Rural Development
Eradication of Poverty in Rural India
Health
INTRODUCTION
India is a large country. It is the seventh largest country in the world. It has nearly 6,00,000 villages. About 75% of our population lives in rural India. Out of every four people three people live in rural India. The dependency on agriculture directly or indirectly is very high.
In India there are 1652 languages, 7 religions, 6748 castes and thousands of customs. There are wide range of differences in dress habits, food habits, and beliefs. The people are highly conventional, God fearing and traditional. It is a land of sentiments and feelings. We have unity in diversity. A garland of flowers remain intact because of a rope that passes through all of them, similarly the people of these many diversities live together because of “dharma’.
Many foreign invaders, such as Huns, Mongols, Kushans, Greeks, and so on made this country, their own motherland.
India has natural boundaries. It has the Himalayas in the north, the Indian ocean in the South, the Bay of Bengal in the East and the Arabian sea in the West.
India is spread in 32,87,263 Sq. kms.[ 81,19,53,961 acres]. It is a country of rivers. Every river has many tributaries. Maximum percentage of these rivers is joining the seas, waste. Out of 81,19,53,961 acres of land only 11% i.e.,8931493 acres are only arable. Now, because of Realters this arable land is also diminishing.
The rural part of India, which is the largest, has been sick for many a year. The downtrodden, the marginalized, the subaltern people cannot seek modern medicine as it is too costly. If the poor are sick, whatever is the meager income in the form of wages goes to treatment. They are left with too little for food. If it is a peasant he cannot invest in agriculture. They cannot get their children educated. As they themselves are weak, they cannot work in fields. So health problem of rural India is multi-headed monster squeezing the rural people in every aspect.
As the most of the diseases they get are common diseases, treatment is easy. For this purpose an MBBS is not so necessary. A person having interest in medicine if taught and trained for six months can be very useful to in the village.
Certain problems they have, come because of their ignorance towards that subject. Such as not washing hands before meals. It is because they use dirt in the fields, use fertilizers, pesticides and other things. They do not wash hands after coming from lavatory.
Rural Water supply - Health
Man is exploiting more than what he actually needs from the resources of nature. Rural India which was highly hygienic once, where highly pure water from various resources was available once, is running in scarcity of pure water. Some places have salty water, fluorinated water, salts less water, and so on are available.
Provision of safe drinking water and sanitation is a State subject and is the primary responsibility of the States. However, the Central Government has been supplementing the efforts of the States through financial and technological inputs under Centrally Sponsored Schemes.
The Accelerated Rural Water Supply Programme (ARWSP), currently implemented through the Rajiv Gandhi National Drinking Water Mission, in the Department of Drinking Water Supply, has been in operation since 1972- 73 to assist the States and UTs to accelerate the pace of coverage of safe and adequate drinking water supply facilities to the rural population.
The Central allocation for this programme has been enhanced from Rs.1,960 crore in 2000-01 to Rs.1,975 crore in 2001-02. An amount of Rs.1,637crore has been released by the Centre and Rs.1,496 crore separately by the States, upto end of January, 2002. The number of habitations covered are 26,803 against a target of 45,527 and the population covered is 10.5 million as against a target of 21.6 million for the period.
The provision of potable drinking water to all villages has been identified as one of the priority tasks of the Government to maintain good health.
RURAL SANITATION - Health
These are the basic necessities of life. In the absence of safe drinking water, most people living in rural areas have to depend on other sources of water such as rain, surface and ground water. The water from these sources is mostly impure and considered unfit for drinking purpose. Many diseases spread out because of drinking this water.
As in April 1999, of the total 14,30,543 rural habitats, 11,63,193 were fully covered under safe drinking water supply, 2,32,887 were partially covered and 34,460 were yet to be covered.
Every 15 seconds, a child under the age of five dies from lack of water and clean sanitation somewhere in the world. This alarming statistic highlights the huge unmet need for safe drinking water and sanitation (popularly known as “watsan”), especially among low-income households and communities. India, home to a sixth of the world’s poor, accounts for an estimated 700 million people lacking access to basic sanitation. A staggering 2.1 million children die each year before they reach their fifth birthday. A look at the supply side shows many public sector-initiated infrastructure projects that have failed to create access and quality, and many more non-governmental initiatives that have failed to achieve scale and financial sustainability. Private sector efforts, mostly limited to informal operators, provide access to solutions at highly exploitative terms. This presents an opportunity for well-designed interventions to address the unmet demand in a scalable, sustainable manner. One can draw an analogy here to microfinance, another bottom of the pyramid (BOP)-focused intervention which offers a similar middle path – semi-formal providers of microfinance have emerged as an alternative to inaccessible formal financial institutions and exploitative money lenders. It has demonstrated a working model of interfacing with low income segments, utilizing innovative delivery models and products, and doing it all at a commendable scale with financial sustainability. This experience can provide valuable lessons for the water and sanitation space.
The Rural Sanitation Programme was launched by the Ministry of Rural Development in 1986 to improve the quality of life of the rural poor and to provide privacy and dignity to the women. The revised Ninth Plan strategy envisages a shift from high subsidy to a low subsidy regime, a greater household involvement.
Rural Poverty - Health
The root cause of social insecurity in India is poverty and that is largely due to lack of adequate or productive employment opportunities. Agricultural growth is crucial for alleviating rural poverty.
Similarly, development of rural industries is the key to rural development. These industries are generally artisan-based, located mostly in rural and semi-urban areas. Rural credit is another significant component of rural development strategy. Access to institutional credit to more farmers and appropriate quantity and quality of agricultural credit are crucial for realizing the full potential of agriculture as a profitable activity.
WHITE REVOLUTION IN RURAL DEVELOPMENT - Health
Operation Flood was a rural development programme started by India's National Dairy Development Board (NDDB) in 1970. One of the largest of its kind, the programme objective was to create a nationwide milk grid.
It resulted in making India the largest producer of milk and milk products, and hence is also called the White Revolution of India. It also helped reduce malpractices by milk traders and merchants. This revolution followed the Indian green revolution and helped in alleviating poverty and famine levels from their dangerous proportions in India during the era.
Gujarat-based Amul (Anand Milk Union Limited) was the engine behind the success of Operation Flood and in turn became a mega company based on the cooperative approach. Verghese Kurien (chairman of NDDB at that time), then 33, gave the professional management skills and necessary thrust to the cooperative, and is considered the architect of India's 'White Revolution' (Operation Flood). His work has been recognized by the award of a Padma Bhushan, the Ramon Magsaysay Award for Community Leadership, the Carnegie-Wateler World Peace Prize, and the World Food Prize.
Operation Flood has helped dairy farmers, direct their own development, placing control of the resources they create in their own hands. A 'National Milk Grid', links milk producers throughout India with consumers in over 700 towns and cities, reducing seasonal and regional price variations while ensuring that the producer gets a major share of the price consumers pay.
The bedrock of Operation Flood has been village milk producers' cooperatives, which procure milk and provide inputs and services, making modern management and technology available to members. Operation Flood's objectives included:
Increase milk production ("a flood of milk")
Augment rural incomes
Fair prices for consumers
Programme Implementation
Operation Flood was implemented in three phases.
Yellow Revolution, improved varieties of fruits and vegetables - Health
| |
| |
The ICAR participated in the Yellow Revolution brought out through increased production of the oilseeds which was catalyzed by the Technology Mission on Oilseeds.
The increase in production of different oilseeds during the period 1985-86 to 1994-95 was spectacular - 26.96% in the groundnut, 111.50% in rapeseed-mustard, 420.50 % in soybean and 74.12% in the total oilseed crops.
This resulted in saving of large part of foreign exchange being spent on the import of edible oil. In 1993-94 foreign exchange worth Rs 24633.5 million was earned through the export of oilmeal and oilcake.
So far more than 300 modern varieties and hybrids of different oilseed crops have been released to the farmers.
The increase in production of different oilseeds during the period 1985-86 to 1994-95 was spectacular - 26.96% in the groundnut, 111.50% in rapeseed-mustard, 420.50 % in soybean and 74.12% in the total oilseed crops.
This resulted in saving of large part of foreign exchange being spent on the import of edible oil. In 1993-94 foreign exchange worth Rs 24633.5 million was earned through the export of oilmeal and oilcake.
So far more than 300 modern varieties and hybrids of different oilseed crops have been released to the farmers.
SIGNIFICANCE OF THE STUDY
India’s rural poverty is like a multi-hooded octopus. Poverty lays proper road to health. Ill-health can lead more and more poverty. The innocence of the rural people, lack of knowledge of things, not knowing the ways of the urban people, unaware of how fast the world is changing, backwardness, etc. are some of the self-defeating-hoods of the rural people. There are some more things, about which the people are not aware of, lack of whose knowledge; the people are frequently losing the battle of life. They are medicine, exploitation, latest techniques in agriculture, facing market to sell their produce and so on. One among many is medicine, which keeps the people healthy.
Health, defined as the state of complete physical, mental, social and spiritual well-being and not merely absence of disease and infirmity. The basic objective of human development is to improve the quality of life. Healthy population plays a key role in achieving the developmental activities as health helps to improve the productivity of mankind both directly and indirectly. The health situation of India is worse. Two thirds of our population lives in worse condition. The developments in science and technology brought drastic changes in medicine, but in the same ratio the prices are shot up. The common man is again far from medical provisions. Health does not exist not alone. For poor health condition of life there are many factors responsible. To name some,
Bhore Committee 1943
Bhore Committee felt that
1. no individual should be denied adequate medical care on grounds of inability to pay,
2. Special emphasis should be given to preventive work.
3. Focus on rural population.
4. Active co-operation of people must be secured.
5. a living wage for all workers,
6. improvement in agriculture
7. Industrial production.
8. elimination of unemployment,
9. suitable housing,
10. clean environment.
The First Five Year plan. 1952
In this plan various health plans are enunciated.
1. medical care,
2. control of communicable diseases,
3. maternal and child health,
4. collection of vital statistics,
5. protection of water supply and environmental sanitation,
6. conduct of school health programme,
7. family planning services which were added on later
8. PHCs are envisaged as a nucleus for all health activities in the area.
Mudaliar Committee 1961
Mudaliar committee recommended
1. consolidation of the then existing services before taking up any expansion.
2. strengthening staffing in the then existing PHCs.
3. the each PHC should serve a population of 40,000 instead of 60,000.
4. not to open any new PHC without ensuring the full staff component.
5. strengthening of the district hospitals with mobile clinics to cover non-PHC populations.
Kartar Singh Committee. 1973.
This committee reviewed the functioning of the PHCs. It observed that there is little co-ordination among the various health workers.
It recommended that,
1. one male multi-purpose worker for a population of six to seven thousand people.
2. one female health worker [ANM] for a population of ten to twelve thousand.
3. integrated training for all workers, and
4. co-ordination of programmes and personnel.
National Health Policy.[1980-85]
This was adopted in the Sixth Five Year plan [1980-85]. The Policy emphasized
1. the need to re-structure the health services.
2. provision of network of primary health care services,
3. curative centres according to the size of the population,
4. large scale transfer of knowledge, skills, and techniques,
5. to buildup individual self-reliance and community participation,
6. referral system to support family health care,
7. establishing a nationwide chain of sanitary-cum-epidemiological stations to provide integrated service to eradicate/control diseases,
8. support voluntary agencies in health services,
9. establishing centres for specialized treatment wherever required,
10. make special efforts in the areas of mental health and rehabilitation work,
11. priority to the provision of services to people living in tribal, hills, backward and disease prone areas.
HEALTH CARE PROGRAMMES
The Government takes concerted measures to combat communicable and non-communicable diseases at the national level. For this purpose, the Centre organizes various National Health Programmes.
1. National TB Control Programme
2. National Programme for the Control of blindness,
3. National Leprosy Control Programme,
4. National Malaria Eradication Programme,
5. National Filarial Control Programme,
6. National Iodine Deficiency Disorders Control Programme,
7. Medical Care for Remote and Marginalized Tribal and Nomadic Communities,
8. National Mental Health Programme,
Medicine is not a word, but a universe of many branches. It itself is a system. From medical point of view rural health can be decided by many factors;
1. Potable water,
2. Good atmosphere,
3. Tensionlessness,
4. Nutritious food,
5. Chemicals used in fields,
6. Superstitions,
7. Ignorance,
8. Illiteracy and many more.
India is a country of villages. The largest percentage of our population resides in rural India. If the rural India is strong, then the nation will be strong. Rural India is like our mother. Mother always sees the needs of the children and gives what is needed to them. The farmer is the back bone of this nation. That farmer is not strong financially, in health, and knowledge. He has been exploited for generations. He is a very hard worker, but his lack of knowledge of other things is making him weak.
The farmer, who was self sufficient once, has become dependent on others for everything. For seeds, fertilizers, agricultural implements, and many other things the poor people of India have to depend on the multinationals. Many plants, roots, ashes, and other Ayurvedic items which saved the rural people also have lost their prominence. For small or big items the poor have to depend on the corporate for treatment. That is why, treatment has become costly and beyond the reach of the common man.
“India is in need of many things. You choose one problem, think it, discuss it, and dedicate your life to it.” Swami Vivekananda. This inspired me to learn medicine, which is one of the common problems of rural India. It is a skill that never goes waste. Wherever such people reside,-- Baba Amte, Norman Bethoon, Kotnis, Puchalapalli Rama Chandra Reddy, Jetty Sesha Reddy, -- their ideas can help an ordinary man.
Secondly, in China, Mao implemented bare-foot doctors. Generally what are the health problems of common people in rural side? Fever, motions, headache, cuts, and many types of first-aid treatments are the common ailments. For ladies delivery problems, menses problems, and other general ailments. To give minimum treatment to such diseases, one need not study M.B.B.S. It is time consuming and lots of money consuming. If the knowledge to cure such small diseases is imparted to those volunteers who have interest in medicine, a major problem can be solved. This idea was used and lakhs of volunteers were given training in common diseases and sent to the rural China to serve the people. Mao was successful. This thought of Mao inspired me to learn medicine, a valuable skill, needed by the people.
In 1978, in Alma Ata city a world conference was conducted on “Health’. Keeping in view of the suggestions, our government formulated a National Health Plan. In 2002 the then NDA government modified and reformulated the same plan.
Health for all is the basic objective of Primary Health Care and proper planning was initiated to achieve it.
The amount that is expended on ‘health’ in USA is 15% of GDP, in England it is 8% and in India it is 8%.
As per government’s Macro Economic Commission on Health, the per capita expenditure required is 34 dollars, but we get Rs.215 out of which only Rs. 120 are allotted.
As WHO commission the per capita expenditure in America 4,900 dollars, England 4500 dollars, but in India it is only 250 dollars.
The life expectancy in USA and England 75 years, China and Sri Lanka 74 years and in it is 64 years.
71% of rural families do not have sanitary latrines.
In tribal India, 80% people are suffering from nutrition problem.
20% TB patients of the world live in India.
The number of doctors per 1,00,000 people in USA 279, England 164, China 162 and in India 48.
The number of nurses per 1,00,000 people in USA 972, England 479, China 99 and in India 45.
Brain drain of doctors is more in India, that is out of 31000 doctors who come out of 271 medical colleges only 6 are living in India.
During Mao’s thousands of volunteers were given training to treat various diseases. They were called ‘barefoot doctors’. Those barefoot doctors served the rural areas and contributed a lot in nation building.
Substitutes, false drugs and unnecessary medication are some other problems to rural India.
Drastic changes have come in medicine but they are so costly, the common man cannot afford it.
Medicine to all is of four types.
1. Promotive- giving balanced nutritious diet improving hygienic and immunity power.
2. Preventive – safe drinking water, sanitation, cleanliness of surroundings, protection from atmospheric pollution, vaccination, and bringing changes in living conditions.
3. Curative – prevention of diseases, hospitals, medicines, operation facilities.
As of now there are 1,37,271 Health Sub-Centres, 22,975 Primary Health Centres, and 2,935 Community Health Centres in the country. Besides these, there are 5,435 Family Welfare Centres functioning.
4. Rehabilitative – prevention of polio, measures after eliminating a disease.
Poverty is the main thing that is paving way for ill-health.
State of Rural Healthcare in India-NRHM Report
India's rural health centers are critically short of trained medical personnel. The country's 22,669 primary health centers are in sorry state of affairs increasing people's suffering. According to the recent National Rural Health Mission report nearly 8% PHC don't have a doctor while nearly 39% were running without a lab technician and about 17.7% without a pharmacist. The PHCs are supposed to have one medical officer supported by paramedical staff.
To compound the problem PHCs in some states do not have adequate labour rooms and operation theatres. While not a single of UP's 3,660 PHCs have either a labour room or an operation theatre, the number stands at 208 labour rooms (13%) and 218(13%) OTs in Bihar's 1,641 PHCs,105 (20%) Lrs and 50 (10%)O Ts in Chhattisgarh’s 518 PHCs and 131 (4%) LR s and 108 (12%) O Ts in Kerala's 909 PHCs.
The condition of 3,910 community health centers supposed to provide specialized medical care is equally appalling. Out of the sanctioned posts, about 59.4% of surgeons, 45% of obstetricians and gynaecologists,61.1% of physicians and 53.8% of pediatricians were found to be vacant. Moreover there is a shortfall of 70.2% specialists at the CHCs. The report says there is a huge challenge to meet the shortfall for rural health infrastructure specially the manpower.
According to Planning Commission figures India's CHCs require 3,910 surgeons. While only 2,372 are sanctioned, just 972 are in position creating a vacancy of 1,381 posts for surgeons and a shortfall of 2,376 surgeons in CHCs. As for physicians CHCs require 3,910 of them. There are only 832 in position with 1,296 vacant posts and a shortfall of 2,516 physicians. Of the 3,910 pediatricians required only 1,951 posts are sanctioned of which just 837 are in position. There is a vacancy of 953 posts and a shortfall of 2,511 pediatricians.
Can technology be the route to bring affordable healthcare to millions of rural Indians? This question was explored during the session on healthcare at EmTech2009 in New Delhi. Telemedicine had already touched 2,000 villages and a foundation had been laid for a health superhighway to make the promise of universal healthcare a reality at last. The health superhighway envisages connecting a chain of hospitals -- both government and private sector -- through applications like telemedicine, mobile software and wireless networks so that doctors can connect with villages in India. Every single doctor in every corner of the country through a telemedicine network should be met so that patients can not only get access to healthcare, but can get a doctor of their choice. Other prescriptions to bring 'good health' to a billion Indians included the adoption of a more 'pre-emptive' strategy. The doctors should focus on awareness so that they can postpone the age of lifestyle diseases: if a man is getting a heart attack today at the age of 40, his age can be pushed to 60 by an awareness drive.
The allopathic medicine, homeopathic medicine, Ayurvedic medicine and many other systems have entered the market on a large scale.
India is one among the developing countries in the world. It is in the third world countries.
India is the largest manufacturing country of intellectuals. Brain drain is more in India. Then what will be the alternative to serve the rural poor.
India is a country, which gave great prodigies in medicine like Charaka, and Acharya Nagarjuna. And it also gave a great and valuable medicine called Ayurvedam to the world. Every villager knows something or the other of a medicinal value of a plant, seed, bark, or any other thing. This is really wonderful. In those days people knew that Acharya Nagarjuna knew how to make gold. When requested by the students, Acharya Nagarjuna explained the formula as;
Naagarasa bandhanam, baala ravi chumbanam,
Hema karo, hema karo, hema karo
The corporate world is also entering this medicinal field in a large scale, in manufacturing Ayurvedic medicines. For example triphala, alovera, massage oils and many other combinations.
Now a days, beauty parlors are using many Ayurvedic medicines manufactured by the multi-national companies.
There are many magazines, and books which can help the common man, to know and understand the medicine for common ailments.
1. Andhariki Ayurvedam
2. Amrutam
3. Vydyudu leni chota
4. Mandulu mana desa prajalu
and many others.
These magazines and books also explain the reasons why such and such ailments take place. So prevention is better than cure. The medicine awareness of common man is enriching.
Seeds and other Food Items in Health
Another important thing is seed. Hybrid and HYV seeds really filled the bellies of millions of our people. But if we take the health condition of millions of our Indians it is doubtful. Small children getting diabetes, heart problems, eyes sight problems, etc. All these things are happening because the strength of food is declining. To meet the requirements of population explosion quantity is given more priority than quality. It is only belly filling food.
Vandana Siva
Environmental pollution in Health.
Water- rivers - sentimental
Ganash nimajjanam: - This practice was started by Tilak to speak on the importance of freedom struggle. It was a good dais. That situation was over. Now what is the necessity of continuing that tradition? It has become a tradition and people are making a lot of money on this pretext. In addition to that the nimajjanam is done in rivers, tanks, etc., which pollute the water. It is because the idol is painted with un-dissolvable paints which are very harmful to our health.
The Hindus cremate the dead on the bank of the river Ganges and immerse those ashes in the holy river. The holy river is highly contaminated. The contamination is so high Rajiv Gandhi allocated 100 crores only to purify the river.
Some devotees leave the dead bodies of their relatives as they are in the holy river. This is another contaminating factor.
If these many things contaminate water, even after various filtering techniques, some nano particles of chemicals remain back in the water. If such water is consumed people get many ailments.
Agriculture :- In agriculture the farmers use many types of fertilizers, pesticides, insecticides, gamaxyn, and many more. The molecules enter human bodies in various ways. That may be through vegetables, chili powder, through milk and other sources. Certain molecules were banned in USA long back, but they are still in use India.
Industrial wastes
Deforestation
Because of deforestation, the green house effect is severe. Even ice in tundra regions is melting. There is a disturbance in the regularity of rains and also plants flowering.
Photosynthesis process is severely being hampered. This leads to Green house effect. This
Vehicular excretions.
Noise pollution on health
RURAL HEALTH IN OTHER COUNTRIES
CHINA : Barefoot doctors
China got independence in 1949. It has large rural sector. To provide medical aid to villages is a gigantic task to the government. Mao realized that to cure small ailments an MBBS doctor was not necessary. So he introduced the concept of barefoot doctors. He invited rural people who were interested in medicine. He had those volunteers trained in identifying the diseases, symptoms, and to administer medicine. Those farmers who received minimal basic medical and paramedical training, worked in rural villages in the People's Republic of China. Their purpose was to bring health care to rural areas where urban-trained doctors would not settle. They promoted basic hygiene, preventive health care, and family planning and treated common illnesses. The name comes from southern farmers, who would often work barefoot in the rice paddies.
In the 1930s, the Rural Reconstruction Movement had pioneered village health workers trained in the basic health medicine. Mao Zedong gave a speech on healthcare in 1965. After that the concept was developed and institutionalized. It is because the rural population is the largest spread entire country. This new concept revolutionized rural health. This was also called Rural Cooperative Medical Systems. Those barefoot doctors became a part of the Cultural Revolution. This radically diminished the influence of the Weishengbu, China's health ministry, which was dominated by Western-trained doctors.
Training
The barefoot doctors usually graduated from secondary school and then received about six months of training at a county or community hospital,[1] though training length varied from a few months to one and a half years. Training was focused on epidemic disease prevention,[3] curing simple ailments that were common in the specific area, and were trained to use Western medicines and techniques. An important part of the Cultural Revolution was the movement of sending intellectuals, and in this case doctors, to serve in the countryside. They would live in an area for half a year to a year and continue the education of the barefoot doctors. About a fifth of the barefoot doctors later entered medical school.
Work
Barefoot doctors acted as a primary health-care provider at the grass-roots level. They were given a set of medicines, Western and Chinese that they would dispense. Often they grew their own herbs in the backyard. As Mao had called for, they tried to integrate both Western and Chinese medicine, like acupuncture and moxibustion. An important feature was that they were still involved in farm work, often spending as much as 50% of their time on this - this meant that the rural farmers perceived them as peers, and respected their advice more. They were integrated in a system where they could refer seriously ill people to township and county hospitals.
Barefoot doctors provided mostly primary health care services, and they focused on prevention rather than treatment.[1] They provided immunizations, delivery for pregnant women, and improvement of sanitation. The income of the barefoot doctors was calculated as if it were agricultural work; they were paid roughly half of what a classically trained doctor made.
The work of the barefoot doctors effectively reduced health care costs in the People’s Republic of China, and provided primary care treatment to the rural farming population in large scale.
Telemedicine:-
Mobile dispensaries :-
104 ambulance is a mobile hospital. It is a hospital on the wheels. It has a doctor, two nurses, compounders, all the infrastructure facilities needed for treatment except surgery. It goes to villages and stays there for a day. It is vitally useful during droughts and floods. If the patients are to be brought to the city hospital it takes lot of time, money and sometimes death to the patient. During rainy season 104 can do what no one can do to the rural people.
Seminars :-
Seminars conducted by expert doctors in rural villages are very useful. This helps them to prevent diseases better than curing. These experts can explain many preventive measures to be adapted, such as;
1] Keeping dung heaps away from house;
2] Washing hands after lavatory;
3] Washing hands before and after meals;
4] How dangerous is taking liquor, smoking cigars, eating tobacco, etc.;
5] Proper way to spray and handle fertilizers, pesticides, and other agri cultural chemicals;
6] The need to eradicate superstitions, blind beliefs, and age old ortho-
dox traditions;
7] The cunningness of babas, ammas, god men, etc.;
8] How their weaknesses are exploited;
Practical demonstrations to eradicate blind beliefs:-
I am a member of the Dist. Hetuvada Sangham [rationalist society]. In many incidents I was also a participant.
Case I :- There a village called sanja thanda. Thanda is a place where STs-Lambadi sect live. There was a place which was to be occupied by the landlord of that thanda. He sent his men to burn the huts of those tribals. The henchmen went to that village and threw white phosphorous on the huts without anybody suspecting them. It happened 4 times. The villagers used to call babas to heal and send away evil spirits from their village. After fourth time they approached the Dist. Hetuvada Sangham [rationalist society]. These people disclosed the secret to the villagers. They showed them that it is not evil spirit but white phosphorous.
Case II :- People walk on burning coal telling that it is the miracle of the gods. But the rationalist society proved that anybody can walk on burning splinters. Thus they exposed the cunningness of those people who want to exploit the simple villagers.
Case III :- Worshipping snake is another means to loot the people. Snakes do not milk. We made a snake pit with mud and arranged it on a stool. It was placed in such a hiding place no one could doubt. From every hole one pvc pipe was passed through and their another ends were put in a vessel. This arrangement was completed 15 days before the snake festival. On the actual day women came to that and poured milk in the pit. Through those pipes milk reached into the vessel. We drank that.
Case IV :-
OBJECTIVES OF RESEARCH
1. To gain familiarity with a phenomenon or to achieve new insights into it. [exploratory/formulatory]
2. to portray accurately the characteristics of a particular individual situation or a group. [descriptive]
3. to determine the frequency with which something occurs or with which it is associated with something else. [diagnostic]
4. to test a hypothesis of a casual relationship between variables. [hypothesis – testing]
In order to get familiarity with “health” the subject which itself has become a universe with many specializations.
Today one MBBS is not enough to a doctor who wants to continue his practice. He needs another specialization to diagnose and treat many diseases. For every part of our body, a specialization has come.
Environment causes great health problems. Environment consists of air, water, soil, and trees of nature and chemicals, garbage, all unwanted things thrown out, dust, smoke and so many other things of man-made items.
Water is fundamental to life and it is the medium in which all living processes occur. It is universal solvent. It regulates body temperature, supports structures and removes waste products. Our body contains 60% of water.
If we pollution it is not natural. Every type of pollution is man-made. The objective is to study various types of pollutions which cause health hazards and future plans to reduce such pollutions.
Water pollution:-
1. It destroys fishing economy.
2. It also destroys indigenous irrigation system that exists throughout the course of the river.
3. The industrial wastes joining the rivers cause a lot of damage to the crops as well as the health of the villagers.
4. The micro-nutrients which enter crops, when consumed by living things enter their bodies and cause incurable damage to the bodies.
5. drainage water joining rivers.
6. it can change the pH value of the soils.
Air Pollution:-
Effects of air pollution can be observed on the growth of plants and health of human beings and animals. It can fade away the coatings on exterior designs. It can also reduce visibility. It can damage historic monuments such as Taj Mahal.
The various sources that pollute the air are,
1. surface mines,
2. blasting operations,
3. vehicles running on fuels,
4. CFCs, HCFCs, and HFCs from cooling plants,
5. burning of waste materials,
6. volatile oils and other substances,
7. acidic vapours,
8. wind erosion,
9. dust storms,
10. dust storms contain toxic heavy metals, arsenic, lead, and other items,
11. wastes liberated from radiation plants.
12. the smoke and other things liberated by volcanoes.
13. pollen liberated by tlowers,
The atmosphere contains self-cleaning properties, which continuously clean and remove the pollutants from the atmosphere under natural process. But it is helpless, if artificial wastes are liberated into the atmosphere. The same atmosphere can damage our properties, affect our vegetation, and cause acid rains and so on.
From a small nickel pin to gigantic machines and from a tiny dust particle to a volcano everything has hazardous effect on health.
DDT when introduced was considered a wonderful discovery for pest control. Later predicted long term effects on humans caused a great damage. Hence it was banned.
Pesticides have short term effects such acute poisoning, illness and long term effects such as induce cancer, birth effects, and immunological problems.
Nitrates in excess, can cause blue bay syndrome in infants which is very fatal to new born babies.
Underground mining liberates many poisonous gases, explosive gases, respiratory diseases, black lung disease and fibrosis because of accumulation of fine coal dust in the lungs.
Food chain is the main one. If there is any break in the food chain, it will be havoc to all the other species.
The all types of cides sprayed on crops, enter our bodies through nuts, fruits, vegetables and others can create heavy damage to our bodies.
Pollen can cause allergies to skin and respiratory tract. Some of the symptoms are high fever and asthma problems.
In the smoke, liberated by vehicles there is lead. It damages blood system, behavioural disorders, sometimes death.
If plastic items are burnt or tobacco smoking, cadmium is liberated. It causes hypertension, disturbs metabolism and damages kidney.
The nickel liberated in tobacco smoking, and other vehicle smoke is dangerous in respiratory symptoms, and lung cancer.
Air pollution can also cause;
1. damage to delicate tissues,
2. inflammation,
3. painful cough,
4. production of sputum,
5. involuntary muscle spasms that constrict airways,
6. emphysema,
7. asthma,
8. fibrosis.
Certain gases can cause various ailments.
SO2 chest constriction, head ache, vomiting, and death
H2S causes nausea, eye and throat irritation.
CO reduces oxygen carrying capacity of blood.
H-chemicals effect on nerve cells, dry throat, indistinct vision, and headache.
NH3 upper respiratory tract inflammation
Hydrocarbons nasal and respiratory tract irritation,
The more and more air pollution leads to green house effect. This will have global effect. This can influence ice formation in tundras, unseasonal rains or no rains, or anything that can hamper regular cyclic process.
Soil Pollution
Soil can be polluted in various unnatural incidents.
1. use of high power fertilizers,
2. spraying of pesticides, insecticides, etc.,
3. pathogens present,
4. silting,
5. flood water,
6. acid rains.
7. over dependence on soil,
Soil is the prime source for cultivation of crops. Once soil is polluted, its products are also highly polluted. Humans and animals which ever eat those items, lose health.
STATISTICAL TECHNIQUES USED
According to World Bank report, on 27-8-2008, there are 45 crore people in India who live on 1.25 dollars per day.
The per capita expenditure in India is $ 250 where as in China is $ 80, England $ 4,500 and in USA $ 4,900.
According to Health index the average life span of USA and England is 75 years, China and Sri Lanka 74 years, and in India 64 years.
The number of babies die per every 1000 births is 23 in China, 19 in Sri lanka and in India.
The number of children nutrition deficient is 31% in Pakistan, 6% in China and 46% in India. In rural agency areas 80% are dying because of malnutrition.
According to Family health Survey-3 in India
Two crore families do not have potable water,
71% of villagers do not have sanitary latrines,
Having no such provisions, 2.6 millions are dying every year.
3 crore 77 lakh people die every year because of water pollution,
15 lakh die because of dysentery, 66 million die because of excess fluorine in water.
T.B. patients are more than one crore. They are 20% in the world’ TB patients.
HIV cases are above 3 lakhs.
In tribal areas per every 30,000 people there is one PHC and in tribal areas per every 30,000 people.
Number of corporate hospitals in A.P. is more than any state in this country.
According to survey, 6.3% doctor posts are vacant in rural India. Out of appointed 67% are not in duty.
The number of doctors per every one lakh people in India is 48; in China 162; in England 164; in USA 279.[ WHO report – 2002]
The number of nurses per every one lakh people in India is 45; in China 99; in England 479; in USA 972.[ WHO report – 2002]
Smt. Prathibha Patil, the President of India, told on 7th July 2009, Convocation in Tirupathi that there are 271 Medical Colleges in India. Every year 31,000 medical graduates are coming out. But only 0.5% or less of them are only available for posting in India. It is high time that the rural India needs trained, skilled doctors, nurses to meet the problems of women, children and the old.
Medical facilities available in Andhra Pradesh.
PHCs 1572
Govt. hospitals 233
Autonomous hospitals 3
Super-specialty hospitals 3
In Directorate of Health
Civil Assistant Surgeon 3,608
Deputy C.S.s 455
C.S.s 53
No doctors in 93 PHCs
[source – September 2008, Seminar daily, Prof. Lalith M Nath]
As per National Family Health Survey N0.3 [2005-2006] of India
Anemia in males 25%
Anemia in females 50%
Deliveries without a doctor 52%
Death of women at the time of delivery 300/1,00,000
Children die because of dysentery per year 6,00,000
People die of TB every year 3,70,000
HIV cases yearly 25 – 31 lakhs
Tobacco related deaths yearly 10,00,000
Death of children below 5 years old yearly 72/1000
Death of children below one year old yearly 57/1000
What we have to achieve:
S.No. subject object achieved
1. IMR -- 60/1000
2. MMR 479 lakhs 200 lakhs
3. weight of baby when 30% 10%
Born 2.5 Kgs
4. vaccination 100% 42%
5. safe deliveries 100% 16%
| Country | Expenditure on health of GDP | Average life span | Children die below 5 years of age per 1000 | Doctors Per 1000 | Nurses per 1000 | |
| America | 15.4% | 75/80 | 8 | 2.56 | 9.37 | |
| England | 8.1% | 72/80 | 6 | 2.3 | 12.12 | |
| India | 5% | 62/64 | 85 | 0.6 | 0.82 | |
| China | -- | -- | 26 | 1.06 | 1.05 | |
| Sri lanka | 4.3% | -- | 14 | 0.55 | 1.2 | |
Source – WHO report
LIMITATIONS
Water is highly polluted by the sewages from the industries.
The waste water of the city.
Immersion of Durga and Ganesh idols in the rivers, tanks, and other water resources.
Pouring ashes of the dead into the rivers on the name of moksha.
Throwing the dead bodies directly into the rivers.
Sewage water joining rivers, and these rivers joining the seas is not only harmful to human beings but also to the fishes.
Good food and good water make one healthy. They are not available 40% of Indians who live below poverty line. They take only belly-filling food. Mostly pickle oriented food. For good health, medicines are not the solution. Medicines cannot eradicate all the ailments. The medi-cine maybe good and powerful, but if the constitution of the body is very weak they cannot help. Good food can only prevent one from getting diseases. Generally people cannot spend more money on good food, but spend thousands once they get some or the other disease.
The latest available varieties of food are hybrid which are not at all healthy but only can quench the appetite. So use medicines has become very common. In 1948, in our country, the total medicines produced are worth 10 crores. In 1994 it went up to 690 crores. The per capita expenditure on medicine then was Rs.4 but now it is Rs. 86.
Advertisements make a thing necessary but it is not at all necessary. For example fridge. If we put something in fridge and eat later, it leads to gas trouble. The corporate is selling some-thing telling that it is very essential. If all the fresh things are avai-lable in the near by market, then what is the necessity of buying things and keeping in the fridge. Fridge is a must preserving certain medicines for chemists.
There are many chemicals which are very dangerous. Parathion, Malathian, , Argano Phosphate, various spidermites, Calcium arpinote, DDT, BHP, Taxafin, Carboryl, Trichlorophon and so on.
The people of rural India work with these chemicals. The che-micals became a part of life of the farmers. So the after effects of these chemicals cannot be avoided. The use of chemicals in rural India is doubling every 8 years. Even after using these many chemicals, the farmer is not getting good returns.
DDT consists of Argano Chlorine, Argano Phosphorous, Aldrine, Di-Alidrine.
These chemicals when sprayed, spread and pollute the atmos-phere. It is used widely in England in different forms, More than 800 types are there in this. These are sprayed in fruit gardens, agricultural fields, golf courts, etc. to kill silver fish, butterflies, grass hoppers, white ants, and others. The residue of these chemicals are found in Antarctica penguine birds. These are found in drinking water. These pollutants cause cancer, abnormal children etc.
The parliamentary committee after due enquiry found and sub-mitted a report that 25% of the insecticides cause cancer.
If the insecticides and pesticides are sprayed from an aero plane or a helo, many creatures die such as bees, birds, and other delicate ones. The effect of these DDT molecules is that they are appeared in milk.
GUIDELINES FOR FUTURE
1. At present we have 0.9% of national income towards health. This should be increased at least to 3%.
2. PHCs are to be provided with infrastructure.
3. Every PHC should be given an ambulance.
4. There should be an MRI, and a CT scan, at district HQ hospitals.
5. The vacant posts of nurses, male nurses, and other paramedics should be employed.
6. The number of doctors available to the public should be increased.
7. Preventive steps should be given priority than cure methods.
8. Vaccines should be given regularly.
9. Potable water is to be provided. With many diseases like typhoid, dysentery, hepatitis-B, fluorosis like diseases can be cured.
10. Good sanitary facilities should be provided which can prevent diseases like dengue, yellow fever, malaria, etc.
11. Training hospitals should be taken up to super-specialty hospitals.
12. every private nursing home should get registered. They should be made accountable to the public.
13. educate and train people or volunteers in medicine and post them in rural areas to serve the poor.
14. the idea of Mao in creating “bare foot doctors” can solve major portion of health problems.
15. if the sex workers are recognized and medical aid is pro-vided to them spread of AIDS disease can be controlled.
16. family planning programme is to be implemented with some incentives such that the population explosion can be controlled.
17. the number of PHCs should be increase.
18. the government should take over basic fields such as health under its direct control.
19. with the help of 8mm projectors, OHPs, information should be passed on in the use of medicines, hygienic conditions, how to develop social factors for themselves.
20. encourage experts to take seminars on different subjects such that they can be well aware of the basic things.
21. strictly implementing Hathi Committee Report.
22. Ayurvedic medicine is to be developed and the rural people are to be guided to use the plants as medicines.
23. as there is levy system in rice, the government should introduce the same in medicines. The medicines thus obtained are to be distributed to the rural Indians.
24. unless the rural people are financially developed, their social factors cannot be developed. To achieve this, plants of medicinal values are to be grown. For example alevera, ashwagandha…
25. the multinational units in the fields of drug and pharma-ceuticals should be taken over by the government and managed by the National Drug Authority.
26. multinational companies won’t produce bulk drugs. They thrive on the bulk drugs, manufactured by the Indian companies.
27. the government should provide medicines and other facilities to voluntary institutions such Puttaparthi Super Speciality Hospital.
In our state
In training hospitals 1,024 posts are lying vacant. No body is applying for. So the government should enhance salaries to get our intelligentsia from brain drain.
In our state there are 23,000 villages and 35,000 habita-tions. At present we have 1570 PHCs, 12,255 sub-centres. These are far away to meet the rural people.
For every one thousand people one unit should be formed in rural India. In that one trained health assistant, one lady assistant, and a compounder are to be posted.
Those RMPs who have already settled and treating people should be retained as they are. If needed such are to be trained.
As per government’s modifications in health department – main document ;
The present number of doctors, and health assistants, are not sufficient. It should be modified keeping the ever growing population in view.
To get medical specialists in rural India, attractive salaries are to be given.
The present day technology-- ultra sonography--is very useful to identify the gender of the baby. Thus a female baby can be killed, or abortioned. This is reducing male-female ratio. For every 1000 boys the girls ratio in Punjab is 874, in Haryana 861, in Chandigarh 773, in Tamil Nadu 986, and so on. This is really a dangerous situation. The government should take proper steps in this issue.
The government should do something to improve Human Development Index figures;
In human resources development India stands in 135 position.
We do not have per capita income but per capita debt. Every baby born in India is in a debt of 22,000 rupees.
Among 174 countries, India stands in 39th position in poverty.
India has to march a lot to achieve minimum needs to its people. China got independence two years later than us. But it is in number one world countries list. Its per capita income is 9700 dollars. It plays a prominent role in UNO. When the whole world was facing financial crisis, it conducted Olympics and showed to the world how economically powerful it is.
CONCLUSION
The government has been implementing many poverty elevation programmes, sanctioning scholarships, giving tax-holidays, writing off loans and many other things, but the poverty is remaining same as it was. Where lies the problem? The problem is not with the government but with the people themselves. People do not have proper homework, or vision, or targets for themselves to come out of their plights, their poverty. In such a situation any amount of help is futile in front of the myriad needs of the common man. When he gets money he enjoys, when there is no money he suffers. Once a great business man of America said that if the entire wealth of the world is distributed equally among the people of the world, within a short time a rich man becomes rich and a poor man becomes poor. The richness or the poorness does not lie in the wealth but in the mind set. So unless the government teaches the people how to come up in life, solve problems, be a responsible citizen, etc. the common man cannot come up in life.
Another problem is the reservation system. Dr. Ambedkar thought that if one generation is uplifted then it becomes the responsibility of that generation to develop their succeeding generations. But the main motto disappeared. Everything is politicized. Let the downtrodden be given boarding, education, and opportunities. Enable them to come up in life. But because of this, the creamy of layer of ours intelligence and skill is draining to foreign countries. Unless this brain-drain is converted into brain-gain, generations come and generations go, but we will be where we were.
There are many other things which effect the health of the rural people.
1. Liquor :- There are many types of liquors. They are arrack, toddy, ippa sara, hundiya etc.
The rural poor people work a lot in fields or factories and get a little amount as wages. But in that also a major portion is spent for drinking intoxicating liquors. With this, they are not only spoiling their health but also their families.
They cannot come up financially.
They cannot educate their children. So their children too follow the same path as their father does i.e., daily wage workers. This makes no future to their children.
Sometimes these drunkards, because of their ill-health conditions die early leaving only poverty to their families.
2. Family Planning :- This is a must for the rural people. Their spend their entire lives as labourers. If they have many children, what can they give to them? They can only give them poverty, ill-health, ignorance etc.
The government authorities should educate them the importance of family planning. They must be encouraged by offering them incentives.
3. Fire :- Fire accidents are very common in rural side. Whatever little they have will be burnt in the fire. It is because, most of the houses in villages are huts. They become paupers. That is why fire engine services should be very near to them.
Even after these many years of independence, the villagers are depending on the cities for what they need. So their requirements, such as seeds, fertilizers, implements, etc. should be made available at mandal level only.
Agriculture does not provide the workers employment throughout the year. So various handicrafts are to be encouraged such that the villagers can earn their livelihood in the non-crop seasons.
They should be educated by various seminars, to get rid of their superstitions.
REFERENCES
1. From Wikipedia, the free encyclopedia
2. Status of land Reforms in Andhra Pradesh and the need to implement
Radical Land Reforms
3. C:\Documents and Settings\s\Desktop\RURAL DEVELOP MENT...NET\State of Rural Healthcare in India-NRHM Report.htm
4. C:\Documents and Settings\s\Desktop\RURAL DEVELOP MENT...NET\Of tech and affordable healthcare for rural India Re diff_com India News.htm
5. C:\Documents and Settings\s\Desktop\RURAL DEVELOP MENT...NET\WHO Operation and maintenance of rural water supply and sanitation systems A training package for managers and planners.htm
6. C:\Documents and Settings\s\Desktop\Rural Water Supply & Sanita tion Initiative - African Development Bank.htm
7. C:\Documents and Settings\s\Desktop\RURAL DEVELOP MENT...NET\India - Rural Water Supply.htm
8. Rural Development Programmes -,M.A.[Rural Development], IGNOU, MRD 102-2, Programmes for Self & Wage Employment and Society Se curity – Current Stategy. Swarnjayanthi Gram Swarozgar Yojana [SGSY] – 1
9. Rural Development Programmes -,M.A.[Rural Development], IGNOU, MRD 102-3, other development programmes.
10. C:\Documents and Settings\s\Desktop\RURAL DEVELOP MENT...NET\Rural Development and Poverty Eradication in India by Mukundan, N_ - Interna tional Specialized Book Services.htm
11. Rural Development Programmes -,M.A.[Rural Development], IGNOU, MRD 102-2, Programmes for Self & Wage Employment and Society Se curity – Current Stategy. Swarnjayanthi Gram Swarozgar Yojana [SGSY] – 1
12. Rural Development, Resources for Public expenditure analysis in agri culture – APEA- www.google.com ]
13. Competition success Review Year Book 2002, page No. 529
14. Rural development and planning, M.A.[social development] IGNOU,
MRD 103-1 page 62
15. Rural development planning and Management-, M.A.[Rural Develop ment], IGNOU, MRD 103-1 Rural Development Planning. page 21
16. Rural development planning and Management-, M.A.[Rural Develop ment], IGNOU, MRD 103-1 Rural Development Planning. Page 61
17. Rural development planning and Management-, M.A.[Rural Develop ment], IGNOU, MRD 103-1 Rural Development Planning. Page86
18. Rural development planning and Management-,M.A.[Rural Develop ment], IGNOU, MRD 103-3, Voluntary Action. page 51
19. Rural development planning and Management-,M.A.[Rural Develop ment] IGNOU, MRD 103-3, Voluntary Action. page 82
20. Research Methods in Rural Development -, M.A.[Rural Development], IG NOU, MRD 004-1,Research in Rural Development . page 18
21. Rural Development Programmes -,M.A.[Rural Development], IGNOU, MRD 102-1, Poverty Alleviation Programme – A, Retrospect – page 21, 26
22. Status of Land Reforms in Andhra Pradesh and the Need to Implement Radical Land Reforms
23. A summary of the paper presented by K. Gopal Iyer in the Hyderabad convention on “Land Reforms and State Repression”
24. Rural Health [ andariki arogyam, Dr. Y Radha Krishna Murthy ]prajasakti publications.
25. Rural Development Programmes -, M.A.[Rural Development], IGNOU, MRD 102-3, Other Development Programmes
26. Arun’s Expected Essays, Young Man & Co. 1983
28. Vandana Shiva on global food crisis, You Tube, [Chrome, internet]
29. Hope Shand and Pat Mooney THIRD WORLD TRAVELER, Terminator Seeds Threaten an End to Farming, [Earth Island Journal, Fall, 1998]
| 30. Monsanto Buys ‘Terminator’ Seeds Company, by F. William Engdahl |
31. Jardhari, remembers FRONTLINE, Volume 25 - Issue 02 :: Jan. 19-Feb. 01, 2008[ Internet]
32. ______, FRONTLINE, Volume 25 - Issue 02 :: Jan. 19- Feb. 01, 2008
[ Internet]
33. Hope Shand and Pat Mooney, THIRD WORLD TRAVELER, Terminator Seeds Threaten an End to Farming, Earth Island Journal, Fall, 1998
34. ______, THIRD WORLD TRAVELER, Terminator Seeds Threaten an End to Farming, Earth Island Journal, Fall, 1998 [Internet]
37. THIRD WORLD TRAVELER, Terminator Seeds Threaten an End to Farming, by Hope Shand and Pat Mooney, Earth Island Journal, Fall, 1998
38. Monsanto Buys ‘Terminator’ Seeds Company, by F. William Engdahl
Global Research, August 27,2006 [Internet]
39. Dalit Human Rights Monitor, 2000-2003, Andhra Pradesh, Sakshi Publica tions.
40. Public Report on Basic Ecducation in India, Oxford University Press, 1999.
41. Indian Government and Politics, K.U., Distance Education, M.A.- I year, IV paper, 2009, p.149
42. (Annual Report 2004-2005, Ministry of Rural Development, Government of India, page 211).
43. Annual Report, 2004-2005, Ministry of Rural Development, Government of India Page 213.
44. https://www.microfinanceinsights.com/articles_new.asp?member=nonmembers&id=370 Added by Zunia on January 10, 2009
45. September 10th, 2008 - 8:02 pm ICT by ANI @TELL A FRIEND G Y
- By Girija Shanka Ojha
47. Daari tappina rupai – ABK Prasad
48. Idena prajaa vydyamv- Dr. Deme Raja Reddy, Vipla Computer
Servic es, Hy derabad, 2009
49. PURUGU MANDULA VISHA VALAYAM [telugu version]
Robert Van Bosch, Hyd Book Trust, 1998.
No comments:
Post a Comment