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Mar 13, 2007

Fragile lives

The fundamental causes leading to high maternal mortality are yet to be addressed

Mamta Bahelia, A tribal woman in Pathadeori village of Madhya Pradesh's Seoni district. Weighing 52 kg into the eighth month of her pregnancy, she continues to do laborious work.
ACCORDING to the Sample Registration Survey for 2001-03, around 78,050 pregnant women die in India every year. For every hundred thousand live births, there are 301 maternal deaths, the survey says. According to the White Ribbon Alliance of India (WRAI), a nationwide initiative that promotes safe motherhood, there has been no significant decline in India's maternal mortality rate (MMR) since the 1990s. Surveys of the causes of the high MMR show how inaccessible timely medical attention still is to many pregnant women. An inadequate health care system, lack of awareness, bad roads and, of course, poverty are some of the major factors that come in the way of safe deliveries for pregnant women. Surveys have also found that the maximum number of maternal deaths is recorded among the Scheduled Castes, the Scheduled Tribes and Other Backward Classes.

Bimla of Duhiya village in Murar block of Madhya Pradesh's Gwalior district is an Accredited Social Health Activist (ASHA). Madhya Pradesh is one of the 18 Empowered Action Group States covered under the National Rural Health Mission (NRHM); it is one of the "low-performing" States in terms of institutional deliveries, along with Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Chhattisgarh, Rajasthan, Orissa and Jammu and Kashmir. As an ASHA, Bimla gets Rs.600 for every pregnant woman she is able to take to a government hospital for delivery. Indeed, all she can remember of her "training" is that she, and others like her, were told that they would be paid if they took pregnant women to hospital.

But Bimla could not save the life of her own sister-in-law, Khiloni. The family says she died because there was no trained "birth attendant" in the village and the government hospital where they took her would not accept the case because it was complicated.

Bimla's is a family of landless farm hands. Duhiya is a village of mainly Jatavs, though there are a few landed, upper-caste families too. Only a kutccha road links Duhiya to Gwalior city. Bimla does not seem fully aware of the provisions of the Janani Suraksha Yojana (JSY), operational since April 12, 2005, under which pregnant women get Rs.1,400 if they give birth in a government hospital and are also compensated if they give birth at home or in accredited private hospitals. Only two of the 25 women she took to a government hospital for delivery got paid under the JSY. Her own payment is often not on time and she is not paid for conveyance any way. She is supposed to serve a `population area' of 1,000, but she serves two panchayat areas with a total population of 2,000. Sometimes, she says, Auxiliary Nurse Midwives (ANMs) refuse even to "touch" pregnant women of lower castes, let alone attending to their needs.

According to an activist from a rights organisation in Murar, there have been several cases in Duhiya where pregnant women were turned away from the government hospital and forced to spend small fortunes on treatment at private hospitals. "This also means that the ASHA does not get paid," she said.

In an area where maternal mortality obviously needs more attention than it gets, priorities sometimes seem strangely misplaced. The medical officer in charge of the primary health centre (PHC) in Hastinapur town of Murar block, for instance, could only think of the missing boundary wall at his PHC when asked what problems he faced at work. The centre he runs has no blood bank or ambulance services, no female doctors, and its nurses are not trained in Emergency Obstetric Care Services (EmOC). It has a proper building but is understaffed. Local people say there is no one at the centre after evening though it has been converted into a 24-hour First Referral Unit under the NRHM.

He denied that there had been any cases of maternal mortality at his PHC. But he added that the families of pregnant women were usually to blame for pregnancy-related deaths because they did not organise timely medical attention. By the time a pregnant woman was taken to a doctor, he said, it was usually too late. He also said that anaemia was a major cause of maternal mortality. At least on this last point, the National Family Health Survey III would agree with him. The survey data, released recently, show that nearly 82.6 per cent of the children in the age group of six to 35 months are anaemic; 40.1 per cent of women have a body mass index (BMI) below normal; 57.9 per cent of pregnant women and 57.6 per cent of women who were ever married are anaemic.

The Economic Survey (2005-06) says the NRHM is the chief vehicle for making good the promises made on health care in the National Common Minimum Programme. Commenting on the implementation of the NRHM so far, WRAI spokesperson Aparajita Gogoi said there was no arrangement for training midwives under the Mission. Most ANMs are at present involved with family planning and health care for children. Skilled assistance at childbirth is not easily available. Much of what happens in communities and in the hospitals goes unreported and there is little accountability for maternal deaths. Doctors are often not trained in emergency obstetric care services and nurses and midwives are not encouraged to carry out life-saving procedures. Gogoi also said that panchayats were entitled to Rs.5,000 from the Health Department for emergency obstetric care services, but most of them were not aware of it and did not use the money.

Lack of nutrition is also a problem. The Integrated Child Development Services centre at Duhiya functions from the home of an Anganwadi worker. The only diet supplement that children and pregnant and lactating mothers receive here is soya puffs.

EVEN A BASIC labour room like this one is not something women have easy access to in rural India. The government now offers cash incentives to encourage women to go to hospitals for delivery.

The story is the same everywhere. Banjara Ka Pura, also in Murar, is a village dominated by Banjaras, a Scheduled Tribe. All families in the village are landless and daily wages do not exceed Rs.40. The entire village should have been categorised as Below Poverty Line, yet few residents hold BPL cards. Even the grain allotted for the BPL category is not sold at BPL prices. There are young widows and old destitute women in the village who are not covered under the Antyodaya scheme for foodgrain entitlement. Expenditure on health leads to bondage in the village.

One woman, Lakshmi, narrated how her pregnant daughter-in-law died of haemorrhage after a miscarriage because she did not get timely treatment. "We used to take her in a bullock cart every day to the PHC. But the centre refused to admit her. We spent Rs.800 on a jeep to bring her body back," she said. She added that the entire family now worked as bonded labourers for the local temple priest, who had lent them Rs.35,000. Lakshmi's second daughter-in-law was luckier; she delivered her child in a tractor.

A recent Maternal and Perinatal Death Inquiry (MAPEDI) study by the United Nations Children's Fund (UNICEF), in Guna and Shivpuri districts of Madhya Pradesh and Purulia district in West Bengal, says most maternal deaths occur within six to 24 hours of delivery, the immediate cause being hemorrhage. In most of the cases surveyed, the women were found to be severely anaemic, and had been so from adolescence.

The MAPEDI study, based on interviews with families that had lost pregnant mothers, highlighted that the majority of the deaths were preventable and that people would access services if they could. Financial constraints and bad roads are among the factors that prevent pregnant women and their families from accessing medical attention during and after pregnancy. The fact that trained nurses and midwives are not available round the clock also pushes up maternal mortality.

In the Purulia study of nearly 106 maternal deaths, it was found that nearly 80 per cent of the women had sought formal care at some point of their illness and nearly 46 per cent had sought formal care after complications arose. Among the reasons for not seeking formal care, 23 per cent of the respondents (family members) felt that transportation was a leading cause. While 16 per cent felt that the person herself did not perceive she was sick enough, only a meagre 8 per cent felt that the problem required traditional care. Nine per cent could not pay for transport, while 10 per cent said transport was not available.

The study, presented by Sudha Balakrishan, indicated there was an awareness of the need to seek health care, just as there was in Madhya Pradesh. But while most respondents in Purulia could afford transport to hospitals and health centres, very few in the Madhya Pradesh case study said they could do so.

Following the UNICEF study, the Government of West Bengal decided to review every maternal death. It also issued an order making all maternity beds in government hospitals free of cost. The problem is that despite heightened allocations for health care, the Central government continues to view health care as important "not only for reaping the demographic dividend, having a healthy productive workforce and general welfare, but also for attaining the goal of population stabilisation. Population stabilisation is proposed to be achieved by addressing issues like that of child survival, safe motherhood and contraception" (Economic Survey 2006-2007). Health activists have increasingly begun to de-link the goals of population stabilisation from MMR and infant mortality rate (IMR), the government's approach remains much the same.

The NFHS-III interviewed 230,000 women in the 15-49 age group and men in the 15-54 age group. It found that 44.5 per cent of the women were married before the age of 18. Jharkhand recorded most of the cases (61.2 per cent), followed by Bihar (60.3 per cent) Andhra Pradesh (54.7 per cent) and Rajasthan (57.1 per cent); the lowest numbers were reported from Himachal Pradesh (12.3 per cent), Jammu and Kashmir (14 per cent), Kerala (15.4 per cent) and Punjab (19.4 per cent).

There seems to have been a shift from a vertical approach to health care to a more decentralised one and the 2007-08 Budget proposals include higher allocations for health care. But there needs to be a greater emphasis on an inter-sectoral approach, especially on food security. It is not only a question of meeting the Millennium Development Goals any more, it is about being accountable and sensitive to the needs of one half of the nation's population.

http://www.hinduonnet.com/fline/stories/20070323001708900.htm

Moratorium is voluntary

Interview with Dr. Anil Kakodkar, Chairman, AEC.

THE year 2006 was "exciting" for the Department of Atomic Energy (DAE) on several counts. It kicked off the year with the inauguration of the golden jubilee celebrations of its nerve centre, the Bhabha Atomic Research Centre (BARC), Trombay on January 20. It was on this day 50 years ago that Prime Minister Jawaharlal Nehru formally inaugurated the Atomic Energy Establishment, Trombay (AEET), making the beginning of India's atomic energy programme. The AEET, founded in 1957 by Homi J. Bhabha, the paterfamilias of the programme, was renamed after him in January 1967, by Prime Minister Indira Gandhi. Today, BARC is the largest research and development organisation in the world. Dr. Anil Kakodkar, Chairman, Atomic Energy Commission and Secretary, DAE, calls it "a technology powerhouse".

Dr. Srikumar Banerjee, Director, BARC, describes it as "the fountainhead of all major activities" of the DAE.

On March 2, 2006, during U.S. President George W. Bush's visit, India and the U.S. agreed upon a Separation Plan document, which enables export of nuclear reactors to India from other countries. The plan was a sequel to the Joint Statement made by Prime Minister Manmohan Singh and President Bush on July 18, 2005, in Washington D.C. It entailed that India would place 14 of its 22 pressurised heavy water reactors (PHWRs), in operation or under construction, representing 65 per cent of its nuclear capacity, under the International Atomic Energy Agency's (IAEA) safeguards. The DAE was, however, firm that its breeder reactors, would be kept out of the purview of these safeguards.

On May 21, 2006, the third reactor at Tarapur, an indigenous PHWR with a capacity of 540 MWe, reached criticality. India will no longer build 220 MWe or 540 MWe PHWRs. All its future PHWRs that use natural uranium as fuel will be of 700 MWe capacity. A problem, however, remains: the shortage of natural uranium that fuels the indigenous PHWRs. The projects for mining uranium are delayed because of the local opposition especially in Meghalaya and Andhra Pradesh. This in turn has led to a delay in starting the construction of 700 MWe indigenous PHWRs. The capacity factor of the operating 220 MWe PHWRs has also dropped because of the shortage.

Kakodkar and representatives of six other countries signed an agreement in Brussels on May 24, 2006 to launch the construction of the International Thermonuclear Experimental Reactor (ITER), which is a fusion reactor.

The year was not without its share of big controversies. In April/May 2006, Russia supplied about 50 to 60 tonnes of enriched uranium for the two light water reactors at Tarapur, invoking the safety clause of the Nuclear Suppliers' Group guidelines. This angered the U.S.

On July 26, 2006, the U.S. House of Representatives passed the "United States and India Nuclear Cooperation Promotion Act of 2006." The Bill provoked angry reaction in India from the media, academics and nuclear science community because it imposed many new, tough conditions that were not part of the joint statement by Manmohan Singh and Bush. As Dr. M.R. Srinivasan, former Chairman, Atomic Energy Commission, said, "During much of July and August 2006, politicians, Members of Parliament, media, public opinion and the scientific community were greatly agitated over the attempts of the U.S. Congress to rewrite what India perceived as a settled agreement." There was a similar angry reaction when the U.S. Senate passed in September 2006 the "United States-India Peaceful Atomic Energy Cooperation Act." The Hyde Act, passed by the U.S. Congress in December 2006, was equally unpalatable to the DAE officials.

Asked whether the Hyde Act impinged on India's strategic programme, Kakodkar, in an interview published in The Hindu of January 27, 2007, said, "... Whether you take it at the level of the sense of the Congress, the level of U.S. policy or the assessment and reporting requirement, there are a fairly large number of sections which essentially seek to, sort of contain or cap the Indian strategic programme. And in fact, in some places, it also articulates a policy or philosophy of rollback. This is a very serious issue and we need to seek clarifications. This is one of the most important things. There are of course many others."

Problems have surfaced again between India and the U.S. in the negotiations leading to the "123 agreement" with the U.S. insisting that India could not conduct any more nuclear tests and India sticking to its position that its unilateral voluntary moratorium "cannot be converted into a bilateral legality." The DAE is also firm that India should get lifetime of fuel supply for the reactors it places under the IAEA safeguards, not merely one extra "core" of fuel that the U.S. says these reactors are entitled to.

It was in this context that T.S. Subramanian met Dr. Kakodkar at BARC on March 2, 2007, for an interview:

What will be the future thrust of BARC activities?

BARC is a technology powerhouse. The future thrust will essentially be, of course, in the utilisation of thorium as fuel, which has been the thrust all along. Next comes the generation of nuclear energy at high temperature so that we can produce hydrogen in addition to electricity because hydrogen is likely to be another important carrier of energy in future. Then another thrust will be on ways of using technologies for storage, transportation and utilisation of hydrogen. We are also talking about the role of particle accelerators.

Do you mean accelerator-driven systems?

A lot of technologies have to be developed because particle accelerators can be used for energy production, for example, through accelerator-driven systems. This is as far as area of energy is concerned.

There are other areas. The spent fuel that comes out of the reactor contains a lot of radioactive products such as cesium. It is an important material for radiation processing. It is better than cobalt.

Can cesium be used for irradiation of spices, potatoes and onions to increase their shelf-life and prevent sprouting?

We can have a whole set of new technologies for radiation processing using cesium. Other thrust areas will be a host of technologies, including MEMs [micro-electro-mechanical systems], high-precision engineering and even futuristic micro-maching.

When will you start the construction of the Advanced Heavy Water Reactor (AHWR) that will use thorium as fuel, which will signify the beginning of the third stage of India's nuclear power programme? When you were BARC Director, you had written an article in the BARC newsletter in 1999 that India should accelerate the utilisation of thorium, which we have in plenty.

Correct.

In 2003, you said the DAE will start the construction of the AHWR in 2004. It is 2007 now.

I know.

Construction of the AHWR has not begun. You said it would begin in 2004.

The peer review was completed sometime ago. It was being looked at by the Atomic Energy Regulatory Board for pre-licensing review. I believe that has just been completed. They are now preparing the project document. So we want to start the construction this year. That will be our attempt.

Has Tarapur been selected as the site for the AHWR?

We have not decided on the site yet.

How was the criticality of the third nuclear reactor at Kaiga, Karnataka on February 26?

Kaiga-3 criticality went off very well.

It is said there has been a delay in starting the construction of the 700 MWe PHWRs because the natural uranium supply from the country will not match the demand. (The indigenous PHWRs use natural uranium as fuel and heavy water as both coolant and moderator).

Yes. We have to make some more progress on the mining and milling capacity of natural uranium in the country. We have this new mine coming up now.

Where is this new mine?

The uranium mine at Bandurung [near Jaduguda in Jharkhand State] is ready. The erection of a mill at Turamdih [also near Jaduguda for processing the natural uranium] is almost complete.

We have the environmental clearance for the Tumalapalle mine in Andhra Pradesh. We also have the environmental clearance for exploratory mining at Gogi in Karnataka.

Is the mine at Bandurung producing uranium ore?

They have reached the ore body. As soon as the mill at Turamdih starts working, they will start producing the ore at Bandurung. The mill is mechanically complete. They must be commissioning it now.

You have not been able to bring around the Meghalaya government to start the process of uranium mining in the State.

In Meghalaya, some progress is there. It will take time. In the meantime, we are working on the preliminary activities on [starting the construction of] 700 MWe reactors [at Rawatbhatta in Rajasthan and Kakrapar in Gujarat].

You said in September 2006 that India would not allow its unilateral, voluntary moratorium on nuclear tests into a bilateral legality with the United States. The U.S. officials have told their Indian counterparts during their negotiations on the "123 agreement" that it is not merely a nuclear test by India but any event in India that "jeopardises supreme U.S. national interests" will lead to the termination of the Indo-U.S. nuclear cooperation.

The question is our position remains the same. The Prime Minister has very clearly stated our concerns in Parliament. Now, we are, of course, approaching the whole matter in a positive spirit. So what we would like to see is explicit provisions that safeguard our interests in the light of the concerns that were expressed in Parliament by our Prime Minister. That will be the basis on which we will approach the negotiations.

If the U.S. insists that India should not conduct any more nuclear tests and that it will terminate the Indo-U.S. nuclear cooperation if we do the tests...

We don't want to convert this [unilateral, voluntary moratorium on nuclear tests] into a bilateral legality. We cannot do that. The moratorium on nuclear testing is unilateral, voluntary. So that is the position. Nothing more than that.

The U.S. says that it would supply only one extra "core" of fuel for the reactors instead of the lifetime fuel supplies which had been agreed upon earlier by India and the U.S.

The March 2006 Separation Plan document has a clear provision for building stockpiles of fuel to meet the lifetime requirements of reactors placed under the International Atomic Energy Agency's safeguards. That is what I am saying. We need everything to be built into the 123 agreement in a very explicit manner so that our interests are protected.

At what stage is our negotiations with the U.S. on the 123 agreement?

The 123 draft has just been given to them.

http://www.hinduonnet.com/fline/stories/20070323003411800.htm

Nod to terminate doctors for absence

Ranchi, March 8: The state government today gave its nod for terminating the services of 10 doctors due to their prolonged absence from duty.

State health minister Bhanu Pratap Sahi said these doctors posted in different districts of the state went on leave five years ago without informing the department and they did not resume office till date.

Since the Jharkhand Public Service Commission appointed these doctors, the government would forward the names of the doctors to the commission for its mandatory approval. “It was a tough decision. But there was no other way since absence from duty for such a long period calls for disciplinary action,” said the health minister.

The health department had initially showcaused these erring doctors seeking explanation for their absence from duty. “The showcause to these doctors were sent through mail. And in most of the cases, the mails were returned, as there was no one to receive them at the addresses that the doctors had given in their applications,” health officials said.

The health department has also decided to lodge cases against a computer operator and a medical officer for their alleged involvement in fraud.

Sahi assured to address the demand of the doctors of Rajendra Institute of Medical Sciences (RIMS) for promotion within a week.

“We would also take an appropriate decision on the contractual doctors after the panel submits its report to the department in the next one month,” Sahi stated

http://www.telegraphindia.com/1070309/asp/jamshedpur/story_7492846.asp

Flush with funds, health sector remains dry

NEW DELHI: The union budget allocation for health and family welfare is growing - this year it was up by 21.9 per cent making it to Rs 15,291 crores - but it is hardly reflecting on the health indices of the country.

Despite getting huge allocations and ambitious policy planning from the Centre, the states hardly feel inspired which is evident from the utilisation of funds by them. Almost half the states in the country have failed to put the central funds to proper use and some of the health ministry’s flagship programmes like Reproductive and Child Health Scheme (RCH)-II are the worst sufferers.

RCH II aims at reducing maternal mortality ratio (MMR), infant mortality rate (IMR), total fertility rate (TFR), increasing the contraceptive prevalence rate (CPR) and complete children immunisation. The government plans to spend Rs 40,000 crore on the second phase of the RCH.
But out of Rs 898.83 crore released to 35 states and union territories by the union government in 2005-06 for RCH II, not even half the amount was spent on these fronts. In fact, the actual utilised money till March 2006, was Rs 386.18 crore. Worse still, some states had below 10 per cent money utilisation, with Nagaland being the most glaring example: Out of Rs 6.61 crore given to the state it could spend none.

Out of the 18 states that barely touched the 50 per cent money, West Bengal was allotted Rs 59.8 crore but used just Rs 3.18 crore, i.e. a mere five per cent. Assam spent six per cent and Manipur nine. And despite cornering the highest funds in the country — a whopping Rs 170 crore - Uttar Pradesh could use only 28 per cent and Bihar used 15 per cent. Incidentally, UP and Bihar have some of the highest occurances of Japanese Encephalitis, polio and other vector borne diseases besides having shameful MMR and IMRs. The IMR in UP is 73/1000 while 62/1000 in Bihar.

“The results are clearly reflecting in their various programmes like population stabalisation and immunisation,” said a health ministry official. “The money is mainly being used on infrastructure development and hardly anything is being passed on to the patients as part of the intervention methods. It’s true that the states are lacking the attitude but it’s also unfortunate that the absorption capacity was not calculated at the planning level,” said a health expert.

Sadly, even big states like Maharashtra could use only Rs 15.98 crore out of allocated Rs 52.8 crore, touching a mere 30 per cent and Kerala which usually has impressive Human Development Indices has spent merely 22 per cent. However, while southern states like AP and Tamil Nadu have traditional better health indices, what surprises is that the Empowered Action Group states like Chhatisgrah and Orissa focusing attention to health. In 2005-06, Chattisgarh utilised about 93 per cent followed by Orissa (90), Andhra Pradesh (87), Tamil Nadu (86) and Haryana (71).

The reason for stunted health care delivery in North East is evident by the poor spending by the states, which shows that despite getting Rs 109.6 crore the eight NE states could just use Rs 21.6 crore. Out of these, Sikkim stands out by having 103 per cent spending. With such a huge gap and lack of co-ordination between the central and state governments in RCH, it would be tough task for the nation to meet the Millennium Development Goals.

http://www.dnaindia.com/report.asp?NewsID=1084647

Hope flickers for Kala Azar victims of Bihar

Kalu Paswan and Mangry Manjhi, landless labourers of a Bihar village affected by Kala Azar, will soon have a decent house, thanks to the government's plan to check the spread of the deadly disease.

Dream of a pucca house made of brick and mortar is all set to become a reality for these landless labourers of Naubatpur village near Patna, affected badly by Kala Azar, a parasitic disease transmitted by the tiny sand fly.

Now they will be provided houses by the central government to check the spread of the disease.

'By providing proper houses to Kala Azar affected families, our aim is clear to create a friendly environment to check and control the disease,' Rural Development Minister Raghuvansh Prasad Singh said Tuesday.

According to Singh, about 12,960 pucca houses will be built in addition to the Indira Awas Yojna units for the Kala Azar affected families in 216 villages spread in over two dozen districts of the state.

'At least 60 houses will be built in each of 216 villages for the kala azar affected families at the cost of Rs.24.30 crores (Rs.243 million),' Singh said.

Experts said that due to poor living standard and unhygienic conditions, the disease spread faster among the poor Dalit community of Mushahars.

Kala Azar, medically known as Visceral Leishmaniasis and locally called black fever, is also known as the poor man's disease because it affects the poorest of the poor. It has affected mostly the Mushahar community since they are easy prey due to their socio-economic compulsions and unhygienic living conditions.

The official record estimated that 25,000 people, mostly poor in 31 of the state's 38 districts, are in its grip. The disease is characterised by fever, weight loss, swelling of the spleen and liver and leads to cardiovascular complications resulting in death.

According to former union health minister C.P. Thakur, an expert on Kala Azar, more than 50,000 people are suffering from the disease.

The little sand fly that transmits the disease multiplies in the cow dung that villagers use liberally to plaster their shanties or as cow dung cakes for fuel. The flies survive on the sap in banana and bamboo groves and the decomposed cow dung heaps and make their home in the straw thatches of houses.

'Decent houses will prove hostile to the little sand fly to survive and will help the fight against the disease,' Singh told IANS over telephone.

Deaths from Kala Azar in different parts of the state have been reported regularly in local dailies. The state government's claims of providing treatment for Kala Azar still remains on paper.

Many of the worst Kala Azar hit areas are in the north Bihar districts of Vaishali, Muzaffarpur, Vaishali, Sitamarhi, Sheohar and East and West Champaran.

In October-November last year, 29 died in Muzaffarpur and 35 in Vaishali due to Kala Azar.

Bihar last faced a Kala Azar epidemic in 1991 when 250,000 cases were reported. In 2000, the numbers were low but started rising from 2003.

The disease occurs in 62 countries, primarily in the developing world. Around 90 percent of world cases are found in India, Bangladesh, Nepal, Sudan and northeast Brazil.

Experts say over 60 percent of the cases in India are found in Bihar alone.

http://www.indiaenews.com/india/20070313/42909.htm

One maternal death every 2 hrs in West Bengal

NEW DELHI: Unabated maternal deaths in West Bengal are causing concern. The West Bengal Commission for Women has sought immediate help from state MPs in this regard. According to a survey conducted during their Safe Motherhood Project, one maternal death takes place every two hours in the state. While the survey estimated that about 4,624 maternal deaths took place in 2005-06, it also found that only 39% cases were reported.

Jasodhara Bagchi, chairperson, West Bengal Commission for Women, says, "The issue is a grave one and needs to be addressed collectively by including civil society, law-makers and government. Though several schemes have been

initiated by the government to prevent maternal deaths,

the need of the hour is to make an all-out effort to tackle it. We have come to the Capital to meet all our MPs and apprise them of the gravity of the situation and seek their involvement."

Atanu Thakur, project consultant for the commission, says, "While five lakh mothers die every year worldwide, about 1.25 lakh die in India alone. As far as West Bengal is concerned, there are 266 maternal deaths for every one lakh live births. However, exact data is not known. There are many hill and rural areas where mothers give birth in their homes and die without medical aid."

Augustine Veliath, Unicef, says, "Reproductive health problems are the biggest cause of women's ill-health and mortality worldwide. These include unintended pregnancies, high fertility, abandoned children and unsafe abortions. Another factor affecting reproductive health is empowerment of women and their ability to choose when they want to get married, start a family and choose an appropriate gap between children."

http://timesofindia.indiatimes.com/NEWS/India/One_maternal_death_every_2_hrs_in
_West_Bengal/articleshow/1720120.cms

Number of candidates fewer for HS board too

Kolkata, March 12: Much like the reduction in the number of candidates for the Madhyamik examinations this year, the Higher Secondary examinations is also seeing a drop in the number of candidates — albeit a less startling number.

At least the reasons cited by the West Bengal Board for Higher Secondary Education justifying the drop are more logical than the ones offered by the West Bengal Board for Secondary Education.

Last year, the number of candidates who took their HS examination was 4,29,472. Even though the number of students who had enrolled for the exams had increased by 6,000, compared to last year, this time the number has reduced to 4,03,154 — which means there are 26,000 fewer candidates taking the Class XII board examinations.

Debashis Sarkar, secretary of the board, said: “Last year, there was an increase in the pass percentage and hence this year the number of repeaters is less. Also, under the new syllabus, there will be no external examinations. So this year, no external candidates will be appearing for the examinations.”

The HS examinations will also be devoid of candidates taking their tests in the vocational stream, because under the new norms of the state government a new vocational council has been formed to hold the vocational examinations.

“Since the syllabus has been bifurcated, the weaker students are being detained in Class XI itself. Hence the number of detentions in standard XII has decreased,” said Sarkar. One of the main reasons for the reduction in the number of candidates is the reduction in the ratio between the backlog and the regular candidates.

While last year, the ratio was 40:60, this year it has reduced to 25:75. And according to the verdict of the board, the decrease in the backlog and the regular ratio is a positive sign for the Higher Secondary Educational System.

This year, the HS examinations and the Class XI annual examinations will be held simultaneously. While the HS exams will be held from March 16 to April 16, the Class XI examinations will be held from March 17 to April 17. Timings for the Class XI annual examinations to be held on April 16 has been changed from 10 am to 2 pm.

“Since this year we will be conducting the Class XI and the HS examinations, both for the old and new syllabus, the board has decided to pack the question papers in different coloured packets to avoid confusions and mix-ups,” said Sarkar.

http://cities.expressindia.com/fullstory.php?newsid=226445

12 NGOs under CBI scanner for foreign funds

The Central Bureau of Investigation (CBI) is probing accounts of at least 12 NGOs which have received funds under the Foreign Contribution Regulation Act (FCRA) in the last three years and discreet enquires are also on to ascertain their activities and antecedents of their office bearers.

Minister of State for Home Sriprakash Jaiswal told the Lok Sabha Tuesday that NGOs' annual returns in the prescribed FC-3 forms were being studied by the monitoring unit of the FCRA.

'Where it is established that the nature of violation by the association is serious and mala fide, punitive action is taken under Section 10(a) of the Act and the association is prohibited to accept any foreign contribution or is placed in the prior permission category,' the minister said.

'Furthermore, in such serious cases where it is prima facie established that funds are being diverted for other purposes the matter is referred to the CBI.'

The NGOs under the CBI scanner are Reach in the Nilgris and Church of Christ Trust in Tamil Nadu, Central Calcutta Lord Jesus Medical and Welfare Society and Darjeeling Jesuits of North Bengal in West Bengal, Reach Valley View Academy, Madhya Pradesh, Tauheed Education Trust, Bihar, Khwaja Khushal Charitable Trust, Uttar Pradesh, IICD, Uttarakhand, Idar-ed-Talimate Eslamia, Gujarat, United Team Leadership Ministry, Manipur and Abdul Kalam Azad Islamic Awakening Centre, Delhi.

After the government opened a new facility, 'FCRA on line', in September last year, over 576 applications have been received for grant of registration.

According to Jaiswal, over 8,673 organisations have been placed under the prior permission category for non-submission of FC-3 forms.

http://www.indiaenews.com/india/20070313/42856.htm

Self-help doubts

Opposition grows to the microfinance Bill on the grounds that it, among other things, excludes the big players in microfinance.

THE heightened allocations to the social sector and the rhetoric of women's empowerment notwithstanding, a Bill meant to guarantee financial services to women and other disadvantaged sections has run into rough weather. The Ministries of Women and Child Development and Rural Development are not in agreement with certain provisions of the Micro-Financial Sector (Development and Regulation) Bill, 2007, which they believe has been drafted in haste.

The main objective of the Bill is to provide for the promotion, development and orderly growth of the microfinance sector in rural and urban areas so as to offer an enabling environment to ensure that the people, especially women and certain disadvantaged sections, have universal access to integrated financial services of banks.

Another objective is to regulate the functioning of microfinance organisations. In its previous avatar it was known as the National Bank for Agriculture and Rural Development (Amendment) Bill, 2006. The Bill was first drafted in 2000 with the objective of giving a legalised structure to microcredit and microfinance organisations.

According to a note prepared by the Department of Economic Affairs (Banking Division) in the Finance Ministry, the Bill was formulated after consultations with the Reserve Bank of India (RBI), the National Bank for Agriculture and Rural Development (NABARD), and the Indian Banks' Association (IBA).

The logic was that "many microcredit-providing institutions such as MFIs [microfinance institutions] and SHGs [self-help groups] have been repeatedly stressing the need for regulation of this sector in view of its rapid growth and fear of less-than-credible institutions dealing with the poor and illiterate people." But the main problem with the Bill is that it excludes the big players in microfinance.

The Bill demonstrates perhaps that the talk of "inter-sectoral" convergence is just rhetoric. It also brings out the lack of inter-Ministerial discussion and deliberation.

For instance, the Rashtriya Mahila Kosh (RMK), set up in 1993 under the Ministry of Women and Child Development to provide credit to poor rural women, has been left out from the to-be-constituted microfinance development council (MDC), whose objective is to advise NABARD on matters relating to microfinance.

The council will have two women nominees, who may not necessarily represent the Ministry of Women and Child Development. This, said a senior woman bureaucrat, was ironical as 90 per cent of microcredit borrowers were women. Women and Child Development Minister Renuka Choudhary said the Bill was inimical to the interests of poor women. Excluding the RMK was a big surprise, considering that it has benefited 5,68,000 women so far. The Bill has also run into trouble from women's organisations and those closely involved with SHGs.

The All India Democratic Women's Association (AIDWA) believes that while the microfinance Bill ought to be rejected outright, there is also a need to look at the working of SHGs over the past two decades. According to AIDWA, unlike women's and people's science groups, the Government of India and other high-profile NGOs viewed SHGs as banking institutions whose savings needed to be mopped up in order to ease the burden of public investment.

Among the problems facing SHGs, it said, was the exclusion of a great number of poor people from the formation of SHG federations because of definitional problems and the lack of representation of women in the decision-making processes. Said Sudha Sundararaman, general secretary, AIDWA: "Instead of replacing formal credit institutions, the SHGs are designed to function as groups to ensure efficient transactions and repayments on a limited credit-based agenda. This works against the inclusion of issues such as domestic violence, sexual and reproductive rights and political participation. Such issues are then addressed by women `in spite of' rather than as a legitimate agenda of the SHGs."

Main objections

The main objections to the Bill are that it excludes from its purview non-banking financial companies (NBFCs) and companies registered as not-for-profit under Section 25 of the Companies Act; these two categories of companies deal with 90 per cent of microfinance. The Bill, instead, seeks to regulate societies, cooperative societies and trusts registered under State laws, also called microfinance organisations (MFOs), which handle only 10 per cent of such services in the country.

These smaller organisations could also get into trouble, given the conditionalities such as profitablity, 15 per cent capital adequacy ratio (that is, the capital base of the organisation should comprise at least 15 per cent of its outstanding loans), three years' experience and NABARD certification.

Nevertheless, the Cabinet and the Group of Ministers has cleared the Bill and it is likely to be tabled in the current session of Parliament.

The concern among non-governmental organisations (NGOs) involved with SHGs is that MFIs, profit-oriented as they are, may introduce practices that might corrupt the SHG model itself. They also feel that the conditionalities are harsh considering that even commercial banks were required to have a capital adequacy ratio of only 8 per cent.

Thomas Franco Rajendra Dev of the Mahalir Association for Literacy Awareness and Rights (MALAR), a federation of SHGs in Kanyakumari district, said repayment rates were, by and large, very good and that was one reason why MFIs wanted to enter the picture in a big way and that too without many regulations.

He said MFIs in Andhra Pradesh used coercive methods to make women repay their loans and added that he knew of many instances of such harassment. He said that in the last seven or eight years, a lot of SHGs and microcredit institutions had been formed with the sole purpose of obtaining and disbursing loans. Only in some States, especially Kerala, where linkages had been made between literacy, political empowerment and economic empowerment within SHGs, the poorest among the women had benefited and emerged as a force.

Incidentally, estimates of the number of SHGs in the country range from seven million to more than a crore. The demand for micro-credit is estimated to be close to Rs.1 lakh crore. Until December 2006, 24.82 lakh SHGs had been credit-linked with a cumulative bank loan of Rs.13,720.82 crore. As on January 25, 2007, about 24.33 lakh SHGs, with a bank loan of Rs.10,895 crore, had been formed under the Swarnajayanti Gram Swarojgar Yojana of the Ministry of Rural Development. Last year alone, Rs.65,000 crore was disbursed as microcredit.

But there are doubts whether it can help rural poverty. Franco Rajendra Dev said it was an illusion that microfinance alone would eradicate poverty; it had to be accompanied by other measures, including land reforms, which was the experience of both Kerala and West Bengal. The Integrated Rural Development Programme, which began in 1979, he said, failed to reduce poverty, as it was unconnected with the other causes of poverty.

He said that within MALAR, which was based on the People's Science Movement model, nearly 10 per cent of the women had improved their quality of life; handloom weavers had become owners of looms, pottery workers had turned owners and women had opened grocery shops and got into lease cultivation.

While this was a positive outcome, the main problem was the small net profit in these ventures and the challenges of the market. There was a lot to learn from the Kudumbashree model in Kerala, where the poorest of the poor among women were identified under the Asraya scheme and marketing outlets were provided for their SHG products. In West Bengal, too, 16 government departments were involved in SHGs in one way or other. There was a separate Ministry for SHGs as well. The marketing of the products was allowed through the public distribution system (PDS).

Critics of the Bill accused the major players of charging high rates of interest and resorting to other irregularities, including inhuman methods of recovery, which, in States such as Andhra Pradesh, even drove women to commit suicide. The majority of the borrowers were women, organised into SHGs or otherwise. Last year, the Collectors of East Godavari and Krishna districts submitted a report each to the RMK about women committing suicide because of harassment by the MFIs. Most of the suicides were reported from Guntur, East Godavari and Krishna districts.

In Krishna district, of the 19 unnatural deaths of women in 2005-06, 10 were confirmed to have committed suicide. In general, the district administration's observations were that MFIs imposed a non-transparent, flat rate of interest instead of a simple interest on the diminishing principal amount; the periodicity of repayment was weekly instead of monthly, the insurance policy of MFIs was such that premiums were collected without giving any policy; and they used methods of recovery that were demeaning to women, including making them stand in the hot sun, locking up their homes and even advising them to commit suicide.

In raids on the local offices of some of the MFIs operating in the district, signed cheques, blank, signed plain sheets of paper, and home-site pattas and land title-deeds were seized.

Contentious proposal

One of the proposals in the Bill is to allow MFOs that have a capital base of Rs.5 lakh to mobilise thrift. Such a move, critics argued, would restrict the expansion of the capital that was being created by SHGs. They said group savings were normally used in an emergency, but if MFOs were allowed to mop up the thrift, the purpose of SHGs would be defeated and women would find themselves again at the mercy of moneylenders.

Sources in the RMK said the word "thrift" was a clever way of defining "public deposit" as the RBI had not prescribed any "safety norms" for banks that accepted public deposits. This could allow unscrupulous MFOs, as also moneylenders who could register as MFOs, a backdoor entry and accept not only savings from people but also lend at very high rates of interest. Another worry was that caste and communal organisations could enter the fray, especially if the Bill allowed them to collect deposits through thrift.

The Bill does not provide any cap on the rate of interest, especially when there were known instances of MFIs charging flat rates of 15 to 30 per cent and using unethical means of recovery. On the other hand, there was a cap of Rs.50,000 on borrowing. There were objections to NABARD functioning as the regulatory body because it was insufficiently manned in the districts and there could be a conflict of interest as it was a promoter of SHGs and NGOs. "A promoter cannot be a regulator," said Franco.

Yet another criticism has been that State governments were not consulted during the formulation of the Bill despite the fact that many of the MFOs were registered under State laws.

The controversy over the Bill also comes in the context of a widespread SHG movement comprising mainly of poor women in the villages. The experience of the SHGs has been a mixed one, depending on the level of political awareness and rate of literacy and social and political organisation in the States. The possible enactment of the microfinance Bill has caused consternation among groups working with SHGs.

A two-day national consultation organised by Nirantar, an organisation that deals with gender and education issues, debated the implications of the Bill as well as the role of the SHGs.

More than 40 organisations from 19 States participated. The conference discussed a study prepared by Nirantar, titled "Examining empowerment, poverty alleviation, education within self-help groups" and a broad consensus emerged on the positive and the negative outcomes of the experiences of women in SHGs.

The study was done among 2,750 SHGs, the majority of them formed under government programmes, in 16 States. The survey revealed that the benefits had not percolated equitably to all women and most of them had not received any capacity-building inputs for the past two years. The experience differed from State to State and on the level of political consciousness as well.

At the consultation itself, the consensus was that the microfinance Bill would do more harm than good to rural women. It sought a wider consultation with all the stakeholder before the Bill is passed.

http://www.hinduonnet.com/fline/stories/20070323002409700.htm

Orissa police post set afire over demolition

Furious over demolition of a place of worship, a mob Tuesday set ablaze a police post and two vehicles in Orissa's Sambalpur town, 321 km from here, police said.

The local administration in the town had launched a drive to remove encroachments on government land in Budharaja area.

During the drive, the officials allegedly demolished an illegally constructed structure that the local people say was home to Hindu monkey god Hanuman, district police chief S.S. Debadatt Sing told IANS.

In a spontaneous reaction, hundreds of people set ablaze the local police post and two vehicles parked near it at about 2.15 pm, he said. Some furniture in the police post was also burnt, Sing added.

Police, however, brought the situation under control in about half an hour, Sing said, adding that the situation was tense but under control

http://www.indiaenews.com/religion/20070313/42897.htm

Orissa NGOs brought under RTI Act

Bhubaneswar: After failing to make the non-government organisations directly accountable to it, Orissa Government has brought the NGOs operating in the State under the purview of the Right to Information Act in order to make them answerable to the people at large.
In a press note released to the media on Monday, the State Government said that it had framed the Right to Information rules prescribing certain procedures, forms and fees for the purpose.

Stating that Section 2 (h) (d) (ii) of the Right to Information Act, 2005 defined an NGO as `public authority' if it is substantially financed directly or indirectly by Central or State Government, the State Government said that as a public authority an Ngo was required to disclose on its own the information pertaining to the organisation for information of the general public, as required under Section 4 of the Act.

The government announcement comes close on the heels of NGOs seeking information on implementation of various government programmes through the Information Commission set up under the RTI Act. There has been a spurt in the number of applications seeking information under the provisions of the RTI Act in the recent months.

The press note issued by the Planning and Coordination Department said that the NGOs as public authority has to designate a Public Information Officer, Assistant Information Officer and an Appellate Authority.

Although a majority of NGOs were likely to oppose the government announcement, an NGO activist welcomed the official move. `When NGOs were trying to make the government accountable to the public, the NGOs utilising public money either through donations or grant should also be accountable to the people.'

A senior NGO activist running the affairs of a leading Bhubaneswar-based voluntary organisation was, however, critical of the government action. `While making this announcement that NGOs should designate officers for discharging duties under the provision of the RTI Act, the government should also make the corporate houses running charitable organisations accountable to the public,' she said.

`The NGOs will be badly hit while making budgetary provisions for the officials designated as Public Information Officer, Assistant Public Information Officer and Appellate Authority. The government should clarify the position in this regard,' she said.

http://www.kalingatimes.com/orissa_news/news/20070313_Orissa_NGOs_brought_under
_RTI_Act.htm

Maoists kill two Chhattisgarh tribals

RAIPUR: Maoist rebels killed two tribals in an overnight attack in Chhattisgarh's violence-wracked Bastar region, police said on Tuesday.

"A group of armed Maoists raided a forested village late night on Monday. They took away two youths aged around 30 years, killed them with sharp-edged weapons and then dumped the bodies on a road," a senior police official said on Tuesday.

The incident took place in Kanker district, 230 km south of capital Raipur. Kanker district along with the Bastar and Dantewada districts form the 40,000 sq km hilly Bastar region where the guerrillas have held sway for about three decades.

"The youths were killed as the rebels suspected they were police sympathisers and had been assisting local police to target militant hideouts," a police source said.

The Chhattisgarh government informed the state assembly on Monday that 325 people were killed in Maoist violence between April 1, 2006 and Feb 4, 2007 and these included 226 civilians and 23 policemen.

http://timesofindia.indiatimes.com/NEWS/India/Maoists_kill_two_Chhattisgarh_tribals/
articleshow/1757872.cms

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