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While Jammu and Kashmir has always had among the lowest suicide rates (0.3% of all suicides) in India, statistics show a rising trend (44.3% more in 2012 than 2011) as opposed to a slight decline (0.1% less in 2012 than 2011) in the overall national figures. The dramatic increase is concerning in a state where the ongiong conflict creates a volatile situation or the youth.

Suicide - warning signsDr. Raminder Jit Singh knows loss personally. Every decade of his life had been dotted with people he cared about logging out of life, leaving behind bewildered families. His cousin's suicide left behind a wife and three children, and it was the impetus that led him to start The - Sara.

'The - Sara' is the first Registered Non - Profit Organization  working in the field of Suicide Prevention & providing Emotional Support in the State of J&K. 'The - Sara' is a non-religious, non-political and non-sectarian Organization formed by a group of like minded professionals, Health Care Givers, Business people, Artists, Homemakers, Engineers, Teachers and Retired Government Employees dedicated to the cause of Suicide Free Society.

 Recent Activity - 'The - Sara' in March 2013 carried out a Pamphlet Campaign on an issue "How to deal with Exam Stress". This initiative was supported by Companies/Brands like AOC India, Jammu & Kashmir Bank Ltd., Vodafone and Simula Infra Development. (Pamphlet attached)

Present Activity 
- at present we are working on a Project "Epidemiological Study of Suicides in Jammu" in co-ordination with J&K Police. (Permission Proof attached)Upcoming Activity - Continuing with our commitment towards our cause and Society 'The - Sara' is planning to carry out Pamphlet Campaign with the Theme "Learn Suicide Warning Signs". These Pamphlets will be distributed in various parts of Jammu & Kashmir.
Future Activity - we have moved Proposal with IGP Jammu Zone for establishment of "Suicide Prevention & Emotional Support Center". DGP of J&K Police has agreed to take up this Project under Civic Action Programme. This S.P.E.S Center shall provide On-line, Telephonic and Face - to - Face Counseling Services. This proposal is facing numerous glitches. (Proposal Proof attached)
https://aamjanata.com/wp-content/uploads/2013/09/Proposal-to-PHQ.pdf

Since Suicide Prevention is accorded little priority in India therefore is no 'Grant in Aid' Scheme of Govt.of India to support Suicide Prevention Organizations/NGO's. Henceforth, we are carrying out our activities through donations of few well wishers including some Police Officials & through sponsorships of our campaigns. "I am fighting a lost battle." says Raminder Jit Singh. "Jub Tak Hai Jaan the show must go on."

If you think this is an important cause, do contact @abdullah_omar, the CM of J&K and ask him to explain what is goingr. Why would the state not support an NGO wrking on a subject of concern?

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English: Montek S. Ahluwalia, Deputy Chairman,...
English: Montek S. Ahluwalia, Deputy Chairman, Planning Commission, India, speaks at the closing plenary of the World Economic Forum's India Economic Summit 2008 in New Delhi, 16-18 November 2008 (Photo credit: Wikipedia)

The provisional census data on houselisting has a shocker on sanitation in India - sanitation in India statistics reveal that less than 31% of Indians had access to proper toilets. Yep. You got that right. MOST INDIANS DO NOT HAVE ACCESS TO A TOILET. Half of india still defecate in the open.

A proposal to make Human Right to toilet an integral part of the 12th 5 year plan document was discarded by the Planning Commission of India. Ghosh, a professor at JNU said that a cabinet minister "gave a bizarre argument that Indian women like to defecate in the open". Of all the things that get blamed on women, from obesity in children to rapes, this is one I had never imagined I would encounter. That women do not want the luxury and privacy of a toilet and like to defecate in the open.

This, of course happens to be the Planning Commission of India which spent 35 lakh rupees for renovating 2 toilet blocks, 5.19 lakhs of which went into a smart card system to limit access to toilets to those who had cards issued. The electronic access system got disabled after protests by people on the floor. Gone 5 lakh. Poof. Planning Commission chairman Montek Ahluwalia spent Rs. 2 lakh per day of foreign travel at a time when our Prime Minister was making noises about austerity. One toilet for public use can be added for Rs.10,000/- but right to toilet seems to be limited to the stinking elite.

In other news, yesterday, the Delhi high court judge expressed displeasure at the negligible number of public toilets for women (269) in Delhi, as compared with men (3,712). Not to mention India being seriously behind on toilets with respect to its commitment to UN's millenium development goals and four South Asian Conferences on Sanitation, not to mention on a National, state, district and mohalla basis. Big promises, empty inside. Naam bade aur darshan chote, etc.

News from Madurai is that residents of Alwarpuram, Shenoy Nagar and Gandhi Nagar are defecating in the riverbed of Vaigai, because the toilets in their area are either locked or defunct due to stinking conditions. Complaints raised have not worked, concerns raised about both health and river have failed to worry anyone into action.

Raichur, in Karnataka ran into a strange problem when its 3 fancy e-toilets costing 5 lakh each and with a working life of 7-10 years were not being used by the public. You put a coin into a slot, the door unlocks. Exhaust fan starts, FM radio plays... you are supposed to do what you normally do in a toilet. When done, if you forget to flush, never mind, the toilet does it for you, and there is a timer that rings when your time is up at the end of two minutes or something. Such miraculous toilets probably freaked out the public at large. Or possibly our crowds are either not used to paying for peeing or take newspapers into loos to poop and 2 minutes won't do.

Whatever it is, the experiment follows Kerala installing some 450 of these toilets (that's a cool Rs. 22.5 crores, by the way) by the same manufacturer, who also got (the visibility to get) a grant by the Bill Gates Foundation. Considering that Raichur City Municipal Council and Kerala are both ruled by the Congress with its reputation for you know what, one starts wondering about all kinds of things about these 5 lakh rupee toilets that play FM music.

Though they do seem to be doing good work when in the mood. Intinta Paarishudhyam in Andhra Pradesh seems to have built 50,000 toilets in four months for the sane cost of Rs.10,000/- (of which they pay about a third) or so, using sanitation kits and local labour. They claim that this model can be easily replicated all over India and I found myself wondering why it took 65 years to figure out that people can build toilets when mobilized. So I am a bit skeptical. God knows how good it actually turns out to be. Reports that use words like "high voltage" for a sanitation programme in India leave me wary.

Dakshina Kannada district Sarva Shiksha Abhiyan (SSA) is constructing sanitary napkin incinerators in schools to encourage hygiene and prevent blocked toilets when girls gispose them in toilets. An astonishingly caring move.

Nirmal Bharat Abhiyan, the rural sanitation programme has failed abysmally to meet its target in UP due to lack of funds. Only 7% f the target toilets were constructed. 11,44,430 toilets were to be constructed in 5,799 gram panchayats, but it could construct only 79,653 toilets. The rural development department was able to provide only Rs 74.6 crore under MGNREGS against the requirement of Rs 514.9 crore to panchayati raj department for executing of the scheme till March 2013. Further meetings led to another Rs.108 crore. The state couldn't use Rs 576.28 crore available for construction of individual toilets in rural households last year because of revised guidelines. Apart from MGNREGS share, the state received Rs 256.84 crore (against Rs 366.22 crore) from the centre and Rs 32.9 crore from the state. It also had about Rs 200 crore lying unutilized from the previous year. The department has to spend Rs 10,000 to get a single toilet constructed under NBA. To construct a toilet, Rs 4,500 comes as a MGNREGS share, Rs 3,200 as centre's share, Rs 1,400 as state's share and Rs 900 has to be contributed by the beneficiary.

Chennai Corporation failed to get any bids to construct 2,000 toilets, so it is waiting to fail once more before it rolls up its sleeves and gets to work.

In other news, some 85% of rural households in Bihar not having access to toilets is contributing to rapes, it seems. Police and social activists speak of a worrisome trend or rapes happening when women go to defecate in the open, particularly in the early morning and late evening. Mr. Pandey estimates that 400 out of Bihar's 87 rapes reported last year would be avoided if there was access to toilets. This is interesting and worth examining if there is any corelation. It reminds me of a horrendous gang rape of a child last month. She was caught by her rapists when she went to defecate in the open. The link has more such recent incidents.

A report by Ministry of Drinking water and sanitation for the Nirmal Bharat Abhiyan on the sanitation situation in some districts of Maharashtra tells us that the number of households without access to toilets is 71% in Aurangabad division, 62% in Amravati division and 60% in Nashik division. Additionally, another 12% are not working.

CSR fitted 48 bio-toilets jointly developed by the Railway Research Design and Standard Organisation and Defence Research Development Establishment and is looking to fit 200 more on trains at a cost of Rs.80,000 each. This will prevent the night soil from dropping onto the tracks and create a hygienic, aesthetic and safety hazard (corrosive to rails) and reduce the excreta to water and gas.

Even the economic capital of Mumbai has a shocking 1,137 manual scavengers, even though they are (token) banned by the state.

I have no point to make. All the points are made. This is a sample. This is where we stand. thought it was worth a compilation to get a large view. The Nirmal Bharat Abhiyan has a long, long way to go.

Primary health care with skilled nursing facilities and medical technology for prenatal care and delivery. Possibly medical technology for a cesarean section and a neo natal intensive care unit. How complex can it be for the abilities of an upcoming superpower like India? Health care reform is an urgent need, yes, but what does it take to provide a clean and safe birthing environment? Even speaking of skilled nursing facilities, what terribly difficult skills are involved?

Mistry is a carpenter. He has worked with my husband for many years. Today, he arrived in a hurry to collect some money my husband had left for him. Thin, wiry man in his fifties with a cadence from rural Maharashtra, he claimed to be in a hurry and refused tea. Accepting a glass of water, he chatted with me for a short while as he took out a miniature cheap note pad and a "one rupee pen" (the plastic kind you get in trains) from his shirt pocket. Tucked in the spiral bound notebook was a carefully folded A8 size paper with numbers. Presumably accounts or information related with the job. Frowning in concentration, he noted something on the paper, carefully folded it and tucked it into that notepad and returned both note pad and pen to his shirt pocket, hooking the clip of the pen on the cloth so it won't fall off. Testing to make certain the pen was secure.

This is a working class man from an older generation. No flash and dazzle for him. Careful work. Attention to detail. Careful recording of hard earned money.

When I enquired after his family, he informed me that he needed the money for his daughter's hospitalization. Alarmed, I asked him what was wrong with her. There was nothing wrong. Her pregnancy due date was near. Mistry was to be a grandfather soon, and his wife had returned to her parent's home for her first delivery.

He said he had gone to the government primary health care center first, for prenatal care and to register for delivery. He was told to take her to a private maternity home for delivery because the government hospital didn't have skilled nursing facilities or medical technology - these were the two exact reasons given. Remarking wryly that in his time women had babies at home, he said he was collecting all his dues and taking advances where possible to have money ready. He did not want his daughter to suffer unnecessarily or face risks to her health or life as her pregnancy due date approached.


Community health in India

The people in the government hospital had recommended him to a private hospital telling him that she would be safer there. I was aware that this is likely a routine practice of getting paying customers by advertising to people approaching public health facilities. My mother had been recommended to another private nursing home a few years ago in the very first meeting when we had first started to get her help for schizophrenia. This is in spite of government hospitals boasting of "expert doctors" (who usually own private clinics).

I remarked that private hospitals are not necessarily better with medical care considering my experience with Nisarga's nightmare birth, where I was in the private maternity hospital that specialized in deliveries and was reputed to be the best in the area. Besides, delivery hardly takes any specialized medical technology in routine cases, and government hospitals with their surgical facilities and doctors on duty and neonatal wards would be far better in a crisis than a private maternity home, where doctors are usually absent till the baby starts crowning.

He agreed. Then paused and said that if it was this bad in a private hospital, the government one would be worse. His daughter may not be helped with pain management or the medical care may be lacking or his grandchild may suffer infections. Can't dispute that. Particularly the last. Hospitals are hot beds of neonatal infections in India. I have two friends with children who died within a day of birth from infections - ironically, both in highly competent medical facilities with the latest in everything, but this was clearly not the time to bring it up. And in any case, the government hospitals have no better records to go by news.

Besides, the government hospital near their home was not so big and it hadn't looked very hygienic when he went there. I cringed, knowing that this man is paying for private care he cannot afford, because the government facilities are there, yet not. For a moment I almost recommended a home birth which, in my opinion is probably the most healthy choice, particularly with a home healthcare provider, ideally a midwife or "dai" - check out infant mortality in hospitals), then stopped. It was a long reasoning and against the recommendations of what is best by the "medical profession" in which he had put his faith. If anything went wrong... This was not the time to throw him into indecision on the basis of my ideas, with the pregnancy due date within a week.

He left.

I am left with thoughts of how 65 years after independence, the government's healthcare system cannot assuredly handle something that has been happening naturally since the birth of mankind and usually happens spontaneously with very little "facilities". Nor can it monitor private facilities for something this basic. We have discarded ages and ages of wisdom in favor of a new system we cannot offer consistently. So the common man is literally left neither here nor there.

One has to wonder what exactly it is that the government means by healthcare. Or is it healthscare? A citizen has a right to free health care. A government hospital refering patients to private clinics because it doesn't offer basic medical facilities must ask the patient to submit the bill for reimbursement!

I am a fairly heavy smoker, and have been wanting to quit smoking for a long time. I quit easily enough, but I enjoy smoking too, and end up right back later. I had earlier tried shifting to electronic cigarettes, but it didn't work. Then, I got a better electronic cigarette from Smokefree, and it worked. Sharing what I learned, in case it is useful to anyone else. A lot of this information can be found on the Wikipedia page, which is a good starting point for references to read for further information.

Buy this one or bigger (as a general guide). With the smaller ones, you end up refilling, recharging and cleaning so often that it gets boring.

What are electronic cigarettes?

Electronic cigarettes are vaporizers, that use batteries to heat liquid and form thick vapor that can be inhaled like cigarette smoke.

How safe are they?

It is not known. They are a fairly new product, only a few years old, so there is little research and no long term research. However, the general consensus seems to be that in comparison with cigarettes, they are far safer. The main base is propylene-glycol, which is already used for delivering inhaled medications. Since there is no smoke or combustion involved, any risks associated with that are gone. Some research indicates that cartridges may not be as safe as tank atomizers. Also good idea to investigate contents of liquid if you are very health conscious. While all ingredients are food grade, there is of course, no research on "inhale grade".

That said, a doctor friend was blunt. "It is much better than smoking."

How expensive are they?

The premium kit I am using comes for a thousand rupees at Smokefree. I would suggest buy spares. Either buy two kits or buy spare tank atomizer [don't buy cartridge ones - I found the frequent refilling and cleaning enough to send me back to regular cigarettes] and battery at least and a few different flavors of liquid, so that you don't end up shifting to vaping only to return to a cigarette because your electronic cigarette ran out of battery or fluid, etc. Spare battery is a must at the least for any serious plan to quit smoking permanently. Though I guess it doesn't matter if you aren't quitting cigarettes and can always have a smoke.

I would say a good initial investment to make would be around Rs.2,500/- This looks fairly expensive, but if you are spending a hundred rupees on cigarettes a day, it is the equivalent of less than a month's smokes. This purchase should be good for months. After which, the expected expense is a few hundred rupees when you run out of liquid. In the long run, it works out extremely cheap, but if you are buying to try, then it is expensive. In that case, you should try disposable ones.

How will the satisfaction from a cigarette be duplicated?

The vapor from the e-cigarette feels very similar to smoke, and if you are using a liquid with nicotine, you get the nicotine hit that you normally get with a cigarette. In my experience, the tank atomizer and a larger e-cigarette works better for this satisfaction than a slim one that looks like a cigarette. I have used several brands and find that the ones that look like cigarettes may seem more likely to replace cigarettes to beginners, but they do not deliver the kind of experience that will replace the satisfaction of smoking. In the end, if you smoke, it isn't because you like how it looks.

What kind of side effects should be expected?

I have quit several times, and shifted to electronic cigarettes several times. In my experience, the side effects were the same. A day after quitting cigarettes, I usually get a cough that lasts for several days - in either case. Additionally, I found that I get more thirsty with electronic cigarettes. I didn't experience any other symptoms. I didn't get any symptoms other than feeling more thirsty than usual from the cigarettes. However, your mileage may vary. I have not heard of anyone get any dangerous side effects, so if you feel anything alarming at all, it might be good to check with a doctor.

What are the risks to others from the passive smoke?

There isn't any smoke at all. There is no evidence of danger to anyone else.

Can I use it to quit completely?

Sure. Many people seem to. I find that my habits around smoking having changed, I end up vaping less often than I smoke. I have two electronic cigarettes and I alternate between the one with nicotine and without normally.

Any advice on how to shift from cigarettes to electronic cigarettes?

Buy several flavors of liquid. Test-smoke them when you get them, and fill your favorite for when you do the shift. Then, simply run out of cigarettes and don't buy any. When you want to have a smoke, use your electronic cigarette. Initially, it can be disorienting, as if you are a regular smoker, you automatically reach for cigarette and to light it, etc. So you keep realizing there is nothing to light and it is more like picking a pen on and off and sucking on it - and getting smoke, not to worry :p

If you don't have cigarettes at all, you will not "automatically" light one, and the new habit forms faster.

Any precautions?

Several:

  • Do NOT stand in balconies and such to smoke if you normally do. You may automatically throw away your new electronic cigarette once done smoking 😀 I have tried to stub mine out several times.
  • If you are a chain smoker, keep an eye on how much you are smoking. Since the cigarette doesn't "end", it may be possible to smoke "too much". No clue what that would be like. Buzzed from the nicotine, I guess. Not heard of it happening though and I have read considerably.
  • Drink water. Lots. I don't know if it is the vapour or the quitting smoking, but I am thirsty. Your mileage may vary.
  • NEVER EVER let your electronic cigarette run dry. Will likely damage the heating element and give you smoke full of burnt residue - if there is smoke.
  • You WILL get the withdrawal symptoms from stopping smoking, though not nicotine. Cough will happen without your regular dose of whatever chemicals in cigarettes prevent it. This is not from your electronic cigarette, but from the quitting smoking. This will happen even if you don't use the electronic cigarette, unless you start smoking again. It resolves fairly quickly - within a week.

What does it feel like?

It feels very good, actually. Four biggest changes I appreciate are:

  • I don't smell of smoke. Clothes, breath, etc stop stinking.
  • The body is allowed to heal itself and return to normal functioning. My lips became softer, most notably. They weren't rough, earlier, so it was a surprise.
  • Sense of smell. Sense of smell increases. Be prepared to smell things you hadn't noticed before. The only other description similar to this is acute sense of smell during pregnancy without the nausea. It is actually the nose starting to function better. It is noticeable.
  • Breathing becomes noticeably ligther, smoother. Other than the temporary cough.

Problems drive an alcoholic to drink

Well... kind of true. Problems, achievements, company, lack of company, boredom.... all drive an alcoholic to drink. Problems drive an alcoholic to drink, yes, but so does everything else.

Alcoholics are only showing their true nature

This is not true. Alcoholism changes the perception of needs so that the need for alcohol is always urgent and more critical than the need for relationships, dignity or other objectives that drive social interactions. It is not "inner nature" to court damage to reputation for example - even for exploitative or self-destructive people, but it is a frequent sacrifice in the pursuit of alcohol. The laziest alcoholic will court a mile long walk to buy alcohol, for another example.

I write/paint/sing/whatever better after a peg or two // Alcohol makes me creative

What alcoholism does is lower inhibitions. It removes internal censors by the simple means of reducing the brain's capacity for complex thinking. It may seem like increased productivity if you have self image issues or other inhibitions preventing you from working freely, but it most certainly does not improve quality unless your standards are really low. The lowered inhibitions are as likely to let your creativity through as your lack of it.

I don't drink in the morning, so I am not an alcoholic // You turned me into an alcoholic

Alcoholism evolves. If people have raised concerns about your drinking, if you drink compulsively, if social occasions seem boring without drinks, if you avoid non-drinking company in your drinking timings, if being denied drinks makes you angry... then it is a matter of time.

A person's presence in another's life may coincide with an escalation in drinking, but one person cannot turn another into an alcoholic. Period. Such accusations by alcoholics are a way of shifting the burden of guilt. They should be ignored.

I drink from my own money // I know my limits

On running out of alcohol, the ownership or source of the money (or directly alcohol) are no longer issues. Limits get reviewed and approved extensions automatically. It does not matter where the money for the drink comes from, when it runs out, the price of alcoholism is paid by the home with emotional damage, physical damage, financial damage that goes well beyond the cost of the alcohol consumed. This could be anyone coming into intimate contact with the person if the alcoholic no longer lives with family.

I am really respected and loved by the people who work at XYZ Bar/Club/Liquor shop // They let me pay later if I don't have money

If you are known and regular enough for an establishment serving alcohol to be paying special attention to you, it is worth considering that you have become business they count on. This is not to say that there is no genuine affection and friendly relationship that grows, but it is extremely concerning when a person flaunts these relationships in front of other relationships. Many alcoholics also start nurturing their self-images that are damaged badly by alcoholism by seeing this as servitude and superiority, much like a ruler of the bar. This fantasy is profitable to waiters, because it invariably leads to magnanimous gestures and generous tips. A very definite warning sign for the person reduced to asserting self worth in this manner.

 

If you have used these explanations for yourself or someone else, know that the need for those explanations to be required in itself is a sign of alcoholism. No one asks a person who doesn't drink too much why they drink so much. At least not often. Requiring explanations for drinking, particularly when speaking with people who drink themselves, means those explanations are myths, unless they are "I drink, because I feel I cannot do without"