Monday, 29 June 2009

Swine flu

A fatal disease?

A third death ‘related to swine flu’ was confirmed today. Its very sad, not least because this case was a child, who incidentally had other serious health medical conditions.

We know no more at this stage, so any comment on the specifics would be both wrong and speculative.

But it is worth commenting on how cases of this sort are reported in the press and the conclusions that members of the public might draw.

What exactly does it mean, swine flu related...., other serious medical conditions.. ?

So far there have been 5937 reported laboratory confirmed cases of swine flu – or to use a more technical name A/H1N1. These people have come from all walks of life, most may have been relatively healthy and young, and the vast majority have recovered uneventfully. It should be no surprise if some of these infections have happened in people with other conditions like diabetes, heart disease, other less common chronic diseases where the body is more susceptible to common viral infections either because of the nature of the disease or because of treatment with drugs like steroids or chemotherapy. These individuals have as much chance of catching the A/H1N1 virus as anyone else.

So the question is this if some one in this latter group dies, is the death due to the viral infection or is it due to the underlying condition with the H1N1 virus infection being an incidental occurrence.

It’s an important point. If the deaths are due to the virus infection and would not have happened without the virus then we have one sort of situation. If on the other if a small number of people (3 in the UK ,as it happens, at least thus far) died with, rather than of, the H1N1 virus, then we are dealing with no more serious an infection than the regular winter flu we see every year.

Media reports and official press releases that fail to make this distinction do us no favours. The public might well conclude that we have a dangerous new virus on our hands. Maybe we do and maybe it will yet mutate into something more serious than we have seen so far, But all the evidence thus far is to the contrary.

Sunday, 21 June 2009

Caste based reserved quotas in education and jobs

A policy that has failed and needs reform.

Ever since Independence India has had a system of reservations for Dalits and people from other backward castes and classes.

This policy has failed abysmally to help the vast majority of backward caste people. On the other hand it has led to widespread corruption and a culture of dependency and entitlement that has not only allowed but actually encouraged the continued neglect of the truly downtrodden.

Compelling arguments were put forward in favour of reservations when the Constitution of India was drafted. Centuries of oppression of a large group of citizens of a free India by the majority on the basis that they belonged to a so-called lower caste had to be overturned. Caste discrimination was reprehensible, corrupt, scientifically unjustified and morally repugnant. The people at the bottom of the heap had to be given a leg up.

Now, however, 60 years later, that policy, well-meaning though it may have been in concept, is in need of review and overhaul.

Consider the following arguments.

Firstly, the reservations policy has failed miserably. If the original objective was to speed up the emancipation of Dalit people, then one can hardly claim that this objective has been met. There are still many millions of people (much more than in 1947) in India’s villages and smaller towns who suffer unspeakable indignities. Reserved quotas may have placed a few Dalits in well-paying jobs but it can hardly be argued that the benefits have trickled down to the vast majority of Dalits. Segregation and discrimination is a sad reality for the vast majority of Dalits and for tribespeople .

This is hardly surprising. Even if 50 or 60% of jobs are reserved that would still leave vast numbers of dowtrodden groups exactly where they were, for the simple reason that there can only be so many jobs available in the public sector. It is a drop in the ocean compared to the numbers of people who need help.

Secondly, the system has allowed corruption to thrive. It is easier for a politician now to campaign for a caste or a tribe to be granted a quota than to fight for policies that genuinely seek to emancipate such downtrodden groups. No party and no politician can afford to turn down a demand for categorisation of a group as an ‘OBC’ – the new badge of honour. And so instead of helping themselves, people from ‘lower’ castes and tribes, and their so-called leaders are devoting their time and energies not to social activism but to self-defeating campaigns to be counted as a lower caste. Reformist zeal has been replaced by a culture of dependency.

Thirdly, quotas erode standards. Its one thing to suggest that jobs requiring few skills are reserved for people from lower social classes, or for quotas in entry level jobs. It is quite something else to reserve even high paying jobs and positions requiring great skill, knowledge and educational attainment for a so-called lower caste without regard to ability. Maybe politicians who advocate caste based reservations should be treated care only by doctors who qualified or won their positions on the basis of their reserved status!

Finally, the most telling argument against continuing the reservations policy is the pernicious effect it has had on developmental policies in general. By supporting caste quotas, politicians of all hues have successfully presented themselves as pro-poor; it has allowed them to avoid the real task of devising and implementing policies that have a chance of truly helping the down trodden. There is no pressure therefore to enforce the law against caste discrimination; or ensure the availability of high quality primary school education to every child regardless of caste; or provide additional help and support to children from Dalit families so that they can truly overcome the ill-effects of societal discrimination and compete on their own merits and win places in universities and jobs on the basis of their ability rather than the badge of caste.

By looking only to short term political expediency politicians have taken the easy route: opting for a policy that appears to help Dalits and OBCs, while in reality it helps no one, and even harms the long term prospects of most Dalits. Paradoxically, the few Dalits Scheduled Tribes and OBCs who benefit from caste quotas need the majority to remain downtrodden to justify the dubious advantages they enjoy. Dalits and OBCs are seen as little more than vote banks to be exploited cynically by politicians, electoral fodder for populist policies that benefit a tiny few and disadvantage the vast majority.

Reform must start by the Government’s Human Resource Development (HRD) Ministry announcing a policy of phased withdrawal and ultimately a time table for the end of reservations, starting at the upper end of jobs and education.

Such a policy would be politically unacceptable. It needs therefore to be accompanied by constituional guarantees of tough targets with a clear time table for true emancipation of dalits. Governments both at the Centre and in the States must enforce existing laws on discrimination, guarantee land rights, ensure access to well run schools that provide a quality education to all but especially to the poor, the Dalits and other backwards castes, enforce existing laws for the protection of women, punish discrimination of all kinds but especially that based on caste. There may also be a case for direct financial help for the most needy.

For too long, Dalits, tribespeoples and other backward classes have been taken for a ride. Politicians have thrown them a crumb of a quota here and a reservation promise there and in return have demanded their electoral allegiance. Quotas are too weak a tool to emancipate a people downtrodden for centuries but they are damaging enough to harm civil society.

India needs a more enlightened policy. A policy that works, one that’s fair, and something that helps the majority.

Sunday, 17 May 2009

A week in politics is a long time - Politics in Britain and India

I’ve followed the 2009 general elections in India with interest, fascination, and since I am an Indian, with pride. Here was the world’s most populous democracy coming together to elect the 14th Lok Sabha, to choose how and by whom it will be governed for the next 5 years. Never mind all the hyperbolic statistics so beloved of western journalists, the results were what would matter for all of us.

At the same time I watched with increasing dismay and not a little sadness the goings on in the Palace of Westminster. MPs twisted and bent the rules on expenses for personal profit. Not just a few bad eggs, but almost everyone was in on the game. There were guidelines, yes but hey, what the hell, rules may be enforced but guidelines are there only for those who chose to follow it. Just don’t get caught.

Now that it’s all out in the open, everyone has a view of how to reform the system. No doubt some new system will emerge and surely if slowly politics can return to some semblance of business as usual.

The contrast between the two apparently unrelated events could not be starker. On the one hand a raucous, noisy election in India hailed as a great success, and on the other a mature democracy (the mother of Parliaments and all that) suffering from an acute loss of confidence in the very fabric of the parliamentary system of elected government.

In reality, the truth for both countries is somewhere in between those two extremes. The Indian election may have filled me with pride but maybe that’s just because of the view of it that I got from NDTV. Our politicians are no less venal than they ever were, some are even convicted criminals, there’s very little in the way of ideology that separates the main parties, there are scores of regional parties that serve the interests only of the local thug, and caste and religion appear to pervade the whole process. We feared major violence and the best result we dared hope for was a hung parliament leading to an unstable short-lived Government.

It turned out differently and how! The Election Commission pulled off a Herculean feat of organisation and logistics to deliver a free and fair vote; the security services ensured a largely safe election – albeit there were 60 deaths due mainly to Maoist violence. But the real prize goes to the people for returning a clear verdict in favour of continuity, and against a creed of religious intolerance and persecution of minorities. In their favour the politicians too acted honourably – the losers were quick to concede defeat and accepted the verdict with good grace; and the winners acknowledged their victory without humility and without hubris.

So where does this leave us in India? Well, after all the euphoria dies down, it will come as a sobering shock that none of the massive problems facing us has gone away. The poverty, the economic policy dilemmas, the mess of our education system, the degrading lack of basic amenities, the denial of fundamental economic and social freedoms - all remain to be tackled.

Contrast that with what happened in the last couple of weeks in Britain. MPs’ claims for expenses were published and we learned that they were claiming for a whole lot more than just legitimate expenses. It was sad to see a senior figure like Menzies Campbell being boo-ed and heckled on Question Time. Most British politicians are decent hardworking people – okay they sometimes throw away their convictions and act on the basis of whatever they think will make them popular but that’s practical democracy for you. Their crime in claiming expenses for things that were not ‘wholly, necessarily and exclusively’ in the pursuit of their parliamentary role, was small indeed compared to the things politicians in other countries get up to. And yet there is a mood of anger, of disgust and revulsion at what our MPs have been up to that is out of all proportion to the consequences of their actions.

Why is there so much public anger in Britain at such a seemingly inconsequential violation of the expenses rulebook?

Perhaps it is all down to our expectations. In Britain we expect better from our MPs. We expect basic honesty. We expect them to be morally upright. We expect them to level with us.

In India we expect little from our political institutions and even less from our politicians. And so when we get a decent election and politicians behave half intelligently, I am elated, hopeful of brighter days ahead for India, proud that India is coming of age.

In Britain we expect a lot from our politicians. So when they fiddle the system and when we learn how the system allowed it for so long, I feel let down, fearful of difficult times ahead for Britain with the threat of extremist parties finding favour with a disillusioned electorate, dismayed that Britain is sliding backward.

Perhaps there is a lesson here for India’s democracy. The 543 new MPs in the new Lok Sabha in New Delhi had better take note.

Sunday, 26 April 2009

The death of a child in a Delhi School

Earlier this week a school girl died in a large well-endowed school in Delhi. Medical help came too late. She had asthma; eminently treatable and not a condition you would expect a young person to die of.

Allegedly there was negligence on the part of the school. The administration came in for a lot of criticism: there should have been better medical facilities in the school, some said; all schools should have a doctor and nurses available, teachers and others should be trained in first-aid. Parents and pupils marched in protest; they called for heads to roll and the school had to be closed for a couple of days.

I heard the discussion and debate programme on NDTV. Everyone seemed to agree that the rules governing schools should be tightened to ensure that this does not happen again.

So why am I blogging about this? To bring a rational alternative point of view. Not about the specific case; I don't know enough about it and even if I did I would hesitate to say anything at all for fear of intruding on private grief. Any loss of life is sad; more so when it is avoidable, and it is particularly tragic and devastating when it is a young person.

My take on this is rather about the reaction and the hasty ill-judged calls for rules to be changed. Hard cases make bad law, it is said, and here we have a tragedy that may well lead to ill-considered actions that may be misplaced for two reasons.

First, they may not achieve the intended purpose. After all good intentions are never enough to achieve positive change for the better. The next medical emergency in a school may be beyond the capability of whatever medical resources are put in; and the calls for action entirely miss the point that children spend their lives in a variety of settings; what about vacation time? holidays? school trips? What about schools in smaller Indian towns and villages? its hard enough to get medical help under any circumstance never mind for someone who becomes seriously ill during the school day.

Second and more important, all the commentators seem entirely to have forgotten the role of prevention. Schools in India present scores of hazards for children: many children die or are injured each year in road crashes during the journey to and from school; once in school they face a heavy burden of rote learning that denies them opportunity for play and robs them of a true rounded education experience. They have to put up with bullying, harsh punishment from teachers, poor or absent toilet and hand-washing facilities. And thats just for those who are lucky enough to have a school to go to and parents to send them there.

Schools can do a great deal to promote the health of their pupils and prevent harm. But providing top-notch medical facilities that can deal with unusual and rare occurrences of serious illness in children cannot be the role of a school. Schools don't exist in a vacuum. They are part of the society and the community they serve. If the community has poor access to medical facilities then it is illogical to expect the school to provide it.

The recent case in Delhi highlights the role of schools in promoting the health of pupils but not in the way most commentators seem to think. Its a responsibility hat cannot and must not be seen as the sole responsibility of schools.