Sunday, 26 October 2014

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?


Saturday, 25 October 2014

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.



  

Sunday, 19 October 2014

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,




Monday, 7 July 2014

051. Hospital Window Poems Released In You Tube. Aaspathri Jaalakam Kavithakal

051. Hospital Window Poems Released In You Tube. Aaspathri Jaalakam Kavithakal

Visit Bloom Books Channel To See These Videos

By Special Correspondent,
Kerala Health Research Online






 

The first-of-its-kind Hospital Window Poems, Aaspathri Jaalakam Kavithakal, has now been released in the world's largest video site, You Tube. They are released by Bloom Books Channel. Presently there are only 8 song videos in this album but the publishers have claimed that this series may or may not continue, depending......They also claim that they  have been approached by a few for adapting these songs for T.V. and producing as full length films which will launch a new trend in Malayalam film-making.

Written by P.S.Remesh Chandran and first released in print in February 1999, it was included in the book Kaalam Jaalaka Vaathilil. Recited, recorded and released as video by him in 2014. This is the first series of song videos ever to appear on this subject of the world of virtues and vices in hospitals. Almost all news papers and magazines in Kerala declined to publish these songs at that time. The Kerala State Health Services Department denied Pension and Every Other Service Benefit for 33 years to the employee who wrote these lines, and threw him out penniless. He was one of their best and truthful employees. Before his time too is past, he let Bloom Books Channel to let the world listen to what poor hospital victims have to tell the world, the first-hand experience of an inside person. If anyone sees any resemblance to persons, incidents or situations in real life, it is because every song in Aaspathri Jaalakam Kavithakal versifies real-life incidents and situations. Truth has the divine right to come out.

These videos are produced in the MP4 format and optimized for finer view in computers and other devises. So, it is better to download them and play in computers, laptops and other devises than viewing on web.

Here are the thumb nails and links to these song videos.

1. MR 014 Dokdarennoru Naamam Kettaal.....


https://www.youtube.com/watch?v=LfuUZqoJ5uM

 
2. MR 015 Oridatthoru Bassapakadam..... Nissabda Desam


http://youtu.be/ADaWq_IjZtc

 
3. MR 016 Aasupathriyil Pandu..... Ekaantha Veliccham.



http://youtu.be/qd8JFArpVxs


4. MR 017 Medikkal Kollege Hostalinte..... Raagging http://youtu.be/g0FdRVR-T9k


http://youtu.be/g0FdRVR-T9k

 
5. MR 018 Penshanaay Nilkkunna.... Panam Kaaykkunna Kendra Maram 




 
6. MR 019 Maanassikayaarogyatthin Kendratthin Sooprantariyaan..



http://youtu.be/jmR97XsmZQ8

    
7. MR 020 Aarogyavakuppinte Addhyakshannariyaanaay.....


http://youtu.be/ATnST7yB8DI

 
8. MR 021 Kurupuzha Ninnoru.... Aaspathri Jaalakam



http://youtu.be/t7Rf9Ec-sMc



Bloom Books Channel in their videos has declared that they belong to the Fifth Estate and believe in instant publishing and world audience, and that they will not commit themselves to the Fourth Estate.


Kerala Health Research Online
7 July 2014

 




Tuesday, 15 April 2014

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





   


Thursday, 10 April 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