Group President, Group Managing Director & Editor In Chief: Dr.Shelly Ahmed
Showing posts sorted by date for query Chhattisgarh. Sort by relevance Show all posts
Showing posts sorted by date for query Chhattisgarh. Sort by relevance Show all posts

Thursday, August 03, 2017

Speciasl Report: Inside The Surreal Battle For Mind Control Playing Out In Rajasthan's Classrooms

From history to politics to math, text books are throwing caution to the wind, as teachers grow divided.

For someone who is courageously speaking truth to power, 51-year-old Mahavir Sihag is exceedingly soft spoken. On occasion, you have to remind him to speak louder, so that you can hear.

Friday, June 30, 2017

What Cow-Loving India Should Focus On: Making More Fodder Available To Starving Cattle

With forests overrun by weed and other unwanted growth, free-grazing lifestock face a grim situation.

Much passion is now generated in our country on the subject of protecting cattle. However, a dispassionate narration of the reality about the fodder situation for them seems to be largely missing. There are 108 million adult female cows in a cattle population of 200 million, according to the National Dairy Development Board. In addition, there are about 100 million buffaloes in the country.

Monday, May 01, 2017

Telangana, Andhra Pradesh Reel Under Heatwave, But Petty Politics Takes Centrestage

As the mercury soared to a new 10-year record of 43 degrees Celsius in Hyderabad recently – a heatwave for the third consecutive year — the demand for spicy buttermilk or masala majiga too soared. This product of Heritage, a unit owned by Andhra Pradesh Chief Minister N Chandrababu Naidu, notched an all-time high business of nearly 12 lakh sachets being sold by 17 April. It also kicked off a political satire on social media that summer did not take note of bifurcation of state and that it did not differentiate between people of Telangana and Andhra.

RERA Myths Busted: No Big Relief For Stuck Home Buyers, House Prices Won't Rise

The dust has finally settled on RERA or the Real Estate Regulation & Development Act. From Monday (1 May 2017) it comes into force across India, and the day will be remembered as a special day for home buyers who have been committing the largest chunk of their life savings to an industry which has been free for all.

A press release from the Housing Ministry stated how this day marks the end of a 9-year-long wait; and for the first time 76,000 companies engaged in building and construction activities across the country will become accountable for quality and delivery. Union Minister for Housing Venkaiah Naidu in his tweets called it the beginning of a new era making buyer the king, while the developers benefit from the confidence of a King in the regulated environment.

Friday, August 05, 2016

Spotlight: Should Hospitals Give Patients 'Unbanked Blood' To Save Lives?.


Unbanked blood transfusion is illegal. But short of blood, rural hospitals in Chhattisgarh say it is not unethical.

In April, a woman walked into a hospital in Baitalpur in Bilaspur district of Chhattisgarh, bleeding heavily. She was in her thirties, and had ruptured her uterus while delivering a baby at home in a nearby village. She needed urgent medical attention. When a van dropped her off on the highway, she trudged two kilometres to Baitalpur's Evangelical Mission Hospital – only to be turned away.

The hospital had an operation theatre and a gynaecologist, but no blood.

With buses plying only once in two-three hours from Baitalpur to Bilaspur, the district headquarters, getting blood from the blood bank takes at least four to five hours, if not a day. Without a quicker way to access blood, the hospital is not equipped to handle an emergency.

“She had a ruptured uterus and was anaemic," said Dr Kusum Masih, the medical superintendent of the hospital who is also a gynaecologist. "We could not operate without blood."

The doctors sent her to Bilaspur about 35 km away – but she died on her way there.

Eleven districts with no blood banks
There are 16 blood government-run blood banks and 30 private ones across 27 districts of Chhattisgarh.

The deficit of blood in the state is about 48%, said Dr SK Binjhwar, from the State Blood Transfusion Council. According to the World Health Organisation, a country should have a stock of blood equivalent to 1% of its population. By this standard, Chhattisgarh alone needs 25 lakh units of blood at any given point – but it usually collects 16 lakhs units a year.

What's more, 11 out of 27 districts in Chhattisgarh do not have blood banks – the largest deficit in any state in the country. In all, there are 81 districts in the country without blood blanks, according to data from the Union Ministry of Health and Family Welfare. Most of them are concentrated in Chhattisgarh, Jharkhand, Bihar, Uttar Pradesh and the North East.

For Chhattisgarh, a state with very high rates of anaemia, especially among women and children, the shortage of blood throws up multiple challenges.

According to the National Family Health Survey, more than half of the women of the state – about 57% – suffer from anaemia, as do nearly three-quarters, or 71.2% of children aged 0-5. About 2% of both women and children have severe anaemia, with a haemoglobin level below seven grams per decilitre of blood, for which most patients need blood transfusions.

Apart from this, about 60,000 children are estimated to have sickle cell anaemia, a severe form of the condition caused by a genetic blood disorder.

Anaemic women additionally face a higher risk of postpartum haemorrhage, which is a leading cause of maternal mortality in India. The maternal mortality rate of Chhattisgarh is 230 deaths for every 1,00,000 live births, as compared to the national average of 178.

Unbanked blood
For a rural hospital in Chhattisgarh, there is just one option in case of emergencies where blood is required – to refer a patient to a bigger facility. This often means that the person reaches the hospital in a critical condition, or dies on the way, as in the Baitalpur case.

Some hospitals are countering this by opting for an illegal way of giving blood, called unbanked direct blood transfusion. Under this, the blood of a willing donor’s that matches with the recipient’s group is collected, tested for infection with a rapid blood kit and then transfused without roping in a blood bank.

Take the case of a 40-year old woman from Shahdol district in Madhya Pradesh, who had been having extremely painful menstrual bleeding for nearly four months.

“Khoon girat rahe [I was bleeding all the time],” she said. “But, I would still have to work in our fields. How can I stop?” She was also not able to eat or walk and had severe chest pain.

On June 28, she somehow made it to a rural hospital in Chhattisgarh, which shares a border with Madhya Pradesh, travelling more than 200 km by train and bus with her husband and son.

When the doctors examined her blood, they saw she had a haemoglobin count of 4.6 – the normal range for women is between 12.1 and 15.1 – which meant she needed immediate transfusion. She also required an abdominal hysterectomy, as she had a large fibroid in her uterus.

In all, she needed three units of blood.

“I do not know how she managed to travel so far,” said a doctor at the hospital. “There is barely any oxygen reaching the organs. We have patients coming in with haemoglobin count of one as well. We can't direct such patients to other hospitals as their condition is already critical.”

The names of the hospitals and the doctors have been withheld because it is illegal to get blood from any other establishment other than a blood bank.

In this case, her son gave one unit of blood through unbanked direct blood transfusion, while two other units were arranged legally.

Doctors have been arrested in the past for using unbanked blood in other states.

Hospitals that practice unbanked blood transfusion usually have a list of donors in the community who can come and give blood when required. These donors are usually not paid – unless they demand payment and the situation is dire.

Insufficient blood
In 1996, the Supreme Court outlawed professional blood donation – that is, donating blood for money – and ordered the establishment of National Blood Transfusion Council to oversee and strengthen policies and systems governing blood transfusion in the country. In 1998, unbanked directed blood transfusion was disallowed.

In 2002, the council allowed the setting up of blood storage centres that were allowed to keep blood from licensed blood banks (but were not authorised to collect it). These storage centres could come up in villages and towns, while the mother blood banks would usually be in the district headquarters or cities.

In Chhattisgarh, there are 60 such storage units, mostly in community health centres, many of which do not use the blood at all and direct patients to go to other healthcare facilities. For instance, the community health centre in Gaurella, attached to the Chhattisgarh Institute of Medical Sciences in Bilaspur, has never approached the storage unit for blood. “I am not even sure it [the centre] functions,” said Dr VP Singh, who is in charge of the blood storage centre in the Bilaspur college.

Patients from community health centres often make their way to Jan Swasthya Sahyog, a non-profit in Ganiyari, near Bilaspur city. “Often, we see patients who are bleeding copiously after childbirth and are referred to us in that condition,” said Dr Yogesh Jain, one of the founders of the hospital.

Even hospitals that do use blood storage units, such as Jan Swasthya Sahyog, Shaheed Hospital in Dalli Rajahara in Chhattisgarh's Balod district and the mission hospitals, said they get insufficient units of blood.

“Our storage centre is attached to a mother blood bank in Durg,” said Dr Saibal Jana, chief physician of Shaheed Hospital. “We need about 150 units per month, but have barely about 35 units from the bank. Last month, they gave us only 10.”

Jan Swasthya Sahyog has an understanding with a private blood bank in the city, which gives them blood nearing its expiry date for free. This they use for scheduled surgeries, when the blood requirement is known.

Replacement donation
For every unit of blood taken from the bank, hospitals are supposed to send a replacement donor to the mother blood bank. This unwritten rule holds true even for hospitals that send relatives of patients to collect blood from a blood bank – private or public – for a planned surgery.

This is against the country’s National Blood Policy, which prohibits coercion in enlisting replacement donors and aims to phase replacement donations out.

Dr SK Binjhwar, from the State Blood Transfusion Council in Chhattisgarh, said that the state has 80% voluntary donation. Public health activists, however, said this figure is highly debatable and that more than 99% of the blood is likely collected through replacement donation.

“A hospital that has a blood storage unit organises blood donations camps for mother blood banks,” said Bhinjwar. “This is enough to meet the demands of the districts.”

The demand for a replacement donor for the mother blood bank hangs like a sword over the heads of patients’ family members.

Many donors from the hinterlands are not willing to travel to the nearest blood bank in the city to replace blood. It’s also difficult to find eligible donors in the immediate family – if a patient has anaemia, it’s likely that members of her family would also suffer from the condition.

Many also have an apprehension towards donating blood, fearing it causes weakness.

In such a scenario, touts who can provide ready donors for a price thrive. There are many such businesses in operation near blood banks in the state that provide donors for a sum of money to provide replacement units to the banks.

Rajesh Sharma, who runs the laboratory in Jan Swasthya Sahyog said that touts realise that people are looking for donors for replacement donation when they see an icebox in their hands. To combat this, Jan Swasthya Sahyog sends a patient's relative for replacement donation, they now send a letter (pictured below) that has to be signed by the blood bank.

People who are unaware about the dangers of remunerative blood donation – which has higher chances of infection – are willing to pay for the blood, despite having meagre resources.

In a rural hospital in Chhattisgarh, a 76-year-old was diagnosed with nectrotising fasciitis – a severe bacterial skin infection that spreads to the tissues quickly – on her arm. She had to be operated upon immediately to remove the infected tissues, but her haemoglobin count was just 6.3. During the surgery, the hospital collected blood via unbanked direct blood transfusion. But they were short of one unit.

“I do not know who will donate now...can we buy the blood?,” asked her daughter, who was tending to her.

While admitting that most units of blood are given only after a replacement donation, Dr Singh from the Bilaspur college's blood storage unit said: “We give blood to people who do not have replacements too."

"Usually if someone is an orphan with no family support, or someone comes without attendants, we give the bank without exchange too (referring to replacement donation)," he added.

Dr Singh said he had instituted a rule that no sickle-cell patients should be asked for replacement donors as he found out that the patients' families were bringing in professional donors, especially when the patient needed immediate treatment.

Unbanked blood ethical?
In a scenario where lack of access to blood banks has resulted in deaths that could have been avoided and helped touts flourish, doctors and healthcare activists practicing in rural areas have pushed for unbanked direct blood transfusion to be legalised, even as other activists argue that it shouldn't.

In June, Dr Yogesh Jain and Dr Raman Kataria from Jan Swasthya Sahyog wrotein favour of the practice in Indian Journal of Medical Ethics. They said that unbanked directed blood transfusion, if done by trained and certified healthcare teams, meets ethical standards and helps fulfil emergency blood requirements in rural areas.

In 2014, the Ministry of Health and Family Welfare met a delegation from the Association of Rural Physicians that sought to legalise this practice. Though the Drug Technical Advisory Board considered the proposal, it was eventually rejected.

The delegation argued that there the Drugs and Cosmetics Act allows unbanked directed blood transfusion for Armed Forces in border areas and peripheral hospitals, which should be extended to the same in emergency situations in rural areas too.

The Drug Technical Advisory Board, however, said that testing of safe blood requires a lot of infrastructure and trained manpower, without which the blood is likely to be infected. Besides, they said, it would be difficult to monitor them. They also said that the exemption given to Armed Forces cannot be given to rural hospitals.

“Are soldiers' life more important than a woman giving birth?" asked Dr Jain. "The implication of this policy is that either people go to the cities for treatment, or choose to die wherever they are. People who have to handle emergencies have to be equipped with technology and regulations should look into the ethical requirement of safe blood.”

An ideal solution, said doctors, would be to increase blood availability in the country by having a central blood bank in each district, with well-equipped storage centres.

However, activists working towards ensuring voluntary blood donation said that unbanked direct blood donation should not be allowed.

“All hell will break loose," said Vinay Shetty, from Think Foundation, Mumbai and a member of Voluntary Blood Donation Committee of Maharashtra State Blood Transfusion Council. "There will be no control over the blood in this country and we will go back in time."

The state has to take responsibility for the shortage of blood and has to ensure that no bank is short of blood, he said.

“The only answer to this is blood sufficiency," said Shetty. "Organising blood is not the responsibility of the patient. It is the responsibility of society at large. This is happening because there is no value to human life. Somebody in the state has to take charge."

Sunday, July 31, 2016

Adivasis: Cheated Of The Constitution


Tribal people who account for 8.2% of India’s population can be broadly classified into three groupings. The first grouping consists of populations who predate the Indo-Aryan migrations. These are termed by many anthropologists as the Austro-Asiatic-speaking Australoid people. The Central Indian Adivasis belong to this grouping. 

Wednesday, July 27, 2016

What's Wrong With Abortion Laws: The Case Of A Rape Victim Missing The 20-Week Deadline


A 23-year-old tribal woman from Chhattisgarh was abducted, raped and got pregnant. Bureaucratic hurdles delayed her quest for an abortion.

In April, the Chhattisgarh High Court allowed a 23-year-old tribal woman to undergo an abortion even though her foetus was older than 20 weeks – the deadline set by the Medical Termination of Pregnancy Act, 1973. The woman from Jashpur district in Chhattisgarh had been raped by her boyfriend, who abducted her and took her to Alwar in Rajasthan, where she remained for nearly a year.

Monday, July 25, 2016

India's Model Villages: Why Modi's Pet Rural Development Scheme Is Not Working Properly?


Only 53 of 278 BJP MPs in the Lok Sabha have selected new villages in phase two of the scheme.

Close to two years after its launch, there seem to be few takers among parliamentarians for Prime Minister Narendra Modi's flagship rural development scheme, the Saansad Adarsh Gram Yojana, which aimed to develop at least three “model villages” in each parliamentary constituency by 2019. 

Soon after the launch of the scheme in October 2014, 701 of total 795 ruling and opposition MPs had adopted a village each to be developed over two years.

Friday, July 01, 2016

Telugu Desam Party Supremo & AP CM Chandrababu Naidu, Still Loyal To NDA For Now Even As Discontentment With Narendra Modi Grows


TDP Supremo Chandrababu Naidu was rarely seen without a laptop in the last years of his previous term as the Andhra Pradesh chief minister. Once, when I called him 'Laptop' Naidu, he took it as a compliment. He constantly monitored sundry schemes on a laptop and exuded supreme confidence that he would sweep the 2004 elections. He lost. And it took him 10 years to return as the CM.

Naidu is a changed man now. It's not because, instead of a laptop, he now has an iPad as a constant companion and he talks of 'iCloud' and 'file-sharing' to review his government's work.

Tuesday, June 28, 2016

Average Deposit In Accounts Under 'Jan Dhan Yojana' Scheme Doubled In 21 Months


The number of accounts opened under the Prime Minister's financial inclusion programme quadrupled between September 2014 and May 2016.

The average deposit per account under Pradhan Mantri Jan Dhan Yojana – a financial inclusion programme launched by Prime Minister Narendra Modi in August 2014 – increased 118%, from Rs 795 in September 2014 to Rs 1,735 in May 2016, according to IndiaSpend's analysis of government data.

Monday, June 20, 2016

Barring Flag Hoisting, Yoga Day Seems At Par With Indian 'National Days'


The linking of International Yoga Day to Lord Shiva, who is said to have become the first yogi on June 21, is a reversal of the secularisation of yoga.

June’s scorching, sultry heat seems to get the worst out of those in power in Delhi. It is the month in which Indira Gandhi imposed the Emergency and threatened to extinguish forever the flame of liberty.

Wednesday, June 15, 2016

How Telangana CM KCR is Wiping Out The Congress And Telugu Desam Party From The State?


While the TDP is down to three legislators, the Congress is left with just 12 after a series of defections to the chief minister's Telangana Rashtra Samithi.

Telangana Chief Minister K Chandrasekhar Rao seems to be generously assisting the Bharatiya Janata Party in its mission to wipe out the Congress from India.

Since the formation of Telangana in 2014, the Congress’ strength in the 119-member state Assembly has fallen from 21 to 12. Over the last two years, there has been a steady trickle of Parliamentarians and legislators from the Congress' Gandhi Bhavan to Telangana Bhavan, the office of the ruling Telangana Rashtra Samithi.

Tuesday, June 14, 2016

Indian National Congress: Death Of The 'Dynastic Rule'?


The Congress is prone to describing the ongoing rebellion in its ranks, as also the departure of leaders from its fold, as glowing examples of opportunism bedevilling Indian politics. What the Congress fails to comprehend is that opportunism is inevitable in a system which privileges dynasty over ideology.

The Congress does indeed have an ideology, nebulous though it may be seem to observers. The problem, however, arises from the fact that the Gandhis personify the party ideology. It is consequently subordinated to the family in the hierarchy of importance, exposing the Congress to the perils inherent to any dynastic rule.
For one, the dissidents in the Congress frame their rebellion against the wrong choices of the dynasty. 

Sunday, June 05, 2016

Fake Federalism: How 'National Parties' Turned The Concept Of 'Rajya' In Rajya Sabha Into A Farce?


The upper House of Parliament, literally a Council of States, was meant to be a federal chamber to look out for the interests of the states.

The continued abuse of the idea of the Rajya Sabha – or the Council of States – by the so-called national parties continues with the upcoming round of Rajya Sabha elections.

Monday, May 23, 2016

Exclusive: Sexual Violence Routinely Used As A Weapon In Conflict Zones Across South Asia


In Kashmir and Balochistan, Chhattisgarh and Nepal, sexual violence is used with impunity to subjugate women, say researchers.

There is an exponential increase in the incidence of sexual violence – which is often used as a tool of punishment, for revenge and to teach other communities a lesson – in areas of conflict in India, Pakistan, Bangladesh, Nepal and Sri Lanka. These are the findings of a three-year long project exploring sexual violence and impunity in South Asia, which were discussed during a conference in New Delhi on Saturday.

Friday, October 02, 2015

Special Report: Indian Doctors Are Shamelessly Lying On Women To Perform Unwarranted Hysterectomies


In Chapla Naik, a tiny village in Karnataka’s Kalaburgi district close to the state border with Telangana, two women died this year.

Arati (name changed) died of pancreatic cancer. Sumana bai (name changed) died of sepsis in her abdomen. What the two women had in common with each other—and with many other women in the village—is that they were aged less than 30, and they had recently undergone hysterectomies.

Monday, September 07, 2015

Chhattisgarh's Experiment With Modi's 'Cash Transfers' For 'Food Rations' Has Been Turned Aa A Sheer Disaster!


During a pilot project in direct benefits transfers, a fifth of the beneficiary households never received any money, and among those who did 70% got it after much delay.

Chhattisgarh has been lauded for the reforms initiated in 2004 in the public distribution system to ensure that subsidised foodgrains meant for the poor actually reached them. Over the last decade, the state’s network of food ration shops expanded to reach 85% of the population. It became the first state to implement a food security law in 2012 and was highlighted in numerous studies as a model state for the public distribution system.

Sunday, September 06, 2015

Focus: Why India Should Stop Celebrating Teacher’s Day?


We have all had great teachers who have shaped our lives. Yet, we can’t pretend that India’s education system is not broken. Most of it has to do with teachers. Indian school students famously don’t ask questions in class. If you ask questions, you are a problem child. When there is rote learning to see you through examinations, why do you need to ask questions?

This Indian Boy Deserves Attention As The Syrian Toddler


The truth is that we are numb to the tragedies around us. It was the way he was dressed: the dark shorts, the red shirt and the shoes. It made countless people on my Facebook timeline say: This could have been my child.

But what if he had been wearing tattered clothes, broken slippers, or perhaps not even that? What if he had been thin and dark and malnourished? What if he had been just another poor child escaping not war but hunger and landing up on the streets of our cities? Would he even get a passing glance?

Friday, August 07, 2015

Electricity Conundrum In India: Idle Generators In The Midst Of Acute Power Deficit In Telangana & Andhra

The Southern region of India is expected to face high energy deficit this year while the Western and Eastern region will have a surplus of energy generation. INNLIVE explains why such regional skew in energy generation and energy consumption exists and what it will take to resolve it.

Southern India is expected to face a severe electricity shortage this year. The Central Electricity Authority (CEA) in its latest annual forecast anticipates the energy deficit in the southern electricity grid to be over 11 percent, equivalent to a generation capacity deficit of 4000 MW. For Karnataka and Telangana, the forecasted energy deficit is greater than 16 percent.