Archive for the '- Public health' Category

Pregnancy kits for rural brides

charukesi June 18th, 2008

Puzzled over this since I read it a couple of days ago - Government’s gift for rural brides: Pregnancy test strips!

The government will give packets of pregnancy test strips to rural women on the occasion of their marriage - to reduce unwanted pregnancies and maternal mortality across India
. So how are pregnancy kits a way to avoid unwanted pregnancies?

So has the government accepted defeat over its family planning program and has decided that abortion is better than prevention? Whatever happened to varmala ke saath saath aur ek mala ko dhyan me rakhna? and all that?

The morning after

charukesi November 13th, 2006

I read this piece on India Together - Morning-after pills seized in Chennai - a while ago, shook my head in disbelief, book-marked it and forgot about it. Yesterday, I read Harini’s posts on sex and sensibility - I try not to be judgemental about it - but there is something fundamentally wrong when a 15 year old goes for a MTP not because she had sex, but because she did not know about safe sex - and why, because their mothers did not want to talk to their daughters about it since it was “not part of our culture”. Right.

In the case of the morning-after pill which were to become available OTC from October, the Tamilnadu government’s drug controller seized stocks from Chennai’s pharmacies responding to protests - that such medical aids promoted free sex and took away responsibility from the act of sexual intercourse.

More from the article - In what was seen as a major step forward for the reproductive rights of women, in September 2005, the Drug Controller General of India officially made a levonorgestrel-based EC available over the counter. But the Chennai-based Responsible Parents Forum and Satvika Samuga Sevakar Sangam are seeking to challenge that order.

The Responsible Parents Forum and the Association for Social Welfare have jointly decided that what is required is not a step forward but several steps backward, preferably with eyes tightly shut to the real world out there. And they have gone ahead and got the drug withdrawn from the market. Serves you right, you immoral girls.

Please read the entire article at India Together and Harini’s post - it is scary to think of how we persist with the speak-no-evil-see-no-evil-andhey-there-IS-no-evil (sex = evil in this context) attitude. What about women who are vulnerable - rape victims, women who have been forced into the sex act but wish to avoid pregnancy, even within a marriage? Or simply, women who have had sex out of choice but aree not ready for a pregnancy?

Reproductive rights, please go take a walk. Morality, take a bow in the meanwhile.

AIDS, adoption and ipods

charukesi February 10th, 2006

A few things that have been disturbing me over the last week or so… random, casual lines heard or read, images that make me shudder every time I think of them, attitudes that make me despair… they pop up at inconvenient times, little imps that dance in my mind, those morsels I have not been able to swallow or throw out…

Just finished reading Dr. Abraham Vergehese’s book My Own Country (picked this up based on a faint memory of something I had read on Uma’s blog ages ago) and the after-taste refuses to go away. The book is a doctor’s account of facing and fighting with AIDS deep inside the bible belt of the USA. I found it a humane and honest narrative of the early years of AIDS from a doctor who is involved, compassionate and finally finds that he is living with the disease too, not in exactly the way his patients are but the disease takes over all his waking and sleeping moments…

Here is a line that got me thinking… Gay may have been what he did but it wasn’t who he was… ( a patient’s sister)… What a person does only a part of what he really is - how many of us are able to separate the two this way?

I keep reading reports about misconceptions about the virus and the disease, stigma and basic ignorance… More than twenty years after the disease first reared its head, the stigma remains… Like one of Verghese’s patients who saw himself (and his wife) as innocent victims who had been infected through a blood transfusion. And by extension, other victims not so innocent…? got what they deserved

***
From a link ammani forwarded me a long time ago…
That to me is like is stealing someone’s baby and claiming adoption. Nothing wrong with it at all, but do not say it is your baby — that’s insulting the kid and hiding your inability to produce one yourself .

And then says the author, (The above para has been altered to avoid more comments from my ‘holier-than-Thou’ readers)

And that is the altered version. Read the original version…

‘That to me is like is adopting a kid. Nothing wrong with it at all, but do not say it is your baby — that’s insulting the kid and hiding your inability to produce one yourself.’

Oh, the inability to produce a child… here we go again… do adopt a child, nothing wrong with it (thanks) but don’t call it your own… yeah, right.

And this is not in any treatise on adoption or child bearing. These are lines thrown casually and callously into a review of the movie Zinda by journalist Sudhish Kamath who writes for the Hindu. Like there is not enough prejudice in the country already against adoption…

I know this was a long time ago but this post on caesarean deliveries on Sujatha’s blog and some of the comments on the post put me in mind of this again… (no specific reference to any one of the comments here)

***
And finally, the nightmare of development agencies, well-meaning and clueless donors… There, I have cleaned out my cupboard and conscience at the same time

ineedmantis

[through gizmodo]

I am thinking about the glut of old clothes donated during the tsunami relief efforts and about the 100 dollar laptop (much as Abi and I agree to disagree on our respective faith in leapfrogging development)…

Sex, AIDS and mosquito bites

charukesi December 12th, 2005

Students fear AIDS could spreads through kissing, says report in todays’ ToI. While students were generally found to be knowledgeable about HIV/AIDS, the survey found they had misconceptions about transmission. A large number of believed that kissing (40%), hugging (29.7%) and sharing of clothes (25.4%) caused viral transmission. A shocking 45.1% thought that mosquito bites could cause transmission.

Here is more - Sharing of toilets and eating out with HIV-infected persons was an issue with the students with up to 25.4% saying that it could cause viral transmission.

This from a survey conducted by the Wockhardt-Harvard Medical International HIV/AIDS Education and Research Foundation (WHARF) based on interviews with 1,179 junior college boys and girls. If this is the knowledge level about transmission of AIDS among the young who are the main target group for this disease - global figures indicate that 50 percent of persons infected every year are below 25 years of age… Makes me wonder about the effectiveness of AIDS and HIV related communication campaigns that we see all the time.

Scary…

***
I tried looking for the link to this article on the ToI website but couldn’t find it - I have copied this from their epaper. However, I did find this on their home page - Urmila Matondkar at the Dubai International Film Festival. Oh, and this too - Big B watches Ek Ajnabee in hospital. Why am I not surprised? Surely, Urmila Matondkar makes for better copy than a bunch of ignorant students.

Hiv-hope news updates

charukesi October 27th, 2005

The Science blog had carried this piece recently, HIV Mortality in India Drops with Introduction of Generic Antiretroviral Therapy. The survival rate of HIV-infected patients in India has risen in response to a 20-fold drop in the price of antiretroviral therapy (ART).

The piece ends with this very important point. Making HIV-infected people aware of affordable treatment options is an important additional step toward curbing the spread of a deadly disease in a resource-poor country. True, very true.

Mzansi Afrika reports on clinical trials on the new anti-HIV gel for women (link through global voices). From the report - the trials will begin in South Africa and Uganda this week, and then extend into Tanzania and Zambia later in the year. Similar trials are being conducted in Australia by a research group.

The report also mentions, In India as well, in Tamil Nadu, similar trials are being conducted on a product called Praneem. Praneem is essentially a microbicide. These microbicides will enable women to negotiate condom use or to abandon partners who put them at risk and would also help avoid unwanted pregnancies, according to experts. With such products coming up, women empowerment will acquire new meaning in Tamil Nadu in a few months’ time when the third phase of the clinical trials for at least three candidate microbicides will begin. The Indian Council of Medical Research (ICMR), a premier research institution, is already studying a product called “Praneem”.

Anyone heard more about Praneem?

HIV and morality in Tamilnadu

charukesi September 29th, 2005

This time targeting teenage school drop outs, UNICEF and the Nehru Yuva Kendra have roped in the Song and Drama division of the Ministry of Information and Broadasting to launch a new awareness program in Tamilnadu. This move has been driven by the UNICEF estimate that one of every two new HIV infections is in the 15-24 age group - and that young people who do not go to school have fewer points of exposure to HIV awareness and intervention programs.

This report in the Hindu says, About 1,500 of these will volunteer as peer educators and participate in a three-day long programme and work closely with non-government organisations to create awareness on sexually transmitted diseases and HIV, risk behaviour and trained on behaviour change, communication and life skills required to convince their peers back in their villages to say ‘No to pre-marital sex’ (emphasis mine).

***
Oops. Does this actually suggest that out of school teens in Tamilnadu - and young people in general - actually indulge in pre-marital sex? Is there no morality left in the world? First actress Khushboo says this and now the UNICEF. What about the honour of the Tamil people and women in general? (Of course, Khushboo did fly back in a hurry from Singapore to apologize to her beloved Tamil fans saying that she meant no slur on the good name of all the chaste Tamil girls and women - but the harm was done anyways, wasn’t it?)

Pre-marital sex. Huh!

And also drinking and dancing in hotel bars - not the Bombay Red Rose / Shabnam variety - but the Park in Chennai. I would link to the original Dinamalar piece which carried pictures from the party - but this is a clean family blog and those pictures are downright immoral - just picture this for now - girls wearing tops with spaghetti straps and actually drinking liquor from a bottle.

Shiva, shiva… I need to have a purifying bath again now.

All these dissenting voices. What do they know of Tamil culture?

I guess it is in anticipation of trouble that the Hindu article on the HIV awareness program states this inside a box right on top - There is no study to show that talk on sex have led to increased sex.

Private note : Sunil, read Ammani’s comment :)

Polio and saas-bahu sammelans

charukesi August 25th, 2005

I came across this intriguing article when I was searching for something else on the net (oh the joys of google serendipity!) - to be honest, it was the title that caught my attention initially…. The power of saas-bahu. Eh, what is prime time star plus (the television channel that made saas-bahu the buzzword in Indian er, entertainment) doing on a site on Indian ngo news?

An army of largely illiterate and rustic women from Azamgarh can teach a thing or two on polio eradication to the high profile WHO and UNICEF teams. The district, which gave jitters to the state health machinery for having topped the polio tally in 2001-2002 with 81 recorded cases, has thrown up only one case this year. The credit for the transformation in all fairness goes to the concerted saas-bahu power.. Realising that conservative (and themselves very bored) mothers-in-law would not take too kindly to their daughters-in-law going out of their homes for anything - including getting their children immunised against polio, NGOs in this town hit upon the idea of organising saas-bahu sammelans. - assembly-of-mil-dil…(? in public) - the women got together and fought the polio battle. Women together and not against each other…

“My greatest moment,” says Singh, “was when I administered polio drops to 18 children of a family in Faria at one such sammelan. The same family had shut the doors on the WHO team earlier the same day.”. Read on…

***

While on polio, I googled on and found other interesting articles.

From Frontline, A reluctant battle against polio, which says Uttar Pradesh accounts for 64 per cent of the polio cases reported worldwide, but its Chief Minister, Mayawati, is honoured with the Rotary International award for her “outstanding personal contribution” towards eradicating the disease from the State. - emphasis mine.

Launching the third phase of the national pulse polio campaign on April 7, WHO Director-General Dr. Gro Harlem Brundtland said: “Eighty-three per cent of all new polio cases are now found in India. Uttar Pradesh, in particular, should be the number one priority in order to stop the transmission of the polio virus around the world.”

I wonder what Mayawati’s contribution could have been…

And here is The Eradication of Polio and the Conspiracy-Theory Mentality

By mid-2004 the conspiracy theory had jumped to India, where a health worker noted that in one slum, “many poor and ignorant women regard the anti-polio drops as a deceptive strategy to control the birth rate.”

Groan, not the conspiracy theory again. Exactly how much damage has been caused by our enthusiastic and energetic, if misguided efforts at population control?

Conspiracy theory and birth control

charukesi August 11th, 2005

Time has an interesting piece on Conspiracy Theory and Birth Control . This says that a recent research (500 African-Americans between the ages of 15 and 44) found that one third believe medical researchers use blacks as guinea pigs for unproven forms of contraception. About 25% believe that “poor and minority women are sometimes forced to be sterilized by the government,” and 22% believe that government policies are designed “to control the number of black people.”.

This made me think about likely conspiracy theories in the Indian scenario. After fifty five years of policy and population control measures, the billion mark that we kept seeing for years and years has come and gone on. And we are still struggling with an ineffective population control program.

The cultural and economic factors are the more obvious and well understood. Couples having children and more children in the hope for a son. And then just one more son. Not to forget also the notion that a child is a gift from god. Urban, rural. Rich, poor. No difference here. And then, definitely among the poorer sections - one more child, one more earning hand - what about one more mouth to feed?

Beyond this, the tragic gender issues. A large majority of women, ignorant and powerless.

I remember these quotes from a long ago study on social marketing of condoms in UP.

My father in law is the mukhiya of this village. How can I go and ask for the pills from the centre - if he comes to know, he will beat me (the father-in-law)
My mother in law found out that my husband was using a condom. And she threatened to commit suicide. Ater that, we stopped.

Not just husband, but the mother-in-law and father-in-law in control of the woman’s reproductive life. Everyone but the woman herself. (Did Shashi Tharoor’s Priscilla in Riot die because she helped a muslim woman abort her baby?)

The communication focus - another thing I have believed - that the focus of communication realting to population control programs has been long term and macro focus - concepts like crossing the billion mark and growth in GPD are as irrelevant to me as an individual as they are to the illiterate woman in the village - they hardly touch my now-and-here.

I came across this paper - Family Welfare Programme and Population Stabilization Strategies in India which argues for a welfare focus in population control programs. Some thoughts from that…

It is being argued that macro development, which had been emphasized in the early debate on population and development, is not directly relevant unless it is beneficial for improving the individual’s quality of life. Vijayanunni (1994:193) concludes that what is important is not overall development through large-scale projects and programmes, the benefits of which reach the common man/woman only indirectly and after a long gestation period, but welfare-loaded policies and programmes which impart direct and immediate benefits to the people - these include role of literacy, status of women, child health programs.

And finally the political angle - here is where we come close to the conspiracy theory that I started out with. Somewhere very early on in the policy years, the population control program acquired a strong and agressive target focus. Result - sterilization became the “preferred method”. And I am not even talking about Sanjay Gandhi’s ideas about sterilization here.

Was this the beginning if the undoing of any good that communication programs with a softer, welfare-oriented programs could do - given time?

Unfortunately, over the years, the target has become an end in itself and not the means to bring about a decline in the birth rate (Bose, 1989:186). In order to fulfil targets, it was inevitable that a great deal of drafting and mobilization of personnel from other “nation-building” activities would be required for the sake of the family planning programme. However, these personnel were not equipped to deal with such sensitive areas as those related to individual family life. So the kind of persuasion and pressure applied by these people was very crude, lacking the human touch. Sterilization of unmarried men. Repeat procedures. Operations performed under threat and coercion, and bribes.

I know what a problem it is for many social researchers going into villages to speak with the women. This is what an expert had told me when I interviewed her for my disseratation.

I had to open my bag and show that I was not carrying any instrument – it was literally like hands up, see no weapons!
They were turning hostile… if I only want to speak to the women, why do I want to take them alone to a separate room?

Is UP ready for AIDS?

charukesi August 10th, 2005

In an earlier post Reining in the spread of AIDS, I had written about the surprising and rather unbelievable finding thrown up by the annual AIDS survey. Only 28,000 new infections were reported in 2004, compared to 6 lakh in 2003.

My hypothesis then was that reported cases of AIDS were on the decline - due to other factors including fear of stigma - which was more worrying than an actual increase in cases of infection. I had also said - some states including Bihar have recorded zero cases and officially, Uttar Pradesh, India’s most populated state, has only 0.25 per cent of its people affected by the virus - if that does not sound counter-intuitive, then what does? This is where my hypothesis was born…

Now this article from indiatogether talks about the need for a Wake up call for HIV/AIDS in U.P.

This the reality in UP - When the news of Ram Pravesh’s death in Mumbai reached his family members in Allari in the district of Azamgarh in eastern Uttar Pradesh, the people there were saddened but not surprised. Ram Pravesh had been sick for some time. The villagers remembered that the last time he had come home a year ago he had become as thin as a stick. He was due back again but his health deteriorated and so his wife had gone to look after him a month ago. Now he was dead. He was the eighth person to die of what is now called Bambaiwallah bimari (Mumbai’s sickness) in the village in the last three years.

The report says that UP, alhtough not on the HIV map in India yet, has an increasing number of infections and deaths - and the state is ill-prepeared to deal with it. Worse, the government actually did this -

The one early connection U.P. had with HIV/AIDS was the attack that government authorities had launched on workers involved in HIV/AIDS awareness programmes, in 2000 and 2001. The government had framed charges of pornography and promoting homosexuality on the workers.

Also read this promising report on Andhra Pradesh : Clubbing to combat HIV

Realted link - on the eagerly awaited AIDS vaccine - America torn over AIDS vaccine

AIDS and the c word

charukesi June 21st, 2005

Found this very interesting post on chutneyspears (oh, I love the name!) - Looking with one eye shut (the picture produced below is also from that blog)

Dominic Emmanuel, a Catholic priest from the Delhi Catholic Archdiocese together with the omnipresent Samaritan, Mahesh Bhatt, is leading the efforts to make a Bollywood style movie on HIV/AIDS. The main motto of this movie ‘Aisa Kyon Hota Hain’, full with song and dance flicks, is to communicate to masses that “The best way to evade AIDS is by avoiding promiscuous relationships”. The movie doesn’t ever mention the word “condom”!!!!!!!!!!!!



32-04699r, originally uploaded by Road Blog.

Forget ‘condom’, am sure the movie does not even mention the word ’sex’ - after all, the censors might object. Think about our culture and ancient heritage.

What, you mention Konark and Khajuraho in this context? They were obviously the work of a foreign hand, a conspiracy to tarnish the image of India as a cultural superpower…

UPDATE : Maybe the movie is going to be called ‘Kya Fool Hain Hum’

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