The Hindu, Sunday Magazine, September 22, 2008
The Other Half
Even as we ponder the randomness of life and death as serial bomb blasts hit our big cities, and we live with the chilling reality that India stands second only to Iraq in the number of people killed in terror attacks since 2004, we also cannot forge t that every day people, including little children, are dying because of the terror of poverty. That people are being killed just because they belong to another religion. That women and girls are dying because they bear a triple burden of work and have little access to health care. These too are perennial Indian realities — a constant state of teetering between life and death.
Perpetuating inequality
Another reality is the entrenched system that perpetuates inequality. Thus, while mention of reservation for schedule castes and tribes and OBCs in institutes of higher learning leads to demonstrations and heated debates in the media, the pathetic state of primary education continues virtually unnoticed and unaddressed. And millions of Indian children still go to schools without buildings, without books and without teachers.
Filmmaker Umesh Aggarwal has made a brave attempt to balance the reservation debate in his documentary “Divided Colours of a Nation” that premiered at the Open Frame International Film Festival in Delhi last week and will be shown shortly on Doordarshan. Whether he has actually managed to strike a balance between the extreme positions on this contentious issue could be debated. He has tried to push home the point that the question is not whether reservation is right or wrong but whether the “creamy layer” within these disadvantaged groups should continue to claim the benefits of reservation.
However, the most striking footage in his film is of the village schools he visits. By focusing on the disheartening state of primary education, he has actually struck the right chord. For, whether there are seats reserved at higher levels for the disadvantaged matters little if they continue to be deprived of quality education at the entry level.
(To read the rest of the article, click on the link above)
Sunday, September 21, 2008
Thursday, September 11, 2008
The medical emergency of the urban poor
From InfoChange India, September 2008
By Kalpana Sharma
A man who works as a driver in Mumbai discovered recently that his wife, who complained of breathlessness, had a heart problem. She has a blocked artery and a faulty heart valve. Like others of his ilk, this man lives in a slum. His salary as a driver is not enough to rent, leave alone buy, an apartment anywhere in Mumbai. So he lives in a ‘regularised’ slum, which cannot be demolished, and which is, ironically, located on the most expensive real estate in Mumbai, in the upscale neighbourhood of Malabar Hill.
This preferred location, however, makes little difference to him when facing a health crisis such as this. The choices before him are stark. If he does nothing, because he cannot afford to get his wife treated, then she will die. If he chooses to get her treated, then he faces lifelong indebtedness.
In a city with some of the most expensive and modern healthcare facilities, millions of lower income and poor people face the dilemma of this driver. As opposed to their rural counterparts, even poor people living in cities are well aware of the medical interventions that are possible to prolong life and to deal with life-threatening conditions. But they also know that such interventions are out of their reach in an increasingly privatised healthcare market. The public healthcare systems that exist are simply not enough to meet the demand even for ordinary health conditions, leave alone for specialised care.
Mumbai is actually better served than most other Indian cities with public health facilities. The Brihanmumbai Municipal Corporation (BMC) runs four teaching hospitals, five specialised hospitals, 16 peripheral hospitals, 28 maternity homes and several hundred dispensaries and health outposts. Out of the estimated 40,000 hospital beds available in Mumbai, around a quarter come under the BMC. In addition the state government runs one medical college, three general hospitals and two health units with a total of 2,871 beds. The Central government also runs one hospital.
Yet, despite the availability of these services, people who cannot afford to spend on private healthcare still do not necessarily see public services as the first choice. Several studies have shown that as many as 77% in urban areas and 63% in rural areas turn to private practitioners for outpatient care because the public facilities are either too far, or their procedures are too bureaucratic and take too long to access. Even amongst poor people who cannot afford private care, the percentage of those who use it is over 60%.
However, for in-patient care, the poor seek out public facilities, even if they are at some distance from where they live, because they are the only ones that are affordable. It is evident that these are inadequate to meet the demand. The overcrowding seen in every public hospital is a stark reminder of the shortage of affordable beds in a city where the majority of people cannot afford expensive healthcare. Furthermore, the big hospitals in Mumbai serve as referrals for people from across the state and other states.
(To read the rest of the article, click on the link above)
By Kalpana Sharma
A man who works as a driver in Mumbai discovered recently that his wife, who complained of breathlessness, had a heart problem. She has a blocked artery and a faulty heart valve. Like others of his ilk, this man lives in a slum. His salary as a driver is not enough to rent, leave alone buy, an apartment anywhere in Mumbai. So he lives in a ‘regularised’ slum, which cannot be demolished, and which is, ironically, located on the most expensive real estate in Mumbai, in the upscale neighbourhood of Malabar Hill.
This preferred location, however, makes little difference to him when facing a health crisis such as this. The choices before him are stark. If he does nothing, because he cannot afford to get his wife treated, then she will die. If he chooses to get her treated, then he faces lifelong indebtedness.
In a city with some of the most expensive and modern healthcare facilities, millions of lower income and poor people face the dilemma of this driver. As opposed to their rural counterparts, even poor people living in cities are well aware of the medical interventions that are possible to prolong life and to deal with life-threatening conditions. But they also know that such interventions are out of their reach in an increasingly privatised healthcare market. The public healthcare systems that exist are simply not enough to meet the demand even for ordinary health conditions, leave alone for specialised care.
Mumbai is actually better served than most other Indian cities with public health facilities. The Brihanmumbai Municipal Corporation (BMC) runs four teaching hospitals, five specialised hospitals, 16 peripheral hospitals, 28 maternity homes and several hundred dispensaries and health outposts. Out of the estimated 40,000 hospital beds available in Mumbai, around a quarter come under the BMC. In addition the state government runs one medical college, three general hospitals and two health units with a total of 2,871 beds. The Central government also runs one hospital.
Yet, despite the availability of these services, people who cannot afford to spend on private healthcare still do not necessarily see public services as the first choice. Several studies have shown that as many as 77% in urban areas and 63% in rural areas turn to private practitioners for outpatient care because the public facilities are either too far, or their procedures are too bureaucratic and take too long to access. Even amongst poor people who cannot afford private care, the percentage of those who use it is over 60%.
However, for in-patient care, the poor seek out public facilities, even if they are at some distance from where they live, because they are the only ones that are affordable. It is evident that these are inadequate to meet the demand. The overcrowding seen in every public hospital is a stark reminder of the shortage of affordable beds in a city where the majority of people cannot afford expensive healthcare. Furthermore, the big hospitals in Mumbai serve as referrals for people from across the state and other states.
(To read the rest of the article, click on the link above)
Monday, September 08, 2008
What women "deserve"
The Hindu, Sunday Magazine, Sept 6 2008
The Other Half
Hillary Clinton has lost her chance to have a go at the U.S. Presidential stakes this time around. Yet, she remains a presence. However much those who hated Hillary might have wished that she would fade away, neither the Democrats nor the Republicans will allow her do so. By choosing Alaska Governor Sarah Palin as his running mate, Republican Presidential nominee John McCain has clearly shown that he will go all out to woo Hillary supporters. Some have already joined his campaign. And Barack Obama and the Democrats also know that the 18 million voters who supported Hillary, many of them women, will have to be persuaded to remain with the Democrats.
To us in this country, this might seem peculiar as there is still no defined “women’s vote”. In the U.S., however, the women’s vote has become a factor in elections and in the forthcoming Presidential election, it will be particularly important. Yet, why would women, who supported Hillary not just because she was a woman but also because of her position on a number of issues affecting women such as abortion, now contemplate voting for a man and woman who are against women’s abortion rights and for the war in Iraq?
Generational shift
The explanation perhaps lies in the generational shift in the U.S. amongst women that is not so perceptible in this country. The women’s movement in the U.S. has fought hard for many rights for women. The daughters of those who fought for these rights are now entering the work force, women with the confidence to know that they do not need to apologise for being women.
As a result, their take on women’s rights is different from that of their mothers’ generation. It is mediated by a different reality in which they must survive. It tends to be less strident and perhaps more pragmatic. It is not anti-men. On the other hand, the older women who supported Hillary feel affronted that their candidate was treated badly, that she was derided because she was a woman, and that in the end, there was no place for her. They see this as a reflection of the bitter battles they have fought for decades.
An article by Hannah Seligson, a freelance journalist and author of New Girl on the Job: Advice from the Trenches in The New York Times (August 31, 2008) spells out some of the challenges that women in their twenties face in the U.S. And her conclusions possibly explain the difference between the women who support Obama, or have decided to give him their full support even though Hillary lost, and those who remain unreconciled. Young women in this country, particularly the educated urban woman, would find a resonance in what she writes.
Seligson describes how, while growing up and in college, she did not experience any institutional gender bias. It was a time of “girl power”. Women students excelled in academics. They also helped each other and there was a feeling of solidarity.
Then these women entered the work force and realised that they were unprepared. First, the solidarity amongst women that they had taken for granted in college did not exist in the highly competitive space at work. Career mattered first, peer support could wait.
(To read the rest of the article, click on the link above)
The Other Half
Hillary Clinton has lost her chance to have a go at the U.S. Presidential stakes this time around. Yet, she remains a presence. However much those who hated Hillary might have wished that she would fade away, neither the Democrats nor the Republicans will allow her do so. By choosing Alaska Governor Sarah Palin as his running mate, Republican Presidential nominee John McCain has clearly shown that he will go all out to woo Hillary supporters. Some have already joined his campaign. And Barack Obama and the Democrats also know that the 18 million voters who supported Hillary, many of them women, will have to be persuaded to remain with the Democrats.
To us in this country, this might seem peculiar as there is still no defined “women’s vote”. In the U.S., however, the women’s vote has become a factor in elections and in the forthcoming Presidential election, it will be particularly important. Yet, why would women, who supported Hillary not just because she was a woman but also because of her position on a number of issues affecting women such as abortion, now contemplate voting for a man and woman who are against women’s abortion rights and for the war in Iraq?
Generational shift
The explanation perhaps lies in the generational shift in the U.S. amongst women that is not so perceptible in this country. The women’s movement in the U.S. has fought hard for many rights for women. The daughters of those who fought for these rights are now entering the work force, women with the confidence to know that they do not need to apologise for being women.
As a result, their take on women’s rights is different from that of their mothers’ generation. It is mediated by a different reality in which they must survive. It tends to be less strident and perhaps more pragmatic. It is not anti-men. On the other hand, the older women who supported Hillary feel affronted that their candidate was treated badly, that she was derided because she was a woman, and that in the end, there was no place for her. They see this as a reflection of the bitter battles they have fought for decades.
An article by Hannah Seligson, a freelance journalist and author of New Girl on the Job: Advice from the Trenches in The New York Times (August 31, 2008) spells out some of the challenges that women in their twenties face in the U.S. And her conclusions possibly explain the difference between the women who support Obama, or have decided to give him their full support even though Hillary lost, and those who remain unreconciled. Young women in this country, particularly the educated urban woman, would find a resonance in what she writes.
Seligson describes how, while growing up and in college, she did not experience any institutional gender bias. It was a time of “girl power”. Women students excelled in academics. They also helped each other and there was a feeling of solidarity.
Then these women entered the work force and realised that they were unprepared. First, the solidarity amongst women that they had taken for granted in college did not exist in the highly competitive space at work. Career mattered first, peer support could wait.
(To read the rest of the article, click on the link above)
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