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  • No more crying in the middle of the night 
  • No more playing in the middle of the street
  • No more mischief in the class
  • No more tantrums in the house 
  • No more exams to pass 
  • No more dreams to chase 

How can they, when the children are no more?

Not one, not two, 13 children died yesterday, 309 died in August alone, 1269 this year and all in the BRD government medical college, Gorakhpur, Uttarpradesh. 

This is not just because of a doctors negligence or an equipment failure or a random incident of negligence but a deliberate failure of an entire system. A system that was meant to diagnose, treat and cure, was left to decay so much that the rot just became toxic claiming innocent lives.

The CAG report published in August 2017 for the period beginning from 2011 ending 2016 March, exposes the rotten system of the BRD medical college. From failing to treat cancer patients to failing to conduct prenetal diagnosis to misusing funds to shortage of medical equipments - the medical college broke rule of law and violated the moral code of conduct. 

Excerpts from the CAG report 

✓ the GMCs failed to provide adequate treatment to cancer/heart patients as equipment such as Cobalt Teletherapy, Brachytherapy unit, Left Ventricular Assist Device, etc. were not being operated in hospitals due to lack of doctors/technical personnel/infrastructure.

✓ The GMCs did not execute Annual Maintenance Contract for equipment. As a result, the machines were not functional and tests for cervix cancer, foetal monitoring, prenatal diagnosis, bio-chemical and hormonal tests etc. could not be conducted.

✓ GMCs did not procure clinical and teaching equipment though adequate funds were provided by the Government, resulting in shortages of equipment

✓ The GMCs failed to provide adequate treatment to cancer/heart patients as equipment such as Cobalt Teletherapy, Brachytherapy unit, Left Ventricular Assist Device, etc. were not being operated in hospitals due to lack of doctors/technical personnel/infrastructure.

✓ The GMCs did not execute Annual Maintenance Contract for equipment. As a result, the machines were not functional and tests for cervix cancer, foetal monitoring, prenatal diagnosis, bio-chemical and hormonal tests etc. could not be conducted.

✓ GMCs violated the provisions of General Financial Rules while procuring equipment by extending undue favour to suppliers and purchasing equipment at a higher rate

✓ Financial management of the GMCs was not adequate as there were instances of retention funds for long periods in PLA, diversion of funds, etc

So what's next?
I'm sure the CAG report will have no affected on the administration because if a child's death didn't, then what's a report? And neither did it have any affect on the media, because the deaths continue to happen but not the coverage and further questioning. This leaves, us i.e you and me. So let's begin with questioning the authorities 

  • File an RTI with the BRD medical college to understand what steps they have taken for cours e correction. And if they haven't, then when would they?
  • Call the MLA's and the MP's and put pressure on them to not just fix the current problems but to elevate the standards of healthcare 

If we don't think we can do this, then just remember the faces of the kids who died or should we say, we let them die 

3

"Mama tied a blindfold over my eyes. The next thing I felt my flesh was being cut away. I heard the blade sawing back and forth through my skin. The pain between my legs was so intense I wished I would die."

These haunting words by Waris Dirie, UNFPA Goodwill Ambassador and spokesperson on FGM are the stuff nightmares are made up of. This isn't an attack by a villain, it isn't a rape, it isn't pedophilia. It is the amputation of some of the most sensitive parts of a girl's body by her loved ones. Along with physical pain comes the indignity and helplessness and profound psychological trauma of being betrayed so brutally by those who should be taking care of her.

Female Genital Mutilation or FGM refers to procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons, often through misguided religious views, or tradition. FGM is most common in Africa and the Middle East, but happens increasingly in developed countries as people migrate their and bring their traditions along.

There is no known medical or other advantage to FGM.

FGM is mainly of four types. To quote the World Health Organization:

  • Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
  • Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina).
  • Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
  • Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

The World Health Organization estimates that around 140 million women have undergone FGM. 92 million girls above ten years have undergone FGM and more are at risk in Africa alone. This is no small number, and inflicting such agony on children is no small abuse of their rights and safety.

This happened to me. I may have forgotten the pain, but I will never forgive my parents. I have a young daughter. To keep her safe, I never visit my parents now.

The anonymous comment of a visitor on an article about female genital mutilation. Female Genital Mutilation, also euphemistically referred to a Female Circumcision or Female Genital Cutting was presumed absent in India. However, that is not true. It is still practiced among the Bohra Shia Community in India, who believe it to be a part of their Sharia laws. Many countries have laws criminalizing FGM, but India has no such laws, and the conspiracy of modesty and religious sanction keep Bohra women from speaking up. In theory, an advocate friend suggested that a case could be filed under child abuse, but it doesn't seem to be done and the practice is quite rampant.

Most Bohra communities have one or more women who make a living out of conducting these operations - if they could be called so. In reality, they are crude amputations by untrained (at least in a conventional medical sense) people usually without anesthetic, antibiotic or antiseptic. While the usual age of FGM is between 10 and 14, it is decreasing. Also there is a trend for FGM to be done on babies 4 days after birth by a doctor from that community itself. There are known dangers associated with FGM like infections, disfigurement, uncontrolled bleeding, fistulae, problems urinating, cysts, infertility and death. Women who undergo FGM find it difficult to find sexual pleasure or orgasm. Indeed one of the reasons for FGM is to preserve virginity and morality by making sex undesirable. Needless to say, this is something that needs to stop immediately.

When a Bohra Muslim woman calling herself Tasleem took out a petition on Facebook to stop  FGM last November, she dared not make her identity known. Yet, she took the courageous step with an intent to create awareness and it did raise a storm. As expected, most people were not aware at all about FGM. Those who knew, didn't know that it was practiced in India at all. There were outraged and concerned reactions from many in the society. Others thought that it was a traditional factor and could not be changed.

However, doctors spoke up acknowledging the existence of the practice and warning of medical complications. So there are voices speaking up against, though they are few and far between.

Dr. Zaheer Ahmed Sayeed brought up an important religious point “If the Bhora women come out in protest they would be rendered apostate by the concerned Bohra authorities, despite the mutilation does not carry validity and sanction in the Quran and to my knowledge in the Hadees. I suspect a single individual’s plight should be picked up, highlighted with the Human Rights and Women's Commission requested to echo the barbarism and support the cause against this barbaric act”.

So, the challenges are strong, and the need is great. It makes me wonder, why don't the people in the Parliament make a law banning it and include it as an explicit crime under Child Abuse or separately (adult women also can undergo FGM)? Why must protesting women be at risk within their communities, or inaction extend the suffering of the little girls? The Sharia asks for the cutting off of a thiefs hand too, but our laws prevail over it. We DO NOT cut off the hands of thieves regardless of religion. Sati was a practice accepted in religion. It is illegal. So clearly, laws don't necessarily follow religion in matters of human safety. Similarly, banning Female Genital Mutilation will bring very welcome relief for the girls, and parents of girls who wish to see an end to this practice, but fear consequences.

It can be done. To quote WHO on legal efforts to ban FGM:

In 1997, WHO issued a joint statement with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA) against the practice of FGM. A new statement, with wider United Nations support, was then issued in February 2008 to support increased advocacy for the abandonment of FGM.

The 2008 statement documents evidence collected over the past decade about the practice. It highlights the increased recognition of the human rights and legal dimensions of the problem and provides data on the frequency and scope of FGM. It also summarizes research about why FGM continues, how to stop it, and its damaging effects on the health of women, girls and newborn babies.

In 2010 WHO published a "Global strategy to stop health care providers from performing female genital mutilation" in collaboration with other key UN agencies and international organizations.

Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes:

  • wider international involvement to stop FGM;
  • the development of international monitoring bodies and resolutions that condemn the practice;
  • revised legal frameworks and growing political support to end FGM (this includes a law against FGM in 22 African countries, and in several states in two other countries, as well as 12 industrialized countries with migrant populations from FGM practicing countries);
  • in most countries, the prevalence of FGM has decreased, and an increasing number of women and men in practising communities support ending its practice.

Research shows that, if practising communities themselves decide to abandon FGM, the practice can be eliminated very rapidly.

I would like to end this article saying that this urgent need must not be ignored. Speak up, demand that FGM be banned.

Transcript of Globalizing Inequality - a lecture by P. Sainath, sponsored by the Center for Social and Environmental Justice of Washington State University, Vancouver. Video by pdxjustice Media Productions.

Part 1 || Part 2 || Part 3 || Part 4

http://www.youtube.com/watch?v=TjIcO_mqFKc

We did it weeping in our hearts for we too live in slums and we know our turn will come. The police constables giving protection to the demolition also live in slums and they did not take any pleasure in the actions they were forced to undertake by the government of Maharashtra. The people doing the demolitions were from the slums.

Incidentally. a United Nations habitat report of around late 2003 makes the assessment that by 2030, 25 years from now, fully one-third of humanity will live in urban slums. One third. The largest number of those are going to be in india and Africa.

None of this got covered. Even in covering the Tsunami, even in covering... this is the mindset of inequality. What happened? The poor have no rights. Even in the coverage of the Tsunami.

Whatever was done for the Tsunami victims was a result not of their rights, but of our generosity. You are going to get a new house. Not because you are a citizen of a decent society, not because you are entitled to one, which you are, under the directive principles of the Indian Constitution.

You're not going to get a house because of that. You're going to get a house because I am sorry that half your family was washed away in the Tsunami. It's not about your rights. It's about my generosity.

We've reduced people to that. We've reduced the poor to the objects of our generosity and our sympathy.

You build your own home, we'll demolish it. But we'll give you a new one. If we choose to. That is, if we feel sorry for you.

How agonized we are over how people die. How untroubled we are by how they live.

If you look at the Indian stock market. Coming back to that central indicator of how economies are doing, the Confedration of Indian Industry, which has the most optimistic take on such figures says that the total number of people having any kind of investment in the stock exchange constitute less than 1.15% - I repeat - one point one point percent of India's hundred and eighty million plus households.

1.15% of households. That's the most optimistic figure of those participating in any kind of investment in stock markets.

Yet, as I told... when the stock market collapsed, in May 2004, it collapsed for all of two days. The country's largest newspaper had a front page mimicing 9/11. "Ground Zero!" said the headline. 2,340 billion rupees lost. Notional money. Which came back two days later. Notionally. And it had an aircraft flying into the stock exchange building and the tail of the aircraft had the communist hammer and sickle.

Well, when the stock exchange collapsed for all of 48 hours, this was following what every political analyst across the spectrum says is India's second most historic election since independence - 1977 after the emergency and 2004.

The finance minister of the country abandoned the first day of parliament, did not attend the first day of the new historic parliament. He came rushing to Bombay to the stock market to dry the tears and hold the hands of destroyed millionaires of dalal street.

Two days later it was okay, but he stayed there three days to make sure that the market behaved, then he went home.

It was... ah... meanwhile, an election that was largely fought on the key two states on the issue of farmers suicides, it took another 149 suicides of farmers in the southern state of Andhra Pradesh before the Prime Minister condescended to visit the place.

But a twitch in the SENSEX had the finance minister jetting out to Mumbai. That is the difference of attention that you get if you are poor or if you are rich.

So it is all about our generosity and our feelings and whom we are feeling sorry for today, or who we feel sorry for most of the time. If you start applying these measures to the various forms of generosity that you see, you get a very different picture from what you get from the Tsunami coverage.

One of my favorite forms of generosity is the drive to wipe out malaria in the third world. Some of you may have read about this - the distribution of - the planned distribution of millions of bed nets to protect people against malaria. Have you ever read about this?

It's a plan involving the WHO, the World Bank and anyone else out to make a dollar.

Teh fun part of this malaria nets thing is, by 1980, India had more or less successfully contained malaria. It was almost wiped out by the early 1980s. In the 1990s we entered the brave new world of structural adjustment. Huge cuts in public services. Privatization of medical services in a large way. Soaring costs of medical attention. 21% of the Indian rural public no longer seeked medical attention for their ailments - that's the latest figure we have - because they simply cannot afford it.

Now after all these cuts, malaria resurfaces with a vengeance in India and in neighbouring countries. Having caused it to resurface in the first place, now generosity demands that we distribute bed nets - millions of bed nets to people who don't have beds.

Now, if you're living in a hut, you don't fix your bed net to a wall, because you don't sleep close to the wall, because that's where the crepy crawlies reside. The scorpions and other stuff. You try sleeping a little away from the wall.

I'm a rural reporter. I spend 270 days of every year for the last 12 years in the villages and self-preservation causes you to figure out these sort of things about where you sleep and where you don't sleep.

So first, we're getting these bed nets to people who don't have beds, at the cost of God knows how many million dollars. It's planned. Every time it's been attacked, they have withdrawn quietly, only to try and bring it back through the next government.

Now, if anyone with even half a brain knows that even if these nets... oh, by the way, you'll forgive the gendered language... it doesn't mind, it's theirs. It says that these bed nets will protect you against malaria because the nets are impregnated with anti-mosquito repellent. Whatever that means.

Now, anyone with half a brain knows that the malaria ... we'll exempt the experts, right? - we're talking about people. Anyone knows that the malaria mosquito is not most active when you sleep. It is most active at dawn and dusk when people are in the fields.

Of course, you could make a bold new fashion statement by walking around in your net, but it might cramp your style.

The whole thing is one unmitigated racket. This is the generosity of the generosity, you know... the charity that begins at home and stays there. It has nothing to do with the eradication of malaria in these countries.

Speaking of malaria, one of the astonishing things you can look at in the spectrum of inequality across the globe both in the terms of what's happening and how the media cover it, is what I call the globalization of communicable diseases.

Anyone in the audience remember this word - SARS? Rings a bell? Yeah, it does, doesn't it?

You remember how SARS was perceived as moving about like the black death, mowing down millions in its deadly wake? You know how many people actually died of SARS in India? Zero.

SARS sero.

You can look at the World Health Organization's website on the subject. Total number of cases identified in India? Three. But from the coverage you got from the media, you think that SARS... you know the subcontinent was in danger of its survival, right? The way it was covered.

3 cases from SARS. 0 deaths from sars. Why did SARS get so much attention? And by the way I'm not saying that SARS is not dangerous. You're going to get a hell of a lot of SARS by other names in the not too distant future, because we have globalized communicable diseases through these strategies of the last 10-15 years. Through the policies of the last 10-15 years.

However, it's important to look at why SARS or plague... you know in '94 we had a plague in India. Every aircraft going out of India was sprayed while going out, sprayed while being received at in the airports in the West. The plague killed 53 people. SARS worldwide - in its 100 days according to the World Health Organization's website, in the hundred days of its existence in the first round, across the planet, SARS killed 879 human beings.

That's about half the number of people who die of tuberculosis every day in India.

But TB never gets the same kind of coverage. Because it kills the wrong people. SARS germs, plague germs kill the beautiful people. So they get that kind of attention. In the media, in the medical systems, in the government's policies.

Plague germs, SARS germs, they are notorious for their non-observance of class distinctions. They board aircraft and fly club class to New York and that scares the pants off the world.

So they affect the wrong kinds of people. And I'm not just talking about poor countries. How many people are aware, that in August 2003... in OCTOBER 2003, the government of France, one of the best off countries in the world... The government of France acknowledged that in August 2003, 15,000 senior French citizens had died in a heat wave.

Now France has had heat waves before. Why did 15,000 people die in that heat wave and why is it that all those 15,000 citizens were elderly pensioners and retirees?

You know, the thing is, 879 people from SARS in 100 days. 15,000 people in rich France in the space of a month. And it didn't make the world headlines, because they were largely poor, elderly pensioners whose health benefits had been subjected to severe cuts in the preceeding two or three years. That's why they died.

If it had been 800 people of the flying classes, you got that kind of coverage. When 15,000 - and again, we're not talking about Bangladesh and India - we're talking about France. 15,000 senior citizens died, they didn't even make news. You can get on to the net and look at the figures and the discussion. They had a special parliamentary commission to go into it, I don't know what came out of it.

It may also be interesting to look at why China was the worst affected country by SARS. And that has a lot to do with what we're discussing today. In the 90s... in the 80s and 90s we entered this world of structural adjustment, cut some subsidies, cut some basic services, withdrawal of entitlements of poor people, and privatization of just about everything including soul and intellect.

The Chinese government closed tens of thousands of factories. Now if you are a citizen of China, you have access to health through your workplace, through your school, your factory or the local network that you were aligned with.

When tens of thousands of factories were closed down across China, millions of workers lost access to health. The chain of command, the alarm system, the signal system by which a new disease got reported and got checked at the labs and the tertiary level, that system completely collapsed.

Therefore when SARS hit, there was no plot on the Chinese government's part to conceal it. For most of the time, they really didn't know, because they had destroyed the system by which they could have known. They destroyed it to save a few million dollars, and lost a few billion dollars, because the deprivations you visit on the poor, tend to come back to you.

That was the year when the Chinese GDP took its worst hit in a decade and a half. Also leaving severe scars on the GDP of Singapore, Thailand, and a number of other countries, also hit by SARS.

The great software festival of China was cancelled. China lost billions of dollars though it saved million, in throwing workers out of work. Throwing workers out of their factories. That happened with China.

Did I mention France? In this country, I have no idea. I don't think there is a clear estimate, how many elderly American's cross the border into Mexico and Canada to buy drugs. I do know that your Federal government has responded to it by conducting police raids on pharmacies in Michigan.

Not by trying to provide cheaper drugs to poor people, but by conducting police raids on pharmacies in Michigan and the Mexican border. To prevent people from getting cheaper drugs.

In Africa, thanks to the new institutional arrangements and the trips and the WTO... under the trade related intellectual property rights and the WTO, India... an Indian company which produced so far the cheapest - the company's name is Cipla - which produced the cheapest anti-AIDS drug. Millions of Africans were denied the right to get this drug at dirt cheap prices, by the intervention of multinational corporations of the pharmaceutical sector.

After a huge outcry - after considerable outrage across the world, a compromise was reached, but the owner of the company will still tell you that he can provide it for much cheaper if it were not for the pressures working on him nationally and internationally.