Tag: Ranjit Devraj

Kerala Proved Good Governance Vital in a Pandemic — Global Issues

With decisive leadership and the support of civil society Kerala was able to the spread of COVID-19 down. Picture Supplied
  • by Ranjit Devraj (new delhi)
  • Inter Press Service

NEW DELHI, Oct 06 (IPS) – When COVID-19 claimed millions of lives across India, Kerala state at the southern tip of the subcontinent stood apart for low mortality rates that experts attribute to good governance, a robust public health delivery system and strong civil society support.

Kerala, a state of 35 million people, has consistently ranked above the rest of India on the Human Development Index (0.84), with literacy, life expectancy, and human rights records comparable to that of developed countries. It enjoys an infant mortality rate of 12 per thousand live births and a female literacy rate of 92.07 percent.

One reason for Kerala’s high development indices is its remittance economy, with large numbers of its people finding work abroad — an estimated four million are known to be working in the oil-rich Middle Eastern countries alone. Remittances to Kerala averaged 715,789,912 million US dollars annually during the 2004—2023 period.

However, the same expatriate workers became a liability during the pandemic. As they streamed back home, the state government mounted tight monitoring at its four international airports at Kannur, Calicut, Kochi, and Thiruvananthapuram while following up with quarantine, source tracing and tracking to prevent the virus from spreading in the densely populated state (860 people per square kilometre).

“There are many layers to the measures ordered by the state government, extending to individuals, community, public health systems and private hospitals,” said Jaideep C Menon, professor of adult cardiology and public health at the Amrita Institute of Medical Sciences, Kochi.

Voluntary Agencies

“Everybody pulled together. Community kitchens run by panchayats ensured essential supplies of grains, vegetables, fruits, petroleum products or drugs,” said Jaideep Menon. Additionally, he said, there were awareness creation programmes run by government-backed self-help groups like ASHA and the women’s voluntary agency Kudumbasree.

“There were instances of essential drugs like Factor VIII for haemophilia, cancer care medicines, etc., being sent through the police networks to remote public health centres (PHCs) during lockdowns. Radioisotopes — supplied to hospitals solely by the Babha Atomic Research Centre — were flown in on specially chartered flights and moved to recipients with police help,” Jaideep C said.

According to Jaideep Menon, the police force proved to be an effective arm of the government’s COVID-19 response, not only for facilitating the movement of essentials but also for providing effective policing that was needed to implement contact tracing and quarantine during the first wave of the pandemic that ran from March to November 2020.

Groups such as the Distress Management Collective India networked influential Malayalis (as Kerala natives are called) living around the world to source medicines, vaccines, and equipment such as oxygen concentrators for COVID-19 patients in dire need.

“On receiving the oxygen concentrators, we delivered them to people with breathing difficulties in remote places of Kerala,” says Anil Jabbar, a local coordinator in the state for the DMCI. “The instructions on how to calibrate and use the equipment were then provided over smartphone videos to protect ourselves from getting infected.”

Coordination expertise came from Vinod Chandra Menon, a founder member of the National Disaster Management Authority (NDMA) and former Asia regional director of the International Emergency Management Society, Oslo.

“The odds in Kerala were tremendous because of a moving population – in fact, the first recorded Covid case in India was that of a female medical student in Wuhan who flew back home to Kerala on 23 January 2020,” said Vinod Menon.

“What was instructive was the professional way in which the authorities handled the case,” said Vinod Menon. “She had no symptoms but based on her travel history in China, she was placed in an isolation room, and her throat swab and blood samples were flown to the National Institute of Virology in Pune, where the samples tested positive for COVID-19.”

“It was clear from the start that early detection and early response was the way to go, and Kerala averted a major disaster by simply following the standard operating procedure that was laid down from the start,” said Vinod Menon.

“Unlike in most of India, Kerala’s interdepartmental coordination was excellent and meshed together with voluntary agencies and women’s help groups thanks to backing from the highest levels of government right down to the villages.”

While the number of COVID-19 fatalities in India remains contentious, with some estimates placing it above 5 million, calculations based on National Survey Data indicate that between 1 June 2020 and 1 July 2021 alone, there were 3.2 million deaths from the virus.

In contrast, Kerala’s data, even after the second wave between April and March 2021, suggested “relatively limited spread, fairly effective mitigation and better surveillance of both infections and deaths than in most parts of the country,” according to Murad Banaji a lecturer in applied mathematics at the University Oxford with an interest in analysing the pandemic in India.

It helped that Kerala had been primed up for community participation, interdepartmental coordination, participation of local self-governments and social mobilisation by voluntary agencies through the experience of responding to a massive flood that devastated the state in 2018 and a Nipah virus epidemic in 2018—2019.

Said Sandhya Raveendran, who is both a surveillance officer for Kollam as well as the deputy medical officer for the district: “We hit the ground running. Even before the first case was identified, we were ready with mock drills and rapid response teams, thanks to the legacy of handling a Nipah virus outbreak.”

Sample collection teams, consisting of a medical officer, a nurse or laboratory technician and a driver, all equipped with PPE kits, fanned out daily along predetermined routes after prior intimation to sites that were due to be visited, said Sandhya Raveendran.

“Key to containment was the early setting up of sentinel surveillance using RT PCR tests followed by the setting up of laboratories capable of performing accurate tests,” said Raveendran. “What became clear after four rounds of tests was that most of the cases were imported and that there was no community transmission.”

The laboratories were linked to an ‘integrated health information platform’ for real-time reporting of detailed results so that action could be rapidly taken at the field level and epidemiological investigations could be carried out by special rapid response teams.

By early March 2020, the state had the highest number of active cases in India, but using the trace, quarantine, test, isolate and treat strategy, by June 2020, Kerala managed to keep the basic reproduction number (transmission per primary infected person to the secondarily infected persons) at 0.454 against the India average of 1.225.

Decisive leadership

“What worked was decisive leadership from the top in setting up command centres in various districts under the district collector (chief administrator), following directives from the chief minister and the state health department,” said Jaideep Menon. “This led to health taking centre-stage for a prolonged period in both print and audio-visual media.”

“In sum, Kerala’s proactive approach to quarantine, infection prevention and control, the state’s strong public health system that could reach every household, and an empowered and literate community pulled together to combat the pandemic.”

He says the key lesson for the rest of India is that a robust disaster management plan must be instituted with clarity on who does what, adding that while all the states had voluntary agencies and local self-governments, they were not harnessed towards quick and effective intervention in the way Kerala did.

“Pandemics like COVID-19 are a distinct possibility in the future, and that’s why it is important to clearly define the role and mandate of each implementing agency by governments.”

Note: This article was supported by the Sabin Vaccine Institute and Internews.

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Lawmakers Call on G20 to Prioritise Spending on Youth, Gender, and Human Security — Global Issues

Asian Parliamentarians believe it’s important to prioritise spending on ageing and youth populations. Credit: APDA
  • by Ranjit Devraj (new delhi)
  • Inter Press Service

NEW DELHI, Sep 05 (IPS) – Legislators from around the world, this week, officially submitted to the Sherpa of the G20 meeting set for September in New Delhi a declaration calling on governments to prioritise spending on ageing, youth, gender, human security, and other burning population issues.

The submission to the G20 Sherpa follows a workshop held on August 22 in New Delhi to discuss the Declaration first presented at the G7 Hiroshima summit in April by the Global Conference of Parliamentarians on Population and Development (GCPPD) under the UNFPA. 

“We have now submitted the Declaration to Amitabh Kant, Sherpa to the G-20 so that it can be taken up,” Manmohan Sharma, Executive Secretary of the Indian Association of Parliamentarians on Population and Development (IAPPD), told IPS.

Deepender Hooda, Vice Chair of the AFPPD and a member of India’s Parliament, said the workshop in New Delhi was significant not only because India is hosting the G-20 summit but also because India was expected to have overtaken China as the world’s most populous country reaching 1,425,775,850 people in April.

Lawmakers met in New Delhi to discuss the prioritisation of resources to prepare a declaration to the G20. Credit: APDA

Keizo Takemi, member of the House of Councillors, Japan, and Chair of the AFPPD, observed that India faced many challenges that are hard to overcome, and these included the large size of its population, limited school attendance, and a high rate of unemployment. “Prioritisation of population issues is the most important,” he emphasised.

Hooda, a leader of the opposition Congress party from the state of Haryana, said he was concerned at the dwindling budgetary outlay in social sectors like health and education over the last few years in India. “Currently, for some reason, inclusive growth in education and health has fallen,” he told delegates.

A presentation to the workshop by Suneeta Mukherjee indicated that India is among the top five nations leading the ‘out-of-school’ category, with 1.4 million children in the 6-11-years-old age category not attending school. Also, out of every 100 students, 29 per cent drop out of school before completing elementary education.

Mukherjee, an Indian career bureaucrat who has served at the UNFPA, said the situation appeared to be worsening at the upper primary level given that the dropout rate at the upper primary level had gone up to 3 per cent in 2021-2022 while it was only 1.9 per cent in 2020-2021. The annual dropout rate of secondary school students was 14.6 in 2020-2021.

Citing recent studies in her presentation, Mukherjee said 36 per cent of Indians between the ages of 15 and 34 believe that unemployment is the biggest problem facing the country. She said one survey showed 40 per cent of graduates identified unemployment as their most pressing concern.

Said P.J. Kurien, chairperson of IAPPD: “It is important that all MPs take up population-related issues. They need to ask what percentage of the budget is devoted to education and health and ensure that every child goes to school with special attention given to girls.”

Echoing Kurien, Sharma said it was up to members of parliament to ensure that no child is left out in his or her constituency. “The solution is in your hands, but the prioritisation is missing.”

Delegates outlined at the workshop legislative steps taken by Parliamentarians in their countries in implementing the International Conference on Population Development’s Programme of Action and 2030 Agenda.

Josephine Veronique Lacson-Noel, Member, House of Representatives of the Philippines, said over the last two decades, her country had enacted such legislations as the Magna Carta of Women, Reproductive Health Law, 105-Day Expanded Maternity Leave, Act Prohibiting Child Marriage, Universal Health Care Act, Youth Council Reform and Empowerment Act, and an Act to enable conditional cash transfers.

On the anvil, she said, is the Adolescent Pregnancy Prevention Bill, a law to recognise, evaluate and redistribute unpaid care and domestic work done by women, and another to accord social protection for older persons and the promotion of active aging.

For 2023, the budget allocation for reproductive health was $14.9 million dollars, and that for training teachers to implement comprehensive sexuality education was $13.8 million, Lacson-Noel said.

Andrea W. Wojnar, UNFPA India representative and country director for Bhutan, said with the right expertise and skills, India’s 1.4 billion people could be turned into 1.4 billion opportunities.

Wojnar said India, with its large youth cohort — its 254 million youth in the 15-24 age bracket — can be a source of innovation and solutions, especially if girls and women are provided educational opportunities and skills to access new technologies and are empowered to fully exercise their reproductive rights and choices.

With close to 50 per cent of its population below the age of 25, India has a time-bound opportunity to benefit from the demographic dividend, according to Wojnar.

“Women and girls should be at the centre of sexual and reproductive policies and programmes. When rights, choices, and equal value of all people are truly respected and held, only then can we unlock a future of infinite possibilities,” Wojnar said in a statement.

“As the national fertility rate falls below 2.1 (the replacement level), India is at a unique historical opportunity, witnessing a great demographic transition as a youthful nation,” Wojnar said, adding that India also has the largest number of outmigrants and is affected by ageing, urbanisation and issues around sustainable development.

Wojnar warned that, overall, the Asia Pacific region was six times more likely to be affected by disaster events than other regions and is highly susceptible to changing weather patterns, calling for special attention by governments.

The Declaration presented to the Sherpa of the G-20 called on governments, among other things, to implement comprehensive legislation and policies that address all forms of gender-based violence and eradicate harmful practices such as child marriage, early and forced.

It also called for investment in sexual and reproductive health and rights, as well as comprehensive sexuality education toward making future societies economically dynamic and for building peaceful, inclusive, and sustainable societies. Support for political and economic participation by women and girls could ensure the development of societies that guarantee liberty and individual choice for women and girls, it said.

Governments were asked to promote and assure equitable access to health innovation, finance, technology, and medicines in the global community which can support human security, leaving no one behind.

Acknowledgement of the grave impacts of environment/climate change and global warming was important, as also the need to promote policies that address the needs of geographically vulnerable countries, which is a threat to health and human security, the Declaration said.

Investing in young people by providing decent work opportunities and enabling them to become a driving force for sustainable development was important as also addressing active and healthy ageing to enhance people’s overall quality of life by improving areas such as health and long-term care through resilient universal health coverage, physical security, and income stability.

Governments were also asked to enact national legislation and policies and ensure political will through allocation, oversight, and monitoring of budgetary resources to build universal health coverage, which is vital to enhance the global health framework.

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Politics Behind the Removal of Mughal History From Textbooks Say Academics — Global Issues

The removal of Mughal history from textbooks is seen as a political move which downplays the rich diversity of the Indian subcontinent. This artwork stems from this period. Credit: Govardhan. Jahangir Visiting the Ascetic Jadrup. ca. 1616-20, Musee Guimet, Paris
  • by Ranjit Devraj (new delhi)
  • Inter Press Service

NEW DELHI, Apr 20 (IPS) – The removal from school textbooks of chapters covering the Mughal period of Indian history spanning three centuries has raised a storm of protests from academics.

The Mughals, who ruled much of the Indian sub-continent between the 16th and 19th centuries, left behind an indelible stamp on science, art, culture, and overall development. Their legacy is visible today mainly in a number of monuments recognised as UNESCO World Heritage Sites, including the Agra Fort, Fatehpur Sikri, Red Fort, Humayun’s Tomb, Lahore Fort, Shalamar Gardens, and the Taj Mahal.

UNESCO’s India representative, Hezekiel Damani, said the organisation advises that the curriculum represents a conscious and systematic selection of knowledge, skills and values that shape the way teaching, learning and assessment processes are organised by addressing questions such as what, why, when and how students should learn.

“Therefore, a quality curriculum must pave the way to the effective implementation of inclusive and equitable quality education,” Damani says. “Subject-specific curriculum development, reform and revision are entirely the decision of member states; they must be conscious of today’s curriculum, and future needs while making any intervention.”

“The issue here is that Mughal rule does not align well with present-day politics — it is no surprise that chapters that refer to that period are being deleted by the National Council for Education Research and Training (NCERT),” says Ruchika Sharma, who teaches history at the Delhi University.

Sharma says that from an academic point of view, the Mughal period presents a well-researched part of Indian history because of the rich documentation they left behind. “Removing an entire chapter dealing with such an important period of history from class XII textbooks would certainly affect students’ career choices — they will see a mismatch between visible legacy and the curriculum.”

Sharma referred in particular to the chapter titled ‘Kings and Chronicles, the Mughal Courts,’ from the NCERT history book Themes of Indian History-Part II, which describes how the Mughals encouraged peasants to cultivate cash crops such as cotton grown over a “great swathe of territory that spread over central India and the Deccan plateau.”

The Mughal period saw India becoming the world’s biggest exporter of cotton as well as cotton manufactures such as calico and fine muslins that were shipped to the European markets by the Dutch and English East India Companies that were allowed to set up ‘factories’ or fortified trading posts along the Indian coasts.

Other revenue-generating crops included sugarcane and oilseeds such as mustard and lentil that were grown alongside staples like rice, wheat and millets, the deleted chapter said. The section on ‘Irrigation and Technology’ noted that under the Mughals, cultivation rapidly expanded with the help of artificial irrigation systems and the introduction of crops from the new world, such as tomatoes, potatoes and chilli.

Swapna Liddle, historian and author, says that much of India’s built heritage, language, arts, agriculture and land tenure systems are a legacy of the Mughal period. “It is important to study how India was also progressing in the scientific fields during that period,” says Liddle.

The Mughal period saw a flowering of the sciences, especially astronomy, mathematics, medicine, architecture and engineering, that had an impact long after the dynasty ended in 1857. Akbar’s reign (1556—1605), for example, saw the establishment of medical schools and dispensaries, while his successor, Jehangir, patronised the study of mathematics and astronomy.

On April 7, a group of ‘Concerned Historians’ issued a statement saying: “We are appalled by the decision of the NCERT to remove chapters and statements from history textbooks and demand that the deletions from the textbooks be immediately withdrawn.”

“The decision of the NCERT is guided by divisive motives. It is a decision that goes against the constitutional ethos and composite culture of the Indian subcontinent. As such, it must be rescinded at the earliest,” said the statement, which has been endorsed by hundreds of academics.

According to the statement, the textbooks were designed to be inclusive and provide a sense of the rich diversity of the human past both within the subcontinent as well as the wider world. “As such, removing chapters/sections of chapters is highly problematic not only in terms of depriving learners of valuable content but also in terms of the pedagogical values required to equip them to meet present and future challenges.”

The director of the NCERT, Dinesh Kumar Saklani, has stated that the chapters were removed as part of “rationalisation aimed at reducing the burden on schoolchildren following the COVID-19 pandemic.” He claimed that the rationalisation was vetted by experts and denied that there was any political agenda behind the move.

Says Ajay K. Mehra, a political scientist currently attached to the independent think tank, the Observer Research Foundation: “It would have been far better to modify the chapters on the Mughal and Islamic periods than delete them altogether — this way a very large and important period of mediaeval Indian history is going to be lost to impressionable young students and to future generations.”

The changes to the textbooks, says Mehra, are deliberate and part of a larger, declared political agenda to restore the past glory of Hindu dynasties that existed before the arrival of Islam in India. This can be seen in the renaming of roads and cities, he said, citing the renaming of Allahabad city in 2018 to Prayagraj to reflect its importance as a Hindu pilgrimage site at the confluence of the sacred Yamuna and Ganges rivers.

“What is lost here is the fact that Mughal rule saw enormous economic advancement that lasted three centuries because of a compact with Hindu Rajput (princely) feudatories. “Rajput princes not only led Mughal armies but also entered into marital alliances — two of the important Mughal emperors, Jehangir and Shah Jahan, were born of Rajput princesses, for example,” Mehra said.

Makkhan Lal, distinguished fellow at the Vivekananda International Foundation, a think tank considered close to the government, says that there is a case for the Mughal period getting “disproportionate description and allotment of space” in history textbooks and this needed to be rectified.

Lal, who has taught history at the Banaras Hindu University and worked with the NCERT, said the “correction being made now is a step in the right direction and should have been taken earlier.”

Apart from academics, leaders of opposition parties have also denounced the changes to the textbooks. Sitaram Yechury, general secretary of the Communist Party of India, said the changes made to class textbooks were regrettable because of India’s diversity.

“The lands of India have always been the churning crucible of civilisational advances through cultural confluences,” Yechury says.

Pinarayi Vijayan, who leads a communist party government in the southern Kerala state, Tweeted: “They resort to rewriting history and masking it with lies. So, we must strongly protest the decision of the BJP government to delete certain sections from NCERT textbooks. Let the truth prevail.”

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Healthcare Inequities Exposed by COVID-19 Pandemic — Global Issues

Migrant labourers wait in queues in Kashmir in order to travel back to their homes. The second wave of COVID-19 in India has seen masses of people leave cities and towns to return to their rural homes. Credit: Umer Asif/IPS
  • by Ranjit Devraj (new delhi)
  • Inter Press Service

NEW DELHI, Apr 29 (IPS) – Public health specialists say that an ongoing wrangle between the Indian government and the World Health Organization (WHO) over the COVID-19 death toll in this country is symptomatic of a long-ailing public health delivery system.

India has consistently challenged estimates published by leading scientific journals such as the Lancet, which placed the number of excess deaths in the country at four million from 1 Jan 2020 to 31 Dec 2021.

On 16 April an official note from the Press Information Bureau in response to a New York Times article said, “India’s basic objection has not been with the results (whatever they might have been) but rather the methodology adopted for the same.”

India’s concern was that the projected estimates in the article, titled “India Is Stalling the WHO’s Efforts to Make Global COVID Death Toll Public,” for a country of its geographical size and population could not be done in the same way as for smaller countries. “Such one size fit all approach and models which are true for smaller countries like Tunisia may not be applicable to India with a population of 1.3 billion,” the official note said.

But independent public health specialists said that the concern was that India’s spat with the WHO was detracting from the more serious issue of the country’s tottering health delivery system failing to deal with the pandemic.

“Forget about the actual number of people who died of COVID-19 or because of comorbidities like diabetes, hypertension or cardiovascular disease — the fact remains that an unusually large number of people died during the pandemic because the health delivery system was overwhelmed,” said Mira Shiva, founder-member of the international Peoples Health Movement.

“One could say that the pandemic worked like a stress test of how good healthcare services were, and they were found seriously wanting,” said Shiva. ”Unsurprisingly, it was the poor and marginalised groups that took the brunt of it all — many more died of undocumented causes than usual as reflected in the several calculations based on excess deaths.”

Shiva said that, at the best of times, a cause of death is not properly registered in India. “We can only guess from the very large number of bodies seen floating down the main Ganges and Yamuna rivers during the second wave of the pandemic in 2021. There were also widely-circulated images of bodies laid out in rows on the river banks — these were obviously of people whose relatives could not afford to buy the firewood for cremations.”

Says Satya Mohanty, former secretary in the government and currently adjunct professor of economics at Jamia Milia Islamia University, New Delhi: “You can argue till the cows come home but the figures are going to be in the range of four to five million deaths as shown in several studies and any contestation would require robust data rather than bland denials.”

“If the crude death rate on average is one per thousand per month, anything above that average over a period of two years can be safely taken as deaths due to a differentiator – in this case the COVID and post-COVID effects,” says Mohanty. “There cannot be any other reason unless other differentiators were at play and to the best of our information there were no other differentiators.”

Sandhya Mahapatro, assistant professor at the A.N. Sinha Institute of Social Studies (ANSISS) in Patna, Bihar state, says “while India has made great strides in reducing inequalities in healthcare, large access gaps by socioeconomic status remain. Our studies show that 38 percent of outpatients in Bihar, a state with a population of 128 million, had no access to public healthcare.”

“There is growing concern about the distributive consequences of welfare initiatives on different socioeconomic groups,” Mahapatro added. “The historical disadvantages of healthcare access experienced by women and marginalised groups continue, with factors like caste, class and gender intersecting at various levels to create advantage for some sections and disadvantages for others,” she said.

A paper published by Mahapatro and her colleagues in the peer-reviewed journal Health Policy Open in December 2021 showed that social status clearly determined whether a person could access healthcare or not, despite pledges to ensure equity in healthcare provision and commitment to the United Nations’ Sustainable Development Goals (SDGs) Goal 3 — providing quality health services to all at an affordable cost.

“The issue of inequity played out during the COVID-19 pandemic affecting the poor and marginalised disproportionately,” said Mahapatro. “Internal migrants were greatly affected by the lockdowns with a staggering economic burden befalling them. The pre-existing inequality has widened and is expected to further widen as a result of the pandemic.”

Mahapatro said a study conducted at ANSISS during the post lockdown period found a familiar pattern of deprivation in healthcare services as in earlier studies. “The burden of unmet healthcare needs was substantially higher among the poor, women and people of low caste,” Mahapatro said. “Unmet healthcare needs were found to be particularly high among women of lower caste groups.”

“Importantly, our studies show that the pattern of health spending has remain unchanged over the decades and that the household remains the main source of financing healthcare before and during the pandemic,” she added.

A local priest and relative of a family member who died from Covid watching a pyre burn at the Garh Ganga Ghat in Mukteshwar, in Uttar Pradesh on 4 May, 2021. (Mukteshwar, Hapur/ File-Amit Sharma)

“The ongoing economic crisis due to the pandemic and inadequate healthcare capacity would obviously constrain healthcare utilisation by the marginalised sections of society, with internal migrants being the worst impacted as a result of the lockdowns,” Mahapatro said.

A staggering 450 million Indians are internal migrants according to the 2011 census, 37 percent of the total population. A national lockdown imposed with a four-hour notice on 24 March 2020 left most of these domestic migrants with no option but to undertake long treks back home with little money or food.

The national lockdown, considered among the tightest globally, went into three more phases with increasingly relaxed restrictions on economic and human activity until 7 June.

“Almost 80 percent of the migrant workers we surveyed had lost their jobs during the lockdowns,” said Mahapatro. This naturally affected their ability to access healthcare, with huge nutritional implications for them as well as their women and children.”

“If the unmet needs of such large and deprived social groups are not catered to then equity in healthcare and the UN SDGs on health will remain a distant dream,” Mahapatro added.

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