MFC-ORGNISATIONAL HISTORY
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- MFC-ORGNISATIONAL HISTORY
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RF_NGO_24_SUDHA
I?''
medico friend
circle
bulletin
APRIL-MAY 1984
TEN YEARS WITH MFC : MY PERSONAL VIEW
ASHVIN J. PATEL
When I was told to give my reflections upon
ten years of MFC, I accepted it reluctantly. Firstly,
because I did not have many things to say and
secondly it was not spontaneous for me. However,
I give some stray thoughts that occurred to me.
An Overview
Many of the readers may not know that MFC
was not a planned efforts but a spontaneous one.
It orginated from a socio-political movement Tarun
Shanti Sena which was inspired and ignited by zeal
for total revolution.
Naturally MFC carried
legacy and hang-over of this perspective, values,
culture etc. Many of the founder members were
considered radical and unorthodox Gandhians.
Within a year it could attract friends who rang
ed from academicians to field activists; not suprisingly it also included various shades of opinions from
right to left. I do remember that some friends
clearly denied then, that the doctor has any other
responsible role than treating patients coming to
the dispensary1. While others, on the other hand,
felt that health sendees are just an entry point
into the community.
Real health work is to
struggle for socio-economic-political revolution.
This latter viewpoint was shared by both, the
Gandhians and the Marxists alike.
MFC criticised the present health system and
its approach so eloquently and vociferously that it
could attract attention of many young doctors and
non-doctors. The “prophetic vision” and enthu
siasm of old members proved to be too much for
some. A few resented the indoctrination and the
aggressive way of discussion. A proportion of
them felt that MFC could not give a relevant pro
gramme according to their aptitude and abilities.
There was a feeling that MFC wanted everybody
to agree with its analysis, and then left them alone
to face the frustrating situation.
In the first four years, study-cum-work camps
were organised for medical students and others
which generated lots of enthusiasm. Some medical
colleges could evolve health care programmes for
slums and nearby' villages. Many of them are still
continuing. But /perhaps, except for a few, there is
no continuous follow-up and. dialogue. They have
become just like any philanthropic dispensary
without having a wider perspective of community'
health and development.
How would one measure the progress of such
an organisation? By the number of its members?
It’s impact on society? The growth of its members
as a collective to understand, analyse and respond
to a situation?
As experience showed the annual meets of
MFC served a purpose as a major point of contact.
However, new participants felt isolated, the target
of indoctrination and threatened by the level and
nature of discussions. The objective of increasing
the number was not to be realised effectively. Old
members felt that the preoccupation with new
members kept the level of discussion at a prelimi
nary level. There was no scope for learning and
mutual growth. Robust, impersonal and objective
arguments were appreciated and welcomed by old
members, while many of the new members perceiv
ed in the same exchange of views, aggressiveness
that tended to be personal. I feel that in the ten
years, MFC members have shown a lot of maturity'
to take the arguments and criticism as that of the
thought and not of person. No one ever doubted
another's genuineness, honesty of purpose and
concern for the poor. Even after a session of hot
tions, concepts, values and models like bare foot
and involved exchanges there has been no trace of
bitterness and the feeling of friendship and soli
darity has always grown. To an onlooker sometime
it may seem that we are simply splitting hairs and
arc involved in. mere polemics. But this seeming
polemics represents, deeply.; held differing view
points, perspectives, social & political ideologies
and backgrounds.
In the first few years, the number of .MFC
contacts increased very' fast. It might have been
due to the long felt need for such .a forum, the
unconventional and critical views appearing in
MFC bulletins, the annual meet deliberations or
the regional camps. Then its growth in number
rached a plateau.
Not only the numbers stag
nated, but also the core group, which evolved
spontaneously due to continuous interaction and
concern for the MFC organisation, developed a
kind of disinterest in the organisation. What was
the origin of this disinterest?
doctors — C.H.W.; underfive clinic; campaigns
against bottle feeding, commercial foods and irra
tional therapeutics, attacking drug industry, alter
native simplistic curriculum for medical schools;
people's participation; demystification and de
institutionalisation of health care; self-sufficient
health care programmes; self help; promotion of
other sysetms of health care: etc., etc.,” (to be refe
rred hereafter for sake of brevity as ‘health care
mix’):/And even proponents of the first trend,
though grudgingly endorsed this 'health care mix'
without providing overall framework or model
linking it with the process of socio-dconomic
change. This led to a lot of confusion in some
and smugness in others.
An interesting current was emerging intertwined
with the other trends, now and then. How as a
group were we going to evolve methods and a pro
cess of self learning conducive to personal as well
as collective growth? This perceived need was not
adequately responded to, which led some to dis
continue their interaction with MFC in despair.
However, a sizeable number of members continued
tenaciously to struggle to find the wa.y (out. This
struggle was not born out of merely .emotional
attachment to the organisation, but because the
needs and tasks were demanding so. Moreover,
MFC may be small in terms of resources, infra
structure and manpower, but perhaps it is the only
organisation struggling collectively to search for a
socially m|eaningful and durable alternative. It has
evolved and practised certain norms in public life
consistent with its objectives and concern for the
poor.
Various Trends
There were three discernable trends within
MFC. First trend wanted MFC to be a body to
provide deeper analysis of the health situation and
its relation to socio-economic-political factors.
Second one wanted it to experiment in alternative
health approaches at micro level informed with
critical analysis of present health system. Third
trend wanted it to promote philanthropic health
services. The last trend got disillusioned immedia
tely. They thought MFC with such a thorough
critique of present health affair would now come
out with new sets of concrete alternative program
mes.
This was not to be. Although attempts
were made, through regional camps and some
health care programmes involving a few medical
colleges, to introduce this analytical process to new
comers; a number of constraints (prevailed.
A
questioning process could be initiated, but the
view-point that not only socio-economic changes
were precondition for improvement of health, but
also that "real activity” to be taken up had to logi
cally aiiqled at socio-economic change, had a para
lysing effect on many.
Not surprisingly, the second, trend also consi
dered a socio-economic change tp be precondition
and also aim of their health activities. They could
go upto a point in analysing alternative health
approaches in India and elsewhere. They agreed,
in their eagereness for action, ot “certain interven
A lone but lemphatic voice was raised which
was appreciated by many about a rush for alterna
tive and much ado about ‘health care mix'. No
efforts were put beyond refuting certain historical
events and pointing out some limitations and defi
ciencies in various work. A point of saturation of
thinking and imagination seemed to have arrived.
I remember how one strong protagonist of
communit(y health got alarmed when government
agreed to implement CHW scheme at national
level. His instant reaction was, “Now government
has agreed to implement CHW scheme, what .role
and functions are left for us!” This Was an indi
cation of poverty of understanding and arrest of
growth at a given time point. But experiences in
the field had shown that the ‘health care mix’ was
2
far from adequate. It was misleading and tended to
breed rituals; it gave a false sense of achievement
and even complacency that one was doing everything .
one had to do in community health. Wide gaps
in knowledge, information and strategies were there
waiting to be discovered. These were the growth
points one had to look for very carefully. This
realisation underlines the need to develop experi
ences, in sights and knowledge which is relevant
and pertinent to Indian situation. Both social
sciences as they relate to health problems and natu
ral sciences have to develop further so 'that com
munity health ceases to be underdeveloped and
primitive. More painful and frustrating is that
even some proponents of the second trend are also
equally unattentive to this perception.
world. If yes, how can we go about it? It may
need broadening of our focus to include those from
academic institutions who have knowledge, compe
tence and aptitude to contribute to such efforts.
Simultaneously, we have to learn and develop our
abilities to understand not only social sciences but
natural sciences too. We may jhavq to work out
overall plans off. action informed with this perspec
tive and persuade ourselves and other groups to take
up some of these commonly agreed upon activities
over a period of time so as to improve our insight
as a collective.
The
wateright compartmentalisation
into
political
activists and
health activists can
no longer help.
Competence in health sciences
is essential, but assimilation of egalitarian
values and understanding of political reality are
crucial to undertake such “field research" condu
cive for the health of the masses. Most of (the
MFC members have internalised the latter; ques
tion is to fill up the deficiency in the ■former one.
But MFC members are small in number.
Most of them are already engaged in traditional
project work, political activities, campaigns for
educating masses, teaching and research in establi
shed institutions, etc. according to their aptitudes
and priorities. Would such a shift impinge upon
personal freedom and preferences?
Possible Tasks
MFC has realised the simplistic nature and
sloganism of various technological and social
interventions in vogue. It is not only not enough
to speak about shift from individual to community
diagnosis, but to understand and decipher intricate
webwork of the 'individual as a member of a family,
of much larger social groups to which he belongs
through kinship, residence, occupation, religion,
beliefs, etc. and conditions of his life, his work,
his economic and social placement and culture, his
physical and biological environment. Furthermore
refinement and differentiation in relation to each
disease process. Thus the real problem does not lie
in actual activities but lies in the theoretical under
standing of the complexly of the disease process in
the community that inform these activities. It is
through continuing analysis and actions of various
groups on at least some of these problems in simi
lar perspective that relevant, durable and realistic
pieces of knowledge are going to be built.
We have been busy struggling with ourselves
and for various other factors, we could not interact
with medical students, socially concerned non
medical friends and consumers of health care
adequately. If we refer to the deliberations of the
second annual meet at Hoshangabad it dileneated
guidelines for action programmes quite well. Why
could we not persue it? Can we learn from positive
experiences from KSSP and negative experiences of
other organizations? Is it just a lack of infrastructure
and full time worker or adhooism responsible for
our failures?
Is there a critical mass of socially ■concerned
physiciansl today who are competent enough to
build tip tliis knowledge: Does the ‘health care
mix’ aped by voluntary groups have rigour and
strength to stand the "scientific scrutiny”? Can
voluntary groups face, with their own observation
and evidences, a tough and thorough-going “objec
tive” criticism made by sympathetic academicians?
Could our priority be t,o evolve a (collective voice
known not only for its honesty and commitment,
to tre cause of Lhe poor; but also .respected for its
ability and scientific rigour; not only among like
minded people but also among the professional
Conclusion
I have not tried to reflect on all the aspects of
MFC,j Many things (have been left out $ike ii|s
commendable achievements, its democratic and
egalitarian ways of working, place and role of MFC
bullentin, interaction with various groups and
individuals; details of various projects, campaign
and workshops, managing on low budgets function-
(Continued on page 10)
3
Looking Ahead...
Anant Phadke
If we are to find out how MFC can develop
further in the future, we should try to understand
the factors that affect the growth and develop
ment of MFC. These factors lie both within MFC
and outside it.
Let us start with the social fac
tors outside MFC.
The socio-economic condition in India is
turning from bad to worse. The plight of the
ordinary people is increasing, so is their opposi
tion to their oppressors. A section of the white
collar intellectuals, students, are bound to be
affected by this and some of them are bound to
seek alternatives. This sensitive, humanitarian,
democratic layer from within the intelligentsia
constitutes a potential for MFC. All of us con
tinue to meet many sensitive, socially-conscious
medicos for whom a group like MFC offers a plat
form which they are happy to know about and
which they would like.to join. MFC would grow
if it can approach such individuals. If there is
a social movement amongst the intelligentsia on
any issue concerning human values, justice, we
can even hope to get a large influx of newcomers.
The original group of MFC was a product of the
Jay Prakashwadi movement. There is no such
movement on the horizon now, but to be sure it
is bound to emerge, perhaps in a different form.
The social conditions that gave rise to it still con
tinue to dominate our lives. Today the intelli
gentsia seems to have resigned to whatever is
happening. This cynical aldofness is a counter
acting force which affects the growth of groups
like MFC. Nevertheless, on the whole, the situa
tion contains a lot of potential for the growth of
groups like MFC. But along with the growth of
general dissatisfaction amongst the people, the
challenges in front of a group like MFC have also
grown. What are these challenges?
The publication of the report — "Health for
All : An alternative strategy" has posed a concrete
problem. After the publication of this prestigious
report (prepared by the collaboration of ICMR —
ICSSR with the help of a number of renowned
persons in the field of health-care) groups like
MFC have to take a concrete position about what
is in our view, wrong with the existing system of
medical care and what is the alternative. Is our
analysis and solution any different from what has
been described in this report? If yes, in what way
and why? One of the criticisms of this report
would be — it does not show the process through
which the solution it offers can be brought into
practice. MFC can claim that it can show the
process of change which MFC wants to bring
about and that MFC itself constitutes a part of the
process. Whatever may be our position, we can't
ignore this report. To be sure, there are many
aspects of this report with which MFC agrees.
This report has thus raised the level of debate,
and has set a reference point for discussion and
action. It is no more sufficient for groups like MFC
to discuss and act at the same level as was done
before the publication of this strategic report.
In the non-Government sector, the achieve
ments of some of the pathbreaking voluntary
Health Projects are now well known. What do
groups like MFC have to say about these projects,
their achievements and limitation, their relation
ship with the goal that we want to achieve? A
number of international agencies are fostering the
methodology as being attempted by these projects
and this adds to their importance.
Thirdly within the medical field, a number
of oppositional movements have grown in last
10 years of Junior Doctors, paramedics and Govt.
Medical Officers for better pay and better work
ing conditions; of consumers against misuse of
drugs ................. How groups like MFC should
relate to these movements
Groups like MFC cannot grow and develop
to any substantial extent unless such new deve
lopments are analysed properly and a standpoint
taken in theory and in practice. Does Medico
Friend Circle have the resources-theoretical and
practical — to successfully deal with the new
challenges and hence grow into a trend which can
make a dent on the national scene? To answer
this question, let us locate the strengths and weak
nesses of MFC. MFC has been able to survive
and grow against all odds. (Compare MFC with
similar groups.) MFC has not survived by degene
rating into a lifeless institution. (Such institutions
continue only because some funding source is
ready to "keep" them.) MFC has also not degene
rated into a political sect with no basis in social
movements. To survive as a lively group is an
achievement for group of medicos which is funda
mentally opposed to the existing medical profes
sion and the existing system of medical care.
Secondly MFC is unique in that though most of
Things are bad when we come to the ques
tion of making a co-ordinated effort to make an
impact on a national level by forging, propagating
an alternative viewpoint. Most leading members
of MFC are quite involved in their local work.
Most of us have not been able to devote much
time and energy for MFC's organizational work.
Unless the leading members of MFC replan their
local work in such a way that they spend much
more time for MFC's organizational work, unless
more fresh blood comes in, MFC will not be able
to face at all the challenge posed to her by the
developments in last few years. Unfortunately not
many MFC members see this. Some are even
content with the running of the Bulletin and the
Annual Meet. We must realize that even mere
continuation at the existing level is financially
becoming more and more difficult due to price-rise.
The financial deficit is increasing very fast. Unless
we have atleast 1,000 subscribers (compared to
about 400 to-day) the deficit would become
unmanageable next year (even this year.) There
are more than 2 lacs MBBS doctors in India, (to
take one yardstick of assessing the potential for
MFC to grow) and even one per cent of this
becomes more than two thousand.
MFC is
The third positive asset of MFC is the ten unknown to many of those who would readily
dency in MFC to examine things in a critical the become its members. We should have reached at
oretical perspective, on a principled basis yet in
least this section. But that involves a change in
a way that would be relevant to the problems in the attitude of many leading MFC members
the actual field. Since most of the leading mem towards MFC and hence a re-planning of their
bers are actually working at the grass-root level,
priorities in practice. Are we really serious about
this critical questioning outlook acquires a special
forging an alternative, making a dent on current
down-to-earth practical connotation. This has opinion in India about medical care? Shall we
earned MFC some good name (as well as bad critically study, try to develop and practice comname amongst those who don't like such ques munty medicine much more seriously? Shall we
tioning.)
study and understand in a much more concerned
manner the history, development of social move
But the theoretical development in MFC hasments, social changes in India and abroad? In one
been quite slow. It is only recently that things
word, shall we get rid of amateurism in us? The
have really .begun to move. The tendency in MFC
answer to these questions will decide whether MFC
to be self-complacent and self-congratulating has can play its role in the "fundamental socio-econo
more or less been replaced by a serious concern
mic change” that MFC wants to align with.
to study, work upon and develop our understand
ing. But still it would take a lot more effort to
systematically develop position on the problems
mentioned earlier. There does not seem to be
Your help required for the index :
adequate realisation in most of us that MFC must
(a)
A donation to cover the cost of this
answer these and such problems if it has to make a
special feature, mfc deficits have risen.
dent on the national level. A sense of urgency, requ
(b)
Build up complete sets, for reference by
ired in view of MFC's lagging ebhind as of today,
your group/friends in your region.
is by and large absent. There is a concern for
(c)
If you know of cheap/bargain xerox
developing our understanding; but not in relation
facilities, let us know.
to the challenge posed by the events happening
(d)
Would you like to participate in a re
print distribution system for your area,
around but as a general concern for theoretical
development.
.
— Convenor
the leading members of MFC are politically cons
cious, they have enough of healthy, non-sectarian,
democratic approach to allow medicos from diffe
rent political leanings to come together, debate,
criticise each other, learn from each other and
develop into a tolerant, mature group. It must,
however, be noted that the "friendly" atmosphere
in MFC is partly because there is not much at
stake. If MFC squarely faces the problems men
tioned above, starts growing as a formidable cur
rent on the national plane, the friendly atmos
phere is bound to be affected atleast to a certain
extent. But the tradition, we have set up will help
us in challenging times. The tradition of respect
ing other's viewpoint, of mutual trust, openmindedness has been our asset. To be sure some
sectarian mistakes have been made of because of
which some people got alienated. But many have
come back and on the whole very few have drop
ped out with sharp discontent. (The core-group
of MFC sometimes gives an impression of an arro
gant, radical, intellectual clique involved within
itself. But this is only a cursory impression — even
that should changes and it is not at all the true
nature of this group.)
5
AT THE HUNDREDTH MILESTONE
Ravi and Thelma Narayan
mfc is as of today, mainly a thought current and the monthly medico friend circle bulletin.......
is the medium through which members communicate their ideas and experiences to each other.
Running the bulletin in our chief common activity......
MFC
manifesto 1983
In this centenary issue, as we reflect on the
past, consider the present and look into the future,
we review the preceding ninty-nine issues of the
bulletin, to discover the strengths and weaknesses,
the opportunities and threats that have been part
of its eight years history.
have evolved as time went by — being modified,
re-emphasised and added unto (see Index). Against
the background of these wide objectives the evo
lution and performance of the bulletin has shown
an interesting variety and a rich diversity. Atleast
once during this eight year period a situation of
crisis (45) called into serious question continuation
of the bulletin but the heated discussion threw up
three reasons of organisational significance which
made the bulletin necessary in addition to its
wider relevance. These being that the bulletin was
the only means — to be heard at national/international forums; to involve the new members; and
to prevent degeneration into a federation of local
scattered groups. AH these objectives taken to
gether gave the bulletin a new lease of life at
every crisis.
The Beginnings
The MFC bulletin began as a cyclostyled
note that was circulated regularly to members of
the initial nucleus group, many of whom had links
with the Tarun Shanti Sena in 1974-75. Our re
cords show that there were atleast fifteen such
notes. The style was informal — a sort of 'dear
friends' newsletter keeping members about meettings and discussions, field opportunities and
thought provoking articles on various relevant
health issues.
Founder members will probably
recall with nostalgia the series on the present
health system, 'alternative approaches' and 'radical
medicine', the column entitled 'vocal figures' pre
senting telling statistics of the health situation in
India and the proclamation of Maurice King's book
as the "bible for every doctor"! The characteris
tic feature of this embryonic phase of the bulletin
was its youthful idealism and infective enthusiasm.
Rallying slogans such as "If China can do it why
can’t we?" and 'let's coordinate our efforts to fight
the' situation instead of blaming western culture
and criticising brain drain’ were typical examples.
Outreach
The bulletin subscription has ranged from
250-700 over the years. Presently it is a little
over 400. The readership includes rural health
project workers, medical students, medical college
teachers, academicians, research workers and non
medicos interested in health. These are spread
out all over the country but more particularly in
the Western region — Gujarat and Maharashtra —
the traditional home of MFC. A detailed break
up of the subscription list is not yet ready but a
curscry perusal indicates that the readership among
medical students and non-medicos is still far from
significant.
The MFC bulletin as we know it today took
shape at the second annual meet at Sevagram in
December 1975. The first editorial committee
was formed and a plan of issues outlined for the
whole of 1976. The first bulletin was printed in
January-February 1976. Since then the bulletin
has travelled a long way — 93 months of regular
printing, seven double issues, three editors and
sever, printing press — to reach this hundredth
milestone.
Scope
The articles featured in the bulletin have
represented a very varied range of topics related
to medicine and health. An index of the hundred
issues which is featured as a supplement to this
bulletin shows twenty eight sections in the classi
fication. These include health services, medical
education, maternal and child health, population
control, communicable diseases, environmental
sanitation, mental health, drug policy and drug
Objectives
Though the initial objectives were outlined in
the first issue — as many things in MFC, these
,6
may be representative of the fact that many
of the analysts of yester years are deeply
immersed in action today. In turn these rea
listic issues may be instrumental in stimulat
ing further activism in MFC circles. Here
again we are vulnerable to the criticism that
the emphasis on drug issues represents
medical bias but this is inevitable in our pre
sent doctor oriented predicament.
prescribing. Certain unusual problems like Lathy
rism, discrimination against women in health,
disaster medicine etc., have also been presented.
By and large, however, tne range has been within
the traditional boundaries of medicine — both
clinical and community with a strong preoccupa
tion with nutrition, health service policy and drug
issues.
Non-medical issues which are vital to health
care have been covered peripherally with stray
articles on green revolution, dairying, soya bean
and low energy economics.
Vocal Figures
Feature
Three areas stressed in the MFC manifesto
have been particularly neglected. These being
demystification and popularisation of medical
science, humanisation of medical/health practice
and the open-minded enquiry into non-allopathic
systems of medicine and non-drug therapies.
Does this reflect the existing professional/
medical bias of the group?
1. Articles
a. original
32
b. reprints
10
2. Letters to
Editors/readers
dialogue
49
3. Book reviews 8
4. Activity reports
a. mfc groups 8
b. health
projects
1
Even within the traditional boundaries of
medicine certain issues like ecology and environ
mental health, health problems of tribal regions
and urban slums, workers health, the clinical
investigation, business, unnecessary surgery, malpraxis, the nuclear epidemic and the relevance of
existing research in the country have hardly been
considered. Emerging issues important in a wider
context but relevant to the health movement like
pedagogy, communications, participatory manage
ment and humanistic psychology among others
need also to be included.
(b)
Features
The format of the bulletin has shown much
variation but certain basic features have remained
constant.
(a)
Phase of bulletin
1-25 26-50 51-75 76-100
Lead articles : These have been the key
feature of the bulletin. They have included
original articles written by members and con
tacts as well as reprints from other journals
and sources. These articles have been very
responsible for the reputation of the bulletin.
The selection has been surprisingly consis
tent in terms of relevance and analysis in
spite of the fact that there has never been a
very clear cut editorial policy — our mani (c)
festo reworded from time to time being the
only guiding principle. Of late the articles
have moved from a more abstract analysis of
issues like health policy to more concrete
like drug misuse, community health worker
and health education. This concretisation
7
26
19
32
26
24
17
64
—
14
1
13
8
8
2
4
2
8
2
Discussions/dialogue : The thought current
nature of MFC should have made these a dis
tinctive feature of the bulletin. The experience
has been different. The first phase saw a
very active response from members. Even
though these were often the same inveterate
discussants, they set a healthy precedent. The
second phase saw a very active response from
members. The second phase saw an increase
in this phenomena with a much wider cross
section of readers participating in columns
such as Hyde Park/Dialogue and contributing
letters to the editor. In the last four years
this phenomena has begun to wane and should
be a cause of concern. Are bulletin readers
so busy with their own local preoccupations
that they do not find time to participate in
discussion or is the Bulletin not adequately
thought provoking? Are there many other
factors?
Only a readership survey could
probably throw light on this.
Activity/Project reports: Reports by small
groups all over India with an MFC perspec
tive have been featured on and off. Reports
on projects like Jamkhed, Gonoshasthaya
Kendra and CINI have also appeared. Consi
dering the wealth of field experience gained
in India in the last decade this is an area
literature in health, job opportunities and other
available resources. In 1978-79, a column
of news clippings to keep readers informed
about issues raised in the popular press was
attempted. In the absence of a documenta
tion centre to back the efforts of the editors,
this has been a low key feature.
(g)
Editorials : Like the lead articles these have
MFC organisational reports have been a con
been a distinctive feature of the bulletin
sistent and welcome feature. The informal
though the style has varied greatly. The
nature of these reports have been typical of
first phaes saw annual editorials setting
MFC. Reports of the lively group discus
measurable objectives for the bulletin but
sions at the meets have, helped those who
remaining a silent catalyst in between. The
cannot attend the meet to get a feel of the
second
phase saw a more regular feature
frank and open style of MFC group work.
which not only galvanised the group work but
(d)
Surprisingly in a hundred issues less than
also put the contents of the bulletin in the
twenty books have been reviewed. These
MFC perspective. The last four years has
have included the classics by lllich, Maurice
seen the evolution of a more analytical and
King, Mendelsohn and Morley and the ICMR
technical editorship which has put the bulletin
and WHO compilations of alternative approa
on very scholarly foundations.
ches. In the light of the recent explosion in
(h)
Miscellany : Bulletins 1-29 had the Chinese
health care literature this is a serious lacunae
slogan "Go to the people, live among.
in our efforts. Not that all the material avail
them........" at the bottom of every page
able is necessarily relevant to the MFC search
expressing the beginnings of the MFC quest.
but there is an urgent need to keep members
Bulletin 30-35 saw the introduction of five
and readers upto date and well informed, if
additional
features — these being Hindi
this quest for an alternative people oriented
articles, health related poetry, cartoons and
health system is to be built on a scientific
line
drawings,
a contents list a.nd provocative
base.
gimmickry to enhance readers participation.
(e)
Government policy documents:
In recent
JP
was
the
only
personality to be honoured
years there has been a significant output of
in the front page being a sort of chief
government policy documents and related
inspirator
of
the
group (46). He displaced
reports taking a new look at the Indian situa
the red disc from top right to right down. In
tion and supporting/professing alternative
cidentally the red disc was not selected to
approaches. By and large the MFC bulletin
depict the rising sun of revolution but was a
has carried active response to each of these
practical attempt to balance the numbers and
—■ the Srivastava Report, the Janata Health
break the printed monotony of the first page.
Policy, the Medical Education Policy and the
Coincidentally this gave the bulletin its
Health for all Report. The lack of response
popular
and recognisable symbol.
to the new Health Policy of 1983 is a serious
omisssion. This active analysis and feedback Anthologies
is particularly crucial because the reports of
Twice in recent years, anthologies of the best
late feature very radical statements and pro original articals were published by MFC. The first
grammes that create myths and some confu (In Search of a Diagnosis) covering issues 1-24
sion.
These reports seldom mention the and the second (Health Care — Which Way to Go)
process by which these radical changes can covering issues 25-50, have both seen a pheno
be actually introduced into the existing exploi menal popularity. The first one is now out of print
tative and irrelevant systems. MFC members while the second one is on its way out. The third
have a definite role to bring out these contra anthology is a scheduled to be released later this
dictions and also apply themselves to issues year.
of process ignored by these reports. At the Readership surveys
same time we need to emphasise those
To enable mid-course corrections and get a
elements which are helpful to the evalction of feel for the readers views, readership surveys have
a more humane and just system.
been undertaken. Twice, these have been reported
(f)
Information : Most bulletins have featured in the bulletin. The 1978 survey elicited only a
snippets of information on recent events and nine percent response while the 1979 survey an
needing much more attention.
Reports of
well-known projects are not as important as
sharing by friends of the little lessons in their
field experience, the new perspectives gained
and the small but appropriate innovations
made. The Sevagram group has been parti
cularly remarkable in such little inputs.
8
rr ■
18 percent response. The latter was prompted by
a crisis situation which arose when the then editor
perceived a lack of participation and support and
serious discussion regarding continuation of the
bulletin ensued. The survey showed an overall
support for the bulletin, which then got a fresh
lease.
1978
1979
Readership surveys
Critique:
Abstract analysis
Too much criticism
Too little constructive suggestions
Increasing formality
Suggestions :
— More experience reports
— Recent advances and appropriate
health care techniques
— More editorials
— More organisational news
— More variety in authors
Responder characteristics :
Medicos — 68%
Non-medicos — .32%
Members — 65%
Field Workers — 10%
Medical College teachers — 35%
Response :
Most popular — title articles and
materials
Bulletin useful — 90%
Existing system irrelevant — 90%
Alternative possible — 90%.
Focus : With the diversity of readership and
their expectations 'selection on material for
the bulletin is a gymnastic more difficult than
walking on a tight rope'. (31).
((b)
Availability of articles : Though the Bulletin
appears to have appeared regularly, editors
have had their range of reading and article
extracting ability stretched to the extreme,
resulting in frequent crisis. Typically in
1980, there was an appeal in June as fol
lows : "If this state continues the last issue
will appear in July". The crisis was most
often got over by reprint of suitable articles
from other sources. Many were very good
and added an important dimension to the
bulletin. However, lack of original articles
can be not only a health hazard to the editor,
but it also question the creativity and dyna
mism of our membership I
Finances : This has been a chronic problem
throughout, but the remarkable ability of con
sequent publishers to continue against all
odds deserve real kudos. MFC has fiercely
guarded its independence by committing itself
to a policy of financial support by subscrip
tions and personal donations only. It was felt
that external project funding would result in
some inevitable institutionalisation, possible
loss of independence and very likely decrease
in the personal support of committed mem
bers. The increasing deficit has constantly
challenged this stand and the discussion in
1983 finally resulted in a more open policy of
funding with certain restrictions to maintain
our value stand (87).
(d)
Printers' devil : This has not been as much
of a problem as it could have been in a small
bulletin of this nature because of a series of
meticulous proof readers. On occasion, how
ever, it has caused some degree of embarrass
ment and often comic relief. Recently, in
the front page of the bulletin, 'health' our
main preoccupation was wrongly spelt and
'mgc' not 'mfc' was committed to achieving
it by 200 A.D.
The future
With the increasing diversity in membership,
MFC may have tb consider producing bulletins/
newsletters directed to stimulating 'thought cur
rents' at different levels.
Some problems
A bulletin with this perspective and supported
by subscriptions and donations only, is bound to
have many problems. The three most important
often reported in the bulletin were :
fa)
(c)
The 'demystification of medicine' and 'the
evolution of a style within reach of the common
man' are two important but neglected dimensions
in the bulletin. The fact that many of our member
writers also write for the popular press in the
regional language is some cause for satisfaction
though this needs to be promoted much more
through MFC in the future.
In conclusion the hundredth milestone of our
bulletin has been reached through an exciting and
exacting collective endeavour. What has been the
contribution of this effort to health related thinking
in India in the last decade only the future will tell.
Ivan lllich, when interviewed in 1978 is reported
to have said that "the bulletin was the best periodi
cal in the third world which analyses health struc
ture and its problems". Two readers in the 1979
survey on the other interestingly felt that the
the health care system in India was relevant and
that the bulletin had been responsible for their
opinion! Only our readers can decide where we
stand between these two extremes.
9
RN. 27565/76
mic bulletin : April-May 1984
FROM THE EDITOR'S DESK
With this issue, the Bulletin hits a Century.
At the Annual Meet held at CINI, Calcutta, the
members requested Ashwin Patel, Anant Phadke
and._Ravi, and Thelma Narayan as the past and
present and incumbent convenors, to contribute to
this issue. Ashwin gives a retrospective analysis
and Ravi and Thelma review the hundred issues
of the Bulletin. Anant gives some future directions.
The MFC Bulletin, as its readers know, is
very different from the ordinary run of medical and
health periodicals. It is therefore not surprising
that its readership is small, contributors still less
and funds very much less. It is hence a matter of
pride to all MFC members that the Bulletin cele
brates its 1OOth month of existence, despite all
odds.
It is true that the Bulletin does not show the
dynamism it possessed earlier. In the beginning,
members aired and discussed all the problems
troubling them, and for expressing which they
hither to had no forum. The apparent dwindling
interest stems from two things : some are experi
menting with solutions which they think are right
and are struggling with them; others are unable to
find a suitable way out for the innumerable pro
blems — this latter, reflected in the title of our
second anthology — "Health Care" : Which way to
go." Of course, the dynamic nature of the Bulle
tin was largely also due to the capabilities of the
(Continued from page 3)
ing without paid full time personnel, ,et;c. Inspite
of all its limitations and failures, MFC has 'created
a lot of hopes and expectations ‘from varied quar
ters.
Pertinent question is whether MFCS can
collectively show resilience and 'tenacity to meet
the challenge of examining the process and progress
of its functioning continuously in the light of fresh
experiences and knowledge without slipping into
high profile global fashions, slogans and cliches.
MFC could show a change in emphasis after
a long debate on ‘MFC which way to -go' from
achieving socio-economic change to evloving a
pattern of medical education and methodology of
Editorial Committee:
Anant Phadke
Dhruv Mankad
Padma Prakash
Ravi Narayan
Ulhas Jajoo
Editor
Kamala Jayarao
Repd. No. P.N.C. W-96.
first two editors. Ashwin Patel and Abhay Bang.
The editorship may soon pass on once again onto
young shoulders — perhaps a sign of its rejuvena
tion. The seeming status quo is however no cause
for despair. When one goes on an upward jour
ney, one needs, once in a while, to stands on the
landing and regain one's breath. That helps in
taking the next flight with renewed vigour. MFC
and the Bulletin will continue, for they have a de
finite purpose and serve a group, albeit small,
having definite ideas and ideals.
There are some who are disappointed with
the "purely theoretical" nature of discussions. The
MFC as an organisation can never take up practical
programmes nor should it toy with such an idea.
Every experiment has to be preceded by a sound
hypothesis, properly analysed and discussed. The
Bulletin and organisation are the forum for this.
The traditional Indian blessing is, may you
live upto a hundred. Let us wish the Bulletin will
go through many centennials. For this to come
true, each member and each reader should own
his/her responsibility and help in whatever way
possible — contribute articles, share experiences, ’
write letters, collect relevant published matter for
reprinting, identify writers and last but not the
least, enrol more subscribers. To modify a famous
quote, ask not and what the Bulletin offers you, but
ask what you can do for it. That indeed is the
sign of love and friendship.
health care relevant to Indian needs and conditions
as a part of broader efforts to improve all aspecst of
society for a better life, more humane and just in
contents and purposes. MFC bulletin could also
show a shift from merely paralysing critiquie of
micro level issues to examination of various micro
level alternatives and interventions. Annual meets
also tried to respond to issues like women land
health, medical education, etc. MFC also respon
ded to live and emergent issues like reservation for
seats in medical colleges for the scheduled tribes
and castes.
These experiences make one feel
confident that MFC has the potential to respond to
relevant issues in a mature and courageous way.
Views and opinions expressed in the Bulletin are those of the authors and not necessarily
of the organisation.
Annual subscription — Inland Rs. 15/-. For Foreign Countries — By Sea Mail US 5 4,
by Air Mail — Asia US ? 6, Europe, Africa — US ? 9, U.S.A., Canada — US SilEdited by Kamala Jayarao, 3-6-515, Himayatnagar P.O., Hyderabad-500 029. Printed by
Padma Prakash at New Age Printing Press, 85, Sayani Road, Bombay.400 025. Published
by Anant Phadke for Medico Friend Circle 50 LIC Quarters. University Road, Pune-411016.
Role of mfc
Background Pap01" :f
ON the ethos of mfc discussions
mfc is a progressive, broad-front between socially conscious
medicos of all kipds—from Gandians to Marxists, We come
together with a certain minimum common understanding and
stick to the common perspectives during our discussions. Each
one has to keep his/her own ideology/jargon a bit more to
one self and operate, discuss within the parameters of the
common framework of medico friend circle. It is through this
tradition of restricting oneself to the common perspective and 1
language during discussion that mfc has been able to hold
together politically diverse elements, on a common platform.
Admittedly this does reduce the sharpness of analysis to a cert:
extent. But bringing together medicos fund mentally critical
about the medical system in India, is today a very import nt task
that some organisation must take up. mfc has evolved as such ■*
kind or organisation.
IN view of this background, we feel that persons from different
(but basically pro-people) backgrounds can come together for t
meaningful discussion if *11 of us observe certain norms.
If everybody completely sticks to his/her framework .and
political language, then different people would talk in differ .-r
languages and a meaningful discussion would become almost
impossible.
SECONDLY, though almost all members of mfc are socio-political *.y
oriented, we have kep directly political issues out of our
discussion and confine it to the politics of medical care only.
As we go nearer to the directly political question, differences
emerge sharply and a common consensus can ;ot emerge. It would
therefore be batter to refer to general political issues only ’.'1
they are directly related to the point being discussed. Within
a broad pro-people consensus there ..ire bound to be differences c
opinion and they arc- indirectly linked to politics. But if
different groups/individuals coming together start ’exposing'
each others politics then the purpose of mfc meeting would be
defeated; there would be political polemics and not a discusSix:
on the topic.
As an organisers of such discussions, we are concerned to sec
that these discussions are fruitful and the above lines may
please bo read in that context.
—from a letter written to all _o daily conscious
medico in West Bengal
Anant Phadke Oct 1983
On study and campaigns
I would like to pose a general question. Given that the old t
in mfc are /aware of the relationship between health and socio
economic issues should they or should they not concern themsd /
with study and investigation of. actual issues that ccme up an;
start mobilising around issues? I think the answer is "They
should".
SHOULD not old-timars concentrate on alternatives and compai.> s'
What does campaign peally m .an unless it means study and inv.-r:
getion of relevant issues and mobilising and helping to mobile;
around them?
.. . .Lalit Khanra July 1932
- 3 Regarding fran- ideas and suggestions—we hope that at
least for few coming years we would be having nothing to suggest
to MFC but to adopt from you and transform our awareness.
w B rahmaputhran
Calicut Medical College Kerala.
I am writing for several reasons (after the annual meet
1985). One to express my happiness over the frank and honest
discussions. Two because of the opinions expressed by all those
who are themselves field workers. Three because of lack of
hypocracy among participants. Four .a very keen sense of urgency
militancy and so on.
I am happy for having got acquainted with so many people
who have shown an inspiring disregard for greed, for money
affluence and power etc., I know these things to be not as
absolutely rare as thougntgenerally but meeting them was a
pleasure if not something very astonishing.
I want to also convey my wish that I will be willing to
undertake some sort of specific task for MFC. My own subjects
of interest, work and some elementary research I am doing and
some experiences (othersthan with the Tibetian settlements)
I will be willing to share when they become sufficiently
worthy of being shared.
-—S.K. Kelkar, CMC of a Pvt. Hosoital, Maditeri
Karnataka.
***
*****
*$i***
*$**
Community h;auh ctu
47/1,(First Floor)St. Marks Hoat^
BANGAkOBE • 560 001
ROLE of mfc
Background Pager I
Notes on the discussion at Patiala
July 1985
THE discussion in Patiala was an opportunity to reflect on and
discuss together the papers of ANAHT PHADKE and ASHVIN PATEL
which were featured in the special mfc bulletin nos.100-1
in April-May 1984 and to consider the issues raised by ABHAY
BANG in a recent letter which had been circulated before the
Patiala meeting. A short report of these discussions was featwi.
in mfc bulletin "116-7 (Aug-Sept 1985). The following minute- is
an attempt to highlight the questions/issues/comraents raised
during the discus ion so that a dialogue/discussion initiated
so that a dialogue/discussion initiated in Patiala can continue,
TO help learn from past debates on some of the issues, it was
decided that old timers would support the current debate by
reporting on earlier debates as and when they became necessary.
PART I;
Why are we discussing role?
mfc members have viewed mfc as a common forum where we can
exchange ideas and then go back to our own areas of intervcntic
some others feel that we should play a more active common role.
some problems
A problem we face is that mfc core group members are too busy
with their local pre-occupations ano do not respond as actively
as they could/should to common organizational/action issues.
Bhopal has been an exceptional example but even here the questj
of how much we should get involved and how organised are we
for- such interventions come up. Another problem is that we
are geographically too dispersed to effectively take up common
action. A third problem is that we are also members of other
organizations many of which are involved in action.
some questions/issues
i)
Should all our expectations and priority interests be met
from mfc?
ii)
We should look at what other organizations or networks
similar to mfc are doing and identify a more clear and
specific role for ourselves.■Is this more realistic?
iii)
The pamphlet gives a very broad perspective and it
is expected that e<>ch of us are promoting this
perspective through discussion and action in our local
areas. Is this really happening?
iv)
As individuals we may be doing it on our own. But can
we do some of this collectively?
v)
We feel the need for a near full-time convenor but are
are not willing to give more time organizationally to
support a common endeavour. Is this realistic?
vi)
To ask what we can do as a group or agency...may be
pos-ing a model that creates problems. But should it be
posed?
vii)
If the cor group remains as passive as it is at present
(exception of Bhopal intervention) then should be seriousl.
decide what we c in/eannot do in the future?
.2
Role identification is not just a convenor's headache.
It is neccsary for $11 of us to reflect on this and
• share these ideas so that common priorities can evolve.
How to do. tnis?
viii)
ix)
Arc via joining mfc because we think it'has a role to pl:
in health care toflay or are we joining it because we
are already doing what mfc stands for?
x)
How many of us are really interested or are willing
to give time for collective action? Without such
collectivity how will the organisation grow?
xi)
Should we look at the reality of the health situation
and identify a role in that context? Or should we put
down our limitations and derive a role in that context ;
xii)
Except for Bhopal mfc has not played a rollective role
actively . We have not even reacted collectively to
policy issues like drug policy, health for all by 2000
national health policy etc. Why is that?
xiii)
Many of our new members,contacts and more recently forr..
organizations have great ..xpectations from us. The
pamphlet and the bulletin creates this aura. How do
size up to this expectation?
xiv)
There is a tendency to remember mfc only at meetings
and forget it after \;e go from the meetings. Why is th t
xv)
There is bound to be a constant conflict between’indivipriorities and. interests and organizational priorities
and interest . How are we going to face'this dichotomy':'
xvi)
A key Questions is are we just a discussion group, a t-_ t
tank or an organization with a perspective.beyond
•discussion to action also. This also means can there be
an mfc organizational stand emerging by consensus?
Or is there- no mfc s and but individual standsuhich ■
have some degree of collectivity?
xvii)
Those of us who have felt that mfc should react/respond
to certain issues why did they not react when they felt
we needed to?
xviii)If each of us are responding to issues in health care
in our own ways, writing, lobbying, mobilising etw. ,
is this not also .a type of collectivity?
xix’)
When each of us individually initiates some action arc .
an is ue even if it is local, is it also mfc effort? He ;
do we decide what is and what isnot?
xx)
When we work in coordination with other groups or nctw
networks, there is often ■? degree of urgency” in arriv.tr.’.
at an mfc common stand. How does one. go about getting t.'.
in a specific situation?
PART II;
Keeping Abhay’s list in mind components of role were
identified ass
a)
Evolving/evaluating alternative health care strategies .
field level.
b)
Critical evaluation and analysis of national health
programmes and health care approaches.
:3:
c)
Acting as a forum for raising health issues and organizing
campaigns.
d)
Monitoring health policies and playing a ..atch dog role.
e)
f)
Influencing health policy by lobbying and legal action.
Medical activism which would include organizing people around
health issues.
g)
Investigative research with a critical social perspective.
h)
Documentation, collection, review and dissemination.
i)
Participating/linking with other groups in a health action
network.
j)
Consultancy/support work, for community- health projects.
k)
Organising field orientation for medicos and others to
sensitise them to broader social issues in health.
1)
Building stronger links with members through sharing
of experiences and evolving common perspectives.
a)
What do we mean by alternative strategies', or experiments?
Do we mean those strategies or attempts that help us in our
overall goal a more, people oriented thealth system which
we set ourselves?
We need to identify problems and gaps in these strategies,
formulate research programmes' to. gat over these problems,
look at how such ideas can be practiced on a wider level;
communicate our cri-tique to sensitive sections primarily medi'os
and decision maker, in he...1th care and thus try to influence
health cere policy.
A critical study is not enough. We must communicate our
findings to sensitive sections for it to have real meaning.
Medical education is a good ex maple. What has concretely erne --d
from the discussions? Do we have an alternative medical oducr.tlci
policy worked out. if only in outline? If so, how can we
communicate it?
b)
How do we critically evaluate, existing policies or programs?
Review of literature, case studies and our own small fiuld
studies?' Is it possible to anticipate changasin policy
and lobby against it before it is finalised/formulated?
FROM (a) and (b) the important issues which arise are;
i)
What can the role of the bulletin be? Could we write abou'
our critical findings? Should it be the only forum through was ;h
we communicate our reflections?
ii)
Y/ho are the key groups to which communication should be
directed, apart from members and subscribers? Should wo
send it to key decision makers? Should we k,ep health activist
groups informed/updated?
•
iii) This basically means that whenever we take up an issue
we should identify the important target groups and
evolve a specific COMMUNICATION STRATEGY. Ve have never
.......... 4
done- this specifically in the past.
(Recently, ho /ever, the Bangalore team has done it with
Bhopal reports, Bhopal issues of ml’cb etc. In Narmada
problem influecing bureaucrats did help. Some lobbying wit;
Inj. contraceptives and TB-issues of mfeb has also been
done. In oral contraceptive issue senior politicians were '
useful, in the nuclear fuel complex issue letter to the
Prime Minister was useful. From our own experiences, thor fo: ■,
communic.tion/lobbying is import nt/usefui)
Writing
iv)
reports is not enough. We need to write different
types of reports for different groups so that our arguments
are demystified and available in the form to stimul te actio?- ,
Another important policy issue willbe the need for action/
intervention meetings- not just discu-sions. Just sen- ing cut
information is not enough. Bringing groups together to discu: ;
finding; so that actions by different groups can emerge is also
an import nt task.
v)
Should there be a greater result orientation in our efforts?
vi)
eg. Should we ask ourselves what critical information have
we added to he ,1th activist groups in a year?
vii)
Another
important question is re? the 'critical analysis' a
word that we use often. For whom is this analysis? Is it
just intellectual stimulation or luxury? Do we suggest socially
relevant alternatives? Should critical analysis be an end
by itself?
FROM all the discussions five roles emerged as of greater priority;
1.
Critical analysis of policies and programmes.
2.
Evolving alternative strategies of health core
3.
Lobbying/communic. ting with intention of changing
policies etc.
4.
Support/sharing ideas/consultancy for community health
interventions.
5.
Investigative field research.
TO continue these discussions, it was felt that small groups/c;.l’_s
could bo formed who would go into each of these in greater"
depth and evolve more clarity in action.
1.
Mira Shiva, Padma Prakash, Abbey Bang, An:.nt Phadke
Ravi Duggal.
2&A
Abhay Bang, Narencer Gupta, Anil Patel
3.
Dhruv Mankad, Mira Shiva, Mahtr.b Bamji
5.
Satyamsla, Padma Prakash, Kamalabahen.
MANY core group members were undecided in making a choice
immediately. So it was decided that they could join cells as
and when they evolved their own priorities.
5
:5:
Meetings
DURING the discussions it was often raised that common
perspectives/consensus can emerge only through more common
meetings at the regional level.
Can core group members organise such meetings? Previously
in the past they were done—regional meetings, camps etc.
Even values like not taking drug samples etc., are hardly known
among newer members. These could be discussed along with common
reflection/action.
Non-medicos are intimidated by medical jargon and professionalisi
that commonly creeps in. Medicos are intimidated by socio
political analysis or jargon. Frequent local meetings c: U..
get over this problem. Some of this 'intimidation* is often
due to the aggressive ways in 'which we debate on issues. Can we
recognise each other as thinking/evolving human beings and bring
more spirit of dialogue and listening' to the other rather than
proving a point’type of mentality?
Reporting
A nagging question that came up often in the discussion was:
why do core group members not send reports of their activities,
their -reflections and impressions/responses to issues? Why are
■wo hesitant to share our views? Does it in any way reflect on
the ethos of our discussions/our group?
Role of MFC
Background - III Paper
Requests to the MFC convenor 1984-85
The role of MFC can be discussed in abstract. It can also be
seen in the context of the sorts of requests that come to the
MFC Convenor from different people, groups, organisations. The
following is a list of requests that came ro the mfc office in
1984 and 1985. It gives some idea of the expectations of people
who contact mfc for support, advice, action and solidarity.
(Can we respond to all these requests?
Should we respond
to all these? Do we have the collective technical"know how,
organisational base or shared perspectives to respond to these?)
Note The classification is adhoc and does not represent any
priorities. The list is- also not complete.
1.
Support to Research (mainly information preferences etc)
Govt, of India's policy towards Drug’industry
(research student)
Study of occupational injury among orthopaedic patients in
an ESI Hospital
'(medico social worker)
Ayurveda and occidental medicine (French postgraduate)
Health Education in India (German Research Students)
Medical Education in Bombay presidency (Medical College
Professor, Bombay)
Appropriate technology in wather supply and sanitation in
India (Geography postgraduate, UK)
Drugs availability/marketing in the third world
(Oxfam researchers)
Occupational hazards of radiation in a factory
(researcher from Kerala)
Drugs, pesticides, Dams and Deforestation
(Oxfam campaign researchers
2.
Participation in Seminars/Workshops
Popularisation of science (KSSP Trivandrum)
Science Teaching & Education Policy (Eklavya, Bhopal)
Protecting the child consumer, (Indian Academy of
Paediatrics and QG S I, Gorvkhpur)
Fen' years after Hath! Commission (KSSP, Trivandrum)
Bhopal Never Again ( K Consumer protection Board & I0CU
New Delhi)
The Drugging of Asia-Pharmaceuticals & the poor (IOCU, VHAI,
ACHAN? Madras)
Peoples.Science, Environmental protection and Democratic
rights groups convention (ZGKSM, Bhopal)
People for Drugs or Drugs for people ' (Welfare organisation
J alpaiguri)
Health Workshop (TN Theological seminary, Madurai)
+ Many meetings related to Bhopal and issues arising
our of disaster (various city networks)
Community Health interventions
Planning Health Education programme in urban slums
(Chetan, Delhi)
Support to trainers of community health workers
(Volag, Madras)
3.
Role of MFC
Background - III Paper
Requests to the MFC convenor 1984-85
The role of MFC can be discussed in abstract. It can also be
seen in the context of the sorts of requests that come to the
MFC Convenor from different people, groups, organisations. The
following is a list of requests that came ro the mfc office in
1984 and 1985. It gives some idea of the expectations of people
who contact mfc for support, advice, action and solidarity.
(Can we respond to all these requests?
Should we respond
to all these? Do we have the collective technical'’know how,
organisational base or shared perspectives to respond to these?)
Note The classification is adhoc and does not represent any
priorities. The list is- also not complete.
1.
Support to Research (mainly information preferences etc)
Govt, of India's policy towards Drug’industry
(research student)
Study of occupational injury among orthopaedic patients in
an ESI Hospital
(medico social worker)
Ayurveda and occidental' medicine (French postgraduate)
Health Education in India (German Research Students)
Medical Education in Bombay presidency (Medical College
Professor, Bombay)
Appropriate technology in wather supply and sanitation in
India (Geography postgraduate, UK)
Drugs availability/marketing in the third world
(Oxfaun researchers)
Occupational hazards of radiation in a factory
(researcher from Kerala)
Drugs, pesticides, Dams and Deforestation
(Oxfam campaign researchers
2.
Participation in Seminars/Workshops
Popularisation of science (KSSP Trivandrum)
Science Teaching & Education Policy (Eklavya, Bhopal)
Protecting the child consumer, (Indian Academy of
Paediatrics and QG S I, Gorv.khpur)
Ten years after Hathi Commission (KSSP, Trivandrum)
Bhopal Never Again ( K Consumer protection Board & I0CU
New Delhi)
The Drugging of Asia-Pharmaceuticals & the poor (IOCU, VHAI,
ACHANj Madras)
Peoples Science, Environmental protection and Democratic
rights groups convention. (ZGKSM, Bhopal)
People for Drugs or Drugs for people (Welfare organisation
Jalpaiguri)
Health Workshop (TN Theological seminary, Madurai)
+ Many meetings related to Bhopal and issues arising
our of disaster (various city networks)
Community Health interventions
Planning Health Education programme in urban slums
(Chetan, Delhi)
Support to trainers of community health workers
(Volag, Madras)
. 2
3.
- 2 Opinion on Health Records & under five core
(Coordinating & funding agency, Bangalore)
Course for school teachers' and mothers
(MFC members, Calcutta) ’
Training of .village Health Workers (Volag, Dharwar)
Survey of Tuberculosis in slums (MFC members Calcutta)
4.
5.
Support to medical/ Non medical student initiatives
6 month special elective in Community Health
(Final year Medico, CMC Vellore)
Community Health Project tour in Karnataka, Tamilnadu &
Kerala (Medical students-group from AIIMS, New Delhi)
■ Community. Health & Development Project tour in South India
(postgraduate & Friend, Karnataka)
Elective with MFC to get broader understanding of medicine
(US student before joining medical school)
Public Health Committee of All India Medical Students
Association requesting for-ideas for action by Medicos
Exhibition on'Alternatives - Jamkhed and Astra (Medical
studdnt group, Calicut)
Medical Student's Debate on Health issues (student group,
AIIMS, New DSlhi)
Permission to print mfc articles in student union? magazines
(several Medical Colleges in Keraha
Voluntary placement in MFC related hospital or rural
projects (Psychology Student, US)
Elective ..in Mental Health (Psychology postgraduate,
Chandigarh)
Study tour of volags in Health Education in South India
(French Students)
Lecture discussion byMFC members for Medical student
of groupj New Delhi.
Miscellaneous/Unusal
Discussion on social movements at rural level, Drugs &
environmental issues ( representative of french India
Solidarity group)
Education Foundation in Gujerat requests for MFC members to
give lectures at Community Science- centre in Saurashtra
Technical support requested from medical group working
with refugees from Sri Lanka
Information for All India Science and Technology Directory.
Request's for initiating' National dialogue on building
rural health delivery systems and comprehensive assistance
for low income rural mother & Children (Preluminary
reports from a Volag in Gujerat)
Charitable Trusts requesting for contacts with groups in
'Rural Health Education (a UK registered charity and afamily
trust in Bombay)
Members in state-govt. Health Service requesting for
ideas to tackle the system
A doctor couple (both Ophthalmologists) interested in
voluntary social work - request for-ideas.
Support to peoples Health Forum in Madurai formed as a
result of inspiration from MFC
Paediatrician asking for thought provoking articles on
Community Health for his Department staff (Medical College
Aurangabad)
Material on Tuberculosis for cont.’inuing education of
- 3 Church related Medical Coordinating agency.
Solidarity with Third World Action network for information
dissemination.
Request from consumer group to study baby food sale practices_•
(Consumer guidance Society, Bombay)
Request from German, Drug action group in drug campaign
against German multination.
MFC-Linked action/campaign/initiatives
Writ petition against import of injectable contraceptives
Epidemiological and Socio Medical study of Bhopal gas victims
Rationality study on Antidiarrhoeals
Study of pregnancy outcome in Bhopal
Rationality study of Analgesics and antipyretics
Circulation of a note on communication strategy on health
issues in Bhopal
participation in the evolution of a comprehensive medical
care strategy in Bhopal
Technical support to volags and action groups in Bhopal
Circulation of note on Health Services in tribal regions
to get collective response
Circulation of WHO document on government and
Voluntai'y agency participation to get collective feedback
Technical handout on Sodium Thiosulfate treatment for
doctors and volags in Bhopal
Health Education pamphlet and porler for gas disaster
victims in Bhopal.
Anthology of articles related to medical education
generated by MFC sources
Fact finding report on medical relief and research
in Bhopal
Role of MFC
Background paper
IV
From letters to MFC
I am getting more and more convinced that progress in this
country in community medicine is likely to come from the work of
devoted individuals rather than employees of the system.
'*4 K.,..-Ramachandran,. Professor Biostatistics, AllMS'
At. the outset.let me congratulate the MFC team for their singular,
:ue contribution, you 'have; once again proved what the voluntary
sector can contribute' and that too, in a crucial area where the
public sector has not come upto the expectation.
The way the whole problem has been handled by those responsible
including the administrators and the leaders of the medical
profession does not leave the impression that thoir actions
were guided by the true gravity of the situation and a real
concern for the lives of those affected. The MFC report owes
credit, morethan anything else, for bringing this out. Yours
is not an armchair critique but based on a serious, indepth
on the spot community enquiry .
.
. '
It behoves the sscientific community at large and the medical
profession in particular in their role as custodians of the heath
and wholeness of the community to exercise greater prudence
of their stewardship.
Thanks once again to the MFC Team and its leadership.
.— George Joseph, Ex Professor Community Medicine, AIIMS
I too am deeply concerned why even the concerned community
physicians have not succeeded in developing the sort of thin .' king which could be developed for NTP. I am hoping that people
in MFC will be able to ponder over this, issue and as a result
of the deliberations we will have creative thinking from MFC
which will influence health s ervice development concepts and
hopefully practices in India and abroad
(Jan 85)
My complaint with the s tudy is thatwhile giving so much of
importance to the controversy on the cyanogen theory the MFC
group has unwittingly drawn attention away fro$ much more
important aspects of the tragedy, even in conventional public
health terms. Besides of course there are very critical poli
tical economic and social dimensions.
(June 85)
—D. Banerji, Professor Comm.Health & Social Medicne,
JNU.
This letter comes after repeated readings published in different
papers and EPW about your activities
I believe that you
are also helping to strenghten the organisations which at
aresent are putting upresistant'struggles against the savage
oppression of the state.machinery. I express my solidarity
with you in your fight against these oppressions and social
evils prevailing in the present Indian Society....1 am a health
worker residing in one of the remotest villages of Uttar Pradesh
and while writing to you, hesitate a bit to ask you, whether
you keep yourself confined to only MBBS degree hokdsrfe’' or not?
I hope you will be friendly enough to make this communication
two-way. r~
j1’
i
tl ‘ '
—AmitfVa Choudhry, UP
This is just to inform you- that I would like to stop receiving
the MFC bulletin and to explain why.
2.
- 2 -
There are so many reasons actually. But it boils down to this,
that very few people can gothrough books like Health Care in
India and MFC
still persist in having- faith in radical soc .alism of any type. What penetrates throughout in the .hatred of
the human race, so ...cleverly disguised as the love of suffering
humanity ..It was Russel, who applied the test to those who wou .d
destroy the present system—to find out if they.are creative or
destructive--!ind out whether. they, have a practical alternative,
or. merely mouth slogans.
The World is divided into angels and devils, good men and bad.
Everything is blackand white5 the rainbow is a mirage Human
beings are tools towards a(marxist) heaven, ruled by a (marxis'J
intellectual criche, governed by the pcwsr of fear, hatred and
propoganda.
Forgive my trite statement, but I do. not believe that good
can come out of evil, that gbS^iirfism and hatred can be creative'
There is plenty that needs to be done... .So like so many befor-'
me, I too an. Tearing the negative atmosphere.
—Newton Luis, Muvattupuaha, Kerala
9
I recently read a"handbook entitled ’Health Care which way
to Go'published by MFC. I found several of the articles quite
engrossing. The appendix related to the genesis of the
group was to me specially significant. Being a superintendent
of a 30 bedded rural hospital in a backward district.......... t .■ ■
...... I am becoming increasingly aware of the limits of the ther'peutic approach to health care•Additionally a constant entangle
ment with administrative problems and a growing alienation wit:
actual clinical work (and thus the challenge of Diagnosis) is
rapidly leading to a pre-senile fossilisation of my thought
processes.' Naturally I would like to avoid such a state of
affairs-... .therefore would request you to let me know something
about your organisation and just how I could participate in it
atleast passively if not actively.
— Arab ar Kumar Gupta, Islampur, West Bengal
•Reactionary ideas and wretched trends are becoming powerful
in the medical profession. A sense of inevitability and help
lessness as regards the corruption is-growing. Organisations
like the MFC can a ctively- be in the forefront of a struggle by
the progressive sections amongst medicos to resist these trends.
And this can only be done by actively taking part in struggles
both inside and outside the profession for a. more lust and
rational medical system.
We are trying our best -to mould MARD into one such organisation. With the help of friends like you all and magazines
like MFCB and SHR we hope to do so.
Sanjay Nagral, SHO, Bombay.
Ours is neither a formal organisation nc.r even-a group
It is just a gathering of some 10-20 students moulded uncon
sciously to a common awareness just by living together in a
hostel for 2-3 years.
Some six months ago an idea came into our common talk to th'nk
of some practical forms of activity which we can adopt in our '
future medical practice. And we decided without breaking the
informality of our gathering to reprint relevant articles regard
ing health issues and to distributeit inside the whole campus.
It was at this time that we got the MFC manifesto which we
published m Nov 1983.
3.
8ANGA1.0..t..bv4-5'fc/aoatf
ORGANIZATIONAL DEVELOPMENT OF MEDICO FRIEND CIRCLE
A BRIEF OVERVIEW - (June '88)
INTRODUCTION
This note is primarily meant for prospective core-group
members to appraise them of the organizational development
and status of MFC. But it will be useful for the current
core-group members for the purpose of self-clarification
and for discussions on organizational policy matters in
future. It portrays the evolving process of our development
and explores our strengths, our weaknesses and the
opportunities as well as the threats to further growth.
This note is a supplement to the printed leaflet
which briefly gives an introduction of MFC. This note is
also an attempt at an internal audit and must be read in
that light. It is hoped that it will challenge all of us
to think about the future more creatively.
1•
The Role of MFC
1.1. In the initial period after the formation of
M.F.C., there was a substantial amount of debate both in the
pages of the MFC-bulletin and in several group discussions
about the role of MFC. The debate in the bulletin has been
included in the anthology : HEALTH CARE, WHICH WAY TO GO?
and it is worth going through this debate and the consensus
that emerged at the end of it. Only a very brief summary is
attempted here:
The founders of MFC (the original 'core group* of 1973,
which had links with Jayaprakash Narayan and the Bihar
Movement) were primarily motivated to aid the process of
fundamental socio-economic and political change. On account
of this motivation, they invited and were joined by other
•medico-friends' (not all doctors) of liberal, Marxist and
other background. Therefore, in the initial Annual Meetings, the discussions were very directly overshadowed by
this consideration of social revolution. What is more impor
tant, the content of the discussions tended to rapidly
gravitate to economico-political issues. This resulted in
disastrous consequences, viz :
i)
younger newcomers like medical students thought
that MFC was a sort of platform for political
debate, perhaps a recruiting ground for
political organizations and they had not come
to MFC for such things
ii)
for health activists no concrete programme
in the health field could emerge from the
discussions and in that sense, these
discussions were sterile; and
iii)
since MFC consists.of people from various
political / ideological backgrounds, there
was a danger that political debates would
eventually lead to the splitting of MFC
into many groups, without any advantage to
the health-movement. The concept of a
friends circle would also be in danger.
•
2
2
After much debate, introspection and also after paying a
price in terms of the disappointment of many new comers....
etc.> we decided at an important meeting in Sevagram in 1979
that in MFC we should focus on Health—issues and include the
directly and concretely relevant socio-economic-political
issues involved without getting entangled in the general
economic-political issues and debates. The newer pamphlet
(1981 ) meant to introduce MFC's general perspective to
the newcomer, reflected the minimum common understanding
of MFC about the health system.
1.2 Attempts were made to make MFC active orga-nizationally to lobby for certain reforms in the medical
system and to critically respond to Government's initiatives
or the lack of it, on health-issues. But there were manny
problems. Most MFC-members are so involved in local work
that they do not get much time for MFC's Organizational work.
India is a vast country and social conditions are such that
for any change to occur at the national level, a great deal
of organizational mobilization is required. At least for
the present, MFC-members are not in a position to function
even as an effective watch dog body at the national level.
It is, as of today, primarily a platform of like-minded
critical health activists and a 'thought-current. This in
itself has a kind of an impact in health circles; but that
is all !!
1.3 Attempts were made and are being made to form
a loose 'MFC-group* at a local level, by taking up some
collective action from MFC-perspective at the local level.
In the earlier period, regional study camps to study a health
issue through field work helped to consolidate MFC-identity
at regional-cum-local level. The 1Rewa-Camp' conducted in
1978 to analyse the problem of Lathyrism in all its aspects
was a successful, self-educating experience. But unfortunately
such efforts were not repeated later.
2.
The Core-Group
The core-group is
only an informal group of MFC
members who are concerned about and work for the growth of
MFC. It is also a friends-circle and a platform for full
fledged heated debates and warm exchanges 1 The 'criteria'
for requesting a member to become a part of the core-group
is that the member must have attended at least one annual
meet so that all core-group members meet him/her in person,
and atleast somebody in the. existing core-group should know
the personwell enough to be able to judge whether he/she
can fit into the current 'culture' of the core-group heated debates, yet getting along together, learning from
each other and also being able to face the not so pleasant ‘
organizational weaknesses of MFC. Any core-group member
who does not attend two consecutive core-group meetings, or
annual meetings without even writing to the Convenor auto
matically drops out of the Core-group.
MFC badly needs more core-group members—those who
would spend time and energy for MFC's organizational growth.
Due to the all round steep increase in the costs, running of
the bulletin and maintaining MFC's offices ( now three ! ) has
become more and more difficult - lack of money and lack of
human-power has almost threatened the very existence.of MFC.
Contd....
3.
3
3• R°le of Annual-meets and Core-group meets
This issue has been a very iinportant iseue right
from the beginning since apart from the Publication of the
bulletin, annual meets and core-group meets are the only
two other regular collective activities of MFC.
In the initial years, the annual meets were seen
as mainly to expose interns and the like to MFC, its persp
ective; and also to consolidate MFC's general perspective.
As time went by, most of the core-group members ceased to
have any link with the medical colleges and hence there were
now not many items in our contact circle. Secondly, due to
the Shibir like Annual-meets, the old members did not get
anything new to learn. Similarly-many new MFC-members were
persons who had some expertise or experience in the field of
health and they also did not like the Shibir like annual-meets;
and experience showed that the collective knowledge, under
standing of MFC was enriched by the new inputs from those
new members who had experience or expertise in the field
ofhealth. After a lot of discussion, it was finally
decided in a Core-group-meet in Hyderabad ( in 1983 ) that
influencing interns or housemen is not the function of the
annual-meets. This work has to be done at a local level by
core-group members. The aims of the annual meets, as they
have emerged through experience and discussions are outlined
as follows
3.1.
Annual Mee4 s
1
3.1.1
To develop, share and enrich our collective under
standing of the various aspects' of the health system in India.
Somewhat wideranging topics should be chosen so that doctor's,
health /.orkers working in different aspects of health, new
resource persons, senior workers working' in different areas
of health, would also come to MFC-meets, would know about MFC
in detail, and the MFC circle would broaden in different
directions.
3.1.2
To meet in person,,those individuals whom we have
me, only through the bulletin or through correspondence.
To know each oth@t's experiences, ideas, feelings is an
important function of the annual meet. Conscious efforts
have to be made to see that the annual meet is not totally
dominated by the theme-discussion, but that getting to know
each other, making friends, broadening the circle also
takes place.
3.1.3
Forming a lobby-group, or collectively getting
involved in our action around an issue is not the aim of the
annual-meet, To arrive at an 'action-programme' as a
routine in the final session of the annual meet and then not
to follow it (given the nature and limitations of MFC) is
worthless as well as frustating. We would, however, try to
arrive at conclusions (which may be
in the form of divided
opinions also) so that something concrete emerges out of
the discussion. Secondly, some areas for our further study
would also be outlined. If some participants want to carry
4.
4-
out some action programme on the issue, that is most welcome;
but MFC is not in a position to take up ‘action-programme1 as
one of the aims of the annual-meets.
3.1.4
Getting to know in detail, the project or the insti
tution which hosts the meet is not the aim of the
meet. There will, of course, be a brief introduction,
but for those who want to see the project/institution,
separate arrangement should be made before or after
the meet with consultation with the hosts. Through
trial and error a distinctive mode of discussion at
the annual meet has been evolved. The Note : ’ The
aim and the method of discussion at the MFC annual
meets ’ gives some details regarding this.
3.2
: Core Group Meets : Initially, core group meetings were
dominated by debates about the role of MFC, evalua
tion of earlier annual meet, organizational matters,
preparation of anthologies, arrangements for regional
camps, annual meets etc...etc. It has been a friends'
circle and all sorts of issues were also debated.
Once basic things were sorted out, more attention
was paid to the content of the annual meet.
3.2,1
Apart from discussion on organizational matters, it was
thought that much more time should be given to the
discussion on the content of the coming annual meet.
A pattern has emerged : afte.r the annual meet at
January-end, the topic for the next annual meet is
tentatively decided, a few persons take up the task
of doing some exploratory work and in the coming
core group meet, they present the main issues for
discussion. These presentations and the discussions
about the issues give a more concrete idea about what
needs to be done to organize a good discussion in the
coming annual meet.
Recently, it was thought that we should write
a summary booklet based on the background papers and
discussions of the annual meets, since the material
and the discussions are generally of good quality.
For want of space, this material can't be put in
the bulletin. The booklet would reflect the consensus
of MFC (if that is not possible, more than one view
point would be reflected) on that issue, drawing
liberally from the facts, figures, arguments in the
annual meet papers and discussions. Somebody would
write a draft, to be circulated in advance amongst
core group members. After discussing the draft and
the comments, a final draft would be prepared,again
to be approved by a committee of volunteers. If there
are any sharp differences of opinion, then they would
be clearly spelt out by respective persons.
Alongwith somewhat indepth discussion of the
issue in the forthcoming annual-meet, indepth discu
ssion on the theme of the previous meet would also
take place in the core group meet. For example,
there was a very sharp and good debate on the issue of
critique of the National Tuberculosis Control
Programme.
5
5
3*2.2 The core group meets were so dominated by discussions
on the annual meets and organizational matters
that we found that we had stopped sharing and
analysing our experiences in a systematic manner
—one of the main reasons why we are meeting
together ! It was, therefore, decided at the
Khandala-meet in 1985, that we should consciously
devote a few hours during the mid annual core group
meet for some systematic sharing of what each of us
has been doing, what are the problems one is facing,
what has been the achievement etc. There will be
feed-back,comments, friendly advice etc., after
each sharing; but systematic, indepth discussion
would take place only on some issues / experiences
selected by the whole group. Otherwise indepth
discussions can continue amongst interested indi-viduals, once initial discussion has taken place
collectively.
The mid-annual core group meet would,
therefore, consist of three days as follows :(1 )
Preparation for the coming annual meet-1 day
(2)
Sharing by core group members - 1/2 day
(3)
Discussion on the draft of the booklet
based on the last annual meet, or any
other theoretical presentation, draft
,
(
- 1/2 day
Organizational matters- 1 day.
(4)
Those core group members who want to see the work
of our hosts insome detail, would come earlier or
stay back for this purpose. It is expected that
at least a few would be interested in such a special
visit. (The rest of the core group would of course
have a brief introduction to the project.) If no
body wants to see the project in any detail, there
is not much point in going out of the way to a
corner for the core group meet. The Ashram at
Sevagram is quite a central and convenient place.
It is hoped that in the coming core group meets
there would be a much more fruitful, indepth, syste-matic discussion, sharing and interaction at the
individual.level.
4• Convener-ship/Editership, Editorial policy :
4.1♦ MFC's Convenor and Editor change every two years or so.
This is an attempt at sharing the responsibility
in rotation so as to give scope for newer ideas
from different persons. Those who have been Conv
enors or Editors have a first hand experience of
the woes of this work, and hence, a more sympathetic
and co-operative, responsible attitude develops
vis-a-vis the current Convenor, Editor. As time
goes by, the work of the Convenor is becoming more
or less of full-time nature. This is also true for
the Editor if he/she has to look after the printing
6
6
and despatch of the bulletin as well. Ways must be found
to reduce the burder of the editor and the convenor.
This is a dilemma which has not been solved. Paucity of
members, lack of organizational discipline, lack of funds all have been knotty problems. Unless membership and
subscriptions increase, it would be difficult for MFC to
survive, let along grow, for purely financial reasons.
4.2
The Editorial Policy has emerged through the experience
of last ten years. It has now been formalized in a
brief note meant for prospective authors.
5. Funds :
5.1.
MFC has always been short of funds. Initially the losses
in the publication of the bulletin which was the most
important activity of MFC; (Now the annual meets are
also as important) was about a couple of thousand
rupees a year. This was made good by collecting
individual donations from sympathisers. But this loss
has now mounted upto Rs. 5000.00 per year. We got a
donation of Rs.5000/- twice from the Nutrition Foundation
of India; but this was only a temporary solution.
Additionally, the office-expenses of the MFC convenor
and that of the Rational Drug Policy Cell / registered
office are also there. Unless we increase our subscribes
and members, we would not be able to survive without
loosing our financial autonomy.
5.2.
The idea of having a full-timer for MFC and its financial
implications have been discussed several times. The idea
is : we come across so magy people who did not know
about MFC and have immediately become members after
knowing about MFC, reading the MFC-bulletin or
anthologies. If a full-timer can travel around the
country or a part of it, to medical colleges, science
and health groups, institutions etc., we may get many
new members. But this required :
i)
a proper person who is both capable of and
willing to represent MFC;
ii)
core group members should be able to help
such a full-timer by helping him/her own
area in various ways;
iii)
funds from a proper source.
The last requirement is as important as the other two.
By and large, MFC has avoided taking outside institutional.
funds. The most important reason is unless the major
part of any movement's activity, at or at least its core
activity is financed from members and sympathise-rs or
thro' sale of literature....etc., outside institutional
financing tends to be harmful in the long run by
pushing back voluntary effort and voluntary commitment.
MFC has been an expression of a critical current in the
health field, of 'movement' (understood in a broad sense)
and if MFC starts becoming dependent upon outside
institutional funds, it may become an institution.
Such institutes are likely (thought not necessarily) to
degenerate into one of those institutions which are run
because there are funds and paid' full-timers, irrespective
of the social need for such an institution.
7
7
5.3
Fully recognising the possible danger of outside insti
tutional funds for a full-timer p-MFC twice decided
to take such funds on a temporary basis because
growth in the number of members and subscribers has
become such a vital question. There was an explicit
condition that if after two years, there is no appre
ciable increase in memberships and internal financing
to make MFC financially self-reliant, we would stop
taking such funds. Unfortunately in both the
instances, the individuals who had offered to work
as full-timers, withdrew their offer for personal
reasons.
5.4
Twice, MFC has taken funds from OXFAM (Rs.5000.00 and
Rs.10,000.00 respectively) for its first two antho
logies. There were no conditions set by OXFAM and
taking these funds has not affected MFC's financial
autonomy or self-reliance. Though our anthologies
sell well, the proceeds of sale of these anthologies
are not always sufficient to bring out the next
anthology. Funds for publications are thus going
to be a problem. So long as MFC is serving a
socially felt need, is based on voluntary commitment,
funds from even a foreign funding agency like OXFAM
is not excluded. We reiterate that we are fully
aware of the problems and potential dangers of out
side institutional financing especially from a
foreign source.
6.
Administrative Cell :
Since some organizational matters are primarily of
an administrative nature (preparation of budget,
fulfilling official requirements... etc.) it was
thought that there is no point in the whole of the
General Body or the Core group to spend time on
such matters. An Administrative Cell has been set up
since 1985, consisting of a few past convenors, the
present convenor and a couple of 'experts'. They
meet prior to the annual general body meeting and
work out the details of some of the organizational
matters and present it to the general body. The
General Body may modify their plans if necessary.
This arrangement for administrative matters leaves
more time for the general body to focus on policy
issues or other important matters.
7.
MFC's Involvement : Bhopal-Disaster, Rational Drug
PoTicy~~Ce~n~~;
----------- -------------
7.1
Bhopal ; MFC's involvement in Bhopal has been the only
collective organizational effort (apart from the
Bulletin and Annual-meets) of some major significance.
Several core group members stretched themselves to
the full to conduct two important studies on the gas
exposed people, to prepare educational pamphlets for
them and to participate in medical relief. The first
of these studies was the only published, community
based epidemiological study available on the over-all
health effect of the gas leak on the exposed population.
MFC can thus rise to the occasion and play an .
important role. But by and large, it remains a
platform and thought current.
8
8
7.2
8.
Rational Drug Policy Cell : Concretely criticising irrationalitie's in the production and use of drugs
and putting forward alternatives, has been one
of the activities of MFC-members. MFC has,
therefore, been an active part of the coming
of various groups interested in drug issues from
different parts of the country to form the All
India Drug Action Network (AIDAN). The movement
for a Rational Drug Policy, has been one of the
rare examples of different groups coming together
on a health-issue and preparing a substantial
critique of the National Policy and an equally
solid, concrete alternative to it. MFC-members
have contributed to this movement by participating
in seminars, newspaper campaigns, lobbying with
the government and in the formulation of the
perspective of AIDAN. A Rational Drug Policy Cell
has been formed to look after MFC's involvement in
this issue. The two studies published by this
cell (rationality studies of antidiarrhoeal and
analgesic mixtures) have been found to be very
useful in the drug-campaign.
Modalities to represent _a,nd pursue work on behalf of MFC;
There is lots of action and campaign going in the
health and related field in India, in which MFC
either at local/regional or national level is
required to or is asked to participate. Core group
members are always in dilemma what to do in such
a situation ? Is MFC simply a thought current,
and no active participation is possible or MFC
should respond to theise issues if there is possi
bility ? Local MFC group may participate in such
activities. It is understood that core group members are those who understand the ethos of MFC
and would not take any decision contrary to the
traditions and perspective of MFC. It is in this
spirit that following norms were decided in the
core-group meet at Wardha in June, 1988 :
9.
1)
When an individual or group of MFC core
Group members feel the need or are requested
to represent on the committee, he/she may
do so and inform the convenor.
2)
If the issue is of national or regional
importance then also he/she can take action,
but it will be discussed in the next follo
wing core group meeting and the members
should be present for consultation.
3)
If there is difference of opinion, local
group will act in trust given the autonomy
of the group. Simple majority decision
will not be the criteria for rethinking.
To be or not to be : MFC has survived many crisis and that
reflects its inner strength. But recently, once
again doubts have been raised about the very
existence of MFC because of i)
stagnation in subscriptions and membership
at a very low level, making it even
financially difficult to continue;
9
9
ii)
a feeling that the original aim of aiding;
the social revolution is not being served
(social revolution is not around the corner
as was once thought!) Many core group members have developed their own areas of
creativity and involvement; and do not
really gain anything! from MFC—this is
shown in declining participation and
enthusiasm in even writing for the bulletin
and all other MFC-matters;
iii)
new members are interested only in a parti
cular theme of the annual meet; and not in
the organization. Hence, there is a very
high turnover rate of new members. It was,
therefore, suggested that MFC has outplayed
its role and there is no point in continuing
only for sentimental reasons.
This suggestion, made by a core group member in a letter to
the Convenor before the recent mid-annual core group
meet at Pachod in July '87, was discussed seriously
at this meet. It was agreed that the above argument
is true to a certain extent, but there are the
following counterveiling reasons for which MFC has
a definite role to play and we need to continue to
exist as an entity :-
1.. MFC has, over a period of twelve years,
developed a very healthy tradition. Doctors
and other health activists from different
ideological backgreunds' have debated, shared
their ideas and experiences from a pro-people
perspective in a non-secterian and non-dogmatic
manner and have developed a feeling of solidarity
despite continuing differences. Very critical,
honest, informal, indepth discussions on socially
vital health issues by people who are themselves
engaged in health action at grass root level is
an achievement in the context of the presently
prevailing overall socio-political culture in our
country of opportunism, short-sightedness, and
sectarianism. It would be wrong to liquidate
such a tradition.
2.. Many activists, look upon MFC as a source
which would give them a critical, non-medicalized
view point about different issues in health. The
Bhopal-studies have underlined the important role
MFC would play. There is a social need for such
a group to continue. The Convenor gets scores of
letters from new members who are thrilled to know
about MFC, its perspective, books and who readily
join MFC.
Though MFC would not grow the way it did in the
initial years, it continues to get new members and even core
group members. New core group members also expressed the view
that they found MFC to be a very stimulating, useful, serious
honest platform.
Therefore, it was, decided to continue though
with our fingers crossed !!
********
n-M
EXTRACTS FROM SOME SELECTED RESPONSES
„
RESPONSE NO. 1
COMMUNITY HEALTH CELL
47/1,(First Hoor)St. Marks Road
BANGALORE - 560 001
I am not good at structured writing like filling up
questionnaires. So, I am not sending that. If you find
anything which you can use, you are welcome, to fill the
questionnaire on my behalf.
I must however thank you for sending it. That
instigated me to look up the 100th issue of the Bulletin and I
realized to my consternation that I had not been 'filing' my
copies of the Bulletin from No. 121 onwards. They were lying
all over the place (fortunately, the place is small) and you
have thus helped me in putting them all together. This
negligence may partly be explained by my own loss of interest,
but also the state into which the Bulletin has fallen. This
is no reflection against the editors, but on MFC itself - I
will come to it again.
I suggest that all those planning to attend the Meet
should read the articles by Ashwin & Anant in the 100th issue.
They serve as good background papers. And, please not to miss
my editorial - I was so optimistic then ! (Amar Jesani to
kindly note).
In retrospect, I feel that the saddest mistake we
committed was to try to involve or attract more people to MFC.
In the process, we lost our moorings. No organization expands
in that manner. It does so only naturally, depending on
whether others see it as useful from their view-point or not.
I strongly feel we must stop the Annual Mela, the way it
is being organised now. Atleast for some time (or a long time)
to come, let us have only a core group meeting, be it biannual
or annual. Of course, in .such situation, the 'core group'
ceases to exist and we will have only MFC - a small but
hopefully more vigorous one. We then stop selecting issues
for discussion on the basis of whether it will attract others
or not, but will select them on the basis of the core group's
felt needs. The Core or the group itself need not be rigid
but we will welcome anyone who is interested in the theme.
The formal nature of the Annual meet, about which all of us
have constantly complained, but could do nothing about, will
automatically disappear.
I don't think we should try to compare ourselves with
groups that have come up later. We were after all pioneers!
Each group was formed as a result of particular situation,
and if anyone of them appears to be'more successful', there
is nothing to worry about. It only means that, that
particular group is.seen as more relevant for the present
time, by a larger number of people.
MFC started mainly as a discussion forum and I see no
way it can take up action-programmes. If we aroused hopes
among people that we were capable of doing so, it was our
mistake that we did not make it clear (and also did not
realize ourselves) that we were not equipped for it. Once
this is made clear, expectations may decrease but the
challenges which now come up may be "different and easy to
cope with.
I think the real white elephant is the Bulletin. We
cannot continue to run it, in the present form. It pays
neither financially nor emotionally. I had suggest at the
time of the Pachod meet (1987 or 1988), that we go back to
2
2
the 'Periodical Letter' format. Any member who wants to air
a new or discuss a problem, or give some news, sends it to an
'editor' who sends copies to the members - with the clear
understanding that there is nothing exclusive about it and the
members are at liberty to pass it on to whomsoever they think
will be interested in it. Most of us have lost interest in
contributing articles - which is obvious when we look at the
issues of the past 5-6 years or even more, very few of the
members have contributed articles of the type we wrote in
earlier issues - the type that provoked our feelings and
evoked responses.
The Bulletin, if I am correct, is MFC's biggest financial
liability and a terrible headache to the editor (and quite
unnecessary, too). It should not be regarded as a sign of
failure that we are closing it down. I think it is a practical
thing to do - at present it does not help us much. If it
decides to get itself resuscitated, so much the better, because
it will then come up with renewed vigour. The bulletin has
served its purpose and should be allowed to sleep for sometime.
Needless to say, I
am planning to attend the August meet.
-
X
-
RESPONSE NO. 2
1.
'Impotent Intellectual Mental Masturbation'.
A must for every intellectual. A sort of addiction.
Escape Route. Out of present- confusion.
An illusion of commitment and a sense of belonging
atleast to something.
2.
MFC must
Must come out of 'I' and give courage, stimulus and
moral support which will help in practical reality.
3.
Self proclaimed achievement of wisdom (so that all others
are fools or - in bettor words - "capitalists"’)
is the main problem facing MFC today. So along comes
deafness, colourblindness and Pseudo euphoria. It starts
vomitting statistics. So it can easily block other
loyman's conventional common sense and practical experiences.
4,
5, & 6. 1) Drive out statistics walas.
2) Don't prove with numbers anything which is commonly
perceived by every practitioner.
Like Rani Bang's statistics making notes of prevelant
Gynac Morbidity and Mortality !
Any one practising in Rural area knows it..
tell him/her in Manner of ' 'Eureka*!.
3)
No-. need to
Start a war on this Pseudo research, wast of money
and waste of devoted talents.
4) Funding agencies, are Now a days funding only Preventive
Projects. Thanks to MFC.
Fight it out. Do .think of needs of poors in practical
terms.
5) Publish detail reports of Doctors/workers, actually in
work in Rural area. Like DK 'Prakash Amte', 'Abhay, Rani
Bang'. (Not Gynac statistics - but their actual curative,
3
3
promotive, preventive work, their difficulties,
frustrations, motivations differences in outlook).
6) No Theory or issue is motivating. Emotional thurst
to work for Truth (In every sense) drives each worker.
Try to analyse it pinpoint it, spread it.
Cover failures Reasons Experiences and support every
Rural worker by encouraging him/her and by visiting
him/her. Isolation is Mo. one Enemy of each worker.
7) Voluntary Donation fund to be raised by monthly
contributions from like minded doctors to honour some
(at least one) rural worker yearly. Give MFC award-for
constructive work. For actual PSM/curative work.
8) Form MFC subgroups. Like minded persons must meet,
eat and sleep together once a month at one's place if
possible. At least they must contact by letters.
9) Identify non-MFC person working in Rural/Civil and
reach him/her. Do not Bar any Medical worker actually
helping patients. Only because he is motivated by
Religion/or other Non communist motivation.
10) Remember, Medical field values personal life.
It sees life beyond patient's caste, sex, religion,
socio-economic situation.
Make MFC follow this true Naked Motivation.
In light of this basic Human touch all confusions of MFC
will fizzle out.
1 *
Seek common sense. Act practically. Love each worker.
Spread this atmosphere. MFC will survive.
If not - Death awaits in jungle of statistics, Pseudo
Fanatism, Escapism and Make Relieve World.
-
X
-
RESPONSE NO. 3
1.
The MFC was my introduction to people centred politics,
in the sense that in its early days it brought a fresh view
point to bear on the issues of health care. The fertility of
this approach was borne out by our early achievements, and by
the brilliant successes of the Bhopal days (with which I had
nothing to do, of course). The Shahid Hospital work (at least,
to the extent of my participation in it) was also an outcome of
this approach. The successes of this period stand out in
stark contrast to the sterility of both the technrcentic
"public health" approach (e.g. ICMR in Bhopal) as well as the
so-called left academic approach of JNU ilk, through this
latter was able to provide important supplementary inputs.
The essence of this approach was contained in the old MFC
Bullbtin logo of "Go to the people" etc. The importance of
this formulation was that, to middle class health related
professionals, it presented a radical alternative not only by
way of practice but also in the area of epistemology.
At a personal level, the MFC also provided a place where
one could meet friends and exchange notes - not a small or
negligible advantage for rural - based workers with little
opportunity to interact with like minded health professionals.
4.
4
I am disappointed by a recent tendency to downplay this role,
as if it were an acknowledgement of some slightly shameful
weakness. I don't see it that way. I see it as a strength,
and central to MFC ethos.
3.
What problem....
The biggest problem facing MFC today is an ideological one
that the essentially vernacular values of the past have been
replaced by metropolitan, system oriented and, frequently,
state - centred activity, and belief structures, and epistemology.
This problem is not unique to MFC but a part of the Zeitgeist.
I am aware that my critique incorporates various schizophzenia
but realise that we have to live with them.
What suggestions....
I am not greatly perturbed by the "problems of MFC" as
long as we are able to survive and k p our souls reasonably
pure. A much greater level of local level autonomous activity
is likely to show us the way out, and I am greatly heartened
by the recent emergence of the "Bombay Group" and by vague
noises emanating from Calcutta.
4.
& 6. Most important - to survive..
To this end - to avoid a lot of hoity-toity debate and
place greater value on silence, and fellowship. People who
shout a lot about making our terms of reference more vigorous
etc. should be asked to pipe down. A greater emphasis on
humility, action and "jointly feel’ing our way" should replace
currently fashionable but eminently sterile controversies.
2.
Anybody who appreciates the nature, range and amplitude
of the changes. Social, economic and technological - we are
living through, would be content not-"to see the distant scene
one step enough for me".
X
-
RESPONSE NO. 4
(Excerpts from a response - translated from Gujarati)^
To me, the MFC is a collection or a collective of friends
with similar spirit (samandharmi), ideas and practices. It was
started with the coming" togathe'r of friends who believed in
Vicharkranti (revolution in thinking). We should not forgot
that its’ inner composition or core knitted around a movement
of thought or on being a thought current. From the attitude of
some friends, perhaps due to the pressure of field work, it
appears that this ideological commitment to the MFC has, to
some extent, receded.
Actually, in last one decade, the happenings in the
medical field have brought out and shown that we have added
ideological responsibility. I feel that in the field of health
our responsibility is to start healthy traditions and practices.
Today there is a great need of individuals having different
perspective and understanding to undertake the basic work of
human change. In our core group (CG) we still have such
friends but their energy is scattered all around. One important
work of the MFC is to bring them togather and coordinate. It
seems mat we have forgotten this aspect of our work.
... 5.
5
To share and to analyse good as well as bad experiences
of our field work we have been meeting on a regular basis.
Such meetings provide invaluable opportunity to a person like
me who is working in remote areas to know and understand some
thing or other. All of us get satisfaction by knowing and
discussing about experiences and action-reactions of public
life from friends who are working in different fields. These
meetings also provide necessary emotional warmth.
MFC Bulletin ; The Bulletin is an important regular link
between friends - old as well as new. Given the present
situation in health care, the ideological framework of the
bulletin must be preserved. Friends in its editorial board
should not be there only for the namesake. In the CG meeting
we discuss a lot about subjects-articles to be published in
the Bulletin. But friends have not been able to fulfill their
responsibility due to the pressure of their work and lack of
commitment. That is why for last two-three years the bulletin
is facing problems and able to barely survive. The Bulletin
has a special place as a journal representing our ideas. I
feel pained to state that today the dynamism of Bulletin is
dying. But this is a reality. It can be improved only if we
place the task of editing it in the hands of friends having
perspective and deep understanding. This way it will be able
to preserve a place in the society it ought to have. If we
can't make the Bulletin so dynamic, it would be more appropriate
to close it. The work pressure ,is not allowing friends to
propagate and expand the circulation of the Bulletin. However,
in order to publish a journal and support the movement, this
work is extremely important. From all friends with us, I believe
that Ravi Narayan is the best person to take up the work of
Bulletin. Through regular communication and hard work we should
take the circulation of Bulle’tin to one thousand and maintain it
at that level.
For surviving as an organisation, the MFC will have to form
a nucleus in each state and such nuclei will have to be sustained
by regular activities. For this also, in each state two or throe
committed individuals will have to undertake responsibility.
Such nucleui in the states should also be properly coordinated.
The subject of the annual meeting should not be abstract.
We should not spend all time in just discussing the subject. But
we should also share field experiences. People cannot leave on
thoughts-ideas alone. They can get inspiration and perspective
only through such enlightened sharing.
When Bulletin has thousand subscribers it will be able to
become self supporting. All friends must regularly collect
donation to ease financial problems.
Infact, we have discussed all such things about the MFC
quite often. Despite such discussions the present situation
has come about. We are very brave in discussion but forget
about these things as soon as discussion gets over and we
disperse. It is our duty to see to it that the CG meeting of
4, 5, 6 August also doos not turn out to be so infertile or
unproductive.
-
X
-
********
COMMUNITY HEALTH CELL
47/1, (First Floor)St. Marks Road
BANGALORE-560 001
BACKGROUND PAPER NO; 2
MFC ; "Revitalisation" Meeting, Aug. 4, 5, 6, 1990.
RESPONSES TO QUESTIONNAIRE
1.
We received 27 responses to the guestionnaire we sent.
Those experienced in sending out such guestionnaire
inform us that this is a fairly good response 27/150.
(of these 4 are letters we are reproducing in toto).
2.
As expected there has been a wide variation in responses
and therefore we have grouped the.answers under-.
different heads to facilitate analysis.
Q1.
What has MFC contact meant to you at personal level ?
Groups
No. of responses
a)
Sharing values/beliefs/experiences/
peer support.
20
b)
Friendship with like - minded/
committed persons.
5
c)
Introduction or furthering interest
in health issue, socio-political
issues.
9
d)
Providing alternative approaches
and Demystification.
3
c)
q2
Q3.
Others
,
,
3
& 06. (viz. What are your expectations of MFC ? and
what role do you see for MFC in the 1990's ?)
have been taken together.
Groups
No. of responses
a)
Providing information and debate
on issues.
9
b)
Catalyst/leadership for action
and movement, collective action.
7
c)
Pressure group and Political
influencing critical analysis.
12
d)
Evolving Alternatives and
Demystification.
1
e)
Should continue informal .network.
3
f)
Get newer people to MFC
4
g)
Others
9
What problems do you see with MFC today ?
Groups
No. of responses
a)
No full time worker/Paucity
of workers.
°
.. 2.
2
GrouPs
b)
More theory/less practice
More dialogue/less action.
3
d)
Cliques amongst older members/
No encouragement to new comers.
4
e)
More a friend circle - less of
organization.
3
f)
"I know all" attitude
No "active" listening
"Colourblindness".
5
h)
i)
Q5.
5
c)
g)
Q4.
No. of responses
Lack of concepts/initiatives.
No sound finance support/Economics
Constant flux of new members
No new workers.
.
2
1
4
Don't know.
What suggestions do you have to overcome these problems?
Groups
No. of responses
a)
Have specific objectives/
lobbying, Raising issues.
8
b)
Sounder Economics/Outside
finance support etc.
2
c)
More committed core group
More responsive core group.
3
d)
Participate in programmes to aid
individuals/sub-groups/supporting
other groups.
3
e)
Enter Research/Action Area.
f)
Information disemination )
Publishing etc.
)
Others.
)
1
4
g)
Restructive MFC
3
h)
Join hands with like minded groups.
1
If you have stopped/broken contact with MFC after
joining it initially, What are the reasons ?
Groups
No. of responses
a)
No response
2
b)
Not broken contact
8
c)
Personal reasons
(not related to MFC)
3
d)
Got involved in other activities
- Cannot find time etc.
2
3
3
Groups
e)
Disenchanted with MFC
f)
Contact only through Bulletin.
No. of responses
1
1 ) As is obvious there are multiple responses to questions by
some respondent.
2) Again from the groupings done it is also clear that there is
a degree of overlap in the groupings also - but even then it
was felt that this would facilitate discussion and hence kept.
It is possible that some transgressing/transplacing of
response could have crept in. All the same it should help
being a pointer to facilitate discussion.
Q1. Response
i) It is clear that almost all the respondents have felt
(at least at some time) that MFC has been important
and beneficial to them, and to their convictions and
beliefs, even at personal level.
ii)
These are perceived in various 'experiential' ways like sharing values, beliefs, peer support, Friend ship
etc. furthering interests etc.
iii)
This is one reason perhaps why respondents are
"concerned" about MFC. '
Q2. Response
Whilst 12 (9 + 3) (i.e a + e)’ have pointed out that MFC
ought to continue old functions or role with more vigour,
discipline etc. there are 19 (7 + 12) (i.e c + d) who feel
there must be an 'action' component in MFC persuits.
Q3. & Q4. Response
Each need a separate discussion with participants at
meeting.
Q5. Response
i) A small number are very disenchanted with MFC but
one has discontinued. It will be important to go
into reasons.
ii)
But it is equally important to know why those who
have contact only through bulletin have not
become member.
iii)
or Those who have got involved in other
activities - does it mean MFC was not able to
meet their vec-tions ?
Anil Pilgaokar
BACKGROUND PAPER NO : 1
MEDICO FRIEND CIRCLE
VI'
i i .iuAlvh c 'li
47/1,(FirstHoor)St. mZi,*
EAMGAlOP.E - 560 001
(Background Paper for the Core-Group-cum-General Meeting of the
MFC to be held at Sevagram, Wardha from August 4th to 6th).
REVITALISATION OF MEDICO FRIEND CIRCLE
By Nishith Vora
This paper should logically start with analysis of past
and present functioning of MFC, and why a need is felt for
revitalization. Since I am associated with MFC for a short
time I am not in a position to discuss these issues in detail.
I am writing this on the basis of what I know about MFC by
talking with various people, my experience with MFC regarding
Bhopal work and what I personally think MFC should be.
There will be agreement about the general direction of
the thought current that MFC represents. At various points in
time this is put on paper. MFC is a group of socially concious .
doctor and non-doctor health workers who believe that existing
Health system is exploitative and anti-people. It should be
exposed and fought against. There is a need for developing
alternatives which are pro-people. What needs to be discussed,
defined and clarified is as follows.
(a)
Which are the more important issues in Health system
today, and to analyse and evaluate them.
(b)
The functional role of MFC. as an organisation.
ISSUES IN HEALTH
(a)
PRIMARY HEALTH CARE approach
Ten to twelve years ago Primary Health Care was a
newly developing approach and a lot was expected of it. MFC
has focussed on this more than any other issue. A large
number of members in their individual capacity have been
involved in it since a long time. There is need to debate
and analyse PHC approach in the light of accumulated experience.
It has largely failed. The government has already scrapped CHV
scheme. The experience of voluntary groups though not uniform
is largely negative. In fact the role of voluntary agencies
itself needs reassesment as whether they can be considered
progressive, innovative and pro-people or not is a question.
The answers in Rural health remain elusive. Some fresh
thinking is required. The approach must be comprehensive
including government health system, qualified and non-qualified
private practitioners, indegenous healers etc.
(b)
HEALTH CARE SYSTEM IN URBAN AREA
Though rural health remain important Health system in
the cities is an equally important issue somewhat neglected by
MFC. MFC should give equal importance to public hospitals in
cities, privatisation, practice or malpractice of medicine,
patients’ rights and education etc. to make itself relevant
to city based health workers.
2.
2
There is a need to take an overall comprehensive view of
both rural and urban health. The difference in the approach
should be stated and analysed.
(c)
HEALTH & TYPE OF DEVELOPMENT
Health problems arising from a particular type of
development are becoming more and more frequent. MFC needs to
take take a stand on environmental degradation, hazards of
industrialisation, big dams etc.
There is greater need to clarify stand on the above
mentioned issues though others like drugs, medical education
etc. remain relevant.
MFC AS AN ORGANISATION
At present, there is difference of opinion as to
whether MFC is a 'Friend Circle' or an organisation which
mainly debates but may act. In practice, it has functioned
like a friend circle. The main activity is discussion and
debate but unfortunately here also the courage and honesty
necessary for an objective, in depth and high quality debate
is lacking at least at present. Whenever MFC has taken up
action, it has faced problems because the mentality of members
and methods of functioning remain that of a friend circle. If
MFC wants to motivate and attract new people and play a relevant
and useful role as s.ocially relevant health group this mentality
must change. The role and influence of every member must be
open and based on clearly stated criteria.
To become useful and relevant MFC must consider
following as its functions.
(a)
A forum for discussion and debate.
(b)
Encouraging local groups to initiate activities on locally
relevant issues. MFC must facilitate communication,
coordinate and provide support to these groups.
(c)
MFC must initiate and participate in action regarding
issues of national importance. In fact, failure to take
up certain issues must be viewed seriously. Similarly
certain support action to support the local groups must
also be considered its responsibility, for eg. If activists
of a local group are arrested, the central body must act.
(d)
It should discuss and if possible help in solving the
problems faced by freshly passed doctors who want to do
something different but do not know what. Similarly other
health workers who are working in remote areas will also
need peer group support.
ORGANISATIONAL STRUCTURE & DECISION MAKING PROCESS
At present, MFC has totally loose structure and decisions
are taken in an ad hoc manner. It is arbitary as to who will
take what decisions and on what basis. This may keep everybody
happy but is unsuitable for involvement in any activity or for
attracting new people.
3,
3
ORGANISATIONAL STRUCTURE
One major change that is required is to encourage local
groups either as local MFC group and/or affiliated independant
health groups to become active. The activity may range from
health awareness campaign to agitation on various issues. New
people will get attracted around activity. The issues will vary
from place to place. So the local groups must have freedom to
take up any issue on their own as long as their action doesn't
go against the bread policy framework. One of the main functions
of 'Central MFC' should be to keep the local groups informed
about each other, provide guidance and support and coordinate
action when necessary.
The bodies of Convenor, Core group and general body may
be continued but their role and membership needs to be
streamlined.
The General body will include all members and meet at
least once a year. All the activities in the previous year and
future activities can be discussed, reviewed and finalised.
The size of the Core group should be reduced and only
those who are present in that particular annual meet should be
included. The convenors of the local groups may be made
ex-officio members of the Core group. From the large no. of
members who may not be part of any local group 5 to 7 may be
elected by consensus or majority. Anybody who is a member of
MFC since at least 3 years and has attended at least two of the
last 3 annual meets may be considered eligible. The membership
of the core group may be for two years provided the member
attends the next Core group and annual meetings. If a member
fails to attend next annual meet s/he should be replaced.
The Convenor may be elected as of now for 2 years by the
general body. Anybody who is member of Core group for at least
one term and has attended 3 of the last four Core group meetings
may bo considered eligible. The convenor may or may not be part
of a local group.
DECISION MAKING PROCESS
An urgent need is to lay down a policy framework after
discussion by the active members of MFC and ratified by the
general body. This should act as guideline for the Convenor
and Core group far day today functioning. It will provide a
standard to which the convenor/core group should adhere. This
will include organisational stand on various issues, what sort
of activities it may initiate or participate, to what extent
and with what sort of individuals and organisations it may
associate.
The Convenor is to look after day to-day working and
should be given the power and responsibility to take decisions
as long as they fall within the guidelines. The Convenor is
to follow up various activities and responsibilities distributed
at the time of Core group meeting. In case of doubt he may
consult others but the responsibility must be his/hers. Under
unusual circumstance the convenor must have the power, to call
extra ordinary Core group meeting, or even without that, to
react to a situation either by taking a stand or any other
decision.
4.
4
The Core group meets every six months. Apart from
receiving the happenings of past six months, it will decide
about new activities to be taken up or old one to be
discontinued. It ratifies the decisions taken by the convenor
and divides responsibility. The Core group may change the
policy rramework but it should be ratified in next general body
meeting. Important thing is to keep all Core group members
equally informed and give equal importance to each of them:
The CG meetings may be open to any MFC member but only the
core group members should be allowed to vote.
The general democratic practices like allowing any
member to put any item on agenda without prior notice, giving
everybody a chance to present their views etc. should be
followed. Members are bound to have varying interest, varying
views on some subjects and ertiphasis may shift from time to time.
There is no need to hide these differances, In fact at times
it will be helpful if a person states where he or she stands
rather than keeping quite. This is particularly true about the
Core group members.
Ravi Narayan
326, 5 th Main,
1st Block, Karamangala
Bangalore 560 034.
CIRCLE,
office,
4 3 •Ja.i rt a.r.RucHA rd.,
■ ■ • Y 400 007.
BACKGROUND PAPER NO.: 4
A. response to some questions about MFC' COMMUNITY HEALTH CELL
(preparation for the 1 990 Core group meetTfiMarksa°ad
r
BANGAlO.IE - 56u uul
Thelma Narayan
,CHC, Bangalore
12th July 1990.
1.
What has mfc contact meant to you at a personal level ?
My first contact with mfc was when I w§s a fresh graduate
seeking to be socially relevant in my professional work, Reading
the bulletins then offered me almost a first and very interesting/
exciting exposure to serious thinking being done by a group on
issues relating to health work in India. Also, reading personal
experiences and supporting certain symbolic stands were very
meaningful to me then. Interacting with mfc members later at
meets and elsewhere was also an inspiring experience. They were
serious committed, non-hierarchial, simple in life style and.
oriented to the poor. It felt good to be associated with a group
who provided a moral support as well as an intellectual stimulus
to move beyond one’s own training to seek to apply it sensibly
to the needs of the poor.
2.
What are your expectations of mfc ?
Given the background of mfc I would expect greater
collectivity in the group in terms of thinking around specific
issues.
Issues that have been initiated should be taken to
completion.
The overall situation in the country is different now
compared to when mfc started and during it.s early years. There
arc many more groups, networks and individuals who are aware of
and involved in socially relevant health action. Those may be
issue based or smaller regional groupings : mfc has tu find its
role a new in the context of this change. Health problems are
also changing and growing more complex - demanding a different
sort of response. Being one of the older groups one would
expect greater maturity in interactions, greater depth of study/
analysis of issues taken up, more organised support to newer
groups/individuals in their search.
What problems do you see facing mfc today ?
MFC does seem presently to exist on its ’aura’ of being a
notional-.body of-Socially conscious individuals, of being a
thought current etc. These are very well worded articulations.
But the difference between its stated intentions and actual
functioning does seem to be showing up.
3.
a) The core group is no longer an active, dynamic group
interested in mfc as an entity, in pursuing its philosophy and
interacting with new people like minded groups. We all like to
meet each other when possible for old times sake, but do not seem
to find time for its activities and growth. A certain tradition
seems to have set in where we pride ourselves in our committment
to mfc. by having late night sessions and making various promises
at CGM's which are usually forgotten over the months. We also
seem a little resistant or nor quite open to newer groups or
ideas which may nor eminate from ourselves.
Is this a sign of
ageing ?! There is also a certain sentimentality - Once a CG
member always a CG member 'which may nlso nor be conducive to
actors growth and productive thinking. Also, as a sort of
contradiction to what I’ve said above (I hope I am wrong), I
seem to sense that the bonds of mutual respect and trust between
...
2,
:2s
individuals appear to be under, some strain. For MFC to play a
role in today's situation the CG must be healthy and active.
The stagnation that is evident in our inability to keep
collective committments is a negative feature.
b)
There are organizational/logistic problems of a far flung
□roups taking collective action - causing ulears for the coordi
nating person/group ! Should we restrict ourselves to being a
thought current ? Perhaps we could discuss about this based on
experience of the past years,.
c) The preparation done for Annual Meetings is inadequate hence
the discussion may remain at a superficial level and may not
interest new participants. The good thing about the Meets is
the opportunity to meet and interact with a number of people.
Here too it has been often observed that CG members tend to keep
more to themselves,
d)
Many of us take a lot from MFC - saying that we are a part
of a national group etc.etc. - however we give very little to
mfc organizationally. Keeping mfc just alive but not kicking
seems to have become a comfortable option.
4.
What suggestions do you have to overcome these problems ?
a) Handling organizational responsibilities needs a lot of
time and effort hence may need a more full time effort
or greater group effort.
b)
Need for greater committment of CG members to mfc as an
organization - time, response to requests etc.
c)
Need for greater openness and communication between
members.
d)
More serious homework needs to be done on issues taken up.
e.g. A.M. themes, follow up of promised reports.
e)
At the risk of being thrown out I would say that this
demands a more from a emotional response to a more rational
response, from amateurism to more professionalism, from
adhocism to a more organized/disciplined style. These are
of course often considered bad words among activist,
pro-people groups. However, after seeing a number of
groups and processes evolve over the past .10 years and
after some reflection I feel here are many positive
aspects to these approaches.
Mere good intentions and vague statements after a time
get rhetori—boring and are ineffective.
If you have stopped/broken contact with mfc after joining
it initially, what were the reasons ?
I have not broken contact as yet. However due to personal
reasons of ill-health, young utiliiJien etc, jay time for work is
more limited. Due to a sense of frustration at the lack of
serious homework on various health issues that have been taken
up.
I now no longer give, priority to react/respond to mfc,
but on content to be just a bulletin reader. However, all my
local involvements have been influenced by mfc thinking, hence
I hesitate to break completely, with the group.
5.
3
6.
What role do you see for mfc in the 1990’s ?
MFC has a tremendous potential to play a more active role
in progressive thinking/action in the broad sphere of health in
Indis. It could provide a forum where people can meet, share,
discuss ideas and experiences, evolve strategies. Presently
there are several sources from where information and even
critical thinking on health issues is easily available students
and frosh graduates who are oriented to socially relevant
involvements are already aware about some of these issues. They
look for a forum where awareness can be channelised into meaning
ful activity. This could be a potential role for MFC in the
1990's. However, this is also our weakest spot and demands a
different style of functioning.
At a national level we could perhaps retrain a thought
current and smaller regional groupings could get involved with
more action related to health issues.
C0MiwuNJTy
HEALTH cell
Marks Road
'•OnE-560 001
Anil Pilgaonkar
MEDICO FRIEND CIRCLE
Organizational Office,
34—B, Noshir Bharucha Rd
B°mbaY 4°° 0Q7Date
. -10,7.1990.
Dear Participants,
MFC - Which way to go & How to get there.
Let us first thank you for your responses to the
questionnaire we sent. That will certainly be helpful and when
coupled with your personal participation at the meeting, it
promises to be a very lively and purposeful debate. As is wellknown, this is not the first time that MFC is at crossroads.
Three years after its birth MFC was at crossroads (see the
article "MFC - which way to go" in Health Care which way to go?)
and after the 4th annual meet of MFC, there was an intense debate
on what MFC should/should not be doing. Wide ranging and at
times contradictory views were aired in MFC bulletins but MFC
came through all that steadfastly but also cautiously. Today we
have turned a full circle and come back to the very same question
once more: MFC - Which way to go ? Only this time it would be
important to add "MFC - Which way‘to go and How to get there ?"
MFCs most valued assets ha^e been members, friends and
well-wishers (and this is amply substantiated by the responses
to the questionnaire) and MFC can only hope to draw on this,
perhaps sole asset to steer itself through the present doldrums.
If therefore MFC keeps leaning more and more on this asset, it is
hoped that all the participants will readily understand why.
The responses to the questionnaire have been varied and
there has been a significant number of responses which have
clearly brought forth the message of Frustration but (and not
surprisingly) there has been a wide range of suggestions that
have come from everyone amongst this section, too.
Encouragingly there is one common thread through all the
responses - one of concern and welfare for MFC's future.
If this concern, the Individual suggestions are not
meaningfully deliberated upon at the meeting, MFC stands to lose
heavily by default. It is important to ensure that this does
not happen. Jf frustrations (of members, friends and wellwishers) are to be minimized in the next phase (?) of MFC, it
would be necessary to seek/eVolve a means for feasible implemen
tation of the most meritous suggestions and recommendations.
2
2
To my simple mind, frustration is a shortfall between expectations
and achievement: lesser the shortfall, lesser the frustration. To
make reailistic expectations from MFC, it is felt, a little
background into relevant 'history' as also some currently valid
details might be useful. Some two years back, Anant Phadke with
the help of others, had drawn up a note on Organizational
Development of Medico Friend Circle - An Overview. We feel this
note would be helpful in this respect and hence we enclose a copy
for participants perusal. Other relevant details given separately
are also enclosed.
For the forthcoming mid-annual meeting,' every participants
suggestions and recommendations are vitally important and cannot
be missed out. We therefore plead (yes, plead) everyone of the
participants to do that. It is our feeling that within the
constraints of the meeting, every participant could have more or
less a 10-minute period to make critical comments, suggestions
and recommendations. It would be helpful if the participants
and the discussions thereto took into consideration strengths /
weaknesses of MFC and opportunities / threats before MFC - as
percieved by participants, individually and collectively, to
focus on the most promissing way for MFC to follow. A priori,
the three common questions before us at the meeting would be
(i) What is wrong with MFC and what are our recommendations to
set things right ? (ii) How do we go on implementing the
recommendations and (iii) What are the commitments each one of
us takes towards this. We urge you to make your contribution in
this respect.
With warm regards,
Yours sincerely,
(Anil Pilgaonkar)
Convenor.
P,S.: Briefly speaking the current crisis in MFC is of the
following nature - high turnover of subscribers and
members, declining participation of most core group
members, lesser number of new enthusiasts - all this
leading to quantitative and qualitative stagnation and
financial unsustainability. Many of the old and new
- members, for different reasons, have >been questioning the
role and relevance of MFC through their utterances,
silences and deeds. The question is - can MFC fulfill
various expectation^ relevant fresh ideas, in depth
discussions, relevant action-programmes, impact at
national level ?
1
3
Tentative Plan For Mid-annual Meeting
4th August 1990
Meeting commences at 10.00 a.m.
Three sessions 10.00 a.m. to 12.30 a.m.
2.00 p.m. to
4.30 p.m.
6.00 p.m. to
7.30 p.m.
All three reserved for critical comments, suggestions
and recommendations of each participants.
5th August 1990
Two sessions 9.30 a.m. to 12.30 p.m. & 2.30 p.m. to
6.30 p.m. for "How do we organize ?
What changes
need to be done (effected) and Who takes what
commitments".
Discussion on each.
6th August 1990
Two sessions; 9.30 a.m. to 12.30 p.m. & 2.30 p.m. to
4.30 p.m.
Phases for implementation and other details.
Eagerly awaiting to see you participate at the meeting.
banking on you.
Please don't fail us.
Thank you.
We are
idith
PiloBLeTns
AvftS (a)ardlux.
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_^?j2zre4vJoJ?__ .c.ecoo.cn-^ _ <d QAj-GLQltaA u^y
MFC - BOMBAY GROUP
The Medico Friend Circle is a group of socially
conscious individuals interested in the health problems
of our people. It is in existence for last 16 years.
The MFC is seen by its members and well wishers as a
thought current, providing scope for intense discussion,
interaction, mutual support and if and when possible,
collective action in the field of health and health care.
It does not have a very rigid organisational structure.
This necessitates higher sense of responsibility and
participation on the part of its members to keep it
organisationally active.
At the national level it is involved in two major
regular activities. (1) It organises a national level
workshop/meeting (called the Annual Meet of the MFC) of
health activists and other interested Individuals of to
discuss one relevant issue in health and health care,
every year. (2) A monthly journal, the MFC Bulletin,
provides platform for written debates, reporting of
activities etc., to members as well as non-members.
Both these activities are purely voluntary activities
carried out without any institutional fundings. That
is, the participants share all expenses of the Annual
Meet and the Bulletin is run through individual donations,
subscriptions etc. In addition to these two activities,
other activities undertaken irregularly include: publication
of the anthology of articles from the bulletin (3 books so
far), books (one book on medical education), reports of
research undertaken collectively, participation in the
movement/campaign for rational drug policy (through All
India Drug Action Network) etc. etc. (For details see the
MFC hand-out giving perspective, activities, publication
„ etc.).
MFC Bombay Group
Having a formally constituted local group (or a
local branch) persuing definite collective activity is a
new development in the MFC. This does not mean that the
MFC is not having (or never had) many members from one
town or locality. No consistent attempt to form local
organised group was made-in the past because MFC was seen
more as^a thought current rather than an action oriented
organisation. However, the members of the MFC in Bombay,
due to many circumstances got involved in certain collective
actions such as : coinbating government and other propaganda
on the condition of Bhopal victims, defense of Dr. Arun Bal
who was dismissed for his crusade against drug industry,
etc. Such actions prepared ground for eventual organisation
of Bombay Group last year.
The MFC Bombay group was formed in Sept*. 1989 by the
MFC members in order to intervene in a more organised way
in the health and the health care issues. The need to
form such local group of the MFC was felt for several
reasons: Firstly, we realised that members of MFC in
Bombay were constantly persuing some activity in their
individual capacity in the field of health. Thus, inspite
of having active members we had no locally active
organisation of our own, and hence no coordination amongst
2,
MFC - BOMBAY GROUP
The Medico Friend Circle is a group of socially
conscious individuals interested in the health problems
of our people. It is in existence for last 16 years.
The MFC is seen by its members and well wishers as a
thought current, providing scope for intense discussion,
interaction, mutual support and if and when possible,
collective action in the field of health and health care.
It does not have a very rigid organisational structure.
This necessitates higher sense of responsibility and
participation on the part of its members to keep it
organisationally active.
At the national level it is involved in two major
regular activities. (1) It organises a national level
workshop/meeting (called the Annual Meet of the MFC) of
health activists and other interested individuals of to
discuss one relevant issue in health and health care,
every year. (2) A monthly journal, the MFC Bulletin,
provides platform for written debates, reporting of
activities etc., to members as well as non-members.
Both these activities are purely voluntary activities
carried out without any institutional fundings. That
is, the participants share all expenses of the Annual
Meet and the Bulletin is run through individual donations,
subscriptions etc. In addition to these two activities,
other activities undertaken irregularly include: publication
of the anthology of articles from the bulletin (3 books so
far), books (one book on medical education), reports of
research undertaken collectively, participation in the
movement/campaign for rational drug policy (through All
India Drug Action Network) etc. etc. (For details see the
MFC hand-out giving perspective, activities, publication
... etc.).
MFC Bombay Group
Having a formally constituted local group (or a
local branch) persuing definite collective activity is a
new development in the MFC. This does not mean that the
MFC is not having (or never had) many members from one
town or locality. No consistent attempt to form local
organised group was made'in the past because MFC was seen
more as^a thought current rather than an action oriented
organisation. However, the members of the MFC in Bombay,
due to many circumstances got involved in certain collective
actions such as : combating government and other propaganda
on the condition of Bhopal victims, defense of Dr. Arun Bal
who was dismissed for his crusade against drug industry,
etc. Such actions prepared ground for eventual organisation
of Bombay Group last year.
The MFC Bombay group was formed in Sept.. 1989 by the
MFC members in order to intervene in a more organised way
in the health and the health care issues. The need to
form such local group of the MFC was felt for several
reasons: Firstly, we realised that members of MFC in
Bombay were constantly persuing some activity in their
individual capacity in the field of health. Thus, inspite
of having active members we had no locally active
organisation of our own, and hence no coordination amongst
2,
J
2
ourselves. Secondly, the MFC members tn Bombay had in their
own way started thinking that the concept of MFC as a thought
current should be transcended by gradually combining thought
with action. Thirdly, given over concentration of medical
care facilities, extreme proliferation malpractice in the
profession, unhealthy condition of living for the working
people, increasing dissatisfaction of people with the
medical profession etc.' provided an objective ground for a
health organisation to undertake action oriented programmes.
And lastly, it was felt that if a health organisation was to
be formed, why not a Bombay Group of the MFC itself ?
Organisational Structure
The structure of the
Bombay’Group (BG) will' "Have "to gradually evolve, depending
on the background of members, type of activities undertaken,
and so on. For time being, the main organisational felt
need was general coordination of work and organisa-tion of
activities. This is met in two ways (1) By regular meetings
. of all group members. The BG meeting normally takes place
once in a month. This meeting takes all major decisions and
all activities are reported to it. (2) Coordinators : Tliree
coordinators are entrusted with the task of doing general
coordination of the group as well as coordinating specific
activities collectively undertaken. Every year one coordinator
would retire and in his or her position a new one would be
elected by the general body of the BG.
Membership
Since the MFC-BG is actually a local
organisation of the all India MFC, the membership of the BG
automatically means the membership of the national level MFC
organisation. For an MFC member frem Bombay, becoming member
of the BG actually means increased responsibility - the chief
of it being the need to participate in the activities/actions
organised by the EG.
Membership fee of the national MFC is very nominal.
In fact, the national MFC membership also includes subscription
for the MFC-Bulletin (which is Rs.30 per year). For those who
earn more than Rs.750 per month, the membership fee is Rs.50,
which actually comes to Rs.20 per year after deducting the
subscription amount. For those who earn less than Rs.750 per
month, great concession is given. Thoir membership fee is
only Rs.25 per year. That is, on becoming member, they even
get Bulletin at a concessional rate.
The payment of annual membership fee for the national
MFC is a must for getting foimal membership of the BG. In
addition, in order to run activities of the BG, the members of
BG are required to pay Rs. 10 (for those who earn more than
./Rs.2000 per month) or Rs.5 (for those who earn less than Rs.2000
j per month) every month.
i
In short, The MFC Bombay Group members pay Annual
■Membership Foe of the National MFC and Monthly Fee of the
/ Bombay Group.
Needless to add that although non-mombers are allowed
to attend BG meetings, they are not considered eligible to
.participate in decision making.
3
a
"
2
3
Activities and Actions Currently Undertaken by Bombay Group:
In the first meeting of the EG in Sept. 1989, three
broad areas of activity were identified. They are :
1) Struggle against Malpractices in the health care.
2) Human rights issues in the health care, and (3) Education
of health care providers and the people in general. The
activity within each area is not exclusive, there is actually
great overlap between areas of activity. They are identified
as distinct areas in order to maintain focus and to allow
members to choose an area to give more attention and time.
f
Before we describe activities in each area, it is
necessary to understand that the chief objective of the BG
is not to confine itself to a small locality only and to make
efforts to improve health status of the people in that locality,
although such efforts are not excluded from its activities.
In fact, our aim is to combine micro-local efforts with the
larger campaigns, actions etc. for overall reforms in the system
by building pressure from the organised masses, organised health
workers and ocher interested groups. Thus, the BG's intervention
would be rnulti-proged and would be coordinated with other health
and non-health groups so that maximum impact is created.
Further, in such efforts our political choice is clearly to be
with progressive and humanistic elements, thus, working with
communal, casteist, anti-women and anti-people groups,
organisations and individuals is decisively excluded.
(1) Struggle Against Malpractices in the Health Care :
This is a very bro’ad issue.’ At one extreme there are malpractices
like irrational and unnecessary medical care and at the another
extreme are things like criminal negligence etc. We began our
work by organising a workshop (which was a part of the Human
Rights and Law workshops in the Dec. 1989) on this issue,
followed by organisation of a press conference for a victim of
medical negligence. Since then many victims of medical
negligence have approached the EG for advise, support and
legal action. In this way, a small but significant beginning
has been made and some people made conscious that one can
fight against the malpractices. With this many other areas of
work have opened up. First is a focus on the professional
bodies (like medical council, nursing council etc.) which have
failed in regulating their professions. Second is to expose
agents of vested interested on these bodies. Third, to unevil
secrecy surrounding the functioning of these bodies. Fourth
to motivate socially conscious professionals to make attempt
to get elected on these bodies on thd basis of a pro-people
programme. Fourthly, to bring focus on the malfunctioning and
lack of regulation of the private health care institutions.
Fifthly, to demand better facilities and functioning of the
government health care institutions. Sixthly, to educate
people so that a demand for right to information can be
effectively made against the profession and the government
and so on.
The BG is conscious of the fact that in order to bring
about reforms in the profession and the health care, it is
imperative that people’s pressure is created. Such pressure
4,
:
4
:
should be aided by organising and mobilising the progressive
elements from the health ca'Cre system itself. Thus, our
intervention in this field tries to combine both elements.
(2) Human Riohts Issues in Health Carr ; Certain issues
like ethics in medical 'practice, negligence, right to infor
mation etc. raised under the malpractice overlap with the
human rights. In this field, focus is on three issues which
are distinctly connected to human rights. (h) Right to health
and health care (b) Involvement of health workers in the
violation of human rights and (c) Violation of human rights
of health workers. We began our work in this field with a
press conference-cum-seminar on these issues. It has been
decided to coordinate our work in this field with human rights
and other concerned organisations.
(3) Education s Educating health workers and people is
inseparable part 6? activities in the first two areas. However
it is also identified as a separate activity because there is a
need to build up educational work as a steady and sustained
work irrespective of organisation’s work in other fields.
It should bo kept in mind that these areas and other
likely new areas of activity of the MFC-BG will gradually
evolve. The slow pace of work is simply because the MFC work
is over and above the normal employment and other work of the
members. In a way this is a strength because it gives our
activity a purely voluntary character, not dependent on any
funder or organisation. In long run, hopefully, the efforts
of the MFC would make voluntary health work not an employment
choice (as is often the case in the NGOs) but a political
choice.
MEDICO FRIEND CIRCLE
(BOMBAY GROUP)
V-6/1, Ashok-Va», Borivli (E),
BOMBAY-400 *66.
BACKGROUND PAPER NO.
CRISIS WITHIN mfc
3
SOME REFLECTIONS
-
Dhruv Mankad
Organisations, like individuals, come to a certain point in their
lives when it may become impossible to move further without
taking stock of what they had been doing till then and where they
want to go from there. Circumstances that lead to such a crisis
could be external or internal, or, as is often i.he case, a
combination of both.
mfc has also come to such a stage. That this stage has not been
reached all of a sudden is immaterial now. But, certainly, if the
crisis is not resolved, the organisation’s survival stands
jeopardised.
What is the nature of this crisis ? What are the various
that comprise this situation mfc faces today ?
factors
In order to answer this question, it would not be out of place to
briefly recount the circumstances under which mfc originated.
mfc: Ihe beginning
mfc is a product of very turbulent times, coinciding with the
rise of the JP movement. Some of the founder members, indeed, had
participated in the movement themselves. They saw the potential
of extending the idea of Total Revolution to the field of health
and medicine. Mfc was thus, started as a forum where experiences,
ideas and thoughts regarding the existing situation in health and
medicine as well as alternatives could be discussed.
Thus the focus of its activity was sharing and disseminating of
ideas for social change as applied to the field of ■ health and
medicine rather than acting‘towards such a change directly.The
latter was left to the individuals participating in mfc’s
activities in a manner they saw fit, in their own spheres of work,
Although weakened, the wake of the social upheavals of the 70's
was a long one. It continued to provide mrc with fresh ideas and
fresh insigilts as well as new speakers and new listeners, mfc’s
the feeble voicelits membership never exceeded ....
even at
its highest, the bulletin subscribers not being more than 1000)
was audible
enough to be responded by those sharing similar
views. The main theme it spoke was on Community Health, Health of
the People. Its main audience was the fresh graduates or those
already experimenting with ideas in Community Health through the
Voluntary Agencies.
Though showing signs of weariness, mfc carried on well till the
Bhopal Disaster. In my opinion, involvement in Bhopal was a
watershed in the short organisational history of mfc. Not only
because of our sincere, though modest contribution towards the
cause of the victims of the gas leak, but also for creating by
doing so, new expectations regarding mfc’s role. It also added
fresh dimensions to health activism as well as showed to us our
limitations in go4ng beyond exchange of ideas and experiences.
Today, no broad movement for social change exists that coulci,
generate fresh ideas and with it a fresh wave of optimism. Those
which do exist are in most part, insidious, defensive and
mfc wardha meet aug’90
crisis in mfc
certainly not robust enough to catalyse parallel
social rethinking.
processes
of
With this historical backdrop, we can analyse the nature of the
crisis that,
in a nutshell, has come about as a result of an
organisation evolved under different circumstances having to come
to terms with a new set of circumstances.
This crisis has various facets:
Crisis af PhilosQphV:
The perspective pamphlet of mfc calls itself as a thought
current, sharing a concern about various aspects of health
status, health services and medical practice in India. Although
the concern encompasses almost all the aspects of health and
medicine in India today, but in reality, as reflected both in the
bulletin and the Annual Meets, there is a clear emphasis on
issues in what is conventionally known as ’Community Health’:
Primary Health Care, TB, Child Care, Family Planning, etc.
Finally,- it is implicitly recognised that the new ideas and
insights gained through exchange of experience and thoughts
through mfc, would be implemented through/incorporated in the
project-based
activities
run
by
each
. individualmember/sympath1ser.
Thus, its self-image of a thought-current, Community Health as
its main operative content and Project-based activities form the
triad of mfc’s organisational philosophy.
All these three have come -in sharp ,conf I lot with
reality. I shall take the last first.
the
unfolding
1. Project-based activity: '70s, the decade that saw mfc’s
formation had thrown up several new ideas that needed to be
tested out in the field. Most of them were in the area of health
delivery systems. Almost everyone of them revolved around the
training and deployment of Village Health Workers. It was
essential to have a well-defined project approach to experiment
in this field. Therefore, emphasis of mfc’s members on project
based activities was natural and justified.
loday, it would seem that all new'ideas have been exhausted
- either having been proved and accepted within the establishment
circles however half-heartedly or having been floundered on the
rocks of bureaucratic insensitivity and political exigency. Some
operational details, however may still need to be worked out.
The problems that have surfaced during the last few years:
problems underlined by Bhopal and by Drug Policy are hardly
amenable to experimentation in the same fashion. They probably
need a larger platform: that of public education and action, even
for testing out solutions.
2. Community Health: The problems
that have come up
comparatively recently in their concrete form in Indian health
situation do not fit into the problems that the conventional
community health framework analyses. They are a direct result of
public policies e.g., Drug Policy, growth of private medical
colleges etc. or a .result of popular trends encouraged by the
medical professionals and industry, of excessive emphasis on hightech
diagnostic technologies. Even the problems that
the
mfc wardha meet aug’90
crisis in mfc
conventional Community Health addresses, when extended to a
societal scale, have dimensions that it cannot encompass e.g.,
the problem of TB and overcrowding, diminishing supply or high
costs of anti tubercu I ar- drugs.
These problems have come to the fore after the limitations
of innovations dealing with the CH aspects, have become apparent.
It is therefore imperative either to go beyond CH or expand the
vision of CH to include aspects hitherto not considered.
At the same time, emphasis on the collective has taken us
away from the individual. We have very little to offer to that
large section of health practitioners who deal with individual
problems - general practitioners - and also their victims - those
suffering from/likely to suffer from professional
neglect,
unethical practices and exhorbitant charges.
3.
’Thought-current’ status of mfc: From the ongoing it is
obvious that since the emphasis earlier on was on innovations in
health delivery systems to be experimented with at project level,
it necessitated ( if mfc was to avoid converting itself into a
full-fledged institution with concomitant controls) a loose body
mainly acting as a sounding board of new ideas. That’s exactly
what mfc was. And that’s why it was and continues to be unique.
One could continue to do what one felt best, albeit innovatively,
without any controls and at the same time continue to identify
him/herself with a group ( sharing similar concerns/thoughts
with a thought-current ).
With the need for transcending older emphasis, there is
necessarily a strain on the structure. Our own self-image of
being a thought-cur rent has come under pressure. Newer potentials
for public action and education have brought about
newer
expectations and opportunities, which in turn have generated
these pressures. It is true that the process of social rethinking
is slow and not conducive tb rap'id generation of newer ideas and
ideals,
at the same time it is also true in contradiction that
the ebb in direct responses to political oppression has brought
about the feeling and exprbssioh of other kinds of oppressions elitist oppression by (and sometimes of) professionals, the
oppressions in social subsystems like the legal and health
systems - expressions quite familiar to mfc and echoing concerns
oirtlined in the pamphlet. To an extent this has created a number
of voices of protest, because, as Ravi Narayan (an ex-convenor,
member and a close associate of mfc) puts it,
’mfc
type
organisations’ are now a generic phenomena! This has further
eroded the idea of mfc’s uniqueness.
<
Thus stands challenged the organisational philosophy of mfc.
Crisis of Organisation:
Another facet of the crisis comprises the strength and character
of the membership that goes on to make the organisation. The
membership of a thought-current like mfc cannot be limited to its
official members but must include the bulletin subscribers as
well as participants at the Annual Meets - its two most important
and consistent activities.
Without going into the exact numbers, I can say based on my
experience, that very few members renew their membership. Apart
from the regulars i.e., the Core Group and a few others who are
not only ideologically but emotionally involved with mfc, net
more than 30% carry on to the next year. I think this figure has
reduced over time. So is the case with the bulletin, only in its
mfc wardha meet aug’90
crisis in mtc
case the decline is much steeper. In both cases the total annual
membership is also declining - this is also true for participants
at the Annual Meet.
This
has implications not only on the finances
organisation
as we shall see later, but on its
functioning too.
of
the
overall
1. With no or slow induction of new faces in the decision
making processes and bodies, these tend to take on an informal
but
fixed hierarchical form - the more vocal amongst
the
experienced members who know each other personally forming the
innermost circle. Issues are discussed and nearly decided in this
circle before being brought up at formal fora which are reduced
to being extensions of the same informal discussions with a few
persons more. This further discourages new people to join
because, till they are include'1 in,the inner circle, for most
part of the discussions they feel like outsiders.
2.
The debates that ta: e place reflect concerns
of
experienced members who have parsed the initial stage of having
’naive’ doubts and ideas. 1
y also become insular - not
necessarily out of will, but out of isolation - to newer issues,
and newer concerns of people and well-meaning professionals
outside. One very characteristic instance that comes to one’s
mind,
is that of issues thrown up by various Junior Doctors’
Associations. Thus, while the MARD in Bombay is trying to
concretely change the role of MMC by participating in its
elections, mfc in its long history has never even once, even
informally discussed the role of Medical Councils and means of
influencing them. ( MARD, it must be noted, is not a conventional
TU,
in the past having clashed with authorities - at least the
leadership - on inefficiency and lack of amenities in public
hospitals in Bombay).
Crisis of Finance:
Running an organisation needs money, even "if there’s a lot of
work
done without charging expenses to the
organisation.
Organisations like mfc are not expected to be rolling in money
and have to exercise thrift. But when the belt becomes so tight
as to make the waist disappear, something must be
wrong
somewhere. Today, the finances of mfc are such that the Convenor
has to think twice before xeroxing 10 copies of a letter or
arranging part-time secretarial help. Organisations living under
the poverty line, unlike similar families, cannot cope for long.
We run into losses in the two regular activities: bulletin and
annual
meet.
In both cases,
losses are
met
from
the
organisational funds collected through memberships, donations and
sale of books. This has resulted in erosion of funds kept aside
for publishing books in future. It also prevents us from planning
and taking on any new activity.
Crisis Qf Leadership:
Though, strictly speaking a part of the organisational crisis, I
deal with it separately because of a certain personal element
involved.
In
an open, loose organisation like mfc, to talk
mfc wardha meet aug’90
of
leadership
crisis in mfc
may be inappropriate. But even the most loose of social groups
require a leader/(s). In mfc, this role is fulfilled by the
Core iiroup or at least those active in it from time to time.
Except for two senior members - who did share the zeal, outlook
and attitude of their younger comrades but had differential
responsibilities, all the others in the Core Group belonged to
the 30+5 age-group at the time of mfc’s formation and growth. Not
having many family or professional (or career) commitments, the
time,
energy and mental space they devoted to
mfc
was
substantial. Many of them were learning new experiences, ideas
through mfc, thus growing with mfc’s growth. With the passage of
time,
their responsibilities have not only increased
but
diversified. Families have grown, careers/professions (paid or
honorary) have become more demanding and created new contacts,
all impinging upon the time, energy and mental space once devoted
to mfc. Their personal growth has outmatched mfc’s and thus other
fora have been found to meet their needs. With no new persons who
would devote the same amount of T, E, MS and could have the same
personal stakes as the founders had in earlier times, mfc as an
organisation has aged; its vitality has reduced.
However, unlike individuals, for an organisation aging need not
culminate in death. Rejuvenation, though a painiul and difficult
process, is possible.
Understanding the crisis is only the beginning — of the end
of a New Beginning, is what we are gathering to decide.
mfc wardha meet aug’90
or
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An extract From;
BHOPAL; THE IMAGINATION OF A
DISASTER
Shiv Visvanathan
with
Raj ini Kothari
V
Between the muteness of the victim and the propogadistic
erasure of the State stands the voluntary organization.
Voluntarism attempts to create an ethical space, an eco
logical niohe where the victim as survivor marked by the stigma
of the disaster can grieve, mourn, remember and recover.
But the voluntarist is more than a mourner. He realizes that
the victim becomes in the aftermath of a catastrophe, the
focus of a grid, the huge apparatus of health and social wel
fare seeking to diagnose, survey and map him out. He seeks
humanize and even alter the structure of such an expertise.
One example of such an attempt is the effort to alter the're
lation between doctor and victim in Bhopal. The voluntarist
realizes that much of the formal language of medical expertise
is caught in the mechanics of cause and effect. He seeks to
transform the iriea of a clinical gaze, where the patients is
spread out like a table of symptoms, into speech with its
more encompassing concern for signs, symbols and symptoms.
Through this he hopes to articulate the victimrs conception
of his own p”tn. One strategy adopted in Bhopal was to move
the site of
analysis from a formal organization like a h
hospital into the bastee itself. In the hospital, the patient
is an isolated unit. Now he is a part of the-community. Rather
than being based ona formal reading of symptoms, cure end relief
now become part of . the socio-drama of a. community. The doctor
listens while the patient enacts out his pain amidst a chorus
of familiar actors, Typical of sucha strategy is the work of a
the Medico Friends Circle. (F:FC). Its rep.orcompleted in May
1985 is probably the most sane, compassionate piece of scholar
ship on the problems of relief in Bhopal.
The MFC describes itself as a circle of health interested
professionals united by the belief that the medical system is
skewed in preference for the rich. It seeks to demystifymedical expertise, deconmiercialize medicine, emphasising com
munity orientation of health care. ltd basic survey was under-t
taken between 19-25 March, 1985.Its aim was three fold. It
sought to uphold the idea of an expert as trustee, of science
as publicly available knowledge, it articulated the pain of the
victim and his/her idea of relief into a more integrated plan
for medical rehabilitation. Thirdly, with true anthropological
reflectiveness, it shows how conceptions of the patient, ideas
of cause and effect, diagnoses, and cure form an integrated
consciousness, a gestalt as it were.
The survey began by studying the impact of the gas and in
pursuing this they faced two sets of problems. Firstly, little
was known about the properties of MIC and secondly, what little
was known, was kept secret, "It obtained with difficulty,
Carbide's manuals which showed MIC to bd a toxic gas under
going runvaway reactions when contaimiriated. The voluntary
groups publicized data available in such manuals. The MFC also
launched a survey of the literature available. The doctors
realized that the information available in them was incomplete
and flawed. They referred to lung fibrosis and corneal damage
as the only two long range problems of survivors. The voluntary
groups also realized that government research, despite the
,2
- 2 fanfare, was’sketchy and unsystematic, The ICMR's research
appeared as '’twenty or so vertical programmes, without inte
gration into a wider conception of opidimeological community based
endeavour" What was missing was a systematic rationale for
detoxification by Sodium Thiosulphate.
It was in this context that MFC with the aid of other
groups planned a community survey. It included a people's
■perception of medical services. The doctors also decided that
a summary of findings and technical recommendations would .be
handed over to each person'in the sample. The surveys of the MFC
and those of the Delhi Science Forum and the Morcha showed the
enormity of the crisis as a social s ituation. The studies of
Jai Prakash Nagar showed that income levels had fallen drastically
that rates of interest were high. They proved that compensation
was inadequate, even though at the high point of "the crisis,
it was the only source of income for many disabled p-eople. The
report argued that doles were not enough. The mechanical
hydraulics of the dole could not return the community to it ori
ginal condition. What was required was an imaginative scheme of
occupational rehabilitation. Such <b: scheme could not be
based on the wage that was earned before the exposure as indcator. It had to take into account long range physical disa
bility, the mental traumas, the persisting sense of insecurity.
The MFC and othergroup-s were thus challenging the restrictive
notion of health articulated by the government. The latter seemed
to read the disaster in mere physical terms. What it refused to
see was the psycho-social dimension of the disaster. "Thousand s
of people have experienced mass death, mass morbidity, mass
migrations, disruption of family and social life, escalations
into an acute socio-economic financial crisis ana literally a
loss of moorings in society. Such an experience is bound to
manifest itself in psychological, somatic and psychosocial mor
bidity whoso long term management will probably be more crucial
than troatmeat of physical ill health and disability".
The doctors of the MFC wore true listeners, sensitive to
the word and the sheer detail with- -which patients outlined these
problems. The importance of this is brought put in the report
"The words and examples used by the patients while describing
their sysmptoms clearly showed the gravity of the symptom as wall
as its effect on the person's day-today work. The different
manner in which the symptom was described also showed that the
person was informing us of a problem based on his/her own experi
ence and not just vague hearsay oxp'Jressions. This is particu
larly important since in the absence of signs in the same pro
portion as symptoms, doctors attending on those people in busy
government hospitals were often passing of these symptoms reported
as 'compensation malignering ' or no ixofcfinical significance.'
We have every reason to b elieve that those symptoms were real ex
pressions of physical and mental ill health and many should
be accorded the same significance■as the use of patterns of
cough with or without expectoration on the diagnoses of Chronic
brouchities or the use of Anginal history in the diagnosis of
Ischaemic Heart Disease".
The conception of disease as a problem of the community,
of the patient as diagnostician in his own right, contrasts
with the conventional notion of the doctor as the sole intnrpetor
of signs and symptoms, to which must b-: added the attitude of
many doctors who perceived the behaviour of patients as mali
gnering or compensation neurosis. These doctors prescribed "whole
plates full of colorful capsules in a routine manner". The
MFC survey eventurally shows how such contrasting perceptions
quietly link up to two separate views of diagnoses and cure.
...3.
- 3 The two basic theories were the Pulmonary theory and the
Cyanogen pool theory. The Pulmonary theory is based on the
current literature availabe on MIC, which indicated that fibroses
of the.lungs and corneal damage are the only long term effects,
to be expected. The impact on an any other.system is, it holds,
due to secondary effects. The Cyanogen pool theory contends that
the impact is not one of Pulmonary fibrosis alone but a deeper
cellular one, not merely confined to lungs. Whet is important
for the analysis is the style of research underlying the two t' stheories. The first operates in terms of the direct mechanics
of cause and effect, the second in terms of deeper relations.
The mechanistic theory of pulmonary impact is advocated by th-e
establishment and government'hospitals*. The cyanogen pool theory
finds its advocates among voluntary health specialists and dis
sident doctors.
But what is most fascinating is the manner in which text
and context are related. Voluntary health specialists have
repeatedly advocated that the focus of study should be suffering
in the community, rather than the patient as an isolate in the
hospital. The first they argue, leads to a holistic view of .di-*1-.
sease while the latter propagates a reductionist view of illness
and -an atomistic view of the patient. The latter view which
underwrote the pulmonary model, is based on numerous vertical
studies rather than- an intogra£ed search for interconnections.
In a telling paragraph the MFC report suggests, "The approach of
examining say 200 eyes or 2001ungs and so on independent of one
another lacks this integration. Strange it may sound, but it
seems to derive the rationale-pmconsciously-from the pulmonary
model, wherin toxic gas directly hits the target organ.(lungs,
eyes, etc.; to produce damage without any intrinsic connoctionswhich is at the heart of the’Cyanogen Pool1 model”.
It is this anthropology of gestalts that is fascinating
about the report. What it offered wre two clusters which
deserve further exploration.
1. Patient as an analytical
grid
Patient as Person
2. Clinical gaze of the
doctors
Victim's speech aids
diagnosis
3. Focus of diagnosis is
the hospital
Focus of diagnosis is the
■Community
4. Diagnoses as mechanics
of cause and effect
Diagnosis as an analysis of
inter-relations
5. Pulmonary Model
Cyanogen Pool Model
6. Anti Thiosulphate
Use- of Sodium Thiosul
phate as a critical tool
VI
The experiences of the MFC, the Morcha and other groups
demand that this has to bo located within a wider political
context. The problem of voluntarism has acquired a dramatic
focus within a span of two months. The November riots and
the December gas,leak created a now objective situation which
has to be understood within the theory of the State. The 'riots'
in.Delhi saw the formal emergence of the State as terrorist.
The Bhopal gas leak revealed the complicity of the State in an
act of industrial genocide'. Tn both cities, the traditional
corporate groups-the trade unions, the political parties, the
.
.•.4.
- 4 the universities-failed to act as 8 cushioning medium between
state and the people. In Delhi, it was the civil rights groups,
along with a network of feminists, journalists, university teach
ers and Jesuit priests which brought analytical clarity to the violence of the State and even provided relief to the victims.
The situation in Bhopal was similar.
Caught in the grid of modernity, which sees industrialism
as good and inevitable, the traditional corporate grouns saw
the victim as an embrassmont. Wo must add however that political
patties like the CPI did ginorly conduct a few demonstrations.
Some student wings of leftist groups responded by conducting sur
veys and providing some medical relief. But one felt a whiff
of self-congratulation here, as if a few dozen injections had
transformed them to the status of a Kotnis. Most pathetic wore
the trade unions. So startling was the disaster, and yet so usd
were they to negotiations with the management, that they refused
to see that the normalcy of coll'ctive bargaining was inadequate
to this situation. Eventually Carbide declared closure of the
factory, offering the wo.rkers a nominal compensation. To add to
this the railway unions had failed to claim even workmen's
Dcompensation for the railwaymen who died on duty on December 3.
The Railways passed the buck to the factory and vice versa. But
the Workmen's Compensation Act is clear on this s the victims are
entitled to relief irrespective of the source of damage. Such
lethargy was typical of almost all the corporate groups as.organi
sations, oven if some of the individual members discarded these
routine scripts.
The voluntary organizations had to substitute for these
groups though one must add that few were self consciously
equipped for such a task. Voluntarism in this contxt required
a double responsiblity. It had torodeem not only the traditional
idiom of power but also the repressive nature of modem knowledge.
This point is crucial. As mediators between State and the peophe
they are not only refractors of power but proponents of an
alternative ecology of knowledge. It is not only the victims as
politically defeated people that they had to protect but also
their vdice, their memory, their right to their own vernacular,
pain and distress.
One fact needs highlighting. There is a distinctive
quality about voluntarism in these new contexts. The voluntarism
of the old Sarvodaya-social service kind no longer occupies a
central place. In Bhopal, certain church groups , the RamaKrishna Mission and the SEWA did p-erform important service but
stuck grimly to traditional stylos. They accepted the official
procedures of medication, basically symptomatic treatment,
including use of steroids and antibiotics and looked to the
leadership of the government, in all these activities. The
Health Secretary's question "why can't the Morcha be like the
SEWA ?" sums up this traditional and dedicated stylo. These.
organizations work as extensions of government relief and
avoided confrontationist stances. The litmus test for such an
attitude in Bhopal was-the Sodium Thiosulphate controversy.
All the above mentioned groups refused to administer those injec
tions. The point we wish to make is that the new voluntarists
were not content with relief. What they also sought seek was 1
justice for the victims. In this, the importance of socially c .
conscious professionals became obvious. In the Delhi riots,
university social scientists, researchers and journalists
provided an enormous data base which the State has found diffi
cult to refute. In Bhopal too, the role of- the professional as
'counter expert' has been crucial. These include health groups
environmentalists, lawyers' collectives and peoples science
movements.
REPRINTED FROM LOKAYAN BULLETIN, Vol. 3, No.4/5
13 Alipur Road Exchange Building Delhi 110054.
*****
XIII ANNUAL MEET OF THE MFC
Friends,
Medico Friend Circle will hold its XIII Annual Meet at Seva Mandir Training Centre, Kaya (near Udaipur),
Rajasthan, on the 26th and the 27th of January 1987.
The theme chosen for discussion this time is “Family Planning in India: Theoretical Assumptions, Implementa
tion and Alternatives”.
Family Planning has generally been considered an important part of Primary Health
Care, but over the past two decades, it has come to occupy a key place amongst the country’s development
strategies.
Is its elevation to the level of a panacea, for the problems facing the people, based on well
examined theoretical assumptions ?
What effects has the policy of incentives and coercion has had on the
Out of the existing contraceptive methods which is the least
harmful ? Do some of these methods need to be rejected outright ? Are there safer alternatives ? These
performance of other health programmes ?
are some of the issues to be discussed at the Meet.
As usual there will be no reading of papers.
hand to facilitate discussions.
Background papers on related topics will be circulated before
They include : (a) Problem of population versus resources
(b) Theoretical
assumption of FP policy in China (c) Critical examination of the FP policy in the context of the Child
Survival hypothesis
(d) Comparative analysis of the dangers of pregnancy and contraception (e) Women
as the main targets of FP policy (f) The paradox of higher FP performance in Tribal areas (g) Incentives
and coercions — effects on Primary Health Care (h) Pattern of resource allocation in our Five Year Plans
(i) Evaluation of the existing FP methods
(j) Natural Family Planning methods as safer alternatives.
We invite you to attend the Meet and share your views and experiences.
ground papers on any other topic related to the theme.
We also invite you to write back
Your note / paper should reach the Convenor’s
office by the 31st of November.
The participants are as usual expected to pay for their own travel.
Simple boarding and lodging facilities
will be available at the venue, on a payment of Rs. 20/- per day per person.
We charge a small registration
fee to cover the cost of the cyclostyled background papers. Return reservation facilities are also available.
If you wish to attend, please write to us at : Medico Friend Circle, 1877, Joshi Galli, Nipani - 591 237. We
will then send you the venue details and background papers.
Hoping to hear from you,
Yours,
Dhruv Mankad
Convenor, MFC.
{Issued as a Supplement to MFC bulletin of October 1986)
REPORTING FROM KHANDALA
Annual G.B.M. 29th January
A STATEMENT ON MEDICAL EDUCA
TION AND NEW EDUCATION POLICY:
In view of the nationwide debate on the new
education policy, it was decided that mfc should
take a public stand on the issue of medical
education, mfc has discussed this issue quite
frequently and has been able to form some concr
ete views on the subject. A draft note highlighting
the salient feature of mfc's stand would be circu
lated by Ravi and Thelma Narayan by April 1.986.
All the members of the medical education anthol
ogy committee and others who show interest by
joining the discussion prior to its preparation
would receive the draft. Comments should be
sent back to them by 1st May 86.
4.
The main focus of this year's Annual General
Body Meeting was on the follow up of various
issues which mfc has been involved with last year.
The whole of 29 th was spent on discussing various
matters on the agenda circulated. It included the
annual report, annual accounts and budget, organi
sational changes,bulletin,theanthologies, rational
drug policy cell and mfc's involvement in AIDAN,
followup on TuberculosisMeet (AnnualMeet1985)
and NETEN campaign and other issues. The key
decisions are given below forinformation. Minutes
of GBM will be circulated to members at a laterdate.
IMPORTANT DECISIONS:
1.
BULLETIN: a) The Union Home Ministry
informed us some time end of 1985 that mfc can
not continue publishing the mfc bulletin (a registe
red newspaper) as mfc had received a foreign don
ation from an Indian doctor friend resident abroad.
The letter suggested that mfc set up a seperate
body. After a lot of discussion it was decided to
initiate procedures to register a seperate trust for
publishing the bulletin, if there was no other
choice. Meanwhile, newsletters will continue to
be published.
b) Satyamala will take over the editorship of
the bulletin from Ravi Narayan from the March
issue. She would also explore the possibilities of
publishing and printing it from New Delhi.
c) Anil Patel and Vimal Balasubrahmanyam
replaced Anant Phadke and Ulhas Jajoo who wit
hdrew from the Editorial Board.
2. ANTHOLOGY III: Due to various unavoida
ble problems, the anthology Under the Lens-Med
icine and Health could not be made available by
VHAI, New Delhi, on time. Now, it is ready for
sale. Orders could be booked from VHAI, New
Delhi or mfc office at Nipani (for address, see
below). VHAI would be requested to despatch pre
publication orders and other orders received before
February end, directly from New Delhi.
3.
ANTHOLOGY IV : The Medical education
anthology was to be ready by January. But due
to various reasons, it could not be completed. It
was decided to postpone the publication to later
this year. There were suggestions for inclusion of
articles on capitation fee and on the changes sug
gested in the teaching of Tuberculosis, at the last
Annual Meet as well as the changes suggested in
the teaching of Environmental Health during
this meet.
5. FOLLOW-UP OF TB MEET: Binayak Sen
and Anant Phadke were to prepare a note on the
critique of the strategy adopted by the National
Tuberculosis programme. The note is almost ready
and Anant will circulate the final draft by February
end to Binayak Sen, Mira Shiva, Mira Sadgopal,
Kashyap Mankodi, Anil Patel, Ashvin Patel, Ulhas
Jajoo, Marie D'souza,
Ravi Narayan and
colleagues from National Tuberculosis Institute
Bangalore. Deadline for sending comments to
Anant is March end. To those who differ sharply
from this draft, a revised draft will be sent and if
they still continue to differ, their argument written
in their own words would be added as a foot note
as an alternate point of view within mfc.
6. NET-EN CAMPAIGN: It was felt that be
fore taking any firm stand opposing /upholding
injectable contraceptives, a rigorous critique of the
technical arguments favoring its introduction is
needed, besides raising relevant social, and ethico
-moral issues. There are indications that the
data collection and statistical methods used in the
ICMR clinical trials have not been rigorous. While
formulating our case, it was suggested that advice
of demographers/statisticians and pharmacologists
should be taken. For this purpose, Satyamala will
put down the main arguments pointing to the gaps
and circulate it to Karuna Pattanayak (for demo
grapher ) Kamala Jayarao, Vimal Balasubrahman
yam, (for a Pharmacologist / biochemist's Views).
7. BHOPAL INTERVENTIONS :
a The report of the March survey is published
and has been well received. Now only ab
out 25 copies are available with the conven
or, the rest being sold/distributed for sale /
complimentary/review.
b) Pregnancy Outcome Survey: The survey is
complete and the tabulation of the data will
be over by March. A workshop will be held
at ARCH, Mangrol between 15 and22 of March'
1986 to finalise the results and also to find out
if a control would be necessary. Sanjeev Kulk-
A Report on the discussion (27-28th January;
on Environmental Health and Pesticides will be
featured in the April Issue - Ed.
2
imagination of a disaster Shiv Vishwanathan
and Rajni Kothari (Rs. 8/-) Lokayan, 13 AlipurRoad, Delhi - 110 054.
KEEPING TRACK
MNC Monitor : Asia
Bhopal remembered - a publication on the
aftermath of the Bhopal gas tragedy.
Order publication from Documentation for
Action groups in Asia (DAGA), 57 Peking Road,
5th Floor, Kowloon, Hong Kong.
11.
1.
Docpost
A postal documentation service culled from
150 newspapers and magazines; over 500 infor
mation sources; at your doorstep and low cost;
adaptable to your specific needs. For further
details contact Centre for Education and Docu
mentation, 3 Suleman chambers, 4 Battery Street,
Behind Regal Cinema, Bombay 400 039.
Asia's Struggle to Affirm wholeness
of Life
A report of a consultation on TNC's in Asia.
Available from Christian conference of Asia-urban
Rural Mission, 57 Peking Road, 5/F, Kowloon,
Hong Kong.
12.
Drugs
Drugging of Asia - Pharmaceuticals and
the poor
Summary of workshop conclusions. For copy
contact Low cost Drugs and Rational therapeutics
cell, VHAI, C-14 Community Centre, SDA,
New Delhi -110 016.
2.
3.
Rational Drug Policy - a AIDAN statement
For copy contact Mira Shiva - AIDAN coord
inator, VHAI, C-14 Community Centre, SD4,
New Delhi - 110 016.
Pesticides
Issues in Environmental Health ; The case
of pesticides
CED-mfc publication. Set of background
papers for the mfc annual meet - 1986
Order your copy from C E D (address refer-1)
5.
Pesticide Dilemma in the third world
A case study of Malaysia. Write for copy to
Sahabat Alam Malaysia (Friends of the Earth) 37
Lopong Birch, Pulaupinang, Malaysia
6.
Will my Work Make me Sick.
A preliminary report on the effects of pesti
cides and other Agro - Chemicals on Banana and
Pineapple plantation workers in the Phillipines.
For copy write to Health and Workers group
Council for Primary Health Care, P 0. Box
SM-463, Sta.'Mesa, Manila, Philippines.
7.
Danger of Pesticides and Circle of poison
Postcardsand posters on the dangers of the
indiscriminate use of pesticides.
Contact IOCU, P.O. Box.1045, Penang, Malaysia.
4.
Bhopal
8.
The Lessons of Bhopal
A community action resource manual on
hazardous technologies. Contact IOCU, Malaysia
(refer address No. 7)
9.
No more Bhopal - Plant a Neem
Poster available from Research Foundation
for Science Technology and Natural Research
Policy, 105 Rajpur Road, Dehra Dun 248 001.
10.
On Survival
Special Double issue of Lokayan Bulletin
(3-4/5) including special article on Bhopal - The
Mental Health
13.
Manual of Mental Health for Medical
Officers
By Mohan Issac, C R Chandrashekar and
R. Srinivas Murthy, Community Mental Health
unit. National, Institute of Mental Health and
Neuro Sciences Bangalore (copies from Dr"
G. N. N. R addy, Director, NIMHANS, P.O. Box
2900, Bangalore - 560 029).
14.
Manual of Mental Health for Multipurpose
Workers
ICMR, Advanced Centre for Research on
Community Mental Haalth, NIMHANS Bangalore
(Copies from Dr. R Srinivas Murthy, Officer incharge ICMR-A CMH, NIMHANS, P.O. Box 2900,
Bangalore - 560 029)
Development
Development with people
Experiments with participation and non-formal education. Also includes a chapter on Com
muni y Heath in India. Ed. Walter Fernandes,
Indian Social Institute, Lodi Road, New Delhi 110 003 (Rs. 30/-)
15.
Traditional Systems of Medicine
Proceedingof the workshop on Tradition
al Systems of Medicine (Ayurveda and
Siddha) and Primary Health Care
April 1984 - For copy contact Arya Vaidyan
Rama Varier Educational Foundation of Ayurveda,
366 Trichy Road, Coimbatore - 641 018, (Tamilnadu).
17.
Ancient Science of Life
A new quarterly research journal in English.
For further details write to publication Division,
International Institute of Ayurveda, P. B. No.
7102, Coimbatore 641 045 (Tamilnadu).
16.
Occupational Health
18.
4
The number game
A study of the occupational health hazards of
Indian Rare Earths, at Alwaye by Padmanabhan
V.T. For copy contact C.E.D. (refer address No I ).
19.
Beware of Hazards in the workplace
A kit by SAM workers. Education Programmes
Available for Rs. 23/- from C E D, Bombay (Refer
Address No 1.)
DEAR FRIENDS
Role of mfc
I feel that the apprehensions expressed by
Ulhas (mfcb 119) are mostly unfounded. I
don't see any signs, even remote, of mfc splitting
up into splinter groups.
Health Services
20.
The Makings of Health Services in a Cou
ntry - Postulates of a theory
by D. Banerji, published by Lok Paksh (Rs.
7.50) Available from Lok Paksh, Post Box 10517,
New Delhi - 110 067.
It is true that there always has been a comp
laint or criticism that the schedule at the Annual
Meet is so tight as to not allow for forging new
friendships. However, although mfc is a circle of
friends, making friends is neither its sole aim nor
its primary aim. Just as according to Ulhas, there
is nothing like mfc activity, but activity by the
members, so also there can be no mfc friendship
but friendship between members. And, discuss
ion during the meeting is a good background for
assessing each others viewpoints, which are very
necessary for making friends. Those that do drop
out, of mfc, and those that do not come for a sec
ond time, do so mostly because they do not see
eye to eye with mfc, and not because they find no
friends.
(Continued from page 3)'
12. ANNUAL MEET 1987 :
The XIII Annual Meet would be held at Udai
pur on 27, 28 Jan 1987. It would be preceded by a
core group meeting on the 26 and followed by
the GBM onthe 29. The theme of theAnnual Meet
would be "Family planning in National Health
policy". The exact venue and other details will
be conveyed later. Narendra Gupta accepted the
responsibility of organising the Meet.
Note :- All members/ readers interested in parti
cipating in any of the above collective actions may
please get in touch with the convenor.
I see absolutely no danger of mfc splitting up.
It is as healthy as ever. As I said at the 'heart to
heart' session at the Patiala meet, this is both
mfc's strength and its weakness; strength because
it shows the deep give and take attitude of the
members and weakness because it perhaps reflects
a lack of total commitment by individual members.
Available
A listing of recent articles (1980- 85) on
Health and Medicine, Nutrition, Family Planning,
Environment in Economic and Political Weekly.
For copy write to MFC Office or Padma Prakash,
EPW, ‘Skylark' 284 Shahid Bhagat Singh Road,
Bombay - 400 038 (Maharashtra)
NEW
What is wrong if mfc takes up a collective ac
tivity? It is a good sign that instead of being a pu
rely discussion platform, mfc does try to get its
hands dirty. However, the Drug Action Network
is not a 'mfc activity', in my opinion, mfc provi
ded a platform for those committed to this issue to
get together. Just as individuals are committed
to their individual activities, a group of members
are committed to a single cause-but remember it
is not a splinter group. This is where the friend
ship part of mfc really shows through, because
people who are not mfc members could come to
know mfc, its members and what they stand for,
at the DAN meet.
PUBLICATION
Health and Family Planning
Services in India
An epidemiological, sociocultural and
political analysis and a perspective
D. BANERJI
Lok Paksh, 1985
Bhopal is an entirely different issue. With due
apologies, it was a unique opportunity. Here was
a health problem arising entirely out of a social
and economic aetiology. It was not an accidental
disaster but a deliberate negligence which blew
itself into an unexpected disaster. It did not mer
ely catch the medical community napping but rev
ealed its inability to deal with such situations in a
scientific manner. If this is not where mfc was to
be found, where else should it be and whose
friends do we want to be anyway?
The book makes an analytic review of the
growth and development of healt h services in
India and discusses the factors influencing their
accessibility and availability to different segments
of the population. It emphasises that health
service development is a socio-cultural process, a
political process and a technological and a mana
gerial process based on epidemiological and
sociological perspectives.
For copy/details/Price contact Lok Paksh,
Post Box 10511, New Delhi - 110067.
I totally disagree with Ulhas that we limit the
role of mfc to a body of friends with a common
5
Not only that these issues demand an organisat
ion's involvement, but other organisations based
upon such issues start expecting such an involve
ment like what happened in the case of Bhopal.
These demands cannot be seen merely as whimsof
this or that organisation- they may be, but cannot
be called so, a priori - for what else are the needs
of a movement if not those expressed by organis
ations taking part in the movement? If we, as an
organisation fail to make an attempt to act upon
these needs, our relevance to the social movement
is lost. We lose the claim to be a part of such a
movement. And therefore, changes in an organi
sation's direction may become inevitable - even
withdrawals of members and splits. That should
not put one off from making the necessary changes.
2. MFC members have commitment but no
sense of collectivity. It is unrealistic to expect peo
ple to do the above (1) unless adequate time is
given for sharing abouts one's activities and prob
lems and giving opportunity to establish personal
bonds of friendship.
MFC role is mainly to facilitate such type of
discussions and only when such a thing happens,
will a need be felt to give time for organisational
work. Since the discussions of late are very bus
iness like-lacking this personal touch no collect
ivity is in sight. Attempts should be made to build
up respect for the other's opinions, and limitations.
From these two major standpoints the partici
pants viewed the interrelationship of personal
relationships and potential for collective action.
It was felt by some that personal bonds could only
be created during organisational involvement on a
problem. Bhopal exemplified this-it was claimed.
Through intense action, it became possible to
understand each other and to relate to each other.
It was felt that a methodology of such involvement
has not been worked out. Others felt that since
no attempt is made to establish relationship out
side the main issue of action, people come togeth
er only for business. Some felt that one of the
reasons for non-involvement of members at an
organisational level is because they are individuals
at their own places, while it requires a critical
mass of people for interactions, for fresh ideas to
be generated on an organisational issue.
All this is not to be little the significance of
Ulhas's main argument, that bonds of friendship
tend to be neglected in the heat of discussions on
action. Once, Ulhas had suggested to me, that
we should have a mid - annual meet of mfc, not
to discuss any theme, but to relax and talkl An
idea deserving our serious attention.
Yours,
Dhruv Mankad
Nipani
The core group dialogue on role
continues
O A core group meeting was held on 26th
January 1986 to continue the dialogue on the role
of mfc initiated at Patiala in July, 1985. To
facilitate the ongoing discussion some back-ground
papers were distributed which included - the
minutes of the Patiala meeting; a listing of reque
sts for action/support received by the mfc office
in 1984-85; excerpts from letters written to mfc
indicating role expectations; a Lokayan comment
on mfc's role in Bhopal and so on.
Suggestions Regarding the Methodology of
Collective Involvement:
After this intense debate on the role of mfc,
some very interesting and pointed suggestions
came up for working out a methodology whereby
the expectation of members can be fulfilled at an
organisational level.
1. The cells that were formed at Patiala should
be concretised.
2. Every core group member should share at the
core group meeting what he or she is doing as
mfc member and otherwise.
3 The Cells should be formed around a few
areas with which most core group mem
bers are interested in/involved in.
4. The cells should report at the core group
meetings.
■ 5. To maintain a continuity, one theme should be
selected out of 3 or 4 areas on which cells are
working, for the theme of the Annual Meet.
6. Administrative matters should also be dealt
only by a cell so that other members may have
more time to discuss many vital issues. Only
the important policy decisions be brought to
the core group or GBM.
O Though no clear consensus emerged at the
end of over three hours of discussion, some conc
reteproposals to continue to define mfc's role
were arrived at. Some of the major trends that
could be discerned were
1. MFC members share a common perspective
but it is still essential to reserve a place in one's
time schedule for organisational work of MFC.
This may even mean changing of the plans of the
work one is doing in a local area. Organisati
onal work may include making new members,
new subscrbers; writing responses to letters/
circulars from convenor; commenting upon some
major organisational • involvements and or
participating in it; writing in the bulletin.' respon
ding to matters of national/regional importance
where it may be imperative to take up a collective
stand as an organisation.
O
7
To recall - the following cells were formed at
Patiala
SUBJECTWISE INDEX OF MFC BULLETINS
ISSUES 1-99
JANUARY 1976—MARCH 1984
Subject Categories :
1)
Health Services — General
2)
Health Services in Other Countries
3)
Health Schemes, Projects and Groups
4)
Medical Education
5)
Problems of Doctors
6)
The Nursing Profession
7)
Science and People
8)
Indigenous Medicine
9)
Community Health Worker
10)
Sexist Bias in Health
11)
Maternal Health
12)
Contraception and Abortion
13)
Population Growth and Control
14)
Children and Health
15)
Nutrition and Hunger
16)
Lathyrism
17)
Environmental + Occupational Health
I.
Health Services — General
Banerji D, History of health services in India, 1-2:
jan-feb 1976, p1
Jaya Rao K, Nanavati K, Katgade V, Report B: dis
cussion on 'our present day health problems
and needs', 1-2: jan-feb 1976, p7 (proceed
ings of II ann. mfc meet)
Patel A, Report D: discussion on 'health for the
people : finding a practical way', 1-2: jan-feb
1976,
p9 (prcfiee.jings of II ann. mfc meet)
Banerji D, Evoluj. 3n of the existing health services
systems ofiMndia, 3: 1976, p1
Qadeer I, A rush for alternatives, 3: may. 1976, p7
(review <*rf,>3,.recent WHO/UN publications)
Elliott C, Is,- primary health care the newi priority?
Yes, but. .... (part I), 4: apr 1976, p5
Elliott C, Is primary health care the,new priority?
Yes, but......(part II), 5: may 1976, p3
— , Health or 'health servipes'?, .5: may 1976,
p5 (review of Care of Health in Communities
and Medical Nemesis)
Qadeer I, Dear friend : much ado about
6:
jun 1976, p7 (about King M, Medical Care in
Developing Countries)
Bang A, Much ado about
8: aug 1976, p4
Qadeer I, Dear friend : much ado about
10:
oct 1976, p8
Parmer S, Health care in the context of self-reliant
development, 12: dec 1976, p4
Phadke A, Report B: discussion on 'health services:
an analysis', 13: jan 1977, p6 (proceedings
of III ann. mfc meet)
Jain T, New national health policy, 20: aug 1977,
P1
Phadke A, A programme for immediate action, 21:
sep 1977, p1
18) Health during Mass Calamity
19) Water Supply and Sanitation
20) Diarrhea and Oral Rehydration
21) Drug Industry Malpractices
22) Drug Misuse
23) Rational Drug Therapy + Action
24) Drug Policy Alternatives
25) Tuberculosis
26) Malaria
27) Leprosy
28) Mental Health
29) Miscellaneous: Technical and Medical
30) Misc. : Non-Technical or Non-Medical
31) Role of MFC and Members
32) MFC Bulletin
33) MFC Meet Reports (Organisational)
Compiled by Mira Sadgopal
Qadeer I, People's participation in health services,
23: nov 1977, p1
Shah D, Dear friend: new national health policy,
23: nov 1977, p8
Jaya Rao K, Why an alternative health policy?, 25:
jan 1978, p7
Bang R, Health services in India: report of discus
sion on paper, 26: feb 1978, p7 (proceedings
of IV ann. mfc meet)
Destanne G, Two ways for health economics
(part I), 27: mar 1978, p1
Destanne G, Two ways
(part II), 28: apr 1978,
p5
Gideon H, Making the community diagnosis, 30:
jun 1978, p1
Banerji D, Political dimensions of health and health
services, 31: 1978, p1*
— , News clippings: the need, the words, and
the deeds
. 33: sep 1978, p4
MFC, The rural health care scheme — mfc view,
34: oct 1978, p2
— , Rural orientation of policy makers, 34: oct
1978, p8
Ganguli M, Health & Society, 51: mar 1980, p7
(journal notice) '
Maru R, Murthy N, Rao T, and Satia J, Professional
management in health bureaucracy, 53-54:
may-jun 1980, p1
Barreto L, Primary health care, 55: jul 1982, p1
Jaya Rao K, Kerala : a health yardstick for India,
58: oct 1980, p1**
Deshpande M. Dear friend: people's participation,
59: nov 1980, p6 (response to A Bang's
account of Savar project in 58)
Bang A, People's participation and economic selfreliance in community health: 64: apr
1981, p1**
Clark A, What development workers expect from
health planners, 67: jul 1981, p1**
Ramprasad V, Primary health care: The real pic
ture, 77: may 1982, p6
Subramanian A, Health for all: an alternative stra
tegy (a note on the current tasks), 79: jul
1982,
p1
Narayan R, Keeping track — 1, 80: aug 1982, p5
(review of two documents on alternative
health care by ICSSR/ICMR)
Narayan R, Keeping track — II, 81: sep 1982, p3
(review of Hlich I, Medical Nemesis and
Horobin D, Medical Hubris)
Swaminathan S, Why PHCs have failed: reflec
tions of an intern, 81: sep 1982, p4
Dandare M and Karandikar V, Integrated health
programmes: some questions, 84: dec 1982,
p5
Nabarro D, Health for all by the year 2000 : a
great polemic dissolves into platitudes?
(part I) 90: jun 1983, p1
Nabarro D, Health for all........? (part II), 91: jul
1983,
p1
Jesani, and Prakash P, Health for all?, 94: oct
1983, p8 ,reply to D Nabarro's article)
Ladiwala U, Dear friend: I would like to visit Nag
pur, 32: aug 1978, p4
Kapadia R, MFC news: MFC group in Bombay, 33:
sep 1979, p5
— , MFC news: Sevagram (report of two dis
cussion — 1. drug industry 2. nurses) 34: oct
1978,
p4
Soni M, MFC news : Ahmedabad (report of a meet
ing of members), 34: oct 1978, p4
Parikh I, Dialogue : health project — a means of
social change, 39, mar 1979, p7
— , MFC news : (MFC ground at Sevagram),
40: apr 1979, p6
— , MFC news : (Meeting of MFC group at
Calicut, Kerala), 41: may 1979, p8
— , 'India is Kundungal' (Calicut group experi
ence), 42: jun 1979, p7
—- , When the search began (field experience
of MFC group, Sevagram), 47-48: nov-dec,
1979,
p5
Desikan K, Dear friend (response ttf Sevagram
group's article in 47-48) 50: feb 1980, p5
Arole R, Comprehensive rural health project,
Jamkhed, 49: jan 1980, p1
Tharyan T and Joseph A, The Vepppmpet story,
53-54: may-jun 198, p6
2. Health Services in other countries — , The paramedics of Savar : an experiment in
health in Bangladesh, 57: sep 1980, pl-fc*
Prem R, Few points to ponder over....... . 17: may
Bang A, Learning from the Savar project (part I),
1977,
p7 (European health services)
58: oct 1980, p5
Rajan V, Community health in China, 22: oct 1977
Bang A, Learning from the Savar project (part II),
p1
59: nov 1980, p1
^fr R 22: oct 1977, p (obser
Bang A, 'ACHAN' — a-ne.w Asian organisation,
vations in southeast Asian countries — part-1}
59 : nov 1980, p6.
— , CINI — Child In NSed”(“institute, 60; dec
—
23: nov 1977, p5 (part-ll)
1980,
p1
Conover S, Donovan S and Susser E, Reflections — , Some more activities of CINI, 6y: jan 1981,
on health care in Cuba, 68: aug 1981, p1
p4
'
3. Health Schemes, Project and Groups Phadke A,f RUHSA (Rural Unit for Health and
Affairs), 63: mar 1981, p5
Khanra L, Report F: report on projects description, —■ Social
, Some more activities of Clh£|s6l: jan 1981,
1-2: jan-feb 1976, p11 (proceedings of II annp4
mfc meet)
— , News (reports received from Vadodara and Jajoo U, Community participation!^ primary health
care, 66: jun 1981, p4*>
Surat groups in Gujarat), 4: apr 1976, p3
— , Health Action International, 77: may/982,
Nanavati K, Community health care centre, Thaltej,
p4 (HAI is affiliated with the international
4: apr 1976, p4
organisation of consumers unions — IOCU)
Chandran N, Report: regional mfc camp, Kerala, 9: George T, Calcutta National Welfare Organisation,
sep 1976, p7
88: aug 1982, p6 (report after CNWO
Katgade V, Health care delivery through ESIC, 15:
seminar)
mar 1977, p1
— , Socially conscious epidemiological ap
proach, 82: oct 1982, p6 (report of Mangrol
Sadgopal M and Gupta V, Doctors' camp at Kishore
group's work, from mid-ann. meet)
Bharati: a probe into the cycle'of poverty and
disease, 15: mar 1977, p5
— , Health work in a working class movement,
82: oct 1982, p6 (report of Binayak Sen’s
Jaya Rao K, Dear friend: health care delivery
work with Chattisgarh Mukti M.orcha, from
through ESIC, 18: jun 1977, p7 (response to
mid-ann. meet presentation)
V Katgade's article in No. 15)
Katgade V, The scope of health projects: report of
4.
Medical Education
discussion on paper, 26: feb 1978, p7
— , Mao Tsetung's June 26th direptive (slightly
Bang R, One 'Sir' every two minutes 30: jun 1978,
amended) of 1965, 9: sep 1976, p8
p5
Schumacher E, The two ways, 10: oct 1976, p7
Kapadia N, Pujai: an experience with mud and Anon., Dear friend : needed — new managers for
rain, 32: aug 1978, p3 (a student recollection)
medical colleges, 14: feb 1977, p5
2
£
Dey S, Dear friend: needed — new managers
....... (I), 15: mar 1977, p4
Jindal T, Dear friend: needed — new managers
........ II) 15: mar 1977, p4
Kothari M and Mehta L, Knowledge is confusion I
17: may 1977, p5
Nene D, Dear friend : needed — new managers
for medical colleges, 17: may 1977, p8.
Zala M, Dear friend : Knowledge is confusion, 18,
jun 1977, p7
— , Dear friend : increase in the seats for medi
cal college students in Maharashtra, 22: oct
1977,
p
Patel B, Dear friend : Up against new medical
colleges 23, nov 1977, p8
— . Medical studies in Malayalam, 32: aug
1978,
p4
Kashlikar SJ, medical education : physiology and
frogs, 33: sep 1978, p4
Dhaddha S, Dear friends : on 'medical education
in Malayalam', 33: sep 1978, p5
Singh T, Dear friend : medical education and
investigation dependance, 35: nov 1978, p7
— , Product of medical education, 37: jan 1979
p4 (cartoon)
Agarwal D, Threat to PSM, 42: jun 1979, p8
(G.O.I.), National medical education policy (draft
plan), 46, oct 1979, p2
Sonwalkar A, Dialogue : concerning three years
medical college, 46: oct 1979, p4
Sathyamala C, Innovative programme in medical
education: three case studies; 87-98: jan-feb
1984,
p10
Jaya Rao K, From the editor's desk, 97-98: jan-feb
1984, p16
Mankad D, Group A: structure and content of preclinical, clinical and para-clinical subjects,
99: mar 1984, p1 (ann. meet report)
Jesani A, Group B: content and structure of com
munity medicine, 99: mar 1984, p4 (ann.
report)
Sathyamala, Khanra L and Kapoor I, Group Cr
changing the methodology of training in medi
cal schools, 99: mar 1984, p7 (arin. meet
report)
5.
Problems of Doctors
Fatel A, Hyde park : doctor-patient relationship :
an acute crisis, 31 : jul 1978, p4
— , And the doctors get what they want, 31:
jul 1978, p4
Gole S, Dear friend: medical council elections, 35;
nov 1978, p7
tai, tat!
qlfferr h ferg
36: dec 1978, p6
— , Chloroform (review notice of book in
Marathi by Limaye A), 36: dec 1978, p7
Sen B and Barreto L, Unemployment among doc
tors, 37: jan 1979, p3
Dharmadhikari, D, The challenge of history to
medicos, 38: feb 1979 p1
Punse D, Dear friend: unemployed doctors and
unsold cloth, 38: feb 1979, p3
Patel A, Unemployment among doctors X 50 heads
(ann. meet report of discussion at Varanasi
meet), 38: feb 1979, p5
— , Operation medicine: on the path of agita
tion, 40: apr 1979, p6
tJTTI T, Dialogue:
H er W H Tiz TT,
40: apr 1979, p7
Chandra S, Dialogue: the rural, internship: The facts
and the factors, 44: aug 1979, p4
Huang C. City doctors go to the countryside, 44:
aug 1979, p6
Jagannatha Rao P, Morel T and Madhavan P,
View-point: why doctors too agitate, 55: jul
1980, p3
Jaya Rao K, Editor’s note, 55: jul 1980, p7 (doc
tors' strikes)
Punwani D, Dear friend (unethical medical prac
tices), 58: oct 1980, p8
— , From the editor's desk: the ban on private
practice, 91: jul 1983, p8
Medical Action Forum, Medical ethics and practice,
93: sep 1983, p6
insist),
<5^311^(^^146: oct 1979, p5
SIISL g, Dialogue: alT W $1 fe'atal sfh
47-48
nov-dec p7
31, Dialogue : A41S5
47-48:
nov-dec 1979, p8 (reply to Jajoo S)
— . News clippings : triumph of reaction, 47-48:
nov-dec 1979, p11
Fatel A, Dialogue : Three year medical diploma (I),
49: jan 1980, p11
§> Dialogue : Three year medical diploma
(II), 49 : jan. 1980, p11
4H at Dialogue : Three year medical diploma
(III), 49: jan 1980, p11
Cook G, Another view-point : training of doctors
and delivery of health care in developing
countries; 55: jul 1980, p5
Jain T, View-point: medical education and training
of interns, 62: feb 1981, p5
Phadke’A, The caste war by medicos, 63: mar
1981,
p1**
— , Substandard doctor?, 63, mar 1981, p8
Phadke A, Important facts about the medicos' agi
tation in Gujarat, 64: apr 1981, p3
— , Basic (k) medical education, 37: jul 1981,
p6
Tharyan T, A reorientation of medical education,
68: aug 1981, p2
Mankad D, People and health : a brief report on
the Dhaka conference, 89: may 1983, p1
6.
The Nursing Profession
Bang R, Nurses: the cursed nightingales, 33: sep
1978, p5*
— , News clippings : Nursing profession not for
men?, 34: oct 1978, p4
*
— , News clippings: SiSFft - PTS
50: feb 1980, p6
3
Bang R. Nurse: the woman in the medical system
(part-1), 71: nov 1981, p1
Bang R, Nurse: the woman....... (part-ll), 72: dec
181, p8
7.
, All India convention of people's movement,
88: apr 1983, p4
Umapathy P, Rural nutrition education : a futile
effort?, 94: out 1983, p1
__
8.
Science and People
— , go to the people....... 1-2: jan-feb y976, p3
Kothari M and Mehta L, Points of view: medicine
2000 AD, 18: jun 1977, p1
Conklin E, The effects of the professional agnosti
cism of scientists, 18: jun 1877, p3
Guevara C, The principle upon which the fight
against disease should be based....... 18: jun
1977,
p7
Kabuga C, Why andragogy , 29: may 1978, p1
— , Current concepts in parasitology, 29: may
1978,
p8
—
The debt, 34: oct 1878, p1 (quote from
Bhore Committee Report)
Abu, 'On weekends, I always became rural orient
ed', 34: oct 1978, p8 (cartoon)
Gandhi M, To the scientists of India, 35: nov 1978,
PBhagwat A, Bhagwat's seven laws, 31: nov 1978,
p1
Roy D and Qadeer I, Is a stethoscope appropriate
technology? 36: dec 1978, p4
Knaus W, God that is failing, 40: apr 1979, p1
Bearden J, A research fable: the needle in the
haystack, 37: jan 1979, p5
Huxley J, Genes and the Society, 41: may 1979,
p1
— , Low cost slide projector by NID, 42 : jun
1979.
p8
Choudhury B, Polygamy and positive eugenics, 42:
jun 1979, p7 (response to article by Huxley J)
Patel A, Dear friend: eugenics is anti-evolutionary,
anti-democratic, 42: jun 1979, p7
Mehrotra N, Management of Indian science, 49:
jun 1980, p10 (symposium notice)
— , Teaching aids,at low cost, 52: apr 1980, p3
— , Concern of young scientists: Indian science,
53-54- may-jun 1980, p7
Phadke A, Vigyan jatra in Maharashtra, 53-54:
may-jun 1980, p4
Brecht B, A worker's speech to a doctor, 60: dec
1980,
p8
Chowdhury Z, Research : a method of colonization,
62, feb 1981, p1**
— , Whither Indian scientists? 67: jul 1981, p4
Panth M, Scientists in villages, 68: aug 1981, p8
(poem)
— , Aids — posters for disabled by AHARTAG,
71: nov 1981, p3
— , The best foot forward, 72: dev 1981, p7
(approp. tech, in artificial limb rehabilitation,
Jaipur)
Bang A and Bang R, Other side of health educa
tion some experiences of health education in
a rural community, 76: apr 1982 p1**
Jaya Rao K/From the editor's desk, 81: sep 1982,
p8 (urban health care system and public
research establishments)
Indigenous Medicine
Khanra L, Report C: discussion on 'alternative
approach: various pathies' 1-2; jan-feb 1976,
o9 (ann. mfc meet)
Vaidya B, Dear friend, 3: mar 1976, p6 (history
of ayurveda — response to article by Banerji
D in 1-2
Patel A, Dear friend, 3: mar 1976, p6
Aron, Dear friend. The limits of fasting, 9: sep
1976,
p6
Vaidya B, Ayurveda and allopathy, 10: oct 1976, p6
Jaya Rao K, Dear friend: ayurveda and allopathy
(I), 11: nov 1976, p8
Singh T, Dear friend: ayurveda and allopathy (II),
11- nov 1.976, p8
Phadke A, Dear friend: ayurveda and allopathy,
12: dec 1976, p7
Soni M and Surahiyala K, Role of various 'pathies'
in community health, 14: feb 1977, p8
(report of MFC seminar at Ahmedabad)
Kapur S, Dear friend: a topic for study groups,
19: jul 1977, p6 (study of simple remedies)
&T R antt’T $ RRFJT 3?r<
f?F3T,
31 jul 1978, p5
Vaidya A, Modern medicine and ayurveda: a syn
thesis for people's medicine, 33: sep 1978,
p1*
Bang A, Editorial, 33: sep 1978, p3 (synthesis of
modern and indigenous medicine)
Kanchana Mala NP, Clinical trials with some
ayurvedic preparations 33: sep 1978, p8
313RT
34:
oct 1978, p7
CCRUM, ‘gRKft
R RI4RR
gf^i’
55: jul 1980, p8
Vad B, Herbal remedies and medical relief, 64:
apr 198y, p4
Multani P, Ayurvedic drug industry, 67: jul 1981,
p4
Jaya Rao K, 'Allo-ayurvedopathy', a non-scientific
hybridization, 73-74: jan-feb 1982, p5**
— , Attention please! (notice of first Asian Con
ference on Traditional Medicine), 85-86: janfeb 1983, pl 1
— , Naturopaths in the USA, 93: sep 1983, p5
9.
Community Health Worker
Shah P, Junnarkar A, Dhole V, Village health assis
tants, 12: dec 1976, p1
Raju U, Relevance of ICMR research project: tea
cher's training as barefoot doctor, 20: aug
1977,
p5
Werner D, The VHW — lackey or liberator?, 25:
jan 1978, p1*
— . A para-medical worker paid Rs. 6 per month,
31: jul 1978, p4
1974
Ujjain
1975
Sevagram
1976
Vadadara
Rasulia
1977
Calicut
Ahmedabad
1978
1979
Vadordara
Rewa
Varanasi
1980
Jamkhad
1981
Kavanur
New Delhi
Vadodara
1982
Bombay
Tara
MFC MILESTONES
Relevance of Present
New Delhi
Second Anthology printed
Health Service (M)
Campaign against
Present Health Problems
irrational diarrhoea
(M)
management
Sewagram
Meeting with David
First Bulletin published
Werner
Nutrition Problem in
Jaipur
Drug Workshop (N)
India (M)
1983 Anand
Prejudice against women
Community Health
in Health (M)
Approach and Role of
Dhaka
People and Health
Doctor in Society (M)
Conference (N)
'Other Pathies' —
Trivandrum
People Science Move
Workshop
ments Convention (N)
First Anthology printed
Hosangabad
Alternative Medical
Kissa Kesari Ka Camp
education — EC Meeting
Unemployment among
— Campaign against
doctors (M)
irrational production
Community Health
and marketing of
drugs
Worker (M)
— Coordination of
Community Paediatrics
Dr. Zafarullah
(M)
Chowdhury's visit
Drug Industry and the
1984 Calcutta
Why an alterative medical
Indian People (N)
curriculum (M)
Campaign against
Drug Action Network
medicos-agitation on
Meeting (N)
reservations
Bombay
100th bulletin published
Women and Health (N)
Misuse of Drugs by
Doctors (M)
M = Annual Meet; N = National level meet with
Campaign against
other organisations; Regional camps and EC
EP-forte
meets have also been held at various places.
Werner D, Liberation of VHW, 49: jan 1980, p6
Werner D, Comparison of doctor and village health
worker, 49: jan 1980, p7
Maru R, Community health worker: some aspects
of the experience at national level, 51: mar
1980, p1*
Sadgopal M, VI all-lndia meet of mfc at Jamkhed,
52: apr 1980, (topic: the community health
worker plus field study of CRHP Jamkhed)
Vaidya A, Dear friend, CHW, National experience,
52: apr 1980, p10
Jajoo U, Role of the village health worker — a
glorified image, 62: feb 1981, p4**
Vaughan JP, Barefoot or professional: Community
health workers in the third world, 70: oct
1981,
p1
Jaya Rao K, From the editor's desk, 70: oct 1981,
p8 (community health worker — overview)
IO.
Agarwal A (figures from Bangladesh on hospital
admissions and deaths in women), 76: apr
1982,
p7
Ehrenreich, B and English D, Witches, healers and
gentlemen doctors, 85-86: jan-feb 1983, p1
Ruzek SB, The women's health movement, 85-86:
jan-feb 1983, p5 (book review)
Ehrenreich B and English D, Oppressive 'scientific'
procedures, 85-86: jan-feb 1983, p6
Grossman M and Bart P, Taking the men out of
menopause, 85-86: jan-feb 1983, p7
Phadke A, From the editor's desk: not so glorious,
85-86: jan-feb 1783, p12
Gupte M, Chatterji M and Patel V, Prejudice
against women in medical care, 87: mar 1983.
(proceedings of IX ann. mfc meet)
Phadke A, Session V: evaluation of the discussion,
87, mar 1983, p8 (proceedings of IX ann.
mfc meet)
Chhachhi A and Sathyamala C, Sex determination
tests: a technology which will eliminate
women, 95: nov y983, p3
Sexist Bias in Health
Sanford W, Dialogue: woman as consumers of
medical care, 51: mar 1980, p6
CSIV, The Worecesterward: violence against
women, 57: sep 1980, p3 (feminist group
opposes abuse of psychiatry)
Jaya Rao K, Women and health: report of a work
shop, 67: jul 1981, p8
Bang R, Third international conference on women
and health, 69: sep 1981, p6
II.
Maternal Health
Sadgopal M, Training of dais, 24: dec 1977, *
Gole S, Dear friend: increased percentage of
caesarean deliveries in private hospitals, 28:
apr 1978, p4
5
Jajoo U, Dear friend: increased percentage of
caesarean deliveries in private hospitals, 29:
may 1978, p7 (response to Sanjeevani Gole’s
letter in 28: apr 1978)
Gupta S, Training of dais, 42: jun 1979, p5
Jaya Rao K, Who is malnourished: mother or the
woman? 50: feb 1980, p1*
Patki, PS, Letter to editor, 92: aug 1983, p7 (com
parative safety of aspirin and paracetamol in
pregnancy)
12.
Prepared for Dr. Zafarullah Chowdhury's
visit in December 1983 by mfc/ISI/OXFAM at
Rupees Five (Rs. 5.00 only) from mfc Bangalore
office. Please send money order.
Contraception and Abortion
Dingwaney M, Dear friend: can doctors sympathise
with abortion? 21: sep 1977, p7
Jaya Rao K, From editor's desk, 65: may 1981, p3
(influence of male thinking in contraceptive
research)
Bamji M, How safe is the pill? 65: may 1981, p1
Bamji M, Male contraception, 71: nov 1981, p'**
— , Abortion: the woman's plight and right, 50:
feb 1980, p7
Norsigian J, Redirecting contraceptive research,
65: may 1981, p3
— , Abortion in India, 71: nov 1981, p5
— , Complications of abortion in developing
countries, 71: nov 1981, p6
— , Abortion and contraception, 71: nov 1981,
p7
Sadgopal M, Letter to editor, 89: may 1983, p7
(natural family planning methods)
— , From the editor's desk, 93: sep 1983, p8
(barrier methods of contraception)
13.
AVAILABLE
A reference file on Gonoshasthya Kendra, G. K.
Pharmaceuticals and the Bangladesh Drug Policy.
44 4, (?W
441
Panat S. Dear friend: doctors and family planning,
32- aug 1978, p5
, Rewards beyond motherhood, 51: mar 1980,
p7 (review of Newland K, Women and Popu
lation growth)
Phadke A, Dialogue: family planning and the pro
blem of resources, 67: jul 1981, p3*fk
—
Population Growth and Control
14.
Phadke A, Population explosion: myth and reality,
9- sep 1976, p1
4?at 31141$
9 sep 1976, p4
Qadeer I, Population problems: a view point, 10:
oct 1976, p1
Shah D, Dear friend: population control and cul
tural values, 10: oct 1976, p8
Jaya Rao K, Dear friend: Population problem: a
viewpoint, 12: dec 1976, p8
Jaya Rao K, Dear friend: family planning ............
when , 16: apr 1977, p7
Maheshwari S, Population control vis-a-vis family
welfare, 23: nov 1977, p3
Children and Health
Warerkai U, A simplistic approach, 14: feb 1977,
p7 (review of Morley D, Paediatric Priorities
in the Developing World)
Gibran K, Living arrows, 40: apr 1979, p5
Nene D, The child in the health centre, 18: jun
1977,
p8 (review of a manual of health cen
tre paediatrics)
Jaya Rao K, Dear friend: to which school shall we
send our children?, 20: aug 1977, p8
Bang A, Editorial: 1979, 36: dec 1978, p3 (inter
national year of child)
Utkal Gandhi Smarak Nidhi, Need for a parents'
movement, 36: dec 1978, p2
Rani P, Peep in the child's mind, 40: apr 1979, p4
ANNOUNCEMENT
HEALTH CARE IN INDIA
The Centre for Social Action has just publish
ed an interesting, thought-provoking and rather
comprehensive booklet of 144 pages on "Health
Care in India". This booklet first presents the
historical background of our health system, inclu
sive of a chapter on "Health for AH" and the new
"National Health Policy". It then reviews the pre
sent, situation and analyses the root causes of our
failures. After its chapter on the "meaningful
experiences" of China, Cuba and Vietnam, and the
State of Kerala, the booklet finally describes the
"possibilities of relevant action" in the fields of
"Community Health Care" and "Conscientisation,
Political Action and Health".
4441S =4.
4 4^ afa 41^1 4^,
49: jan 1980, p10
Nair S, Gowri and the international year of the
child, 49: jan 1980, p9
Gopalan C, The child in India (part-l), 59: nov
y980, p1
Gopalan C, The child in India (part-ll), 60: dec
1980, p6
Nadkarni N, Towards a new immunization strateqv,
65: may 1981, p5
Singh T, Accident-prone children, 70: oct 1971, p5
(UNICEF), The disabled child, 72: dec 1981, p6
— , From the editor's desk, 88: apr 1983, p8
(mass immunisation of children)
This well done booklet is available for
Rs. 4-00 only (postage included; discount of 20%
for 5 copies or more; payable by money order)
from Centre for Social Action, 64 Pemme Gowda
Road, Bangalore 560 006.
6
Nayyai , V and Sharada, L, Appropriate Strategy for
childtiood immunisation in India, 88: apr
1883, p1
. Life in the vaccine, 88: apr 1983, p5 (test
indicator for viability of vaccines)
, Journal of rural paediatrics, 94: oct 1983,
p5 (notice)
Nutrition and Hunger
IS.
^aVa
Th® myth of the protein gap, 4: apr
Patel A, Dear friend: who is the culprit?, 5 may
1976,
p7
Shah D, Dear friend: the protein gap, 5: may 1976,
p7
Jaya Rao K, Dear friend: who is the culprit? 7:
jul 1976, p7
Jaya Rao K, Vitamin A deficiency, 8: aug 1976, p1
Singh N, Dairy research for whom? 8: aug 1976,
P5
Jaya Rao K, Dear friend: dairy research for whom?
9: sep 1976, p6
Muller M, The baby killer, 11: nov 1976, p6
Jaya Rao K, Report C: discussion on 'socio-econo
mic aspects of the nutrition problem in India'.
13: jan 1977, p8 (proceedings of ann. mfc
meet)
Qadeer I, How relevant are feeding programmes?
14: feb 1977, p1
— . The green revolution for whom , 14: feb
1977,
p8
Jaya Rao K, How important is birth weight in
infant health?, 16: apr 1977, p1
Jawlekar K, Dear friend: the green revolution for
whom?, 16: apr 1977, p6 (response to arti
cle in 14)
Shatrughna V, Milk for the baby!, 16: apr 1977,
p8
Warerkar U, Dear friend: how important is birth
weight........?, 18: jun 1977, p6
Shatrughna V, Dear friend: how important is birth
weight in infant health?, 19: jul 1977, p6
Jaya Rao K, Dear friend: how important is 'size
at birth'? 21: sep 1977, p7
Singh N, Nutritional problem in India, 19: jul 1977,
p1
Nene D, Dear friend: food for heart?, 20: aug 1977,
p7
. .
Singh N. How not to try solving nutritional prob
lems, 27: mar 1978, p5
Mathew, I was hungry and......... 33: sep 1978, p
Rendra W, Prayer of the hungry, 35: nov 1978, p8
Kshudha, No child shall drink it's mothers tears
as milk, 36: dec 1978
—
To restrict bottle feeding, 36: dec 1978, p3
(legislation in Papua, New Guinea)
— , News clipping: Too much iron in milk foods,
39: mar 1979, p3
.
Lele R, Nutrition in India: medical problem
political solution, 42: jun 1979, pl
Sukhatme P, Who are the real hungry? 43: jul
1979,
p1
Jaya Rac K, Dear friend: nutrition: medical prob
lem, political solution (I), 43: jul 1979, p6
Patel A, Dtar friend: nutrition: medical problem,
political solution (II), 43: jul 1979, p6
Bang A, Food requirements as a basis for minimum
wages, 72: dec 1981, p1**
Gopalan C, Nutritional basis of minimum wages,
76: apr 1982, p4
Jaya Rao K, From the editor's desk, 76: apr 1982,
p8 (food supplements — commercial inte
rests )★★
— , Boycott against Nestle pays off, 77: may
1982,
p4
Bang A, Dear friend, 78: jun 1982, p4 (response
to comments by Gopalan on Bang's article)
'Food requirements...')-*•>
Gupta M, (letter to editor), 82: oct 1982, p11
(body weights of Indian labourers)
— , From the editor's desk: malnutrition and
intelligence, 83: nov 1982, p8>*
— , International Code of Marketing of breast
milk substitutes, 84: dec 1982. p1
Lucey J, Does a vote of 118 to 1 mean the USA
was wrong , 84: dec 1982, p2
May C, The 'infant formula controversy': a noto
rious threat of reason in matters of health,
84: dec 1982, p3
Surjono D et al, Breast vs. bottle — scientific
evidence, 84: dec 1982, p6
— , It's worthwhile to restrict infant formulas,
84: dec 1982, p8
— , What the companies say, 84: dec 1982, p8
— . The Nestle boycott, 84: dec 1982, p8
Jaya Rao K, From the editor's desk: the business
of infant feeding, 84: dec 1982, p10
— , Weaning food and diarrhea, 90: jun 1983,
p8
Jaya Rao K, How successful are supplementary
feeding programmes? 91: jul 1983, p3 (also
see cover article in 14)
Acharya K, Why soya bean? 93: sep 1983. p7
— , World Health authorities condemn industry
practices, 92: aug 1983, p6 (milk food)
I6.
Lathyrism
Jaya Rao K, Kissa Khesari ka, 24: dec 1977, p1*
Bang A, Dear friend: kissa khesari ka. 26: feb
1978,
p8
Barreto L. Kissa khesari camp ka, 30: jun 1978, p4
. (report of the regional camp on lathyrism)★
Chand H. Dear friend: Lathyrus and homoeopathy,
31: jul 1978, p4
Jaya Rao K, From the editor's desk: The poor
man's poison is nobody's concern. 77: may
1982, p8
I7.
,—
—
Environmental and Occupational
Health
, Smoking burns up memory, 32: aug 1978,
p4
, Smoke of 100,000 million dollars. 32: aug
1978,
p4
ORT: The Turkish experience, 47-48: novdec 1979, p4*
Jaya Rao K, Oral rehydration therapy: do you
believe in it? 60: dec 1980, p3
Hirschhorn N, Issues in oral rehydration, 60: dec
1980,
p4
Data,- S, Dear friend, 61: Ian 1981, p6 (prepara
tion and use of ORS)
Parekh B, Communication (on treatment of diarr
hea), 64: apr 1981, p5
Feachem R, Oral rehydration with dirty water?,
68: aug 1981, p7
Ganguli M, (supply of ORS packets according to
WHO formulation), 77: may 1982, p5
Steinhoff M, Treatment of acute diarrhea in child
ren, 78: jun 1982, p1*>
— , Rice powder as an alternative of success in
oral rehydration solution, 78: jun 1982, p3
(to be continued in 79)
Ganguli M, Dialogue, 78: jun 1982, p6 (use of
ORS packets by CHW)
Feachem R, Priorities for diarrheal disease con
trol, 79: jul 1982, p5
— , Rice powder instead of sucrose, 79: jul
1982, p7 (remaining part of article in 78)
— , Attention please: the campaign on diarrhea,
80: aug 1982, p4
Phadke A, Educational campaign against diarrhea,
81: sep 1982, p5
— , From the editor's desk, 90: jun 1983, p8
(rice starch solution as ORT)
__
, News clippings: less infections if docs have
short hair, 34: oct 1978, p4
, News clippings: chemicals pose hazards to
human sperm, 34: oct 1978, p4
— , Alcohol: the problems increase, 42: jun
1979,
p4
— , News clippings: pollution — the time to act,
44: aug 1979, p7
Bhat R, Pesticides: a necessary evil, 61: jan 1981,
p1
Jaya Rao K, From the editor's desk, 61: jan 1981,
p4 (food contamination by pesticides)
— , How pure is our food?, 61: jan 1981, p8
Krishnamurthy C, Environmental cancer in India,
82: oct 1982, p10
Mankad D, Health problems of tobacco, process
ing workers, 95: nov 1983, p1
Jaya Rao K, From the editor's desk: Tobacco sick
ness, 95: nov 1983, p8
—
—
18 Health during Mass Calamity
Patel A, Approach to health problems in famine,
44- aug 1979, p1
Foege W, Guidelines for disease control in times
of famine, 44: aug 1979, p8
Patel A, Morbi disaster: health problems (a case
against mass cholera vaccination), 45: sep
1979,
p1*
Shah R, Dear friend: natural calamity — an oppor
tunity, 47-48: nov-dec 1979, p10
— , Emergency care in natural disasters: views
of an international seminar, 66: jun 1981, p1
Jaya Rao K, From the editor’s desk, 66: jun 1981,
p4 (preparation of health personnel for natu
ral disasters)
— , Education and training of medical students
for mass casualties situations, 66: jun 1981,
p8 (Israel)
— , Cholera vaccine: Inappropriate aid? 94:
oct 1983, p2
19.
Water Supply
, Adequate, clean, available, 19: jul 1977, p7
(review of The Poverty of Power by B Com
moner)
Barreto L, The national water scene, 37: jan 1979,
p1
Gupta V and Takiar S, Drinking water: newer
appropriate techniques vis-a-vis experiences
in the village, 31: jul 1978, p6
Patel A, Water supply in tropical countries: quan
tity vs. quality, 52: apr 1980, p1*
Shinde D, Dear friends (water supply) 55: jul
P7
—
20.
Diarrhea and Oral Rehydration
Damodaran M, Oral rehydration: the principles,
practice and the possibilities, 47-48: nov-dec
1979,
p1*
Patel A, On diarrhea and rehydration: what, why
and how?, 47-48: nov-dec 1979, p3>
__
Guidelines for the treatment and prevention
of dehydration, 47-48: nov-dec 1979, p4*
21.
Drug Industry Malpractices
Phadke A, Brand names: a ruse for higher prices,
6: jun 1976, p5
Agarwal A, Dear friend: brand names (I), 7: jul
1976, p7
Kashlikar S, Dear friend: brand names (II), 7: jul
1976, p7
Bang A, Dear friend, brand names (III), 7: jul
1976, p3
Phadke A, The drug industry: an analysis, 7: jul
— , How drug companies operate, 19: jul 1977,
p5
— , Doctors in the drug industry’s pocket, 28:
apr 1978, p1
— , The joke of the year, 33: sep 1978, p8
(drug price propaganda of OPPI)
— , Do you know this (about the world blood
trade), 55: jul 1980, p8
Ganguli M, Have you read this?, 59: nov 1980,
p7 (notice)
— , The high cost of Metakelfin, 68: aug 1981,
p8
Surana S, Dear friend, 70: oct 1971, p6 (compa
rative costs of drug brands)
Phadke A, Multinationals in Indian drug industry:
no positive role to play, 73-74: jan-feb, 1982,
p1 ★★
Agarwal A, Vietnam: herbs and war, 73-74- ianfeb 1982, p6
Agarwal A, Sri Lanka's experience with bulk pur
chasing, 73-74: jan-feb 1982, p7
8v
O)
Jaya Rao K From the editor's desk, 73-74: janteb 1982, p10 (multinational in drug industry)
, It there are no side effects, this must be
Argentina, 73-74: jan-feb 1982, p12
Vaidya A, Dear friend, 76: apr 1982, p5 (response
to Phadke A in 73-74)
Jaya Rao K, From the editor's desk, 78: jun 1982,
p8 (imports of bulk drugs)
Jajoo U High cost medicine, 80: aug 1982, p1
, Bitter pills: Medicines and the third world
poor, 87: mar 1983, p8A
Victors, C, Statistical malpractice in drug promo
tion: a case study from Brazil, 92: aug 1983,
p1
— , Reporting of adverse drug, reactions in Bri
tain, 94: oct 1983, p2
— , Campaign against the irrational production
and marketing of drugs, 96: dec 1983, p8
22.
Patki U, Global amnesia with clioquinol, 83 nov
1982, p5
Sun M, The controversy around Depo-Provera, 97:
mar 1983, p1
— , From the editor's desk: wrong choice,
wrong solution, 87: mar 1983, p10 (indiscri
minate use of injectable steroid contracep
tives)
— , Antibiotics in developing countries, 93: sep
1983,
p5
— , Battle of the body: antibiotics vs. super
germs, 95 nov 1983, p6
23.
Drug Misuse
Jaya Rao K, Tonics: how much an economic waste,
11: nov 1976, p1
Singh T and Kaur C, Dear friend: brand names and
tonics, 12: dec 1976, p8
— , 'I did take the tonic. Sir........', 33: sep
1978,
p8 (cartoon)
Shatrughna V, Drug prescription: Service to whom?
31: nov 1978, p4*
— , Ban on tetracycline liquid form, 13-14: mayjun 1980, p5
Gopalan C, 'The body has limited ability to store
water soluble vitamins........', 55: jul 1980, p8
— , Vitamin therapy, 55: jul 1980, p8
— , Do you know this (about Lomotil), 60: dec
1980,
p3
— , Upjohn, Depo-Provera and the third world,
65: may 1981, p3
Mankad D, Report of the VIII annual mfc meet, 75:
mar 1982, p4 (misuse of drugs)
Phadke A, Campaign against hormonal 'pregnancy
test', 75: 1982, p7
Phadke A, From the editor's desk, 75: mar 1982,
p8
Mathur V, Hazards of hormonal pregnancy test, 75:
mar 1982, p9
— , From the horse's mouth........: progesterone/
estrogens, 75: 1982, p10 (warnings from
PDR, 1981)
— , Health education campaign....... . 76: apr
1982, p7 (hormonal pregnancy test)
Jajoo U, Misuse of antibiotics, antimicrobials, 77:
may 1982, p1**
Anand R, Dear friend, 77: may 1982, p5 (ban on
liquid tetracycline)
— , Attention please! campaign irrational use of
drugs, 77: may 1982, p7
— , (Saheli/VHAI poster), 80: aug 1982, p4
(poster against hormonal pregnancy test)
Phadke A, From the editor's desk: banning hormo
nal pregnancy drugs — only a partial victory,
80: aug 1982, p8
Balasubramanyam V, Dear friend, 82: oct 1982,
p11 (misuse of anabolic steroids)
1-
Rational Drug Therapy + Action
Patel A, A story of r factor, 26: feb 1978, p1 (anti
biotic resistance)
Gambhir A, In search of appropriate medicine, 36:
dec 1978, p7 (antibiotics)
Bharatiya Grahak Panchayat and Arogya Dakshata
Mandal, Operation medicine : an appeal for
vigilant action, 37: jan 1979, p7
Sonwalkar A, Dear friend: 'Operation medicine',
38: feb 1979, p3
Chugh S, In search of appropriate medicine — I
cough mixtures 56: aug 1980, p5**
Jajoo U, Low-cost drug therapy, 81: sep 1982, p1
Phadke A, Drug workshop at Jaipur 83: nov 1982,
p4
Desai D, An Indian low cost drugs project, 83: nov
1982, p5
Jajoo, U, Rational therapeutics: selection of appro
priate drug, 90: jun 1983, p4 (analgesics)
— , Antibiotic therapy, 92 aug 1983, p4
Bang A, Single dose therapy for acute infection,
92: aug 1983, p5
Nagar N, More on aspirin, 94: oct 1983, p8 (also
see letter by Patki in 92)
Kulkarni S, Fancy, fallacy and facts about fixed
dose formulations, 96: dec 1983, p5
Phadke A, Drug action network meet, 99, mar
1984,
p11
24.
Drug Policy Alternatives
— , A new strategy for drugs, 60: 1980, p8
Phadke A, The committee for rational drug policy,
73-74: jan-feb 1982, p13
Agarwal A, Towards a relevant drug policy, 75
mar 1982, p1
__
MFC resolution on events in Banglaoesh.
82 oct 1982, pl 1 (national drug policy
against multinational)**
— , Conclusions reached by the drug sub-group
at the natioal health policy seminar, 91:
jul 1983, p6
25.
Tuberculosis
Patel A, Tuberculosis: a health problem, 6: jun
1976, p1
Junnerkar A and Ketkar Y, Community participa
tion in TB control, 18: jun 1977, p4
Jajoo U, In search of appropriate medicine-ll:
critical evaluation of utility of chest radiology,
57: sep 1980, p6
9’
Aitken J, Point of view: to inject or not to inject,
61: jan 1981, p7**
Jaya Rao K, From the editor's desk, 79: jul 1982,
p8 (Koch centenary)★★
Talwalkar V, Dear friend, 81: sep 1982, p6 (TB
control programme)
Jaya Rao K, Is BCG vaccination useful , 89: may
1983,
p7
— , Centenary of tuberculosis bacillus, 92: aug
1983, p8
Sadgopal M, Health 'care' vs. the struggle for life
(part-l) 93: sep 1983, p1
Sadgopal M. Health 'care' vs......... (part-ll), 94:
oct 1983, p2
Nagar N, Is antitubercular treatment really very
expensive? 96: dec 1983, p3
26.
Malaria
Soni M and Thakkar J, MFC regional camp, Pindval
(malaria survey), 6: jun 1976, p3
Patel A, Malaria eradication programme: its
genesis, 13: jan 1977, p1
Patel A, Malaria eradication vs. malaria control: a
case of confusion of terms, 14: feb 1977, p4
Patel A, Malaria control programme: an integral
part of community health and development,
16: apr 1977, p4
Sen B, Malaria in post-independence India, 17:
may 1977, p1
Agarwal A, Pesticide resistance, 61: jan 1981, p8
Linear M, FAO: the pesticide connection, 67: jul
1981,
p5
Farid M. Malaria and global politics. 82: oct 1982,
p1
Chapin G and Wasserstrom R, Agriculture and
malaria, 82: oct 1982, p3
Jaya Rao K, From the editor's desk: under the
mosquito net........ 82: oct 1982, p12
27.
Leprosy
<44(41, *F4 m44-gmi, 39: mar 1979, p1
Gupte M, Leprosy control: problems and possibili
ties, 39: mar 1979, p1
Pandya S, Can India eradicate leprosy?, 39: mar
1979,
p4
Gupte M, Leprosy control: problems and possibili
ties, 39: mar 1979, p1
Pandya S, Can India eradicate leprosy? 39: mar
1979, p4
— , New developments in leprosy, 39: mar
1979, p6 (XI International Leprosy Congress,
1978)
Bang A, Editorial, 39: mar 1979, p3
Sharma R, Leprosy control in India: review and
suggestions for future, 40: apr 1979, p3
443 g, Dear friend: M ^4 ? 41: may 1979,
p6
28.
Mental Health
Steiner C, Radical psychiatry: principles, 5: may
1976, p1
4(4 ®f, Dear friend: 4tffa 4141 : sjfarft 41 914 4l^414t,
10
43: jul 1979, p7
.
Srinivasa Murthy R and Wig N, Auxiliaries and
mental health care, 56: aug 1980, p1
Dhara R, The attitude of society and the psychiatrist towards madness, 56: aug 1980, p3
Jaya Rao K, Editorial 56: aug 1980, p4>>
Srinivasa Murthy R, Mental health education for
auxiliaries, v6: aug 1980, p8
Chandrashekhar C, Serving the unserved: PHCs for
psychiatric care, 69: sep 1981, p5
29.
Miscellaneous —Technical and
Medical
Chugh K, Acute renal failure in north India, 43:
jul 1979, p5
Suryanarayana V, Cataract surgery by tumbling
method. 83: nov 1982. p6
— , Medical laboratory manual for developing
countries (volume 1), 85-86: jan-feb 1983, p5
30.
Miscellaneous: Non-technical or
Non-Medical
— , Low energy economics, 8: aug 1976, p7
Jaya Rao K, Dear friend: are we truly independent?,
21: sep 1977, p6
— , Our typewriter works quite well except for
one key............. 26: feb 1978, p8
fam 4, R
31 jul 1978, p6
Gandhi, The talisman, 32: aug 1978, p1 (poem)
94H4T 9,
'ffa Mtcff 4 4151... 32: aug 1978, p8
Sidgwick H, Free thinking, 33: sep 1978, p1
mpai 4, mfa? 44i gwft t g^itr....?
33: sep 1978, p3
fam m, miqfa, g3K 4? i;9i 4?a 4ivft 4 anW,
34: oct 1978, p1
Frost R, a semi-revolution, 37: jan 1979, p7
Williams 0, a total revolution (an answer to Robt.
Frost), 37: jan 1979, p7
Marx K, Man: the alienated individual, 38: feb
1979, p1
— , Work experience gives vision, 39: mar 1979,
p8 (a student's experience of adult literacy
work)
— , Modern medicare, 40, apr 1979, p8 (cartoon)
Chopra P, the plan plants a time bomb, 41: may
1979, p7 (land redistribution)
31^t ?, aft mt (Mm : 42: jun 1979, p6 (poem)
mm4, 434141 43: jul 1979, p8 (poem)
(4441?, ffaiifi ! 41C( 4414 3?44...”......... 46: oct
1979, p1
4R1401 m, Sft44 fwiSiaff ft WI t, 46: oct 1979, p1
— , Rural medicare hospital: trying to appear
‘rural’!, 47-48: nov-dec 1979, p12
Aptekar N, Death: reflections, 59: nov 1980, p5
Laxman R, "You are going to ask for a second
opinion? well...", 67: jul 1981, p6 (cartoon)
Bang R, Small-pox reappears?, 69: sep 1981, p7
Wind J, LDC — WHO cares?, 76: apr 1982, p3
’
31.
Role of MFC and Merrbers
. Medico Friend Circle: objectives, organisa
tion and programmes, 1-2: jan-feb 1976, p10
(as approved at H ann. MFC meet)
Sadgopal M, where do we fit in?, 7: jul 1976, p3
Phadke A. Dear friend: from the horse's mouth....,
8: aug 1976, p3
Phadke A, Dear friend- limitations and role of
MFC, 16: apr 1977, p5
Patel A, Dear friend: limitations arid role of MFC,
18: jun 1977, p6
Singh T, Dear friend: encourage us, 19: jul 1977,
p6
Phadke A, MFC — which way to go?, 28: apr
1978, p5
Qadeer I, Dear friend:- MFC — which way to go?
(I), 29: may 1978, p5*
Phadke A, Dear friend: MFC —- which way to go?
; (II), 29: may 1978, p5
Bang A, Dear friend: MFC — which way to go?
(Ill), 29: may 1978, p6*
Bang A, Editorial: From awareness to action, 32:
aug 1978, p3
Gaitonde R, Dear friend: role ‘ of non-me'dicos,
32: aug 1978, p4
Banerji D, Health work as a lever for social and
economic change, 32: aug 1978, p1
Roy D, Hyde Park: MFC — which way to go? (I),
32: aug 1978, p5
Qadeer I, Hyde Park: MFC — which way to go?
. (II), 32: aug 1978, p7
Phadke A, Dialogue: MFC, which way to go?, 34:
Oct 1978, p5
Jaya Rac K, Dialogue: Settle the question once and
for all, 34: oct 1978, p6
Qadeer I, Dialogue: dilemma of individual medico,
34: oct 1978, p7
apqq 44 ’TlK'lffa, 35: nov 1978, p3
Patel A, Dialogue: economic change is not the
panacea-health work can become the key,
35: nov 1978, p5
Wagh H, Dear friend: decision is essential, 35:
nov 1978, p7
Rindani A, Dear friend: MFC friend in USA, 36:
dec 1978, p8
Gokani A, Dear friend: great grandson of Mahatma
Gandhi writes, 39: mar 1979, p5'
’
Parikh J, Dialogue: health project.— a means of
social change, 39: mar 1979, p7
Punpani D, Dialogue: in search of utilization, 39:
mar 1979, p7
Sen B. Dialogue: to' a soul 'in search of utiliza
tion', (I), 40: apr 1979, p7
Bang R, Dialogue: to a soul 'in search of utiliza
tion' (II), 40: apr 1979, p7
Kashalikar S, Dear friend: what can be done? 41:
may 1979, p6
44 ar, 441^4 : anqYr ! g®14 4< 45 443....,
...... 44: aug 1979, p3
Bhagwat A, Dialogue: why retired doctors for the
villages?, 44: aug 1979, p5
Sen B, Revitalisation of MFC: hard introspection,
crucial decisions, 45: sep 1979, p3 (mid
annual MFC meet report)
— , Changing emphasis of MFC, 45; sep 1979,
p6
43 31,
: 441 1&, 441 4I<
? 46: oct 1979,
46: oct 1979, p3
Gurubani S, Dear friend: kudos to MFC, 47-47:
nov-dec. 1979. p10
Mankad D, Communication: a search for alterna
tives, 63: mar 1981, p7
Wagh H, Dear friend, 66: june 1981, p6 (res
ponse to article by Bang A in 64)
Werner D, Health care and politics: a personal
statement. 69: sep 1981, p1**
Rao M, Communication (medical ethics and poli
tics), 67.- jul 1981, p7
Ganguli M, Dear friend....... . 76: mar 1982, p6
(criticism of MFC)
Mankad D, Dear friend, 80: aug 1982, p7 (res
ponse to M Ganguli)
Phadke A, Role of health work done by MFC
members, 82: oct 1982, p7 (mid-ann. meet
32.
MFC Bulletin
Patel A, Editorial, 1-2: jan-feb 1976, p3 (MFC
role and bulletin)
— , About the bulletin, 1-2: jan-feb 1976, p3
Phadke A, Dear friend, 4: apr 1976, p4 (bulletin,
role of MFC)
Qadeer I, Dear friend: is this a readers' bulletin?,
5: may 1976, p7
— , An appeal....... . 6: jun 1976, p4
Katgade V, Dear friend: from the horse's mouth...,
7: jul 1976, p5 (criticism of MFC bulletin)
Roy D, Dear friend: why readers do not respond ,
7: jul 1976, p7
— , To the readers, 8: aug 1976, p4
— , To the readers, 7: sep 1976, p3 (bulletin
questionnaire)
Shah S, Dear friend: had enough about myths, 9:
sep 1976, p5 (appeal for more field experi
ences)
Patek A, Editorial, 13: Jan 1977, p3 (progress and
problems of MFC bulletin)
— , Reminder, 14: feb 1977, p1 (bulletin subs
cription and membership fees)
Singh T and Kaur C, Dear friend: be practical, 18:
jun 1977, p7
Junnarkar A, Dear friend: an appropriate title, 18:
jun 1977, p7
Kapur S, Dear friend: points of view — medicine
2000 AD, 19: jul 1977, p6 (response to arti
cle in 18)
— , Subject index of back issues of MFC bulle
tin from the first issue, 24: dec 1977, p
Patel A, Editorial, 26: feb 1978, p3 (problems of
the mfc bulletin)
Tejinder Singh, Dear friend: which way the bulle
tin to go? 29: may 1978, p7
Bang A, Editorial, 30: jun 1978, p3 (mfc bulletin
standards and perspectives)
Bang A, Editorial, 31: jul 1978, p3 (problems of
the mfc bulletin)
Sadgopal M, Dear friend: about the bulletin, 31:
jul 1978, p3
— ■ Pl,eas.e
31: jul 1978, p4 (bulletin
article instructions)
Kathiria V, Dear friend: why hyde park?, 32: aug
1978, p4 s
Bang A, editorial: Where is the space?, 34- oct
1978, p8
Panchai P, Dear friend: simplify still more, 35:
nov 1978, p7
Bang A, Editorial (review of the mfc bulletin for
1978), 38: feb 1979, p3
— , Internship and you, 40: apr 1979, p8
(appeal for written experiences)
Manudhane S, About the bulletin: a view from
USA, 42: jun 1979, p8
Sarmandal D, Dear friend: I am surprised to
know
43: jul 1979, p7
— , You be ouh hands, 43: jul 1979, p8
Bang A, Dear reader, 45: sep 1979, p8
— , In case you have not
47-48: nov-dec
1979, p11
— , To catch the next month's train, 47-48:
nov-dec 1979, p12
Patel A and Bhargava A, The readers speak about
mfc bulletin 52: apr 1980. p4
— , Please note (change of bulletin editor), 52:
apr 1980, p12
Phadke A. (Explanation for not bringing out may
issue), 53-54: may-june 1980, p5
Jaya Rao K, Editor's note (on taking over editor
ship), 53-54: may-jun 1980, p8
— , Will you help us? (sample subscription
scheme) 60: dec 1980, p2
— , Important: (increase in subscription rate)
62: aug 1981, p3
— , Attention please!, 76: apr 1982, p7 (MFC
life subscription)
Sadgopal M, Proceedings of the fourth ail India
meet of MFC — Report A, 26: feb 1978, p4
Barreto L, Proceedings of V annual of mfc, 38:
feb 1979, p4:
Jaya Rao K, proceedings of MFC general body
meeting, 52: apr 1980, p9 (VI ann. mfc
meet)
Phadke A, MFC VII annual meet, 63: mar 1981, p5
Phadke A, The biannual executive committee meet
at Hyderabad, 68: aug 1981, p3
( „ ) , Attention please (MFC is now a regis
tered association and trust), 75: mar 1982,
p9 (VIII ann. meet report)
( ,,
, Attention please (decisions taken at VIII
ann. meet), 76: apr 1982, p7
( „ ) , Attention please (decisions taken at VIII
ann. meet), 76: apr 1982, p7
( ,, ) , Mid-annual executive committee meet
ing, 82: oct 1982, p5
( ,, ) , MFC organisational decisions, 87: mar
1983, p8A (IX ann. MFC meet report)
( „ ) , Report of the X general body meeting,
99: mar 1984, p9
A- included in the second anthology;
★★ Included in the third anthology
Note
a.
New address of MFC is:
326. V Main, I Block,
Koramangala,
Bangalore 560034
(Phone: 565484).
b.
Limited copies of issues No. 41, 42, 45, 46,
56, 57, 65, 66, 70, 71, 78-81, 85-86, 92-95
and 99 are available at Rs. 2-00 each (50 US
cents or equivalent).
c.
All other issues in xerox from are available
with the MFC office in Bangalore at Rs. 5.00
a copy (US $2/- or equivalent).
Cheaper
arrangements still being negotiable.
33. MFC Meet Reports (Organisational) d. Limited copies .of Anthology — Health Care
Sadgopal M, Report A: the meet, 1-2: jan-feb
Which Way to Go—, covering issues 26-52,
1976, p5 (proceedings of II all India meet
are available with the MFC office and with the
of mfc)
Voluntary Health Association of India (VHAI),
C-14, Community Centre, Safdarjung Develop
Bhatt N, Report A: the meet, 13: jan 1977, p4
ment Area, New Delhi 110016.
(proceedings of IH all India mfc meet)
OBJECTIVES OF BULLETIN
To feature materials from other walks
of |jfe
education, psychology, socio
logy, economics and agriculture —
which have a bearing on health.
To gather together lone fighters seeking
for an identity and friendship.
To cover lacunae in our knowledge of
the health system and health planning
in India and new field experiments.
To motivate and involve the readers
sitting on the fence through dialogue
and debate.
To evolve a style and level of content
within the reach of the common man.
To encourage medical students to share
new, raw and enthusiastic ideas.
To become a medium of expression,
dialogue and communication as well as
a source of. conceptual and informative
inputs for all those who are trying to
think differently and fall out of the
routine and established pattern -of
medicine.
12
medico friend
©Dtrefe
.J.
APRIL-MAY 1984
TEN YEARS WITH MFC : MY PERSONAL VIEW
ASHVIN J. PATEL
When I was told. to. give my reflections upon
ten years of MFC, I accepter! it reluctantly. Firstly,
because I did not have many things to say and
secondly it was not spontaneous for me. However,
I give some stray thoughts that occurred to me.
An Overview
Many of the readers may not know that MFC
was not a planned efforts but a spontaneous one.
It orginated from a socio-political movement Tarun
Shanti Sena which was inspired and ignited by zeal
for total revolution.
Naturally MFC carried
legacy and hang-over of this perspective, values,
culture etc. Many of the founder members were
considered radical and unorthodox Gandhians.
Within a year it could attract friends who rang
ed from academicians to field activists; not suprisingly it also included various shades of opinions from
right to left. 1 do remember that some friends
clearly denied then, that the doctor has any other
responsible role than treating, patients coming to
the dispensary'. While others, on the other hand,
felt that health services are just an entry point
into the community.
Real health work is to
struggle for socio-economic-political revolution.
This latter viewpoint was shared by both, the
Gandhians and the Marxists alike.
MFC criticised the present health system and
its approach so eloquently and vociferously that it
could attract attention of many young doctors and
non-doctors. The "prophetic vision” and enthu
siasm of old members proved to be too much for
some. A few resented the indoctrination and the
aggressive way of discussion. A proportion of
them felt that MFC could not give a relevant pro
gramme according to their aptitude and abilities.
There was a feeling that MFC wanted everybody
to agree with its analysis, and then left them alone
to face the frustrating situation.
In the first four years, study-cum-work camps
were organised for medical students and others
which generated lots of enthusiasm. Some medical
colleges could evolve health care programmes for
slums and nearby villages. Many' of them are still
continuing. But perhaps, except for a few, there is
no continuous follow-up and dialogue. They have
become just like any philanthropic dispensary
without having a wider perspective of community'
health and development.
How would one measure the progress of such
an organisation? By the number of its members?
It’s impact on society? The growth of its members
as a collective to understand, analyse and respond
to a situation?
As experience showed the annual meets of
MFC served a purpose as a major point of contact.
However, new participants felt isolated, the target
of indoctrination and threatened by the level and
nature of discussions. The objective of increasing
the number was not to be realised effectively. Old
members felt that the preoccupation with new
members kept the level of discussion at a prelimi
nary level. There ms no scope for learning and
mutual growth. Robust, impersonal and objective
arguments were appreciated and welcomed by' old
members, while many of the new members perceiv
ed in the same exchange of views, aggressiveness
that tended to be personal. I feel that in the ten
years, MFC members have shown a lot of maturity
to take the arguments and criticism as that of the
thought and not of person. No one ever doubted
another's genuineness, honesty of purpose and
concern for the poor. Even after a session of hot
tions, concepts, values and models like bare foot
doctors — C.H.W.; underfive clinic; campaigns
against bottle feeding, commercial foods and irra
tional therapeutics, attacking drug industry, alter
native simplistic curriculum for medical schools;
people’s participation; demystification and de
institutionalisation of health care; self-sufficient
health care programmes; self help; promotion of
other sysetms of health care: etc., etc.,” .(to be refe
rred hereafter for sake of brevity as ‘health care
mix’). And even proponents of the first trend,
though grudgingly endorsed this 'health care mix'
without providing overall framework or model
linking it with the process of socio-economic
change. This led to a lot of confusion in some
and smugness in others.
and involved exchanges there has been no trace of
bitterness and the feeling of friendship and soli
darity" has always grown. To an onlooker sometime
it may seem that we are simply splitting hairs and
are involved in mere polemics. But this seeming
polemics represents deeply held differing view
points, perspectives, social & political ideologies
and backgrounds.
In the first few years, the number of MFC
contacts increased very fast. It might have been
due to the long felt need for such .a forum, the
unconventional and critical views appearing in
MFC bulletins, the annual meet deliberations or
the regional camps. Then its growth in number
rached a plateau.
Not only the numbers stag
nated, but also the core group, which evolved
spontaneously due to continuous interaction and
concern for the MFC organisation, developed a
kind of disinterest in the organisation. What was
the origin of this disinterest?
An interesting current was emerging intertwined
with the other trends, now and then. How as a
group were we going to evolve methods and a pro
cess of self learning conducive to personal as well
as collective growth? This perceived need was not
adequately responded to, which led some to dis
continue their interaction with MFC in despair.
However, a sizeable number of members continued
tenaciously to struggle to find the way tout. This
struggle was not born out of merely -emotional
attachment to the organisation, but because the
needs and tasks were demanding so. Moreover,
MFC may be small in terms of resources, infrasliructure and manpower, but perhaps it i's (he only
organisation struggling collectively to search for a
socially m|eaningful and durable alternative. It has
evolved and practised certain norms in public life
consistent with its objectives and concern for the
poor.
Various Trends
There were three discernable trends within
MFC. First trend wanted MFC to be a body to
provide deeper analysis of the health situation and
its relation to socio-economic-political factors.
Second one wanted it to experiment in alternative
health approaches at micro level informed with
critical analysis of present health system. Third
trend wanted it to promote philanthropic health
services. Tire last trend got disillusioned immedia
tely. They thought MFC with such a thorough
critique of present health affair would now come
out with new sets of concrete alternative program
mes. This was not to be. Although attempts
were made, through regional camps and some
health care programmes involving a few medical
colleges, to introduce this analytical process to new
comers; a number of constraints prevailed.
A
questioning process could be initiated, but the
view-point that not only socio-economic changes
were precondition for improvement of health, but
also that "real activity-’ to be taken up had to logi
cally aim/ed at socio-economic change, had a para
lysing effect on many.
Not surprisingly, the second trend also consi
dered a socio-economic change (o be precondition
and also aim of their health activities. They could
go upto a point in analysing alternative health
approaches in India and elsewhere. They agreed,
in their eagereness for action, ot “certain interven
A lone but lemphatic voice was raised which
was appreciated by many about a rush for alterna
tive and much ado about ‘health care mix'. No
efforts were put beyond refuting certain historical
events and pointing out some limitations and defi
ciencies in various work. A point of saturation of
thinking and imagination seemed to have arrived.
1 remember how one strong protagonist of
community health got alarmed when government
agreed to implement CHW scheme at national
level. His instant reaction was, “Now government
has agreed to implement CHW scheme, what .role
and functions are left for us!” This 'was an indi
cation of poverty of understanding and arrest of
growth at a given time point. But -experiences in
the field had shown that the ‘health care mix’ was
2
far from adequate. It was misleading and tended to
breed rituals; it gave a false sense of achievement
and even complacency that one was doing everything
one had to do in community health. Wide gaps
in knowledge, information and strategies were there
waiting to be discovered. These were the growth
points one had to look for very carefully. This
realisation underlines the need to develop experi
ences, in sights and knowledge which is relevant
and pertinent to Indian situation. Both social
sciences as they relate to health problems and natu
ral sciences have to develop further so 'that com
munity .health ceases to be underdeveloped and
primitive. More painful and frustrating is that
even some proponents of the second trend arc also
equally unattentive to this perception.
world. If yes, how can we go about it? It may
need broadening of our focus to include those from
academic institutions who have knowledge, compe
tence and aptitude to contribute to such efforts.
Simultaneously, we have to learn and develop our
abilities to understand not only social sciences but
natural sciences too. We may (havq to work out
overall plans of. action informed with this perspec
tive and persuade ourselves and other groups to take
up some of these commonly agreed upon activities
over a period of time so as to improve our insight
as a collective.
The
wateright compartmentalisation
into
political
activists and
health activists
can
no longer help. Competence in health sciences
is essential, but assimilation of egalitarian
values and understanding of political . reality are
crucial to undertake such “field research” condu
cive for the health of the masses. ■ Most of ithe
MFC members have internalised the latter; ques
tion is to fill up die deficiency in 'the ■former' one.
But MFC members are small in number.
Most of them arc already engaged in traditional
project work, political activities, campaigns for
educating masses, teaching and research in establi
shed institutions, etc. according to their aptitudes
and priorities. Would such a shift impinge upon
personal freedom and preferences?
Possible Tasks
MFC has realised the simplistic nature and
sloganism of various technological and social
interventions in vogue. It is not only not enough
to speak about shift from individual to community
diagnosis, but to understand and decipher intricate
webwork of the individual as a member of a family,
of much larger social groups to which he belongs
through kinship, residence, occupation, religion,
beliefs, etc. and conditions of his life, his work,
his economic and social placement and culture, his
physical and biological environment. Furthermore
refinement and differentiation in relation to each
disease process. Thus the real problem does not lie
in actual activities but lies in the theoretical under
standing of the complexly of the disease process in
the community that inform these activities. It! is
through continuing analysis and actions of various
groups on at least some of these problems in simi
lar perspective that relevant, durable and realistic
pieces of knowledge are going to be built.
We have been busy struggling with ourselves
and for various other factors, we could not interact
with medical students, socially concerned non
medical friends and consumers of health care
adequately. If we refer to the deliberations of the
second annual meet at Hoshangabad it dileneated
guidelines for action programmes quite well. Why
could we not persue it? Can we learn from positive
experiences from KSSP and negative experiences of
other organizations? Is it' just a lack of infrastructure
and full time worker or adhooism responsible for
our failures?
Is there a critical mass of socially concerned
physicians today who are competent enough to
build up this knowledge: Does the ‘health care
mix’ aped by voluntary groups have rigour and
strength to stand the “scientific scrutiny”? Can
voluntary groups face, with their own observation
and evidences, a tough and thorough-going "objec
tive” criticism made by sympathetic academicians?
Could our priority be to evolve a (collective voice
known not only for its honesty and commitment
to tre cause of the poor; but also .respected for its
ability and scientific rigour; not only among like
minded people but also among the professional
Conclusion
I have not tried to reflect on all the aspects of
MFC q Mfany. tilings (have been left out lljike ii|s
commendable achievements, its democratic and
egalitarian ways of working, place and role of MFC
bullentin, interaction with various groups and
individuals, details of various projects, campaign
and workshops, managing on low budgets function*'’
(Continued on page 10)
3
Looking Ahead...
Anant Phadke
would be — it does not show the process through
which the solution it offers can be brought into
practice. MFC can claim that it can show the
process of change which MFC wants to bring
about and that MFC itself constitutes a part of the
process. Whatever may be our position, we can't
ignore this report. To be sure, there are many
aspects of this report with which MFC agrees.
This report has thus raised the level of debate,
and has set a reference point for discussion and
action. It is no more sufficient for groups like MFC
to discuss and act at the same level as was done
before the publication of this strategic report.
If we are to find out how MFC can develop
further in the future, we should try to understand
the factors that affect the growth and develop
ment of MFC. These factors lie both within MFC
and outside it.
Let us start with the social fac
tors outside MFC.
The socio economic condition in India is
turning from bad to worse. The plight of the
ordinary people is increasing, so is their opposi
tion to their oppressors. A section of the white
collar intellectuals, students, are bound to be
affected by this and some of them- are bound to
seek alternatives. This sensitive, humanitarian,
democratic layer from within the intelligentsia
constitutes a potential for MFC. All of us con
tinue to meet many sensitive, socially-conscious
medicos for whom a group like MFC offers a plat
form which they are happy to know about and
which they would like to join. MFC would grow
if it can approach such individuals. If there is
a social movement amongst the intelligentsia on
any issue concerning human values, justice, we
can even hope to get a large influx of newcomers.
The original group of MFC was a product of the
Jay Prakashwadi movement. There is no such
movement on the horizon now, but to be sure it
is bound to emerge, perhaps in a different form.
The social conditions that gave rise to it still con
tinue to dominate our lives. Today the intelli
gentsia seems to have resigned to whatever is
happening. This cynical aloofness is a counter
acting force which affects the growth of groups
like MFC. Nevertheless, on the whole, the situa
tion contains a lot of potential for the growth of
groups like MFC. But along with the growth of
general dissatisfaction amongst the people, the
challenges in front of a group like MFC have also
grown. What are these challenges?
In the non-Government sector, the achieve
ments of some of the pathbreaking voluntary
Health Projects are now well known. What do
groups like MFC have to say about these projects,
their achievements and limitation, their relation
ship with the goal that we want to achieve? A
number of international agencies are fostering the
methodology as being attempted by these projects
and this adds to their importance.
Thirdly within the medical field, a number
of oppositional movements have grown in last
10 years of Junior Doctors, paramedics and Govt.
Medical Officers for better pay and better work
ing conditions; of consumers against misuse of
drugs ................ How groups like MF.C should
relate to these movements
Groups like MFC cannot grow and develop
to any substantial extent unless such new deve
lopments are analysed properly and a standpoint
taken in theory and in practice. Does Medico
Friend Circle have the resources-theoretical and
practical — to successfully deal with the new
challenges and hence grow into a trend which can
make a dent on the national scene? To answer
this question, let us locate the strengths and weak
nesses of MFC. MFC has been able to survive
and grow against all odds. (Compare MFC with
similar groups.) MFC has not survived by degene
rating into a lifeless institution. (Such institutions
continue only because some funding source is
ready to "keep" them.) MFC has also not degene
rated into a political sect with no basis in social
movements. To survive as a lively group is an
achievement for group of medicos which is funda
mentally opposed to the existing medical profes
sion and the existing system of medical care
Secondly MFC is unique in that though most of
The publication of the report — "Health for
All : An alternative strategy" has posed a concrete
problem. After the publication of this prestigious
report (prepared by the collaboration of ICMR —
ICSSR with the help of a number of renowned
persons in the field of health-care) groups like
MFC have to take a concrete position about what
is in our view, wrong with the existing system of
medical care and what is the alternative. Is our
analysis and solution any different from what has
been described in this report? If yes, in what way
and why? One of the criticisms of this report
4
the leading members of MFC are politically cons
cious, they have enough of healthy, non-sectarian,
democratic approach to allow medicos from diffe
rent political leanings to come together, debate,
criticise each other, learn from each other and
develop into a tolerant, mature group. It must,
however, be noted that the "friendly" atmosphere
in MFC is partly because there is not much at
stake. If. MFC squarely faces the problems men
tioned above, starts growing as a formidable cur
rent on the national plane, the friendly atmos
phere is bound to be affected atleast to a certain
extent. But the tradition, we have set up will help
us in challenging times. The tradition of respect
ing other's viewpoint, of mutual trust, openmindedness has been our asset. To be sure some
sectarian mistakes have been made of because of
which some people got alienated. But many have
come back and on the whole very few have drop
ped out with sharp discontent. (The core-group
of MFC sometimes gives an impression of an arro
gant, radical, intellectual clique involved within
itself. But this is only a cursory impression — even
that should changes and it is not at all the true
nature of this group.)
The third positive asset of MFC is the ten
dency in MFC to examine things in a critical the
oretical perspective, on a principled basis yet in
a way that would be relevant to the problems in
the actual field. Since most of the leading mem
bers are actually working at the grass-root level,
this critical questioning outlook acquires a special
down-to-earth practical ' connotation.
This has
earned MFC some good name (as well as bad
name amongst those who don't like such ques
tioning.)
But the theoretical development in MFC has
been quite slow. It is only recently that things
have really begun to move. The tendency in MFC
.to be self-complacent and self-congratulating has
more or less been replaced by a serious concern
to study, work upon and develop our understand
ing. But still it would take a lot more effort to
systematically develop position on the problems
mentioned earlier. There does not seem to be
adequate realisation in most of us that MFC must
answer,these and such problems if it has to make a
dent on the national level. A sense of urgency, requ
ired in view of MFC's lagging ebhind as of today,
is by and large absent. There is a concern for
developing our understanding; but not in relation
to the challenge posed by the events happening
around but as a general concern for theoretical
development.
(
Things are bad when we come to the ques
tion of making a co-ordinated effort to make an
impact on a national level by forging, propagating
an alternative viewpoint. Most leading members
of MFC are-iquite involved in their local work.
Most of us have hot been able to devote much
time and energy for MFC's organizational work.
Unless the leading-members of MFC replan their
local work in such a way that they spend much
more time for MFC's organizational work, unless
more fresh blood comes in, MFC will not be able
to face at all the challenge posed to her by the
developments in last few years. Unfortunately not
many MFC members see this. Some are even
content with the running of the Bulletin and the
Annual Meet. We must realize that even mere
continuation at the existing level is financially
becoming more and more difficult due to price-rise.
The financial deficit is increasing very fast. Unless
we have atleast 1,000 subscribers (compared to
about 400 to-day) the deficit would become
unmanageable next year (even this year.) There
are more than 2 lacs MBBS doctors in India, (to
take one yardstick of assessing the potential for
MFC to grow) and even one per cent of this
becomes more than two thousand.
MFC is
unknown to many of those who would readily
become its members. We should have reached at
least this, section. But that involves a change in
the attitude of many leading MFC members
towferds MFC and hence a re-planning of their
priorities in practice. Are we really serious about
forging an alternative, making a dent on current
opinion in India about medical care? Shall we
critically study, try to develop and practice communty medicine much more seriously? Shall we
study and understand in a much more concerned
manner the history, development of social move
ments, social changes in India and abroad? In one
word, shall we get rid of amateurism in us? The
answer to these questions will decide whether MFC
can play its role in the "fundamental socio-econo
mic change" that MFC wants to align with.
Your help required for the index :
(a)
A denation to cover the cost of this
special feature, mfc deficits have risen.
Build up complete sets, for reference by
your group/friends in your region.
(c)
If you know of cheap/bargain xerox
facilities, let us know.
(d)
Would you like to participate in a re
print distribution system for your area,
— Convenor
(b)
5
AT THE HUNDREDTH MILESTONE
Ravi and Thelma Narayan
mfc is as of today, mainly a thought current and the monthly medico friend circle bulletin.......
is the medium through which members communicate their ideas and experiences to each other.
Running the bulletin in our chief common activity.......
MFC
manifesto 1983
In this centenary issue, as we reflect on the
past, consider the present and look into the future,
we review the preceding ninty-nine issues of the
bulletin, to discover the strengths and weaknesses,
the opportunities and threats that have been part
of its eight years history.
The Beginnings
The MFC bulletin began as a cyclostyled
note that was circulated regularly to members of
the initial nucleus group, many of whom had links
with the Tarun Shanti Sena in 1974-75. Our re
cords show that there were atleast fifteen such
notes. The style was informal — a sort of 'dear
friends' newsletter keeping members about meettings and discussions, field opportunities and
thought provoking articles on various relevant
health issues.
Founder members will probably
recall with nostalgia the series on the present
health system, 'alternative approaches' and 'radical
medicine', the column entitled 'vocal figures' pre
senting telling statistics of the health situation in
India and the proclamation of Maurice King's book
as the "bible for every doctor"! The characteris
tic feature of this embryonic phase of the bulletin
was its youthful idealism and infective enthusiasm.
Rallying slogans such as "If China can do it why
can't we?" and 'let's coordinate our efforts to fight
the situation instead of blaming western culture
and criticising brain drain' were typical examples.
The MFC bulletin as we know it today took
shape at the second annual meet at Sevagram in
December 1975. The first editorial committee
was formed and a plan of issues outlined for the
whole of 1976. The first bulletin was printed in
January-February 1976. Since then the bulletin
has travelled a long way — 93 months of regular
printing, seven double issues, three editors and
seven printing press — to reach this hundredth
milestone.
Objectives
Though the initial objectives were outlined in
the first issue — as many things in MFC, these
have evolved as time went by — being modified,
re-emphasised and added unto (see Index). Against
the background of these wide objectives the evo
lution and performance of the bulletin has shown
an interesting variety and a rich diversity. Atleast
once during this eight year period a situation of
crisis (45) called into serious question continuation
of the bulletin but the heated discussion threw up
three reasons of organisational significance which
made the bulletin necessary in addition to its
wider relevance. These being that the bulletin was
the only means — to be heard at natiqnal/international forums; to involve the new members; and
to prevent degeneration into a federation of local
scattered groups. All these objectives taken to
gether gave the bulletin a new lease of life at
every crisis.
Outreach
The bulletin subscription has ranged from
250-700 over the years. Presently it is a little
over 400. The readership includes rural health
project workers, medical students, medical college
teachers, academicians, research workers and non
medicos interested in health. These are spread
out all over the country but more particularly in
the Western region — Gujarat and Maharashtra —
the traditional home of MFC. A detailed break
up of the subscription list is not yet ready but a
cursory perusal indicates that the readership among
medical students and non-medicos is still far from
significant.
Scope
The articles featured in the bulletin have
represented a very varied range of topics related
to medicine and health. An index of the hundred
issues which is featured as a supplement to this
bulletin shows twenty eight sections in the classi
fication. These include health services, medical
education, maternal and child health, population
control, communicable diseases, environmental
sanitation, mental health, drug policy and drug
prescribing. Certain unusual problems like Lathy
rism, discrimination against women in health,
disaster medicine etc., have also been presented.
By and large, however, tne range has been within
the traditional boundaries of medicine — both
clinical and community with a strong preoccupa
tion with nutrition, health service policy and drug
issues.
may be representative of the fact that many
of the analysts of yester years are deeply
immersed in action today. In turn these rea
listic. issues may be instrumental in stimulat
ing further activism in MFC circles. Here
again we are vulnerable to the criticism that
the emphasis on drug issues represents
medical bias but this is inevitable in our pre
sent doctor oriented predicament.
Non-medical issues which are vital to health
care have been covered peripherally with stray
articles on green revolution, dairying, soya bean
and low energy economics.
Vocal Figures
Feature
Phase of bulletin
1-25 26-50 51-75 76-100
1. Articles
a. original
32
32
24
26
b. reprints
10
19
26
17
2. Letters to
Editors/readers
dialogue
49
64
14
13
3. Book reviews 8
—
1
8
4. Activity reports
a. mfc groups 8
8
2
4
b. health
projects
1
2
8
2
Three areas stressed in the MFC manifesto
have been particularly neglected. These being
demystification and popularisation of medical
science, humanisation of medical/health practice
and the open-minded enquiry into non-allopathic
systems of medicine and non-drug therapies.
Does this reflect the existing professional/
medical bias of the group?
Even within the traditional boundaries of
medicine certain issues like ecology and environ
mental health, health problems of tribal regions
and urban slums, workers health, the clinical
investigation, business, unnecessary surgery, malpraxis. the nuclear epidemic and the relevance of
existing research in the country have hardly been
considered. Emerging issues important in a wider
context but relevant to the health movement like
pedagogy, communications, participatory manage
ment and humanistic psychology among others
neeci also to be included.
(b)
Discussions/dialogue: The thought current
nature of MFC should have made these a dis
tinctive feature of the bulletin. The experience
has been different. The first phase saw a
very active response from members. Even
though these were often the same inveterate
discussants, they set a healthy precedent. The
second phase saw a very active response from
members. The second phase saw an increase
in this phenomena with a much wider cross
section of readers participating in columns
such as Hyde Park/Dialogue and contributing
letters to the editor. In the last four years
this phenomena has begun to wane and should
be a cause of concern. Are bulletin readers
so busy with their own local preoccupations
that they do not find time to participate in
discussion or is the Bulletin not adequately
thought provoking? Are there many other
factors?
Only a readership survey could
probably throw light on this.
(c)
Activity/Project reports: Reports by small
groups all over India with an MFC perspec
tive have been featured on and off. Reports
on projects like Jamkhed, Gonoshasthaya
Kendra and CINI have also appeared. Consi
dering the wealth of field experience gained
in India in the last decade this is an area
Features
The format of the bulletin has shown much
variation but certain basic features have remained
constant.
4a)
Lead articles: These have been the key
feature of the bulletin. They have included
original articles written by members and con
tacts as well as reprints from other journals
and sources. These articles have been very
responsible for the reputation of the bulletin.
The selection has been surprisingly consis
tent in terms of relevance and analysis in
spite of the fact that there has never been a
very clear cut editorial policy — our mani
festo reworded from time to time being the
only guiding principle. Of late the articles
have moved from a more abstract analysis of
issues like health policy to more concrete
like drug misuse, community health worker
and health education. This concretisat.on
?
literature in health, job opportunities and other
available resources. In 1978-79, a column
of news clippings to keep readers informed
about issues raised in the popular press was
attempted. In the absence of a documenta
tion centre to back the efforts of the editors,
this has been a low key feature.
(g)
Editorials : Like the lead articles these have
MFC organisational reports have been a con
been a distinctive feature of the bulletin
sistent and welcome feature. The informal
though the style has varied greatly. The
nature of these reports have been typical of
first phaes saw annual editorials setting
MFC. Reports of the lively group discus
measurable objectives for the bulletin but
sions at the meets have helped those who
remaining a silent catalyst in between. The
cannot attend the meet to get a feel of the
second phase saw a more regular feature
frank and open style of MFC group work.
which not only galvanised the group work but
(d)
Surprisingly in a hundred issues less than
also put the contents of the bulletin in the
twenty books have been reviewed. These
MFC perspective. The last four years has
have included the classics by lllich, Maurice
seen the evolution of a more analytical and
King, Mendelsohn and Morley and the ICMR
technical editorship which has put the bulletin
and WHO compilations of alternative approa
on very scholarly foundations.
ches. In the light of the recent explosion in
(h)
Miscellany: Bulletins 1-29 had the Chinese
health care literature this is a serious lacunae
slogan "Go to the people, live among
in our efforts. Not that all the material avail
them....... " at the bottom of every page
able is necessarily relevant to the MFC search
expressing the beginnings of the MFC quest.
but there is an urgent need to keep members
Bulletin 30-35 saw the introduction of five
and readers upto date and well informed, if
additional features — these being Hindi
this quest for an alternative people oriented
articles, health related poetry, cartoons and
health system is to be built on a scientific
line drawings, a contents list a.nd provocative
base.
gimmickry to enhance readers participation.
(e)
Government policy documents:
In recent
JP was the only personality to be honoured
years there has been a significant output of
in the front page being a sort of chief
government policy documents and related
inspirator of the group (46). He displaced
reports taking a new look at the Indian situa
the red disc from top right to right down. • In
tion and supporting/professing alternative
cidentally the red disc was not selected to
approaches. By and large the MFC bulletin
depict the rising sun of revolution but was a
has carried active response to each of these
practical attempt to balance the numbers and
— the Srivastava Report, the Janata Health
break the printed monotony of the first page.
Policy, the Medical Education Policy and the
Coincidentally this gave the bulletin its.
Health for all Report. The lack of response
popular and recognisable symbol.
to the new Health Policy of 1983 is a serious
omisssion. This active analysis and feedback Anthologies
Twice in recent years, anthologies of the best
is particularly crucial because the reports of
late feature very radical statements and pro original articals were published by MFC. The first
grammes that create myths and some confu (In Search of a Diagnosis) covering issues 1-24
sion.
These reports seldom mention the and the second (Health Care — Which Way to Go)
process by which these radical changes can covering issues 25-50, have both seen a pheno
be actually introduced into the existing exploi menal popularity. The first one is now out of print
tative and irrelevant systems. MFC members while the second one is on its way out. The third
have a definite role to bring out these contra anthology is a scheduled to be released later this
dictions and also apply themselves to issues year.
of process ignored by these reports. At the Readership surveys
same time we need to emphasise those
To enable mid-course corrections and get a
elements which are helpful to the evalction of feel for the readers views, readership surveys have
a more humane and just system.
been undertaken. Twice, these have been reported
(f)
Information : Most bulletins have featured in the bulletin. The 1978 survey elicited only a
snippets of information on recent events and nine percent response while the 1979 survey an
needing much more attention.
Reports of
well-known projects are not as important as
sharing by friends of the little lessons in their
field experience, the new perspectives gained
and the small but appropriate innovations
made. The Sevagram group has been parti
cularly remarkable in such little inputs.
8
18 percent response. The latter was prompted by
a crisis situation which arose when the then editor
perceived a lack of participation and support and
serious discussion regarding continuation of the
bulletin ensued.
The survey showed an overall
support for the bulletin, which then got a fresh
lease.
1978
1979
•(c)
Finances : This has been a chronic problem
throughout, but the remarkable ability of con
sequent publishers to continue against all
odds deserve real kudos. MFC has fiercely
guarded its independence by committing itself
to a policy of financial support by subscrip
tions and personal donations only. It was felt
that external project funding would result in
some inevitable institutionalisation, possible
loss of independence and very likely decrease
in the personal support of committed mem
bers. The increasing deficit has constantly
challenged this stand and the discussion in
1983 finally resulted in a more open policy of
funding with certain restrictions to maintain
our value stand (87).
(d)
Printers' devil : This has not been as much
of a problem as it could have been in a small
bulletin of this nature because of a series of
meticulous proof readers. On occasion, how
ever, it has caused some degree of embarrass
ment and often comic relief. Recently, in
the front page of the bulletin, 'health' our
main preoccupation was wrongly spelt and
'mgc' not 'mfc' was committed to achieving
it by 200 A.D.
Readership surveys
Critique :
Abstract analysis
Too much criticism
Too little constructive suggestions
Increasing formality
Suggestions :
— More experience reports
— Recent advances and appropriate
health care techniques
— More editorials
— More organisational news
— More variety in authors
Responder characteristics :
Medicos — 68%
Non-medicos — 32%
Members — 65%
Field Workers — 10%
Medical College teachers — 35%
Response :
Most popular — title articles and
materials
Bulletin useful — 90%
Existing system irrelevant — 90%
Alternative possible — 90%.
The future
With the increasing diversity in membership,
MFC may have'to consider producing bulletins/
newsletters directed to stimulating 'thought cur
rents' at different levels.
Borne problems
A bulletin with this perspective and supported
by subscriptions and donations only, is bound to
have many problems. The three most important
often reported in the bulletin were :
The 'demystification of medicine' and 'the
evolution of a style within reach of the common
man' are two important but neglected dimensions
in the bulletin. The fact that many of our member
writers also write for the popular press in the
regional language is some cause for satisfaction
though this needs to be promoted much more
through MFC in the future.
(a) Focus : With the diversity of readership and
their expectations 'selection on material for
the bulletin is a gymnastic more difficult than
walking on a tight rope'. (31).
•(b)
Availability of articles : Though the Bulletin
appears to have appeared regularly, editors
have had their range of reading and article
extracting ability stretched to the extreme,
resulting in frequent crisis. Typically in
1980/ there was an appeal in June as fol
lows : "If this state continues the last issue
will appear in July".
The crisis was most
often got over by reprint of suitable articles
from other sources. Many were very good
and added an important dimension to the
bulletin. However, lack of original articles
can be not only a health hazard to the editor,
but it also question the creativity and dyna
mism of our membership I
In conclusion the hundredth milestone of our
bulletin has been reached through an exciting and
exacting collective endeavour. What has been the
contribution of this effort to health related thinking
in India in the last decade only the future will tell.
Ivan lllich, when interviewed in 1978 is reported
to have said that "the bulletin was the best periodi
cal in the third world which analyses health struc
ture and its problems". Two readers in the 1979
survey on the other interestingly felt that the
the health care system in India was relevant and
that the bulletin had been responsible for their
opinion! Only our readers can decide where we
stand between these two extremes.
9
RN. 27565/76
mic bulletin : April-May 1984
FROM THE EDITOR'S DESK
With this issue, the Bulletin hits a Century.
At the Annual Meet held at CINI, Calcutta, the
members requested Ashwin Patel, Anant Phadke
and Ravi and Thelma Narayan as the past and
present and incumbent convenors, to contribute to
this issue. Ashwin gives a retrospective analysis
and Ravi and Thelma review the hundred issues
of the Bulletin. Anant gives some future directions.
The MFC Bulletin, as- its readers know, is
very different from the ordinary run of medical and
health periodicals. It is therefore not surprising
that its readership is small, contributors still less
and funds very much less. It is hence a matter of
pride to all MFC members that the Bulletin cele
brates its 100th month of existence, despite all
odds.
It is true that the Bulletin does not show the
dynamism it possessed earlier. In the beginning,
members aired and discussed all the problems
troubling them, and for expressing which they
hither to had no forum. The apparent dwindling
interest stems from two things : some are experi
menting with solutions which they think are right
and are struggling with them; others are unable to
find a suitable way out for the innumerable pro
blems — this latter, reflected in /he title of our
second anthology — "Health Care" : Which way to
go." Of course, the dynamic nature of the Bulle
tin was largely also due to the capabilities of the
{Continued from page 3)
ing without paid full time personnel, etc. Inspite
of all its limitations and failures, MFC has -created
a lot of hopes and expectations 'from varied “quar
ters.
Pertinent question is whether MFC can
collectively show resilience and tenacity to meet
the challenge of examining the process and progress
of its functioning continuously in the light of fresh
experiepces and knowledge without slipping into
high profile global fashions, slogans and cliches.
MFC could show a change in emphasis after
a long debate on ‘MFC which way to -go' from
achieving socio-economic change to evloving a
pattern of medical education arid methodology of
Editorial Committee:
Anant Phadke
Dhruv Mankad
Padma Prakash
Ravi Narayan
Ulhas Jajoo
Editor
Kamala Jayarao
Repd. No. P.N.C. W-96
first two editors. Ashwin Patel and Abhay Bang.
The editorship may soon pass on once again onto
young shoulders — perhaps a sign of its rejuvena
tion. The seeming status quo is however no cause
for despair. When one goes on an upward jour
ney, one needs, once in a while, to stands on the
landing and regain one's breath. That helps in
•taking the next flight with renewed vigour. MFC
and the Bulletin will continue, for they have a de
finite purpose and serve a group, albeit small,
having definite ideas and ideals.
There are some who are disappointed with
the "purely theoretical" nature of discussions. The
MFC as an organisation can never take up practical
programmes nor should it toy with such an idea.
Every experiment has to be preceded by a sound
hypothesis, properly analysed and discussed. The
Bulletin and organisation are the forum for this.
The traditional Indian blessing is, may you
live upto a hundred. Let us wish the Bulletin will
go through many centennials. For this to come
true, each member and each reader should own
his/her responsibility and help in whatever way
possible — contribute articles, share experiences,
write letters, collect relevant published matter for
reprinting, identify writers and last but not the
least, enrol more subscribers. To modify a famous
quote, ask not and what the Bulletin offers you, but
ask what you can do for it. That indeed is the
sign of love and friendship.
health care relevant to Indian needs and conditions
as a part of broader efforts to improve all aspecst of
society, for a better life, more humane and just in
contents and purposes. MFC bulletin could also
show a shift from merely paralysing critique of
micro level issues to examination- of various micro
level alternatives and interventions. Annual meets
also tried to respond to issues like women trtid'
health, medical education, etc. MFC also respon
ded to live and emergent issues like reservation for
scats in medical colleges for the scheduled tribes
and castes.
These experiences make one feel
confident that MFC has the potential to respond to
relevant issues in a mature and courageous way.
Views and orynions expressed in the Bulletin are those of .the ‘ authors and not necessarilyof the organisation.
's
Annual subscription — Inland Rs. 15/-. For Foreign Countries — By Sea Mail US ?4
by Air Mail — Asia US $6, Europe, Africa — US $9, U.S.A., Canada — US 511.’
Edited by Kamala Jayarao, 3-6-515, Himayatnagar P.O., Hyderabad-500 029. Printed by
Padma Prakash at New Age Printing Press, 85, Sayani Road, Bombay.400 025. Published
by Anant Phadke for Medico Friend Circle 50 LIC Quarters. University Road, Pune-411 016.
MEDICO FRIEND CIRCLE
Registered Office Address
50 L.I.C. Quarters
University Road
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RULES AND REGULATIONS
Membership of the organisation s
Any person who professes agreement with the aim's' and
objects of the society can become its member upon payment of
annual fees as fixed from time to time by the general body.
Membership Fees :
Rs. 25/- per annum for students and for those who are earn
ing less than Rs. 750/- per month and Rs. 50/- per annum for
those earning above Rs. 750/Termination of membership.
a member-
(a)
A member shall.cease to'be
by submitting a duly signed letter of resignation to
the executive committee.
(b)
by non-payment of fees for six.months.
(c)
being considered unfit by the executive committee for
furthering the goals of the society, after giving him/
her opportunity to explain his/her case.
General body meetings^,
1. ’ There shall be an annual General Meeting of the
members of the organisation which shall be convened
by a majority decision of the executive committee at
any time within six months of.the end of -the firancial
year.
2.
3.,
#
4.
The convener of the executive committee shall give
members of' the society minimum thirty days notice
as to the date, time and place of the annual General
Meeting, provided members who have been enrolled
within thirty days prior to the date of notice of
such meeting shall neither be entitled to intimation
. of the meeting nor entitled to v.ote therih.
The Annual General Meeting shall:
a.
adopt the Annual Report of the Society ;
b.
discuss and pass the audited statements of Income
and Expenditure and Balance sheet of the Society
c.
appoint the auditors for the current financial
year;
{
d.
elect members of executive committee, Convenor
and Treasurer by simple majority.
e.
sanction the budget; and;
f.
conduct such other business as may be prescribed
in the notice convening the meeting.
Any member may p-.t forward a matter for consideration
in the general meeting provided he has given written
notice of it to the Convenor at least 10 days before
the meeting.
*
...2.
5.
2
The quorum shall cpnsist ofl/ld^of the, total member-r
ship entitled to vote or 15 such members present,
whichever'*±'s less.
6.
In the event of•there not being-a quorum at the annual
general meeting it shall be adjourned to the next day
for some time and place. At such adjourned meeting
fio quorum shall be necessary.
7;
An extra-ordinary general meeting may be summoned by
the Executive-Committee...Which--shall be required to
pass a resolution summoning an extra-ordinary meeting
by a majority of 2/3rd of the members present at a
meeting of the Executive Committee.
.
8,
The members of the Society entitled to-vote may
requisite an extra-ordinary<general meeting of the
Society by forwarding to the Convener of the Executive
Committee a memorandum requisioning an extra-ordinary
general meeting stating the purpose of the meeting .
signed by not less than 25 members entitled to vote
or. 1/4th of the total membership entitled to vote
whichever is less. Upon receipt of such a requisition
duly signed by members, the Executive Committee shall
be obliged to convene an extra-ordinary meeting within
thirty days.-
/
" ’
9.
5.
The resolutions passed at the meeting of the Society
shall be by a majority of the members present and
voting.
The Executive ’Committee (EC)
1.
The Executive Committee shall have the sole and full
’control in regards to management and organisation
of the society and the-, affairs, funds' and properties
of the society shall be managed by the EC.
2.
The members of the EC shall also be the members of
the Board of Trustees.
3.
The EC shall consist of.at least 5 and not more than
15 members who shall be elected by the members of the
Society at the Annual General Meeting by simple
majority.
A member elected as a member of the EC shall hold •
office for a period of two years.
One half of the
, . total number of the elected members shall retire at
every annual general meeting. Those members who are
longest in office shall so retire and in case of
members who have become members on the said day the
agreement between them. A retiring member.shall be
r
eligible for re-election.
- 4.
5.
Any member, desirous of being elected to the Executive
Committee shall be proposed by a member and seconded
by two other members. The names of the members who
are duly proposed and seconded as candidates for
election should be submitted to the Convener of the
' out going EC at least 24 hours prior to the notified
time of the annual general meeting.
The Convener shall
prepare a list of such ..candidates and circulate it
among the members of the Annual General Meeting.
,6;
The EC may appoint not more than three members of the
Society as co-opted members on the EC who shall/office
for a period of two years.
Such co-Opted members
shall have all the rights as if they were elected
members and also be eligible.for appointment as a
Convener.
•
-A
'
*'
.3
3
6.
7.
Members of the EC shall appoint from*amongst'its members
a Convener who shall call the meeting of the EC from
time to time and shall preside over the same.
8.
The new Executive Committee shall take charge after
the close of the Annual General Meeting at which it is
elected.
9.
A meeting of the EC shall be convened by giving 15 days
notice.
10.
In.the absence of the Convener the meeting of the EC
shall 'be presided over by any member of the EC as may
be decided by the meeting.
11.
In event of opinion being divided equally on any issue
in the EC the Chairman of the meeting' shall have the
• casting vote.
12.
Any'three members-of the EC may, by submitting a duly
signed memorandum stating-the purpose of the meeting
to the Convener, request him to convene a meeting of
the EC within 30 days from the date of receipt of the
memorandum.
■ 13.
The EC shall have right to suspend or terminate from
membership of the society any member acting in any
manner detrimental to the objects and aims of the
. society.
It shall have right to suspend or terminate
the members.
Finance of the Society
1.
All expenditures incurred by the society not sanctioned
by General/meeting will be required to be approved by
a majority decision of the EC.
2.
The Cashier shall maintain books of account which shall
be audited annually by a suitably qualified auditor or
Chartered Accountant.
The financial year of the Society
will be from 1st April to 31st.March of each calender
year.
3.
The EC may fix up such remuneration of honorarium as
it deems fit for the Convener and other workers if they
devote their substantial time for the work of the
society.-
4.
The account of the organisation shall be opened in the
name of the Society and the account shall be operated
by the joint signatures of the any two members or as
decided by EC from time to-time.
/body
DUTY OF CONVENOR S
To convene the Annual or Special General Body Meeting
and Executive Committee Meeting.
To manage the day to day affairs of the Organisation.
DUTY OF TREASURE R
To keep accounts of the income and expenditure of the
(income and expenditure) organisation.
To submit these accounts
to the Annual General Body Meeting and to the Annual Executive
Committee Meeting.
To get these, accounts audited by a qualified auditor.
To operate bank account on behalf of the Society and
to sign cheques.
' - 4 7.
Amendment of the Constitution/Dissolution
A list of persons who' are members* of the Society within
the meaning of Section 15 of the Societies Registration Act
1860 shall be maintained in the form of -Schedule VI to the
Societies Registration (Maharashtraa) Rules 1971 vide Rule
15 thereof.
If change is desired in the Objects or Name of the
Society or if amalgamation of two‘or more societies is
desired,' procedure laid down in Section 12 or 12 A of
Societies Registration Act 1860, -will be followed.
8.
If on the winding up or dissolution of the Society
there shall remain after the satisfaction of all its debts
and liabilities any property whatsoever, the same shall not
be paid or distributed among the members of the Society or
any of them, but shall be given or transferred to some
association, institution, society or body having similar
objects to that of the Society to be determined on the
recommendation of the EC for the time being by a" majority
of the Society specially convened for the purpose.
In case
of dissolution, section 13, 14 of the Society's registration
Act would be followed.
in.
Fourth All India Medico Meet, Kerala, 29th, 30th and 31st December 77.
-A
-j-j
I am willing to participate in the meet, please send me the details.
I will not be able to attend the meet this time because
Particulars
Name (in BLOCK LETTERS )_
Permanent address :
Present address :
PIN
_
Educational status
Present
_______________________________________________
activities
Medico Friend Circle Bulletin
yes / no
1.
Do you find the bulletin
2.
Your reactions on the matter published so far in the bulletins
3.
Suggestions for further issues
4.
Can you contribute matter for the bulletin ? On what subjects ?
5.
Will some of your friends be interested in subscribing to MFC BULLETIN" If you give
thair names and addresses bellow, we shall send them free sample issues.
( i )< " >-------------------- -------------------------------------
useful ?
PIN.
PIN
If you are a member of Medico Friend Circle
1.
When did you come in contact with MFC ? And through whom ?
2.
So many individual and group programmes were suggested at Ujjain, Sevagram and
Hoshangabad Meets. Have you been carrying out some of them individually or
collectively ? If yes. please specify.
If you are not a
Yes/No
member of
Medico
Friend
( If you need, please use the space overleaf )
Circle,
do
you wish to become
one ?
.
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(J'iTI)
medico friend circle
Objectives
Medico Friend Circle is a group of people involved in
health and health related activities, dissatisfied with
the present system of health services in India and
conscious about the problems and its responsibilities
in relation to society. It works with the following
aims in view:
a.
To evolve a pattern of medical education and
methodology of health care relevant to Indian
needs and conditions; and.
b.
To make positive efforts towards improving the
non-medical aspects of society for a better
life, more humane and just in contents and
purposes.
Perspective
History and experience show that present health
services copied from over professionalized, consum
ption oriented, capital intensive and centralized
model of health services cannot meet the basic
health needs of all the people. It is, therefore, essen
tial to take a fresh look at the existing priority of
health problems and alternative approaches to their
solution.
The approach needs change in total orientation and
contents of medical education, health care and rese
arch so as to focus the health programmes on rural
and neglected communities rather than on big cities.
A shift will have to be made from hospital oriented
and specialists based approach and more emphasis
be put on human efforts than money inputs. The
conflict between the traditional and modern system
of health care should be resolved by evolving a
national system of medicine and health services.
But all these changes cannot be brought about
against the background of a socio-economic struc
ture in which the largest mass of people still live
below poverty line. There is therefore no alternative
to making a direct, sustained and vigorous attack
on the root cause of mass poverty.
This is clearly neither a question of applying more
trchnical know-how nor simplifying health
care
^^iniques. This situation needs drastic and revolu
tionary changes in the approach to health services
as well as motivation and commitment on the part
of the people.
Beginnings
Keeping this in view few medicos have started a
dialouge among themselves in May 1973 through
a cyclostyled bulletin. Out of this dialouge a group
emerged who eventually took the form of Medico
Friend Circle.
So far three all India meets of MFC have been
organised .The first meet was held at Ujjain in 1974
where we discussed the relevance of present health
services. At the second meet at Sevagram in 1975
we decided present day health problems and needs
of India, tried to study different systems of medicine
ajgk searched for an alternative approach to meet
t™ real health needs of the masses. At the third
meet at Rasulia (M.P.) in 1976 we made an attempt
to understand the nutritional problem of India and
questioned the traditional concepts and remedies
of nutritional problem.
Number of regional study and work camps were orga
nised in M. P., U. P„ Kerala and Gujarat. The camps
departed from traditional way of service or relief
work. Participants were inspired to discuss and analyse
the present health system in general and specific
problem in particular. The work part of the camps
were designed to raise questioning process among
the participants.
Number of members of MFC are engaged in comm
unity health work individually and collectively at
different places in the country providing health care
to the rural and neglected communities.
In January '76 the cyclostyled bulletin took the form
of printed magazine and within a short period of
two years has acquired a place among rhe medicos.
Number of thought stimulating articles have appe
ared in the bulletin. Articles on myth of protein
gap, population problem, drug industry, dairy rese
arch, nutrition problem, modern medicine in 2000
A.D., new national health policy etc. were appre
ciated by the readers. In addition to such articles
book review, reports and readers views also form
features of the bulletin.
Organisation
MFC is not a rigid organisation. It is a loosely-knit
group, dissimilar though in ramifications but thinking
and working for similar goals and as a homogeneous
unit. Any person who professes agreement with the
aims and objects of MFC can become its member
on payment of annual fee- membership fees is Rs.
20.00 per annum for students and for those who
are earning less than Rs. 500.00 per month and Rs.
40.00 per annum for those earning above Rs. 500.00
per month. Membership fee includes the annual
subscription of the bulletin. It is understood that
capable members should pay more than this minimum
limit and that the Convener can waive or reduce
this fee in deserving cases.
4.
To arrange camps, conferences, meetings,
seminars and MFC's annual meet.
5.
To encourage medicos to take up health, deve
lopmental and educational activities for negle
cted communities,
6.
Maintaining bio-data of all members with a
view of helping and encouraging contacts and
communication.
Finances
The expenditure involved in all these central activi
ties will be shared and borne by the members and
friends of MFC. Subscription, membership dues and
contributions should be sent through M.O., bank
drafts or cheques to the Convener, Medico Friend
Circle, 21 Nirman Society, Vadodara-390 005. If
money is sent through cheque Rs 3.00 may be
added as bank commission.
Programmes for individuals and groups
(A)
MFC shall work mainly through its members and
groups at various places. Central co-ordination will
be done by the Executive Committee which among
others will perform the following functions.
Functions
1.
2.
3.
To analyse critically the present health system
so as to increase the understanding of various
health and. socio-economic issues involved
in it.
To foster involvement of new groups and indi
viduals in the task of realisation of the objec
tives MFC stands for.'
To publish a monthly bulletin keeping in view
the above functions.
1.
Each member should select a problem or
topic, study it thoroughly and then circulate
the knowledge to others. The study should
not be a mere academic gymnastic. It should
be something concerning health and health
related activities keeping in view the social
needs and perspectives e.g. poverty, mal
nutrition, failure of malaria eradication
programme etc.
2.
To collect data or try to study any problem
which can become a topic for research.
Small practical problems and simple obser
vations should be the choice.
(B)
1. To study other-'pathies'to learn their usefu
parts; and seek and enlist the cooperation
of their adherents.
(C)
1. To emphasise more on preventive and
social medicine during their educational
period.
2.
Try to curtail the unnecessary use of drugs
and use minimum amount of drugs.
3.
Emphasise more on health education, pre
vention of diseases during practice.
4.
(D)
2.
To seek the cooperation of the N.S.S- and
P.S.M. departments for these activities.
(H) 1. To enroll new members and subscribers of
the bulletin.
1. Study sociology, economics, political science
and similar social sciences, because a doctor
is not merely a physician of individual pati
ents but also a social being, and so he
should understand society, its working and
its problems.
2. To collect fund for the organisation.
To discuss various socio-medical problems
with other friends, try to create an awareness
among them, and try to develop a group
of medicos with similar interests at their
place.
Specific programmes for groups
Having developed a group of medicos, interested
in similar programmes, problems, and want to do
something, following programmes can be taken to
increase and strengthen the group as well as to
reach our goal.
1.
Develop a study circle, where frineds meet and
discuss problems.
2.
Doing collective social work like-survey of a
village community, some medical or social
problems, relief work, inoculation, health educa
tion etc.
3.
To select and adapt a village or a community
and try to study their health problems, their
origin, the extent and nature, and if possible
help them in solving them. This will give an
opportunity to understand the health problems
in society 'in vivo' - as they exist with its socio
economic context and will also help in deve
loping social relationship.
4.
To have dialogues with general practitioners
and develop groups to discuss problems as
well as to provide medical assistance.
5.
Try to expose, whenever, and wherever possible,
‘the faults of the present medical education
system and make an attempt to change it.
6.
Arrange week-end one-day camps for these
activities.
1. To learn clinical medicine perfectly, relying
less' on costly investigations.
(E)
2. Try to learn nursing procedures and basic
investigations yourself.
;F) 1. Not to accept 'physician's samples' from
the medical representatives as it is a subtle
corruption.
2
Symbolic acts to change the social values
e.g. doing productive labour etc. and to give
up cultural slavery.
3.
To oppose ragging in Medical Colleges at
individual and group levels.
4.
Try to improve relations amongst the diffe
rent catagories of health workers.
5.
Try to learn more about ’health team.
6.
Help blood donation ‘activity.
,G) 1. To visit rural health projects during vaca
tion so as to get a first hand experience of
rural life, its problems and their solutions
2. To develop medical services in rural areas
and devote at least one year to develop a
new pattern of medical care suitable to
rural India. Some of the members of MFC
are already working on rural
Projects in
different parts of the country.
More are
needed for similar action.
Published by Ashok Bhargava, Convener, Medico Friend Circle,
21, Nirman Society, Vadodara-390005.
Printed at Sanjiv Printery, Ahmedabad-One.
IW
Medico Friend Circle
PERSPECTIVE
Medico Friend Circle is a group of socially
conscious individuals, interested in health problems
of our people. MFC is trying to evolve an appro
priate approach towards developing a system of
medical care which is human and which can meet
the needs of the vast majority of the population in
our country.
The existing system of medical care, we have
realized is not geared to the needs of the people. It
requires a fundamental change. Such a change
would come about as a part of a fundamental cha
nge in the total social system since medical system
is only a part of the total social system. MFC
believes that the potential created by modern medi
cal science cannot be realized properly without
such a fundamental change in the social systerR^\,
What is wrong with the existing medical system
in India 7
H Though after Independence there has been a
rapid growth of the medical services organised by
the Government, Private Practice remains the domi
nant feature of medical care in India. In private
practice, medical care like any other commodity in
the market, is available only to those who have
money to pay. The medical profession resembles
any other commercial sector and therefore has
been dominaned by the concern for money than for
the patients. The commercial competition and inte
rests of doctors lead to numerous mal-practices.
This behaviour is promoted by the profit oriented
drug companies which dump many useless or even
harmful drugs onto the consumer by co-opting the
doctors.
MFC upholds the interestff'of the people>.s
* wants medical care to be available to ev^ry
one irrespective of his/her ability to pay, \
* wants to develop an approach of medical
intervention strictly guided by the needs of
our people and not by the needs of comme
rcial interests.
s
Since the purchasing power is mainly concen
trated in cities, commercial medical practitioners
are also concentrated in the cities. This over-cro^Bsg of the doctors in the cities is partly responsil^Wor the overgrowth of specialists and for the
denigration of the role of the basic doctors to
"cough and cold" doctor. The training of doctors
has also been influenced by this situation. Hospital
based training by Western and Urban oriented spe
cialists creates a graduate conditioned to urban
and hospital set up. Therefore even after the pro
longed training in medical college, such a graduate
is not capable of dealing with the situation in rural
areas.
MFC would work towards
* a pattern of medical-care adequately geared to
the predominantly rural character of our country and
* towards medical curriculum and training tailo
red to the needs of the vast majority of the people
in our country.
■ For their narrow professional interests, doctors
^ve gained a monopoly control over madical kno^0!ge and medical practice. Medical knowledge
has been jargonised and a halo has been created
around it. This monopoly and mystification opens
the door for the domination of medical profession
over patients and of doctors over the nurses and
other paramedics.
MFC stands for
* popularization and dymystification of medical
science and
* believes that different categories of medical
professionals be regraded as equal members of a
democratically functioning team.
® Commercial interests demand a growing market
for drugs, medical therapies and this is partly res
ponsible for medical practice being reduced mainly
to curative services. It denigrates the primary role
of preventive and social measures. Drugs, surgery,
even vaccines have so far^Sontributed marginally to
the improvement in people’s health in different
countries. In spite of the primary role of socio
economic development in improving health of a
peole, a wrong belief is promoted that medical
intervention-use of drugs, surgery etc—is primarily
responsible for improvement in the people's health.
* MFC realizes the importance ofj curative tech
nology in saving a persons life, alleviating suffering
or preventing disability but
* stresses the primary role of preventive and
social measures to solve health problems on a
social level.
® The Govt, health sector is not commercial and
the P.H.C. doctors are supposed to emphasize pre
ventive medicine. But this sector has not changed
the basic pattern outlined above. The doctor wor
king in PHC is inclined and trained to do mainly
curative, clinical work and generally reflects the
typical attitude of the upper class, urban, elite pro
fessional. Preventive measures when undertaken
are therefore reduced to pure technological and
administrative measures without any social contentMFC stands for
* the primary importance of preventive measures
planned and carried out with active participation of
the community and
* for democratic decentralization of responsibili
ties wherever possible.
q
Medical practice in its existing form reflects
and reinforces some of the negative, unhealthy cul
tural values, attitudes in our society — glorification
of money, power, division of labourers into manual
and intellectual labourers; domination of man over
woman, urban over rural, foreign over Indian.. ..
MFC works towards
* a kind of medical practice built upon human
values, concern for human needs, equality, demo
cratic functioning.
E
In the present medical system, non-allopathic
therapies are given a step motherly treatment. Allo
pathic doctors call non-allopaths as quacks without
knowing anything about these systems of medical
care. Equally unscientific are the claims of success
made by some non-allopaths and by some drug
companies. Prejudices, ignorance, self interest have
prevailed over open-minded scientificity in this
important area of medical care.
MFC believes that
* research on these therapies be encouraged by
allotting more funds and other resources and
* that these therapies be encouraged to-take their
proper place in the modern system of medical care.
MFC thus tries to foster amongst medicos a
current upholding human values and aims at res
tructuring the medical profession to enable it to
realize the potential created by modern scientific
medicine.
MFC offers a forum for dialogue/debate,
sharing of experiences and experiments with the
aim of realizing the goal outlined above; and for
taking up issues of common concern for action.
ACTIVITIES
MFC members are spread all over India and
try to propagate the perspective of MFC through
their practice. Some members are engaged fulltime in organizing helth-projects in rural areas.
B
MFC is as of today, mainly a thought-current
and the monthly MEDICO FRIEND CIRCLE BULLE
TIN now in its eighth year of publication, is the
medium through which members communicate their
ideas and experiences to each other. The Bulletin
publishes articles broadly reflecting the MFC pers
pective on health problems. Running the MFC
BULLETIN is our chief common activity.
Publication of the ANTHOLOGY of selected
articles publised in the Bulletin has been a mile
stone in the development of MFC. The first antho
logy—"In search of diagnosis" was very well recei
ved and was rapidly sold out. KSSP translated it
in Malyalam (two editions). The second anthology
''Health-care-which way to go ?" is available (see
the enclosure attached).
b
Once a year MFC members gather at All-lndia
Annual Meet to explore a relevant topic through
discussion or to understand the functioning of a par-
Membership Fee
ticular health care project in terms of a chosen
topic. Since 1974, annual meets have been held at
Ujjain (relevance of the present health services),
Sevagram (present health problems), Hoshangabad
(Indian nutritional problem), Calicut (community
health approach, role of doctor in society), Varanasj
(unemployment among doctors), Jamkhed (commu
nity health worker)' RUSHA Project (community
paediatrics), Tara (misuse of drugs by doctors).
Anand (Prejudice against women in medical care).
Membership fee includes subscription to the MFC
Bulletin.
BULLETIN ONLY
Within India — Rs. 15/- per year (Add Rs. 3/for payments by cheque)
Life subscription — Rs. 250/-
The ANNUAL MEET provides an opportunity for
far-flung medico-friends from different parts of the
country to meet each other for an intensive dialo
gue and to chalk-out a common action grogramme.
e
Study and action-projects by local groups,
regional camps to understand a local health prob
lem and its broader dimensions, health educational
campaigns are other activities through which MFC
has grown and consolidated. The camp on lathyrism
in Rewa District in 1978, the educational campaign
against Oestrogen—Progesterone forte, about dia
rrhoea and misuse of drugs are examples.
ORGANIZATION
The Medico Friend Circle is not a rigid organization.
It is loosely knit, composed of friends from various
backgrounds, usually medical to start with, often
differing in their ways of thinking and in their
modes of action. But the understanding that the
present health services and medical education sys
tem is lopsided in the interest of the priviledged few
and must change to serve the interests of the poor
people of India, is common conviction.
MFC is registered under The Societies Regis
tration Act 1860; No. MAH/902/Pune/81 & under
The Bombay Public Trust Act, 1950; Reg. No.
F-1996 (Pune).
Foreign countries
— Sea Mail - US $4
— Air Mail - Asia - US $6, Europe,
Australia, New Zealand, AfricaUS $9, USA, Canada - $11.
A list of Back-issues is available on request.
Payment are to be made
in the name of Medico
Friend Circle and sent
to the convenor:
I
I
I
j
I
,
,
MEMBERSHIP
Anybody who broadly agrees with the perspec
tive and the rules and regulations of MFC is wel
come to become a member. Non-doctors are encou
raged to join. The membership fee is given below.
It is understood that members capable of contribu- I
ting more than the minimum will do so. Conversely,
the convenor can waive or reduce the membership
fees in deserving cases. For membership forms and
rules and regulations, please write to the convenor.
ravi narayan
convenor
medico friend circle
326, V Main, 1 Block
Koramangala
Bangalore 560 034
[ Published as a supplement to the October—
1983 Issue of the Medico Friend Circle Bulletin ]
medico friend circle
PERSPECTIVE
fr
'
The medico friend circle (mfc) is a group
of socially conscious individuals, interested in
kthe health problems of our people, mfc is trying
•to critically analyse the existing health care syst
em which is highly medicalized and to evolve an
appropriate approach towards developing a system
of health care which is human and which can
meet the needs of the vast majority of the popu
lation in our country, mfc is trying to build a
nation-wide current committed to this philosophy.
The existing system of health care, we have ■
realised, is not geared towards the needs of the
majority of the people, the poor. It requires a
fundamental change. Such a change would occur
as a part of a fundamental change in the total so
cial system in the country, since the medical syst
em is only a part of the total social system, mfc
believes that the potential created by modern
medical science cannot be realised fully without ,
a fundamental change in the social system.
1 th’
What is wrong with the existing health care
system in India?
f
Though after Independence there has been
a rapid growth in medical services organized by
the government, private practice remains the dom
inant feature of medical care in India. In pri
vate practice, medical care like any other commod
ity in the market is available only to those who
have money to pay. The medical profession now
resembles any other commercial sector and, there
fore, has become dominated by concern for money
rather than for people. Commercial competition
and personal interests of doctors lead to numerous
malpractices.
This behaviour is encouraged and promot^B
by profit oriented drug companies which dur^B
many useless or even harmful drugs onto the con-|
sumer by co-opting doctors through their sales!
promotion techniques
mfc upholds the interests of the people and 1
* wants medical and health care to be avai/a-l
ble to everyone irrespective of his/her abifl
ity to pay .
■
fl
* wants to develop methods of medical inte-1
rvention and health care systems strictly!
guided by the needs of our people and not!
by commercial interests.
■
9
Since purchasing power ismainly concentra-1
ted in urban areas, commercial medical practition-1
^hrs are also concentrated in cities and towns. This’
^Overcrowding of doctors is partly responsible for;
the overgrowth of specialists. This has resulted in
the denigration of the role of a basic doctor to
just a "coiiqh and cold" doctor. The training of .
doctors has been influenced and is also partly res- I
ponsible for this situation. Hospital based training
by westernised and urban oriented specialists pr
oduces a graduate conditioned to urban and hos
pital practice. Therefore even after prolonged
expensive training in a medical college, such a
graduate is still not capable of dealing with the
situation in rural areas.
mfc would work towards
* a pattern of medical and healthcare adeq
uately geared to the predominantly rural ch
aracter of our country and
* towards a medical curriculum and training
tailored to the needs of the vast majority
of the people in our country.
To further their narrow professional intere
sts doctors have established a monopoly control
over medical knowledge and medical practice.
Medical knowledge has been jargonised and a
halo has been created around it This monopoly
and mystification opens the door for domination
by medical professionals over patients and by
doctors over nurses and other paramedics.
mfc stands for
* popularisation and demystification of medi
cal science and
* believes that different categories of medical
professionals be regarded as equal members
of a democratically functioning team.
0
Commercial interests demand a growing ma\ rket for drugs and medical therapies- and this is
partly responsible for medical practice being red
uced mainly to curative services.. It denigrates the
primary role of preventive and social measures.
Drugs, surgery and even vaqcines have so far co
ntributed only marginally to the improvement in
people's health in different countries. In spite of
the primary role of socio-economic development in
improving the health of a people, a wrong belief
is promoted that medical intervention - use of dr
ugs, surgery etc., is primarily responsible for imp
rovement in people's health.
mfc realizes
* the importance of curative technology in
saving a persons life, alleviating suffering
or preventing disability but
* stresses the primary role of preventive and
social measures to solve health problems
on a social level.
@
The government health sector is not comm
ercial and the PHC doctors are supposed to emp
hasize preventive medicine. But this sector has
not changed the basic pattern outlined above. The
doctor working in a PHC is inclined and trained to
do mainly curative work and generally reflects the
typical attitude of the upper classes which is urban,
elitest and professional. Preventive and promotive
measures when undertaken are, therefore, reduced
to pure technological and administrative measures
without any social content, which are thrust on
the people.
mfc stands for
* democratic decentralized team functioning
and
* for active participation by the community
in the planning and carrying out of preven
tive and promotive measures.
*
Medical practice in its existing form reflec
ts and reinforces some of the negative, unhealthy
cultural values and attitudes in our society; eg. ,
glorification of money and power, division of lab
ourers into manual and intellectual workers, dom
ination of men over women, urban over rural, for
eign over Indian.
mfc works towards
* a kind of medical practice built upon human
values, concern for human needs, equality
and democratic functioning.
®
In the present medical system, non-allopathic therapies are given a step-motherly treatment.
Allopathic doctors call non-allopaths quacks
without knowing anything about their systems of
medical care. Equally unscientific .are the claims
of success made by some non - allopaths and by
some drug companies. .Prejudices, ignorance, self
interest have prevailed over open-minded scientificity in this important area of medical care.
mfc publications
mfc believes that
* research on these therapies be encouraged by
alloting more funds and other resources, and;
* that these therapies be encouraged to take
their proper place in the modern system of
medical care.
1. IN SEARCH OF DIAGNOSIS (analysis of
present’ system of health care) First anthology of
bulletin articles. Ed. AshvinJ Patel, first published
December 1977, Reprinted May 1985. Price Rs.
12.00 or US $5.00. Includes Health Service Evo
lution, Medical Education, National Health poli
cy, Alternatives in Health Care, Population Prob
lem, Drug Industry, Nutritional problem in India,
Protein Gap myth. Tonics and Community Health
Care.
mfc thus tries to foster among medicos a
current upholding human values and aims at
restructuring the medical profession to enable
it to realize the potential created by modern
scientific medicine.
mfc offers a forum for dialogue/debate,
sharing of experiences and experiments with
the aim of realizing the goal outlined above
and for taking up issues of common concern
for action.
2.
HEALTH CARE WHICH WAY TO GO? (ex
amination of issues and alternatives) Second
anthology of bulletin articles. Ed. Abhay Bang &
Ashvin J Patel, first published October1982, Rep
rinted May 1985. Price Rs. 15.00 or US$6.00.
Includes Drug Issues, Lathyrism, Water Supply,
Oral Rehydration Therapy, Problems of Nurses,
Community Health Workers, Dai training. Govern
ment Rural Health Scheme, Political Dimensions
of Health and mfc debate on which way to go.
ACTIVITIES
mfc members are spread all over India and try
to propagate the perspective of mfc through their
work. Some members are engaged full-time in
organizing health projects in rural areas and urban
slums.
Bulletin
mfc is as of today, mainly a thought current
and the monthly -medico friend circle bulletin
now in its eleventh year of publication, is the medi
um through which we communicate our ideas and
experiences. The bulletin publishes articles broa
dly reflecting the mfc perspective on health
problems. Running the mfc bulletin is our chief
common activity. The bulletin is also read by a
larger circle than its members through a subscrip
tion system.
Anthologies
Publication of anthologies of selected articles
Published in the bulletin has been a milestone in.
the development of mfc. The first anthology'In
Search of Diagnosis' was very well received and
•was.rapidly sold out.
KSSP translated it into
Malayalam (two editions). The second anthology
'Health Care Which Way to Go?' has also been
sold out. Reprints of the first and second anthol
ogies are . now available. The third anthology
'Under the Lens : Health and Medicine- has just
been -printed. An anthology on 'Alternatives in.Medical Education' is under preparation. ..
3.
HEALTH AND MEDICINE-UNDER THE LENS
Third anthology of bulletin articles. Ed. Kamala
J Rao and Ashvin J Patel, October 1985. Price
Rs.15.00 or US $6.00. Includes Critical Examinat
ion of Community Health, People's Participation,
Health for All by 2000 AD, Health Education, Drug
Misuse, Medical Research, BCG vaccination. Sup
plementary Feeding Programmes, Drug Policy and
Therapeutics, Minimum Wages, Family Planning
and the Kerala Model.
i
4. Anti-Diarrhoeal Formulations— a rationa
lity study by Shishir J Modak for mfc Rational
Drug Policy Cell. Price Rs.2.00 or US$ 1.00
5.
Analgesics and Antipyretics— a rationality
study by Jamie Uhrig and Penny Dawson for mfc
Rational Drug Policy Celt. Price Rs. 2.00 orUS
$ 1.00.
6.
Medical Relief and Research in Bhopal—
the realities and recommendations. Price Rs. 2.00
or US$1.00
7.
The Bhopal Disaster aftermath:an epidemi
ological and socio-medical survey
Price:
(a) complete report
(b) summary
Rs.8.00/US $5.00
Rs.2.00/US $1.00
8.
Subject-wise index of first 100 issues
mfc bulletin. Price Rs.2.50
9
(a)
Bulletin back issues
xerox. copies of mfc bulletin back issues are
available with the Centre for Education and
Documentation (CED), 3 Suleman Chambers,
4 Battery Street, Behind Regal Cinema, Bo
mbay 400 039.; In order to cover costs and
at the same time provide subsidies to des
erving groups a graded rate structure has
been worked out and is available on request
from CED.
For mfc members the rate isi)
set of 100 issues - Rs.240.00
ii)
specific issues - Rs.4.00 each
iii)
Specific article - 0.60 paise per page
(b)
Back issues of some of the past bulletins are
also available with mfc office (ask for sepa
rate list).
10. Background of Annual Meets are also avai
lable (ask for separate list).
Publications available from :
mfc office; 1877, Joshi Galli, Nipani 591237,
Belgaum Dist., Katnataka.
All payments may be made in the name of medico
friend circle by MO/DD
Items 1 to 3 are also available singly/bulk
from the Publications Section, Voluntary Health
Association of India, C-14 Community Centre.
SDA., Opp. HT Main Gate. New Delhi - 110 016.
of
Annual Meets
Once a year mfc members gather at an all India
annual meet to explore a relevant topic through
discussion or to understand the functioning of a
particular health care project in terms of a chosen
topic. Since 1974, annual meets have been held
at Ujjain (relevance of the present health services)-,
Sevagram (present health problems); Hoshangabad
(Indian nutritional problem); Calicut (community
health approach, role of doctors in society); Vara
nasi (unemployment among doctors); Jamkhed
(community health worker); RUHSA, Vellore
(community paediatrics); Tara (misuse of drugs by
doctors); Anand (prejudice against women in
medical care), CINI, Calcutta (alternative medical
education) and Bangalore (TB and Society).
ORGANIZATION
The mfc is not a rigid organization. It is a
loosely knit group of friends from various backgr
ounds, medical and non-medical, often differing
in their ways of thinking and in their modes of
action. But the understanding that the present
health services and system of medical education
are lopsided in the interest of the privileged few
and must change to serve the interests of the poor
people of India is common conviction.
mfc is registered under the Societies Reg
istration Act 1860; No. MAH/902/Pune/81 and
under the Bombay Public Trust Act, 1950; Reg NoF-1996 (Pune). The mfc Reg. Office is 50 L I C
Quarters, University Road, Pune - 411016
The annual meet provides an opportunity for
far flung medico friends from different parts of the
country to meet each other for an intensive dia
logue and to chalk out some common action
programmes.
Collective Involvement
MEMBERSHIP
Anybody who broadly agrees with the per
spective and the rules and regulations of mfc is
welcome to becomes member. Non - doctors are
encouraged to join. The membership fee is given
below. It is understood that members capable of
contributing more than the minimum will do so.
Conversely the convenor can waive or reduce the
membership fees in deserving cases. For member
ship forms and rules and regulations, please write
Study and action projects by local groups,
regional camps to understand a locaPhealth prob
lem and its broader dimensions and health educ
ational campaigns are other activities through
which mfc has grown and consolidated. Some
examples are a camp on lathyrism in Rewa district
in 1978, a campaign against oestrogen-progesterone forte, a campaign about diarrhoea and mi
suse of drugs, and presently an ongoing campaign
with other women's groups against the introduct
ion of long acting injectable contraceptives, mfc
is also an active member of the All India Drug
Action Network.
Bhopal involvement: In response to requ
ests from groups working in Bhopal following the
gas disaster, mfc intervened as a group (i) to
study the health problems of the disaster victims(ii) to support the efforts of voluntary groups
and the emerging people's movement in an attem
pt to get rational health care services for the affe
cted people.
An epidemiological study (March 1985) f0.
llowed by a pregnancy outcome survey (Sept 1985)
were two interventions. Apart from research, co
ntinuing education of health service providers'and
decision makers was carried out as part of a com
munication strategy and health education materi
al for the disaster victims was prepared. Techni
cal support was given for health activities of many
voluntary agencies and action groups Working
among the disaster victims.
tn the convenor:
Narendra Gupta
Prayas Village
Dev§arh (Deolia)
partabgarh
Dist Chittorgarh,
Rajasthan 312 621
Membership fees
Those earning less than Rs. 750/- p.m. Rs. 25/- p.a.
Those earning more than Rs. 750/-p.m. Rs. 50/-p.a.
Membership fee includes subscription to
the mfc bulletin
a
Bulletin subscription
Within India-Rs.15.00 per year
Life subscription : Rs. 250.00.
Foreign countries:
- sea mail : US$4; for all countries
-airmail : Asia - US$6; Europe,
Africa and
Australia—US$9; North & South America—US$11.
All payments may be made in the name of
medico friend circle and sent by money order/
demand draft to the convenor.
mfc Drug Campaign
For further derails write to Anant Phadke
at the Registered Office.
medico friend circle
PERSPECTIVE
fr
The medico friend circle (mfc) is a group
of socially conscious individuals, interested in
the health problems of our people, mfc is trying
to critically analyse ths existing health care syst
em which is highly medicaiized and to evolve an
appropriate approach towards developing a system
of health care which is human and which can
meet the needs of ths vast majority of the popu
lation in our country, mfc is trying to build a
nation-wide current committed to this'philosophy.
The existing system of health care, we have
realised, is not geared towards the needs of the
majority of the people, the poor. It requires a
fundamental change. Such a change would occur
as a part of a fundamental change in the total so
cial system in the country, since the medical syst
em is only a part of the total social system, mfc
believes that the potential creajpd by modern
medical science cannot be realised fully without-i-.
a fundamental change in the social system.
thr
What is wrong with the existing health care
system in India?
£
Though after Independence there has been
a rapid growth in medical services organized by
the government, private practice remains the dom
inant feature of medical care in India. In pri
vate practice, medical care like any other commod
ity in the market is available only to those who
have money to pay. The medical profession now
resembles any other commercial sector and, there
fore, has become dominated by concern for money
rather than for people. Commercial competition
and personal interests of doctors lead to numerous
malpractices.
This behaviour is encouraged and promoted
by profit oriented drug companies which dump
many useless or even harmful drugs onto the con
sumer by co-opting doctors through their sales
promotion techniques
mfc upholds the interests of the people and
* wants medical and health care to be availa
ble to everyone irrespective of his/her abil
ity to pay
* wants to develop methods of medical inte
rvention and health care systems strictly
guided by the needs of our people and not
by commercial interests.
9
Since purchasing power ismainly concentra
ted in urban areas, commercial medical practition
ers are also concentrated in cities and towns. This
overcrowding of doctors is partly responsible for
the overgrowth of specialists. This has resulted in
the denigration of the role of a basic-doctor to
just a "cough and cold" doctor. The training of
doctors has been influenced and is also partly res
ponsible for this situation. Hospital based training
by westernised and urban oriented specialists pr
oduces a graduate conditioned to urban and hos
pital practice. Therefore even after prolonged
expensive training in a medical college, such a
graduate is still not capable of dealing with the
situation in rural areas.
mfc would work towards
* a pattern of medical and healthcare adeq
uately geared to the predominantly rural ch
aracter of our country and
* towards a medical curriculum and training
tailored to the needs of the vast majority
of the people in our country.
To further their narrow professional intere
sts doctors have established a monopoly control
over medical knowledge and medical practice.
Medical knowledge has been jargonised and a
halo has been created around it This monopoly
and mystification opens the door for domination
by medical professionals over patients and by
doctors over nurses and other paramedics.
mfc stands for
* popularisation and demystification of medi
cal science and
* believes that different categories of medical
professionals be regarded as equal members
of a democratically functioning team.
q
Commercial interests demand a growing ma
rket for drugs and medical therapies and this is
partly responsible for medical practice being red
uced mainly to curative services. It denigrates the
primary role of preventive and social measures.
Drugs, surgery and even vaccines have so far co
ntributed only marginally to the improvement in
people's health in different countries. In spite of
the primary role of socio-economic development in
improving the health of a people, a wrong belief
is promoted that medical intervention - use of dr
ugs, surgery etc., is primarily responsible for imp
rovement in people's health.
mfc realizes
of. success made by some non-allopaths and by
some drug companies. Prejudices, ignorance, self
interest have prevailed over open-minded scientificity in this important area of medical care.
* the importance of curative technology in
saving a persons life, alleviating suffering
or preventing disability but
* stresses the primary role of preventive and
• social measures to solve health problems
on a social level.
9
_
The government health sector is not comm
ercial and the PHC doctors are supposed to emp
hasize preventive medicine. But this sector has
not changed the basic pattern outlined above. The
doctor working in a PHC is inclined and trained to
do mainly curative work and generally reflects the
typical attitude of the upper classes which is urban,
elitest and professional. Preventive and promotive
measures when undertaken are, therefore, reduced
to pure technological and administrative measures
without any social content, which are thrust on
the people.
mfc stands for
mfc thus tries to foster among medicos a
current upholding human values and aims at
restructuring the medical profession to enable
it to realize the potential created by modern
scientific medicine.
* democratic decentralized team functioning
and
* for active participation by the community
in the planning and carrying out of preven
tive and promotive measures.
®
Medical practice
in ,
its existing
____ ...
o/xioLiiiy form
iwiiii refleciciicv
ts and reinforces some of the negative, unhealthy
cultural values and attitudes in our society, eg.,
glorification of money and power, division of lab
ourers into manual and intellectual workers, dom
ination of men over women, urban over rural, for
eign over Indian.
mfc works towards
* a kind of medical practice built upon human
values, concern for human needs, equality
and democratic functioning.
4)
In the present medical system, non-allopathic therapies are given a step-motherly treatment.
Allopathic doctors call non-allopaths quacks
without knowing anything about their systems of
medical care. Equally unscientific are the claims
mfc believes that
* research on these therapies be encouraged by
alloting more funds and other resources, and;
* that these therapies be encouraged to take
their proper place in the modern system of
medical care.
mfc offers a forum for dialogue/debate,
sharing of experiences and experiments with
the aim of realizing the goal outlined above
and for taking up issues of common concern
for action.
ACTIVITIES
mfc members are spread all over India and try
to propagate the perspective of mfc through their
work. Some members are engaged full-time in
organizing health projects in rural areas and urban
slums.
Bulletin
mfc is as of today, mainly a thought current
and the monthly 'medico friend circle bulletin'
now in its eleventh year of publication, is the medi
um through which we communicate our ideas and
experiences. The bulletin publishes articles broa
dly reflecting the mfc perspective on health
problems. Running the mfc bulletin is our chief
common activity. The bulletin is also read by a
larger circle than its members through a subscrip
tion system.
Anthologies
Publication of anthologies of selected articles
Published in the bulletin has been a milestone in
the development of mfc. The first anthology'In
Search of Diagnosis' was very well received and
was rapidly sold out. KSSP translated it into
Malayalam (two editions). The second anthology 'Health Care Which Way to Go?' has also been
sold out. Reprints of the first and second anthol
ogies are now available. The third anthology
'Under the Lens : Health and Medicine' has just
been printed. An anthology on 'Alternatives in
Medical Education' is under preparation.
mfc publications
1.
IN SEARCH OF DIAGNOSIS (analysis of
present system of health care) First anthology of
bulletin articles. Ed. AshvinJ Patel, first published
December 1977, Reprinted May 1985. Price Rs.
12.00 or US $5.00. Includes Health Service Evo
lution, Medical Education, National Health poli
cy, Alternatives in Health Care, Population Prob
lem, Drug Industry, Nutritional problem in India,
Protein Gap myth. Tonics and Community Health
Care.
2.
HEALTH CARE WHICH WAY TO GO? (ex
amination of issues and alternatives) Second
anthology of bulletin articles. Ed. Abhay Bang &
Ashvin J Patel, first published October!982, Rep
rinted May 1985. Price Rs. 15.00 or US$6.00.
Includes Drug Issues, Lathyrism, Water Supply,
Oral Rehydration Therapy, Problems of Nurses,
Community Health Workers, Dai training. Govern
ment Rural Health Scheme, Political Dimensions
of Health and mfc debate on which way to go.
3.
HEALTH AND MEDICINE-UNDER THE LENS
Third anthology of bulletin articles. Ed. Kamala
J Rao and Ashvin J Patel, October 1985. Price
Rs.15.00 or US$6.00. Includes Critical Examinat
ion of Community Health, People's Participation,
Health for All by 2000 AD, Health Education, Drug
Misuse, Medical Research, BCG vaccination. Sup
plementary Feeding Programmes, Drug Policy and
Therapeutics, Minimum Wages, Family Planning
and the Kerala Model.
4.
Anti-Diarrhoeal Formulations— a rationa
lity study by Shishir J Modak for mfc. Rational
Drug Policy Cell. Price Rs.2.00 or US$ 1.00
5.
Analgesics and Antipyretics— a rationality
study by Jamie Uhrig and Penny Dawson for mfc
Rational Drug Policy Cell. Price Rs. 2.00 pr US
$ 1.00.
6. Medical Relief and Research in Bhopal—
the realities and recommendations. Price Rs. 2.00
or US$1.00
7. The Bhopal Disaster aftermath:an epidemi
ological and socio-medical survey
Price:
(a) complete report
(b) summary
Rs.8.00/US $5.00
Rs.2.00/US $1.00
8. Subject-wise index of first 100 issues
mfc bulletin. Price Rs.2.50
9
(a)
Bulletin back issues
xerox copies of mfc bulletin back issues are
available with the Centre for Education and
Documentation (CED), 3 Suleman Chambers,
4 Battery Street, Behind Regal Cinema, Bo
mbay 400 039. In order to cover costs and
at the same time provide subsidies to des
erving groups a graded rate structure has
been worked out and is available on request
from CED.
For mfc members the rate isi) set of 100 issues - Rs.240.00
ii) specific issues - Rs.4..00 each
iii) Specific article - 0.60 paise per page
(b)
Back issues of some of the past bulletins are
also available with mfc office (ask for sepa
rate list).
10. Background of Annual Meets are also avai
lable (ask for separate list).
Publications available from :
mfc office; 1877, Joshi Galli, Nipani 591237.
Belgaum Dist., Karnataka.
All payments maybe made in the name of medico
friend circle by MO/DD
Items 1 to 3 are also available singly/bulk
from the Publications Section, Voluntary Health
Association of .India, C-14 Community Centre,
SDA., Opp: HT Main Gate, New Delhi - 110 016.
of'
Annual Meets
Once a year mfc members gather at an all India
annual meet to explore a relevant topic through
discussion or to understand the functioning of a
particular health care project in terms of a chosen
topic. Since 1974, annual meets have been held
at Ujjain (relevance of the present health services);
Sevagram (present health problems); Hoshangabad
(Indian nutritional problem); Calicut (community
health approach, role of doctors in society); Vara
nasi (unemployment among doctors); Jamkhed
(community health worker); RUHSA, Vellore
(community paediatrics); Tara (misuse of drugs by
doctors); Anand (prejudice against women in
medical care), CINI, Calcutta (alternative medical
education) and Bangalore (TB and Society).
ORGANIZATION
The mfc is not a rigid organization. It is a
loosely knit group of friends from various backgr
ounds, medical and non-medical, often differing
in their ways of thinking-and in their modes of
action. But the understanding that the present
health services and system of medical education
are lopsided in the interest of the privileged few
and must change to serve the interests of the poor
people of India is common conviction.
mfc is registered under the Societies Reg
istration Act 1860; No. MAH/902/Pune/81 and
under the Bombay Public Trust Act, 1950; Reg No'
F-1996 (Pune). The mfc Reg. Office is 50 L I C
Quarters, University Road, Pune - 411016
The annual meet provides an opportunity for
far flung medico friends from different parts of the
country to meet each other for an intensive dia
logue and to chalk out some common action
programmes.
MEMBERSHIP
Anybody who broadly agrees with the per
spective.and the rules and regulations of mfc is
welcome to become a member. Non - doctors are
encouraged to join. The membership fee is given
below. It is understood that members capable of
contributing more than the minimum will do so.
Conversely the convenor can waive or reduce the
membership fees in deserving cases. .For member
ship forms and rules and regulations, please write
to the convenor:
Dhruv Mankad
1877 Joshi .Galli
Nipani 591237
Belgaum, dist., Karnataka
Collective Involvement
Study and action projects by local groups
regional camps to understand a local health prob
lem and its broader dimensions and health educ
ational campaigns are other activities throuoh
which mfc has grown and consolidated. Some
examples are a camp on lathyrism in Rewa district
in 1978, a campaign against oestrogen-proaes
terone forte, a campaign about diarrhoea and mi
suse of drugs, and presently an ongoing c'ampaion
with other women's groups against the introduct
ion of long acting injectable contraceptives mf
is also an active member of the All India n '0
Action Network.
ru9
Bhopal involvement: In response toreau
ests from groups working in Bhopal followino th
gas disaster, mfc intervened as, a group (nt
study the health problems of the-disaster victim
(ii) to support the efforts of voluntary
and the emerging people's movement in an att<=.
• pt to get rational health care services for the aH
cted people.
An epidemiological study (March 1985W
llowed by a pregnancy outcome survey (Sept 1 corn
were two interventions. Apart from research S&
ntinuing education of health service providers
decision makers was carried out as part of a c™
munication strategy and health education man.™'
al for-.the disaster victims was .prepared. Tech'"
cal support was given for health activities of ma'
voluntary agencies and action- groups work'
among the disaster victims. .
Kln9
Membership fees
Those earning less than Rs. 750/- p.m. Rs. 25/- p.a.
Those earning more than Rs. 750/-p.m. Rs. 50/-p.a.
Membership fee includes subscription to
the mfc bulletin
@
Bulletin subscription
Within India - Rs.1 5.00 per year
Life subscription : Rs. 250.00.
Foreign countries:
- sea mail : US$4; for all countries
"airmail : Asia - US$6;
Europe, Africa and
Australia—US$9; North & South America—US$11.
All payments may be made in the name of
medico friend circle and sent by money order/
demand draft to the convenor.
mfc Drug Campaign
For'further details write to Anant Phadke
at the Registered Office.
\<WQ
medico friend circle
PERSPECTIVE
The medico friend circle(mfc) is a group of socially
conscious individuals, interested in the health problems of
our people, mfc is trying to critically analyse the existing
health care system which is highly medicalized and to evoli )
an appropriate approach towards developing a system of
health care which is human and which can meet the
needs of the vast majority of the population in our country.
mfc is trying to build a nation-wide current committed to this
philosophy.
The existing system of health care, we have realised, is
not geared towards the needs of the majority of the people,
the poor. It requires a fundamental change. Such a change
would occur as a part of a fundamental change in the total
social system in the country, since the medical system is only
a part of the total social system, mfc believes that the
potential created by modern medical science cannot be
realised fully without a fundamental change in the social
system.
What is wrong with the existing health care
system in India?
Though after Independence there has been a rapid
growth in medical services organised by the governme!rat
private practice remains the dominant feature of medical
care in India. In private practice, medical care like any other
commodity in the market is available only to those who have
money to pay. The medical profession now resembles any
other commercial sector and, therefore, has become
dominated by concern for money rather than for people.
Commercial competition and personal interests of doctors
lead to numerous malpractices.
This behaviour is encouraged and promoted by profit
oriented drug companies which dump many useless or even
harmful drugs onto the consumer by co-opting doctors
through their sales promotion techniques.
mfc upholds the interests of the people and
»
wants medical and health care to he available to
everyone irrespective of his/her ability to pay.
»
wants to develop methods of medical intervention
and health care systems strictly guided by the
needs ofour people and not by commercial i nterests.
»
Since purchasing power is mainly concentrated in
the urban areas, commercial medical practitioners
are also concentrated in cities and towns. This
overcrowding of doctors is partly responsible for the
overgrowth of specialists. This has resulted in the
denigration of the role of a basic doctor to just a
’cough and cold’ doctor. The training of doctors has
been influenced by and is also partly responsible for
this situation. Hospital based training by
westernised and urban oriented specialists
produces a graduate conditioned to urban and
hospital practice. Therefore even after prolonged
expensive training in a medical college, such a
graduate is still not capable of dealing with the
situation in rural areas.
mfc would work towards
»
a pattern of medical and health care adequately
geared to the predominantly rural character of our
country and
»
towards a medical curriculum and training tailored
to the needs of the vast majority of the people in our
country.
• To further their narrow professional interests doctors
have established a monopoly control over medical
knowledge and medical practice. Medical knowledge has
been jargonised and a halo has been created around it.
This monopoly and mystification opens the door for
domination by medical professionals over patients and
by doctors over nurses and other paramedics.
t
c stands for
»
popularisation and demystification of medical
science and
»
believes that different categories of medical
professionals be regarded as equal members of a
democratically functioning team.
• Commercial interests demand a growing market for
drugs and medical therapies and this is partly
responsible for medical practice being reduced to
curative services. It denigrates the primary role of
preventive and social measures. Drugs, surgery and even
vaccines have so far contributed only marginally to the
improvement in people’s health in different countries. In
spite of the primary role of socio-economic develop ment
in improving the health of our people, a wrong belief is
promoted that medical intervention - use of drugs,
surgery, etc.,- is primarily responsible for improvement
in people’s health.
mfc realises
»
the importance of curative technology in saving a
person’s life, alleviating suffering or preventing
disability but
»
stresses the primary role of preventive and social
measures to solve health problems on a social level.
• The government health sector is not commercial and the
PHC doctors are supposed to emphasize preventive
medicine. But this sector has not changed the basic
pattern outlined above. The doctor working in a PHC is
inclined and trained to do mainly curative work and
generally reflects the typical attitude of the upper classes
which is urban, elitist and professional. Preventive and
promotive measures when undertaken are, therefore,
reduced to pure technological and administrative
measures without any social content, which are then
thrust on the people.
mfc stands for
democratic decentralised team functioning and
for active participation by the community in the
planning and carrying out of preventive and
promotive measures.
• Medical practice in its existing form reflects and
reinforces some of the negative, unhealthy cultural
values and attitudes in our society, for example,
glorification of money and power, division of labourers
into manual and intellectual workers, domination ofmen
over women, urban over rural, foreign over Indian.
»
»
mfc works towards
a kind of medical practice built upon human values,
concern for human needs, equality and democratic
functioning.
• In the present medical system, non-allopathic therapies
are given a step-motherly treatment. Allopathic doctors
call non-allopaths quacks without knowing anything
about their systems of medical care. Equally unscientific
are the claims of success made by some non-allopaths
and by some drug companies. Prejudices, ignorance and
self-interest have prevailed over open-minded
scientificity in this important area of medical care.
»
mfc believes that
»
research on these therapies should be encouraged by
allotting more funds and other resources, and
»
that these therapies be encouraged to take their
proper place in the modern system of medical care.
mfc thus tries to foster among medicos a current
upholding human values and aims at restructuring
the medical profession to enable it to realize the
potential created by modern scientific medicine.
mfc offers a forum for dialogue/debate, sharing of
experiences and experiments with the aim of
realizing the goal outlined above and for taking up
issues of common concern for action.
ACTIVITIES
mfc members are spread all over India and they try to
propagate the perspective of mfc through their work. Some
members are engaged full-time in organisinghealth projects
in rural areas and urban slums.
Bulletin
mfc is as of today, mainly a thought current and the
monthly ’medico friend circle bulletin’ now in its
sixteenth year of publication, is the medium through which
we communicate our ideas and experiences. The bulletin
publishes articles broadly reflecting the mfc perspective on
health problems. Running the mfc bulletin is our chief
common activity. The bulletin is also read by a larger circle
than its members through a subscription system.
Anthologies
Publication of anthologies of selected articles published
in the bulletin has been a milestone in the development of
mfc. The first anthology In Search of Diagnosis was well
received and rapidly sold out. KSSP translated it into
Malayalam (two editions). The second anthology ’Health
Care: Which Way to go Y has also been sold out. Reprints
of the first and second anthologies are now available. The
third anthology Under the Lens: Health and Medicine
has been printed and is available. Another anthology
Medical Education Re-examined has just been
published.
Annual Meets
In the past, mfc members gathered once a year at an
all-India annual meet to explore a relevant topic through
discussion or to understand the functioning of a particular
health care project in terms of a chosen topic. Since 1974,
annual meets have been held at Ujjain (relevance of the
present health services)-, Hoshangabad (Indian nutritional
problem) ; Calicut (role of doctors in society) ; Jamkhed
(community health worker) ; RUHSA Vellore (community
paediatrics) ; Tara (misuse of drugs by doctors) ; Anand
(prejudice against women in medical care) ; CINI, Calcutta
(alternative medical education); Bangalore (TB and society)
; Jaipur (child survival) ; Udaipur (family planning) ; and
Calicut (medical technology).
Recently, the frequency has been decreased to allow for
indepth discussions within the organisation on themes of
members interest.
The annual meet provides the opportunity for far- flung
medico friends to meet each other for an intensive dialogue
and to chalk out some common action programmes.
Collective involvement
Study and action projects by local groups, regional
camps to understand a local health problem and its broader
dimensions and health educational campaigns are other
activities through which mfc has grown and consolidated.
Some examples are : a camp on lathyrism in Rewa district
(MP), 1978; a campaign againstoestrogen progesterone forte
; campaign about diarrhoea and misuse of drugs ; and a
campaign with women’s groups against introduction of long
acting injectable contraceptives, mfc is also an active
member of the All India Drug Action Network.
Bhopal involvement : In response to requests from
groups working in Bhopal following the gas disaster, mfc
intervened as a group (i) to study the health problems of the
disaster victims; (ii) to support the efforts of voluntary
groups and the emerging people’s movement in an attempt
to get rational health care for the affected people.
An epidemiological study (Mar. ’85) followed by a
pregnancy outcome survey (Sept.'85) were two such
interventions. Technical support was given for health
activities of many voluntary agencies and action groups
working among the disaster victims.
ORGANISATION
mfc is not a rigid organisation. It is a loosely knit group
of friends from various backgrounds, medical and
non-medical, often differing in their ways of thinking and in
their modes of action. But the understanding that the
present health service and the system of medical education
are lopsided and in the interest of privileged few isa common
conviction.
The looseness of the organisation has created certain
problems in its functioning. Without giving up its essentially
open character, a restructuring of the organisation is
underway since August 1990. The main feature of the new
structure is the formation of local and issue-based groups.
There are two local groups, mfc- Bombay and mfc-Calcutta.
Moreover, a group on Primary Health Care and one on
Health Policy have been formed to facilitate study of the
various aspects of these topics in greater detail. The
Executive Committee has assumed a more active role in
supporting the convenor in day-to- day decision-making.
mfc is registered under the Societies Registration Act
1860 (MAH/902/Pune/81) and under the Bombay Public
Trust Act,1950 ( Reg.No. F-1996, Pune). The mfc registered
office is at 50, L I C Quarters, University Road, Pune
411016.Donations to mfc are exempt from the Income Tax
under Section 80(G).
MEMBERSHIP
Anyone who broadly agrees with the perspective as well
as the rules and regulations of mfc is welcome to become a
member. Non-doctors are encouraged to join. The
membership fees are given below. It is understood that
members capable of contributing more than the minimum,
will do so. Conversely the convenor can reduce or waive the
membership fees in deserving cases. For membership forms
and copy of the rules and regulation, please write to the
convenor:
Anil Pilgaonkar,
34B, Noshir Bharucha Marg,
Grant Rd(W), Bombay 400 007.
•
Annual Membership Fees
Those earning less than Rs.750 p.m. Rs 25.
Those earning more than Rs.750 p.m. Rs 50.
Membership fee includes subscription to the mfc
bulletin.
•
_ 30 .
Bulletin subscription
Within India:
:
Rs. 300 -
Foreign countries: sea mail
:
US$4; for all countries
airmail
:
Asia - US$6; Europe,
Africa, Australia, North
& South America US$11.
Annual
Life
All payments may be made in the name of medico friend
circle and sent by money order/demand draft to the
convenor.
Rational Drug Policy Cell
Concretely criticizing irrationalities in the production
and use of drugs, and putting forward alternatives has been
one of the activities ofmfc members. MFC has therefore been
an active part of the coming together of various drug
interested groups from the different parts of the country to
form the All India Drug Action Network (AIDAN). The
movement towards a rational drug policy has been one of the
rare examples of different groups coming together on a
health issue and preparing a substantial critique of the
National Policy in India and an equally solid, concrete
alterna tive to it. MFC members have contributed to this
move ment by participating in seminars, newspaper
campaigns, lobbying with the government and to the
formulation of the perspective of AIDAN.
A Rational Drug Policy Cell has been formed to look
after mfc’s involvement in this issue. Two studies,
evaluating the rationality of the top-selling antidiarrhoeals
and analgesic formulations in the market has been
published by this cell. These studies have been valuable in
the drug-campaign and have been reprinted by KSSP. For
further details write to : Anant R S, Coordinator, Rational
Drug Policy Cell, 50 LIC Quarters, University Road, Pune
411 016.
6.
Analgesics and Antipyretics- a rationality study
by Jamie Uhrig and Penny Dawson for mfc Rational Drug
Policy Cell. Price Rs.2.00 US $ 1.00.
7.
Medical Relief and Research in Bhopal the
realities and recommendations. Price Rs.2.00 or US $ 1.00.
a)
8.
b)
The Bhopal Disaster aftermath : an
epidemiological and socio-medical survey
Price: a) Complete report Rs. 8.00/US $ 500
b) Summary Rs. 2.00/US $1.00.
Distorted Lives : Women’s Reproductive
Health and Bhopal Disaster : October 1990.
Price Rs. 10.00 or US $ 6.00.
9.
Subject-wise index of first 100 issues of mfc
bulletin. Price Rs. 2.50.
10.
mfc publications
a)
T . IN SEARCH OF DIAGNOSIS (analysis of present
system of health care) First anthology of bulletin articles.
Ed. Ashvin J Patel, first published December 1977,
Reprinted May 1985. Price Rs. 12.00 or US $ 5.00. Includes
Health Service Evolution, Medical Education, National
Health Policy, Alternatives in Health Care, Population
Problem, Drug Industry, Nutritional problem in India,
Protein Gap myth, Tonics and Community Health Care.
2.
HEALTH CARE WHICH WAY TO GO?
(Examination of issues and alternatives) Second anthology
of bulletin articles. Ed. Abhay Bang and Ashvin J Patel, first
published October 1982, Reprinted May 1985. Price Rs.
15.00 or US $ 6.00. Includes Drug Issues, Lathyrism, Water
Supply, Oral Rehydration Therapy, Problems of Nurses,
Community Health Workers, Dai training, Government
Rural Health Scheme, Political Dimensions of Health and
mfc debate on which way to go.
3.
HEALTH AND MEDICINE-UNDER THE LENS :
Third anthology of bulletin articles. Ed. Kamala J Rao and
Ashvin J Patel, October 1985. Price Rs. 19.00 or US $ 6.00.
Includes Critical Examination of Community Health,
People's Participation, Health for All by 2000 AD, Health
Education, Drug Misuse, Medical Research, BCG
vaccination, Supplementary Feeding Programmes, Drug
Policy and Therapeutics, Minimum Wages, Family Planning
and the Kerala Model.
4.
MEDICAL EDUCATION RE-EXAMINED: Has
just been published. (Ed. Dhruv Mankad. Includes articles
and papers on Medical Education.)
5.
Anti-diarrhoeal Formulations-a rationality study
by Shishir J Modak for mfc Rational Drug Policy Cell. Price
Rs.2.00 or US $ 1.00.
8.
Bulletin Back Issues
Xerox copies of mfc bulletin back issues are
available with the Centre of Education and
Documentation Regal Cinema, Bombay400039.
In order to cover costs and at the same time
provide subsidies to deserving groups graded
rate structure has been worked out and is
available from CED.
For mfc members the rate is
1.
Set of 100 issues - Rs. 240.00
2.
Specific issues
- Rs. 4.00 each.
3.
Specific article
- 0.60 paise per page
b)
Back issues of some of the past bulletins are also
available with mfc office, (ask for separate list).
11.Background of Annual Meets are also available:
(ask for separate list).
Publications available from :
mfc office :
Anil Pilgaonkar,
36B, Noshir Bharucha Marg,
Grant Road(W),
Bombay 400 007.
All payments may be made in the name of medico friend
circle by MO/DD.
Items 1 to 3 are also available singly/bulk from the
Publications Section, Voluntary Health Association ofIndia,
40 Institutional area, South of IIT, New Delhi 110 016 and
item 4 is available from CED at the address given under item
w
medico friend circle
PE™
»: zs,opi“i“»
philosophy.
The existing system of health care, we have realized,
is not geared towards the needs of the majority of the
people, the poor. It require a fundamental change. Such
a change would occur as a part of the total social, system
in the country, since medical system is only a part of the
total social system, mfc believes that the potential created
by modern medical science cannot be realized fully
without a fundamental change in the social system.
What is wrong with the existing health care
system in India?
Though after independence there has been a rapid
growth in medical services organised by the government,
private practice remains the dominant feature of mcdj^al
care in India. In private practice, medical care likdj^y
other commodity in the market is available only to those
who have money to pay. The medical profession now
resembles any other commercial sector and, therefore, has
become dominated by concern for money rather than for
people. Commercial competition and personal interests
of doctors lead to numerous malpractices.
This behaviour is encouraged and promoted by profit
oriented drug companies which dump many useless or
Z?ncTfU1 drugS Onl° lhc “msumer by co-opting
doctors through their sales promotion techniques.
mfc upholds the interests of the people and
» wants medical and health care to be available to
everyone irrespective of his/her ability to pay.
|
»
»
£
wants to develop methods of medical
intervention and health care systems strictly
guided by the needs of bur people and not by
commercial interests.
Since purchasing power is mainly concentrated
in the urban areas, commercial medical
practitioners are also concentrated in cities and
towns. This overcrowding of 'doctors is partly
responsible for the overgrowth of specialists. This
has resulted in the denigration of the role of a
basic doctor to just a ‘cough and cold’ doctor.
The training of doctors has also been influenced
by and is also partly responsible for this situation.
Hospital based' training by westernised and urban
oriented specialists produces a graduate
conditioned to urban and hospital practice.
Therefore even after prolonged expensive
training in a medical college, such a graduate is
still not capable dealing with the situation in
rural areas.
of our people, a wrong belief is promoted that
medical interventions - use of drugs, surgery, etc. ..
is primarily responsible in people’s health.
mfc realizes
»
»
@
mfc would work towards
•
»
a partem of medical and health care adequately
geared to the predominantly rural health
character of our country and
»
towards a medical cirriculam and training tailored
to the needs of the vast majority of the people
in our country.
lb further their narrow professional interests doctors
have established a monopoly control over medical
knowledge and medical practice. Medical knowledge
has been jargonised and a halo has been created
around it. This monopoly and mystification opens the
door for domination by medical professionals over
patients and by doctors over nurse and paramedics.
n^c stands for
•
believes that different categories of medical
professionals be regarded as equal members of
democratically functioning team.
Commercial interests demand a growing market for
drugs and medical therapies and this is partly
responsible medical practice being reduced to
curative services. It denigrates the primary role of
preventive and social measures. Drugs, surgery and
even vaccines have so far contributed only marginally
to the improvement in people’s health in different
countries. In spite of the primary role of
socio-economic development in improving the health
stress the primary role of preventive and social
measures to solve health problems on a social
level.
The government health sector is not commercial and
PHC doctors are supposed to emphasize preventive
medicine. But this sector has not changed the basic
pattern outlined above, the doctor working in a PHC
is inclined and trained to do mainly curative work
and generally reflects the typical attitude of the upper
classes, which is urban, elitist and professional.
Preventive and promotive measures when undertaken
are, therefore, reduced to pure technological and
administrative measures without any social content,
which are then thrust on the people.
mfc stands for
®
»
democratic decentralised team functioning and
»
for active participation by the community in the
planning and carrying out preventive and
promotive measures.
Medical practice in its existing form reflects and
reinforces some of the negative, unhealthy cultural
values and attitudes in our society, for example,
glorification of money and power, division of
labourers into manual and intellectual workers,
domination of men over women, urban over rural,
foreign ovdr Indian.
mfc works towards
»
popularisation and demystification of medical
science and
»
the importance of curative technology in saving a
person’s life, alleviating suffering or preventing
disability but
•
a kind of medical practice built upon human
values, concern for human needs, equality and
democratic functioning.
In the present medical system, non-allopathic
therapies are give a step-motherly treatment.
Allopathic doctors call non-allopaths quacks without
knowing anything about their system of medical care.
Equally unscientific are the claims of success made
by some non-allopaths and by some drug companies.
Prejudices, ignorance, and self-interest have prevailed
over open-minded scientificity in this important area
of medical care.
mfc believes that
»
research on these therapies should be encouraged
by allotting more funds and other resources, and
»
that these therapies be encouraged to take their
proper place in the modern system of medical
care.
mfc thus tries to foster among medicos a current
upholding human values and aims at restructuring the
medical profession to enable it to realize the potential
created by modern scientific medicine.
mfc offers a forum for dialogue / debate, sharing of
experiences with the aim of realizing the goal outlined
above and for taking up issues of common concern for
action.
ACTIVITIES
mfc members are spread all over India and they try
to propagate the perspective of mfc through their work.
Some members are engaged full-time in organising health
projects in rural areas and urban slums.
Bulletin
mfc is as of today mainly a thought-current and the
monthly (currently bimonthly) ‘medico friend circle
bulletin’ now in its seventeenth year of publication, is the
medium through which we communicate our ideas and
experiences. The bulletin publishes articles broadly
reflecting the mfc perspective on health problems.
Running the mfc bulletin is our chief common activity.
The bulletin is also read by a larger circle than its
members through a subscription system.
(TB and society); Jaipur (child survival); Udaipur (family
planning) and Always (medical technology).
Recently, the frequency has been decreased to allow
for indpeth discussion within the organisation on themes
of members interests.
Collective involvement
Study and action projects by local groups, regional
camps to understand a local health problem and its
broader dimensions and health educational campaigns are
other activities through which mfc has grown and
consolidated. Some examples are: a camp on lathyrism n
Rewa disctrict (MP), a campaign against
oestrogen-progestcrone forte; campaign about diarrhoea
and misuse of drugs; and a campaign with women’s groups
against introduction of long acting injectable
contraceptives, mfc is also an active member of All India
Drug Action Network.
Bhopal involvement : In response to requests from
groups working in Bhopal following the gas disaster, mfc
intervened as a group (i) to study the health problems of
the disaster victims; (ii) to support the efforts of voluntary
groups and the emerging people’s movement in an
attempt to get rational health care for the affected people.
An epidemiological study (Mar. ’85) followed by a
pregnancy outcome survey (Sept. 85) were two such
interventions, "technical support was given for health
activities of many voluntary agencies and action groups
working among the disaster victims.
Anthologies
ORGANISATION
Publication of anthologies of selected articles
published in the bulletin has been a milestone in the
development of mfc. The first anthology Tn Search of
Diagnosis’ was well received and rapidly sold out. KSSP
translated it into Malayalam (two editions). The second
anthology “Health Care: Which way to go” has also been
sold out. Reprints of the first and second anthologies are
now available. The third anthology ‘Under the Lens:
Health and Medicine’ has been printed and is available.
Another anthology ‘Medical Education: Re-examined’ has
just been published.
mfc is not a rigid organisation. It is a loosely knit
group of friends from various backgrounds, medical and
non-medical, often differing in their ways of thinking and
in their modes- of action. But the understanding that the
present health service and the system of medical
education are lopsided and in the interest of privileged
few is a common conviction.
Annual Meets
In the past, mfc members gathered once a year at the
all India annual met to explore a relevant topic through
discussion or to understand the functioning of a particular
health care project in terms of a chosen topic. Since 1974,
annual meets have been held at Ujjain (relevance of the
present health services)', Hosangabad (Indian nutritional
problem)-, Calicut (role of doctors in society)' Jamkhed
(Community health worker)' Thra (misuse of drugs by
doctors)-, Anand (prejudice against women in medical care);
CINI, Calcutta (alternative medical education); Bangalore
The looseness of the organisation has created certain
problems in its functioning. Without giving up its
essentially open character, a restructuring of the
organisation is underway since August 1990. The main
feature of the new structure is the formation of local,
regional and issue-based groups. There are two loval
groups, mfc-Bombay and mfc-Calcutta. Moreover a group
on Primary Health Care and one on Health Policy have
been formed to facilitate study of the various aspects of
these topics in greater detail. Two regional groups, one
in Gujarat and one in Maharashtra, have just been
initiated. The Executive Committee has assumed a more
active role in supporting the convenor in day to day
decision making.
By convention, the convenorship changes hands every
MEMBERSHIP
various drug interested groups from different parts of the
country to form the All India Drug Action Network
(AIDAN). The movement towards a rational drug policy
has been one of the rare examples of different groups
coming together on a health issue and preparing a
substantial critique of the National Policy in India and an
equally solid, concrete alternative to it. MFC members
have contributed to this movement by participating in
seminars, newspaper campaigns, lobbying with
government and to the formulation of the perspective of
AIDAN.
Anyone who boradly agrees with the perspective as
well as the rules and regulations of mfc is welcome to
become a member. Non-doctors are encouraged to join.
The membership fees are given below. It is understood
that members capable of contributing more than the
minimum, will do so. Conversely, the convenor can reduce
or waive the membership fees in deserving cases. For
membership forms and copy of the rules and regulations,
please write to the convenor :
A Rational Drug Policy Cell has been formed to look
after mfe’s involvement in this issue. TWo studies,
evaluating the rationality, of the top-selling
antidiarrhocals and analgesic formulations in the market
has been published by this cell. These studies have been
valuable in drug-campaign and have been reprinted by
KSSP. For further details write to Anant R.S.,
Coordinator, Rational Drug Policy Cell, 50 L1C Quarters,
University Road, Pune 411 016.
two years at the year ending March 31, every alternate
year, though some have had to carry the burden of
convenorship for more than two years.
mfc is registered under the Societies Registration Act
1860 (MAH/902/Pune/81) and under the Bombay Public
Trust Act, 1950 (Reg. No.F-1996, Pune). The mfc
registered office is at 50, LI C Quarters, University
Road, Pune 411 016. Donations to mfc are exempt from
the Income Tax under Section 80(G).
Manisha Gupte
11 Archana Apartments, 3rd Floor,
163 Sholapur Road,
Hadapsar, Pune 411 028.
•
Annual Membership Fees
Those earning less than Rs. 750/- p.m. Rs. 25/-
Those earning more than Rs. 750/- p.m. Rs. 50/Me'mbership fees does not include suscription to the
mfc bulletin.
•
Bulletin subscription
Within India
Annual
: ' Rs. 30/-
Life
:
Rs. 300/-
Institutions:
Rs. 500/-
Foreign countries: sea mail :
airmail
USS 4; for all countries.
Asia - USS 6; Europe,
Africa, North & South
America USS 11.
5.
Medical Relief and Research in Bhopal the realities
and recommendations. Price Rs. 2/- or USS 1/-.
I
*
I
1.
IN SEARCH OF DIAGNOSIS (analysis of present
system of health care). First anthology of bulletin articles.
Ed. Ashvin J.' Patel, first published December 1977,
Reprinted May 1985 Price Rs. 12.00 or US 5.00. Include
j
Health Service Evolution, Medical Education, National
Health Policy, Alternatives in Health Care, Population
J
Problem, Drug Industry, Nutritional problem in India,
Protein Gap myth, Tbnics and Community Health.
2.
HEALTH CARE WHICH WAY TO GO?
(Examination of issues and alternatives) Second
t
anthology of bulletin articles. Ed. Abhay Bang and Ashvin
!
Patef, first published October 1982, Reprinted May 1985.
Price Rs. 15.00 or US 6.00. Includes Drug Issues,
Lathyrism, Water Supply, Oral Rehydration Therapy’
Problems of Nurses, Community Health Workers, Dai
training, Government rural Health Scheme, Political
Dimensions of Health and mfc debate on which way to
go-
Rational Drug Policy Cell
Concretely criticizing irrationalities in the production
and use of drugs, and putting forward alternatives has
been one of the activities of mfc members. MFC has
therefore been an active part of the coming together of
4.
MEDICAL EDUCATION RE-EXAMINED : Has
been just published (Ed. Dhruv Mankad). Price Rs. 35/and US 10. Medical Education: Re-examined is an
anthology of articles form the medico friend circle bulletin
a)
6.
The Bhopal Disaster Aftermath : an
epidemiological and socio-medical survey.
Price: a) Complete report Rs. 8.00/,US$ 5.00. (b)
Summary Rs. 2/- US$1.00
6.b)
Distorted Lives: Women’s Reproductive Health
and Bhopal Disaster: October 1990
Price: Rs. 20.00 or USS 6.00
’
7.
Subject-wise Index of first LOO issues of mfc
bulletin. Price Rs. 2.50
8.
mfc publications
3.
HEALTH AND MEDICINE - UNDER THE LENS
: Third anthology of bulletin articles. Ed. Kamala J. Rao
and Ashvin Patel, October 1985. Price Rs. 19.00 or US
6.00. Includes Critical Examintion of Community Health,
People’s Participation, Health for All by 2000 Ad, Health
Education, Drug Misuse, Medical Research, BCG
vaccination, Supplementary Feeding Programmes, Drug
Policy and Therapeutics, Minimum Wages, Family
Planning and Kerala Model.
All payments may be made in the name of medico
friend circle and sent by money order/dcmand draft to the
convenor. (In case the payment is made by cheque, please
be sure to add Rs. 10/- to cover bank charges).
and papers presented at the conference on Alternative
Medical Curriculum held at Gonoshasthaya Kendra,
Bangladesh as well as at the X Annual Meet of the mfc
held at Calcutta. It looks closely at the training of doctors
in India and makes an effort to present a comprehensive
argument for a change in the orientation and content of
the existing medical curriculum, providing some pointers
to the direction of such a change.
Bulletin back issues
a)
i
Xerox copies of mfc bulletin back issues are
available with the Centre for Education and
Documentation, 3 Saleman Chambers, 4 Baltary
Street, Behind Regal Cinema, Bombay 400 039.
In order to cover costs and at the same time
provide subsidies to deserving groups graded
rate structure has been worked out and is
available from CED.
For mfc members the rate is
1.
Set of 100 issues - Rs. 240.00
2.
Sepcific issues
- Rs. 4.00 each
3.
Specific article
- 0.60 paise per page
b)
Back issues of some of the past bulletins are also
available with mfc office, (ask for separate list).
9.
Background Paper of Annual Meets are also
available: (ask for separate list).
Publications available from :
mfc office :
Manisha Gupta
11 Archana Apartments
3rd Floor, 163 Sholapur Road, Hadapsar,
Pune 411 028
All payments may be made in the name of medico
friend circle by MO/DD.
Items 1 to 3 are also available singly/bulk from the
Publication Section, Voluntary Health Association of India,
40 Institutional Area, South of IIT, New Delhi 110 016 and
item 4 is available from Centre for education and
documentation, 3 Saleman Chambers, 4 Baltary Street,
Behind Regal Cinema, Bombay 400 039.
medico friend circle
PERSPECTIVE
The medico friend circle (mfc) is a group of socially
conscious individuals interested in the health problems
of our people, mfc is trying to critically analyse the existing
health care system which is highly medicdlized and to evo. '
an appropriate approach towards developing a system of
health care which is humane and which can meet the needs
of the vast majority of the population in our country, mfc
is trying to build a nation-wide current committed to this
philosophy.
The existing system of health care, we have realized,
is not geared towards the needs of the majority of the
people, the poor. It require a fundamental change. Such
a change would occur as a part of the total social, system
in the country, since medical system is only a part of the
total social system, mfc believes that the potential created
by modern medical science cannot be realized fully
without a fundamental change in the social system.
What is wrong with the existing health care
system in India?
Though after independence there has been a rapid
growth in medical services organised by the government,
private practice remains the dominant feature of mec“~y
care in India. In private practice, medical care like any
other commodity in the market is available only to those
who have money to pay. The medical profession now
resembles any other commercial sector and, therefore, has
become dominated by concern for money rather than for
people. Commercial competition and personal interests
of doctors lead to numerous malpractices.
This behaviour is encouraged and promoted by profit
oriented drug companies which dump many useless or
even harmful drugs onto the consumer by co-opting
doctors through their sales promotion techniques.
mfc upholds the interests of the people and
»
wants medical and health care to be available to
everyone irrespective of his/her ability to pay.
»
»
A
wants to develop methods of medical
intervention and health care systems strictly
guided by the needs of our people and not by
commercial interests.
Since purchasing power is mainly concentrated
in the urban areas, commercial medical
practitioners are also concentrated in cities and
towns. This overcrowding of doctors is partly
responsible for the overgrowth of specialists. This
has resulted in the denigration of the role of a
basic doctor to just a ‘cough and cold’ doctor.
The training of doctors has also been influenced
by and is also partly responsible for this situation.
Hospital based’training by westernised and urban
oriented specialists produces a graduate
conditioned to urban and hospital practice.
Therefore even after prolonged expensive
training in a medical college, such a graduate is
still not capable dealing with the situation in
rural areas.
of our people, a wrong belief is promoted that
medical interventions - use of drugs, surgery, etc. ..
is primarily responsible in people’s health.
mfc realizes
»
»
o
mfc would work towards
•
»
a pattern of medical and health care adequately
geared to the predominantly rural health
character of our country and
»
towards a medical cirriculam and training tailored
to the needs of the vast majority of the people
in our country.
lb further their narrow professional interests doctors
have established a monopoly control over medical
knowledge and medical practice. Medical knowledge
has been jargonised and a halo has been created
around it. This monopoly and mystification opens the
door for domination by medical professionals over
patients and by doctors over nurse and paramedics.
Qp stands for
•
believes that different categories of medical
professionals be regarded as equal members of
democratically functioning team.
Commercial interests demand a growing market for
drugs and medical therapies and this is partly
responsible medical practice being reduced to
curative services. It denigrates the primary role of
preventive and social measures. Drugs, surgery and
even vaccines have so far contributed only marginally
to the improvement in people’s health in different
countries. In spite of the primary role of
socio-economic development in improving the health
stress the primary role of preventive and social
measures to solve health problems on a social
level.
The government health sector is not commercial and
PHC doctors are supposed to emphasize preventive
medicine. But this sector has not changed the basic
pattern outlined above, the doctor working in a PHC
is inclined and trained to do mainly curative work
and generally reflects the typical attitude of the upper
classes, which is urban, elitist and professional.
Preventive and promotive measures when undertaken
are, therefore, reduced to pure technological and
administrative measures without any social content,
which are then thrust on the people.
mfc stands for
0
»
democratic decentralised team functioning and
»
for active participation by the community in the
planning and carrying out preventive and
promotive measures.
Medical practice in its existing form reflects and
reinforces some of the negative, unhealthy cultural
values and attitudes in our society, for example,
glorification of money and power, division of
labourers into manual and intellectual workers,
domination of men over women, urban over rural,
foreign ovdr Indian.
mfc works towards
»
» popularisation and demystification of medical
science and
»
the importance of curative technology in saving a
person’s life, alleviating suffering or preventing
disability but
•
a kind of medical practice built upon human
values, concern for human needs, equality and
democratic functioning.
In the present medical, system, non-allopathic
therapies are give a step-motherly treatment.
Allopathic doctors call non-allopaths quacks without
knowing anything about their system of medical care.
Equally unscientific are the claims of success made
by some non-allopaths and by some drug companies.
Prejudices, ignorance, and self-interest have prevailed
over open-minded scientificity in this important area
of medical care.
mfc believes that
»
research on these therapies should be encouraged
by allotting more funds and other resources, and
»
that these therapies be encouraged to take their
proper place in the modern system of medical
care.
mfc thus tries to foster among medicos a current
upholding human values and aims at restructuring the
medical profession to enable it to realize the potential
created by modern scientific medicine.
mfc offers a forum, for dialogue / debate, sharing of
experiences with the aim of realizing the goal outlined
above and for taking up issues of common concern for
action.
ACTIVITIES
mfc members are spread all over India and they try
to propagate the perspective of mfc through their work.
Some members are engaged full-time in organising health
projects in rural areas and urban slums.
Bulletin
mfc is as of today mainly a thought-current and the
monthly (currently bimonthly) ‘medico friend circle
bulletin’ now in its seventeenth year of publication, is the
medium through which we communicate our ideas and
experiences. The bulletin publishes articles broadly
reflecting the mfc perspective on health problems.
Running the mfc bulletin is our chief common activity.
The bulletin is also read by a larger circle than its
members through a subscription system.
(TB and society); Jaipur (child survival); Udaipur (family
planning) and Always (medical technology).
Recently, the frequency has been decreased to allow
for indpeth discussion within the organisation on themes
of members interests.
Collective involvement
Study and action projects by local groups, regional
camps to understand a local health problem and its
broader dimensions and health educational campaigns arc
other activities through which mfc has grown and
consolidated. Some examples are: a camp on lathyrism n
Rewa disctrict (MP), a campaign against
oestrogen-progesterone forte; campaign about diarrhoea
and misuse of drugs; and a campaign with women’s groups
against introduction of long acting injectable
contraceptives, mfc is also an active member of All India
Drug Action Network.
Bhopal involvement : In response to requests from
groups working in Bhopal following the gas disaster, mfc
intervened as a group (i) to study the health problems of
the disaster victims; (ii) to support the efforts of voluntary
groups and the emerging people’s movement in an
attempt to get rational health care for the affected people.
An epidemiological study (Mar. ’85) followed by a
pregnancy outcome survey (Sept. 85) were two such
interventions. Technical support was given for health
activities of many voluntary agencies and action groups
working among the disaster victims.
Anthologies
ORGANISATION
Publication of anthologies of selected articles
published in the bulletin has been a milestone in the
development of mfc. The first anthology Tn Search of
Diagnosis’ was well received and rapidly sold out. KSSP
translated it into Malayalam (two editions). The second
anthology “Health Care: Which way to go” has also been
sold out. Reprints of the first and second anthologies are
now available. The third anthology ‘Under the Lens:
Health and Medicine’ has been printed and is available.
Another anthology ‘Medical Education: Re-examined’ has
just been published.
mfc is not a rigid organisation. It is a loosely knit
group of friends from various backgrounds, medical and
non-medical, often differing in their ways of thinking and
in their modes of action. But the understanding that the
present health service and the system of medical
education are lopsided and in the interest of privileged
few is a common conviction.
Annual Meets
In the past, mfc members gathered once a year at the
all India annual met to explore a relevant topic through
discussion or to understand the functioning of a particular
health care project in terms of a chosen topic. Since 1974,
annual meets have been held at Ujjain (relevance of the
present health services); Hosangabad (Indian nutritional
problem)-, Calicut (role of doctors in society); Jamkhed
(Community health worker); Thra (misuse of drugs by
doctors); Anand (prejudice against women in medical care) ;
CINI, Calcutta (alternative medical education); Bangalore
The looseness of the organisation has created certain
problems in its functioning. Without giving up its
essentially open character, a restructuring of the
organisation is underway since August 1990. The main
feature of the new structure is the formation of local,
regional and issue-based groups. There are two loval
groups, mfc-Bombay and mfc-Calcutta. Moreover a group
on Primary Health Care and one on Health Policy have
been formed to facilitate study of the various aspects of
these topics in greater detail. Two regional groups, one
in Gujarat and one in Maharashtra, have just been
initiated. The Executive Committee has assumed a more
active role in supporting the convenor in day to day
decision making.
By convention, the convenorship changes hands every
various drug interested groups from different parts of the
country to form the All India Drug Action Network
(AIDAN). The movement towards a rational drug policy
has been one of the rare examples of different groups
coming together on a health issue and preparing a
substantial critique of the National Policy in India and an
equally solid, concrete alternative to it. MFC members
have contributed to this movement by participating in
seminars, newspaper campaigns, lobbying with
government and to the formulation of the perspective of
two years at the year ending March 31, every alternate
year, though some have had to carry the burden of
convenorship for more than two years.
mfc is registered under the Societies Registration Act
1860 (MAH/902/Pune/81) and under the Bombay Public
Trust Act, 1950 (Reg. No.F-1996, Pune). The mfc
registered office is at 50, L I C Quarters, University
Road, Pune 411 016. Donations to mfc are exempt from
the Income Tax under Section 80(G).
MEMBERSHIP
AIDAN.
A Rational Drug Policy Cell has been formed to look
after mfe’s involvement in this issue. TWo studies,
evaluating the rationality of the top-selling
antidiarrhoeals and analgesic formulations in the market
has been published by this cell. These studies have been
valuable in drug-campaign and have been reprinted by
KSSP. For further details write to Anant R.S.,
Coordinator, Rational Drug Policy Cell, 50 LIC Quarters,
University Road, Pune 411 016.
Anyone who boradly agrees with the perspective as
well as the rules and regulations of mfc is welcome to
become a member. Non-doctors are encouraged to join.
The membership fees are given below. It is understood
that members capable of contributing more than the
minimum, will do so. Conversely, the convenor can reduce
or waive the membership fees in deserving cases. For
membership forms and copy of the rules and regulations,
please write to the convenor :
Dr. Vijay Jani,
Convenor, mfc,
34, Kailash Park Society
Near Water Tank, Akota,
Vadodara - 390 020.
•
Annual Membership Fees
Those earning less than Rs. 750/- p.m. Rs. 25/Those earning more than Rs. 750/- p.m. Rs. 50/-
Membership fees does not include suscription to the
mfc bulletin.
•
Within India
Annual
Rs. 30/-
Life
Rs. 300/-
Institutions
Rs. 500/-
Foreign countries: sea mail
airmail
USS 4; for all countries.
Asia - USS 6; Europe,
Africa, North & South
America USS 11.
The Bhopal Disaster Aftermath : an
epidemiological and socio-medical survey.
Price: a) Complete report Rs. 8.00/USS 5.00. (b)
Summary Rs. 21- US$1.00
6.b)
Distorted Lives: Women’s Reproductive Health
and Bhopal Disaster: October 1990
Price: Rs. 20.00 or USS 6.00
7.
Subject-wise Index of first 100 issues of mfc
bulletin. Price Rs. 2.50
8.
Bulletin back issues
a)
Xerox copies of mfc bulletin back issues are
available with the Centre for Education and
Documentation, 3 Saleman Chambers, 4 Baltary
Street, Behind Regal Cinema, Bombay 400 039.
In order to cover costs and at the same time
provide subsidies to deserving groups graded
rate structure has been worked out and is
available from CED.
Rational Drug Policy Cell
Concretely criticizing irrationalities in the production
and use of drugs, and putting forward alternatives has
been one of the activities of mfc members. MFC has
therefore been an active part of the coming together of
4.
MEDICAL EDUCATION RE-EXAMINED • Has
and”Us' PiUnllMed. (E,d cDhrUV Mankad)- Pr>ce Rs. 35/US 10. Medical Education: Re-examined is an
anthology of articles form the medico friend circle bulletin
|
a)
6,
1.
IN SEARCH OF DIAGNOSIS (analysis of present
system of health care). First anthology of bulletin articles.
Ed. Ashvin J.' Patel, first published December 1977,
Reprinted May 1985 Price Rs. 12.00 or US 5.00. Include
Health Service Evolution, Medical Education, National
Health Policy, Alternatives in Health Care, Population
Problem, Drug Industry, Nutritional problem in India,
Protein Gap myth, Tbnics and Community Health.
3.
HEALTH AND MEDICINE - UNDER THE LENS
: Third anthology of bulletin articles. Ed. Kamala J Rao
and Ashvin Patel, October 1985. Price Rs. 19.00 or US
6.00. Includes Cnucal Examintion of Community Health
People s Participation, Health for All by 2000 Ad, Health
Education, Drug Misuse, Medical Research BCG
pXv’Th Supplementary Ceding Programmes, Drug
Policy and Therapeutics, Minimum Wages, Familv
Planning and Kerala Model.
family
All payments may be made in the name of medico
friend circle and sent by money order/demand draft to the
convenor. (In case the payment is made by cheque, please
be sure to add Rs. 10/- to cover bank charges).
5.
Medical Relief and Research in Bhopal the realities
and recommendations. Price Rs. 2/- or USS 1/-.
mfc publications
2.
HEALTH CARE WHICH WAY TO GO?
(Examination of issues and alternatives) Second
anthology of bulletin articles. Ed. Abhay Bang and Ashvin
Patef, first published October 1982, Reprinted May 1985.
Price Rs. 15.00 or US 6.00. Includes Drug Issues,
Lathyrism, Water Supply, Oral Rehydration Therapy,
Problems of Nurses, Community Health Workers, Dai
training, Government rural Health Scheme, Political
Dimensions of Health and mfc debate on which wav to
go.
’
Bulletin subscription
and papers presented at the conference'on Alternative
Medical Curriculum held at’Gonoshasthaya Kendra,
Bangladesh as well as at the X Annual Meet of the mfc
held at Calcutta. It looks closely at the training of doctors
in India and makes an effort to present a comprehensive
argument for a change in the orientation and content of
the existing medical curriculum, providing some pointers
to the direction of such a change.
For mfc members the rate is
1.
Set of 100 issues - Rs. 240.00
2.
Sepcific issues
- Rs. 4.00 each
3.
Specific article
- 0.60 paise per page
b)
Back issues of some of the past bulletins are also
available with mfc office, (ask for separate list).
9 Background Paper of Annual Meets are also
available: (ask for separate list).
Publications available from :
mfc office :
Dr. Vijay Jani
Convenor, mfc..
34. Kailash Park Society,
Near Water Tank, Akota,
Vadodara - 390 020
All payments may be made in the name of medico
friend circle by MO/DD.
Items 1 to 3 are also available singly/bulk from the
Publication Section, Voluntary Health Association of India,
40 Institutional Area, South of IIT, New Delhi 110 016 and
item 4 is available from Centre for education and
documentation, 3 Saleman Chambers, 4 Baltary Street,
Behind Regal Cinema, Bombay 400 039.
medico friend circle
PERSPECTIVE
The medico friend circle (mfc) is a group of socially
conscious individuals interested in the health problems
of our people, mfc is trying to critically analyse the exif*"g
health care system which is highly medicalized and to ev&ve
an appropriate approach towards developing a system of
health care which is humane and which can meet the needs
of the vast majority of the population in our country, mfc
is trying to build a nation-wide current committed to this
philosophy.
The existing system of health care, we have realized,
is not geared towards the needs of the majority of the
people, the poor. It require a fundamental change. Such
a change would occur as a part of the total social, system
in the country, since medical system is only a part of the
total social system, mfc believes that the potential created
by modern medical science cannot be realized fully
without a fundamental change in the social system.
What is wrong with the existing health care
system in India?
Though after independence there has been a rapid
growth in medical services organised by the governpjfs.1,
private practice remains the dominant feature of mc<_ "al
care in India. In private practice, medical care like any
other commodity in the market is available only to those
who have money to pay. The medical profession now
resembles any other commercial sector and, therefore, has
become dominated by concern for money rather than for
people. Commercial competition and personal interests
of doctors lead to numerous malpractices.
This behaviour is encouraged and promoted by profit
oriented drug companies which dump many useless or
even harmful drugs onto the consumer by co-opting
doctors through their sales promotion techniques.
mfc upholds the interests of the people and
»
wants medical and health care to be available to
everyone irrespective of his/her ability to pay.
»
»
9
wants to develop methods of medical
intervention and health care systems strictly
guided by the needs of our people and not by
commercial interests.
Since purchasing power is mainly concentrated
in the urban areas, commercial medical
practitioners are also concentrated in cities and
towns. This overcrowding of doctors is partly
responsible for the overgrowth of specialists. This
has resulted in the denigration of the role of a
basic doctor to just a ‘cough and cold’ doctor.
The training of doctors has also been influenced
by and is also partly responsible for this situation.
Hospital based’ training by westernised and urban
oriented specialists produces a graduate
conditioned to urban and hospital practice.
Therefore even after prolonged expensive
training in a medical college, such a graduate is
still not capable dealing with the situation in
rural areas.
of our people, a wrong belief is promoted that
medical interventions - use of drugs, surgery, etc. ..
is primarily responsible in people’s health.
mfc realizes
•
mfc would work towards
•
»
a pattern of medical and health care adequately
geared to the predominantly rural health
character of our country and
»
towards a medical cirriculam and training tailored
to the needs of the vast majority of the people
in our country.
the importance of curative technology in saving a
person’s life, alleviating suffering or preventing
disability but
»
stress the primary role of preventive and social
measures to solve health problems on a social
level.
The government health sector is not commercial and
PHC doctors are supposed to emphasize preventive
medicine. But this sector has not changed the. basic
pattern outlined above, the doctor working in a PHC
is inclined and trained to do mainly curative work
and generally reflects the typical attitude of the upper
classes, which is urban, elitist and professional.
Preventive and promolive measures when undertaken
are, therefore, reduced to pure technological and
administrative measures without any social content,
which are then thrust on the people.
mfc stands for
»
democratic decentralised team functioning and
»
for active participation by the community in the
planning and carrying out preventive and
promotive measures.
Medical practice in its existing form reflects and
reinforces some of the negative, unhealthy cultural
values and attitudes in our society, for example,
glorification of money and power, division of
labourers into manual and intellectual workers,
domination of men over women, urban over rural,
foreign ovdr Indian.
lb further their narrow professional interests doctors
have established a monopoly control over medical
knowledge and medical practice. Medical knowledge
has been jargonised and a halo has been created
around it. This monopoly and mystification opens the
door for domination by medical professionals over
patients and by doctors over nurse and paramedics.
•
stands for
mfc works towards
»
» popularisation and demystification of medical
science and
»
•
»
believes that different categories of medical
professionals be regarded as equal members of
democratically functioning team.
Commercial interests demand a growing market for
drugs and medical therapies and this is partly
responsible medical practice being reduced to
curative services. It denigrates the primary role of
preventive and social measures. Drugs, surgery and
even vaccines have so far contributed only marginally
to the improvement in people’s health in different
countries. In spite of the primary role of
socio-economic development in improving the health
•
a kind of medical practice built upon human
values, concern for human needs, equality and
democratic functioning.
In the present medical system, non-allopathic
therapies are give a step-motherly treatment.
Allopathic doctors call non-allopaths quacks without
knowing anything about their system of medical care.
Equally unscientific are the claims of success made
by some non-allopaths and by some drug companies.
Prejudices, ignorance, and self-interest have prevailed
over open-minded scientificity in this important area
of medical care.
mfc believes that
»
research on these therapies should be encouraged
by allotting more funds and other resources, and
»
that these therapies be encouraged to take their
proper place in the modern system of medical
care.
mfc thus tries to foster among medicos a current
upholding human values and aims at restructuring the
medical profession to enable it to realize the potential
created by modern scientific medicine.
mfc offers a forum for dialogue I debate, sharing of
experiences with the aim of realizing the goal outlined
above and for taking up issues of common concern for
action.
ACTIVITIES
mfc members are spread all over India and they try
to propagate the perspective of mfc through their work.
Some members are engaged full-time in organising health
projects in rural areas and urban slums.
Bulletin
mfc is as of today mainly a thought-current and the
monthly (currently bimonthly) ‘medico friend circle
bulletin’ now in its seventeenth year of publication, is the
medium through which we communicate our ideas and
experiences. The bulletin publishes articles broadly
reflecting the mfc perspective on health problems.
Running the mfc bulletin is our chief common activity.
The bulletin is also read by a larger circle than its
members through a subscription system.
(TB and society); Jaipur (child survival); Udaipur (family
planning) and Always (medical technology).
Recently, the frequency has been decreased to allow
for indpeth discussion within the organisation on themes
of members interests.
Collective involvement
Study and action projects by local groups, regional
camps to understand a local health problem and us
broader dimensions and health educational campaigns are
other activities through which mfc has grown and
consolidated. Some examples are: a camp on lathyrism n
Rewa disctrict (MP), a campaign against
oestrogen-progesterone forte; campaign about diarrhoea
and misuse of drugs; and a campaign with women’s groups
against introduction of long acting injectable
contraceptives, mfc is also an active member of All India
Drug Action Network.
Bhopal involvement : In response to requests from
groups working in Bhopal following the gas disaster, mfc
intervened as a group (i) to study the health problems of
the disaster victims; (ii) to support the efforts of voluntary
groups and the emerging people’s movement in an
attempt to get rational health care for the affected people.
An epidemiological study (Mar. ’85) followed by a
pregnancy outcome survey (Sept. 85) were two such
interventions. Tbchnical support was given for health
activities of many voluntary agencies and action groups
working among the disaster victims.
Anthologies
ORGANISATION
Publication of anthologies of selected articles
published in the bulletin has been a milestone in the
development of mfc. The first anthology ‘In Search of
Diagnosis’ was well received and rapidly sold out. KSSP
translated it into Malayalam (two editions). The second
anthology “Health Care: Which way to go” has also been
sold out. Reprints of the first and second anthologies are
now available. The third anthology ‘Under the Lens:
Health and Medicine’ has been printed and is available.
Another anthology ‘Medical Education: Re-examined’ has
just been published.
mfc is not a rigid organisation. It is a loosely knit
group of friends from various backgrounds, medical and
non-medical, often differing in their ways of thinking and
in their modes of action. But the understanding that (he
present health service and the system of medical
education are lopsided and in the interest of privileged
few is a common conviction.
Annual Meets
In the past, mfc members gathered once a year at the
all India annual met to explore a relevant topic through
discussion or to understand the functioning of a particular
health care project in terms of a chosen topic. Since 1974,
annual meets have been held at Ujjain (relevance of the
present health services); Hosangabad (Indian nutritional
problem); Calicut (role of doctors in society); Jamkhed
(Community health worker); Thra (misuse of drugs by
doctors); Anand (prejudice against women in medical care);
CINI, Calcutta (alternative medical education); Bangalore
The looseness of the organisation has created certain
problems in its functioning. Without giving up its
essentially open character, a restructuring of the
organisation is underway since August 1990. The main
feature of the new structure is the formation of local,
regional and issue-based groups. There are two loval
groups, mfc-Bombay and mfc-Calcutta. Moreover a group
on Primary Health Care and one on Health Policy have
been formed to facilitate study of the various aspects of
these topics in greater detail. Two regional groups, one
in Gujarat and one in Maharashtra, have just been
initiated. The Executive Committee has assumed a more
active role in supporting the convenor in day to day
decision making.
By convention, the convenorship changes hands every
MEMBERSHIP
various drug interested groups from different parts of the
country to form the All India Drug Action Network
(AIDAN). The movement towards a rational drug policy
has been one of the rare examples of different groups
coming together on a health issue and preparing a
substantial critique of the National Policy in India and an
equally solid, concrete alternative to it. MFC members
have contributed to this movement by participating in
seminars, newspaper campaigns, lobbying with
government and to the formulation of the perspective of
AIDAN.
Anyone who boradly agrees with the perspective as
well as the rules and regulations of mfc is welcome to
become a member. Non-doctors are encouraged to join.
The membership fees are given below. It is understood
that members capable of contributing more than the
minimum, will do so. Conversely, the convenor can reduce
or waive the membership fees in deserving cases. For
membership forms and copy of the rules and regulations,
please write to the convenor :
A Rational Drug Policy Cell has been formed to look
after mfe’s involvement in this issue. T.vo studies,
evaluating the rationality of the top-selling
antidiarrhoeals and analgesic formulations in the market
has been published by this cell. These studies have been
valuable in drug-campaign and have been reprinted by
KSSP. For further details write to Anant R.S.,
Coordinator, Rational Drug Policy Cell, 50 LIC Quarters,
University Road, Pune 411 016.
two years at the year ending March 31, every alternate
year, though some have had to carry the burden of
convenorship for more than two years.
mfc is registered under the Societies Registration Act
1860 (MAH/902/Pune/81) and under the Bombay Public
Trust Act, 1950 (Reg. No.F-1996, Pune). The mfc
registered office is at 50, L I C Quarters, University
Road, Pune 411 016. Donations to mfc are exempt from
the Income Tax under Section 80(G).
Manisha Gupte
11 Archana Apartments, 3rd Floor,
163 Sholapur Road,
Hadapsar, Pune 411 028.
•
Annual Membership Fees
Those earning less than Rs. 750/- p.m. Rs. 25/Those earning more than Rs. 750/- p.m. Rs. 50/-
Membership fees does not include suscription to the
mfc bulletin.
:' Rs. 30/-
Life
:
Rs. 300/-
Institutions:
Rs. 500/-
Foreign countries: sea mail :
USS 4; for ail countries.
:
Asia - USS 6; Europe,
Africa, North & South
America USS 11.
airmail
All payments may be made in the name of medico
friend circle and sent by money order/demand draft to the
convenor. (In case the payment is made by cheque, please
be sure to add Rs. 10/- to cover bank charges).
6.b)
Distorted Lives: Women’s Reproductive Health
and Bhopal Disaster: October 1990
Price: Rs. 20.00 or USS 6.00
7.
Subject-wise Index of first 100 issues of mfc
bulletin. Price Rs. 2.50
a)
4.
MEDICAL EDUCATION RE-EXAMINED : Has
been just published (Ed. Dhruv Mankad). Price Rs. 35/.
and US 10. Medical Education: Re-examined is an
anthology of articles form the medico friend circle bulletin
Annual
The Bhopal Disaster Aftermath : an
epidemiological and socio-medical survey.
Price: a) Complete report Rs. 8.00IUSS 5.00. (b)
Summary Rs. 2!- US$1.00
8.
Concretely criticizing irrationalities in the production
and use of drugs, and putting forward alternatives has
been one of the activities of mfc members. MFC has
therefore been an active part of the coming together of
Within India
a)
6.
1.
IN SEARCH OF DIAGNOSIS (analysis of present
system of health care). First anthology of bulletin articles.
Ed. Ashvin J.' Patel, first published December 1977,
Reprinted May 1985 Price Rs. 12.00 or US 5.00. Include
Health Service Evolution, Medical Education, National
Health Polity, Alternatives in Health Care, Population
Problem, Drug Industry, Nutritional problem in India,
Protein Gap myth, Tbnics and Community Health.
Rational Drug Policy Cell
Bulletin subscription
5.
Medical Relief and Research in Bhopal the realities
and recommendations. Price Rs. 2/- or USS 1/-.
mfc publications
2.
HEALTH CARE WHICH WAY TO GO?
(Examination of issues and alternatives) Second
anthology of bulletin articles. Ed. Abhay Bang and Ashvin
Patef, first published October 1982, Reprinted May 1985.
Price Rs. 15.00 or US 6.00. Includes Drug Issues,
Lathyrism, Water Supply, Oral Rehydration Therapy^
Problems of Nurses, Community Health Workers, Dai
training, Government rural Health Scheme, Political
Dimensions of Health and mfc debate on which way to
go3.
HEALTH AND MEDICINE - UNDER THE LENS
: Third anthology of bulletin articles. Ed. Kamala J. Rao
and Ashvin Patel, October 1985. Price Rs. 19.00 or US
6.00. Includes Critical Examintion of Community Health,
People’s Participation, Health for All by 2000 Ad, Health
Education, Drug Misuse, Medical Research, BCG
vaccination, Supplementary Feeding Programmes, Drug
Policy and Therapeutics, Minimum Wages, Family
Planning and Kerala Model.
•
and papers presented at the conference on Alternative
Medical Curriculum held at Gonoshasthaya Kendra,
Bangladesh as well as at the X Annual Meet of the mfc
held at Calcutta. It looks closely at the training of doctors
in India and makes an effort to present a comprehensive
argument for a change in the orientation and content of
the existing medical curriculum, providing some pointers
to the direction of such a change.
Bulletin back issues
Xerox copies of mfc bulletin back issues are
available with the Centre for Education and
Documentation, 3 Saleman Chambers, 4 Baltary
Street, Behind Regal Cinema, Bombay 400 039.
In order to cover costs and at the same time
provide subsidies to deserving groups graded
rate structure has been worked out and is
available from CED.
For mfc members the rate is
1.
Set of 100 issues - Rs. 240.00
2.
Sepcific issues
- Rs. 4.00 each
3.
Specific article
- 0.60 paise per page
b)
Back issues of some of the past bulletins are also
available with mfc office, (ask for separate list).
9.
Background Paper of Annual Meets are also
available: (ask for separate list).
Publications available from :
mfc office :
Manisha Gupta
11 Archana Apartments
3rd Floor, 163 Sholapur Road, Hadapsar,
Pune 411 028
All payments may be made in the name of medico
friend circle by MO/DD.
Items 1 to 3 are also available singly/bulk from the
Publication Section, Voluntary Health Association of India,
40 Institutional Area, South of 11T, New Delhi 110 016 and
item 4 is available from Centre for education and
documentation, 3 Saleman Chambers, 4 Baltary Street,
Behind Regal Cinema, Bombay 400 039.
medico friend circle
I PERSPECTIVE h
. The medico friend circle (mfc) is a nation-wide group
of socially conscious individuals interested in the Ik 1th
problems of our people. For more than 20 years, mfc has
critically analysed the existing health care system and has
tried to evolve an appropriate approach towards health
care which is humane and which can meet the needs of
the vast majority of the people in our country.
,, The existing sy stem of health care, we have realized,
is not geared towards the needs of the majority of the
people, the poor. It requires a fundamental change. This
would occur as a part of the total social transformation in
the country, since the medical systeih is only a part of the
total system.
To achieve this goal, measures however small have to
begin here and today, mfc is trying to build a nation-wide
current committed to this philosophy. Briefly outlined here
is mfc’s position on the existing health-care system in
India:
O
• AFTER independence there has been a rapid growth
in medical services organised by the government. Yet
private practice remains the dominant feature of medical
care in India. Private medical care is widely available in
India. Ho wever.like any other commodity in the market it
is accessible only to those who have the money to pay.
The medical profession now resembles any other
commercial sector and therefore, has become dominated
by concern for profits rather than for people. Commercial
competition and personal interests of doctors lead to
numerous malpractices.
This behaviour is encouraged and promoted by profit
oriented drug companies which dump many useless or
even harmful drugs on to the consumer by co-opting
doctors through their sales promotion techniques. All the
above tendencies will be exacerbated with further
privatisation of medical services and medical education.
w the establishment of an appropriate health-care system
in which different categories of health professionals
are regarded as equal members of a democratically
functioning team
Let us uphold the interest of the people and
• COMMERCIAL interests demand a growing market
for drugs and medical therapies and this is partly
responsible for medical practice being reduced to curative
services. This denigrates the primary role of preventive
and social measures. Drugs, surgery and even vaccines
have so far contributed only marginally to the
improvement in people’s health in different countries. In
spite of the primary role of socio-economic development
in improving the health of our people, a wrong belief is
promoted that medical interventions — use of.drugs,
surgery, etc. is primarily responsible for maintaining
people’s health.
ss demand that medical and health care be available to
everyone irrespective of her/his ability to pay.
:s» demand that medical intervention and health care
strictly guided by the needs of our people and not by
commercial: -erests.
® SINCE purchasing power is mainly concentrated
in the urban areas, commercial medical practitioners are
also concentrated in cities and towns. This overcrowding
of doctors is partly responsible for the overgrowth of
specialists. This has resulted in the denigration of the role
of basic doctor to just a ‘cough and cold’ doctor.
Tire training of doctors has also been influenced by
and is also partly responsible for this situation. Hospital
based training by westernised and urban oriented
specialists produces a graduate conditioned to urban and
hospital practice. Therefore even after prolonged
expensive training in a medical college, such a graduate
is still not capable dealing with the situation in rural areas.
Let us work towards
ss a pattern ofmedical and health care adequately geared
to the predominantly rural health concerns of our
' country and
sst a medical curriculum and training tailored to the needs
■ of the vast majority of the people in our country.
* THOUGH there has been an explosion in medical
knowledge on the one hand, a number of innovative field
experiments have shown that many common health
problems in India can be taken care of by community based
health workers if they receive limited yet good quality
training. A system of health-care based on such health
workers and supported by referral services of doctors is
more appropriate, more so for a developing country like
India.This would also demystify medical knowledge. In
India however, health-care remains doctor-based and
doctor-dominated.
Let us
give due importance to curative technology in saving
a person’s life, alleviating suffering or preventing
disability, and'also
«s stress the primary role of preventive and social
measures to solve health problems on a social level.
• THE government health sector is not commercial
and PHC doctors are supposed to emphasise preventive
medicine. But this sector has not changed the basic pattern
outlined above. The doctor working in a PHC is inclined
and trained to do mainly curative work. Preventive and
promotive measures when undertaken, are therefore
reduced to pure technological and administrative measures
without any social content, and are then thrust on the
people.
A large part of the resources of the PHC are spent on
family planning programmes (read population control)
which target women and push invasive female
contraceptive in a hazardous manner. Women are seen
only as child-bearers and health-programmes for women
are geared only towards maternity and' contraception. It
is no wonder that people 1 ook upon PHCs mainly as centres
for immunization or fammily planning. For their ailments,
most people approach the private sector, whatever its
quality and price.
Let us work towards
Let us Lobby
sa popularisation and demystification of medical science
and;
m for a sensitive and comprehensive public health system
which caters to all health-needs of the people, and;
sa for active participation by the community in the
planning and carrying out preventive and promotive
measures.
©■ MEDICAL practice in its existing form reflects and
reinforces some of the negative, unhealthy cultural values
and attitudes in our society, for example,, glorification of
money and power, division of health-workers into
intellectuals and manual workers, domination of men over
women, of urban over rural, and of foreign over Indian.
Let us build
ss health-care services based upon human values, concern
for human needs, equality and democratic functioning.
® IN the present medical system, non-allopathic
therapies are given an inferior treatment. Allopathic
doctors call non-allopaths ‘quacks’, without knowing
anything about their system of medical care. Equally
unscientific are the claims of success made by some non
allopaths and by some drug companies. Prejudice,
ignorance, and self-interest have prevailed over openminded scientiflcity in this important area of medical care.
Let us insist that •
sa research on non-allopathic therapies be encouraged
by alloting more funds and other resources, and;
ss that such therapies get their proper place in our health
care.
mfc thus tries the foster among health workers a
current that upholds human values and aims at
restructuring the health care system.
mfc offers a forum for dialogue / debate and sharing
of experiences with the aim of realizing the goal
outlined above and for taking up issues of common
concern for action.
| ACTIVITIES
As individuals, mfc members are spread out and
involved at their local levels in various capacities. Quite
a few of us are part of rural or urban projects, or initiatives
concerned with community health and development. Some
of us are in part-tifne or full-time private medical practice.
Others among us are teaching or studying in medical
colleges , some are serving in government hospitals or
primary health centres, and some are involved in
disciplines like health economics or administration and
in health worker training.
The mfc bulletin (now in its twentieth year of
publication), is the main medium through which we
.communicate experiences, ideas and information and stay
in touch with each other. It carries articles which usually
represent varying points of view of our membership within
the broad ‘mfc perspective’. There are reports on relevant
events and developments relating to health and health care.
Importance is given to letters from members, either
spontaneous or in response to articles.
Publication of bulletin article anthologies has been
done periodically (for details please see ‘mfc
publications’). They have been very well received.
We meet at the mfc Annual Meet, usually in lanuary.
We nearly always focus upon a particular theme or issue.
Examples are « relevance of the
health services
« role of doctors in society
s. doctor’s misuse of drugs
® alternative medical
education
ss child survival
« medical teclmology
»under-nutrition
A
® community health ”
workers
■9 bias against women in
medical care
a tuberculosis and society
a family planning
» reproductive health
We also allot special time for sharing of our local
experiences and problems, thereby strengthening
friendship and solidarity.
To respond to the specific interests and needs of mfc
members and for indepth discussion and interaction on
specific topics, the Primary Health care Cell and
Women and Health Cell were formed in the early 1990s.
This process of forming specialised cells will hopefully
be an ongoing process.
From time to time, mfc members have taken up coll^ve
activities usually to study or act on a certain problem,
such as
« lathyrism survey in Rewa District, MP,
® study of health effects of the Bhopal Gas Leak, March
1985,
» pregnancy outcome study in Bhopal nine months after
exposure to the toxic gas,
s with women’s groups, campaign against hazardous
hormonal contraceptives,
« support of the International Medical Commission on
Bhopal, 1994.
In Bhopal in 1985 we also gave technical support for
the health activities of voluntary agencies and action
groups among the gas victims.
mfc is registered under the Societies Regishation_
1860 (MAH7902/Pune/81) and the under Bombay ruonv
Trust Act, 1950 (Reg.No.F-1996,Pune)
mfc has been an active founder member of the All
India Drug Action Network. In 1980, a Rational Drug
Policy Cell was formed in mfc to contribute to the
campaign for a Rational Drug Policy through the AIDAN.
mfe’s registered address is :
C/o. Manisha Gupte
11, Archana, Kanchanjunga Arcade, 163, Solapur Road,
Hadapsar, Pune 411 028. Phone - (0212) 675058.
In an attempt to consolidate regional groups for more
frequent and intensive interaction or to initiate collective
action at local level, attempts have been made to form
region based groups in Calcutta, Gujarat and Maharashtra.
The Bombay mfc has been consistently active since
1990 on issues such as medical malpractice, human rights
in health, regulation of private practice and improvement
of public health services.
| ORGANISATION ||
mfc is not a rigid organisation. It is a loosely-knit group
of friends from various backgrounds, medical and non
medical, often differing in their ways of thinking and in
their modes of action! But the understanding that our
present health service as well as the system of medical
education is lopsided and is in the interest of a privileged
few, prevails as a common conviction.
Those members who have been consistently active in
mfc and are prepared to give time and energy for it’s
organisational growth have constituted the so called ‘core
group’. The ‘core-group’consisting of twenty to thirty
friends at any given time is informal and new-comers are
eilcouraged to join it.
Given the fact that mfe’s limited membership is
geographically scattered, that our members are getting
increasingly over burdened with local responsibilities,
given our ideological heterogeneity and given the self
imposed shoe-string budget of the organisation, it has been
rather difficult to keep ourselves going as a collective.
Major and minor b’ccoughs have been part of mfe’s
existence. Nonetheless, we have contributed for more than
two decades as a nation-wide, secular, pluralist, alternative
and pro-people platform of health activists and friends.
An executive committee made up of members
supports the work of the mfc convenor who serves in
rotation for a term of two years. The mfc bulletin editor is
also chosen from among the members.
| MEMBERSHIP [|
•
Anyone who broadly agrees with the perspective as
well with as the pluralistic spirit of mfc is welcome to
become a member. Non-doctors are encouraged to join.
The membership fees are given below. It is understood
that members capable of contributing more than the
minimum, would do so. Conversely, the convenor can
reduce or waive the membership fees in deserving cases.
Annual Membership Fees
Those earning less that Rs.750 p-.m. - Rs. 25.
Those earning more than Rs.750 p.m. - Rs. 50. This
does not include subscription to the mfc bulletin.
subscription to the mfc bulletin are :
Within India
Annual
Life
—_____
Asia______
Other countries
Individual
Rs. 100/Rs. 1000/-
Institutional
Rs.200/Rs.2000/-
$10
$15
$100
$150
-
All payments should be made in the name of ‘medico
friend circle’ by MO or demand draft to the registered
office. If you wantto pay by cheque, please add Rs 10 for
bank charges. For membership forms and copy of the rules
and regulations. Diease write tojhe Convenor •
Anand Zachariah, Madhukar Pai, Prabir Chatted^
C/0 Anand Zachariah, Medicine Unit I
J ’
Christian Medical College Hospital,
Vellore - 632 004, Tamil Nadu
| PUBLICATIONS p
’
. -------- !
presen! WtJhealffifare £GNOSIS (analysis of
articles. Ed. Ashvin J-Patel! fim‘pubiSh^ °fbulletin
1977.
Reprinted May 1985 price Rs. 12 00 or
includes Health Sen-ice Evolution, Medical EdS$ 5;°°-
National Health Policy, Alternatives in Health Care
Population Problem, Drug Industry, Nutritional Problem
in India, Protein Gap Myth, Community Health and
Tonics.
2.
HEALTH CARE-WHICH WAY TO GO
(Currently out of print) (Examination of issues and
alternatives) Second anthology of bulletin articles.
Ed. Abhay Bang and Ashvin Patel, first published October
1982.
Includes Drug Issues, Lathyrism, Water Supply, Or
Rehydration Therapy, Problems of Nurses, Community
Health Workers, Dai Training, Government Rural Health
Scheme, Political Dimensions of Health and mfc debate
on ‘which way to go’.
3.
HEALTH AND MEDICINE - UNDER THE
LENS: Third anthology of bulletin articles. Ed.Kamala
J.Rao and Ashvin Patel, October 1985. Price Rs.19.00 or
USS 6.00. Includes Critical Examination of Community
Health, People’s Participation, Health for All by 2000 AD,
Health Education, Drug Misuse, Medical Research, BCG
Vaccination, Supplementary Feeding Programmes, Drug
Policy and Therapeutics, Minimum Wages, Family
Planning and Kerala Model.
4.
MEDICAL EDUCATION RE-EXAMINED
Ed.Dhruv Mankad, 1991 Price Rs.35/- and USS 10.
Medical Education Re-examined is an anthology of
articles from the mfc bulletin and papers presented at the
conference on Alternative Medical Curriculum held at
Gonoshasthaya Kendra, Bangladesh as well as at the X
Annual meet of the mfc held at Calcutta. It looks closely
at the training of doctors in India and makes an effort to
present a comprehensive argument for a change in the
orientation and content of the existing medical curriculum,
providing some pointers to the direction of such a change.
5(a) The Bhopal Disaster Aftermath : An
Epidemiological and Socio-Medical Survey.
Price : Rs. 8.00 USS 5.00
. 5(b) Distorted Lives : Women's Reproductive
Health and Bhopal Disaster : October 1990
Price : Rs. 20/- or USS 6.00
6. mef Bulletin back issues : Xerox copies are
available from the registered office. Rs.l/- per page.
Publications are available from the Convenor and the
registered office.
SUBJECTWISE INDEX OF MFC BULLETINS
ISSUES 1-99
JANUARY 1976—MARCH 1984
Subject Categories :
1) Health Services — General
2)
Health Services in Other Countries
3)
Health Schemes, Projects and Groups
4)
Medical Education
5)
Problems of Doctors
6)
The Nursing Profession
7)
Science and People
8)
Indigenous Medicine
9)
Community Health Worker
10)
Sexist Bias in Health
11)
Maternal Health
12)
Contraception and Abortion
13)
Population Growth and Control
14)
Children and Health
15)
Nutrition and Hunger
16)
Lathyrism
17)
Environmental + Occupational Health
I.
Health Services—General
Banerji D, History of health services in India, 1-2:
jan-feb 1976, p1
Jaya Rao K, Nanavati K, Katgade V, Report B: dis
cussion on 'our present day health problems
and needs', 1-2: jan-feb 1976, p7 (proceed
ings of II ann. mfc meet)
Patel A, Report D: discussion on 'health for the
people : finding a practical way', 1-2: jan-feb
1976,
p9 (proceedings of II ann. mfc meet)
Banerji D, Evolution of the existing health services
systems of India, 3: 1976, p1
Qadeer I, A rush for alternatives, 3: mar 1976, p7
(review of 3 recent WHO/UN publications)
Elliott C, Is primary health care the new priority?
Yes, but
(part I), 4: apr 1976, p5
Elliott C, Is primary health care the new priority?
Yes, but
(part II), 5: may 1976, p3
— , Health or 'health services'?, 5: may 1976,
p5 (review of Care of Health in Communities
and Medical Nemesis)
Qadeer I, Dear friend : much ado about
6:
jun 1976, p7 (about King M, Medical Care in
Developing Countries)
Bang A, Much ado about
8: aug 1976, p4
Qadeer I, Dear friend : much ado about
, 10:
oct 1976, p8
Parmer S, Health care in the context of self-reliant
development, 12: dec 1976, p4
Phadke A, Report B: discussion on 'health services:
an analysis', 13: jan 1977, p6 (proceedings
of III ann. mfc meet)
Jain T, New national health policy, 20: aug 1977,
P1
Phadke A, A programme for immediate action, 21:
sep 1977, p1
18)
19)
20)
21)
22)
23)
24)
25)
26)
27)
28)
29)
30)
31)
32)
33)
Health during Mass Calamity
Water Supply and Sanitation
Diarrhea and Oral Rehydration
Drug Industry Malpractices
Drug Misuse
Rational Drug Therapy + Action
Drug Policy Alternatives
Tuberculosis
Malaria
Leprosy
Mental Health
Miscellaneous: Technical and Medical
Misc. : Non-Technical or Non-Medical
Role of MFC and Members
MFC Bulletin
MFC Meet Reports (Organisational)
Compiled by Mira Sadgopal
Qadeer I, People's participation in health services,
23: nov 1977, p1
Shah D, Dear friend: new national health policy,
23: nov 1977, p8
Jaya Rao K. Why an alternative health policy?, 25:
jan 1978, p7
Bang R, Health services in India: report of discus
sion on paper, 26: feb 1978, p7 (proceedings
of IV ann. mfc meet)
Destanne G, Two ways for health economics
(part I), 27: mar 1978, p1
Destanne G, Two ways
(part II), 28: apr 1978,
p5
Gideon H, Making the community diagnosis, 30:
jun 1978, p1
Banerji D, Political dimensions of, health and health
services, 31: 1978, p1*
— , News clippings: the need, the words, and
the deeds
33: sep 1978, p4
MFC, The rural health care scheme — mfc view,
34: oct 1978, p2
— , Rural orientation of policy makers, 34: oct
1978, p8
Ganguli M, Health & Society, 51: mar 1980, p7
(journal notice)
Maru R, Murthy N, Rao T, and Satia J, Professional
management in health bureaucracy, 53-54:
may-jun 1980, p1
Barreto L, Primary health care, 55: jul 1982, p1
Jaya Rao K, Kerala : a health yardstick for India,
58: oct 1980, p1**
Deshpande M. Dear friend: people's participation,
59:. nov 1980, 'p6 (response to A Bang's
account of Savar project in 58)
Bang A, People’s participation and economic selfreliance in community health: 64: apr
1981,
p!**
Clark A, What development workers expect from
health planners, 67: jul 1981, p1**
Ramprasad V, Primary health care: The real pic
ture, 77: may 1982, p6
Subramanian A, Health for all: an alternative stra
tegy (a note on the current tasks), 79: jul
1982,
p1
Narayan R, Keeping track — 1, 80: aug 1982, p5
(review of two documents on alternative
health care by ICSSR/ICMR)
Narayan R, Keeping track---- II, 81: sep 1982, p3
(review of lllich I, Medical Nemesis and
Horobin D, Medical Hubris)
Swaminathan S, Why PHCs have failed: reflec
tions of an intern, 81: sep 1982, p4
Dandare M and Karandikar V, Integrated, health
programmes: some questions, 84: dec 1982,
p5
Nabarro D, Health 'for all by the year 2000: a
great polemic dissolves into platitudes?
(part I) 90i'jun 1983, p1
Nabarro D, Health for all......? (part II), 91: jul
1983,
p1
Jesani, and Prakash P, Health for all?, 94: oct
1983,
p8 ,reply to D Nabarro's article)
Ladiwala U, Dear friend: I would like to visit Nag
pur, 32: aug 1978, p4
Kapadia R, MFC news: MFC group in Bombay, 33:
sep 1979, p5
— , MFC news: Sevagram (report of two dis. cussion — 1. drug industry 2. nurses) 34: oct
1978,
p4
Soni M, MFC news : Ahmedabad (report of a meet
ing of members), 34: oct 1978, p4
Parikh I, Dialogue : health project — a means of
social change, 39, mar 1979, p7
— , MFC news : (MFC ground at Sevagram),
40: apr 1979, p6
— , MFC news : (Meeting . of MFC group at
Calicut, Kerala), 41: may 1979, p8
— , 'India is Kundungal' (Calicut group experi
ence), 42: jun 1979, p7
— , When the search began (field experience
of MFC group, Sevagram), 47-48: nov-dec,
1979, p5
Desikan K, Dear friend (response to Sevagram
group's article in 47-48) 50: feb 1980, p5
Arole R, Comprehensive rural health project,
Jamkhed, 49: jan 1980, p1
Tharyan T and Joseph A, The Veppampet story,
53-54: may-jun 198, p6
2. Health Services in other countries — , The paramedics of Savar : an experiment in
health in Bangladesh, 57: sep 1980, p1**
Prem R, Few points to ponder over......... 17: may
Bang A, Learning from the Savar project (part I),
1977,
p7 (European health services)
58: oct 1980, p5
Rajan V, Community health in China, 22: oct 1977
Bang A, Learning from the Savar project (part II),
p1
59: nov 1980, p1
<JT3J,
22: oct 1977, p (obser Bang A, 'ACHAN' — a new Asian organisation,
vations in southeast Asian countries — part-l)
59 : nov 1980, p6
— , CINI — Child In Need Institute, 60: dec
—
H
R 23: nov 1977, p5 (part-ll)
1980,
p1
Conover S, Donovan S and Susser E, Reflections
, Some more activities of CINi, 6y: jan 1981,
on health care in Cuba, 68: aug 1981, p1
p4
3. Health Schemes, Project and Groups Phadke A, RUHSA (Rural Unit for Health and
Social Affairs), 63: mar 1981, p5
Khanra L, Report F: report on projects description,
1-2: jan-feb 1976, pl T (proceedings of II ann- — , Some more activities of CINI, 61: jan 1981,
p4 ,
mfc meet)
Jajob U, Community participation in primary health
— , News (reports received from Vadodara and
care, 66: jun 1981, p4**
Surat groups in Gujarat), 4: apr 1976, p3
-4c , Health Action International, 77: may 1982,
Nanavati K, Community health care centre, Thaltej,
p4 (HAI is affiliated with the international
4: apr 1976, p4
organisation of consumers unions — IOCU)
Chandran N, Report: regional mfc camp, Kerala, 9: George T, Calcutta National Welfare Organisation,
sep 1976, p7.
88: aug 1982, p6 (report after CNW0
Katgade V, Health care delivery through ESIC, 15:
seminar)
mar 1977, p1
— , Socially conscious epidemiological . ap
proach, .82: oct 1982, p6 (report .of Mangrol
Sadgopal M and Gupta V, Doctors' camp at Kishore
group's work, from mid-ann. meet)
Bharati: a probe into the cycle of poverty and
, disease, 15: mar 1977, p5
— , Health work in a working class movement,
82: oct 1982, p6 (report of Binayak Sen's
Jaya Rao K, Dear friend: health care delivery
work with Chattisgarh Mukti Morcha, from
through ESIC, 18: jun 1977, p7 (response to
mid-ann. meet presentation)
V Katgade's article in No. 15)
Katgade V, The scope of health projects: report of
4. Medical Education
discussion on paper, 26: feb 1978, p7
— , Mao Tsetung’s June 26th directive (slightly
Bang R, One 'Sir' every two minutes 30: jun 1978,
amended) of 1965, 9: sep 1976, p8
p5
Schumacher E, The two ways, 10: oct 1976, p7
Kapadia N, Pujai: an experience with mud and Anon., Dear friend : needed — new managers for
rain, 32: aug 1978, p3 (a student recollection)
medical colleges, 14: feb 1977, p5
2
Dey S. Dear friend: needed — new managers
........(I), 15: mar 1977, p4 •
Jindal T, Dear friend: needed — new managers
........ II) 15: mar 1977, p4
Kothari M and Mehta L, Knowledge is confusion 1
17: may 1977, p5
Nene D, Dear friend : needed — new managers
for medical colleges, 17: may 1977, p8.
Zala M, Dear friend : Knowledge is confusion, 18,
jun 1977, p7
— , Dear friend : increase in the seats for medi
cal college students in Maharashtra, 22: oct
1977,
p
Patel B, Dear friend : Up against new medical
colleges 23, nov 1977, p8
— . Medical studies in Malayalam, 32: aug
1978, p4
Kashlikar SJ, medical education : physiology and
frogs, 33: sep 1978, p4
Dhaddha S, Dear friends : on 'medical education
in Malayalam', 33: sep 1978, p5
Singh T, Dear friend : medical education and
investigation dependance, 35: nov 1978, p7
— , Product of medical education, 37: jan 1979
p4 (cartoon)
Agarwal D.'Threat to PSM, 42: jun 1979, p8
(G.O.I.), National medical education policy (draft
plan), 46, oct 1979, p2
Sonwalkar A, Dialogue : concerning three years
medical college, 46: oct 1979, p4
aietfecrsH
Sathyamala C, Innovative programme in medical
education: three case studies; 87-98: jan-feb
1984,
p10'
Jaya Rao K, From the editor's desk, 97-98: jan-feb
1984,
p16
Mankad D, Group A: structure and content of preclinical, clinical and para-clinical subjects,
99: mar 1984, p1 (ann. meet report)
Jesani A, Group B:'content and structure of com
munity medicine, 99: mar 1984, p4 (ann.
report)
Sathyamala, Khanra L and Kapoor I, Group C:
changing the methodology of training in medi
cal schools, .99: mar 1984, p7 (ann. meet
report)
5.
Problems of Doctors
Patel A, Hyde park : doctor-patient relationship :
an acute crisis, 31 : jul 1978, p4
— , And the doctors get what they want, 31:
jul 1978, p4
Gole S, Dear friend: medical council elections, 35:
nov 1978, p7
'ftfen h feta
36: dec 1978, p6
— , Chloroform (review notice of book in
Marathi by Limaye A), 36: dec 1978, p7
Sen B and Barreto L, Unemployment among doc
tors, 37: jan 1979, p3
Dharmadhikari, D, The challenge of history to
medicos, 38: feb 1979 p1
Punse D, Dear friend: unemployed doctors and
. unsold cloth, 38: feb 1979, p3
Patel A, Unemployment among doctors X 50 heads
(ann. meet report of discussion at Varanasi
meet), 38: feb 1979, p5
— , Operation medicine: on the path of agita
tion, 40: apr 1979, p6
4,
Dialogue: <33ft : 4 37 44 4 413 44,
40: apr 1979, p7
Chandra S, Dialogue: the rural internship: The facts
and the factors, 44: aug 1979, p4
Huang C. City doctors go to the countryside, 44:
aug 1979, p6
Jagannatha Rao P, Morel T and Madhavan P,
View-point: why doctors too agitate, 55: jul
■ 1980, p3
Jaya Rao K, Editor's note, 55: jul 1980, p7 (doc
tors' strikes)
Punwani D, Dear friend (unethical medical prac
tices), 58:-oct 1980, p8
— , From the editor's desk: the ban on private
practice, 91: jul. 1983, p8
Medical Action Forum. Medical ethics and practice,
93: sep 1983, p6
ftfe4ra st&si
44 3141473 34 33 414:
46: oct 1979, p5
snsj. g, Dialogue: rflT 431 44
efa <4, 47-48
nov-dec p7
44 ai, Dialogue : flSIB
3JT t, 47-48:
nov-dec 1979, p8 (reply to Jajoo S)
— . News clippings : triumph of reaction, 47-48:
nov-dec 1979, p11
Patel A, Dialogue : Three year medical diploma (I),
49: jan 1980, p11
Dialogue : Three year medical diploma
(II), 49 : jan 1980, pl 1
44 at Dialogue : Three year medical diploma
(III), 49: jan 1980, p11
Cook G, Another view-point : training of doctors
and delivery of health care in developing
countries, 55: jul 1980, p5
Jain T, View-point: medical education and training
of interns, 62: feb 1981, p5
Phadke A, The caste war by medicos, 63: mar
1981,
p1**
— , Substandard doctor?, 63, mar 1981, p8
Phadke A, Important facts about the medicos' agi
tation in Gujarat, 64: apr 1981, p3
— , Basic (k) medical education, 37: jul 1981,
p6
Tharyan T, A reorientation of medical education,
68: aug 1981, p2
Mankad D, People and health : a brief report on
the Dhaka conference, 89: may 1983, p1
6. The Nursing Profession
Bang R, Nurses: the cursed nightingales, 33: sep
1978, p5*
— , News clippings : Nursing profession not for
men?, 34: oct 1978, p4
,
— , News clippings: Wftt ~ TT 34 4ft, 347
4ft 7ft 50: feb 1980, p6
3
Bang R,. Nurse: the woman in the medical system
(part-1), 71: nov 1981, p1
Bang R, Nurse: the woman........(part-II), 72: dec
181, p8
7.
, All India convention of people's movement,
88: apr 1983, p4
Umapathy P, Rural nutrition education : a futile
effort?, 94: out 1983, p1
—
Science and People
— , go to the people....... 1-2: jan-feb y976, p3
Kothari M and Mehta L, Points of view: medicine
2000 AD, 18: jun 1977, p1
Conklin E, The effects of the professional agnosti
cism of scientists, 18: jun 1877, p3
Guevara C, The principle upon which the fight
against disease should be based....... 18: jun
1977,
p7
Kabuga C, Why andragogy , 29: may 1978, p1
— , Current concepts in parasitology, 29: may
1978,
p8
—
The debt, 34: oct 1878, p1 (quote from
Bhore Committee Report)
Abu, 'On weekends, I always became rural orient
ed', 34: oct 1978, p8 (cartoon)
Gandhi M, To the scientists of India, 35: nov 1978,
PBhagwat A, Bhagwat's seven laws, 31: nov 1978,
p1
Roy D and Qadeer I, Is a stethoscope appropriate
technology? 36: dec 1978, p4
Knaus W, God that is failing, 40: apr 1979, p1
Bearden J, A research fable: the needle in the
haystack, 37: jan 1979, p5
Huxley J, Genes and the Society, 41: may 1979,
P1
— , Low cost slide projector by NID, 42 : jun
1979,
p8
Choudhury B, Polygamy and positive eugenics, 42:
jun 1979, p7 (response to article by Huxley J)
Patel A, Dear friend: eugenics is anti-evolutionary,
anti-democratic, 42: jun 1979, p7
Mehrotra N, Management of Indian science, 49:
jun 1980, p10 (symposium notice)
— , Teaching aids at low cost, 52: apr 1980, p3
— , Concern of young scientists: Indian science,
53-54" may-jun 1980, p7
Phadke A, Vigyan jatra in Maharashtra, 53-54:
may-jun 1980, p4
Brecht B, A worker's speech to a doctor, 60: dec
1980,
p8
Chowdhury Z, Research : a method of colonization,
62, feb 1981, p1**
— , Whither Indian scientists? 67: jul 1981, p4
Panth M, Scientists in villages, 68: aug 1981, p8
(poem)
— , Aids — posters for disabled by AHARTAG,
71: nov 1981, p3
— , The best foot forward, 72: dev 1981, p7
(approp. tech, in artificial limb rehabilitation,
Jaipur)
Bang A and Bang R, Other side of health educa
tion some experiences of health education in
a rural community, 76: apr 1982 pl-fr*
Jaya Rao K, From the editor's desk, 81: sep 1982,
p8 (urban health care system and public
research establishments)
8.
Indigenous Medicine
Khanra L, Report C: discussion on 'alternative
approach- various pathies' 1-2: jan-feb 1976,
p9 (ann. mfc meet)
Vaidya B, Dear friend, 3: mar 1976, p6 (history
of ayurveda — response to article by Banerji
D in 1-2
Patel A, Dear friend, 3: mar 1976, p6
Aron, Dear friend. The limits of fasting, 9: sep
1976,
p6
Vaidya B, Ayurveda and allopathy, 10: oct 1976, p6
Jaya Rao K, Dear friend: ayurveda and allopathy
(I), 11: nov 1976, p8
Singh T, Dear friend: ayurveda and allopathy (II),
11- nov 1976, p8
Phadke A, Dear friend: ayurveda and allopathy,
12: dec 1976, p7
Soni M and Surahiyala K, Role of various 'pathies'
in community health, 14: feb 1977, p8
(report of MFC seminar at Ahmedabad)
Kapur S, Dear friend: a topic for study groups,
19: jul 1977, p6 (study of simple remedies)
31 jul 1978, p5
Vaidya A, Modern medicine and ayurveda: a syn
thesis for people's medicine, 33: sep 1978,
p1*
Bang A, Editorial, 33: sep 1978, p3 (synthesis of
modern and indigenous medicine)
Kanchana Mala NP, Clinical trials with some
ayurvedic preparations 33: sep 1978, p8
xTl
ajgHT
34:
oct 1978, p7
CCRUM,
R ’SHR’I
^1 gferai’
55: jul 1980, p8
Vad B, Herbal remedies and medical relief, 64:
apr 198y, p4
Multani P, Ayurvedic drug industry, 67: jul 1981,
p4
Jaya Rao K, 'Allo-ayurvedopathy', a non-scientific
hybridization, 73-74: jan-feb 1982, p5**
— , Attention please! (notice of first Asian Con
ference on Traditional Medicine), 85-86: janfeb 1933, p11
— , Naturopaths in the USA, 93: sep 1983, p5
9.
Community Health Worker
Shah P, Junnarkar A, Dhole V, Village health assis
tants, 12: dec 1976, p1
Raju U, Relevance of ICMR research project: tea
cher's training as barefoot doctor, 20" auq
1977,
p5
Werner D, The VHW — lackey or liberator?, 25:
jan 1978, p1 *
— , A para-medical worker paid Rs. 6 per month,
31: jul 1978, p4
MFC MILESTONES
1974
Ujjain
1975
Sevagram
1976
Vadadara
Rasulia
1977
Calicut
Ahmedabad
1978
1979
Vadordara
Rewa
Varanasi
1980
Jamkhad
1981
Kavanur
New Delhi
Vadodara
1982
Bombay
Tara
New Delhi
Relevance of Present
Health Service (M).
Present Health Problems
(M)
First Bulletin published
Nutrition Problem in
India (M)
Community Health
Approach and Role of
Doctor in Society (M)
'Other Pathies' —
Workshop
First Anthology printed
Kissa Kesari Ka Camp
Unemployment among
doctors (M)
Community Health
Worker (M)
Community Paediatrics
(M)
Drug Industry and the
Indian People (N)
Campaign against
medicos-agitation on
reservations
Women and Health (N)
Misuse of Drugs by
Doctors (M)
Campaign against
EP-forte
Sewagram
1983
Dhaka
Trivandrum
Hosangabad
1984
Calcutta
Bombay
M = Annual Meet; N — National level meet with
other organisations; Regional camps and EC
meets have also been held at various places.
Werner D, Liberation of VHW, 49: jan 1980, p6
Werner D, Comparison of doctor and village health
worker, 49: jan 1980, p7
Maru R, Community health worker: some aspects
of the experience at national level, 51: mar
1980, p1*
Sadgopal M, VI all-lndia meet of mfc at Jamkhed,
52: apr 1980, (topic: the community health
worker plus field study of CRHP Jamkhed)
Vaidya A, Dear friend, CHW, National experience,
52: apr 1980, p10
Jajoo U, Role of the village health worker — a
glorified image, 62: feb 1981, p4Jr>
Vaughan JP, Barefoot or professional: Community
health workers in the third world, 70: oct
1981,
p1
Jaya Rao K, From the editor's desk, 70: oct 1981,
p8 (community health worker — overview)
IO.
Jaipur
Anand
Second Anthology printed
Campaign against
irrational diarrhoea
management
Meeting with David
Werner
Drug Workshop (N)
Prejudice against women
in Health (M)
People and Health
Conference (N)
People Science Move
ments Convention (N)
Alternative Medical
education — EC Meeting
— Campaign against
irrational production
and marketing of
drugs
— Coordination of
Dr. Zafarullah
Chowdhury's visit
Why an alterative medical
curriculum (M)
Drug Action Network
Meeting (N)
100th bulletin published
Agarwal A (figures from Bangladesh on hospital
admissions and deaths in women), 76: apr
1982,
p7
Ehrenreich, B and English D, Witches, healers and
gentlemen doctors, 85-86: jan-feb 1983, p1
Ruzek SB, The women's health movement, 85-86:
jan-feb 1983, p5 (book review)
Ehrenreich B and English D, Oppressive 'scientific'
procedures, 85-86: jan-feb 1983, p6
Grossman M and Bart P, Taking the men out of
menopause, 85-86: jan-feb 1983, p7
Phadke A, From the editor's desk: not so glorious,
85-86: jan-feb 1783, p12
Gupte M, Chatterji M and Patel V, Prejudice
against women in medical care, 87: mar 1983.
(proceedings of IX ann. mfc meet)
Phadke A, Session V: evaluation of the discussion,
87, mar 1983, p8 (proceedings of IX ann.
mfc meet)
Chhachhi A and Sathyamala C, Sex determination
tests: a technology which will eliminate
women, 95: nov y983, p3
Sexist Bias in Health
Sanford W, Dialogue: woman as consumers of
medical care, 51: mar 1980, p6
CSIV The Worecesterward: violence against
women, 57: sep 1980, p3 (feminist group
opposes abuse of psychiatry)
Java Rao K, Women and health: report of a work
shop, 67: jul 1981, p8
Bang R, Third international conference on women
and health, 69: sep 1981, p6
II.
Maternal Health
Sadgopal M, Training of dais, 24: dec 1977, >
Gole S, Deaf friend: increased percentage of
caesarean deliveries in private hospitals, 28:
apr 1978, p4
5
Jajoo U, Dear friend: increased percentage of'
AVAILABLE
caesarean deliveries in private hospitals, 29:
may 1978, p7 (response to Sanjeevani Gole's A reference file on Gonoshasthya Kendra, G. K.
letter in 28: apr 1978)
Pharmaceuticals and the Bangladesh Drug Policy.
Gupta S, Training of dais, 42: jun 1979, p5
Jaya Rao K, Who is malnourished: mother or the
Prepared for Dr. Zafarullah Chowdhury's
woman? 50: feb 1980, p1*
visit in December 1983 by mfc/ISI/OXFAM at
Patki, PS, Letter to editor, 92: aug 1983, p7 (com Rupees Five (Rs. 5.00 only) from mfc Bangalore
parative safety of aspirin and paracetamol in office. Please send money order.
pregnancy) .
12.
Contraception and Abortion
Dingwaney M, Dear friend: can doctors sympathise
with abortion? 21: sep 1977, p7
Jaya Rao K, From editor's desk, 65: may 1981, p3
(influence of male thinking in contraceptive
research)
Bamji M, How safe is the pill? 65: may 1981, p1
Bamji M, Male contraception, 71: nov 1981, p’^Ar-A— , Abortion: the woman's plight and right, 50:
feb 1980, p7
Norsigiari. J, Redirecting contraceptive research,
65: may 1981, p3
-— , Abortion in India, 71: nov 1981, p5
— , Complications of abortion in developing
countries, 71: nov 1981, p6
— , Abortion and contraception, 71: nov 1981,
P7
.
Sadgopal M, Letter to editor, 89: may 1983, p7
(natural family planning methods)
— , From the editor's desk, 93: sep 1983, p8
(barrier methods of contraception)
I3.
Population Growth and Control
9 sep 1976, p4
Qadeer I, Population problems: a view point, 10:
oct 1976, p1
Shah D, Dear friend: population control and cul
tural values, 10: oct 1976, p8
Jaya Rao K, Dear friend: Population problem: a
viewpoint, 12: dec 1976, p8
Jaya Rao K, Dear friend: family planning ............
when , 16: apr 1977, p7
MaheshWari S, Population control vis-a-vis family
welfare, 23: nov 1977, p3
Panat S, Dear friend: doctors and family planning,
32- aug 1978, p5
. Rewards beyond motherhood, 51: mar 1980,
p7 (review, of Newland K, Women and Popu
lation growth)
Phadke A, Dialogue: family planning and the pro
blem of resources, 67: jul 1981, p3-A*
—
I4. Children and Health
Phadke A, Population explosion: myth and reality,
9- sep- 1976, p1
ANNOUNCEMENT
HEALTH CARE IN INDIA
The Centre for Social Action has just publish
ed an interesting, thought-provoking and rather
comprehensive booklet of 144 pages on "Health
Care in India". This booklet first presents the
historical background of our health system, inclu
sive of a chapter on "Health for All" and the new
"National Health Policy". It then reviews the pre
sent situation and analyses the root causes of our
failures. After its chapter on the "meaningful
experiences" of China, Cuba and Vietnam, and the
State of Kerala, the booklet finally describes the
"possibilities of relevant action" in the fields of
"Community Health Care" and "Conscientisation,
Political Action and Health".
This well done booklet is available for
Rs. 4-00 only (postage included; discount of 20%
for 5 copies or more; payable by money order)
from Centre for Social Action, 64 Pemme Gowda
Road, Bangalore 560 006.
Warerkai U, A simplistic approach, 14: feb 1977,
p7 (review of Morley D, Paediatric Priorities
in the Developing World)
Gibran K, Living arrows, 40: apr 1979, p5
Nene D, The child in the health centre, 18: jun
1977,
p8 (review of a manual of health cen
tre paediatrics)
Jaya Rao K, Dear friend: to which school shall we
send our children?, 20: aug 1977, p8
Bang A, Editorial: 1979, 36: dec 1978, p3 (inter
national year of child)
Utkal Gandhi Smarak Nidhi, Need for a parents'
movement, 36: dec 1978, p2
Rani P, Peep in the child's mind, 40: apr 1979, p4’
h
atk
49: jan 1980, p10
Nai,cSW!d°”9:”S ,1hs,S0.np™,i<>nal
G°Pala980C'p?e ChHd
,ndia (part-'’' 59: nov
^WSO,' p?6 Ch"d in
lndia (pa^">' 60: dec
“I?1 .N™J°S?S ’p6ne"
swepy,
Singh T, Accident-prone children, 70- Oct 1971 o5
(UNICEF), The disabled child, 72- dec 1981 n6
- , From the editor's desk 88- ap?
&
(mass immunisation of children)
83' P8
6
NayyTh'iiHhan<lSl?arada' L- Appropriate Strategy for
1983 °p1d lmmunlsation in lndia> 88; apr
Jaya Rac K, Dear friend: nutrition: medical prob
lem, political solution (I), 43: jul 1979, p6
Patel A, Dtar friend: nutrition: medical problem,
political solution (II), 43: jul 1979, p6
Bang A, Food requirements as a basis for minimum
wages, 72: dec 1981, p1**
Gopalan C, Nutritional basis of minimum wages,
76: apr 1982, p4
Jaya Rao K, From the editor's desk, 76: apr 1982,
p8 (food supplements — commercial inte
rests)**
— , Boycott against Nestle pays off, 77: may
1982,
p4
Bang A, Dear friend, 78: jun 1982, p4 (response
to comments by Gopalan on Bang's article)
'Food requirements...')**
Gupta M, (letter to . editor), 82: oct 1982, p11
(body weights of Indian labourers)
— , From the editor's desk: malnutrition and
intelligence, 83: nov 1982, p8**
— , International Code of Marketing of breast
milk substitutes, 84: dec 1982. p1
Lucey J, Does a vote of 118 to 1 mean the USA
was wrong , 84: dec 1982, p2
May C, The 'infant formula controversy': a noto
rious threat of reason in matters of health,
84: dec 1982, p3
Surjono D et al, Breast vs. bottle — scientific
evidence, 84: dec 1982, p6
— , It's worthwhile to restrict infant formulas,
84: dec 1982, p8
— , What the.companies say, 84: dec 1982, p8
— . The Nestle boycott, 84: dec 1982, p8
Jaya Rao K, From the editor's desk: the business
of infant .feeding, 84: dec 1982, p10
— , Weaning food and diarrhea, 90: jun 1983,
p8
Jaya Rao K, How successful are supplementary
feeding programmes? 91: jul 1983, p3 (also
see cover article in 14)
Acharya K, Why soya bean? 93: sep 1983. p7
— , World Health authorities condemn industry
practices, 92: aug 1983, p6 (milk food)
. Life in the vaccine, 88: apr 1983, p5 (test
indicator for viability of vaccines)
, Journal of rural paediatrics, 94: oct 1983,
p5 (notice)
IS. Nutrition and Hunger
Jaya Rao K, The myth of the protein gap, 4: apr
1976, p1
Patel A, Dear friend: who is the culprit?, 5 may
1976, p7
Shah D, Dear friend: the protein gap, 5: may 1976,
p7
Jaya Rao K, Dear friend: who is the culprit?, 7:
■
jul 1976, p7
Jaya Rao K, Vitamin A deficiency, 8: aug 1976, p1
Singh N, Dairy research for whom? 8: aug 1976,
p5
Jaya Rao K, Dear friend: dairy research for whom?
9: sep 1976, p6
Muller M, The baby killer, 11: nov 1976, p6
Jaya Rao K, Report C: discussion on 'socio-econo
mic aspects of the nutrition problem in India'.
13: jan 1977, p8 (proceedings of ann. mfc
meet)
Qadeer I, How relevant are feeding programmes?
14: feb 1977, p1
— . The green revolution for whom , 14: feb
1977, p8
Jaya Rao K, How important is birth weight in
infant health?, 16: apr 1977, p1
Jawlekar K, Dear friend: the green revolution for
whom?, 16: apr 1977, p6 (response to arti
cle in 14)
Shatrughna V, Milk for the baby!, 16: apr 1977,
p8
Warerkar U, Dear friend: how important is birth
weight........?, 18: jun 1977, p6
Shatrughna V, Dear friend: how important is birth
weight in infant health?, 19: jul 1977, p6
Jaya Rao K, Dear friend: how important is 'size
at birth'? 21: sep 1977, p7
Singh N, Nutritional problem in India, 19: jul 1977,
p1
Nene D, Dear friend: food for heart?, 20: aug 1977,
p7
Singh N, How not to try solving nutritional prob” lems, 27: mar 1978, p5
Mathew, I was hungry and....... . 33: sep 1978, p3
Rendra W, Prayer of the hungry, 35: nov 1978, p8
Kshudha, No child shall drink it's mother's tears
as milk, 36: dec 1978
__
To restrict bottle feeding, 36: dec 1978, p3
(legislation in Papua, New Guinea)
—
News clipping: Too much iron in milk foods,
39: mar 1979, p3
Lele R, Nutrition in India: medical problem —
political solution, 42: jun. 1979, p1
Sukhatme P, Who are the real hungry? 43: jul
1979,
16. Lathyrism
Jaya Rao K, Kissa Khesari ka, 24: dec 1977, p1*
Bang A, Dear friend: kissa khesari ka. 26: feb
1978,
p8
Barreto L. Kissa khesari camp ka, 30: jun 1978, p4
(report of the regional camp on lathyrism)*
Chand H. Dear friend: Lathyrus and homoeopathy,
31: jul 1978, p4
Jaya Rao K, From the editor's desk: The poor
man's .poison is nobody's concern. 77: may
1982, p8
I7. Environmental and Occupational
Health
—
—
p1
7,
, Smoking burns up memory, 32: aug 1978,
p4
, Smoke of 100,000 million dollars. 32: aug
1978,
p4
, News clippings: less infections if docs have
short hair, 34: oct 1978, p4
, News clippings: chemicals pose hazards to
human sperm, 34: oct 1978, p4
— , Alcohol: the problems increase, 42: jun
1979,
p4
— , News clippings: pollution — the time to act,
44: aug 1979, p7
Bhat R. Pesticides: a necessary evil, 61: jan 1981,
P1
Jaya Rao K, From the editor's desk, 61: jan 1981,
p4 (food contamination by pesticides)
— , How pure is our food?, 61: jan 1981, p8
Krishnamurthy C, Environmental cancer in India,
82: oct 1982, p10
Mankad D, Health problems of tobacco, process
ing workers, 95: nov 1983, p1
Jaya Rao K, From the editor's desk: Tobacco sick
ness, 95: nov 1983, p8
—
—
18 Health during Mass Calamity
Patel A, Approach to health problems in famine,
44- aug 1979, p1
Foege W, Guidelines for disease control in times
of famine, 44: aug 1979, p8
Patel A, Morbi disaster: health problems (a case
against mass cholera vaccination), 45: sep
1979, p1*
Shah R, Dear friend: natural calamity — an oppor
tunity, 47-48: nov-dec 1979, p10
— , Emergency care in natural disasters: views
of an international seminar, 66: jun 1981, p1
Jaya Rao K, From the editor's desk, 66: jun 1981,
p4 (preparation of health personnel for natu
ral disasters)
-—■ , Education and training of medical students
for mass casualities situations, 66: jun 1981,
p8 (Israel)
— , Cholera vaccine: Inappropriate aid? 94:
oct 1983, p2
19. Water Supply
, Adequate, clean, available, 19: jul 1977, p7
(review of The Poverty of Power by B Com
moner)
Barreto L, The national water scene, 37: jan 1979,
p1
Gupta V and Takiar S, Drinking water: newer
appropriate techniques vis-a-vis experiences
in the village, 31: jul 1978, p6
Patel A, Water supply in tropical countries: quan
tity vs. quality, 52: apr 1980, p1*
Shinde D, Dear friends (water supply) 55: jul
P7
—
20 Diarrhea and Oral Rehydration
Damodaran M, Oral rehydration: the principles,
practice and the possibilities, 47-48: nov-dec
1979,
p1*
Patel A, On diarrhea and rehydration: what, why
and how?, 47-48: nov-dec 1979, p3-A—■ , Guidelines for the treatment and prevention
of dehydration, 47-48: nov-dec 1979, p4-*r
, ORT- The Turkish experience, 47-48: novdec 1979, p4*
Jaya Rao K, Oral rehydration therapy: do you
believe* in it? 60: dec 1980, p3
Hirschhorn N, Issues in oral rehydration, 60: dec
1980,
p4
Datar S, Dear friend, 61: Jan 1981, p6 (prepara
tion and use of ORS)
Parekh B, Communication (on treatment of diarr
hea), 64: apr 1981, p5
Feachem R, Oral rehydration with dirty water?,
68: aug 1981, p7
Ganguli M, (supply of ORS packets according to
WHO formulation), 77: may 1982, p5
Steinhoff M, Treatment of acute diarrhea in child
ren, 78: jun 1982, p1**
— , Rice powder as an alternative of success in
oral rehydration solution, 78: jun 1982, p3
(to be continued in 79)
Ganguli M, Dialogue, 78: jun 1982, p6 (use of
ORS packets by CHW)
Feachem R, Priorities for diarrheal disease con
trol, 79: jul 1982, p5
— , Rice powder instead of sucrose, 79: jul
1982, p7 (remaining part of article in 78)
— , Attention please: the campaign on diarrhea,
80: aug 1982, p4
Phadke A. Educational campaign against diarrhea,
81: sep 1982, p5
— , From the editor's desk, 90: jun 1983, p8
(rice starch solution as ORT)
__
21. Drug Industry Malpractices
Phadke A, Brand names: a ruse for higher prices,
6- jun 1976, p5
Agarwal A, Dear friend: brand names (I), 7: jul
1976, p7
Kashlikar S, Dear friend: brand names (II), 7: jul
1976, p7
Bang A, Dear friend; brand names (III), 7: jul
1976, p3
Phadke A, The drug industry: an analysis, 7: jul
— , How drug companies operate, 19: jul 1977,
p5 '
— , Doctors in the drug industry's pocket, 28:
apr 1978, p1
— , The joke of the year, 33: sep 1978, p8
(drug price propaganda of OPPI)
— , Do you know this (about the world blood
trade), 55: jul 1980, p8
Ganguli M, Have you read this?, 59; nov 1980,
p7 (notice)
— , The high cost of Metakelfiri, 68: auq 1981,
p8
Surana S, Dear friend, 70: oct 1971, p6 (compa
rative costs of drug brands)
Phadke A, Multinationals in Indian drug industryno positive role to play, 73-74: jan-feb, 1982,
p1 ★★
Agarwal A, Vietnam: herbs and war, 73-74- ianfeb 1982, p6
J
Agarwal A, Sri Lanka's experience with bulk pur
chasing, 73-74: jan-feb 1982, p7
'
Jaya Rao K, From the editor's desk, 73-74: janfeb 1982, p10 (multinational in drug industry)
, If there are no side effects, this must be
Argentina, 73-74: jan-feb 1982, p12
Vaidya A, Dear friend, 76: apr 1982, p5 (response
to Phadke A in 73-74)
Jaya Rao K, From the editor's desk, 78: jun 1982,
p8 (imports of bulk drugs)
Jajoo U High cost medicine, 80: aug 1982, p1
— , Bitter pills: Medicines and.-/che third world
poor, 87: mar 1983, p8A
Victora, C, Statistical malpractice in drug promo
tion: a case study from Brazil, 92: aug 1983,
p1
— , Reporting of adverse drug reactions in Bri
tain, 94: oct 1983, p2
— , Campaign against the irrational production
and marketing of drugs, 96: dec 1983, p8
—
Patki U, Global amnesia with clioquinol, 83 nov
1982, p5
Sun M, The controversy around Depo-Provera, 97:
mar 1983, p1 ■
— , From the editor's desk: wrong choice,
wrong solution, 87: mar 1983, p10 (indiscri
minate use of injectable steroid contracep
tives)
— , Antibiotics in developing countries, 93: sep
1983,
p5
— , Battle of the body: antibiotics vs. super
germs, 95 nov 1983, p6
2J. Rational Drug Therapy + Action
Patel A, A story of r factor, 26: feb 1978, p1 (anti
biotic resistance)
Gambhir A, In search of appropriate medicine, 36:
dec 1978, p7 (antibiotics)
Bharatiya Grahak Panchayat and Arogya Dakshata
22. Drug Misuse
Mandal, Operation medicine : an appeal for
vigilant action, 37: jan 1979, p7
Jaya Rao K, Tonics: how much an economic waste,
11: nov 1976, p1
Sonwalkar A, Dear friend: 'Operation medicine',
38: feb 1979, p3
Singh T and Kaur C, Dear friend: brand names and
tonics, 12: dec 1976, p8
Chugh S, In search of appropriate medicine — I
— , 'I did take the tonic, Sir........', 33: sep
cough mixtures 56: aug 1980, p5**
1978, p8 (cartoon)
Jajoo U, Low-cost drug therapy, 81: sep 1982, p1
Shatrughna V, Drug prescription: Service to whom? Phadke A, Drug workshop at Jaipur 83: nov 1982,
31:nov 1978, p4*
p4
— , Ban on tetracycline liquid form, 13-14: mayDesai D, An Indian low cost drugs project, 83: nov
jun 1980, p5
1982, p5
Gopalan C, 'The body has limited ability to store
Jajoo, U, Rational therapeutics: selection of appro
water soluble vitamins....... ', 55: jul 1980, p8
priate drug, 90: jun 1983, p4 (analgesics)
— , Vitamin therapy, 55: jul 1980, p8
— , Do you know this (about Lomotil), 60: dec — , Antibiotic therapy, 92 aug 1983, p4
Bang A, Single dose therapy for acute infection,
1980, p3
92: aug 1983, p5
— , Upjohn, Depo-Provera and the third world,
Nagar N, More on aspirin, 94: oct 1983, p8 (also
65: may 1981, p3
see letter by Patki in 92)
Mankad D, Report of the VIII annual mfc meet, 75:
mar 1982, p4 (misuse of drugs)
Kulkarni S, Fancy, fallacy and facts about fixed
dose formulations, 96: dec 1983, p5
Phadke A, Campaign against hormonal 'pregnancy
test', 75: 1982, p7
Phadke A, Drug action network meet, 99, mar
1984,
p11
Phadke A, From the editor's desk, 75: mar 1982,
P8
24. Drug Policy Alternatives
Mathur V, Hazards of hormonal pregnancy test, 75:
— , A new strategy for drugs, 60: 1980, p8
mar 1982, p9
Phadke A, The committee for rational drug policy,
— . From the horse's mouth....... : progesterone/
73-74: jan-feb 1982, p13
estrogens, 75: 1982, p10 (warnings from
Agarwal A, Towards a relevant drug policy, 75
PDR, 1981)
mar 1982, p1
— , Health education campaign....... . 76: apr
— , MFC resolution on events in Bangladesh,
1982, p7 (hormonal pregnancy test)
82 oct 1982, p11 (national drug policy
Jajoo U, Misuse of antibiotics, antimicrobials, 77:
against multinational)**
may 1982, p1**
—
,
Conclusions reached by the drug sub-group
Anand R, Dear friend, 77: may 1982, p5 (ban on
at the natioal health policy seminar, 91:
liquid tetracycline)
jul 1983, p6
— , Attention please! campaign irrational use of
25. Tuberculosis
drugs, 77: may 1982, p7
__ , (Saheli/VHAI poster), 80: aug 1982, p4 Patel A, Tuberculosis: a health problem, 6: jun
1976, p1
(poster against hormonal pregnancy test)
Phadke A, From the editor's desk: banning hormo Junnerkar A and Ketkar Y, Community participa
tion in TB control, 18: jun 1977, p4
nal pregnancy drugs — only a partial victory,
80: aug 1982, p8
Jajoo U, In search of appropriate medicine-ll:
critical evaluation of utility of chest radiology,
Balasubramanyam V, Dear friend, 82: oct 1982,
57: sep-1980, p6
p11 (misuse of anabolic steroids)
S
43: jul 1979, p7
Srinivasa Murthy R and Wig N, Auxiliaries and
mental health care, 56: aug 1980, p1
Dhara R, The attitude of society and the psychia
trist towards madness, 56: aug 1980, p3
Jaya Rao K, Editorial 56: aug 1980, p4**
Srinivasa Murthy R, Mental health education for
auxiliaries, v6: aug 1980, p8
Chandrashekhar C, Serving the unserved: PHCs for
psychiatric care, 69: sep 1981, p5
Aitken J, Point of view: to inject or not to inject,
61: jan 1981, p7**
Jaya Rao K, From the editor's desk, 79: jul 1982,
p8 (Koch centenary)** ■
Talwalkar V, Dear friend, 81: sep 1982, p6 (TB
control programme)
Jaya Rho K, Is BCG vaccination useful , 89: may
1983,
p7
— , Centenary of tuberculosis bacillus, 92: aug
1983, p8
Sadgopal M, Health 'care' vs. the struggle for life
(part-l) '93: sep 1983, p1
Sadgopal M. Health 'care' vs......... (part-ll), 94:
oct 1983, p2
Nagar N, Is antitubercular treatment really very
expensive? 96: dec 1983, p3
26.
29.
Chugh K, Acute renal failure in north India, 43:
jul 1979, p5
Suryanarayana V, Cataract surgery by tumbling
method. 83: nov 1982. p6
— , Medical laboratory manual for developing
countries (volume 1), 85-86: jan-feb 1983, p5
Malaria
Soni M and Thakkar J, MFC regional camp, Pindval
(malaria survey), 6: jun 1976, p3
Patel A, Malaria eradication programme: its
genesis, 13: jan 1977, p1
Patel A, Malaria eradication vs. malaria control: a
case of confusion of terms, 14: feb 1977, p4
Patel A, Malaria control programme: an integral
part of community health and development,
16: apr 1977, p4
Sen B, Malaria in post-independence India, 17:
may 1977, p1
Agarwal A, Pesticide resistance, 61: jan 1981, p8
Linear M, FAO: the pesticide connection, 67: jul
1981,
p5
Farid M. Malaria and global politics. 82: oct 1982,
p1
Chapin G and Wasserstrom R, Agriculture and
malaria, 82: oct 1982, p3
Jaya Rao K, From the editor's desk: under the
mosquito net....... 82: oct 1982, p12
27.
30.
Miscellaneous: Non-technical or
Non-Medicai
— . Low energy economics, 8: aug 1976, p7
Jaya Rao K, Dear friend: are we truly independent?,
21: sep 1977, p6
— , Our typewriter works quite well except for
one key............. 26: feb 1978, p8
R, q
31 jul 1978, p6
Gandhi, The talisman, 32: aug 1978, p1 (poem)
UTHRT
MRH R 5?!... 32: aug 1978, p8
Sidgwick H, Free thinking, 33: sep 1978, p1
HRcft 4, snftR W gw4t |
33: sep 1978, p3
fqq ST,
giro
SFRT
T 3q^,
34: oct 1978, p1
Frost R, a semi-revolutioh, 37: jan 1979, p7
Williams O, a total revolution (an answer to Robt.
Frost), 37: jan 1979, p7
Marx K, Man: the alienated individual, 38: feb
1979, p1
— , Work experience gives vision, 39: mar 1979,
p8 (a student's experience of adult literacy
work)
— , Modern medicare, 40, apr 1979, p8 (cartoon)
Chopra P, the plan plants a time bomb, 41: may
1979, p7 (land redistribution)
31^1 T, 311
^fl i 42: jun 1979, p6 (poem)
W, JRITOT 43: jul 1979, p8 (poem)
fTTTI,
I *Stl JITOI aiqq...”......... 46: oct
1979, p1
Rimq st, sfaq
q qq t, 46: oct 1979, p1
, Rural medicare hospital: trying to appear
'rural'l, 47-48: nov-dec 1979, p12
Aptekar N, Death: reflections, 59: nov 1980, p5
Laxman R, "You are going to ask for a second
opinion? well...", 67: jul 1981, p6 (cartoon)
Bang R, Small-pox reappears?, 69: sep 1981, p7
Wind J, LDC — WHO cares?, 76: apr 1982, p3
Leprosy
qwr
39: mar 1979, p1
Gupte M, Leprosy control: problems and possibili
ties, 39: mar 1979, p1
Pandya S, Can India eradicate leprosy?, 39: mar
1979, p4
Gupte M, Leprosy control: problems and possibili
ties, 39: mar 1979, p1
Pandya S, Can India eradicate leprosy? 39: mar
1979, p4
— , New developments in leprosy, 39: mar
1979, p6 (XI International Leprosy Congress,
1978)
Bang A, Editorial, 39: mar 1979, p3
Sharma R, Leprosy control in India: review and
suggestions for future, 40: apr 1979, p3
TO g, Dear friend: M
? 41: may 1979,
p6
28.
Miscellaneous — Technical and
Medical
Mental Health
Steiner C, Radical psychiatry: principles, 5: may
1976, p1
81, Dear friend:
TOT :
%-flT’T ^4isft,
10
31.
Role cf MFC and Members
Sen B, Revitalisation of MFC: hard introspection,
crucial decisions, 45: sep 1979, p3 (mid
annual MFC meet report)
— , Changing emphasis of MFC, 45: sep 1979,
p6
44 31, 4qi<^4 : 441
441 414
? 46: oct 1979,
46: oct 1979, p3
Gurubani S, Dear friend: kudos to MFC, 47-47:
nov-dec. 1979. p10
Mankad D, Communication: a search for alterna
tives, 63: mar 1981, p7
Wagh H, Dear friend, 66: june 1981, p6 (res
ponse to article by Bang A in 64)
Werner D, Health care and politics: a personal
statement. 69. sep 1981, p1**
Rao M, Communication (medical ethics and. poli
tics), 67: jul 1981, p7
Ganguli M, Dear friend......... 76: mar 1982, p6
(criticism of MFC)
Mankatf D, Dear friend, 80: aug 1982, p7 (res
ponse to M Ganguli) Phadke A. Role of health work done by MFC
members, 82: oct 1982, p7 (mid-ann. meet
, Medico Friend Circle: objectives, organisa
tion and programmes, 1-2: jan-feb 1976, p10
(as approved at II ann. MFC meet)
Sadgopal M, where do we fit in?, 7: jul 1976, p3
Phadke A. Dear friend: from the horse's mouth....,
8- aug 1976, p3
Phadke A, Dear friend- limitations and role of
MFC, 16: apr 1977, p5
Patel A, Dear friend: limitations and role of MFC,
18: jun 1977, p6
Singh T, Dear friend: encourage us, 19: jul 1977,
p6
Phadke A, MFC — which way, to go?, 28: apr
1978, p5
Qadeer I, Dear friend: MFC —which :way to go?
,
(I)
29: may 1978, p5*
Phadke A, Dear friend: MFC — which way to go?
,
(II)
29: may 1978, p5
Bang A, Dear friend: MFC — which way to go?
(Ill), 29: may 1978, p6*
Bang A, Editorial: From awareness to action, 32:
aug 1978, p3
Gaitonde R, Dear friend: role of non-medicos,
32: aug 1978, p4
Banerji D, Health work as a lever for social and
economic change, 32: aug 1978, p1
Roy D, Hyde Park: MFC — which way to go? (I),
32: aug 1978, p5
Qadeer I, Hyde Park: MFC — which way to go?
(II), 32: aug 1978, p7
Phadke A, Dialogue: MFC, which way to go?, 34:
oct 1978, p5
Jaya Rac K, Dialogue: Settle the question once and
for all, 34: oct 1978, p6
Qadeer I, Dialogue: dilemma of individual medico,
34: oct 1978, p7
ajqq 44
35:'nov 1978, p3
Patel A, Dialogue: economic change is not the
panacea-health work can become the key,
35: nov 1978, p5
Wagh H, Dear friend: decision is essential, 35:
nov 1978, p7
Rindani A, Dear friend: MFC friend in USA, 36:
dec 1978, p8
Gokani A, Dear friend: great grandson of Mahatma
Gandhi writes, 39: mar 1979, p5
Parikh I, Dialogue: health, project — a means of
social change, 39: mar 1979, p7
Punpani D, Dialogue: in search of utilization, 39:
mar 1979, p7
Sen B. Dialogue: to a soul 'in search of-’ utiliza
tion' (I), 40: apr 1979, p7
Bang R, Dialogue: to a soul 'in search of utiliza
tion' (II), 40: apr 1979, p7
Kashalikar S, Dear friend: what can be done? 41:
may 1979, p6
44 ar,
: anrfa ! gai4
.4? 443....,.- rirt1
........ 44: aug 1979, p3
Bhagwat A, Dialogue: why retired doctors-for the
villages?, 44: aug 1979, p5
—
32.
MFC Bulletin
Patel A, Editorial, 1-2: jan-feb 1976, p3 (MFC
role and bulletin)
— , About the bulletin, 1-2: jan-feb 1976, p3
Phadke A, Dear friend, 4: apr 1976, p4 (bulletin,
role of MFC)
Qadeer I, Dear friend: is this a readers’ bulletin?,
5: may 1976, p7
— , An appeal....... . 6: jun 1976, p4
Katgade V, Dear friend: from the horse's mouth...,
7: jul 1976, p5 (criticism of MFC bulletin)
Roy D, Dear friend: why readers do not respond ,
7: jul 1976, p7
— , To the readers, 8: aug 1976, p4
— , To the readers, 7: sep 1976, p3 (bulletin
questionnaire)
Shah S,. Dear friend: had enough about myths, 9:
sep 1976, p5 (appeal for more field experi
ences)
Patel Aj Editorial, 13: jan 1977, p3 (progress and
problems of MFC bulletin) •
— , Reminder, 14: feb 1977, p1 (bulletin subs
cription and membership fees)
Singh T and Kaur C, Dear friend: be practical, 18:
jun 1977, p7
Junnarkar A, Dear friend: an appropriate title, 18:
jun 1977, p7
Kapur S, Dear friend: points of view — medicine
2000 AD, 19: jul 1977, p6 (response to arti
cle in 18)
— , Subject index of back issues of MFC bulle
tin from the first issue, 24: dec 1977, p
Patel A, Editorial, 26: feb 1978, p3 (problems of
the mfc bulletin)
Tejinder Singh, Dear friend: which way the bulle. tin to go? 29: may 1978, p7
Bang A, Editorial, 30: jun 1978, p3 (mfc bulletin
standards and perspectives)
1.1
Bang A, Editorial, 31: jul 1978, p3 (problems of
the mfc bulletin)
Sadgopal M, Dear friend: about the bulletin 31jul 1978, p3
— ■ P'ease......... 31: jul 1978, p4 (bulletin
article instructions)
Kathiria V, Dear friend: why hyde park?, 32: aug
1978, p4
Bang A, editorial: Where is the space?, 34: oct
1978, p8
Panchai P, Dear friend: simplify still more, 35:
nov 1978, p7
Bang A, Editorial (review of the mfc bulletin for
1978), 38: feb 1979, p3
— , Internship and you, 40: apr 1979, p8
(appeal for written experiences)
Manudhane S, About the bulletin: a view from
USA, 42: jun 1979, p8
Sarmandal D, Dear friend: I am surprised to
know....... . 43: jul 1979, p7
— , You be ouh hands, 43: jul 1979, p8
Bang A, Dear reader, 45: sep 1979, p8
— , In case you have not......... 47-48: nov-dec
1979, p11
— , To catch the next month's train, 47-48:
nov-dec 1979, p12
Patel A and Bhargava A, The readers speak about
mfc bulletin 52: apr 1980. p4
— , Please note (change of bulletin editor), 52:
apr 1980, p12
Phadke A. (Explanation for not bringing out may
issue), 53-54: may-june 1980, p5
Jaya Rao K, Editor's note (on taking over editor
ship), 53-54: may-jun 1980, p8
— , Will you help us? (sample subscription
scheme) 60: dec 1980, p2
— , Important: (increase in subscription rate)
62: aug 1981, p3
— , Attention please!, 76: apr 1982, p7 (MFC
life subscription)
Sadgopal M, Proceedings of the fourth all India
meet of MFC — Report A, 26: feb 1978, p4
Barreto L, Proceedings of V annual of mfc, 38:
feb 1979, p4
Jaya Rao K, proceedings of MFC general body
meeting, 52: spr 1980, p9 (VI ann. mfc
meet)
Phadke A, MFC VII annual meet, 63: mar 1981, p5
Phadke A, The biannual executive committee meet
at Hyderabad, 68: aug 1981, p3
( ,, ) , Attention please (MFC is now a regis
tered association and trust), 75: mar 1982,
p9 (VIII ann. meet report)
( ,,
, Attention please (decisions taken at VIII
ann. meet), 76: apr 1982, p7
( ,, ) , Attention please (decisions taken at VIII
ann. meet), 76: apr 1982, p7
( ,, ) , Mid-annual executive committee meet
ing, 82: oct 1982, p5
( ,, ) , MFC organisational decisions, 87: mar
1983, p8A (IX ann. MFC meet report)
( „ ) , Report of the X general body meeting,
99: mar 1984, p9
included in the second anthology;
★★ Included in the third anthology
Note
a.
New address of MFC is:
326. V Main, I Block,
Koramangala,
Bangalore 560034
(Phone: 565484).
b.
Limited copies of issues No. 41, 42, 45, 46,
56, 57, 65, 66, 70, 71, 78-81, 85-86, 92-95
and 99 are available at Rs. 2-00 each (50 US
cents or equivalent).
c.
All other issues in xerox from are available
with the MFC office in Bangalore at Rs. 5.00
a copy (US $2/- or equivalent).
Cheaper
arrangements still being negotiable.
33. MFC Meet Reports (Organisational) d. Limited copies of Anthology — Health Care
Sadgopal M, Report A: the meet, 1-2: jan-feb
Which Way to Go —, covering issues 26-52,
1976, p5 (proceedings of II all India meet
are available with the MFC office and with the
of mfc)
Voluntary Health Association of India (VHAI),
C-14, Community Centre, Safdarjung Develop
Bhatt N, Report A: the meet, 13: jan 1977, p4
ment Area, New Delhi 110016.
(proceedings of III all India mfc meet)
OBJECTIVES OF BULLETIN
—
—
—
—
—
To gather together lone fighters seeking
for an identity and friendship.
To cover lacunae in our knowledge of
the health system and health planning
in India and new field experiments.
To motivate and involve the readers
sitting on the fence through dialogue
and debate.
To evolve a style and level of content
within the reach of the common man.
To encourage medical students to share
new, raw and enthusiastic ideas.
12
__
To feature materials from other walks
of life — education, psychology, socio
logy, economics and agriculture —
which have a bearing on health.
—
To become a medium of expression,
dialogue and communication as well as
a source of conceptual and informative
inputs for all those who are trying to
think differently and fall out of the
routine and established pattern
of
medicine.
- Media
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