different space, who have no voice, clout or energy to fight the battle for decent health-care.

The parents of the kids fortunate to have their hearts fixed may thank the newspaper and the journalist who broke, and followed up the story. The act of getting a few private hospitals to do the pending cases is but only a temporary solution.

Even worse, it strengthens the belief that such care can only be provided in the private sector. Some of the private hospitals will seize the moment to actually market themselves.

The specific reason for the delay in sanctioning the heart-lung machines could have been a slowly moving file, an indifferent official or even a lack of follow-up from the departments concerned. But each time a life-saving ventilator doesn’t work, a CT scan is not available for a young man who has fallen off a train and a young pregnant woman dies, as she is transported from hospital to hospital in ramshackle ambulances, a media story cannot correct the problem.

Unless we realise that by abandoning these hospitals we are complicit in the process of dismantling our public health-care system. Whether we like it or not, at some stage in our lives we need the services of public hospitals; what if you are knocked down on the road and carried by passersby to the nearest public facility?

The heart-lung machines have probably been temporarily procured and unlike the unfortunate ones who died, some of the kids will now live to tell the tale of the holes in their hearts. Many years later when they grow up will there still be a long queue for poor kids born with heart defects?

Their fate is inextricably linked with the value we give to the development of an efficient public health system. And that in turn will be determined by whether we relate to our civic hospitals as our own and are outraged by its inadequacies and indifference.

The holes in the babies’s hearts is currently a gap in our collective minds.

Dr Sanjay Nagral is a consultant surgeon, department of surgical gastroenterology, Jaslok Hospital and Research Centre, Mumbai. Photograph: Sahil Salvi

Dr Sanjay Nagral in Mumbai

 

#Mumbai- Inquiry indicts Hinduja’s Dr Jnanesh Thacker for removing organs from corpse


Probe was initiated after Mirror reported that Hinduja’s Dr Jnanesh Thacker had removed the heart and lung of a cadaver at KEM on the pretext that he was teaching students
By Lata Mishra
Posted On Thursday, December 06, 2012, Mumbai Mirror

 

An internal inquiry launched following a Mumbai Mirror report has indicted a senior cardiovascular and thoracic surgeon and transplant expert of trespassing and illegally removing organs from a corpse at the government-run KEM Hospital.

On November 12, Mirror reported how Dr Jnanesh Thacker, a consultant with Hinduja Hospital, entered the KEM mortuary, where government doctors were performing a post-mortem on a 40-year-old accident victim, and removed the heart and lung. When the government doctors protested, he told them he was there in his capacity as an honorary doctor with another government-run hospital and that he had taken authorisation from their superiors. Unconvinced, the doctors lodged aprotest and an inquiry was commissioned.

Dr Shubhangi Parkar, academic dean, KEM, who conducted the inquiry has now said in her report that had Dr Thacker had no business being in the mortuary, and that his claim that he was teaching students was a lie. Dr Parkar said Dr Thacker’s claim that he was passing by and some student had called him to demonstrate some procedure was not true. Her report said not a single under-graduate student was there as claimed by Dr Thacker.

While resident doctors from the pathology department were around, none of them asked Dr Thacker to teach them anything, the report added. However, it is still not clear why Dr Thacker removed the organs. While Dr Parkar said it was not in her brief to find that out, Dr Thacker did not answer his phone despite repeated calls. In the report submitted to the Brihanmumbai Municipal Corporation and Hinduja Hospital, Dr Parkar rejected Dr Thacker’s claim that he had authorisation to enter the mortuary.

The report also said no student has come forward to testify that Dr Thacker was teaching them that day and eyewitnesses have corroborated that there were no students with Dr Thacker. “I have forwarded Dr Parkar’s inquiry report to Additional Municipal Commissioner Manisha Mhaiskar for further action,” said Dr Sandhya Kamat, dean, KEM. “Our enquiry finds Dr Thacker guilty. Eyewitnesses have stated that Dr Thacker was inside the mortuary and removed organs from a body on which a post-mortem was being conducted in a medico-legal case.”

Dr Kamat said the report also debunks Dr Thacker’s claim that Dr Amita Joshi, professor, pathology department, KEM, had given him oral permission to visit the mortuary. “In her statement, Dr Joshi has said that she asked Dr Thacker to approach me for permission and that she never authorised him to go and dissect the body,” said Dr Kamat. “Our report concluded that Dr Thacker entered the mortuary room without any permission when a medico-legal post-mortem was going on.

As per government rules, nobody apart from forensic doctors can enter the mortuary when a post-mortem is going on. And it is clear that he was there, without any permission.” Dr Parkar, in her report, also said that the two doctors conducting the post-mortem, Drs. Ravindra Devkar and Poonam Verma, have confirmed in their statements that he removed organs. Finally, the report said that while Dr Thacker claimed he was an honorary doctor at the Sewri tuberculosis hospital, his stint had in fact ended in September.

 

Top surgeon accused of illegal autopsy, he says he was ‘teaching’

Dr Jnanesh Thacker from Hinduja allegedly removed a lung and heart from the body of an accident victim at KEM; hospital authorities said he wasn’t even authorised to enter the mortuary

 

Posted On Tuesday, November 13, 2012  Mumbai Mirror

 

Monday afternoon saw plenty of drama at Parel’s KEM Hospital, where one of the city’s top surgeons has been accused of illegally entering the mortuary and removing organs from a corpse.

Dr Jnanesh Thacker, consulting cardio thoracic surgeon at Hinduja Hospital, has been accused of opening up the body of a 40-year-old accident victim, and removing a lung and the heart, before he was ‘caught’ around 2.30 pm.

The hospital has submitted a complaint against Thacker to the dean, Dr Sandhya Kamat, but there has been no police complaint. The hospital also said Thacker may have opened up the body for “personal research”.

In his defence, Thacker said he had a meeting with a friend working at the KEM mortuary, and a few students there requested him to teach them some aspects of human anatomy dissection. “I wasn’t aware that the body was of an accident victim and a medicolegal case. I was merely trying to help the students,” he told this newspaper.

The KEM officials, including the dean, said no permissions were granted to Thacker to enter the mortuary, leave alone access the body which is classified as a medico-legal case.

Dr Ravindra Devkar, assistant professor, KEM Forensic Department, said he and his colleague were scheduled to conduct the autopsy on the body. “I was shocked when I saw Thacker inside the room. He had already removed a lung and the heart, and had begun dissecting the body,” he said. Devkar asked the hospital security to ensure Thacker was not allowed to leave the premises, and alerted other officials. “He didn’t have a piece of paper on him to prove that he was authorised to touch the body, leave alone opening it up,” Devkar said, “The equipment he used to open up the body didn’t belong to KEM.” Thacker said he was authorised to enter the mortuary by Dr Amita Joshi, head of the hospital’s Pathology Department. However, Joshi denied having issuing any permission, saying she didn’t have the authority to issue such sanctions.

“It’s a clear case of trespass,” said the KEM Forensic Department head, Dr Harish Pathak, “Thacker is a senior doctor who is well aware that no-one can enter the mortuary without permissions. We all are deeply offended by his actions, and have urged the dean to take action.”

Kamat said she would speak to the Hinduja Hospital director before deciding on action against Thacker.

“Even if he had approached me, I wouldn’t have allowed him inside the mortuary,” she said. “We are recording the statements of the eyewitnesses, and those who granted him access to the mortuary will not be spared either.”

Regarding Thacker’s claim that the students at KEM had requested him to help with dissection, Pathak said Thacker was “lying”. He said, “The students learn at the anatomy department, not in the mortuary. Besides, why would they learn about dissection from a cardiovascular thoracic surgeon?“

 

Five Star Hospitals take advantage of Charity laws, but poor patients ignored


 

The Uncharitable Trust Hospitals

A huge amount of capital is being invested in multi-specialty hospitals in Maharashtra which take advantage of the Public Charitable Trust Act, 1950 and avail of tax waivers and land concessions. However, the mandatory benefi ts to poor patients in lieu of these waivers are totally ignored. There should be an investigation into this social and economic crime and the loss to the exchequer should be recovered along with penalties imposed on these hospitals.
Ravi Duggal, EPW, June  2012
The Public Charitable Trust Act, 1950 was enacted to enable private entities to set up charities that would serve the deprived sections of society. To encourage and incentivise such investments, the Act provided for waiver of income tax for such charitable insti­tutions. Historically, many seths (merchant capitalists) invested in setting up charitable hospitals. The initial trend was to build and equip the hospital and even provide working capital annually and hand it over to the government or the municipality to run it. Their only expectation was that the particular hospital should be named after a close relation. Thus many of the top public hospitals we have in Mumbai today, including the teaching hospitals, like the J J Hospital, Cama Hospital, KEM Hospital, Nair Hospital, and the two Bhabha Hospitals were established through charities and later became government or municipal hospitals.1 Apart from this, many small hospitals and dispensaries were set up by businessmen and their charities, by missionaries and other motivated individuals to provide healthcare to those in need.
Post-Independence the trend changed. Bourgeois capital entered the fray and began to use the Public Trust Act to set up hospitals, instead of using the Companies Act, so that they could get the advantage of the tax waiver benefits. While a number of them began with being genuinely charitable, over time most of them have become hospitals for the use of the elite or those who can afford health insurance. The classic examples are the Jaslok, Breach Candy, Bombay Hospital, Leelavati, Hinduja, Nanavati, and Ambani Hospitals apart from others that no longer engage in any form of charity or follow the minimal provisions of the law for providing free services in lieu of the tax breaks. Thus their not-for-profit status needs to be challenged and all taxes that were forgone along with appropriate penalties should be collected from them. The Maharashtra assembly has rightly raised the issue of having the Economic Offences Wing (EOW) investigate the ­finances of these hospitals. Further, the issue is not only the tax waivers but also a host of other benefits they may have received like concessional land2 or a cheap lease rent, extra floor space ­index (FSI), concessional utility rates, waivers or concessions for other taxes like octroi, customs duty, etc. All these benefits add substantially to the surpluses of these hospitals. And if there is no charity forthcoming from them, it amounts to a huge economic and social crime that should be investigated.
Loss to Society
What is the economic loss to society due to this state of affairs? I have inquired into the finances of large public and private hospitals3 and found that on an average a multi-specialty hospital has a net expenditure between Rs 15 and Rs 20 lakh per bed per year (turnover between Rs 25 and 35 lakh per bed per year, the difference being their gross profit). We have over 70 trust hospitals in Mumbai that have an estimated total of 10,000 beds. This means roughly a minimum turnover of Rs 2,500 crore per year and a gross profit of nearly Rs 1,000 crore across these hospitals. As for-profit ­entities such hospitals would have contributed Rs 300 crore in income taxes to the state exchequer. We know that these hospitals are exempt from taxes but there is a quid pro quo. They are obliged to ensure that 10% of the beds are free and another 10% are given on concessional rates to poor patients. The free beds in this case would mean 1,000 beds or an expenditure of Rs 150 crore and the 10% concessional beds would be at half the rate or an additional Rs 75 crore. Together this is much less than the taxes forgone by the state and if the land and indirect tax benefits are ­included then the loss to the state exchequer is much more. If we add up all the years of the non-compliance of trust hospitals to the legal provisions then we are looking at lakhs of crores which could have been added to the health budgets of the government.
Civil society groups and health activists have been demanding that such institutions should be made accountable for over two decades now, including filing a public interest litigation to make these hospitals provide all benefits as mandated by the law of the land. The government on its part has been very lax and the concerned authorities like the charity commissioner and the income tax department have failed to monitor, audit and assure the rule of law with ­regard to these hospitals. The efforts of the government in response to the Bombay High Court orders to set up committees to review the situation and suggest action points or draft schemes to utilise these benefits have been piecemeal, and lacking in political commitment and ­seriousness. The committee set up under Ratnakar Gaikwad recently consists entirely of bureaucrats and is doomed to failure. The issue here, apart from the failure of the trust hospitals to comply with legal provisions, is one of the ­accountability of the government agencies and the government goes and ­appoints only bureaucrats on this committee! How can they be expected to be self-critical and take action against their own fraternity?
Finally, the insurance-based Jeevandayi Yojana scheme of the government is in itself a questionable scheme, and the move to link it with the benefits due to the poor under the Public Trust Act provisions is problematic. The Trust Act benefits are in lieu of income tax waivers to these hospitals. If they want to be a part of the Jeevandayi Yojana then they should engage with the scheme independent of the Act. This scheme should not be confused with the 20% free and concessional beds which are due to poor citizens as a right under the Trust Act. The government too seems to be inclined to maintain the confusion. This is illegal and will further complicate matters relating to the uncharitable trust hospitals.
Notes
1 Government of Maharashtra (GoM) 1986, Gazetteer of India – Maharashtra: Greater ­Bombay District, Vol III (ed. K K Chaudhari), Gazetteer Department, Government of Maharashtra, Bombay.
2 The recent CAG Report on Maharashtra revealed that a number of hospitals received land in fraudulent ways at a huge loss to the state exchequer, including the Dhirubhai Ambani Hospital – CAG, 2011: Audit Report (Revenue) Maharashtra 2010-2011, Chapter 4: Land Revenues, http://saiindia.gov.in/english/home/Our_Products/Audit_Report/Government_Wise/state_audit/recent_reports/Maharashtra/2011/Revenue/Chap_4.pdf
3 Ravi Duggal (2011), “Financing the Cost of Universal Access to Healthcare”, mfc bulletin 348-50, August 2011-January 2012, pp 8-12.
Ravi Duggal (rduggal57@gmail.com) is with the International Budget Partnership.

 

“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)

Archives

Kractivism-Gonaimate Videos

Protest to Arrest

Faking Democracy- Free Irom Sharmila Now

Faking Democracy- Repression Anti- Nuke activists

JAPA- MUSICAL ACTIVISM

Kamayaninumerouno – Youtube Channel

UID-UNIQUE ?

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 6,233 other followers

Top Rated

Blog Stats

  • 1,763,104 hits

Archives

October 2019
M T W T F S S
« Jun    
 123456
78910111213
14151617181920
21222324252627
28293031  
%d bloggers like this: