Sunday, August 14, 2011

Doctor, heal thyself!

IIPM Mumbai Campus

In collusion with pharma biggies, doctors in government hospitals across Madhya Pradesh are conducting dubious drug trials on unsuspecting patients, thus endangering lives and the reputation of a noble profession

For the last few years, drug trials have been carried out in some hospitals of Madhya Pradesh in a hush hush manner. This is apparently being done by multinational companies hand in glove with some doctors. Patients are neither informed, nor is their consent taken. The matter has been brought to light of late, and the government has started looking into the issue seriously now.

If you are going to a Madhya Pradesh hospital for treatment of a serious disease and are made to sign a consent form in English, beware. It is quite possible that you unknowingly become the guinea pig for a vaccine trial. In the last five years, thousands of patients in Madhya Pradesh have faced this fate.

Sharad Geete’s wife Sheela Geete died on August 8, 2010. She was suffering from Alzheimers. Her husband had brought her to Indore’s MGM Medical College’s neurology department. After his wife passed away, Sharad came to know through local media reports that the doctor in question was deep into drug trials. He then collected material which indicated that Eisai Pharma’s Donepezil Immediate Release and Donepezil Sustained Release were being tried on her. Geete subsequently complained to the state’s health minister Mahendra Hardia.

Similarly, Ajay Nayak of Indore complained that in the name of ordinary vaccination, one doctor at Chacha Nehru Hospital conducted a vaccine trial on his newborn. He was made to sign a consent form in English which he did in good faith. When he took the infant home, the newborn fell sick and developed white marks all over his body. In yet another case in Jabalpur, cancer patient Rammani Upadhya died of another drug trial as well.

Despite these deaths, information received on the calling attention motion of Congress MLAs Pratap Singh and Pratap Grewal and Independent MLA Paras Saklecha reveals that there are no such trials taking place in the state nor have there been any deaths related to drug or vaccine trials.

This goes against the fact that many doctors independently confirm that such trials are one – in fact, one particular doctor is even reported to have conducted 30 drug and vaccine trials on 1,700 patients (yet, the doctor in question did not disclose the names of any patient). Dr Anand Rai of MP’s Resident Doctor’s Association says, “This [not disclosing of patients’ names] has been done deliberately so that it cannot be found out what the condition of the patient is post trial.”

In the monsoon session of the Madhya Pradesh Assembly when this matter became public, a committee was formed under the principal secretary of the Assembly. After two meetings, the committee recommended that new drug trials should not be conducted but those being conducted should not be stopped. Hence the drug and vaccine trial business continues to flourish in the state.

In the winter session of the Assembly, Paras Saklecha questioned the trials of the HPV vaccine. The response was that trials were conducted on 39 people at the Chacha Nehru Hospital, Indore. It is surprising that the trial for a drug, HPV Vaccine V 503, which is to be used on women with cervical cancer, is being done by a child specialist and not by a gynaecologist. According to Dr Anand Rai, “Many doctors in MP are taking money from pharma companies to conduct drug trials. Almost all the doctors present in the local ethical committees are involved in the trials. How can it then be imagined that they are taking the right decision? This is the reason why the cervical cancer vaccine was tried by a child specialist on females between the ages of 15 and 26 when patients above the age of 12 should not even have come under the purview of treatment.”
Drug trials are happening for diseases which are not even found in the state, whereas there is no concern about the diseases the state is battling with. Cervical cancer, for instance, is more common in American and European women. In those countries, strict laws govern drug trials. This is why multinationals prefer to conduct drug trials in India. The trial for V 503 vaccine is a result of this.

Even in the past, trials for cervical cancer vaccines have triggered controversy in the country. Pharma major Merck’s Gardasil vaccine was tried in Andhra Pradesh’s Khammam area and Gujarat's Vadodara on girls aged 10-14. Two girls died in Vadodara and four in Khammam as a result of the trial. That had caused health workers across the country to unite against the propriety use, negative effects and costs of the vaccine, forcing the government to end all such trials. Merck then graduated to trials of V-503.

In summary, the fact is that the two big multinationals, Merck and Glaxo, are in a race to find a cure for cervical cancer. So, trials in Indore are on in full swing. The control mechanism is not well defined and the government needs to set up definite rules as soon as possible.

State minister for health Dr Mahendra Hardia says, “A separate committee has been formed in the Madhya Pradesh Assembly to look into the matter. Its directives shall be followed. An investigation by the state human rights commission is also being considered. There is also consultation about drafting a drug trial law in the state. Drug trials are necessary for the availability of common drugs. But no new drug trials will be conducted in the state.”

Saklecha says, “There must be a health research policy in the state. Patients who are going to hospitals for treatment are being tricked into drug and vaccine trials. The V503 trial has terrible side effects. It uses sodium borate which is a chemical used to kill rats. The polis argon eti used in it is a detergent which can cause cancer. It also contains aluminium salts which cause heart diseases.”

While the government might be right in holding that drug trials are necessary, conducting such tests on unknowing patients is not only unethical but also absolutely uncalled for.

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Thursday, August 11, 2011

With 4,000 divorce applications filed in the last 10 months

IIPM Mumbai Campus

India's IT hub of Bangalore is also fast becoming the nation's divorce hub. N K Suprabha tries to fathom the reasons...

Bangalore-basedDivorce IT professional Sunil tied the knot with Ramya in 2008 on a high note. Chennai-based Ramya, too, is in the same profession and the two quite liked each other when they met. Barely a year down the line, the two felt that they had had enough and decided to part ways.

Subsequently, Sunil got a divorce notice from Ramya and accepted it. “My wife was not ready to compromise on any of the issues that cropped up between us. Instead, she used to call her parents and they would meddle in everything. In the short span of one year, her parents travelled all the way to Bangalore several times to ask for explanation for petty fights between us. Their interference only worsened the situation. At last my wife went off to her parents’ house and sent a divorce notice to me from there,” says Sunil.

Sunil's is not a one-off instance. During the last 10 months, more than 4,000 divorce applications have been filed in Bangalore. The number of divorce applications has been on the rise for the last few years. India's IT hub is in fact on the verge of earning the sobriquet of India's divorce hub. In 2004, a total of 2,229 divorce cases were filed. The number went up the next year when 2,493 applications were filed. In 2006, the figure was 2,888 and in 2007, it was 3,025. In 2008 and 2009, a total of 3,357 and 3,500 cases were filed respectively. The year 2010 has not yet ended and the number of divorce applications has already crossed the 4,000 mark. Interestingly, most of these applications (about 70 per cent as per the records) have been filed by IT, BT and BPO professionals and about 60 per cent of them were filed with mutual consent.
People see a direct link between the pulls and pressures of professional life as well the financial security that it brings with it and the rising number of divorce cases in urban India.

Riding high on their newly found financial independence, socially empowered and financially secure women today want to live on their own terms and want to be treated as equals. This sometimes leads to ego clashes between the partners and, combined with a few other issues, often culminates into divorce. Hemalatha Mahishi, an eminent legal representative from Bangalore, says, “The increasing number of cases of divorce reflect a changing lifestyle. Women have adopted a new style of living and their thoughts have changed. We can't say the same for men.” Elaborating further, she adds, “Men want their spouses to be respectful and obedient but you can’t expect so from any self-respecting 21st century girl. So, problems crop up.” The facts that girls are getting support from their families in going ahead with their decision to part ways and that remarriage is not difficult further boost their morale.

The divorced women have the same opinion about their husbands. “I did not want to fight with my husband on petty issues. Yes, I am financially independent and want equal respect from my husband. Instead, he wants me to be submissive and respectful every time. He had problems with my parents visiting me and them helping me in making decisions. He used to get angry if I lent financial help to my parents. He was not at all ready to acknowledge my opinion on any issue and had insecurity regarding my high salary which always led to fight between us,” says Suman, a BPO employee who recently sent a divorce notice to her husband.

However, men who have gone through the ordeal of a failed marriage, have got different tales to tell. “My wife is a software professional earning Rs 50,000 per month. She recently sent me a notice for divorce, barely six months after marriage. I can see no reason behind her step and I am trying to persuade her to reconsider but she is adamant. Even her parents are backing her decision,” says Ramesh , a manager in a leading software firm. “If a girl decides to divorce her husband, she can easily get over it. The good old law is on women's side. But now the law needs to be changed as wives are no longer as vulnerable as they used to be. Instead men are suffering,” Ramesh adds.

There are other reasons too for breaking relationships. The social stigma over the word ‘divorcee’ has almost vanished from urban societies. Today people are accepting girls with the divorced tag and new concepts such as 'single mom' and 'live-in relationship' are gaining grounds. The present generation, largely brought up in nuclear families, has shed much of the sacredness attached with family values. Western values are fast replacing the traditional Indian ones and consumerism is playing its part in eroding social ethos. Well-known psychiatrist Dr Ashok Pai tells TSI, “Feminine identity, emotional security, sexual equality and the desire to grow individually from within make many women prefer to remain single and look out for better options at an opportune time. Disturbed family set-up, inadequate parentage model and disharmony with peer groups are factors for women preferring to remain single. More than insecurity and inferiority, it is a combination of de-personalisation and de-individualisation which gives rise to egoistic traits.”
Still, there are women who prefer the family's integrity over their career or aspirations. Shreeza, a journalist, resigned from her job in a mainstream newspaper and joined a smaller magazine because her husband did not like her coming home late every night. Shreeza found her marital relationship more important than her professional life and quit her job. But perhaps not many women today would like to go Shreeza's way.

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Monday, August 08, 2011

Divorces are the reality of today

IIPM Mumbai Campus

Dr Ashok Pai, a well-known psychiatrist from ShimogaDr Ashok Pai, a well-known psychiatrist from Shimoga

Divorce cases are increasingly being noticed among BPO, IT and BT employees. What could be the possible reasons?
Divorces are the reality of today. There are multiple factors. In fact, earlier there were instances of emotional divorce in the traditional culture-bound family set ups. With globalisation, women's empowerment, growth of structured female identity, the emotional divorce has taken a legal format because of affordability and self-ascertainment.

Do you see any link between the increased exposure of these sectors to the west and rising number of divorces?
Yes. With consumerism expanding its tentacles and by working as effective tools of hidden persuaders, we are catching up fast with the west. More than insecurity and inferiority, it is a combination of de-personalisation and de-individualisation which gives rise to egoistic traits.
To what extent does a woman's financial independence cause her decision to separate?
Economic security makes a woman feel independent, secure and decisive in her role play. It is this identification and insight which makes her decision making more relevant in tune with the immediate reality.

Do you think the increased possibility of remarriage of divorced women also contributes to this?
There is liberalisation in the mental and physical perspective of the individual psyche which greatly contribute to live-in relationships and pre-marital sex. Extra-marital affairs and homosexual relations are almost getting social and legal acceptability. Remarriage of divorced or widowed women has become a socially accepted reality.

In metropolises like Mumbai and Bangalore, many women prefer to remain single. What is the thought behind such mindset?
As I said earlier, increased consciousness about feminine identity, emotional and financial security, sexual equality and the desire to grow individually urge women to remain single rather than tying themselves up in marriage.

Do the prevalent feminist theories contribute to the disintegration of family?
Partly yes and partly no. We cannot make a generalised statement about this as there are several other factors too in the picture.

Don’t you think the institution of Indian family is itself at stake here?
Not necessarily. There is no clear cut definition for family as an institution. It's dependence and interdependency of more than one individual that comes within the purview of a family.

What about people who kill their spouses?
That is an instance of deviant behavioural pattern that can be termed psychopathic disorder or personality disorder.

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Friday, July 01, 2011

Climate change and an advancing shoreline have devoured several villages in Orissa’s Kendrapara district.

The hamlets that have survived are counting their days

Whenever a radio announcer spouts meteorological terms like Vanishing villages“low pressure” or “deep depression”, a strange fear assails 700 families of Satabhaya. For the last few decades, these villagers have been living under the shadow of dread in their undersized huts. As bad weather sends the sea into a fury, huge tides cross the shoreline and threaten to wipe away their dwellings in the flash of an eye. “This area is perhaps the worst sufferer of global warming and climate change in Orissa,” says noted environmentalist Ranjan Panda.

Life is really pitiable in Satabhaya though it is just 150 km from the state capital of Bhubaneswar. Cut off from the mainland, people living in here are deprived of standard facilities available in any village of Naveen Patnaik’s Orissa. Satabhaya has no pucca house, no television set, no telephone, no fan and the list of nos goes on. Even basic minimum facilities like safe drinking water, electricity and primary health care facilities are as good as non-existent. The Pradhan Mantri Gram Sadak Yojana (PMGSY) has also been unable to make its presence felt here.

Getting to Satabhaya is really difficult. One has to cross Baunshgadi river, a tributary of Mahanadi, on a country boat. The ghat is at least eight km away from the village. If you don’t manage a lift from a biker or cyclist, the walk can be energy sapping. “Everyday more than 300 people cross the river to gather their daily needs in my boat. Since my service is not available after sunset, villagers prefer to stay in nearby Okilpal or Gupti. As crocodiles are seen frequently in the river, it’s considered dangerous to cross by any other means,” says boatman Karunakar Behera.

When told that we are journalists, Suka Dei, a housewife aged around 45 years, a co-passenger, spontaneously tells us, “Sambadik babu, please write strongly about our misery. The government is doing nothing to resolve our long-standing problems.”

The hapless people of Satabhaya, a cluster of villages in Kendrapara district, located a hundred meters off the Bay of Bengal coast, are silent witnesses to nature’s wrath. When the weather is inclement, they spend sleepless nights. “The situation wasn’t so terrifying earlier. The sea was at a distance of two km from our village. We had to walk for 20 to 25 minutes to reach the shore. The sea water has gradually inched in, submerging our homes and agricultural lands. We were forced to shift to this comparatively safer place, adjacent to our village. The place where you are standing is not our original village; we were forced to shift here after the super cyclone of 1999,” reveals Bishnu Charan Sahani of Kanpur hamlet of Satabhaya Panchayat.

“The sea advanced at least 10 feet into Kanpur two years back,” says Sudarshan Rout, a social activist working for relocation of villages to a safer area. “It has wiped out the primary school and one of the tube-wells that provided drinking water to the villagers.”

Satabhaya Panchayat, which once covered seven villages, now represents only two. The remaining five villages have vanished, swamped by the sea. The people of Satabhaya and Kanpur are counting their days.

In the early 1980s, the first villages to vanish into the sea were Govindpur, Mohanpur and Kuanriora. Kharikula and Sarpada villages were submerged in the mid 1990s. Haramani Biswal, a housewife aged 75 years, recalls, “Panchubarahi temple, shrine of our community goddess, was at the centre of the village and surrounded by houses but now it stands alone on the shore.”

This ancient shrine, built some 1,200 years ago, was two km from the sea in 2000. By 2006, the distance shrank to 200 metres. And in 2008, the tidal waves hit the temple. The situation is worsening with every monsoon.

According to people’s perception, every year sea is grabbing around 50 meters of land in this region. But it has been noticed that sea water is marching towards the shoreline more rapidly after 1999. The sea has advanced almost 1.5 km since then. Revenue records of the area confirm that in the last 50 years, the size of this area has dwindled to almost half. As per the land settlement done in the year 2000, Satabhaya region spanned 155 sq km, while this figure was 320 sq km in the previous settlement.

Then why are the people of Satabhaya still here? Why haven’t they shifted? Susmita Das, sarpanch of the area, replies: “How could they have shifted? As many as 249 families of our panchayat are below the poverty line. They do not have sufficient resources to relocate. Direct your question at the administration. In the last 20 years, the state government has promised thrice to rehabilitate the Satabhaya families, but nothing has been done.

” In 1992, the state government prepared a master plan to rehabilitate people in the Sunei-Rupei area at an expense of Rs 1 crore. After Rs 14 lakh had already been spent in digging ponds and constructing roads within the Bhitar Kanika National Park, environmental concerns stalled work on the plan.

Twelve years later, in 2004, chief minister Naveen Patnaik laid the foundation for the construction of Biju Nagar, a township named after his father for Satabhaya villagers at Magarkanda.

This plan also ran aground. As a last resort, the state government has now decided to shift all the 700 families of Satabhaya Panchayat to Bagapatia near Gupti Panchayat. Its implementation, it seems, is quite some time away.

The Kendrapara district collector insists that “the process for rehabilitation has already started and will be complete as soon as possible”.

But the sarpanch and people of Satabhaya have a different story to tell. “The government has demarcated 132 acres of land in the proposed area but land acquisition hasn’t got underway yet. We don’t know what fate awaits us,” says the sarpanch. She could well be echoing the sentiments of many other villages around the country that are similarly on the brink of catastrophe.

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