Birth of a Miracle - III : Shock of Life

Period: 16 November, 1968
Location: Tiruchendur, Tamilnadu, India

The body of the child was lying in wrapped clothes in the next room for the next hours. In about two hours after the birth, the doctor's wife (a non-medical person), came down to see Mrs. Rose and the child. I had told you that the family of Mr. Rathna knew the doctor's family well. Since the hospital was functioning in the ground floor of the house of the doctor, it was easy for the lady to come and see Mrs. Rose. Also because it was a courtesy visit, as the child was "still born", as the doctor had informed her.

She was accompanied by a nurse. They spent few minutes with Mrs. Rose who was recovering, and was deeply tired. The nurse and the doctor's wife moved to see the child --more as a point of giving consolation to the family. While there, the doctor's wife asked the nurse if they had given any shock to the child. The nurse said, "No". The lady said, "I have read that electric shock can sometime bring life back, if there is some life left. Why don't you get a wire? Let us check!". Since this small sized hospital did not have any of the modern equipment, even of that time, they found a wire with naked end on either side as their tool. 

Now it was getting bizarre. They checked once more to confirm that there was no heartbeat or breathing signs of the child. This was in conformity with what Dr. Moses had told them. The doctor's wife told the nurse. "You keep one end of the wire on the child'd body. I shall keep another end into the plug, and I shall switch it on for a second, and switch off. Let's keep an eye on the child. If there is some life, we will know!"

So, this bizarre experiment of these two ladies started. The nurse kept one end of the wire on the child. The doctor's wife put the other side into the plug, and had her hands on the switch. Both were holding their breath! The child was lying on a bed under their observation for this shock....or electrocution? There was fear...suspense...worry...concern.... Both their eyes were on the child. The doctor's wife started counting, "One... Two.... Three.... ON... OFF... "Kadavuley!" (Oh, my God!) both shouted, as they had seen the little finger of the left hand of the child shaking for a second at the time when the electricity was switched on! They both shouted, "The child is alive, the child is alive!" The nurse ran up to call the doctor. The old man came down, and as he was hearing of this experiment, he checked the baby. There was very feeble heartbeat, and the child was struggling to breathe. He asked the child to be put on Oxygen, and it was given three injections within minutes. Further, it was wrapped in wool, and was kept so under medical observation for three days. 

By the third day, the child was better, and the mother too. After three more days, they left the hospital in good health. Mr. Rathna and Mrs. Rose thought of this as nothing short of a miracle. This is something not heard of! They got the child baptized immediately at the local Church following their Christian faith with the name, "Puthumai", which in Tamil means - "miracle", or "newness". 

Lock Down

Corona has hit. Often this is labeled as the disaster of the century, as it crosses national, political, religious and any other human border one can imagine. Since its humble beginnings in Wuhan in China, it has crossed to over 150 countries and has taken over 23,000 lives as on 27 March 2020. The entire human race is behind closed doors across several countries in order to ensure "social distancing" - as the key to fight the virus that has virulently fought to keep its presence by the act of few who become the detonators in local communities. Doomsday sayers have  written off part of the human race, and the global economy seems to be shrinking. Politically, whether one is left or right, it doesn't seem to matter any more.

The schools closed first. Then the malls. And soon the whole nation shut its doors. There have been several good examples and a few bad in the process. The way people have been organized to do shopping in grocery stores in West Bengal state has been praised across the globe. Several other states India have replicated it with some twist into the thing. News has come in that the Indian railways plans to convert each coach of trains into isolation wards - which enables every coach of train can be converted to a 10 bed separated mini hospital. More clarity needs to emerge on how they plan to keep electricity to be running 24x7 and with the summer arriving, will only the AC coaches be converted into such isolation wards. But, the thought is good and important. India is aggressively looking to contain the disease as we are moving towards the first 1000 of the patients.

There are also some gaps in the initial days of this national lockdown that began in three days ago. One serious gap is in ensuring supply chain for grocers. This needs exceptionally clear plan as materials have to move from farm to homes without break. Personally I feel that we would have this lockdown extended as the number of cases in India continues to rise, and we get better control of it and be in a position to prevent the spread in a month or so. This means, we need to short-circuit the supply chain. Materials should reach from farms and large warehouses to groceries across the country without going through too many human hands to reduce  infections. One way could be combining the logistic capabilities of Coke, Pepsi, Haldiram, Hindustan Unilever, DHL, DTDC etc and state specific major supply chains such as Modern Bread in some of the states for delivery up to grocery stores, along with utilization of Swiggy, Zomato and UberEats for home delivery exclusively for senior citizens.  Any of our software majors can come up with a platform which can be utilized by all stakeholders to ensure smooth flow of groceries and vegetables on which the above mentioned supply chains can operate along with State administrations. People falling hungry can have huge social impact and may give way for unrest. Better that we put in some effort on this.

After all, children can't go hungry. And children can't wait.

An Issue that troubles NGOs in Nepal

International Non Profit Organizations, specially those well meaning ones from India are facing troubles because Indian government is restricting carrying of materials or money to India for relief and rehabilitation purposes. Technically taking money or materials to another country are supposed to pay customs duty to the government. Considering that the operations in Nepal need high amount of money, taking hard cash, which in any case is restricted, is a bad way to follow. Further it can call for legal action. Transferring money to an account in Nepal without the permission of Reserve Bank of India can be construed as money laundering! As the initial special permissions for taking more cash and materials with easy permissions without paying Customs Duty is coming to a close, NGOs are beginning to feel the pinch. 

As for Nepal, all NGOs from India or any other country, shall be treated as International NGOs. The International NGOs are required to be registered with the Social Welfare Council. Read Rules here.  Section 20 under the rules are very important for INGOs. 

There are four important steps:

a) Register with the Social Welfare Council (SWC) which is under the Ministry of Women, Children and Social Welfare. (There is a need to coordinate with this Council on the part of INGOs, and support them where necessary so that all INGOs are registered properly.)

b) INGOs must open an account at any authorized Commercial Bank one single central account into which it can receive all its foreign funds, and it can open sub-accounts to use the money if required. Once in every four months, the INGO must submit a report of receipts to the SWC. 

c) If an INGO is supporting an NGO, such NGO also must be registered with the SWC. That NGO must have different accounts for different projects. The selected NGO is preferred to be a Nepali NGO.

d) Every year, at the end of financial year, the agency must inform the Auditor General in approved format of the closing of accounts, and the Auditor General shall appoint auditors to audit the accounts.

At this moment, the most important thing is for INGOs to register with the SWC, start a central bank account, and if needed sub-accounts linked to the central bank account for spending purposes. Donor money from any country should be directly sent to the account in Nepal. Do not route the money through India, as the money is not meant to be used in India. Any money sent from India needs the approval of the Government of India. (Latest heard is that Indian Government is asking NGOs to put the money in the Prime Minister's Relief Fund to showcase works in Nepal as activities of the Indian Government, and contribution of the people of India.)

Clean India Campaign - Problems and Lasting Solutions in Urban Areas

Another campaign of the government to make and look India cleaner seem to be going to dogs, literally. The campaign is blamed often as a photo-op event management than a genuine effort in cleaning up. Where do some of its problems lie and how should we overcome them?

Municipal workers dump garbage on street as animals and
rag pickers vie for it in Patna, India

1. Planning in Cleaning Up: Whereas it is easier to clean up a stretch or a road, it is much difficult to clean up a city or a town. This can only be done with micro-planning (as done for polio immunization). The point is to clean up to such a level that no one sees filth sooner or nearer. If one stretch is clean when the rest or not, the probability of cleaned up stretch getting filthier increases. Remember the "broken windows" theory, and how every sub-urban train in NY was cleaned up every night to ensure that the hooligans get fed up for writing on them. This might require high schools, colleges, non-governmental organizations, municipalities, other government officials and business bodies getting united and supporting the same. A detailed micro-plan on who would do what, where, when, and equipping them adequately with voluntary and paid-up support, where necessary. Most of this can come up through volunteerism, as for example, students and volunteers bringing in spades and brooms, businessmen supporting with trucks that can carry the garbage, municipalities and government officials supporting in additional resources, planning and monitoring. Do it in a single stretch, for dedicated hours and review it.

2. Sustain the Efforts: Cleanliness is not a one time event. It is related to daily life-cycle. First, if required, repeat the general cleaning after a month or two, plugging the loopholes. In fact, it would be easier this time as there would be less filth that what was in the first time. Sustaining the efforts means, ensuring that we generate less waste and improve processing. How can we do this:

a) Remove taxes on bio-digestors for two years: This should reduce the cost of installation of bio-digestors in all housing complexes and markets in cities and towns. Follow up with legal sanctions to ensure that every market in a town or city of more than 100,000 population, and a housing complex of more than 10 families has a bio-digestor.

b) Corporate and Educational Involvement in Drainage: Drainage in most towns and cities are done on unplanned or crudely planned engineering. Include all engineering colleges in the country to help plan drainage in cities and towns. Allow Corporates to spend the 2% of their CSR money on building drainage in the country. Remember, the too much attention on bathrooms can wait....because, it is only the filthy garbage filled areas and walls get the attention of people who go for open defecation or peeing in cities.

c) Public Partnership: Just as providing ambulances by corporates and private entrepreneurs is free from tax, give tax exemptions for public health spending by private donors. For example, providing truck to a government body to lift and carry garbage can be freed from taxes. Over a period this will get all poorer municipalities and Corporations to have adequate resources to manage.

d) Support Recycling Industry: The recycling industry is vastly unorganized till the segregation and terminal point from where materials go for recycling. Support this group by extending health benefits (as given to tea garden or mine workers), as they hand often toxic or other materials risking their health. 

e) Regularize garbage collection: In the town where I live, many families leave their garbage outside their house, not because they do not have the money to keep it with them till the garbage is collected, but because no one knows when will the garbage collectors would come! The garbage kept outside the houses fall into drains and fly in the air clogging the drain and polluting air. In Uttarakhand towns, trucks come every morning or in evenings, with a loudspeaker announcement inviting people to bring and dump the garbage. Why can't this be done across the country?

f) Make Available Easy-to-use Public Toilets: Mobile easy to use public toilets can be one of the regular features added to improving municipal sanitation services. These can be self-sustaining at a minimum cost. Adequate light, water and ease of access to public toilets is essential for improving services. For example, take a look at the public toilet at Boring Road Chowraha in Patna city. It is on the one side surrounded by vendors, and on the other side is surrounded by garbage thrown by municipal workers. Expecting someone to use it of no use.

g) Punish the Offenders: It is important that there is a system to catch the offenders. Have plainclothes men and women to catch people and give tickets on spot. This must start with innocuously dirtying people who make every place a suitable one for what is known in India as "public nuisance" - those spitting paan. Look a the way the majestic pillars of Howrah bridge had to be hidden because of the bloody spitting from the pedestrians was damaging them! Just start catching people and fine them on spot. (By the way, the way of collecting fines has to improve in India. All fines must be payable online after 24 hours of issuing the ticket.) Or, go one step further: profile those peeing in public. Do not start a huge catch on a single day as most of the times things are done. That only stops behavior till the campaign is on. Catching 10 persons in a day in a city gets people to change their behaviour than catching 500 in a day. This is because, catching 500 in a day needs huge investment of human and material resources. But catching 10 in a day can be done through normal duty. The news spreads over a period. Sustain it.
3. Beautification: As the places get cleaner it is also important to beatify them. Involvement of citizen groups, corporates and collaboration of local government are key to success in this regards. Painting and planting are two activities that can be taken up beyond the mere task to the level of aesthetically appealing. Art on public walls and staircases can be one of the tasks that can be easily given to students and institutions of art!

The whole effort might take nearly a decade. But start moving now. Involve people who can coordinate institutions to establish and execute. Include experts in micro-planning to execute macro plans. The agenda is national, solutions are local.

Victims of Darkness

As the new Government in India, which had been elected so that policy paralysis can be removed and decisive action can be taken on various fronts is going about its task in full gun. The problem however seem to be is that decisive verdict given to the government seem to have been construed as handing over of power to take any decision. What is visible is very little attention to issues that go beyond the acts of government: governance, participation and protection of the vulnerable. With rise in political and gender violence across the country there has not been any credible action on that front. Several commissions have been removed or members asked to resign; but not much of alternative has been suggested. And recently, the expected judicial reforms has been hit by a plan to create judicial commissions with judiciary powers, and to be placed under the law ministry (thus curtailing the fundamentals of independence of judiciary). As this has been called into question, the Chief Justice of India has questioned the intentions based on which such decisions are being taken, as there is no supervisory control over such bodies, and thereby the perpetrator is often the supervisor. As a Tamil saying goes, it is the story of the fence eating up the crop.

In that context, the Chief Justice has quoted William O'Douglas, the longest serving judge in the US Supreme Court, "As nightfall does not come all at once, neither does oppression. In both instances, there is a twilight when everything remains seemingly unchanged. And it is in such twilight that we all must be most aware of change in the air, however slight, lest we become unwitting victims of the darkness".

Vigilance to protect one's own freedom is essential, or we could soon have a honored form of the mid-seventies, when personal freedom was robbed of us from many fronts. This Prime Minister is for "less of government, more of governance". But the actions of the government seem to speak otherwise. The recent guidelines to the Secretaries (To Do List) is one step on the right direction.

Disaster Management Plans

I had the opportunity to study through at least eight disaster management plans from one of the districts in the last 25 days. I have also had the opportunity of studying more plans in the past year, specially while undertaking a study with colleagues in Unicef and State Inter Agency Group of West Bengal. As I get in deeper into them, I can identify the following positive points that are emerging over the period :

a) There is a lot more appreciation of integration of plans by various departments, although not all relevant departments submit their departmental plans.
b) There is a move to view emerging disaster risks, albeit the fact that these are mostly geophysical or infrastructure related risks. For example, a block has identified train accidents as a risk after a new rail line has come up in the block.
c) Good amount of data / information is being added into the plans in most blocks and districts.

Where do they lack in making a good plan?

a) All these plans are mostly response plans, and not risk reduction plans. Therefore, the plans have a life time of just one year, and need annual revision.
b) Tools are not used to identify and link the broader line of stakeholders into the plan. Therefore vital support services are not mapped into most of the plans. Critical services cannot run effectively without support service systems. For example, if a plan identifies hospitals for managing rail accidents, it has not mapped blood banks, ambulance services, crowd and transport management into the plan itself.
c) Disaster risks with emerging from external elements or elements with long-term impact are not planned for, and they are left as international issues or health hazards etc. For example, a block that has serious problem with floride contamination in water has not brought it into the plan as it is a "health hazard". Similarly, a block that has seen civilians dying in fire between Indian and Bangladeshi border security forces has not mapped any plan for civilian evacuation in such emergencies. Increasing deficiency in drinking water availability in a block has been  left as a drinking water problem, and not seen from the perspective of climate change issues merged with environmental exploitation that will lead to long term impact on the community.

What do we need to do immediately?

a) The disaster management plans must have two sections : one for emergency response and another for identification of long term risks and planning -- say for 30 years or 50 years.
b) Officers and elected representatives involved need to be seriously trained in long term risk reduction planning and risk assessment.

Largesse of the Government

The deaths due to consumption of spurious liquor has crossed 170 and still some are battling against death. The government of West Bengal has announced an ex-gratia of 200,000 rupees for the bereaved families. On 9th Dec 2011 after the major fire in AMRI hospital in Kolkata too the government announced similar grant. I wonder from where does this money come from. I have no problem in giving out the money, but my question is from where is this kind of money being generated? Before we discuss this, the death toll in the hooch tragedy has gone well past the total deaths due to Cyclone Aila in 2009. Only 139 persons died in the aftermath of cyclone Aila; but this tragedy has killed more than 170 people. Should we call it a disaster?

Now, about the money. AMRI is a hospital for the rich, of the rich, and by the rich. I am not sure if some of these families whose loved ones died in the fire really require this 200,000 rupees that comes from the government. The other question is, if people die drinking spurious liquor, and their families get 200,000 rupees, will this event become a tipping point, and the situation escalate that the poor think that they can die drinking spurious liquor, and their families can get the money, and live happily ever after?!!! We are walking on a very fragile paradigm. Secondly, what is the source of money that the government is giving out? If it is money of the general public and that of the tax payers, I am against. it. If AMRI authorities are at fault, the government must realize the compensation from them. Let them take 500,000 rupees per each patient. No issues on that! Let them take over the entire land and the building, and pay for damages. That would be exemplary, honest in every way, and not impinging on the money for development. In the case of the hooch tragedy, the government must attach the properties of all those involved in production, sale and permitting such sale. I might sound harsh. But unless exemplary punishments burn a hole in the pockets of these people, it would not be an example. 

There is something called Law of Torts. This is hardly used in India, although it exists. It is simply the law relating to civil damages. The only civil damage cases we see are some big politician asking for money from media houses for a perceived damage to their supposedly good name. We must take this further. Civil damages must be compensated, but the damager, and not by people's money. For heaven's sake, will someone say this to the Chief Minister, please!

Spurious Liquor Claims 34 Lives

According to breaking media reports in another kind of tragedy in West Bengal, in one of the worst hooch tragedies, at least 34 people died and over 100 were admitted to hospitals on Wednesday after drinking toxic liquor at Mograhat in South 24-Parganas district, West Bengal, India

CNN-IBN reports: "Thirty-four people died and over 100 were admitted to hospitals at Diamond Harbour and Sangrampur complaining of severe stomach ache, vomiting and loose motion after consuming the liquor", SP Lakshmi Narayan Meena said.

Four persons were arrested in connection with the case, Meena said. Angry locals smashed the liquor dens. Sunderban Affairs Minister Shyamal Mandal said medical teams were rushed from Kolkata while some of the victims were brought to city hospitals for treatment.

The state government announced compensation of Rs 2 lakh each to the families of those who died.

Public Health Engineering Minister Subrata Mukherjee announced the compensation in the assembly"

Dry and Long - Huge Rainfall Shortage in India

Northern India in general is going through a long dry spell. The report of the Indian Meteorological Department has shown that there has been a huge deficit in this year's rain fall. Whereas the usual North-Eastern monsoon period for western, eastern, north and north-eastern states of India stretches from 1 June to 15 October each year, the South Western monsoon starting from 1 October to December facilitates rainfall in the east coast of India. Looking into the available data and maps, the early rainfall in June was excess in many states, and normal in July. But, after that there has been a huge drop in rainfall. Though the cumulative rainfall for the period looks normal in most counts, in actual terms there has been very little rainfall since August in most states, and huge deficit in north-eastern states. 

The data available till date for the October to 7 December 2011 period shows further deviations, as the state of Andhrapradesh in south, several northern, north eastern, eastern and western states are under severe shortage of rainfall. The Gangetic belt is showing signs of stress as the average rainfall shortage for this period is above 80% in most cases. Although not much of rain is expected during this period, it is important in terms of agriculture, arrival of winter and warding of pests! The lack of rainfall has the potential to push up input costs on agriculture for small farmers who hold less than one acre of land, and increase debts for medium farmers who often take big loans. This could also hit production of vegetables, cereals and pulses of the winter crops and summer crops. On the one side the winter has set in very late. On the other side, the Indian agricultural industry is looking at deep drops in the coming summer.

Retail and FDI

India is looking at allowing Foreign Direct Investment (FDI) in retail markets. India also hopes that this would lead to creation of at least 4 million jobs, and the investment has to be to the tune of a minimum of 100 million US $. So, with this India expects huge inflow of foreign retail marts to start huge stores across the country-- from Wal Mart to Burger King, everyone will be looking into tapping the 600 billion $ Indian retail market ! Although I am personally in favor of opening up the Indian market, certain things seem to hit hard the Indians. And I am afraid of this one too.

Let us start with the first assumed benefit: 4 million jobs in the country, with possibility of another 4- 6 million jobs in allied services. Well, but how many will lose jobs because of this? That one is answering. Few years back, when Pepsi and Coca-Cola where allowed into the country, initially they were allowed to sell drinks in a bottle of 500 ml or more. Now, that meant, keeping the local companies live, including many who were making cool drinks from their own homes, and were selling in the local market in container bottles of 180 ml and 300 ml. Then the law allowed these giants to sell 180 ml and 300 ml bottles as well. Suddenly, the home based entrepreneurs and small vendors vanished! Even my own brother lost business! When I asked him three years ago why his business was going down, he said this as the reason. Now, his business is fully closed, and is unemployed. I do not know how many extra people Coke or Pepsi employed. But I know that some people lost their livelihood too.

During my trips in Eur0pe and the U.S. I have heard some of my friends saying how small shops cannot do business because everyone goes to the big shops, the super-markets to get things cheap, make their own choice and ultimately....leaving the small time vendors heart-broken. I am apprehensive of this move of the government.

The second presumed benefit is, if more money flows in, then inflation would come down! That is really funny. How much of inflation came down with the first round of reforms in India? 3 - 4 percent? But then it went up again. It is now hovering around 10-11 % Cost of basic goods have gone up. Gone up skywards....

What we need today is agricultural reforms--a second green revolution, that benefits both the farmer and the consumer. There are too many middlemen surviving on the farmers' plight and consumers' woes. This must end. Now.