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The Hindu Editorial Analysis | 17th July ’20 | PDF Download

Beds don’t treat patients: Doctors do | ToI

  • Leading epidemiologists predict that by 2021, India will have millions of Covid-19 infected patients.
  • Let us prepare for the worst and pray for the best.
  • Focus: reducing mortality, especially in rural India.
  • The first round of the Covid battle was won by doctors and nurses working mainly in government and some private hospitals.
  • At both private and government hospitals, we are not short of beds.
  • Our doctors and nurses are tired and burnt out.
  • Who can take care of sick Covid patients?
  • The ideal doctor to do so in the ICU is an MBBS doctor who has worked in a critical care unit for at least two years.
  • They should be less than 50 years old and fit.
  • They should have the skill to insert monitoring lines into blood vessels and maintain vitals.
  • Some of them should be experienced enough to paralyse a patient, insert a tube into the lungs to ventilate.
  • These are extremely skilled jobs.
  • A minor mistake can endanger the patient’s life or their own lives.
  • It’s not true that every doctor can look at the cardiac monitor in the ICU, diagnose and treat.
  • To manage 1,000 private and government hospitals with over 200 beds for a year we need at least 50,000-75,000 young MBBS doctors who, after internship have gained experience in medical ICU or surgical ICU or coronary care unit, accident and emergency rooms.
  • A 200-bed Covid hospital will need at least 50-75 specialist doctors, 500 nurses to cover 6-hour shifts, weekly off and sickness leave since a few of them will get infected.
  • How to get 50,000 young trained specialist doctors for Covid ICUs?
  • Generally ICUs need 20% of doctors who are trained in the critical care unit/ anaesthesia or emergency rooms.
  • 80% of the doctors should have the knowledge to interpret the data from the cardiac monitor, biochemical and haematology results, and act on them.
  • About 25,000 young medical specialists who have completed three years of training in clinical specialties in teaching hospitals under MCI or DNB banner and are waiting for the final DNB or MD, MS exams.
  • Most of these skilled doctors are currently jobless since they do not have a postgraduate degree.
  • According to Dr Manoj Gupta, ambassador of DNB Doctors Association, most of these doctors will be happy to serve Covid patients in district hospitals for a year if exempted from the exams.
  • About 3,000 doctors who underwent a fellowship programme for 2-3 years after internship as intensivists in large private hospitals and acquired great skills.
  • According to Dr Dhruva Choudhury, president of Indian Society of Critical Care Medicine, most of these specialists will be delighted to work in Covid hospitals in districts provided the Medical Council of India (MCI) recognises them as “intensivists”.
  • About 1,200 young medical specialists who after internship spent 3 years working in emergency rooms, resuscitating critically ill patients and certified as emergency medicine specialists under the Society of Emergency Medicine.
  • Most of them will be happy to work in Covid hospitals for one year provided MCI recognises them as emergency medicine specialists.
  • About 1,700 young specialist doctors who after the internship spent 2 years in large heart hospitals and gained experience in non-interventional cardiology and coronary care units.
  • According to Dr Rajesh Rajan, chairman of Association of Clinical Cardiologists, most of them will be delighted to work in Covid ICU for a year, provided their diploma degree is recognised by MCI.
  • About 90,000 Indian doctors who are trained in Russia and China couldn’t clear the Indian exit exam.
  • Good number of them are working as physician assistants in critical care units across India.
  • If we can choose about 20,000 brightest young doctors and make an offer to work as junior doctors in Covid hospitals for a year in return for exemption from exam, we’ll get an adequate number of junior doctors to tide over the crisis.
  • There are about 2 lakh final year nursing students who finished training waiting at home for the final exam.
  • Most of them will be happy to work in Covid hospitals provided they are exempted from the final exam and recognised as ICU nurse practitioner on additional 1 year of ICU service.
  • Healthcare industry is rigidly regulated, which only recognises degrees even with basic skills.
  • For example, any doctor who spends 10 years working full time as an anaesthesiologist post-MBBS, and acquires great skills but without “MD in anaesthesiologydegree, is legally not allowed to anaesthetise patients independently.
  • However, the aim should be to create a large floating skilled workforce of doctors and nurses who can be deputed where Covid peaks, especially to protect rural India.
  • The Covid crisis has clearly demonstrated that government job or money will not attract MBBS doctors, postgraduate degrees will.
  • This offer can be entirely optional.

In exchange for their service to Covid patients if MCI as an exception recognises their skill, a few thousand precious lives can be saved.

The lost voice of the Indian university | TH

  • In the 19th and 20th centuries, Indian universities emerged as institutions where a privileged generation of colonial subjects trained to serve the colonial regime and further Western political ideals.
  • Some graduates went on to serve the colonial state, while others contributed to the nationalist movement.
  • In the 20th century, the growth of nationalism, liberal education and the process of de-colonialisation offered universities with an opportunity to revise the curriculum and to define new goals.
  • Right after independence, focus was on nation-building.
  • The Indian Institutes of Technology and Indian Institutes of Management along with other distinctly envisioned institutions of academic excellence like the Indian Institute of Science, Indian Statistical Institute, and Jawaharlal Nehru University emerged as model institutions that defined the new academic ethos and the vigour of the modern Indian nation.
  • These institutions got institutional and academic autonomy.
  • Other universities in India also took the lead, revised curricula and set about the task of reforming the university as a space for healthy academic engagement.
  • These changes were marked by the growing importance of various large representative institutional bodies like faculty committees, committees of courses, board of studies, university senates, academic councils and executive councils.
  • These bodies oversaw the administrative and academic functioning of the university and ensured a collective decision-making based on serious academic deliberation.
  • It was here that academicians contested each other’s claims over ideological positions, scholarly beliefs, collectively shaped curricula and defined the fertile learning space that these institutions of higher learning espouse.

A new intellectual regime

  • National Knowledge Commission
  • Strong emphasis on privatisation of education
  • Discussions within various academic bodies were discouraged
  • Bureaucratic centralisation
  • Academicians were disenfranchised of their role in designing curricula and their own academic work was removed from the regulatory gaze of peers to that of the government bureaucracy.
  • During this period, the university emerged as an extension of government.

Bureaucratic centralisation

  • The manner in which the Central government and the University Grants Commission have imposed themselves on the daily functioning of all higher educational institutions (Central, State and private) represents a new government-oriented bureaucratic centralisation.
  • Decisions about the conclusion of academic term, the modalities for evaluation and the conduct of the teaching-learning process have become exclusive government prerogatives overnight.
  • In the last 15 years, the government and Central regulatory agencies have systematically transitioned from being external facilitators to becoming decision-makers within institutions of higher education.
  • At a time when global politics is undergoing a systemic transformation and being infused with new ideas, institutions of higher education, which ought to be fertile intellectual spaces that can inform and shape society, are increasingly being undermined in India.
  • The time has come for institutions of higher education in India to recover their lost voice and restore the fertile academic space where ideas are discussed and debated rather than suppressed and dismissed.

For equal treatment

  • Delhi High Court, 2012: “people suffering from disabilities are also socially backward, and are therefore, at the very least, entitled to the same benefits as given to the Scheduled Castes/Scheduled Tribes candidates”.
  • Supreme Court has recognised the travails of the disabled in accessing education or employment, regardless of their social status.
  • Under-privileged and under-represented section.
  • A counterpoint to the idea of eliminating the distinction between the disabled and the Scheduled Castes and Scheduled Tribes may arise from those questioning the attempt to equate physical or mental disability with the social disability and experience of untouchability suffered by marginalised sections for centuries.
  • For instance, the social background of disabled persons from a traditionally privileged community may give them an advantage over those suffering from historical social disability.
  • However, this may not always be the case.
  • Educational indicators captured in the 2001 Census showed that illiteracy among the disabled was much higher than the general population figure.
  • The share of disabled children out of school was quite higher than other major social categories.
  • The 2001 Census put the illiteracy rate among the disabled at 51%.
  • There was similar evidence of their inadequate representation in employment too.
  • The 2016 law sought to address this by raising the quota for the disabled from 3% to 5% and envisaging incentives for the private sector to hire them too.
  • It is vital that this is fully given effect to so that this significant segment of the population is not left out of social and economic advancement.

State of deluge

  • In the last week of April, Assam Chief Minister Sarbananda Sonowal took stock of the state’s flood preparedness.
  • Less than a month later, the river Brahmaputra swelled up and has been in spate ever since.
  • In spite of the CM’s directives, the state administration seems to have been caught unawares.
  • At least 65 people have lost their lives.
  • More than 35 lakh people in 26 districts of the state have been affected.
  • Nearly 90 per cent of the Kaziranga National Park is reportedly submerged.
  • Ecologists point out that flood waters have historically rejuvenated croplands and fertilised soil in the state’s alluvial areas.
  • But it’s also a fact that for more than 60 years, the Centre and state governments have not found ways to contain the toll taken by the raging waters.
  • The state has primarily relied on embankments to control floods.
  • This flood control measure was introduced in Assam in the early 1950s when the hydrology of most Indian rivers, including the Brahmaputra, was poorly understood.
  • The river changes course frequently and it’s virtually impossible to contain it within embankments.
  • Several of the state’s embankments were reportedly breached by the floods this year.
  • Guwahati’s topography — it’s shaped like a bowl — does make it susceptible to water logging.
  • Document of “Mission Flood Control Guwahati” — a programme of the Assam government and the city’s Metropolitan Development Authority — correctly points out, “the unplanned expansion of the city… has led to severe encroachments in the wetlands, low lying areas, hills and shrinkage of forest cover. The denuded hills and loss of wetlands lead to artificial floods”.
  • The document also notes that rainwater from Meghalaya and the surrounding hills often causes flash floods in Guwahati.
  • However, recognition of the problem has not led to any meaningful conversation between the two states on flood control.

NEWS

  • High-Level Segment of the United Nations Economic and Social Council session
    • Prime Minister Narendra Modi will deliver a keynote address virtually at this year’s High-Level Segment of the United Nations Economic and Social Council session today at the United Nations in New York.
    • The Prime Minister will be speaking at the valedictory session along with the Prime Minister of Norway and UN Secretary General Antonio Guterres.
    • The annual High-level Segment convenes a diverse group of representatives from the Government, the private sector, civil society and academia.
    • The theme of this year’s High-level Segment is Multilateralism after COVID19: What kind of UN do we need at the 75th anniversary.
    • This session will focus on critical forces shaping the course of multilateralism and explore ways to bolster the global agenda through strong leadership, effective international institutions, a broadening of participation and enhanced significance of global public goods.
    • This will be first opportunity for Mr Modi to address the broader UN membership since India’s overwhelming election as a non-permanent member of the Security Council on 17th June, for the term 2021-22.
  • The Government said that less than two percent of the COVID affected patients are admitted in ICUs.
    • Inaugurating the Rajkumari Amrit Kaur OPD Block of AIIMS Delhi, Union Health Minister Dr. Harsh Vardhan said, gradually we are moving in the direction to win the battle against the pandemic.
    • The Rajkumari Amrit Kaur OPD Block has been built in an area of approximately six thousand 300 squar metre, which is the largest known OPD in the country.
    • The new OPD Block has SMART Lab, built at the cost of 15 crore rupees.
    • It has a capacity of expansion up to 2 lakh tests per day, with a handling capacity of more than 10 thousand patients per day.
    • He said, the lab network has been strengthened in the country and at present, a total of one thousand 234 laboratories are conducting the test for Covid-19.
    • He said, the number of the recovered COVID-19 cases continues to increase steadily.
    • The Central Government said the total number of recovered people from coronavirus crossed the six lakh mark today.
    • A total of six lakh 12 thousand 815 people have recovered so far and with this the recovery rate reached to 63.25 per cent in the country.
    • In the past 24 hours, a record 20 thousand 783 people have recovered.
    • Presently, the total number of active corona cases in the country is three lakh 31 thousand 146.
    • The Health and Family Welfare Ministry said, a total of 32 thousand 695 new cases of Covid-19 have been reported in the country in the last 24 hours taking the total number of cases to nine lakh 68 thousand 876.
    • This is the highest number of cases registered in a single day since the outbreak of the pandemic in India.
    • 606 deaths have also been reported taking the nationwide toll to 24 thousand 915.
  • The fourth phase of the Vande Bharat Mission which is currently underway has been augmented with addition of around 120 new flights between 15th and 31st of July.
    • External Affairs Ministry spokesperson Anurag Srivastava said, these additional flights will cater to demand for repatriation from GCC countries, Malaysia, Singapore, UK, Europe, Kyrgyzstan, and Ukraine.
    • With this, this phase now has 751 international flights catering to 34 airports in India.
    • As of 15th July, 6 lakh 87 thousand 467 Indian nationals have returned.
  • Defence Minister Rajnath Singh will undertake a two day visit to forward areas of Jammu and Kashmir and Ladakh starting today.
    • Army Chief General M M Naravane will accompany him. During this visit, they will review the security situation in Eastern Ladakh.
    • Senior Defence officials including the Northern Army Commander will also  accompany Mr Singh.
    • This will be Defence minister’s first visit to Ladakh since the faceoff with China commenced.
    • Mr Singh is likely to visit Atal Tunnel, previously known as Rohtang Tunnel, named after former Prime Minister Atal Bihari Vajpayee
    • This is a highway tunnel being built under the Rohtang Pass in the eastern Pir Panjal range of the Himalayas on the Leh-Manali Highway.
    • At 8.8 km length, the tunnel will be one of the longest road tunnels in country and is expected to reduce the distance between Manali and Keylong by about 46 kilometres.
    • Strategically important Manali-Leh highway is used by the Army to transport essential material to the soldiers deployed in the border areas of Ladakh.
  • External Affairs Ministry today said South China Sea is a part of global commons and India has an abiding interest in peace and stability in the region.
    • External Affairs Ministry spokesperson Anurag Srivastava said India’s position on this issue has been clear and consistent.
    • He said, India firmly stands for the freedom of navigation and overflight and unimpeded lawful commerce in these international waterways, in accordance with international law, notably UNCLOS.
    • Nepal Prime Minister’s recent comments on Lord Ram, the spokesperson said India’s rich civilizational heritage is known to the world. He added that Nepal Foreign Ministry had already given clarification in this regard.
  • External Affairs Ministry today said Indian officials have proceeded for the meeting with Kulbhushan Jadhav on the basis of assurances provided by Pakistan.
    • Ministry spokesperson Anurag Srivastava said, India has been requesting for an unimpeded, unhindered and unconditional consular access to Kulbushan Jadhav.
    • He said, the situation will be assessed after officials return and provide a report.
    • Mr Srivastava also said, India strongly protested against construction of Diamer Basha Dam to Pakistan government.
    • He said, it will lead to submergence of large part of land of Jammu and Kashmir and Ladakh.
    • He said, India condemns attempts by Pakistan to bring about material changes in Indian territories under its illegal occupation.
  • India and China have been engaged in discussions through established diplomatic and military channels to address the situation along the LAC in India-China border areas.
    • External Affairs Ministry spokesperson Anurag Srivastava said, the two sides remain committed to the objective of complete disengagement and full restoration of peace and tranquility in the India-China border areas.
    • The process of disengagement along the LAC is complex and therefore, unsubstantiated and inaccurate reports need to be avoided.
    • He said, this mutual re-deployment should not be misrepresented and there is absolutely no change with respect to India’s position on the Line of Actual Control.
    • India is fully committed to observing and respecting the LAC and any unilateral attempts to change the status quo along the LAC are not acceptable.
  • National Commission for Women has taken cognizance of police brutality where a farmer couple was assaulted for trying to stop their crops from being destroyed by the revenue officers in Guna, Madhya Pradesh.
    • The Commission chairperson Rekha Sharma has written to State DGP for ensuring swift and fair investigation in the matter.
    • The farmer couple drank pesticide in front of police after administration destroyed  their crop.
  • The Government today launched the implementation guidelines for Animal Husbandry Infrastructure Development Fund, AHIDF worth 15 thousand crore rupees.
    • The fund was approved by the Union Cabinet last month under the Atma Nirbhar Bharat Abhiyaan stimulus package for ensuring growth in several sectors.
    • Launching the guidelines, Fisheries, Animal Husbandry and Dairying Minister Giriraj Singh said, government has been implementing several schemes for incentivizing the investment made by dairy cooperative sector for development of dairy infrastructure.
  • As per World Intellectual Property Indicators-2019 Report, India has emerged as the top tenth nation in the ranking of the total (resident and abroad) Intellectual Property (IP) filing activity.
    • With government push to schemes like ‘Make in India’, ‘Skill India’ and now ‘Atma-nirbhar Bharat’, IP Filing and grant activity is likely to increase.
    • Industry 4.0 is witnessing new inventions and breakthroughs as it faces challenges in providing the right environment to stimulate innovation, especially in Artificial Intelligence and Machine Learning.

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