Could treatment be unhealthy?

Rajiv had an unknown type of Gastric Headache for which he consulted a local doctor and got temporary relief. Later for permanent treatment he visited Fortis Malar hospital to see Doctor Jimmy. There he got a list of tests and scans including MRI (Magnetic Resonance Imaging), two tires blood test, Lipid test and some other tests. But the doctors could not find out the problem with the test results. He was prescribed some medicines also, which he took for two months continuously though he never got any relief from it.

By this time, he had spent Rs 18,000 on doctor’s fees, medicines, tests and scans without any redressal. After being exasperated and disappointed, he took an appointment with a local doctor who practices in a small clinic. There he hardly spent Rs 500 to get temporary relief from the pain which doctors of Fortis Malar Hospital could not provide even after such a large expense.

“Other than good infrastructure, parking lots and various facilities with highly equipped and latest technological machines, treatment in Fortis Malar is way too expensive. Most of the staffs are also rude and not friendly with the patients or their guardians,” said Rajiv.

Apart from big issues and cheatings in renowned private hospitals, small private clinics, and even the lab test centers are earning their fortunes by cheating on patients irrespective of their financial status. For the past few years, it has become a convention for the doctors to write most of the tests to patients even if it is not required. Tests like MRI and CT Scans emits radiations which are harmful to a body. If it is done repeatedly on a human body, it shows its side effects on the health of the patient.

“C T Scans, MRIs, and X-Rays emit radiations which are harmful to body and brains. It is better to avoid these tests if possible. The doctors do not stop asking their patients go for such tests because they make money out of it. For the doctors who are employed in some renowned private hospitals it is difficult to avoid it because of the target they have got to meet,” said an Orthopedics in Chennai.

In private hospitals, the doctors are demanded to recommend their patients for these tests by the hospital management. This is compulsory for the doctors to send the expected number of patients for the tests as it generates revenue for the hospital. When a doctor refers a patient to some particular Test Lab for the tests and scans, he gets a large amount of commission which is sophistically called ‘Interpretation Charge’. Interpretation Charges are direct cut from the amount paid by the patient, to the doctor who refers his patient to some particular test center.

Usually, a patient has to pay a total amount of Rs 8,000 to 9,000 for a normal CT scan. The actual price for a normal CT Scan is Rs 3,500 which is also the price which is kept by the Test and Scan centers. The rest of the amount from the total charge of Rs 8 – 9,000 is given back to the doctor who has recommended the particular patient there. The test and scan centers pay back the money as commission to the doctors in the name of Interpretation Charges so that the doctors could keep recommending their patients to them.

Shadma and her brother Baquir have some neurological problem. Baquir went to see Doctor S.K. Verma with his mother. Doctor asked him about his father’s profession. Knowing that he is a son of a father who works for Railways, he handed him a test list which demanded to be conducted to the particular place recommended by the doctor. He went for MRI which costed him around Rs 2,000. Two weeks later when Shadma went to the same doctor with her father, the doctor asked the profession of her father.

Her father who was there present with her told the doctor that he is a primary school teacher in some private school. The doctor gave her also a list of test which again demanded to be conducted to some particular test center. This test was different from the test center her brother was prescribed. And not just the test center, even the expenses were different. Her test was done only in Rs 800.

“India’s private healthcare sector largely treats patients as mere revenue generators. Irrational drug prescribing, kickbacks for referrals and unnecessary tests and surgical procedures are widespread in the private healthcare system,” said Doctor Joseph, Head of the department of Cadaver Transplant Unit in Rajiv Gandhi Government General Hospital.

Jayaram, whose grandfather had cough problem two years back was admitted to Fortis Malar Hospital. He had pain in his chest and was having difficulty in respiration. He was admitted to the Intensive Care Unit (ICU) of the hospital. The doctors conducted some tests and then gave some medicines and injections to him. By evening, he looked, quite better and relieved. Suddenly the doctor came asking us to sign the form because they want to put his grandfather on ventilation.

Jayaram’s father clearly denied and asked doctors to not to do that unless he or his family members allow to put his father on a ventilator. Since the patient was admitted to ICU, Jayaram, and his father decided to go back and spend the night at home. Next day, when they came back, they found their patient dead.

The autopsy report mentioned infection in the lungs of the patient as the cause of his death. Despite the denial of the patient’s guardian, the doctors put the patient on a ventilator. Later the doctors explained that soon after they left the hospital, patient’s condition became critical which forced them to put him on the ventilation. This infection was surpassed from the ventilator’s pipe which became the cause of patient’s death.

There are few doctors who still practices the ethical way of treatment. But a lot of investigative reports and studies has proved it clearly that the majority of doctors basically in private hospitals are indulged in unethical and irrational practices. They are not even affected by the increasing commercialization of the medical sector. After all these, it can be said that not even paying large amount of money can guarantee good health care.

Mute struggle for right to survival; even before learning to speak

1.45 million children dies before their fifth birthday. Photo Courtesy: usatoday.com

The economic growth of a country determines the rate of development of a country. India has now rapid economic growth with GDP of 1500 billion $ but still 9,00,000 newborn children die every year in India. Almost one child dies every minute in the country.

Every year, 1.45 million children do not live to celebrate their 5^th birthday and 55,000 women die during and after childbirth in India. Of every 100 children born in India, 4.4 of them die before their first birthday. 48 of them are stunned, 43 are underweight, and 39 are not fully immunized. Those who win over all these difficulties, 49 of them live without adequate sanitation.

Infant mortality is even higher than maternal mortality. Photo Courtesy: Mint.com

Globally, more than one-third of child deaths are attributed to the cause of undernutrition. The major causes of deaths in children under 5 years are prematurity, birth asphyxia, sepsis, pneumonia, diarrhea. The biggest among these is malnutrition. These cases are more prevalent in rural India and the poor section of society. Early marriage and then early childbearing is very common in rural areas and among the poor. This has a serious effect on the child which is borne by young girls who are too young to carry this whole process from pregnancy to delivery.

Due to poverty, most girls start working from their young age. Since, they have no educational qualification or any other skill; usually they end up doing labour work. They can’t afford to stop working even after their pregnancy. In such cases, the peril of physical stress and depletion results into unsafe motherhood.

Undernutrition, respiratory infections, lack of immunization and health facilities are the underlying causes of newborn deaths. However, most of these deaths are preventable if the government makes the proper arrangements of health centers and qualified doctors at the centers. Children are said to be the future of a country. If the health of a child remains so threatened right from their childhood, what can we expect for their future? Right to survival is their basic right, and if it is no fulfilled, then it is a violation of their right.

Autistic children: Outcasts of society

Autistic children with beautiful colours participated in the painting competition. Photo Courtesy: The Hindu

Tears tumbled down Maria Josephine’s face when her 31-year-old daughter Priya asked, “When am I going to get married? Why don’t you marry me off too?”

Like every other girl, Priya also has dreams. She wants to get married. It was during her younger brother’s marriage ceremony that she asked her mother why she is not getting married. Her mother could never explain to her that her lovely adorable daughter is autistic and no one wanted to marry her.

In a bid to do her bit for children with such special needs, Maria has for many years been running a school called V Excel Education Trust for Children with Autism Spectrum Disorders (ASD) in Chennai.

Most people are not even aware of this neurological disorder. Autism is seen as a taboo in society. Maria was once asked by her neighbour, what sin she had committed that made her give birth to an autistic child.

“All we want is just a proper educational system for our children where only trained professionals can teach them. I have seen teachers and school staff resorting to corporal punishment to discipline autistic children and that is pathetic,” says Maria.

According to the Centers for Disease Control and Prevention (CDC), in 2010, the number of people with ASD was only 1.7million in India which increased to 10 million in 2012. The CDC report has found that in every 88 children, one child is born with autism disorder.

Most of the autistic children are not even diagnosed, depriving them of their fundamental rights to education. Survival itself is a big challenge for these children.

Often parents find it too hard to cope with the condition of their children, leading to family discords and marriage breakdowns. The cost of treatment and care is often beyond the reach of parents who are then left with no other option but to keep their wards shackled and hidden from the world.

Rahul (name changed) was six years old when Maria met him at his home in Tondiarpet, Chennai. The forlorn look in his eyes was heart-rending. His shrunken face and shivering body, which had grown thin without food, revealed the trauma he was undergoing after being abandoned by his parents.

It was his second week without food when Maria, who was working in Shishu Bhawan, got a letter from a doctor who was treating Rahul. The letter mentioned that the six-year-old with ASD is spastic and the parents of the child had planned euthanasia for him. She went to see the child and warned the parents to bring the child to the school if they wanted to avoid getting into trouble with the law enforcement authorities.

“The first thought that comes to the mind when you meet an autistic child is that he is mad. They often get scared of my little nine-year-old son. What harm can he do? I try convincing people to try and accept him and not look down upon him. I ask them, what if your child had this disorder. How would you have expected him to be treated?” asks Fareeda, a mother of nine-year-old Fardeen with ASD.

India doesn’t have enough facilities for children with special needs. Even therapy centres have made it a business.
“We don’t even know what these centres do with our children. We have requested a lot, but they never allowed us to visit the centers,” says Fareeda.

Children with ASD also lack facilities for recreation. When they try to mingle with other children, they are not accepted. Even if they manage to make friends, the parents of the other children restrict their wards from playing with them. Surely, these children deserve better.

Shameful cheating scandal in Bihar

Parents and guardians climbing up on the school building to pass the chit papers with answers written on them of the questions that has been asked in exam. Picture Courtesy: Prashant Ravi

Are the parents and examinees solely responsible?

For a few days now, the bizarre photo of people climbing on a school building wall has become a subject of mockery, anger, pity and disgrace. The picture shows the loopholes in the administrative system in Bihar. The photograph, with dozens of guardians of examinees, clinging to the wall of Vidya Niketan School in Mahnar of Vaishali district in Bihar, went viral on twitter.

But that is not the only school where reports of mass copying and cheating was witnessed. The condition of almost all the other examination centres in the state is more or less the same as Vidya Niketan.  This illegal practice is nothing new and is exercised every year during the state board exams of class 10^th and 12^th. This year in 2015, around 1.43 million students appeared for class 10^th board exam, only for state board (Bihar School Examination Board). Total 1,217 schools were allotted as examination centres for the 1.43 million students appearing for the 10^th board exam this year. Most of these centres do not have  adequate infrastructure facilities and more than required numer of students are accommodated in the little space available.

Girls writing their papers of board exam with the help of chit papers open on the table. Picture Courtesy: Prashant Ravi

Parents and relatives of the examinees climbed up on second and third floor of the examination centres to pass chits with answers written on them through windows to their children. Old people wearing lungi, dhoti and pyjama can also be seen in some of the pictures climbing up, showing that cheating was irrespective of age. Some of them even used bamboo poles and ropes to pass chits through windows. Once the chit reaches to the examinees sitting in the examination hall, it is exchanged with several other students with other chits of their own.

“These people should be in police or fire brigade department. Look, how easily they climb without much assistance and how innovative they get using ropes to carry chits to the desired rooms,” a lathi wielding cop said to HT.

Around 750 students were caught copying and were expelled in just two days after the commencement of the examinations. According to Board’s Special Examinaton Cell, seven parents, indulged in helping their wards were also arrested during these two day period of state board matriculation examination. Here, there is no fear of being caught as cheating seems completly normal. It doesn’t stop there. There are other cases wher parents employ the impersonators to write the exam on behalf of their children.

“My son cannot even write but I wanted him to at least complete his matriculation,” said the father of a student to Hindustan Times after he was arrested on the very first day of exam from R B Jalan College centre along with five other proxy examinees.

Scene of a high school in Saharsa which is also a center for 10th board examination of Bihar School Examination Board. Picture Courtesy: Express Photo File

On 19^th March 2015, Education Minister of Bihar, P K Shahi said, “Cheating-free examination is not possible in State without the cooperation of student’s parents. It is also the responsibility of society to ensure a cheating-free exam”.  He added that the other day, during a raid at just one school, the authorities seized chit-papers with answers that filled up nine sacks. He admitted that holding free and fair exams was a big challenge for the Bihar Government.

Although it proves the inability of the government and the hypocrisy on having any control on such unethical practices. There lies the root of corruption where the young students succeed without any hard work and knowledge. There are times when the students who wrote the exams with the help of chits gets better marks compared to the students who wrote the exams honestly without any help. This is injustice to the students who passed the exam without the help of cheating.

School education system especially in Bihar is on the brink of collapse. Even the minister expressed government’s helplessness to hold a cheating-free and fair exam in the state. It’s a matter of concern that what values are children inculcating when cheating and using unfair means is an accepted norm? Parents and teachers who are supposed to preach them the difference between right and wrong are promoting the use of these unfair means. Why would a child concentrate over his/her studies and work hard to prepare for the board exams when he/she knows that passing the exam is not a big deal for them? If this remains the situation, what is the need of examinations which qualifies the efficiency of a student?

Most of the time children are forced to earn for the family and instead of going to school they are sent to work. Even the parents are not concerned about their education. All they need is just a piece of paper known as mark sheet which certifies that now their child is 10^th pass or 12^th pass. This helps them to get better jobs from government’s employment schemes like MGNREGA which needs minimum qualification of 12^th grade. Exams in Bihar is more about showing proficiency and smartness in cheating and copying rather than proving how well educated.

A boy at the left corner, first bench sits with his legs stretched out leaning on a bench in front of him while the middle row front bencher peeps into others copy not even caring about camera. Picture Courtesy: IBN live

“After all, unless they are taught in schools, how can they be expected to answer? Just passing the test should not be the goal, but unfortunately that is the mindset,” said former board chairperson Rajmani Prasad Sinha. Almost similar was the remarks of some students. “I don’t find anything wrong in using unfair means. It is nothing new, my elder brothers and even my father has passed their exams with the help of chit papers,” said Rashmi Prasad a student of Social Science in Jamuni Lal College, Hajipur.

Infrastructure and facilities like,  teachers, books, regular classes, proper class rooms etc play an important role in the education of students. Education system in Bihar lacks all these facilities. Children are not educated properly. Government’s slogans like ‘Sab Padhein, Sab Badhein’ are just for name sake. But the qualification criteria remain same for all the students of country. In such situations the students and their parents can’t see any other way to pass the exam and to get certificates.

This trend of cheating is so prevalent in Bihar that children who get proper education in private schools with expensive fees also resort to these unfair means. Even the parents help them employ these methods to fetch better marks and score higher than others. There are many other reasons behind this trend and its rootedness in education system. But the question remains the same that; Are we doing justice with our new generation by providing them such an environment where inadequate knowledge is rewarded more than skills and civic values?