Primary neglect [Indian Express] [Mains GS2] In 2005, for every 10,000 people, India had 10 doctors in urban areas but only one in rural areas. And the situation today isn't a lot different. The Lancet reports that even though the number of health facilities in rural areas has shown an upward trend in the last decade, how to get enough doctors to work in villages still remains a formidable challenge for India. The consensus today is that the sole answer to the problem at hand lies in attracting more MBBS doctors into villages, primarily with better working conditions, adequate infrastructure, and increased salaries. OBut the problem transcends the scope of this rather simplistic solution. Its moorings lie in the tastes our medical education system has cultivated over the years. First, "it was evolved to serve a very small privileged section of the society", and West" D Banerji mentions two fundamental shortcomings in the existing system of medical education: second, "along with the natural science essentials, it carried with it the cultural accretions of the To serve the country's health requirements is one of the prime objectives of medical education Keeping with this, our undergraduate medical education was to focus on creating a dedicated and competent primary-care physician, sensitised to the desirability of primary care for the country's health needs, especially those of its rural population. This, however, hardly fructified.
The past few decades have seen a number of passionate calls for medical curricular reform. The Shrivastav Committee (1975) advised the reorientation of medical education in tune with national needs and priorities, while the National Health Policy (1983) advocated training a primary-care physician capable enough of providing essential health services to the rural population. The Regulations on Graduate Medical Education promulgated in 1997 laid a strong emphasis on health and community, apart from prescribing horizontal and vertical integration and problem-based learning The goal has been twofold: That of creating not only a competent primary-care physician While a debate over how much of the former has been realised makes a topic for Despite some positive curricular changes directed at orienting medical education but also one that is oriented to "health and community" rather than "disease and hospital" another day, success in the latter evidently remains elusive. towards the community, we have scarcely succeeded in inculcating a "social perspective" that can allow us to sympathise and relate to the health needs of the community.
A few pertinent and timely observations need to be made here We, through our medical curriculum, haven't actively sought to acquaint medical students with the sociocultural setting in which medicine functions in India. Topics under community medicine, such as maternal and child health and sanitation, have been inadequately integrated with clinical subjects. The current amount and rigour of community postings are grossly insufficient to lead to the desired end, and tertiary hospitals located in urban areas continue to be the temples of primary medical education, alienating it from much of the ground reality of healthcare. Certainly, it is futile to expect doctors trained under such circumstances to feel comfortable in primary health centres at the back of beyond Much more could have been done towards ennobling and upholding primary care as a dignified province of healthcare through medical education While there's no denying that the way to secondary and tertiary medicine has to pass through primary medicine, it ill behooves a country like India to allow undergraduate medical education to be relegated to the status of a mere stepping stone to medical specialisation and super-specialisation Present-day MBBS education, which provides little more than a cursory overview of medical specialties, does more to prime medical students for specialisation than shape them into well-rounded primary care physicians. with medical education failing to hold the torch for primary care, an affiliation for specialty-and super- specialty medicine has grown largely unchecked in a setting which has perennially failed to prioritise primary care over hospital care. As a result, while medical education was supposed to foster the conviction that the real indicators of development are an improvement in things as fundamental as nutrition and sanitation, it has ended up instilling a strong adoration for sophisticated tertiary care systems of relevance to only an affluent few.
Unless the motivation of our medical workforce is aligned with our healthcare needs, no measure shall succeed in effecting a solution to our problem. We need a medical curriculum that is adequately oriented to primary care and community health, and a healthcare system and policy environment that gives them their due OWe can no longer continue to adhere to an "overflow principle" of sorts whereby simply manufacturing more doctors would automatically pump more of them into our villages. The kind of training imparted largely decides the kind of motivation carried into service. This has to be realised at the earliest.
Act of intimidation [The Hindu Editorial] The death of Shujaat Bukhari in a terrorist attack at close range in Srinagar has taken away a journalist who held bold and independent opinions on the conflict in Kashmir and how it should be resolved In the choice of target and the timing of the murder, the attack sends out a chilling message: that on the eve of ld-ul-Fitr and in the closing days of the government's Ramzan ceasefire against militants, there are forces determined to gut the emerging consensus for extending the cease-ops and preparing the ground for dialogue. Bukhari, given the credibility he had painstakingly built with reportage that conveyed the complex reality of life in the Valley, was a prominent advocate of the ceasefire and the need to extend it Whichever terrorist group chose to kill him would have been aware of the consequences of his death. It is easy to spot the insistence to pull Kashmir back into the cycle of violence that was sought to be broken by the ceasefire. It is a challenge that the governments at the Centre and the State, as well as the security forces, would have been prepared for, and they must not allow these provocations to dim the case for a more humane outreach
Dangers Reporters+Editors face Bukhari's killing highlights the dangers that reporters and editors face in the country his death draws a direct line to the attacks on countless journalists, including the murders last year of Gauri Lankesh in Karnataka and Santanu Bhowmik in Tripura. DBukhari himself has been abducted before, in 2006. He survived that ordeal, but had to work thereafter with security cover, something no reporter would envy. It also underscores the irreplaceable role are negotiated amid conflicting narratives, ideologies and affinities. To reconcile these, the reporter needs to have in his tool kit an open heart, the persistence to tease out stories and connect all dots, no matter how they may disturb nationalist or separatist sentiments. of the journalist in Kashmir, where daily lives Without information, reconciliation is impossible. Over the decades, Bukhari enlightened readers even as he mentored journalists as the editor and founder of Rising Kashmir, and earlier as The Hindu's correspondent.
Sweet nothing [The Hindu Editorial] A little over a month after the Centre proposed a special cess under the GST to help alleviate distress among sugarcane farmers, the Cabinet Committee on Economic Affairs approved a 7,000- crore package for the sugar sector last week This package, with a mix of assured minimum pricing and special incentives for increasing molasses and ethanol production to gainfully mop up the glut of sugar in the country, is independent of the cess proposal that was expected to raise 6,700 crore. To put this in perspective, sugar mills, dues to farmers stand at 22,000 crore. Under the proposed bailout scheme, the government will procure sugar from mills at a fixed minimum price to help them clear dues to farmers, and also offer them other financial assistance. O Only about 1,175 crore, however, will be used towards procurement of refined sugar from mills to create a buffer stock of 30 lakh tonnes. This is a fraction of the 63.5 million tonnes output expected in the two sugar seasons from October 2017 to September 2019 With the record output, sugar prices have dropped from an average of 37 a kg in the previous season to 26 in the current season. OThe bailout plan promises to pay f29 a kg. Sugar mills say this is below their production cost of R35 a kg, though it may dissipate their immediate liquidity problems to an extent.
Rating agency Crisil reckons that the fixed price for sugar at mill gates and the buffer stock will at best help mitigate about 40% of the outstanding arrears to sugarcane farmers o And as production will rise again in the coming season, so will the extent of arrears. o The rest of the package will take time to materialise, with 4,440 crore of loans and 1,332 crore of interest subsidies for greenfield and brownfield distillery capacities. o Over time, this could help to use excess sugar for the manufacture of alcohol or ethanol, but it will not be soon enough to address the present crisis. All said and done, the Centre's sweetener for the sector does little to address structural problems and sticks to old-style pricing and stock-holding interventions instead of signalling a shift to market-driven cropping decisions. o The political compulsions driving the bailout are obvious, given that the sugarcane crisis was a rallying cry in the by-election in Kairana in Uttar Pradesh, which the BJP lost. o But that is no excuse for not thinking the package through. o Perpetuating the complex web of state controls in a politically-sensitive sector is no solution. The best way to address the problem of excess supply in the long run is to ensure some linkage between the price paid for sugarcane and the end-products it is used for, and encouraging the feedback from market prices to inform farmers' future cropping decisions. The current sops-driven solution could distort the agriculture sector further. A spate of lynchings [The Hindu Article] DIY Temple and state [The Hindu Article] DIY
Western disturbance to the rescue Weather likely to improve in north India over the next 24 hours with fresh thundershowers Page 2 What do you understand by western disturbances? Explain their origins, causes of increased frequencies and their effect on India. (250 Words) Definition: Western Disturbances are low-pressure areas embedded in the Westerlies, the planetary winds that blow from west to east between 30 and 60 latitude. Origin: They originate in the Mediterranean region, travel westward and enter India loaded with moisture, where the Himalayas obstruct them, causing rain and snow over northern India OThe moisture in these storms usually originates over the Mediterranean sea and Atlantic Ocean. WDs are important to the development of the Rabi crop in the northern subcontinent.
Causes of increased frequency: OThe frequency of western disturbance amplified because of presence of easterlies from Bay of Bengal. Also due to pronounced warming over the Tibetan plateau in recent decades which can be attributed to climatic warming, favours enhancement of meridional temperature gradients. The warming in recent decades over west central Asia led to an increase in instability of the western winds thereby increasing WDs leading to a higher intensity for heavy precipitation. Effects: Such disturbances can damage crops resulting into economic as well as agricultural loss for the people and farmers OFarm output is affected when crops that are ready to be harvested or about to ripen, get soaked in excessive rainfall. OThis is a concern in states like Madhya Pradesh, Gujarat, Maharashtra and Rajasthan, Punjab and Haryana
THE HINDU SATURDAY, JUNE 16, 2018 China to impose equal tariff ' on US. goods Beijing terms Trumps action outdated and backward
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