058. Open Letter To WHO On Pentavalent Vaccine Related Deaths In India

Open letter To WHO On Pentavalent Vaccine-Related Deaths In India

Pentavalent vaccine was introduced in two states of India last year by the World Health Organization (WHO). Several alleged deaths occurring due to the vaccine, prompted the All India Drug Action Network to write to WHO asking for a re-evaluation of the introduction of the vaccine.

By All-India Drug Action Network

To: 

Dr. Margaret Chan,
The Director General,
World Health Organization, 

Geneva

Dear Dr Margaret Chan,

All India Drug Action Network (AIDAN) is a network of not-for-profit civil society organizations that has been campaigning and working for rational use of medicines, largely in the Indian context. We have written to you in the past. We would like to bring your attention to the Pentavalent (DPT + Hib + Hepatitis B) vaccine related deaths in India.

According to the Brighton classification of ‘Adverse Events Following Immunization’ (AEFI), re-challenge and recurrence of symptoms in the individual is needed for classification of AEFI as ‘certainly related to vaccine’. Such re-challenge is impossible if in the first instance, AEFI results in death. In the absence of proof from a re-challenge experiment, deaths caused by vaccines can only be classified as ‘probably related to vaccine or possibly related’ to the immunization.

As you would know, there have been several Pentavalent vaccine related deaths in Sri Lanka, Bhutan and Pakistan. Using the WHO approved classification of AEFI many of these deaths are ‘probably related to the immunization’ because no alternate cause for the adverse events has been found. However an expert panel looking at the deaths in Sri Lanka deleted ‘probably related’ and ‘possibly related’ from the classification of Brighton for purposes of their evaluation report, and then certified that the vaccines were ‘unlikely to be due to the vaccines’. This report (Expert Panel Report 23 December 2008 Sri Lanka) is available on the World Wide Web.

One by one the WHO has de-listed a number of brands of pre-qualified Pentavalent vaccine, but the problem has refused to go away. Pentavalent vaccine was introduced in two states in India on 14th December and 17th December 2011, to evaluate the safety of the vaccine in India.

According to an affidavit filed in the Kerala High Court by the Government of Kerala India, there have been four deaths in less than two months since it was introduced in the public health system. For your information the full text of the submission by Kerala government can be accessed here.

The reactions in India suggest that the cause of the problem is unrelated to the brand or manufacturer or lot of the vaccine. It appears to be a form of ‘hypersensitivity reaction’ as described in the post mortem report on one of the children in Kerala.

The vaccine can be administered to many patients without problems and there is no available method at present to predict which infant will react adversely.

The US FDA has pointed out that vaccines are aimed mostly at healthy individuals for prevention of diseases to which an individual may never be exposed. Unlike conventional drug treatments meant for the management of existing disease, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause death of healthy children cannot be recommended.

Pentavalent vaccine is at present recommended by WHO and its introduction is supported by Global Alliance on Vaccines and Immunization (GAVI) funds. Given these circumstances the WHO needs to re-evaluate the recommendations. We propose to copy this letter to countries supporting the GAVI initiative so that they may be able to initiate action in a responsible manner.

Looking forward to your early action in the regard.


1. Dr Jacob Puliyel, Drug Action Forum– Karnataka (DAF-K), New Delhi

2. Dr Mira Shiva, Medico Friend Circle, New Delhi

3. Dr Gopal Dabade, DAF-K, Dharwad

4. Mr Srinivasan. S, LOCOST, Vadodara

5. Mr Naveen Thomas, Headstreams, Bangalore

6. Mr Prasanna Saligram, AID India, Bangalore

7. Dr Anurag Bhargava, JSS, Chattisagarh

March 12, 2012.


Republished here on public interest by courtesy of All-India Drug Action Network

Links:

Pentavalent Vaccines Promoted by WHO Despite Deaths of Healthy Children – Part I, Asia

http://www.dadychery.org/2012/05/01/pentavalent-vaccines-promoted-by-who-despite-deaths/

Tags:

Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

057. Kerala’s Everyday Drink Of Vaccine Cocktails

Kerala’s Everyday Drink Of Vaccine Cocktails

India serves up costly cocktail of vaccines

By Ranjit Devraj

Source: Inter Press Service News Agency,
New Delhi, India.
Saturday, November 9, 2013.

Ignoring widespread concern over the safety, efficacy and cost of pentavalent vaccines, India’s central health ministry has, this month, approved inclusion of the prophylactic cocktail in the universal immunization programme in seven of its provinces.

Pentavalent vaccine doses, a cocktail of five antigens in a single shot, confers immunity against five paediatric diseases – diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza type b (Hib), with the last one considered particularly problematic by some experts.

Pentavalents, produced by several manufacturers and promoted by the Global Alliance on Vaccines and Immunization (GAVI), has had a history of causing adverse reactions and deaths in India’s neighbouring countries like Bhutan, Sri Lanka and Pakistan.

In 2010, the National Technical Advisory Group on Immunization (NTAGI), a body of experts selected by the Indian government, recommended limited introduction of pentavalents in southern Kerala and Tamil Nadu and evaluation of results over a year before extension to other states.

Pentavalents were launched in Kerala and Tamil Nadu in December 2011, but the results were not encouraging. Kerala recorded four infant deaths following vaccination, with symptoms similar to what were seen in other South Asian countries.

Public health activists in Kerala, a state with 100 percent literacy and human development indices similar to those of advanced Western countries, quickly filed a public interest litigation (PIL) in the Kerala High Court asking for intervention in having the programme called off and a return to the existing health plan.

But despite infant deaths and two pending PILs (with yet another being heard in the Delhi High Court) against pentavalents, the health ministry announced on Apr. 16 that pentavalents would be introduced in five more states – Gujarat, Haryana, Karnataka, Goa, Jammu and Kashmir and Puducherry in October.

In making the decision, the government overlooked the NTAGI, which has not even been convened since August 2010 when the body suggested limited introduction to Kerala and Tamil Nadu as the two states have good adverse event following immunization systems.

“Going by what we have seen in the neighbouring countries and now in the state of Kerala, pentavalents can, without warning, cause children (to suffer) hypersensitivity reactions and death,”

Jacob Puliyel, an eminent paediatrician at St. Stephen’s hospital in New Delhi and member of the NTAGI, told IPS. Puliyel likened the situation to penicillin sensitivity and said it bordered on criminality to be administering pentavalents without first testing a child for hypersensitivity. “Every child that is being given a dose of pentavalent vaccine is a potential victim of the adverse reaction,” he said.

Puliyel was among the many eminent physicians and public health activists in India who wrote to World Health Organization (WHO) director-general Margaret Chan on Apr. 3 asking the health body to “re-evaluate” its recommendation of pentavalent vaccines on the grounds of safety.

Another signatory, Dr Meera Shiva, an expert on pharmaceutical drugs attached to the voluntary Medico Friends Circle, told IPS that WHO had to de-list a number of brands of ‘pre-qualified’ pentavalent vaccine, “but adverse reactions persist and we have surely not heard the last of them.”

The letter to Chan, written under the aegis of the All-India Drug Action Network, an umbrella of public health activist groups, suggested that the cause of the vaccination- related deaths was likely to be “hypersensitivity reaction as described in the post mortem report on one of the children (who died) in Kerala.”

“Unlike conventional drug treatments meant for the management of existing diseases, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause the death of healthy children cannot be recommended,” the letter to Chan said.

Policy analysts specializing in vaccines said they were dismayed at the move to approve pentavalents in as many as seven of India’s states, which account for 340 million of India’s 1.2 billion people.

“Pentavalents are a test case for India’s new policy on vaccines that is in keeping with liberalization and openly favours pharmaceutical majors at the cost of India’s public sector vaccine units,” said Madhavi Yennapu, a scientist who specializes in vaccines at the central government’s National Institute of Science, Technology and Development Studies.

Twenty of India’s 23 public sector vaccination units, once the mainstay of the country’s immunization programme, have been shut down one after another over the last four years on the grounds that the quality of their products was suspect.

Yennapu pointed to the draft National Vaccination Policy, released last year, for clues on why the government has not made any serious attempt to revive the vaccine- manufacturing units by enforcing quality standards, for instance.

The new policy demands that the “risk of manufacturing vaccines by private manufacturers must be cushioned by assistance from (the) government” and suggests that it be made mandatory for the government to support vaccine producers with advance market commitments (AMCs).

Madhavi explained that AMCs provide guaranteed markets for a vaccine even before trials are conducted, with the government committed to paying a supporting minimum price.

“Even if the vaccine turns out to be less efficacious than the existing one the government must honour the AMC by buying the new vaccine at the agreed price.

“This means that AMC funds must be deposited with the World Bank ahead of vaccine delivery by countries that GAVI is supposed to be helping with the introduction of new vaccines,”

Madhavi told IPS:

“Naturally, GAVI would be looking at large countries like India, Brazil and China to provide the AMCs.” For a country like India, what is important is to “see how many vaccines are needed to prevent how many deaths and at what cost, rather than throw out tried and tested vaccines in favour of a cocktail (pentavalent) which not only has doubtful advantages but has been shown to cause adverse reactions,” Madhavi said. According to Madhavi, there is no hard scientific evidence to show that India needs the Hib vaccine .“It is clearly piggybacking on other vaccines and the public made to pay for it.” The existing diphtheria, tetanus, pertussis (DPT) vaccine costs about 30 cents for all the doses needed to immunize a child, while immunization with pentavalents will cost more than 10 dollars. “We need to ask ourselves if introducing the new vaccine is really worth all the public money being spent on it,” Madhavi said.

Republished here on public interest by courtesy of Inter Press Services

Source: INTER PRESS SERVICE News Agency
Saturday, November 9, 2013

Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

056. Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Comptroller and Auditor General of India raps Kerala health department

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness

Press Trust Of India, Thiruvananthapuram
June 22, 2014

The Comptroller and Auditor General (CAG) has expressed concern over the failure of the public health system in Kerala to tackle the prevalence of sickle cell anaemia among the tribal population in Wayanad, home to nearly 31 per cent of Adivasi communities in the state.

According to a recent CAG report, out of the 85 per cent of tribal population screened by health authorities in the district, a total of 706 persons were found to be affected with the disease while 6,992 showed its traits.

Quoting a survey by the National Rural Health Mission (NRHM) from 2007-08 to 2012-13, it said as many as 312 of those suffering from the "life-long inherited disease" were in the age group of 18-40 and 262 in the school-going age of 5-17.

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness.

The NRHM had recommended grant of incentives to the school going students to continue their studies and for preferential treatment and temporary and contract jobs to those patients in the age group of 18-40, it said. However, the government and district administration did not initiate steps to implement this, the report said. The report also found fault with the state health department for not completing the disease screening to cover the entire tribal population in the region.

"No special efforts have been made by the Health Department to extend help to the identified patients to lead a normal life," it added.

Republished here on public interest by courtesy of Business Standard Dot Com

Link: http://www.business-standard.com/article/economy-policy/cag-raps-kerala-health-department-114062200709_1.html

Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, Sickle Cell Anaemia, CAG, NRHM, Adivasi, Wayanad, Tribal

055. Who Will Catch Fake DMOs Who Catch Fake Doctors?

Who Will Catch Fake DMOs Who Catch Fake Doctors?

By Special Correspondent
Kerala Health Research Online

A District Medical Officer of Kerala caught a fake doctor in the private sector. But who will catch fake DMOs in the Kerala State Health Services Department? Justice M P Menon Commission that enquired into the fake mark list and MBBS certificate cases in the 1980s concluded its report by saying that the Commission, with its limited resources, time and staff, could only catch and expose a few fake doctors and the majority of them might still be working in the Health Services Department as Assistant Surgeons and Civil Surgeons. No follow up action was ever ordered and undertaken by the Chief Ministers, Health Ministers, Health Secretaries or the Directors of Health Services of Kerala. Most of them were duly promoted and some may have eventually become DMOs and other key Programme Officers. And it is, was, not the end of faking certificates and bribing for appointments. Things became only easier since then with the advent of computers, laser printers and other advancements available to those who want to fake things. Where do they actually verify the certificates a person claiming to be a doctor produces? There are three major recruiters in government sector- the Kerala Health Services Department, the Kerala Medical Education Department and the new, free, liberal and open route, National Rural Health Mission. In the last, anything is possible with its non-accountability. In the first two, there is no initial verification before appointment; everything is taken as gentleman’s word. After appointment, when the supposed doctor goes to the concerned institution to join is the SSLC Certificate and MBBS Certificate physically verified for proof of age and entry qualification, by a lowly clerk. They rarely hand over these to the clerks but just ask them to prepare a covering letter to the Accountant General without seeing them. A clerk in Trivandrum District once reported this to his superintendent and the superintendent said: ‘this person, from Sooranad, did not show them to even me, then how would to you? Anyway, give him the covering letter.’ SSLC Book of another doctor from Karunagappalli revealed that she secured 5 marks for English I Paper and 8 marks for English II Paper in Eighth standard. How will she ever become a doctor? When these facts were reported to higher authorities, the then Deputy DMO, DMO and DHS were very, very, very eager to suppress news; after decades, they sent this clerk away without four higher grades, promotion as UD Clerk on attainment of 50 years age, gratuity or even a pension, even though he had a corruption-less service of 32 years and was recruited through PSC. (Documentations are available online). They are such long-remembering and spiteful. So, before arresting others for faking, every doctor in the Kerala Health Services Department in Kerala, including the Director, has to prove before the public that they are not fakes. Let them put relevant details with scan copies of certificates in their official website and let people verify. Let IMA and KGMOA officials do it first.

Link to news article:

കൊച്ചിയില്‍ 20 വര്‍ഷമായി ചികിത്സ നടത്തുന്ന വ്യാജ ഡോക്ടര്‍ അറസ്റ്റില്‍

http://www.indiavisiontv.com/2014/09/18/353814.html?fb_action_ids=531725000290925&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Fake Doctors, Illegal Medical Practice, Kerala Health Department, DMO, DHS, IMA, KGMOA, MBBS,

054. Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments.

Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments

'Kasaragode General Hospital spent 50,000 rupees for drawing 30 pictures of Micky Mouse, Tom & Jerry and Donald Duck in the walls of the children’s ward. The hospital superintendent Dr. Narayana Naik told Indian Vision Channel that this was made possible with the help of Hospital Development Committee, and as the next step, every wall in the hospital would be painted and filled with colourful pictures.' (News reported by India Vision Channel Live on 14th September 2014)

Special Correspondent
Kerala Health Research Online

According to health and revenue authorities, Hospital Development Committees in Kerala are outdated and long due for reconstitution. No one cared to regularize and develop them as societies fit enough to hold enormous sums in custody. Kasaragode District Hospital’s HDC is no exception. The District Collector of Kasaragode has full responsibility for the money-spending of this HDC which seems to have unlimited funds accumulated through years but no sense of destination. The politicians in this retired committee are spending money lavishly and foolishly. Indian hospital rooms have their long-approved colour patterns- green below and white above- to create pacifying, soothing effect. Nobody will paint them in red, pink and violet- angry colours. Normal stay for a child in hospital is three days. On the first and second days, the children won’t see practically anything for they would be in pains. On the third day, the day of their discharge, they do not need see anything; they just wish to go home. If they have to stay for more than three days in Kasaragode District Hospital, this hospital is bad in administration, cross-infectious, useless and risky. Because there is money, we cannot spend it; it is our reserves. When large amounts of money needed for a pediatric ward cannot be obtained from government, then, and then alone, can we spend HDC funds. Somebody must tell the Hospital Superintendent and the District Collector of this truth. Does this hospital have enough Pediatric Exam Tables and Scale Tables? Do they have Neonatal Infant Care Infant Warmers? How many working Transportable Infant Incubators do they have? How many Portable Vital Signs Monitors, Hand-Held Pediatric Vital Signs Monitors and Oximeters? How many Baby Finger Print Pulse Oximeters? Do they have Automated External Defibrillators, Fetal Monitors and Fiber-optic Phototherapy Systems? Have they ever demanded these from the Director of Health Services or Medical Services Corporation or have ever written to government requesting these. Have this committee ever discussed these basic necessities of children’s ward in meetings and recorded in minutes? There is a limit to ignorance, negligence and incompetence. Either leave decisions to doctors and other medically-qualified professionals or resign decently from this ornamental committee. Only in hospitals would this cheap political power play become possible. Will Kasaragode District Collector allow and tolerate a politically constituted Collectorate Development Committee imposed upon him, making him a puppet in taking decisions? If this committee, which knows nothing about children’s treatment other than how to make children, want to know about what are needed in pediatric wards, come down from the skies and ask the B.Sc. and M.Sc. Nursing-qualified staff who will tell them to purchase Electric Cots, Mobile Aneroid Stand With Cuffs (Rs.20000/-), Hand-Held Oximeters (Rs.60000/-), Portable Pulse Oximeters With Finger Sensors (Rs.80000/-), Gamma XL Patient Monitor (Rs.300000/-) or even a Da Vinci Robotic Surgical System which will cost only £500,000. Let this HDC prove their mettle.

Mobile Aneroid Stand With Cuffs is a Blood Pressure Machine with reusable blood pressure cuffs of varying sizes to suit any child. Hand-Held Oximeters are used to monitor oxygen levels in babies to prevent damage to vital organs due to lack of oxygen. Portable Pulse Oximeters With Finger Sensors are hand-held devises to monitor pulse and oxygen level while child patients are moved from place to place. Respiratory Humidifiers heat and moisturize the oxygen that is being delivered to children during mechanical ventilation, to prevent them from becoming cold, thick airway secretions from building up, breathing tubes from blocking up and the little lungs from collapsing, based on the principle that humidified and heated oxygen will make children recover faster. Vital Signs Monitors in pediatric and neo natal wards and emergency wards reads, registers and provides all necessary vital signs of the sick child. Gamma XL Patient Monitor can be purchased for Rs.300000/- which will watch all vital signs including Pulse Rate, Temperature, Blood Pressure and Cardiac and Pulmonary functions, replace all other equipments and prevent children from being moved to different monitoring levels, floors or rooms. The latest thing to present a children’s ward in a hospital with is the Da-Vinci Robotic Surgical System which ensures more accuracy in surgery, lesser pain, smaller scars and quicker discharge. The surgeon at the console sees 3D images of internal organs, makes tiny incisions, manipulates miniature instruments and performs surgery. These are becoming popular now- U.S. has 300 0f them and U.K. 1. Why don’t Kasaragode try? Anything is possible, and do not tighten purses where children are concerned. Also take care of a few other things. How many High Dependency Unit Beds, Electric Cots, Pediatric Nurses, Consultant Pediatricians and Anesthetists trained in Pediatric Care are there? Is there a Children’s Ambulatory Care Ward, so that children needn’t stay even a day for surgery? Are cots, waiting room chairs, and equipments including thermometers and birthing-baths beyond or with in Accepted Infection Control Parameters and Standards? Are all beds provided with oxygen space and access to oxygen outlets? What about prevention of cross-infection? Are medical and surgical patients separated? What about cleanliness in children’s baths, toilets and closets?

Link to News Article:

ചികിത്സക്കെത്തുന്ന കുരുന്നുകള്‍ക്ക് കൂട്ടായി കാര്‍ട്ടൂണ്‍ കഥാപാത്രങ്ങളും

http://www.indiavisiontv.com/2014/09/13/352453.html?fb_action_ids=530039403792818&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Kasaragode, Pediatric Equipments, Pediatric Wards, District Hospitals, Hospital Funds, HDC

053. What Does This Minister Harsh Vardhan Know About Horrible Kerala Health?

What Does This Minister Harsh Vardhan Know About Horrible Kerala Health?

By Special Correspondent,

Kerala Health Research Online

Can Government of India’s Union Health Minister be this much ignorant about a state? Can he repeat what his speech-writer scribbles this much blindly? What does this Mr. Harsh Vardhan actually know about Kerala’s health?

From India Today News 21 September 2014:

‘The Union Health Minister was full of praise for the Kerala Health Sector who maintained that the achievements of Kerala in the health sector are a model for the country and the state has been maintaining quality right from the primary health sector to the medical college sector. The minister was inaugurating the 13th Annual Conference of the Association of Otolaryngologists of India, Kerala branch. He admitted it was quite alarming that India occupied the top spot globally in suicide of youths' in the 15 to 35 age group, and it was most unfortunate that 75,455 persons committed suicide in Kerala in the 10 years between 2003 and 2013. Kerala health minister V. S. Sivakumar said Kerala was aiming for comprehensive health protection by including modern scientific technologies in the medical treatment.’ (Reported by PTI)

Note From Editor, Kerala Health Research Online:

The Union Minister's observations cannot be based on statistics collected in their Kerala Health Survey because the Director of Health Services Dr. P. K. Jameela pointed out that these union statistics is erring and differs much from Kerala health department statistics. Mr. Harsh Vardhan’s and Mr. V. S. Siva Kumar’s yelping do not deserve comments. But these two ministers need read some good articles evaluating Kerala’s health. Kerala Health Research Online would like to quote here for their use an article written in February 2007 by Dr. C. R. Soman, Former Professor and Head of the Department at Medical College, Trivandrum, Kerala’s Health Activist and noted Nutritionist. We regret this learned doctor is no more with us; he left us in 2009. Had he lived, he would not have hesitated to make reply to these two ignorant politicians. 

Kerala's Crisis in Public Health. By Dr. C. R. Soman.

Kerala is on the brink of a public health crisis. The state, which set an example for the rest of India and third world countries in providing primary health care, now gropes in the dark and is fast losing the edge. The great achievements in the fields of mortality and fertility have reached a plateau, and the near-universal immunization coverage achieved in the nineties has fallen. 

The state is regularly visited by emerging outbreaks of leptospirosis, dengue fever and other insect-borne viral fevers; the latest entrant is chickungunya. Natural ecology has been tampered with and the once-famous backwaters of the state are polluted and weed-infested. Waste disposal in the municipalities and corporations still remains a formidable challenge. Conventional methods like land-fill evoke furious protests from local inhabitants. Critics have re-christened 'God's Own Country' as 'God's Own Junkyard'. 

The state health department is no longer the prime mover of health development. With less than a third of physicians, beds and institutions under the government, the state health services department is a mute spectator to the rapid decay of health services, particularly primary healthcare. Many primary health centers are unmanned. Drug procurement and distribution systems are outmoded and complaints of drug unavailability appear frequently in the media. The state-run medical colleges have no longer bright young academics to work for. They opt for more lucrative placement in the burgeoning private sector instead. Many super-specialty departments face the threat of closure in the absence of new recruitments. 

There are worse problems. Recent studies suggest that Kerala has the highest burden of coronary heart disease, stroke, hypertension, diabetes and over-nutrition. Conservative estimates put the number of people with diabetes at three million; people with hypertension at 4.5 million and those with overweight and obesity at 10 million. 

Every year in Kerala, between 45,000 and 50,000 people die of heart attacks, while stroke kills over 20,000. In comparison, the annual death toll from HIV/AIDS is just over 200. But the government perceives HIV control as a greater priority. 

It is the healthcare industry that benefits from this sordid state of affairs in Kerala. Private hospitals offering sophisticated tertiary care are mushrooming, even in villages. By-pass surgery and coronary artery stenting are buzzwords familiar even to the children. One would be lucky if an MRI scan is not ordered if you reach a physician with a headache. The doctors prescribe laboratory tests even for minor ailments. 

They may argue that a variety of investigation is necessary for complete profiling of the disease in modern medical practice. According to the Indian Medical Association, the doctor would be in trouble if the diagnosis goes wrong. It argues that they practice defensive medicine. But defensive against whom? Implied in this approach is the assumption that people, individually and collectively, are enemies of the medical profession. The IMA cites stories of attacks against doctors and increasing trend towards litigation against hospitals to buttress their arguments. 

These are convincing arguments for the naive. The sad truth is such arguments are alibis offered to mislead and misinform. The over-use of technology and drugs is driven by greed - a greed that is fuelled and perpetuated by an unholy nexus between doctors, the drug industry and the diagnostic sector. Huge rewards are offered to the physicians for prescribing expensive investigations. Anywhere between Rs.2000 and 2500 is offered as commission for an MRI scan; 40 percent of the fee levied from laboratory investigations reach the doctor as commission. 

Private hospitals make more money through over-investigating patients in their own laboratories than from providing care to the patient. Profit at any cost is the watchword. Doctors in the government sector also gain through the nexus between the industry and the profession. The government has made no attempt to regulate the healthcare industry, and often goes out of the way to provide them with more concessions and soaps. 

Naturally, the victims are common men. Falling sick has become a reason for one to be pushed into debts. The Kerala Sasthra Sahithya Parishad's (KSSP's) studies revealed that at least 15 percent families spend over 30 percent of their income on healthcare alone. While private healthcare costs exceed Rs.55 billion per annum, the government expenditure is falling steadily. The government's failure in providing affordable healthcare is likely to fuel public anger. Hospitals and doctors are likely to be targets of public attacks. Facilities for medical education are being auctioned off to the highest bidders. 

To complete undergraduate course in a private medical college requires Rs. 3-5 million. Naturally, they would expect quick returns for the investment. Fleecing the people would be the only choice! Those who get state-funded medical education are only too eager to fly abroad. And those who choose to stay home prefer to work in cities and towns, leaving primary health centers unattended. 

Medical care in the state has become dehumanized and privatized. Commodifying healthcare- increasingly driven by profit- will demolish all that the state had achieved in the health sector during the last decades of the 20th century. The future looks bleak for Kerala.

Tribute to Late Dr. C. R. Soman.

  

052. Save Health From Shamans of Ayurveda And Shehanshas Of Allopathy

Save Health From Shamans of Ayurveda And Shehanshas Of Allopathy 

By P.S.Remesh Chandran
Editor-in-Chief
Kerala Health Research Online

Ayurveda, Siddha and Unani are the three Indian systems of medicine used widely in Kerala. Before two centuries, there were only these three systems in Kerala. There was no allopathy. The control of these three was put under the Director of Health Services and control of the drugs belonging to these three indigenous systems of treatment was put under the State Drug Control Administration. The variety of plants and herbs relating to these systems were to be cultivated and promoted by the Medicinal Plant Board OF Kerala. In short, under the British and under the post-British governments in Kerala, ayurveda, siddha and unani had no identity. For government, health meant, and still means allopathy. Kerala’s Chief Minister, Health Minister and Health Secretary, if and when they become sick, will only go to an allopathic hospital, that too a large private one, only. 

Doctors, staff and the treatment technology of native systems suffered much and had to compromise much under the allopathic strong hands who controlled them in the health services department of Kerala. They were considered pariahs by those in the department and in the government and allopathic personnel were considered like Brahmins! Hospitals, beds, staff, medicines, equipments and vehicles would only be provided for the allopathic system. Leave, increment, higher grade, promotion and pension applied for by native systems’ staff would be ignored by the staff of the DHS, or kept pending or go missing altogether in the health directorate and the various district medical offices. These systems with more than 2000 years’ tradition were condemned, laughed at, ignored and disparaged by arrogant medical and clerical officers in the health services department, while they catered everyway to the whims of the proponents of a system which was only 200 years old. This neglect and hatred of officers towards these three time-tested and cheap systems of medicine gradually created such a fury and uproar among people who could not afford costly allopathic treatment and medicines, reflected well in the popularity of the few remaining ayurveda, siddha and unani physicians in the state reached a stage where unless these native systems were not separated from the state health services, people will see to it that the allopathic drug industry in the state collapse. At last bifurcation came, against the wishes of the health department. A separate Department of Indigenous Systems of Medicine (Ayurveda) was created, under a new director and staff. Still the question and state of siddha and unani systems remained the same. Like ayurveda suffered under the allopathic directorate, they continued to suffer under the control of the new Ayurveda Directorate. No separate departments and directorates for them were ever created, bi-furcating them from Ayurveda Department. 

The Government of India and people in the health sector of India had by then come to believe that only the creation of an exclusive Ayush Department for catering to the needs of native systems of medicine in India would hold them and save them from the immensely rich and strong allopathic industry. India turned this line and several states including Maharashtra, Madhya Pradesh and Bihar began to bifurcate them from the mainstream of allopathic health services and create separate Ayush Departments for their protection and rescue. Many states in India which are long being ruled and exploited by the allopathic industry, due to politicians and bureaucrats on the payroll of this behemoth industry, still oppose formation of separate Ayush Departments. These states include Kerala which is thought to be one of the most progressive states in India, literally and culturally. The fact is, the State Health Services Department, Directorate and Ministry is heavily bribed by the allopathic industry to make creation of Ayush Department impossible. 

Will creating a separate new department for Ayush solve the problems of indigenous systems of medicine in Kerala and save them is another question. Did the attempts of the health services department save allopathy in Kerala? More hospitals, staff, medicines and equipments came to be built, employed and procured but more number of people became sick and sought treatment each year. Population did not increase much but number of sick people increased unbelievably. Without thousands and thousands of large private hospitals coming into commissioning, the health department could not have contained this situation. Like traitors and cowards, they permitted opening up and privatization of everything in medicine and treatment. 

The problem, when viewed from the people’s side, is enough government hospitals to give free treatment in indigenous systems not being there. Sick people wreck the economy. When they become sick they cannot work; unless they are treated back to well being, they will perish, economy will collapse and country will ruin. That is why state has to provide free treatment. That is the concept of free hospitals system. We may ask, cannot the sick person pay for the treatment? Learn that we become sick only when the last rupee has left our purse. Diseases will not come to us when we are ready with money. Remember that a sick person is a person without money, almost always. So the problem, as far as people are concerned, is setting up new training centres for indigenous systems, creating more doctors and staff, teaching them new techniques, making available new hospitals, staff, medicines and equipments and provide infrastructure. But, for the Ayurveda doctors in Kerala, representing the Ayurveda Medical Association of India, it is only a problem of setting up a new Ayush Department in line with what the central government did in New Delhi and creating a few posts of Joint Directors for them in the Government Secretariate, which was just what they requested to the health minister of Kerala in February 2013. There is a standard phrase in government dealings which every desperate post-seeker uses: ‘this would make no additional financial commitment for the government’, and they used it. In a country where MLAs sit in state assemblies and vote unanimously for their own pay rise instead of conducting public referendum, what else can we expect from ambitious doctors? 

The arguments of the Ayurveda Medical Association of India can be read here: http://www.pharmabiz.com/NewsDetails.aspx?aid=73654&sid=1


Tags: Health, Kerala Health, Indian Health, Health Research, Health News, Health Service, Indian Systems Of Medicine, Indigenous Systems Of Medicine, Allopathy, Ayurveda, Siddha, Unani, Ayush Department,

050. Who Were Behind The Abandoned Health Observatory Surveillance Project Of Kerala?

Who Were Behind The Abandoned Health Observatory Surveillance Project Of Kerala?

By Special Correspondent
Kerala Health Research Online

The first news report to mention Kerala Health Observatory And Basic Surveillance Project was by The Hindu National Daily published on 23 January 2013 which involved Health Secretary Rajeev Sadanandan saying: ‘The State Health Department is putting in place a Health Observatory formulated by the department to track the morbidity and mortality pattern in the State through a survey, covering 2.3 lakh households or a population of 10 lakh covering all panchayats. It is one of the largest armies in the world to track all health-related data. The project is taken up by the Health Department, with technical support from the Population Health Research Institute of McMaster University, Canada under formal technical collaboration, supervised and supported academically by the Achutha Menon Centre for Health Science Studies, Health Action by People, and the Department of Community Medicine at the Medical College. McMaster University will assist in data management and analysis as the State has little experience in handling such mammoth studies. The proposal is to pilot the project in April, by surveying data from two clusters of 55 households each in urban and rural areas in all districts. Health workers will visit the designated areas and administer the questionnaires prepared by a team of experts. The questionnaire will be pre-loaded in a tablet PC so that the health workers need not spend more than 20 minutes in a household for data collection. Personal information on all members in a family will be collected. The tablet is GPRS-enabled so that the supervisors can determine if the health workers are entering the data from the field. The data will be uploaded in a server to be maintained here, ‘a Health official’ said. The training for health workers for administering the questionnaire through tablets will begin in February. The pilot is expected to be completed in a month after which the project will be formally launched. The 28 tablet PCs to be used for the pilot study will be provided by McMaster University. A proposal for supplying tablet PCs to health workers for their field work is being taken up with the IT Department.’

The second news article to come up was what the Times of India published on 18 March 2013, ‘Canadian Expertise To Create Database Of Diseases’, which further revealed that NRHM would fund the survey and the diseases caused due to extensive use of alcohol and tobacco, the food habits of the people, the rate of obesity and its reasons, the rate of prevalence of diabetes and blood pressure, the diseases caused due to lack of exercises and the reasons behind the deaths occurring in the state, would be investigated.

For one full year nothing was heard of this project in news media though everything was happening with the project. It was on 23 March 2014 that Times of India printed Kerala’s Opposition Leader Mr. V. S. Achuthanandan’s allegations on this project, under the heading ‘V S Says Govt. Clarification On Drug Tests Misleading.’ We must note that, by this time, the words Basic and Surveillance had dropped out of the title of the project and we know why. They are dreadful words, attracting the attention of vigilant inquisitors. The news article said, according to Mr. Achuthanandan, ‘the government’s clarification on allegations of drug experiments on citizens was misleading, health minister had not denied receiving money for the survey conducted among 1,540 families across the state for a Canadian organization, the minister had only said that the health department has not accepted any remuneration for the survey and the minister has yet to clarify how an NGO received money instead and why such an initiative was undertaken without the permission of the Government of India or the Indian Council of Medical Research. The Opposition Leader also alleged that a memorandum of understanding signed between Kerala Health Observatory and Population Health Research Institute of Canada had led to handing over of lifestyle and health details of people of the state to the Canadian organization, the health minister and former health secretary Rajeev Sadanandan were involved in the matter, and that the Head of the Department of Community Medicine, Mr. Vijaya Kumar, was receiving the remuneration through a non-government organization of which he is the secretary.’

The New Indian Express also on 21 March 2014 reiterated this allegation of the Opposition Leader that ‘the State Government is conducting dangerous drug trials on people in collaboration with the Canadian Government, people were being treated like guinea pigs by the State Government project Kerala Health Observatory and the Population Health Research Institute in Canada and that under the guise of this experiment, the Canadian Government was being gifted details about the lifestyle and health of the people of Kerala. He also alleged that the Health Department assigned five health inspectors and nurses for this job for over the past one year. Under the agreement signed between the Kerala Government and the PHRI, this is not merely an observation programme, but a scheme to intervene in the health status. This means, drug tests could also be a part of it. It is understood that data collected from 1,540 households in the 14 districts have been transferred to the Canadian Government. He said this is not just illegal and immoral, but also a source of corruption and demanded the State Government to clarify as to what exactly the Kerala Health Observatory Project is. The government should explain whether the subjects were informed that the data would be handed over to Canada and whether the scheme had the clearance of the Union Health Ministry. It should be explained as to how the remuneration is being paid to the organization ‘Health Action by People’. The government should also explain whether drug tests have been conducted on people, he said. 

The Hindu National Daily, on 31 March 2014 reported, in a different tone, that ‘the Opposition Leader’s recent criticism of the so-called drug trials conducted as part of the Kerala Health Observatory Project has caught many public health activists by surprise. Many officials in the health department wonder what caused the octogenarian leader to suddenly raise the issue’ when Health Minister had announced in the Assembly sometime ago that the project, which never involved any drug trial, had been shelved, the minister having had also clarified that the project, sought to be conducted in association with the Canada-based Population Health Research Institute, involved only collecting details on the morbidity and mortality patterns with regard to the high prevalence non-communicable diseases in the Kerala population and advisory body comprising of top health officials and well-known academics and public health activists having overseen the entire exercise, the findings of which having not handed over to any foreign entity.’ According to this news paper, ‘many officials wondered privately whether the Leader of the Opposition had been briefed wrongly about the project by sections not disposed well towards such Health Department initiatives, since allegations regarding drug trials have always been a politically sensitive topic in Kerala.’

We, readers of all these news articles, will now have a few questions of our own in our minds which will have to be answered by the government and a few names printed on our conscience which we ourselves have to clear. The most relevant questions which spring up in our minds have already been asked by the Opposition Leader. The names which trouble us, which we ourselves have to clear, are Kerala Health Observatory Project, Government of Kerala Health Department, National Rural Health Mission, Medical College Department of Community Medicine, Population Health Research Institute Canada and McMaster University Canada, Health Action by People, Achutha Menon Centre for Health Science Studies, Trivandrum and a few names which come up when we search internet for Kerala Health Observatory Project. 

Kerala Health Observatory and Basic Surveillance Project

To tell the truth, the name Kerala Health Observatory Project does not come up anywhere, associated with any credible research institutions. Only news is there, cultivated, planted or officially released. It exists nowhere. It has left behind only paper trails- vouchers, letters, cheques- all conveniently shelved now, to be opened only when an investigation starts or a judicial court summons. It left no electronic trail. Searching the internet with the key words kerala-health-observatory-project leads to nowhere, or to whatever is only there (See the picture below). It leads to the names of only two ladies. Everyone escaped clean, except two young ladies whose names are left there alone on the broad sky of internet for all to view. One is a consultant whose Linked In profile shows she is engaged by Health Action by People since April 2010 as Consultant, holding the responsibility of coordinating their international study funded by McMaster University and other responsibilities including searching out funding options for their research projects. The website of Health Action by People also shows her name. The other is that of a Computer Assistant in the Medical College Hospital, Trivandrum whose Linked In profile also claims she has been associated with Kerala Health Observatory Project. Medical College Authorities do not have Computer Assistants on their pay rolls except those, if any, appointed on daily wages basis by Hospital Development Committee. None of the other governmental and non-governmental organizations’ digital fronts mention anything about this project. Even after questions having been raised by prominent legislators, health minister having answered questions and reputed news papers having reported grave allegations, it is inconceivable that electronic searches for this project lead only to two young women who did not think it prudent and wise to keep back from publicly associating their names to a project which was doomed to be abandoned and hushed up later.

Health Action by People

Health Action by People started near Mutharamman Kovil, Pettah and then moved to near Medical College, Trivandrum. It was founded by the prominent Dr. C.R.Soman of Trivandrum, the late health visionary of Kerala. He was a professor at Medical College, Trivandrum, noted as a trainer of health workers in the state. After his demise, Dr. Raman Kutty, a professor at Achutha Menon Rsearch Centre became its Chairman. Dr. K.Vijayakumar, Professor of Community Medicine at Medical College, Trivandrum is its Secretary. They have two professors from the Achutha Menon Centre in their Executive Council, including the Chairman, and four professors from the Medical College, Trivandrum, including the Secretary. They do have a Dr. Rajasree Gopinath as Consultant. When they say they are committed to serving the people in the field of health and that their organization is led by a group of professionals sharing a common vision and ideal, why should we unbelieve?

Government of Kerala, Health Department and National Rural Health Mission

Government of Kerala through its health minister has admitted that an agreement was signed between the Canadian Organization and the Government which along with everything else was shelved after a time. It has not yet revealed who in Kerala were involved and how much money was spent on this project before its shelving. Also it has yet to answer the specific questions raised by the Opposition Leader of Kerala. The Health Department did involve itself in this project by deputing staff, if they did depute. This department has to answer who were deputed to do what, when and where and what their financial commitments were and who gave them the authority to depute personnel, spend money, collect people’s data and hand over it. The people of Kerala know well about the activities of NRHM. It is a central agency housed in the state, working with a lot of money, living a lavish life like kings and accounting to no one. The central government directed NRHM to create websites and post every activity including daily expenditure so that people can evaluate how they spend public money, following continuous allegations of misappropriation of money were reported from all states. They were even directed to post the names of who work where on which day so that people may check. They totally disobeyed this for fear of peoples’ interfering and public comments in websites. That is why it is said they account to no one and live like kings. Their websites have a few photos of persons, a few telephone numbers, a few links here and there and no information. Whatever is there is available in any government diary. Every dubious project which springs up in Kerala in the name of health is financed by this agency, if it has ‘considerations’. Every ambitious educated entrepreneur set out to make quick money come up with projects for this agency, for they do not provide links in their website to projects undertaken or amounts spent on each. If they are funded by the government of Kerala in any project, the government will not have details of this money once it leaves government coffers. If someone asks details from the government under the Right To Information Act about the money they gave, the government will say details are available only with the NRHM and not with them! In this particular case of Kerala Health Observation and Surveillance Project too, as reported, it was NRHM who was to finance (or distribute money to?) this survey, no wonder. Every unaccountable spending is now delegated to NRHM. Man, even defense establishments are now accountable to people! 

Achutha Menon Centre for Health Science Studies, Trivandrum

The Achutha Menon Centre for Health Science Studies is the Health Sciences wing of the Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum. They train professionals in health research and health policies. Government of India recognized this wing of Sree Chithra as a Centre of Excellence for public health training.  The AMCHSS does have an ongoing research project, the Principal Investigator of which being Dr.V.Ramankutty: Prevalence Of Type II Diabetes In A Rural Community. The path to this project is: Home > About SCTIMST > Organisation > AMCHSS > Projects > List of Ongoing Projects- 12. Apart from this, they mention nothing about any research project undertaken with Canadian partnership or assistance. They do have visiting faculties from abroad and an affiliated WHO Fellowship Programme and there might be Canadian citizens among the scholars who have come and gone, but their official website has zero information on Kerala Health Observatory Project. Perhaps, their name was unnecessarily dragged into this by those who came up with this project. One of their professors, Dr.V.Raman Kutty, is also the chairman of Health Action by People in Trivandrum, incidentally. And another of their professors is in their Executive Council also.

Population Health Research Institute in Canada

The Population Health Research Institute (PHRI) was founded in 1999 as a joint Institute of Hamilton Health Sciences Corporation and McMaster University. Their declared research programs include studying the causes and prevention of cardiovascular diseases, diabetes, obesity, vascular complications, and stroke. They have a global team of collaborators with researchers from eighty countries in six continents, including North America, Africa, Asia Pacific, Europe, Middle East and Latin/South America, according to their public relations. Their Lead Investigators are noted as Dr. Salim Yusuf, D.Phil, FRCP, Canada, Professor of Medicine at McMaster University, Director of the Population Health Research Institute, and Vice-President of Research and Chief Scientific Officer at Hamilton Health Sciences and Dr. Clara Chow, a post-doctoral research fellow.

But their official website does not have information on any projects undertaken in Kerala. In European standards, with the strict European Information Commissioners, if they do not have anything to display on Kerala, it clearly means they do not have any official deal with Kerala. If there does exist a connection, it is personal and out of office. It is very easy nowadays for someone to sign Memorandums of Understanding and mislead institutions, if there is someone in that institution who is prepared to turn head the other way in return for favours once received or offered. 

So, we have to assume that the name of the PHRI was either unnecessarily dragged into this project to boost project profile and secure government support and finance, or the PHRI withdrew from partnering with the project, on wise second thoughts. News reports say that they only intended to provide guidance and expertise, not finance. The PHRI which has undertaken so many research studies in so many countries is unlikely to sign genuine agreements officially and withdraw from them if the projects are feasible, viable, legal and righteous in their evaluation. Then who did sign the agreement for them? Did they sign it with Health Action by People or with the Government of Kerala? What were the terms of this agreement?

We know whoever approved, promoted and travelled along with this project and claimed it as their own has now disowned it, like they do to a leper. The involved establishments did spend money, depute personnel, collect data, hand it over and everything else associated with carrying out a project like this. It was, we can guess, brought forward by private persons, who got eminent institutions and scientific personalities involved, got politicians to speak for them and get favour from government, until it became a government project with government funding. We can also guess it violated so many principles inviolable where two countries, a state government, and sensitive data of people are involved. It all started in 2013 and ended in 2014 within just one year, the same period when people with guts in Kerala were playing with state politicians and bureaucrats and technocrats like playing with dolls and puppets and got projects approved and purses un-stringed. We have seen so many scams not to wonder. Why did the Kerala Government actually abandon this project and shelf it suddenly?

Note: 

This is not the end of the article. We know more things will become public in near future. We will certainly report them here. This article will be updated. Please bookmark this page.

Links To News Articles:

The Hindu News Article Dated 23 January 2013

Times of India News Article Dated 18 March 2013

Times of India News Article Dated 23 March 2014  

New Indian Express News Article Dated 21 March 2014

The Hindu National Daily News Article Dated 31 March 2014





   

046. When Did Kerala Health Qualify For Central Grant For Total Automation?

When Did Kerala Health Qualify For Central Grant For Total Automation?

By Special Correspondent

The Department of Health, Kerala, in their Face Book page dated 24th January 2013, announced that they won a grant for total automation of the department. There was no mention of the amount involved or what specific uses the amount of this grant was ordered to be put into, as if it is their private pleasure and right to hide specific information from people and use this grant at their will. First we shall read here their own article from their Face Book. Do not mind the language and grammar, for it represents only the person going to benefit most from this ‘grant’. 

Then we shall look into the Face Book Set Up of this department to see how current, updated and sophisticated they are to receive such India Government grants for total automation. To tell the truth, they do not qualify for it. A screen shot of their page on April 05, 2014 denotes that they are 8 months back in digital updatedness and that they are not skilled and resourceful enough to control such elaborate e-health governance for an entire state, unless they outsource everything which is what they really wish to do. If they outsource it as is evidenced from this article, it is illegal and against the interests of the people. It seems this is going to become a sequel to the ill famous solar scam, involving perhaps the same kind of people. The government is quite unwilling to disclose the names of the people who ‘expressed their interest’ to participate in the various projects likely to come up in connection with the implementation of e-health in Kerala. Even then they ‘won’ a Union Government grant for total automation. How did this happen and which powers were behind it?

Their article which is reproduced here is just a blabbering of the uninformed and the uncaring in the health field of Kerala, knowing nothing about e-governance or electronic health informatics, interested only in the securing of funds from all possible sources and spending it at their will. They care nothing about people’s health or the privacy and confidentiality of people’s health data or government servants’ accountability. If what they say on doing things in the name of e-health is to be believed to be going to happen actually, they either intend to ignore the legalities of accessibility to health data, protection of health data, citizens’ rights to privacy and confidentiality of their sensitive health data and international guide lines for sharing patient data, or they think they can simply bypass these by sheer criminality. Certainly the health minister of Kerala, a politician who proclaims to know everything under the sun, the political parties of Kerala who assume the role of keeping suspicious views of everything, the various scientific, civil and human rights organizations who pretend to know about every law in the world and interfere in almost everything and the news media in Kerala who report every involvement above five lakhs rupees as scams, did not speak a word against this involvement which is sure to affect the life of every man, woman and child in Kerala. They all will have their piece of the pie, or their relatives or favourites will have it. Violating international chapters on safeguarding sensitive patient data, the people involved in e-health finance and administration in Kerala, are going to enlist private parties and outsource sensitive works to them, at the risk of data loss, theft and manipulation. If there are investigating agencies in Kerala, it is time they begin. 

Note that when it was assured that a considerable amount of money would be allotted by the Union Government, there were a rush of activities. Pages were opened in DHS and NRHM websites, news released to news papers and television channels and articles were posted in Face Book. When the money actually came to Trivandrum, it all stopped; there were no more updating or information release, ever. From then onwards, everything became secret and silent, till the alert and vigilant Treasuries Officers began to turn down e-health bills for enormous amounts.

Department of Health, Government of Kerala. Face Book Article On 24 January 2013. 

Health department Kerala was won a project grant from the Department of IT (DeITY) Government of India for total automation of the department. This will have three arms: automation of demographic data indexed on UID, State Data Centre (where all individual data would be stored) linked to all health institutions and accessed by field workers through a 3G enbled tablets and hospital automation. The field workers will digitise the family health register where each individual will be identified by UID. This data would be sent to the state data centre (SDC) through the Kerala State Wide Area Network (KSWAN). The field worker will be able to down load the demographic data she needs for her planned work for the data and be able to update the individual data at the SDC with new data generated (immunisation, Blood Pressure data) during her work for the day.

When the person visits any government health institution this data would be downloaded to the local server of the institution. This would be available at the OP, Consultation room, pharmacy, lab etc. It will contain alerts for the physician, pharmacist and other staff such as pre-existing condition, specific allergies etc. The communication between different parts of the hospital (e.g: Cinician and laboratory or Ward Nurse and Pharmacy) will be through the system. At the time of discharge an abstract will go back to update the data at the SDC.

Our aim to develop an Electronic Health Record for every citizen of the state. Once it is stablised the private sector may also be invited to participate. The project aims to make data available for planning, research and for individuals to manage their own health. Government of India sees this as a pilot project to apply IT to ensuring Universal Health Coverage in the country. 

The challenge is to develop good Functional Requirement Specifications. Our teams are on this task now.

Screen Shot of Department of Health, Kerala’s Face Book page. See how current they are:

044. Can Papaya Leaves Help Cure Dengue?

Can Papaya Leaves Help Cure Dengue?

By Health India.Com

Pavitra Sampath
October 4, 2013

The capital is grappling with the burden of dengue, and with the numbers steadily rising, people are looking for alternative methods to treat the disease. One such, much talked about remedy is, the use of papaya leaf juice to heal the body ravaged by dengue. While some people claim that it is simply a belief, others swear by the remedy. So, what is the truth? In this post we demystify the clutter.

Truth or hoax?

While some people say that it is simply a hoax, there might be some truth to papaya leaf juice’s claim to fame after all. A number of scientific papers have proved that papaya leaf juice is actually beneficial for the body. One of the first papers to talk about the benefits of the papaya leaf juice was a study by Dr. Nam Dang at the University of Florida Research Center. He found that the papaya leaf juice was capable of fighting cancer, was non-toxic to the body and had the capability to improve one’s immunity. While the plant’s leaf is well known for its curative properties in diseases like malaria and cancer, Dr Sanath Hettige, a general physician in Sri Lanka, found that the juice of young leaves can be used to treat dengue. His paper was published in the Sri Lankan Journal of Family Physicians in 2008.

How does it work?

Papaya leaves are known to be packed with the enzymes like chymopapin and papain which, according to Dr. Sanath Hettige, normalize the platelet count, improves the clotting factor, i.e. helps the blood clot normally, improves one’s liver function and repairs the damage to the liver done by dengue, therefore helping an ailing person recover from the disease. 

How to use the papaya leaf?

The young leaves from a fruit-bearing papaya plant should be used. According to Dr. Hettige, the leaves of the Red Lady Papaya Plant, found commonly in India, are more effective. The important fact is that one should choose leaves that are not too old, neither too young. Now, take only the leafy part and not the stalk, and wash them well with water. Crush the leaves using a wooden mortar and pestle without any additives like water, salt or sugar. Once they are crushed, squeeze out the juice with clean hands and drink it two times a day. Do not add any salt or sugar to the drink. According to Dr. Hettige, an adult should have 10 ml of the juice twice a day (or at eight hour intervals), children between the age of five and 12 should have 5 ml of the juice twice a day, and those below 10 years of age should be given 2.5ml of the juice. 

At what stage should a patient ideally have the juice?

According to Dr. Sanath, it is best the patient start having the juice as early as possible. This means that when they notice the first symptoms of dengue fever (when their platelets show a decline in numbers below 150000 cu mm or when the packed cell volume goes above 10%). It is also beneficial at later stages, but if the condition has progressed and has led to organ failure, the juice is not very effective.

Link: http://health.india.com/diseases-conditions/can-papaya-leaves-help-cure-dengue/


Reproduced here by courtesy of Health India. Com.


Comment From The Editor:

The effectiveness of papaya leaves in the treatment of dengue is not a hoax but a truth. The people of Kerala have been using this remedy for a very long time. Allopathic doctors will not permit its entry into their hospitals. In their hospitals, what they do is supplying patients with blood bags, i.e. extracted platelets to supplement blood components and raise platelet count. Platelets are not easy to get from hospital blood banks. Only if we can donate blood ourselves or present enough healthy and fit people to donate blood would they give an equal quantity of blood platelets, after deducting their margins. It is a very costly treatment. Most people cannot afford it. They die out. We cannot present any blood donor; they have to belong to the same blood group as the patient. Health authorities in Kerala never reveal the numbers of patients who die in their hospitals due to inability to afford blood refill. Government hospitals do not have enough blood for all and even if they have, the hospital bureaucracy will not okay it in time before the patient dies. Private hospitals will provide blood but will realize enormous sums for it. Poor people have no way to recover from dengue. So, they take papaya juice to hospitals, private or governmental, and administer it to their beloved relatives there, secretly. If the doctor, nurse, security guard or nursing attendant sees this, the patient would be summarily discharged, without excuses. Their argument is that papaya leaf does not belong to the allopathic system of treatment and so, they cannot permit it in. Besides, they will say, the doctor is responsible for the treatment of the patient; if the bystander also decides to treat him, who will answer for the life of the patient? But people continue to do this and patients continue to recover from dengue. When they heal, the credit goes to blood bags, and not to papaya leaves. 99 percent of dengue recoveries in Kerala hospitals are due to papaya and not to blood bags. How sad and horrible it is for a relative to have to administer the most effective native drug in the world for the treatment of dengue to a patient, taking utmost care not to be seen doing it! They cry in their agony to save the patient and loath the whole allopathic establishment, bureaucracy and government for forcing them to do this in this way.

There is no vaccine for dengue as it is caused by different viruses. Every doctor and health authority knows this but they still deny papaya juice to patients. It is their insincerity and betrayal of people. Everyone knows that in these hospitals they are not treating dengue but ordering blood bags. A very good and dedicated doctor in Peroorkada Government Hospital in Trivandrum once wrote a letter in a news paper about how he had to administer papaya juice secretly in a government hospital like doing a punishable crime to save the life of his own child. The newspaper published this letter but we never heard any authority repeating it. He was hushed up by the Indian Medical Association, we have to believe, for this organization never took this up and inform people of the effectiveness of papaya leaves. They live in blissful ignorance of almost all their medicines and drugs being coming from plant preparations. But when some pharmaceutical company patents this native plant and put medicine in the market, they will prescribe it the instant. If a poor man administers the same medicine to his dying relative in a hospital, that is a heinous crime in their eyes which make them angry and discharge the patient. There is a chief minister, a health minister, a health secretary and a health director in Kerala who, if you ask them about papaya leaves, will pretend they are hearing about papaya leaves for the first time. And people are relying on them for for their lives. If they do not have the will power for okaying the official entry of papaya leaves into hospitals like decent men, why hold on to those chairs?