INDIA IS UNWELL, SHE NEEDS YOUR HEALING TOUCH!
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INDIA IS UNWELL, SHE NEEDS
YOUR HEALING TOUCH! - extracted text
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Dear Parliamentarian,
INDIA
IS UNWELL,
SHE NEEDS
YOUR
HEALING
TOUCH!
Voluntary Health Association of India
Tong Swasthya Bhawan, 40 Institutional Area
Behind Qutab Hotel, New Delhi 110 016
Association of India
Voluntary Health
7 995
Dear Parliamentarian,
Welcome to Delhi. Our sincerefelicitations for your
success as a member of the eleventh Lok Sabha.
At this criticaljuncture in the Indian history, you
have taken up a major role in shaping the destiny of
the nation. The teeming millions are looking up to you
with hope and expectations. People have reposed faith
in you that you will work for their welfare.
The health situation in the country, among other
things, is farfrom satisfactory at this point of time.
There are many areas warranting your urgent
interventions. We have put together some of these major
concerns for your immediate action.
We are glad to offer you our assistance to bring them
on top of the national agenda.
Kindly indicate a convenient time when we can
meet you and discuss a plan of action on areas of
common interest.
With best wishes,
Yours sincerely,
Executive Director
New Delhi
June 1996
MAKING HEALTH A REALITY FOR THE PEOPLE OF INDIA
Tong Swasthya Bhawan, 40 Institutional Area, South of IIT, New Delhi-110 016 INDIA
Phones • 668071, 668072, 665018, 6965871, 6962953 Fax : 011-6853708 Crams : VOLHEALTH, N.D. 16
VOLUNTARY HEALTH
ASSOCIATION OF INDIA (VHAI)
Voluntary Health Association of India (VHAI) is a national
federation of more than 3500 health and development
organisations and activists groups. VHAI works for a preventive,
promotive and sustainable health care system which is based
on social justice and the basic needs of the millions.
VHAI operates through the State Voluntary Health
Associations and their member institutions in the pursuit its
goal of “making health a reality for all the people of India”.
VHAI conducts training programmes, advocacy, policy
research, communications, publications and information
dissemination as well as running health and development
projects in the most needy and remote areas of the country. In
the course of the past 25 years of its existence, VHAI has built
up a people’s health movement in the country by closely
networking with voluntary and government bodies at the
national and international levels.
CONSUMER PROTECTION
The country is witnessing the emergence of a consumer
movement in India. With the liberalisation of the economy,
consumer options have increased. But on the whole, the play
of market forces have not necessarily improved plight of the
common consumer. Availability of goods and services at
affordable prices and of reasonable quality for everybody is a
dream yet to be realised.
The Consumer Protection Act 1986 did bring about
revolutionary changes in the field of consumer protection. But
it also left lot of areas unattended. Of the 435 District Consumer
Disputes Redressal Fora in the country, almost one third are
non functional due to lack of infrastructure. More than 45% of
the over seven lakh cases filed in the consumer courts have
not been decided within the stipulated time frame of 90 days
or 150 days.
Only an informed consumer can protect himself/herself
against exploitation and thereby enjoy the benefits of
developments.
1. Full time consumer courts should be set up in all districts.
2. Public Distribution System should include more items of
mass consumption and should be strictly monitored.
3. Free medical services given in the Government hospitals
should be brought under CPA.
TOBACCO
Can tobacco cause an epidemic?
Yes. This man-made
disaster kills 8 to 10 lakh people and maims several more
in India every year and 3 million the world over, i.e. one
death every 10 minutes. Half the victims die in the prime of
their lives. At the current rate of increase within 30-40 years
one smoker will be killed every three seconds.
Financial gain for the tobacco industry is the only rationale
behind the tobacco business, and the real losers are the millions
of smokers.
In the developed countries tobacco use has come down by
10 per cent since 1970 but has gone up by 67% in developing
countries during the same period. It is on the rise in India
because of the clever promotion tactics of tobacco companies.
Can a poor country like India afford to allow such a hazardous
industry to flourish at the cost of human lives?
Tobacco in all forms, is a drug which is addictive in
nature and causes cardio-vascular diseases and lung
cancer. The expenditure on health problems created by
tobacco is much more than the earning from tobacco business.
The net loss from tobacco induced health problems is estimated
to be about 200 million dollars globally per annum, an amount
sufficient to take care of the health expenditures of all
developing countries.
Should we not join the health activists and national and
international agencies like WHO in fighting against the public
and private menace of tobacco? Let us provide for our children
a risk free world to grow with.
At the policy level following things need to be addressed
urgently:
1. Comprehensive law needs to be enacted by the
Parliament to effectively ban smoking in public places.
2. Stop sports/culture and arts sponsorships by tobacco
companies.
3. At least double the present tax rate of 70% on tobacco
products. Withdraw all subsidies on tobacco and help
farmers to shift cultivation to other crops.
4. Government should stop investing in tobacco business.
DRUGS (MEDICINES)
India has made great strides in the pharmaceutical sphere. It is
capable of producing 70% of bulk drugs and 100% of
formulations it requires. The 20,000 drug manufacturing units
produced drugs worth Rs 8220 crores in 1994.
Availability of essential and life saving drugs are very
important to health. Despite the phenomenal growth of the
drug industry, about 300 million Indians have no access to
essential drugs or health services. There are shortages of
medicines for the diseases of the poor. 10 million people,
half the TB patients in the world, are Indians of whom
more than 50,000 die every year for want of treatments.
Similar is the case with Malaria, Leprosy, Water-Borne Diseases
and others.
It is estimated that more than one lakh drug preparations
are in the Indian market! WHO and India’s Haathi Committee
in 1975 suggested a list of drugs less than 300 for India! Thus
India has a classical problem of plenty — drug at least.
Drugs have to be necessarily related to the health needs of
the people. Should we allow the drug industry to go on
producing drugs, many of which are unwanted, not
scientifically combined, useless and even hazardous?
There is an urgent need to bring about discipline in the
drug field in the interest of the health consumer.
1. The Drug Policy of India needs to be reviewed and a National
Drug Authority to be formed.
2. A list of essential drugs should be brought out which should
be followed by the public and private sector at the central
and state levels.
3. Withdraw all banned, hazardous, irrational and useless drugs
from the market, and ban unsafe and drugs of doubtful
therapeutic value.
4. Increase the number of drug inspectors and drug testing
mechanism drastically, so as to ensure quality drugs.
5. Set up drug price control bodies with experts from
government and other sectors.
6. Stop the unethical drug promotion techniques adopted by
drug companies and provide for unbiased drug information
for the people.
DISABILITY
Disability is a very severely misunderstood issue in India. So
the problems of the disabled are not in the top agenda of the
nation. The clouds of misinformation, disinformation, wrong
notions have resulted in social, economic and physical
discrimination against the disabled.
The total number of people in India affected by
disabilities like physical handicap, hearing impairment,
visual handicap, mental retardation and others is
estimated to be 10 per cent of the population, i.e., around
90-95 million! The mid term evaluation of the 8th Five Year
Plan found that at least 10 million disabled children do not
have access even to primary education. This is just one indicator
of the status of the disabled in India.
The plight of the disabled in rural areas is a matter of concern.
There are veiy few government and NGO institutions for the
disabled in the hinterlands. The disabled had been consigned
to the fringes of existence. The situation today is not so dismal
as changes have started taking place, though at a snail’s pace.
With the “The Persons With Disabilities (Equal Opportunities,
Protection Of Rights And Full Participation) Act, 1995” coming
into force from 7th February 1996, the Indian Parliament has
endorsed the rights of the disabled people to equal opportunities
and entitlements with independence and dignity like other
Indian citizens. This new law demonstrates the philosophical
shift from charity and welfare to civil rights and the human
rights of persons with disabilities. It has opened up the doors
for them to enjoy the fruits of development not out of charity,
pity or sympathy but as their basic rights.
Attention needs to be paid to the following:
1. The centre and state governments should make special
budget allocations for the disabled and take up immediate
implementation of the provisions of the Disabilities Act 1995.
2. Include a group of competent people with disabilities in
the National Planning
Commission.
3. Formulate a National Policy
on
Disability
Rehabilitation.
and
4. Strict implementation of the
various concessions and
facilities provided to the
disabled
people
by
different
ministries/
departments in travel, postal
services, custom/excise
duty,
conveyance/
educational allowances,
income tax, posting and
bank loans.
AIDS
WHO has estimated that India now has 2-3 million people
infected with HIV — the virus that causes AIDS. WHO estimates
that more than 18.5 million people including 1.5 million
children, have been infected with HIV so far. The disease is
spreading fastest in South and South-east Asia. By 2000 AD,
the total number of people with AIDS will be 30-40 million, 90
per cent of them will be in developing countries, which will
include 15 million women. For every person with AIDS,
countless more people are affected by its impact.
HIV is a sexually transmitted disease, most commonly
transmitted through unprotected penetrative sexual activity,
contaminated needles, un-screened blood and from mother
to infant. HIV infection is high among prostitutes and
intravenous drug users. It strikes mostly young adults and
middle aged — the women and men who are in the
reproductive age and are supposed to raise the young and
support the old.
There is no cure for AIDS. Prevention is the only way
to control the disease which calls for lifestyle changes
especially in sexual habits. When a person gets infected
there is no immediate reaction. This person becomes a full
blown case of AIDS only in 7-10 years time, but infects others
all the time. Death occurs in 1-3 years from a mixture of
infections.
Immediate measures need to be initiated to arrest the spread
of this dreaded disease which is developing into a pandemic:
1. Education on AIDS must be taken up on a war footing.
Condoms distribution should be taken up through several
outlets including family planning centres.
2. NGO involvement in the National AIDS Control Programme
should be promoted in a big way as this has not really
taken off.
3 Stop supplying of untested blood from blood banks in the
country, as about 65% of blood supplies are untested for
AIDS.
4. AIDS clinics should necessarily take care of other related
Sexually Transmitted Diseases (STDs) as well.
MALARIA
Malaria — a major public health' problem which was fairly
controlled two decades back has come back in an epidemic
form in recent years. The malaria deaths in Rajasthan and
Assam recently, and the number of deaths increasing every
year in other parts of the country, show the alarming situation
of the public system in India.
Women and children are the main victims of this disease.
Pregnant women are specially vulnerable to malaria.
Orissa and the North-east are endemic areas. There is a ciying
need to study the focality or locality in its varied local forms.
The epidemiological, entomological, ecological, socio
economic and technical aspects should be seen in detail.
A local decentralised malaria programme has to be evolved to
make it a success.
Urgent steps should be taken to:
■— Diagnose, identify and treat the patients promptly and
adequately as near their houses as possible.
— To control the vector and breeding places.
— To involve the private and voluntary sector in the National
Malaria Eradication Programme (NMEP).
— Adequate availability of finances to meet the various
needs of the programme like drugs, microscopes,
outreach programmes, etc.
— Proper centre-state understanding in the implementation
of the programme.
If these steps are taken immediately involving the
community, the menace of malaria could be erased from
the country.
TUBERCULOSIS
TB is rightly known as a disease of poverty. The rural and
urban poor are mainly the ones afflicted by this disease.
Crowded living in urban slums, malnutrition, stress, lack of
resources, alcoholism and drug abuse helps rapid proliferation.
Five lakh people die of TB in India and 10 million
people catch TB every year of which 2.5 million are
infectious. TB kills 3 million people around the world annually,
of which 95 per cent are in the developing countries. 80 per
cent of the people whom TB strikes are in the most productive
years of their life (age 15 - 59). Of these at least 26 per cent
are avoidable adult deaths.
The National TB Control Programme (NTCP) has been in
operation since 1962 with a well-laid out plan and infrastructure.
But this programme failed to deliver the goods due to the
following reasons:
Lack of diagnostic facilities and technicians.
Shortage of essential anti-TB drugs.
Rise in the cost of anti-TB drugs.
Lack of other basic health care services.
The tragedy of TB is avoidable. The following measures
need to be taken up seriously:
1. Treat TB as the foremost public health problem.
2. Increase budget allocations for TB care and stop neglect of
TB because of over emphasis on family planning and AIDS.
3. Encourage more NGO participation in the preventive,
promotive and curative TB care by supporting projects.
4. Involve Panchayati Raj institutions in health care including
TB care.
5. Set up an expert committee consisting of specialists and
people involved in TB work from the voluntary sector to
review the current policies and programmes.
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WOMEN, HEALTH AND
DEVELOPMENT
What is the status of women in our country? Has their condition
improved over the years? These questions could be debated
for ever. But the startling statistics on women, in front of our
eyes speak for themselves.
There are substantial variations in the status of women among
the different regions in the country.
865 (Haryana)
Sex ratio (per 1000 males)
1036 (Kerala)
Maternal mortality
460 (all India average) 700 (Orissa)
Female literacy (%)
86.17 (Kerala)
20.44 (Rajasthan)
Throughout history women have always been a neglected
lot. Women’s health and development needs remain unmet
even today. Basic health is a luxury, which she is denied.
Good health is not possible without meeting the basic needs
for food, water, wages and human rights. The main problems
are the denial of these basic needs to women, combined with
exploitation, discrimination and increasing physical and mental
violence against them. Gender equality is a human right
which has to be incorporated in all the aspects of a woman’s
life.
For empowering women, the following immediate
measures have to be taken:
— To identify and effectively deal with the customs, practices,
attitudes, misinterpretation of religion, laws and policies
that make life more difficult for women.
— To provide better policies for ensuring basic amenities like
better public distribution system, access to potable water,
etc.
— To ensure minimum wages and safety at work place.
— To have a comprehensive primary health care system
incorporating reproductive health, and to take care of all
the health problems and not just child care and
contraceptives alone.
— To implement legal protection measures against physical
and mental violence to women.
All these changes should be initiated at all levels by linking
together individuals, groups and organisations, so that the
benefits reach every woman in the country who needs the
most.
If these are achieved, we can see a new dawn — a
healthier India.
HEALTH SITUATION IN INDIA
Health of a nation can be best judged by the health status
of its people.
Today, even after almost 50 years of its independence,
India’s health status remains a cause of grave concern. No
doubt, India has made considerable progress in certain areas
of health care during this period which is reflected in some of
the health indicators. Life expectancy has almost doubled
from 31 at the time of independence to 61 years at present.
Overall mortality, measured in terms of Crude Death Rates
(CDR), which was as high as 27 per 1000 persons, has declined
to 9-2 per 1000 persons. Infant Mortality Rate (IMR) at 146 per
1000 live births in 1947 has halved to 73 per 1000 live births
today.
’
But these progresses have not been evenly distributed so
as to make any substantial improvement in the overall health
scenario. Broad aggregates mask large regional disparities
within India, both in health status as well as access to health
sendees (i.e. outreach, efficiency and equity in the public health
care system). There are states like Kerala and Maharashtra having
an IMR of 16 and 54 per thousand respectively as against 98
and 103 for Madhya Pradesh and Orissa. Generally the so
called ‘BIMARU’ states consisting of Bihar, Madhya Pradesh,
Rajasthan, Uttar Pradesh have the worst health indices.
India continues to be one of the many developing
countries which face a high level of mortality and
morbidity especially among infants, children, women
and the elderly. There is also a relatively high incidence of
infectious or communicable diseases which are normally
associated with low levels of sanitation, public hygiene and
poor quality of drinking water. Diseases like Malaria, TB,
water-borne disease are coming back with a vengeance
and the health problems due to modernization like heart
diseases, accidents, traumas, sexually transmitted diseases
etc. are on the rise.
There is a tremendous need to reach out effective health
services to vulnerable people living in pockets of darkness.
About 80% of health care facilities are concentrated in
cities. This makes patients from distance to flock to the cities
which complicates the situation in cities. In order to reverse
this process, government needs to work closely with the private
and voluntary sectors. The private sector is flourishing. Its
potential should be tapped for the National Health Programmes
and family planning. At the same time, commercialisation of
medical services, promotion of irrational drugs and the spiralling
cost of health care must be curbed effectively.
The population policy followed so far has not yielded
the desired results. Family planning programme needs
to be necessarily integrated with general health services
and related social factors.
To make India reach the goal of Health for All by 2000 AD,
the following priority areas need to be addressed to,
effectively:
1. The rural health infrastructure and health services
should be made accountable to village panchayats/zilla
parishads.
2. Enhance the outlay for health from the current level
of about 1.5 per cent to at least 5 per cent of GNP and
drastically cut down expenditure on non-priority which is
at present about 80% of the allocations.
3. Experiment with employing doctors from the Indian
System of Medicine in primary health centres after their
proper orientation.,Make two years’ rural health service
compulsory for MBps doctors seeking -higher education.
4. Use the services Of about five lakh traditional health
functionaries in the country in community health work.
5. Health planning needs to be decentralised. Every district
in the country should have a district plan as well as a sub
plan for vulnerable areas.
6. Referral services to be systematically improved so as
to prevent migration of patients to urban areas for treatment.
7. Private sector (nursing homes) should be regulated with
mandatory registration and standardisation of services and
rates.
8. Involve charitable and voluntary bodies in tertiary care
on a joint programme with the government.
9. The health impact should be properly addressed before
starting any development projects.
“Health is not everything but everything else is
nothing without health.”
We value your feedback!
Dear Parliamentarian,
1. Are you interested in knowing more about the following issues?
Please tick mark and send this card back to us. 171
— Women, Health
— Drugs (Medicine.)
and Development
— Tobacco
— Tuberculosis
— Consumer issues
..
j:
■— Malaria [J
— Any other issue (please specify)
- — AIDS
— Disability
2. Do you like to receive some more materials on any of the above
issues?
Yes
No
3. Would you like to meet us to discuss further on the issues you are
concerned or any other matter you wish to share with us. ■
Yes
No
4. Would you like this health information pack to be translated into
regional languages?
Yes
No
If yes, what language? Hindi/Bengali/Telugu/Urdu/Marathi/Any other
(please specify)
_
5. Would you like to evaluate this information pack for us?
Name and address----------------------------------------------------------- —-------
Signature
Date(Dvn. No.
Thank you very much.
Please post this card as early as possible to
Public Information and Advocacy (PIA)
Voluntary Health Association of India (VHAI)
Tong Swasthya Bhavan, 40 Institutional Area
New Delhi 110 016
)
You have got the
mandate.
Now the people
await your
response.
Voluntary Health Association of India
Tong Swasthya Bhavan, 40 Institutional Area
Behind Qutab Hotel, New Delhi 110 016
Telephones:6518071,6518071, 6515018, 6965871, 6962953
Fax:011-6853798
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