Three days ago, the UK newspaper, Guardian, made public excerpts of a 97-page show cause notice issued by the Directorate of Revenue Intelligence (DRI) to an Adani Group company: M/S Maharashta Eastern Grid Power Transmission Company Limited (MEGPTCL).
On 5/2/2013, DRI under UPA-II initiated an enquiry into over-invoicing on import of electrical machinery by a subsidiary of the Adani Group.
This investigation ended on 15/05/2014. The summary of this investigation:
Note: The accused MEGPTCL, a wholly owned subsidiary of Adani Enterprises Limited, an Adani Group company, is a Power Transmission Company (TransCo). For electricity to reach our homes, first the fuel is procured, then electric power generated in a plant. This power is then transmitted through a Distribution Company to our homes. So the electricity chain is: import coal --> import machinery for Generation Company (GenCo) --> import machinery for TransCo --> sell power through DisCom. The DRI investigation exposes the TransCo part of this chain. The background, as described in Michael Safi's Guardian report:
India is electricity-starved. More than 240 million Indians – enough people to form the fifth-largest country on Earth – lack access to regular power.
In the early 1990s, to encourage power companies to build electrical infrastructure, the Indian government eliminated import tariffs on technical equipment such as reactors and transformers. Profit margins on these projects increased overnight.
Adani saw the business opportunity. In 2010, the Maharashtra Eastern Grid Power Transmission Company Limited (MEGPTCL), a wholly owned subsidiary of Adani Enterprises, was granted a license to develop two electricity transmission networks in the north-east of the state.
Per the DRI investigation, Adani Group routed the purchase of equipment via a front company in Dubai, thus inflating the price of equipment by nearly 400%. The ensuing profits were then transferred to a trust in Mauritius controlled by Vinod Adani.
Vinod Shantilal Adani, the elder brother of industrialist Gautam Adani, set up a firm in the Bahamas in 1993 and, shortly afterwards, "corrected the spelling" of his name to Vinod Shantilal Shah.
The Guardian article also detailed how the illicit profits were siphoned off out of India (as summarized in the DRI notice).
How much money was siphoned off by MEGPTCL? Nearly INR 1,500 crores!
The DRI notice was issued May 15, 2014. 9 days later, Narendra Modi flew from Ahmedabad to Delhi on an Adani aircraft to become India's 15th Prime Minister.
So there's a siphoning off of illicit profits by the Adani Group, who have backed the winning horse in the 2014 General Elections Narendra Modi, who then proceeds to stymie the investigation against them. The public is left to bear the cost of it all, which is where the INR 2/unit #AdaniTax comes in. It’s not only about the INR 1,500 crore; inflated invoices have a downstream impact on wheeling & generation charges:
Further, Adani Group clearly stands to profit from every part of the electricity chain ( import coal --> import machinery for Generation Company (GenCo) --> import machinery for TransCo --> sell power through DisCom). There are more dots to join - one detailed in the June 2016 issue of The Economic & Political Weekly by Paranjoy Guha Thakurta.
Thakurta also co-wrote with Aman Malik a similar article in The Wire which talked about an ongoing investigation into over-invoicing by as many as FORTY of India's biggest energy companies. A side note: Thakurta recently resigned as Editor of EPW after a defamation notice from - no prizes for guessing - Adani Group!]
Summaries of these articles from the INC Press Release:
The more you delay the adjudication process, the more the cases fade away from public memory and our collective consciousness.
Adding up all the over-valuations: in coal imported - INR 29,000 crore; in power plant machinery - INR 9,000 crore; in compensatory tariffs - minimum INR 10,000 crores!
So the INR 50,000 crore question is, how does this affect the electricity tariff charged to consumers? See the excerpts below:
To repeat: As many as 40 energy companies, including Adani Group, overvalued invoices and transferred the (inflated) cost to electricity consumers! Why should consumers foot this padded bill? Why is Narendra Modi, of na khaunga na khaane doonga fame, silent on this?
The demands made by the INC:
Immediate reduction of tariff by up to factor of ₹2/ unit wherever these companies are producing & transmitting electricity.
Immediate CBI investigation monitored by a judge of the Supreme Court into the corrupt practices of over-invoicing
The Central Electricity Regulatory Commission should investigate all private power generating entities to identify over-pricing of equipment
It is high time that Narendra Modi stopped dishing out #LalQileKeJumle and took strong action against looting of Indian public! Expose #BijliScam! Remove #AdaniTax!
Postscript: Aamjanata.com agrees it is high time Narendra Modi delivered on his repeated vows to cleanse the system of political corruption.
In 1865, a child was born in Madras, India. Her parents named her Lucy Deane. As destiny would have it, in 1893, Kensington Vestry (UK) wanted to hire women Inspectors where, at that time all inspectors were men. Lucy Deane was hired and was a factory inspector. In 1898, she cautioned the authorities that asbestos was causing lung disease. The report collected dust. It took a century and in 1998, EU and France banned all forms of asbestos. (1)
As we stand today, Government of India has approved the use of GM Mustard for use in India. Like all throughout the world, there is a pro-GM and anti-GM groups in India. There have been spate of articles and influential voices who are supporting GM Mustard and its widespread use, without knowing the ramifications. Those who are against it are being labelled Luddites, risk averse, unscientific, elites and hypocrites. With government approving this, we know where the government stands.
Comparing the incomparable:
In a recent article in Indian Express(2), an author compares Viagra, Insulin and cell-phone towers and makes a point whether the elites sought zero risk proof for these products. First it pitches the GM crop as pro-poor and pro-farmer and insinuates all others as elites who swallow Viagra and go out to protest. Let me not rebut on this clever ploy of making this about one man versus the other.
The larger stupidity of this is the comparison of risks of Viagra against the risks arising out of a GM Crop. Though it is appealing to the common sense and immediately identifiable, its conceptually flawed from the first word. Viagra is a thin tailed risk and GM is a fat tailed risk. Thin tailed risks are common sense probabilistic and form the majority of Risk Management. The world as we see, revolves around with the use of such risk.
Insurance, the business which completely relies on risk had a seminal paper by Filip Lundberg in 1903 which formed the basis of what risk managers and many insurance actuaries know as Ruin Theory. Ruin is “the physical destruction or disintegration” which has no chance of recovery. There cannot be an un-ruin. Rebuilding is not bringing back the same structure which was there. By ruin, in this context, we mean the ruin of the complete system. This is not fear mongering and is grounded on sound logic and evidence.
The system here is the nature. This system is so complex that we cannot predict the weather pattern for the next month. The complexity of the system also makes the impact of GM crops unquantifiable. In 2005, UNESCO with its advisory body World Commission on the Ethics of Scientific Knowledge and Technology (COMEST), released a paper called as “The Precautionary Principle.”(8) It states:
“The emergence of increasingly unpredictable, uncertain, and unquantifiable but possibly catastrophic risks such as those associated with Genetically Modified Organisms, climate change etc., has confronted societies with the need to develop a third, anticipatory model to protect humans and the environment against uncertain risks of human action: The Precautionary Principle (PP).”
What it states is essentially this: lets protect before something bad occurs and not get into the damage control where we may not have any chance. This paper also puts forth when we need to apply this principle. Just by quoting this, we cannot stop the human progress.
Conditions to satisfy are:
Complexity of the system
Unquantifiable scientific uncertainty
If we look at GM Crops, it is a tailor case to apply this principle.
One, interaction of GM Crops with nature cannot be ascertained because nature is highly complex system and it is non-localised. Two, the impact is unquantifiable. Applying the risk of ruin, which essentially states that the impact cost will be infinity, and any non-zero probability will make the overall risk as infinity.
This is not same as one crore road accidents nor losing Titanic nor losing MH370. These are localised risks. Or the aforementioned opinion item provocatively mentions – Viagra.
Anyone who states that GM is completely safe is fooling us and fooling themselves. A recent study has revealed unintended mutations were induced in mice by a genome editing technique. And we are not sure how that will affect GM Crops.(3)
Thus we can safely conclude, that this is a system which must be seen from the Precautionary Principle and Ruin Theory view.
For detailed study of these risks, please read the books The Black Swan and Antifragile by Nicholas Taleb. Also, he, along with many has authored a paper on GMO based on Precautionary Principle.(7)
Anti GM is essentially anti-corporates:
This is another lie that is being spread against the principled, theory and research oriented stand against GM Crops. What this essentially states are that since the anti-GM group, doesn’t like profits, are somehow socialists or communists and hence hate corporate profits. The same author(2)chides us for being perfectly fine with the duopoly of only Boeing and Airbus for travel and iOS and Android for mobile. Be that as it may, let me not address the trap again but the logic why this is wrong.
Nature provides biodiversity. What we essentially see in GM crops are close to monoculture. The single minded approach to GM crops as espoused by the pro-GM side is productivity. More, for less. More, for less land. More, for less water. More, for less pesticide. More for less, insecticide. More, for less fertilizer. Even our love of our own mother has some negatives but nowhere will you find any negatives that the pro-GM lobby presents with us. This is logical.
Let me present you another evidentiary proof. Between, 1845 and 1852, more than 10 lakh people died of famine in Ireland, also known as Great Famine of Ireland or Potato Famine. The root cause of this is a blight had wiped out the entire crop in Ireland. What is also said and repeated many times, which we tend to forget is that the entire population was dependent on just one or two varieties of potato.
Now, you can see that why one loss of MH370 is not as same as a crop failure.
Now, you can see why the risk is unquantifiable and the losses in this case is near infinity or what we call as ruin.
With our single minded aim to improve productivity, we are laying the foundation for the unknown. Again, this is not fear mongering to be ignored, this is rooted in risk theories and in history.
Recent studies have also shown that GM crops may not be as insect resistance as we might have thought.(4)(5) This states that there is an evolutionary resistance to the GM crop. Again, we do not understand the nature as much as we think we do. And as stated above, nature is complex.
Mankind has always tampered with crops:
This is another half-truth that is being peddled by the lobby. For example, we are shown a black rose which is not available in nature but has been modified by the influence of mankind.
In 1865, Gregor Mendel, gave a speech on his experiments on peapods. The translated title of that speech stands “Experiments in Plant Hybridisation.”(6) This is essentially wrong comparison, again. Methodologies, processes and techniques were human but the ‘law of selection’ was left to nature. But, in present GM crops, we tend to select on behalf of nature. And herein lies the greatest issue we have.
Mankind have played with crops and animals. All the dogs that we see are examples. The interracial kids that we see are examples. We, you and I are examples of this selection. But nowhere but in GM crops have we altered at this micro level, the DNA.
The march of technology is inevitable. The advancement of science is unstoppable. But what can be and must be done is to make these crops into more and more trials till we are near certain that there won’t be any systemic impact of ruin.
The Precautionary Principle also states that the burden of proof does lies with the entity which brings into the system the GM crops.
To borrow Sun Tzu, “it’s a matter of life and death. A road either to safety or to ruin. Hence it is a subject of inquiry, which can on no account be neglected.”
This is the second day in a row I've discovered something suicidally whacky on Twitter. The first was when I found a profile with a UID number on it. Today was crazier. Vivek Namibar, a journalist with India Today with a verified handle on Twitter, posted a series of tweets that can only be described as extremely disturbing. You can check them out here:
I don't know how many of you here have been thinking about the #bluewhalechallenge and talking about it. Here's why we need to.
The thread describes a "suicide challenge game" that involves the participants taking on various tasks assigned to them by a "curator" on the internet. Seemed complete nonsense, but the handle was a journalist and myth or fact, the tweet had already been shared almost a hundred times (and counting). So I decided to find out more.
Based on the myth that blue whales come to the shore when they want to die, the alleged game encourages participants to do various tasks that are depressing or scary or involve self-harm over a period of 49 days and they are asked to kill themselves on the 50th day. One person was arrested in Russia on charges of encouraging 16 people to commit suicide. Various reports and unsubstantiated numbers of teenagers who have killed themselves because of the game. Reports that it had spread to the UK, reports that French police were warning people. Vivek was warning that the game may have reached India with one death in Mumbai and another in Bangalore that he could not trace.
Given the gravity of the warning, I thought it was important to investigate and at least do some initial straight talking based on what I found.
There is no evidence whatsoever that the Blue Whale Challenge exists
While it is hardly unheard of that depressed teenagers (and even perfectly healthy ones as well as adults) succumb to undesirable influences on the internet, given today's modern world of technology, it is impossible that if an organized game involving interaction over the internet over 50 days existed as a link in a large number of deaths in multiple countries, goes undetected. In the event of a suicide, a person's communications will be examined. If the suicide is suspected to have happened because of influences on the internet, there will be an investigation and at least some kind of concrete information would have come up. Given that several of the tasks reported involve self-harm, including making cuts on the body, carving a whale on various parts of the body and so on, it would have been hard evidence linking various suicides - there is no such evidence. There would be statements from the family about this kind of self-mutilation happening before the suicide. There are no such reports.
The game seems to be some sort of an urban myth that originated in Russia. It is possible that there may have been communications or some interactions involving depressed teenagers who committed suicide and tasks and so on, but there is absolutely no proof that such a game exists. It is just that we tend to notice more what has been brought to our attention, so if such a link is heard about, anything that could remotely fit starts looking like it is true. If I told you a pimple was forming on your nose when we met in person, you'd touch your nose a lot more, exploring its contour to catch that pimple!
The only place where the game seems to have spread is in Brazil with several suicides and suicide attempts allegedly related with the game reported. yet there is are no reports of investigations or arrests.
What is the real danger of the Blue Whale Game?
Well, it is obvious. An urban myth that runs wild and gives people ideas. Ideas that exploit others, or seductive ideas for suicidal people to make one last statement and dramatic exit. Another reporter who tried to find out about the game and wrote about it found that a lot of the comments he received were from teenagers seeking the blue whale game! Needless to say, regardless of whether the game exists, it is providing a source of curiosity and potentially interesting teenagers with suicidal tendencies. He provided a button with his story that said "Start game" and over 9% of people who read his article and its warnings clicked the button anyway. The button led to a page where people were asked why they wanted to play the game and answers ranged from the curious to those really wanting to end their lives.
Sociopaths may see opportunity in the teenagers being interested and seek to harm them by engaging them in what they are seeking and expect. An urban myth that makes suicide sound like some kind of rite of passage may encourage vulnerable minds to lose objectivity and choose self-harm.
Malicious online entities could engage people in the game and provide people with links that infected their computers with malware. After all, a person looking to find a person encouraging them to commit suicide is hardly going to expect a hacker.
All the usual cautions about strangers on the internet apply.
What is the good news?
Is there a good news about the blue whale game? Well, yes. Given that the blue whale game involves tasks to be completed over 50 days, tasks that involve fairly conspicuous behavior, like going to the tops of building and standing on the edge, standing on bridges, cutting their arms, cutting designs onto their limbs - this behavior is very easy to notice and trigger concern. And the good news is that it must go on for almost two months before the suicide. I think it beats a teenager committing suicide on a whim and gives people a chance to notice the problem and gives them a chance to change their minds. 49 days of bizarre behavior has a much better chance of someone intervening than a teenager leaving for college and stepping in front of a train. There is no need for paranoia. It isn't true, and even if it were, it has a better chance of someone noticing it and putting a stop to it than an "unorganized" suicide, so to say.
How dangerous is the blue whale game?
This is tough to say. Given that there is no evidence the game exists, there is no "threat score" one can attach to it. I saw several videos said to be music shared as a part of the challenge and I don't feel suicidal at all. And I am someone who has no problems with suicide and have even been suicidal myself in the past. So if there were some mystical power that would make a viewer want to kill themselves, or at least depressed, I should feel something. Nope. Zero wish to kill me. Anyone who watched and did feel depressed probably was reacting to the title saying that it would make them feel depressed or something. There are no supernatural powers in the video.
That said, obviously, self harm is dangerous and suicide is fatal. So I guess, even if the game doesn't exist if people find the idea appealing and try to copy it, it is obviously dangerous. I imagine too many horror movies in the middle of the night on a sleep deprived brain would fry anyone's sense of well being. Nothing catching up on sleep won't fix, I imagine.
The real danger of such secret, coercive interactions would likely to be predatory behavior with teenagers. Online sexual predators, risk of malicious code being downloaded to computers, personal information breached or willingly given that can make someone vulnerable to blackmail... the sane thing to do here is to keep your computer's security updated and not engage in intimate conversations with strangers.
Some last words about this blue whale suicide game thing - try the pink whale challenge instead
The reporter who did that story on the blue whale game and found the teenagers interested created an alternative pink whale challenge. Not going to link to it. If you really landed here looking for something, it will satisfy your need to search for it and find it and you can play it.
With or without the blue whale game, teenage depression and suicides are growing. There is a need to be supportive of vulnerable people and to provide a compassionate listening ear. If you find anyone around you being unusually depressed, engaging in self-harm, withdrawing from the world, do take a moment to check on them, and if necessary, speak with their friends and/or families and see that they receive any attention needed.
If you find yourself interested in suicide, seek help. More importantly, seek information. When emotions are low, it is harder to be convinced that things aren't as bad as we perceive them. Hard facts devoid of positive or negative emotion can serve as an anchor for sanity and allow you to gain a sense of perspective. Contact suicide helplines (search for them). Talk about it with friends you trust to listen to you. Make an abrupt change in life. Quit an environment making you unhappy, try something altogether different. It is a sort of metaphorical rebirth, you know? The giving up of an old unsatisfying life and the trying out of something that appeals more. I have done that often in life. Change careers, live in a different place, break up or fall in love, whatever.
Remember, thoughts of death may be common, acting on it is not. There is no need to fear. It is better to empower yourself with information and pragmatic action. If you are happy, if you care for yourself and seek help when you feel low, you aren't going to want to die, and no game can make you want to do it. That is just the internet being what it is.
Update: After publishing this post, it has come to my attention that the one Mumbai boy's suicide is behind this speculation of the Blue Whale challenge. This is in spite of the police not finding any history of altered behavior in the boy or signs of self mutilation - both of which would have been present if this were a case of the alleged "Blue whale challenge". Regardless, an incredibly uncritical media has widely reported the death as a potential Blue Whale game suicide, Devendra Fadnavis has apparently promised an inquiry saying that if it is an online game, it can easily be blocked (compounding gullibility with rank ignorance of the internet). And to top everything, this was brought up in the Parliament and the government may probably be preparing to issue some kind of a warning on the issue. While they are at it, they should also warn people against trusting Lord Voldemort. The complete gullibility of the media and the state and center governments is staggering. This is what you get by promoting stupidification and superstition. Critical thinking goes for a toss.
Viral trends of this sort spread with panic and reach the fertile ground of the minds of those discontented with life who find them appealing. Chief Minister Devendra Fadnavis, the media and the Parliament ought to show restraint instead of introducing Indian youth to such ideas made all the more melodramatic for the attention they get. There are countless suicides in India on a daily basis. While this one is very sad as well, there is no need to go overboard about it and jump to conclusions that have no evidence in the reported facts of the case.
Today's update from constitutional challenge to linking Aadhaar and PAN from the Supreme Court
Arghya Sengupta started with two broad arguments for the Union of India and UIDAI. (1) That proportionality could not be read into Article 14, and (2) The idea of informational self-determination was equivalent to privacy and privacy was referred to a larger bench.
He countered the proportionality arguments by citing judgments from the UK. He said that a statute could not be struck down for disproportionate penalty because penalty could be decided by the wisdom of Parliament.
He said that the object of this amendment is to fight corruption but no legislative order can completely solve any problem 100%. Sengupta said the object of the amendment is not to discriminate between those who have Aadhaar and those who don't but rather to weed out fake PAN cards.
He then argued that informational self-determination is not absolute even in Germany, and it could not be read into Indian law and that it could only be understood to be a party of privacy.
Justice Sikri said that the right to be left alone is a question of a person’s own life. The question lay in whether in a tax regime you could exercise your right and say that you would pay taxes in the manner you chose to. Sengupta responded by quoting Oliver Wendell Holmes, "taxes are the price we pay for civilised society", he said. Sengupta admitted that there were technical difficulties and errors in the UID system but maintained that biometrics was the best technology in existence.
Zoheb Hussain appearing for the UIDAI said there is a distinction between protected and unprotected speech and that distinction will always be maintained. Every action is not speech. Enrolment for Aadhaar does not amount to exercising the right to free speech. He argued that the object of the amendment was to fight black money, increase tax collection and therefore reduce inequality. The object could not be said to be discriminatory because it was in furtherance of equality.
Senior Advocate Shyam Divan appearing for the petitioners responded to these arguments. He began by establishing again the credentials of the petitioners. He said "it is being alleged that I am a hermit who wants to live in the Himalayas." In fact the petitioners are a decorated Major General in the Army and the other, a Magsaysay Award winner for his work with the Safai Karamchari Andolan. "The petitioners live robust lives and are contributors to society."
He said that the concern raised about Aadhaar was not an elite concern, rather that it was a concern of civil liberties. "The citizens of what we regard to be a free country are being mandated to be fingerprinted."
Mr. Divan went on to explain that "Aadhaar is voluntary but PAN is mandatory." The Income Tax Act makes PAN mandatory and the lack of PAN leads to penal consequences. Aadhaar is completely voluntary. The Aadhaar enrolment form says that Aadhaar is free and voluntary, Section 3 of the Aadhaar Act says that a resident is entitled to get an Aadhaar number, several advertisements in which the UIDAI itself said that Aadhaar was voluntary.
Subsequent provisions specify that residents must be informed how their data will be used. Every requesting agency under the Act must ask for the consent of the individual Aadhaar number holder. Consent and information required under the Act can only exist if Aadhaar is voluntary. He said "it is untenable to claim that Aadhaar can be made mandatory when the statute says that it is voluntary."
Mr. Divan cited a definition of fraud laid down in a judgment and asked whether UIDAI was committing a fraud on the public at large. He said that an institution of the government could not commit fraud on the public and so the only conclusion could be that Aadhaar is voluntary.
He explained that the object of 139AA was discriminatory because it discriminated between those who chose to give up their biometrics and those who didn't. Some people chose Aadhaar but PAN is not replaced by Aadhaar.
Mr. Divan cited a news report where a newborn child was given a UID number before he was given a name because without UID he would not get a birth certificate. Mr. Divan asked "Can you have a system where a child is tagged and numbered before he has a name? Can you have a system of surveillance? It will destroy all political choice."
The UID project violates Article 19(1)(a) because it requires individuals to give my most sensitive information – not to the Government of India – but to unknown third party enrolling agencies.
On the Union’s argument that fingerprints are collected under the Registration Act, he explained that to buy property, fingerprints were given on paper in a process totally distinct from giving fingerprints to a central database where they could be repeatedly authenticated. He said that there might be some instances where invasion of the body might occur (e.g., hospital procedures or wearing helmets, seat belts), but all these actions are protective in nature and to protect the body.
Finally, he showed the Court a reply to an RTI where the UIDAI admitted that only 0.03% of people who had enrolled in Aadhaar had no other form of identity before. He also pointed out that in another RTI query the UIDAI admitted that 1 lakh Aadhaar numbers had been cancelled due to duplication.
Mr. Datar began his rebuttal by stating that the basic argument being made by the Union and UIDAI was "what is your problem?" Mr. Datar said "But one must remember civil rights movement started with a woman made to sit at the back of the bus. No one told her not to make it a big deal." He argued strongly that condoning the violation of the interim orders of the Supreme Court in the earlier batch of petitions would have grave consequences for the rule of law.
Contrary to the belief that the ever increasing attacks on doctors in India are isolated, much has to do with the deteriorating situation of law & order, crumbling public health infrastructure and evangelization of vigilantes.
According to the Indian Medical Association, 75% of doctors in India have faced violence. Although we don’t have any data for Maharashtra, from my experience, I could say almost every resident doctor in a Government hospital has either been abused or manhandled. The attacks are so frequent and intense, that BMC hospitals in Mumbai had hired a private security firm, Eagle Security a year ago. This security is apart from the police units stationed 24×7. And still doctors are facing some of the worst attacks. Previous UPA Gov’t passed Maharashtra Medicare Services Persons and Medicare Service Institution (Prevention of Violence and Damage or Loss to Property) in 2010. This law has been poorly implemented as the data speaks for itself. Even after constant assaults, not a single person was convicted in the last 2 years. Even though the imprisonment extends upto 3 years and the offence is non-bailable, the alleged attackers are bailed out within a day as it happened in Sion hospital after a Polio inflicted doctor was attacked 5 days ago.
India spends only 1.4% of GDP on healthcare compared to 8.3% in US and 7.6% in UK. Even many African countries spend more on healthcare than India. As per World Health Statistics 2015, India’s per capita government expenditure on health in 2012 was a meagre $60, while the US spent $4,153. Central, State Governments and Municipal Corporations have evaded investing in healthcare for decades which has compounded the worsening of the situation. To make matters worse, Fadnavis led Government has actually reduced the health budget allocation for 2017-18 by ₹569 crores. The health budget of 2016-17 was in turn ₹1,308 crore less than in 2015-16. Maharashtra will also spend ₹900 crores less on nutrition schemes. Many ministers and spokesperson have repeatedly assured about increment in health budget, bu the reality is quite different. Public hospitals are constantly hit by shortage of medicines and staff. Patients being told to buy even IV and inhalational drugs in the casualty is a common sight, which obviously angers them. Resident doctors are at the front end of an inefficient, unjust and poorly funded public healthcare system.
IMA survey says 70% of attacks are due to relatives accompanying patients. Dozens of relatives, of which half are drunk accompany a patient in the casualty late at night. Even after constant complaints to the administration, this issue is never sorted out. Be it Dhule or Sion incident, every major assault was carried out by scores of relatives. On paper, only 1 relative is issued a visitor pass to be with the patient. As every other rule, this one lies in the dustbin too. One can’t expect a doctor to work properly who is under the constant threat of an assault. One can’t expect a surgeon to have a steady hand when he is perspiring due to fear.
Dilapidated infrastructure and horrible planning is the cornerstone of every Government project which is 10 times amplified in a public hospital. The X-ray room is situated almost 500 metres away from the casualty. There is always a shortage of wheelchairs and trolleys due to which, again, the junior doctors have to face the brunt, as they are the only ones present there. MRI, USG, CT scan appointments have a waiting period of months. Apart from the well-equipped trauma ward, every other ward has an issue. The resident doctors and interns do the job of class 4 employees due to lack of staff for tracing medical reports, carrying blood from blood bank, shifting patients to other ward. Many a times, I have personally trolleyed the patient to USG and X-ray. There is no clear distribution of duties among staff. Public frustration of this chaos is unleashed on doctors as we are the only ones they could identify.
Normally, only 2 or 3 resident doctors are present in the casualty at night. They are bound to provide only emergency care and diagnostics. Full treatment can only be issued after consulting with senior doctors. This process takes time which agitates patients. There is no counsellor to talk to patient. As the resident doctor has to take history, write notes, examine and provide emergency care; the not so important talking part takes the back seat. A faulty system like this, promotes more attacks on doctors. Not to mention, a resident doctor in a public hospital is overburdened. He/she normally works 14-18 hours a day with at least one 36 hours continuous shift once a week. In towns, such 36 hours shift is almost on every alternate day. Even a basic function like sleep becomes a privilege.
To avoid long queues in OPD, many patients come directly to casualty for instant treatment. Doctors can easily differentiate patients requiring an emergency or an elective care. Indian patients don’t accept oral drugs as they always expect IV drugs in a casualty. This delays the treatment of those who require urgent care. Most of them sit at home and visit the doctor only when the disease takes a severe turn. Diabetes Mellitus and Hypertension can be easily managed by drugs, but due to non-compliance, patients come with severe complications requiring surgeries. OPDs managed by 6-8 doctors have 300-400 patients on a daily basis. Sion hospital itself caters to 20 lakh OPD patients annually. Despite all this, the Government isn’t interested in increasing the number of hospitals. Only 1 out of every 20 MBBS graduate gets a PG seat.
There is no fear of law among mobs assaulting healthcare professionals. Relatives of the arrested Dhule assaulters tried attacking a nursing staff outside the campus. A doctor in Sion hospital threatened of the same consequence of Dhule doctor if the patient doesn’t get well. A rural hospital ransacked in Sangli for an alleged delay in post-mortem. A casualty officer in Bhabha hospital, Bandra slapped. All within the past 24 hours, during the ongoing strike!
Residents doctors are fed up with constant fake assurances and lack of proper implementation of current laws. Gov't keeps on repeating the same promises with a different date. The main demand revolves around providing improved security and limiting entry of relatives.
Appointment of more security and police personnel immediately
2 pass system per patient
To start the installation work of effective alarm system in every casualty
To revoke all charges and action taken against resident doctors
Strengthening of 2010 law, no bail for accused for at least 3 months
Filing of FIR by the institution itself
To release funds to implement the law and appoint a brand ambassador to spread awareness for the safety and security of doctors
To enact a strict law to prevent trespassing in hospital
Formation of a vigilance team within 15 days
Formation of a legal cell withing 15 days
An Ortho resident doctor in Dhule was attacked on 12th March while the statewide strike started on 20th March. The violence was so brutal, that he had an orbital fracture and is feared to lose vision in his left eye permanently. The state Government remained dead silent for a week. In fact, doctors and interns in GMC, Dhule were threatened of dire consequences if they go on a leave. Fearing political pressure, the leave was called off in Dhule. On 18th March, after a helpless junior doctor was attacked in Sion hospital, 4,000 resident doctors decided enough is enough. Even after multiple meetings with Medical Education Minister, Girish Mahajan and Chief Minister, Devendra Fadnavis, there is no visible improvement in the security as of now.
To make matters worse, CJ Manjula Chellur of Bombay High court said, “If doctors are so afraid that you will be assaulted then resign and sit at home. It is a shame on the profession if doctors go on strike like factory men. They are unfit to be doctors then.” This statement seeks of victim blaming, elitism and promotes violence against doctors. It’s a moral equivalent of saying, if women are afraid of rape then they should sit at home. Judiciary, Media and the Government are busy blaming doctors for everything that is wrong with our healthcare system.
The Present Status
As of now, the resident doctors of KEM, Sion, JJ, Solapur and Latur Government hospitals have got eviction notices and suspension of their degrees. According to resident doctors, water supply in PG hostel of KEM and Sion hospital was cut-off. MARD (Maharashtra Association of Resident Doctors) has colluded with Girish Mahajan in breaking the unity of doctors by giving out fake statement of mass leave being called off. An utterly despicable tactic which is the hallmark of the current political discourse in the country. Media has played a disgusting role by siding with the Establishment and parroting their lies. No one is questioning the Gov't for their repeated fake assurances and rehashing their old promises with a different date. No primetime discussions on the dwindling health budget. Even when doctors join their duty again, this faulty health system will still persist.
Individual doctors of public hospitals and not MARD are involved in this protest. Although there is no official confirmation yet, MARD chapter in Mumbai has been dissolved. On 23rd March, more than 40,000 doctors of IMA & IDA joined in an indefinite strike by shutting down all OPD and elective services pan-Maharashtra. Dentists, interns, teaching staff, senior doctors, paramedical staff, nursing unions, class 4 employees in public hospitals are supporting this resistance. Medical Teachers Association has threatened mass resignations if security isn't improved within 48 hours. Over 10,000 doctors in 40 major hospitals except AIIMS, have gone on a mass casual leave in Delhi. Barring pseudo-scientific doctors union, everyone else is echoing #IssBaarAarYaPaar. As I write this article, a new union consisting of resident doctors, private practitioners, IMA members, lecturers, professors, SMOs, DNB doctors, ex-MARD members is being formed.
The emergency services in both private and public hospitals are still working due to senior doctors, nursing staff and interns. The healthcare system is affected, but we have tried our best to reduce the impact. IMA and resident doctors will evaluate about the leave after they get a written court order. Judiciary, netas, celebrities all get private security. All we ask for is improving safety in public hospitals.