A Medical College with two principals- mockery or politics! Who is to blame for the cock-up?

Medical College is the highest seat of education when it comes to the training and teaching of future doctors and other allied health professions.  Worldwide, most medical colleges are deemed universities and enjoy an independent status which helps them to grow and excel both academically and clinically.  Government Medical College, Srinagar has the prestige of being the oldest in the state and once upon a time used to be ranked among the top ten medical colleges in India.  But, one does not have to explain the current state of the health system in the state or of the esteemed Medical College, Srinagar.  For a long time now, it has been in the news for all the wrong reasons, from the death of infants, administrative cock-ups, violence against doctors, poor academics to almost no research.  The very same college and its allied hospitals were the victim of fake drug supply by the very health department which is supposed to run it safely.

From the last few weeks, the issue of the principal medical college (PMC) has become very contentious and one fails to understand who is running the institution? The current PMC (ex-PMC as per some) Dr Rafiq Pampori went on a protest leave few weeks ago alleging bullying and undue interference from the current health minister Lal Singh.  Dr Rafiq Pampori is a well-known ENT surgeon of the country and is highly respected by his colleagues and students alike for his integrity, honesty and humility.  He has been a role model for many newcomers to the medical profession.  But, when it comes to the administrative abilities, many people are sceptical about his role and to what extent he is able to deliver.  Going through the social media debates, everyone is united in vouching about his professional capacity and integrity, but there have been many voices questioning his extension as principal Medical College.  As it stands now, it has been reported that due to the direct intervention of the Chief Minister, Mufti Muhammad Sayeed, Dr Rafiq Pampori decided to join back as the PMC.  Meanwhile, the health minister, Lal Singh has appointed Dr Kaiser Ahmad as the in-charge PMC.  It is still unclear who is running the Medical College, as both have the claim of being the official PMCs. This speaks volumes about the disarray and mismanagement of the health sector in the state and it is not rocket science to figure out who is responsible for the mess!

While submitting his protest leave, Dr Rafiq Pampori alleged that the current health minister is interfering constantly into the day to day work of the medical college and the post of PMC has been rendered impotent.  It is no secret that Lal Singh has been bullying professionals openly and has been in the news repeatedly since he has taken the charge, from almost man-handling senior doctors to publicly harassing female doctors.  He has humiliated Dr Pampori publicly on many occasions, which comes as a surprise in current day and age.  Why Lal Singh got the health portfolio again, is a mystery?  This is, in fact, his second term as health minister and everyone knows his regressive tactics for allegedly improving the health sector in the state.  With the current PDP-BJP coalition, the situation is worse as it is hard to say if there is any coordination between the chief minister’s office and departments headed by BJP ministers.

Like all other departments, the health sector has also been the victim of centralisation of power.  Every decision is made in the secretariat with institutions like the Medical College having no powers to run its own affairs.  We all know why the powers are centralised and how the mafia for nepotism and corruption makes sure that even a small decision like transfer of a class fourth employee is done by the minister.  The hospitals cannot even buy their own medicines and equipment which ultimately led to the fake drug scams with central purchase committees directly under the control of the health minister.  The scandal of the postings and transfers in the health department has made sure that people continue to pay a high price for everything and in this process, the institution has been left to the dogs.  If a doctor has to go outside country for leisure or academic reasons even for few days, it is mind boggling to know that they have to take permission from the chief minister of the state.  Does the government have no better things to do than to micro-manage everything from the secretariat? Is the government for the people or against the people?

Should the medical colleges not be autonomous institutions? Who is responsible for the failings of the Medical College and its allied hospitals? Can we blame the PMC and the faculty for everything? What about the accusations of Dr Rafiq Pampori against the health minister?  Why is no one talking about the allegations he has made?  In any civilised society, a written note by a person of his standing will be entertained as an official complaint and investigated to get to the facts before taking further action. But as we are talking about a minister, it would be blasphemous to consider such an idea as VVIPs are above the law in the current age.  How can elected representatives and more so cabinet ministers be wrong?  Whistleblowing is almost unknown in our setup and anyone who speaks the truth is humiliated and punished in various ways may it be forcible retirement to the threat of transfer to far flung areas.  With the ongoing conflict in the state, people even fear for their safety and lives.  Few months ago when the Doctors Association of Kashmir (DAK) protested against the excesses of the health minister, immediately one of the doctors was transferred hundreds of miles away and the Doctors Association almost disbanded.  There is no space for questioning the coercive methods of the people in power.

That said the senior doctors and faculty of the various medical colleges cannot shy away from their responsibility and role in the degradation of the health education in the state.  There is a culture of yes-manship for various reasons and highly qualified professors can be seen lining the corridors of the secretariat for petty favours. The medical colleges are in bad state academically, clinically and hardly fulfil the role of a university- as the hub of teaching and research.  There are no simple reasons why this has happened. One of the main reasons one can argue is the centralisation of power.  The government should have no role into the day to day running and management of medical colleges and they should be allowed to set their own rules and regulations with short and long term goals. The PMC should not just be a caretaker and always under threat of getting sacked for no reason. Of course, there should be checks and balances but not by the government but by an independent body set for the purpose.

There should be regular appraisal and accreditation of the faculty and not merely by the outdated system of annual reviews (APRs). The promotions of the faculty should be based on their performance than automatic. Becoming a professor, for example, should be based on actual contribution to teaching and research and not just time in the job.  The entry criteria for the faculty posts should be revised and people with academic or research background should be offered the posts and not any doctor with a postgraduate qualification.  Ideally, people need to have a Ph.D. or an additional teaching qualification to qualify for the faculty post, so that they have the drive and passion for training, teaching and engage in fulltime academic work. This would cut the dead wood out and let people chose their paths early on.  

Finally, the government should seriously revisit the portfolio of the health minister and who should run the department.  I am sure there are many highly qualified MLA’s and even doctors in the current government who can run the department more sensibly in the greater good of the state rather than for their personal obsession of bullying medical professionals.  The state has already lost many doctors who are leaving left, right and centre due to unfriendly work culture, bullying, humiliation and lack of job satisfaction.  There is still time to save this (once upon a time) prestigious institute from the further debacle and prevent putting further lives at risk.  It would also mean saving the careers of many efficient brains who decide to become doctors after toiling for years.  The coalition government should rise above the petty politics and appoint someone with experience and qualifications to run the Medical College and not merely the one who is senior on the list.  Decentralising the powers and restoring the dignity of the PMC’s chair cannot be excused if the government is serious to improve the state of healthcare. 
http://www.risingkashmir.com/news/medical-colleges-should-be-autonomous-institutions/ 

Violence against women

This year the United Nations Secretary General’s Campaign “UNiTE” called for the ‘16 Days Activism’ to end violence against women by organising “Orange Events” worldwide held between November 25 (International Day for the Elimination of Violence against Women) to December 10 (Human Rights Day).   

Killing of women by their in-laws is common in the Indian subcontinent with India, Pakistan and Bangladesh trying to outdo each other.  Reports suggest that bride burning accounts for death of at least one woman every hour in India. In most cases, fire is set by their nearest family and in some cases they set fire to themselves out of desperation. Official figures from India’s National Crime Records Bureau revealed that 8233 young women were killed in so-called dowry deaths in 2012 and 8083 such deaths in 2013.  Similarly in Pakistan, around 3000 women have been burnt alive since 2008, and 300 women are burnt by their families every year. Unfortunately, Kashmir too has been in the news lately for cases of domestic violence, throwing acid on girls and burning women alive.

One wonders why such gruesome acts are committed by civilised people. Many theories have been proposed talking about the historic practices of burning woman, inferior status of a woman in the society, patriarchy, women being treated merely as objects and disposable items, sexism, misogyny etcetera but none of this can explain exactly why simply divorcing or leaving her does not suffice and why people have to go to this extreme brutality. Despite being a criminal act, inhuman and surely prohibited by any religion why do we still have such cases? Is it akin to the corruption that no amount of religious teaching or fear of God would make it not doable?

Recently a friend argued that such acts are happening in Kashmir because men are feeling powerless and emasculated due to the ongoing conflict situation and have lost control on their lives. Targeting females starting from domestic voice to and such brutal acts somehow gives a vent to their frustration and they get some sense of control. One may accept this theory but it does not answer the basic question. Also in most of the cases, it is not men in isolation who set fire to a woman; it is usually women who run the mafia. Hence, the case that men are solely responsible for this brutality is not entirely true. It is usually the extended family including mother, sisters, aunts who float the idea that the daughter-in-law has not done enough or brought enough and she deserves to suffer or die. 

One could think that this could be due to poor education, illiteracy and poverty as we often blame everything wrong in society on such factors. But, again most cases happen in allegedly respectable, well-educated middle-class families, who have no financial crisis or starving due to poverty. It would not be wrong to say that every mother-in-law is a mother of a daughter and every husband is a brother or a father as well.  But then why does the same mother, mother- in-law, husband or brother find it so easy to set someone ablaze just because she is not a blood relation? I am not sure what the answer is, are you?

It is fair to argue that people who indulge in such acts/homicides are not suffering from an impairment of mind and they are perfectly able to understand their actions and its consequences. In fact, the inhuman and criminal mind-set makes them cunning and they plan the brutality with a cold heart. They usually get away with covering up the incident and in most cases the victim is blamed for her death, may be suicide or some other reason.

Talking of the Valley, we come on roads protesting for issues which can be as trivial as the installation of electric meters or the ongoing acts of brutality due to the conflict situation. We invoke religion on every aspect of life and criticise people when there is an occasion of happiness or celebration, alleging people are not mindful of the ongoing conflict and there is no fear of Allah in their hearts. We close down roads for days when an innocent is burnt to death by communal forces (I am not trivialising the incident and no amount of protest would suffice), but we do not react when a woman is burned alive by one of our neighbours. There are no strike calls, no agitation on roads as if nothing has happened. There are no sermons by religious leaders and self-styled moral critics on social media do not find such acts that interesting. Even the wazwan and singing on weddings finds more space when it comes to moral policing. I am not arguing whether all those acts are right or wrong. I am just trying to say that surely those acts are more important to us than when a woman is brutalised, violated or burned alive. This speaks volumes about the cultural acceptance of such gruesome practices against women compared to the other often trivial issues.

Despite there being laws in place, like a ban on sex determination, we still see female foeticide and worsening sex ratio. The core beliefs that females are a burden and inferior are so ingrained and deep rooted that even females themselves have become the victims of same thought process and ultimately often the perpetrators of such crimes. What can help to change such mind-set? Presumably religion, education, prosperity, laws, morality so on and so forth would be the answer. But aren’t those factors already there and instead of improving the situation, why has it gone worse? Are we deeply hypocritical and misogynistic? Domestic violence against women is rampant in all forms may it be emotional, sexual and physical, usually accepted as fate and often the victims don’t realise that they are being maltreated. Ultimately burning alive of a woman is the final expression of such mind-set.

What would it take to stop this cruelty and menace? Are we using religion selectively to further compromise the position of woman in our society when it should have made them safer and more respectable? Are we inculcating a type of slave mentality in female children from the time they are born? Are we giving them constant reminders that they are not equal, dependent and somehow there to please the men may it be their father, brother or husband? Are we talking about morals only when  women doesn’t agree with the current social regime or does something not considered right by the society but then somehow passively agree with what men do or demand? After all, why is it acceptable in broader terms that one can burn his wife or daughter-in-law just because somehow they are not happy with her?

Do we consider divorce worse than burning alive?

The answer is yes, there is more shame in breaking a marriage than killing.

So what is the solution? I am not sure, but probably it will start by considering woman as equal, as human and as worthy of living as are men. The culture of subjugation, dependence and inferiority needs to change and it will need much more than education and sermons. It needs a practical change in the way men feel entitled for special treatment in their own homes. Why do we feel humiliated or even shy in helping our women in the kitchen even though both partners may be working the whole day in full-time jobs?

Surely men are not more special and do some wonders which woman can’t. It is time that men change their mind-set than teaching daughters that they need to adjust every time something wrong is done to them. Surely, if women are confident and aware about their rights and somehow don’t feel they have to oblige no matter what; they would not put up with a family who is ultimately going to burn them alive.

The law needs to get stringent and fair and any family which is proved to have engaged in domestic violence or such heinous crime, need to be monitored and punished. Domestic violence in a broader sense needs to be discussed and women need to be mindful when to say no and raise their voice and seek help. 

Confidential helplines for women suffering from domestic violence could be of great help and may encourage many to seek help before they reach the point of no return. There are always tell-tale signs and if we are aware, many cases can be prevented. The government has to take responsibility and provide adequate alternatives when women are subject to domestic violence so that they don’t feel there is nowhere to go but to accept their miserable existence. 

Finally, it is women themselves who can change this status quo as without them men would not be able to stand a chance, so it is time to break such collaborations and refuse to be the victims of gas-lighting.

http://www.risingkashmir.com/news/violence-against-women-new 

The Price of Parental Neglect

There is no simple definition for neglect, more so when we are talking about the neglect of children by their own parents.  The fact is that most parents love and look after their children, at the cost of their own health, comfort and go to any length to make sure that their children are safe and do not come to any harm.  But unfortunately, that is not a rule and one comes across cases where children are neglected and maltreated.  Why it happens, is both complex and worrying.  Neglect is hidden, unlike abuse which can be visible and noticeable to others.  Hence in such situations the children feel helpless, trapped and unsure of what’s happening. 

A simple definition of child neglect is the failure to provide needed age-appropriate care. This encompasses the obvious physical needs of food and shelter to the subtle emotional needs of love, compassion, recognition, sense of safety and validation.  Failure in providing overall compassionate parenting can lead to serious adverse consequences both during childhood and adult life.  When it comes to the provision of physical needs, a family ought to live within its means and this does not mean neglect. A poor family may not be able to provide the same luxuries compared to a well off family.  But the difference is in the way children are provided and cared for, an excess of money and toys apparently sounds good but if there is little personal supervision and emotional care, it can prove counterproductive and harmful in the long run. 

 

Even a baby that is a few days old reciprocates to your body language; they laugh, make eye contact and get scared depending on how a parent is playing with them. They respond to an angry or smiling face, and it is not difficult to note how they change their body language mirroring the parent.  They may not be able to talk, but all these small things make a huge difference in their overall personality development. A child whose behaviour and feelings are not noticed, acknowledged and are interpreted wrongly by their parents receive a powerful message that they are not wanted, their feelings do not matter or whatever they are trying to convey is not acceptable.  Such neglect and acts of omission by parents can lead to serious adverse consequences. 

 

Unlike in the West where the common factors which can lead to child neglect are illicit drug use, unsupported single parent, a breakdown of the family, poverty etcetera, the situation is quite different in the Asian context due to different cultural and local customs.  Some other risk factors which can lead to neglect are family conflict, unemployment, violence and conflict situation in the community, physical and mental illness in the family and acute life stress to name a few. 

 

In our culture, the differential treatment of children based on their gender is another grave issue.  Boys get all the attention and girls are left to fend for themselves and are given an impression that they are mostly a burden and liability.  The discrimination starts even before birth and some people choose to kill them in the womb.  We have seen time and again the cases of domestic violence, mostly directed towards females, which at times ends in brutal and violent acts like burning alive. It is fair to say that the acceptance of such behaviour, at a cultural level, starts subtly decades before the actual heinous act.  Hence, female foeticide continues and culminates in the murder of a grown up woman.  I am not trying to say it is only men who are responsible for such mentality and acts; women are equally responsible and often drive the process. 

Children can be neglected due to the ongoing conflict and dispute between their parents.  Parents who argue in front of their children and physically abuse each other in their presence; put the young minds in severe emotional and ethical dilemma.  Children in such cases become withdrawn, develop a sense of guilt and somehow feel responsible for the actions of their abusive parents.  This leads to a sense of insecurity and children can start acting out, become truant from school and often take on drug addiction.  Some parents are too busy with their work and personal ambitions that they knowingly or unknowingly ignore the needs of their children.  This not only leads to emotional deprivation but can become dangerous when the children are left unsupervised.  Leaving children with others is not always safe and can lead to potential harm.  Cases of physical and sexual abuse are common in such situations and children are caught up in the vicious cycle of neglect and abuse.  This is worsened further when the parents deny or ignore the child’s plea that they are not safe or have been actively harmed. 

 

Children who grow up in problem families as described above find it difficult to adjust to life and are at increased risk of developing psychological problems.  That means difficulties at home, poor schooling and ultimately not being able to live a productive and fulfilled life. Sometimes children can take on similar traits and engage in antisocial or harmful behaviours. Feelings of poor self-esteem, isolation, lack of trust and low self-worth are not uncommon. They also feel insecure and are not able to cope with day to day pressures of life.  They are at high risk of falling into the trap of bad company and drugs.  In some places, such children find refuge in criminal gangs which gives them a sense of purpose and belonging.  Suicide and self-harm is also common in such children.  It is very important to realise that children are highly sensitive about happenings around them and the way they are cared for. 

 

There is no simple answer to the problem, but the solution does come from common sense and from treating children with dignity, respect and love. This gives them the essential feeling of safety and security which is the right of every child.  Treating children partially based on their gender is morally and religiously wrong and harmful to the child and society at large.  Children look up to their parents as role models and if parents do not treat them with honesty and care, the children are unlikely to do well.  It is like teaching a child to speak the truth but acting and behaving otherwise, which not only confuses the tender souls but also sets them in the wrong direction.  Similarly, if the parents behave differently in their public and private lives, it worsens the situation and creates a sense of doubt and disillusionment in children.  

 

Finally, parents have the duty and responsibility to safeguard their children from any abuse or neglect and in no way should be the perpetrators themselves.   It becomes more pertinent in our current age when children are at additional risk due to factors like social media, excessive pressure to achieve, easy access to drugs and vulnerability from people who target children.  If parents are not coping due to any reason or feel they are in a strained relationship, they need to make sure that their children are not trapped in the middle and used to score points against each other.  It is better to seek help and advice than ruin the life and happiness of children.  Unfortunately, there are no safeguarding mechanisms in our society and it is very difficult for neglected children to get any respite.  Society at large also has a responsibility to help end the evil cultural practices which put children at risk, like partial treatment based on gender, female foeticide and dowry etcetera.  It is easy to fell prey to denial and refuse to accept what is happening within the family, but it is never too late to make a fresh start and give children their life back. 

 http://www.greaterkashmir.com/news/opinion/story/203673.html