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





   

049. Kerala Govt. Abandons Plans To Set Up Drug Manufacturing Units, To Please Bosses.

Kerala Govt. Abandons Plans To Set Up Drug Manufacturing Units, To Please Bosses.

By Special Correspondent

The Kerala Government had announced its desire, not decision, to enter the field of pharmaceutical manufacturing in the year 2012. Even after billions of rupees having flown into the coffers of multi national medicine manufacturing companies, the government has not cared to make common man’s dream come true. It is like the politicians in government, and their bureaucratic counterparts as well, do not like medicine manufacturing units to come up in the public sector, and the large corporates who contribute handsomely to their election funds and their children’s educational funds loose their huge sales in Kerala. Their loyalty is to large pharmaceutical companies, not to people or government. And they could not or did ever care to persuade these companies to stop extracting unrealistically high prices for life-saving drugs or refrain from withdrawing low-priced good drugs from the market. 

Even in 2013, the Government of Kerala was said to have been giving serious consideration to proposals for setting up drug manufacturing plants in the state, as was revealed in the health minister’s speech in the Emerging Kerala Global Connect Meet 2012, which in itself was an utter farce. Multi-faceted and many dimensional growth was assured in Kerala’s health sector by many participants but when they learned that it is not easy to cheat and lure the highly politicized people of Kerala as they do in states likes Bihar, these aspiring entrepreneurs suddenly vanished. Government’s declaration to set up state-owned drug manufacturing units today seems like a threat sent to large medicine manufacturers: ‘We are going to start; come up and pay’- which was it. If not, why did they defeat in every way the two dependable medicine manufacturing plants already functioning in Kerala, owned by the very government? 

The Pharmaceutical Corporation of Kerala Ltd for Indigenous Medicine, marketing medicines under the brand name of Oushadhi, was started even before India gained independence from the British. Started in 1941 as Sree Kerala Varma Ayurveda Pharmacy by the Maharaja of Cochin, it became a registered co-operative society in 1959 and then in 1975 was registered under the Indian Companies Act and renamed as The Pharmaceutical Corporation (Indian Medicines) Kerala Ltd, Thrissur. It has modern manufacturing units, regional distribution units, a full-fledged Research and Development Centre and a wide distribution network. It hands over crores of rupees to government each year as dividend. But, when the question of procuring medicines for government came, they were pushed back far, to stand behind large private companies. Politicians and bureaucrats in government are suffocating this company on the hope that it would vanish for ever and clear the field for favourite private companies.

The Kerala State Drugs & Pharmaceuticals Ltd., a Public Sector Undertaking fully owned by the Government of Kerala, ‘has been manufacturing and supplying essential and life saving allopathic medicines to cater to the need of the common patients resorting to Government Hospitals in the State of Kerala’ since 1974. It is self-revealing to analyze how much they are favoured while procuring medicines for the state-owned Kerala State Medical Service Corporation. When the government directly purchased medicine from manufacturers in the past, this public sector unit still had a hope. When government established this particular corporation for procurement of medicine for government, good public sector companies lost all hope. This corporation with its undemocratic bureaucratic haughtiness has been favouring only private companies and has been behaving so from the first. When government directly purchased medicine, there indeed had been corruption by purchasing committees and directors of health services had been charge-sheeted with corruption, but corruption had been comparatively lower and transparency higher when compared with this corporation. It is not illogical to doubt if this corporation was set up to monopolize corruption in drug purchasing in Kerala.

The original news, announcing Kerala government’s decision to enter drug manufacturing field is here, as reported by Pharma Biz.

Kerala Govt. Planning To Set Up Drug Mfg. Units In Public Sector.

By Pharma Biz

Joseph Alexander, New Delhi
Thursday, October 25, 2012

Kerala, which is heavily dependent on other States for medicines, is weighing the options to set up manufacturing plants in the public sector on the lines of the central public sector pharmaceutical manufacturing units to make drugs affordable and accessible.

Kerala which accounts for more than 10 per cent of the national consumption of medicines has only a few manufacturing units to cater to the demand. Out of the 10,000 licensed manufacturing units in the country, the State may have only a few dozens of units, making it almost fully dependent on the other States, a senior official of the State Health Department told Pharma Biz.

“The Government is considering a proposal for setting up drug manufacturing plants in the public sector to make drugs affordable. Detailed modalities were being worked out and feasibility studies were being done. The working and profitability of the central public sector manufacturing units were also being examined to work out a model for the State,” he said.

The State also is weighing options like going for public-private partnership model. The objective is to make available quality healthcare to all at affordable costs, he said, adding that the State has already taken a number of initiatives to bring down the prices of medicines.

“We have a better distribution system with State-run stores to make affordable the drugs. However, the main problem now is the supply side and many were advocating the entry of the government to produce the medicines,” he said.

Referring to the Clinical Establishment Act which was already implemented by many States following the passage of the Bill by the Union Government, he said the State has initiated steps to formulate laws and adopt the same in the State with a view to improving the quality of care to patients by regulating hospitals and laboratories.

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=71823&sid=1

Republished here by courtesy of Pharma Biz Dot Com

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?

043. Dengue Fever: Do Not Give Aspirin Or Ibuprofen To The Patient.

Dengue Fever: Do Not Give Aspirin Or Ibuprofen To The Patient.

By Health India.Com

Dr. Reshma Nayak
October 4, 2013

The cases of dengue are at an all-time high this year, especially in New Delhi. While people are scrambling to find out more about dengue symptoms and its treatment, they don’t know something very important. Since dengue presents as a fever with body ache in the beginning, most people mistake it as a case of viral fever. They end up self-medicating themselves with either Aspririn or Ibuprofen. Now, this can be very dangerous and cause severe bleeding. Why?

The infecting organism in dengue affects the platelets which are responsible for clotting (stopping bleeding), increasing the tendency of the person to bleed. Aspirin and Ibuprofen also have similar action. Both of them together could cause the person to bleed excessively, pushing the patient into what is called the ‘Dengue Shock Syndrome’. And once in this stage, medical treatment is needed in an emergency basis and hospitalization becomes necessary.

So what is dengue?

It is a tropical disease, usually transmitted by mosquitoes and the common symptoms include fever, headache, muscle and joint pains and skin rash. There is no vaccine for dengue and the only way to reduce infections is to improve hygiene levels so as to prevent mosquito-bites and prevent mosquitoes from breeding. It’s particularly difficult to create a vaccine because it’s caused by different viruses and there are no animal models available for testing. The disease kills over five thousand Indians every year and is a seasonal threat, particularly during the monsoon seasons.

So what are the symptoms of dengue?

Characterized by severe flu-like symptoms, dengue affects infants, children and adults alike and could be fatal. The clinical manifestations of dengue vary with the age of the patient. A person suffering from high fever in the range of 40°C/ 104°F, accompanied by any two of the following symptoms could be suffering from dengue:

Severe headache
Pain behind the eyes
Nausea, Vomiting
Swollen glands
Muscle and joint pains
Rash

Symptoms usually last for 2-7 days. Dengue could progress to severe dengue, a potentially fatal complication, causing leaking of plasma, fluid accumulation, respiratory distress, severe bleeding and organ impairment.

The warning signs to look out for occur 3-7 days after the first symptoms along with a decrease in temperature are severe abdominal pain, persistent vomiting, and rapid breathing, bleeding gums, blood in vomit, fatigue, and restlessness.

Link: http://health.india.com/diseases-conditions/dengue-fever-do-not-give-aspirin-or-ibuprofen-to-the-patient/

Reproduced here by courtesy of Health India. Com

042. Iranian Technology To Control Dengue Through Larvicide.

Iranian Technology To Control Dengue Through Larvicide.
 
By Health India. Com
 
October 29, 2013
 

Authorities in Haryana’s Gurgaon district will experiment with an eco-friendly larvicide prepared by an Iranian company to control the spread of dengue and malaria, a spokesman said in Chandigarh on Monday. 

A delegation of scientists from Iran Monday met senior officials of the Gurgaon administration and Municipal Corporation and gave a presentation on how the larvicide could control the spread of these diseases. The delegation offered to give a sample of its technology.

‘This exercise will be completely on ‘no commitment, no costs’ basis. If the results are found to be fruitful, as per the claims of the delegation, then the larvicide would be used in whole of district Gurgaon on experimental basis as a pilot project,’ the spokesman said.

He said that the delegation had claimed that the larvicide is eco-friendly and only kills larva of mosquitoes. ‘It is harmless to plants, animals and even human beings. The water with this larvicide is safe for human consumption as well,’ the spokesman said, quoting the delegation. 

The delegation claimed that since 2000, when this larvicide was used in Iran to control malaria, number of cases of the disease reduced from 20,000 to less than 1,000 annually. It has been used in countries like Oman, Sudan, Turkey, Thailand, Nigeria and Malaysia, he added.

Link: http://health.india.com/news/gurgaon-to-try-iranian-technology-to-control-dengue/
 
Reproduced here by courtesy of Health India. Com 

041. Prevent Dengue With These 10 Practical Tips.

Prevent Dengue With These 10 Practical Tips.

By Health India. Com

Pavitra Sampath
July 10, 2013

With the monsoon come various diseases, and one of the most severe one is dengue. Also known as ‘break bone fever’ it is a painful and debilitating disease spread by mosquitoes. Caused due to the bite of an infected female aedes aegypti mosquito, the disease can be fatal. 

Once bitten, it takes about four to ten days for the symptoms to show. The most common symptoms are high fever, severe headache, pain behind the eyes, nausea, vomiting, swollen glands, muscle and joint pain and in some cases a rash. The more severe forms of dengue are hemorrhagic fever and dengue shock syndrome. There is no clear treatment for the condition nor is there a vaccine against it, so the best way is to prevent the disease from occurring at all. Here are a few simple and practical tips to keep dengue at bay: 

Aedes aegypti mosquitoes are known to bite humans during the day and their most common breeding grounds are man made containers. Therefore, it is advisable to not have any stagnant water around. Remember to clean out empty flower pots and not to over water potted plants. If the container that contains water cannot be emptied, remember to cover it well when not in use. 

Turn over empty pails and buckets, so that they do not collect excess water.

Use mosquito repellants regularly. Apply it well on all exposed areas, during the day as well as at night.

Make sure your window and door screens do not have any holes. If so, block those areas properly to eliminate mosquitoes.

If someone at home is ill with dengue, try to not let the mosquitoes bite them or others in the house.

Always sleep under a mosquito net.

If you use a cooler remember to empty out and clean the water tray regularly, even when not in use.

Always cover your trash can when not in use.

A natural method to keep mosquitoes at bay is to plant Tulsi near your window. The plant has properties that do not allow mosquitoes to breed. 

Using camphor as a repellant also works wonders. Light camphor in a room and close all the doors and windows. Leave it this way for about fifteen to twenty minutes to have a mosquito-free environment. 

Dengue is a completely preventable condition, all you have to do is take a few steps to keep yourself and your family safe. 

Link: http://health.india.com/diseases-conditions/prevent-dengue-with-these-10-practical-tips/

Reproduced here by courtesy of Health India. Com

Comment:

Platelet count in dengue:

How many numbers of platelets are present in blood after being affected by dengue? If the count of platelets decrease, will it lead to dengue?

Normal platelet count in a healthy adult is 140,000-400,000 platelets/cubic mm of blood. When infected with dengue virus, our body’s capacity to produce new platelets is affected. Platelet count starts decreasing below normal. Dengue is a viral disease spread by mosquitoes from one human to another. So, the only way it can really be prevented is by avoiding mosquito bites. Low platelet count per se does not cause dengue.

040. Molecular Diagnostic Kits For Chikungunya And Dengue Tests Coming.

HLL forays into molecular diagnostics with dengue, chikungunya test kits. 

By Pharma Biz  

New Delhi Bureau,
August 08, 2012

Kerala-based HLL Lifecare Limited, a mini ratna public sector undertaking with diversified business, will foray into molecular diagnostics area with a duplex test kit for chikungunya and dengue tests. The new multiplex molecular diagnostic kit, based on PCR (polymerase chain reaction), was developed by HLL in collaboration with the Rajiv Gandhi Centre for Biotechnology, also based in Thiruvananthapuram, said a release here.

Currently, HLL Life Care is in a tie-up with Kerala State Institute for Virology and Infectious Diseases, under the state government’s Ministry of Health and Family Welfare Department, for third-party validation of the diagnostic kits. The product will be launched in the market very soon. “This kit comes as the latest offering from our portfolio to ease the burden of the common man,” said HLL chairman and managing director, Dr. M. Ayyappan. The new product would facilitate conduct of the test with large through-put screening for management of diseases. It is going to be a handy tool in screening of patients on a large scale basis in an affordable manner, he said.

The 1966-founded HLL, the leading manufacturer of condoms, is strong-footed in the diagnostic business with its Hind Labs that provide a complete range of path lab services. The company is planning to extend the facility for other viral platforms as well. HLL has a factory located at Manesar in Haryana, exclusively catering to the manufacturing of in-vitro diagnostic test kits. This unit had started with manufacture of pregnancy test kits and is currently into production of kits for dengue and malaria, among other infectious diseases.

The epidemic of chikungunya continues to resurface in the country every year, especially during the monsoon season. In 2010, as many as 48,176 clinically suspected cases were reported from 18 states/union territories (135 districts), according to the figures from the Planning Commission. Likewise, dengue is endemic to 31 states and UTs. In 2006, the country witnessed an outbreak of the disease with 12,317 cases and 184 deaths, from 270 districts. In 2010, a total of 28,292 cases and 110 deaths reported from 403 districts, recording the highest number in the last two decades. 

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=70525&sid=1


Reproduced here by courtesy of Pharma Biz. Com

039. Kerala's E-Health In Dark Shadows

Bookmark this page; we update information regularly.

Kerala’s E-Health In Dark Shadows

By Special Correspondent

E Health is new to Kerala State in India and, considering the strange avenues into which massive corruption has penetrated into, we have decided to closely follow the state’s activities in this field from the very beginning to as far as we can follow in time and space such that when something happens good or bad, no one will have to wonder. When corruption occurs in large scale in this field which surely will and e-health in Kerala reported to be in shambles and disarray, there will certainly be investigations but within that time, millions of rupees will have gone. We wish to report things from the beginning so that we can pinpoint persons who were responsible when considerable amounts money are lost from public funds. We certainly will have repercussions, oppositions and even retaliation from those involved, which we do expect, which also we hope to report through these pages.

The centres of activities in implementing this project in Kerala are the Health Secretary’s office in Government of Kerala in the Secretariate, the Directorate of Health Services and the Mission Directorate of the National Rural Health Mission, all situated in Trivandrum. The first thing which was got done by those involved was getting prepared a report on the possibilities and scope of implementing e-health in Kerala which, we believe, was commissioned out to persons not in this field. This report got approved and then what we heard was media news about some funds being brought to Kerala, allocated by the Government of India. (We, in these columns earlier have reported the same). Some reported it to be 97 crores and some said it was only 92 crores but all wondered in secret where the balance did go, considering the usual rate of ten percent realized by political agents in India for getting a project approved and financed. Government of India usually allots 100 crores. It is inconceivable that the full amount reached Kerala, if it did, in contradiction to North Indian standards. Or has our country progressed beyond being a puritan state?

All digital health activities in a state will have to be controlled and monitored from a single centre, to minimize theft of confidential patient data which is costly and which would be beneficial to a multitude of commercial organizations from insurance companies to health psychic predictors. We will be startled at the incompetence and lack of imagination with which the Directorate of Health Services operates its own simple website, let alone the massive and complicated encrypted data flow in connection with e-health governance. It is a crude website where people cannot interact; data are scanty, incomplete and unreliable, what shall be there is not there and what shall not be there is there, data never updated since inception and pages will not open and if they open will have only a few irrelevant sentences. We enquired and learned that there was no one there to do these things except temporary hands lent by peripheral institutions. No one can believe that such gross neglect and ignorance can be engaged to monitor the digital clinical maneuvers in the whole state, unless the same is outsourced-something feared in even England, United States, France and Germany. Insurance companies alone will spend a million dollars to see central stores of people’s health data established. Let us take the example of the E-Health Link in the DHS’ web site:

Since the starting of this digital front of the state’s health in 2013, the E-Health link remains skeletally maintained and laughable; it has no important data or information to display. See a snap-shot of this page as on 19 March 2014 which is self-revealing. There is not mention of the important things in the field that have happened! The importance is laid not in enlightening people on this new subject which even these ‘authorities’ know nothing about and which is going to affect people’s lives every way, but on how the 92 crores could be spent safely without public interference.

An Expression of Interest in May 2013, an inevitable corrigendum six days after, four ridiculous queries the same month- this was all. And it was the month of the greatest digital activity in this Directorate- or that was what they wished to make public. Five Months later, in October 2013, there was application invited for the post of Manager but no mention of who applied for and who was selected.  

The Expression of Interest was posted on 3 May 2013 with a deadline on 18 October 2013 with no mention after the deadline of who expressed interest and who were approved and short-listed. Note that this was a period in Kerala when the greatest number of fraudulent people and organizations submitted bids and took part or collaborated in heavily-funded government projects, with Solar Scam in the lead. No wonder the names of people who expressed interest in government’s e-health project could not be publicized!

Things are dubious and large amounts of public money are involved. Why permit them to steal away people’s money in leisure instead of going after them and following every move? We know that there is a Vigilance Wing in the Directorate of Health Services, administered by an Additional Director of Health Services who does nothing but hunt petty lowly employees like Hospital Attendants, Nursing Assistants, Nurses and Clerks. How many doctors and officers of authority did they found out guilty and charged in the past 25 years? Their main duty is to hand over the names of those who report corruption and misdeeds to reported culprits, their actual subordinates! Never did they detect something in their own initiative without someone reporting or complaining. That is the same situation with the government’s vigilance department. No one in vigilance detects something on their own account. Everything has to be detected by people or newspaper reporters and details conveyed to them. Then they will investigate, reluctantly.

So it is now our own duty to detect and report, which we shall do; let us see what they do to charge-sheet and punish them, if there happens to be something punishable. We, decided to follow two routes- private investigation and the broad route of the Right to Information Act. What our private investigations revealed shall be reported to you readers later in its time but we find it nothing inappropriate to publish in time to time what we found out via the broad path.

Here is our original Registered Letter to the concerned Public Information Officers on 20 March 2014. We think these questions we asked are pertinent, which everybody may wish to ask:

Application for information under the Right to Information Act

To

The Public Information Officer,

Government of Kerala, Secretariate, Trivandrum.

Department of Health and Family Welfare,

Government of Kerala, Secretariate, Trivandrum.
Directorate of Health Services, Trivandrum.
Directorate of National Rural Health Mission, Trivandrum.

Dear Sir,

I request you to kindly make available to me under the Right to Information Act, in writing, the following information which is not classified, within the prescribed time limit. I have affixed Rs.10/ worth of Court Fee Stamps as fees.

Does Kerala State Government wish to implement E Health in Kerala?

If yes, which are the agencies/offices through which it is to be implemented? Have the Government of Kerala Collaborators/ Nodal Agencies for formulating/implementing this project?

Did Government of Kerala or any of its departments/offices/collaborators receive any funds from anywhere for formulating, developing or implementing E Health project, and if so, who is the custodian of this fund? Please give name and full official and postal address.

If funds were received or offered, which were the sources of such funds? Please give specific details of communications allowing/releasing/offering of such funds.

Were any amounts from the funds transferred to any individuals/ establishments/ organizations on account of fees, services, salaries, honorarium and/or allowances? If so, please give the mode of payment, their names and full postal addresses and reasons for transfer of money, along with details of cheques, demand drafts and acquittances.

Were any advertisements given in any media inviting Expression of Interest on this project, and if so, where? What were the dead lines and who were the persons/institutions/organizations who expressed their interest? Please give full postal addresses.

Did the names and addresses of those who expressed interest in the project published in media where the original invitation for EOI was advertised, and if not, why? Where else was it published?

Which are the posts created for implementing this project? Please give full pay scales, incentives and other perks.

Where were advertisements inviting applications to these posts published? Please give specific links and dead lines.

Who were selected for each post? Please give their names, full postal addresses and the last institutions where they served with name of designation and period of service there. Were their names and posts published anywhere?

Which posts are yet/proposed to be created in connection with this project and when and where are they going to be advertised?

Please include names and addresses of Appealing Authorities also in your reply.

Sincerely Yours,

P.S.Remesh Chandran, Padmalayam, Nanniyode,
Pacha Post, Trivandrum-695562, Kerala.
Dated: 20 March 2014.

We sent these requests by registered post, and they have 30 days time to give us their answer, if they give in time which is unusual. We will wait and post their replies here, along with papers of appeal if it goes up to there. Meanwhile we will see what other things happen in this field.

Here is a book being announced and we would like to add excerpts from the book here for the readers’ knowledge:

The RTI Letter we sent to The Public Information Officer, Government of Kerala, Secretariate, Trivandrum was returned by the Indian Postal Department, with the endorsement, ‘Not Sufficient Address’ and not with ‘There Is No Such Addressee’. We know government functions through its various departments, but why as a single entity government did not appoint a Public Information Officer? It is dubious. A delivery postman, as per rules, cannot determine in his office whether the designation exists or not or whether the concerned officer would accept it or not, provided the name of the government office and the place where it functions is printed in the address. He certainly has to take the letter to that office. So we shall assume the postman did take the letter to the office but the officer-in-charge declined to accept the letter. What right has a government officer to reject a letter from a citizen addressed to government, on the basis of whatever technical grounds? Even if a citizen does not mention the Right to Information Act in his letter, is not the government liable to convey the information he requested?

The Department of Health and Family Welfare sent a reply signed by one Mr. Sudarsanan, Additional Secretary, which stated that ‘the Government of Kerala implemented the e-health through the National Rural Health Mission and details are available with them’. Does not this department have a Public Relation Officer to reply to RTI letters and why is that designation absent in this reply? He did convey information on point number 1 but omitted point numbers 2 to 10. If government is implementing E-Health in Kerala, why are not details available with Government of Kerala but only with NRHM which is not Kerala Government’s? What kind of a government and what kind of an administration is that? Why are details not available in Secretariate, the seat of government? Are details of E Health available in Secretariate or not? Or is this dubiousness to hide facts or prevent contradictory information from being released from two sources, i.e. from Government and NRHM? These are the usual questions which rise in the minds of common man. We are certainly raising these issues of discrepancy with this department’s Appellate Authority. We are credibly informed that the bids mentioned in the beginning are being finalized on the extended date and things are being kept secret till then.

Shady Recruitment Procedures Adopted For Several E Health Posts.

Dubious advertisements appeared in equally dubious places, inviting applications to these posts. In one place, the How to Apply link leads to admissions section of the Manipal University and the CLICK HERE MORE DETAILS FOR THIS JOB link leads to http://dhs.kerala.gov.in/index.php/transfer where there is nothing about these posts. The DHS, NRHM and Arogya Keralam have nothing to show on these posts in their websites. It is an old trick- to advertise in places where no one will look and even if someone looks there, the links shall lead to nowhere. It is clear these posts are reserved for favourites, to be recruited through shadow agencies. And the posts do have handsome salary packages, in Kerala standards.

1. Finance Manager 50,000

2. Administration Manager 50,000

3. Technical Manager 50,000

4. Manager (Change Management) 50,000

5. Asst. Manager (Finance) 30,000

6. Asst. Manager (Admn) 30,000

7. Office Assistant 15,000

The following was one of the advertisements (or the only advertisement?) for these posts in e-health. It was online and it appeared in one of the shadiest of places:

‘Directorate of Health Services (DHS Kerala) hiring Managers & Office Assistant (CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree holders). Applications are invited for the following posts in the eHealth Project Management Unit (eHealth PMU) on contract/deputation basis. The contract basis appointment will be for a period of two years. Deputation basis appointments will be based on Government rules. Maximum age limit for posts 1 to 6 is 58 years and for post 7 is 40 years as on 01-01-2014. All the postings will be in Thiruvananthapuram.

Company Name: Directorate of Health Services (DHS Kerala)

Position: Managers & Office Assistant

Education: CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree

Experience: 3-10 yrs

Location: Kerala 

Applications may be send to State Mission Director, NRHM, General Hospital Junction, Trivandrum – 35 so as to reach the office on or before 12-03-2014.’

http://www.hirelateral.com/directorate-of-health-services-dhs-kerala-hiring-managers-office-assistant/

Who make money and who use government projects to do favours and repay favours received? So, that's why this great reluctance in conveying information under the right to information act. If what usually happens in Kerala happens in this project also, we will see that the relatives of the very authorities who were bound to give information out were undergoing the recruitment process. 

Updated as on 26 April 2014, 02:35 PM

So, as we feared, government do not know who the custodian of the 92 crores they gave is. The NRHM Directorate also does not know who the custodian of this amount is and how it is spent. See the reply from Smt. Vijayalekshmi P. Nair, Senior Administrative Assistant. We have to wait for months for an information which is available under the roof of a building adjacent to her own office building.

Updated as on 30 April 2014, 12:47 AM

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