Suicide, hidden epidemic

No country in the world is free from suicide.  As per World Health Organisation (WHO), suicide was the fifteenth leading cause of death in 2014, accounting for 1.4% deaths worldwide. More than 800,000 people die of suicide every year with many more attempting suicide, of which 75% occur in low and middle-income countries.  Although suicide occurs throughout the lifespan, it is the second leading cause of death among 15-29 year olds after road traffic accidents. 

The highest suicide rate of 44.2 per 100,000 of the population in the world has been recorded in Guyana followed by the Republic of Korea at 36.8 per 100,000 of the population.  Saudi Arabia has the lowest reported suicide rate of 0.3 per 100,000 of the population.  The South East Asia has the highest suicide rate in the world with a regional average of 17.1 per 100,000 of the population.  Sri Lanka has the highest suicide rate of 29.2 per 100,000 of the population while Indonesia has the lowest suicide rate of 3.7 per 100,000 of the population in the region.  India has the second highest suicide rate at 20.9 per 100,000 of the population in South East Asia.  

There are huge gaps in the reporting and documenting of suicide deaths worldwide especially in low-income countries.  It is partly due to stigma, criminalisation, lack of trained manpower and overall poor record keeping. Hence, it is probable that suicide mortality could be much higher than noted in such regions. There are at times political reasons for not documenting some deaths as suicide, for example, the frequent farmer suicides in India.  Many countries have already decriminalised suicide and India has also decided to do so with the introduction of the Mental Health Care Bill 2016. Decriminalisation of suicide has helped to reduce the stigma and enabled people to seek help.  Globally, there has been 9% decrease in the deaths due to suicide.

In India, 5650 farmers committed suicide in 2014. In the same year, more than 20,000 housewives died of suicide.  It is reported that since 1997, more than 20,000 housewives have been committing suicide every year with a peak of 25,092 suicides in 2009.  A study published in the Lancet in 2012 found that suicide rate in Indian females aged 15 years and older is more than two and half times greater than it is in same age women in high-income countries.  The suicide rate in women is highest in India than any other country in the world. 

Depression and anxiety are the most common mental disorders worldwide affecting one in ten or about 700 million people.  With better national policies and effective treatments for depression and anxiety, many countries mostly in the high-income zone have been able to prevent and reduce suicide mortality.  Moderate and severe depression, both are included in the Mental Health Action plan 2013-2020 of World Health Organisation (WHO) with a target of increasing service coverage to 20%.  Suicide prevention is an integral part of the Action Plan with an aim of reducing suicide mortality to 10% by 2020. 

For any national response to be effective, suicide prevention strategy needs to be multi-sectorial, holistic and workable within the cultural context. This includes training of manpower, early identification, treatment of common mental disorders especially depression, management of suicidal behaviours, follow-up, and management within the community settings.  Restricting access to the means of suicide like pesticides, guns and medications is very important for any strategy to work. 

With the introduction of the Mental Health Care Bill 2016 and decriminalisation of suicide in India, it is imperative that there is a national suicide policy targeting the reasons behind the high suicide rate, especially in women.  Education, training of manpower, social equality, control over social evils like dowry and forced marriages, treatment of mental health problems especially depression are some of the essential measures which need to be included. Pesticides being the number one means of suicide in India, with free availability even in remote places of the country, need strict regulation to save lives.  Finally, it is important to record data effectively and honestly which in turn will help to plan long term policies and prevention strategies. 

http://healthanalyticsindia.com/healthopinion.php?id=253 

Bullet in the Eye

It is hard to keep a count of people maimed by the purportedly nonlethal pellets.  From the skull, chest, abdomen to the precious eyes, nothing is spared.  The victims are of any gender and age, from young children unaware of what just hit them, to the older ones who probably sense that their sight has been snatched away forever.  The 32 bedded twin wards of the ophthalmology department of SMHS Hospital Srinagar had to cope with a flood of patients most of whom need urgent intervention.  The doctors and other allied staff in the department have been working without taking a break, beyond their working hours and under hostile conditions to help the fallen and thus deserve all our commendations.  The situation has been made even more difficult by the unceasing assaults and interruptions by security agencies within the hospital premises, for obvious reasons.

Due to the eye being a very delicate balloon shaped organ, the pellets not only perforate but ricochet inside the eyeball causing severe damage to the cornea, lens, vitreous, and retina thereby destroying the whole eye from within.  In some people, the pellet goes through and through completely destroying the globe of the eye. In some cases, even the optic nerve is damaged.  We have seen horrible looking X-ray images of pellet victims doing rounds on the social media, and one does not have to be an expert to know what damage pellets can do. 

Although classified as a nonlethal weapon by the Indian state, ophthalmologists of repute have unequivocally agreed that the pellet guns are very lethal, blinding most people for life. Dr Tariq Qureshi, Head of the Ophthalmology Department at Government Medical College Srinagar went on record calling for an immediate ban on the further use of pellet guns.  In the past 3 weeks, doctors at the SMHS Hospital have performed 552 operations on those injured; out of which 211 were primary eye surgeries on the pellet victims. 58 further eye surgeries were performed out of which 48 were performed by a visiting surgeon working with an NGO. The surgeries are done to keep the eyeball intact and most patients will need multiple secondary surgeries.

The local ophthalmologists perform urgent surgeries trying to salvage the eyeball with whatever facilities they have.  There is no doubt that they have developed great expertise over the years to treat such patients but one cannot claim that they are able to treat everything locally keeping in view the complexity of the damage caused by the pellets.  The assertion by the Principal Government Medical College Srinagar that full treatment is available locally and “We are equipped as per international standards” is, in reality, the misleading rhetoric of yesmanship, probably articulated to please higher-ups or possibly under political pressure.  Barring few tertiary eye centres in the whole of India, even places like AIIMS are not fully equipped to deal with such complicated injuries. I am sure our ophthalmologists are fully aware of this and have been voicing their concerns.

Treatment of the posterior chamber of eye and retina needs specialised tertiary care facilities. The valley lacks an eye bank, so how are corneal repairs even possible in such a scenario? The team of doctors which was brought from AIIMS by the state government did nothing to help with the grim situation. They parroted the state narrative to keep the media busy, thereby misleading people by creating a false sense of security.

Even if some have chances to regain eyesight with appropriate treatment, they become blind because of the deliberate and forced negligence by the authorities.  There is a sense that any whistleblowing would not be tolerated by the authorities.  The simple narrative of 'all is well' and we have everything to deal with the situation sounds out of place keeping in view that our heath sector even struggles during normalcy let alone a war like situation.  But this is not the first time medical professionals have been used to cover up political failures and state aggression. 

I am not suggesting that everyone should be referred outside the state as the treatment is prolonged and the outcome is usually not good.  The government should officially bring experts from outside the state along with the necessary equipment so that they can work in collaboration with the local ophthalmologists, treating patients and also empowering local experts with the necessary training for future cases.  The hospitals would need to be funded properly and appropriate infrastructure developed to deal with such injuries on urgent basis. There is an urgent need to start an eye bank.

Most of the pellet victims come from poor backgrounds and cannot afford to travel outside of the state.  But patients, who need further treatment, which is not possible locally, need to be referred to appropriate centres and not just any hospital for mere eyewash.  If some patients want to go outside, they should be appropriately referred rather than denying them that chance by giving vague excuses. Medical professionals cannot ignore the limits of their expertise or the facilities available, when dealing with lives and someone’s chance at seeing the world again.  If people are not appropriately guided, they end up at wrong places, where they are not only looted but harmed further.  Even if the NGOs volunteer to help, they should work under the supervision of local Ophthalmology department and referrals to them should be done by doctors.  It is important that right patients are identified for right treatment at the right time.

The use of pellet shotguns was first introduced in Kashmir in 2010.  During the 2010 unrest and subsequent years, hundreds of people received pellet injuries with eyes being a common target. Sadly, most of these poor victims were lost to follow-up. The common reason for not coming back to the local hospitals seems to be the fear of authorities. This has meant that many people who have some hope of recovery did not come back to get further treatment.  Some of them sold everything to get treatment outside of the state on ill-founded recommendations, ending up losing both vision and money. This holds true for the recently injured who are likely to face similar consequences.  There are also allegations that doctors are being forced to discharge these patients from the hospital and many volunteers helping them have been roughed up as well.

There is hardly any research when it comes to the treatment of eye pellet injuries and long-term prognosis in the local context.  A study published in 2012, reported 198 patients with pellet gun injuries attending Sheri-Kashmir Institute of Medical Sciences between the months of June and September 2010.  Another study published in 2012, included 60 patients seen at the ophthalmology department SMHS Hospital Srinagar for various eye injuries between June and September 2010.  The study concluded that the prognosis for pellet gun eye injuries remains very bad.  A study published in 2014, which looked retrospectively at the pellet gun eye cases from 2010 cohort, suggests that visual prognosis remains grim despite adequate treatment at the time of actual injury. Half of the cases were blind with visual acuity of less than 3/60.

Due to lack of a register for such patients, it is hard to know how many young blind people are suffering in silence. If this brutal weapon continues to be showered on the civilian population, we may have another cohort of ‘deliberately blinded’ people in thousands, adding to the list of half widows, orphans, and waiting mothers.  Such weapons were used by the West in the Gulf war but the world’s largest democracy using these weapons against the civilian population can only be described as shameful.  The use of such brutal weapons needs to be stopped immediately as no amount of justification makes them nonlethal under any international law.
http://www.risingkashmir.com/news/bullet-in-the-eye 

Pellet injuries - terrible fallout

During the last 3-4 weeks, an estimated 317 people have received pellet gun injuries in the Kashmir unrest, with half of them being shot in their eyes.  The two sixteen bedded ophthalmology wards in the SMHS Hospital Srinagar had to cope with around ten times the patients they have capacity for.  The use of pellet shotguns was first introduced in Kashmir in 2010.  During the 2010 unrest and subsequent years, hundreds of people received pellet injuries with eyes being a common target.

The eye being a very delicate balloon shaped organ, the pellet not only perforates but ricochets inside the eyeball causing severe damage to the cornea, lens, vitreous, and retina, destroying the whole eye from within.  Although classified as a nonlethal weapon by the police, the medical fraternity, especially the ophthalmologists, have unequivocally agreed that the pellet guns are very lethal blinding most people for life. Even after multiple surgeries, the prognosis remains grim, with majority becoming totally blind.

The local ophthalmologists are able to perform emergency surgeries trying to salvage the eyeball with whatever facilities they have, but the hospitals are not equipped to deal with the type of injury the pellets cause to the inner structures of the eye.  Concerns have been raised that treatment of pellet eye injury is not available locally, with the state being complacent; the victims are not referred to the appropriate centres outside for unknown reasons.  The valley even lacks an eye bank.  Most of the pellet victims come from a poor background and cannot afford to travel outside of the state for specialised treatment. Hence if some have chances to regain eyesight with appropriate treatment, they become blind because of the negligence of authorities. There is a sense that any whistleblowing would not be tolerated by the authorities for political reasons.

There is hardly any research when it comes to the treatment of eye pellet injuries and long term prognosis in the local context.  A study published in 2012, reported 198 patients with pellet gun injuries attending Sheri-Kashmir Institute of Medical Sciences (SKIMS-MC) between the months of June and September 2010. Another study published in 2012, included 60 patients seen at the ophthalmology department SMHS Hospital for various eye injuries between June and September 2010. The study concluded that the prognosis for pellet gun eye injuries was bad.  A study published in 2014, which looked retrospectively at the pellet gun eye cases from 2010 cohort, suggests that visual prognosis remains bad despite adequate treatment at the time of actual injury. Half of the cases were blind with visual acuity of less than 3/60.

Western literature suggests that people who lose their eyesight late in life are worse off emotionally that those who are blind from birth. Even people losing their eyesight due to medical reasons are highly likely to develop depression and other psychological problems.  This is thought due to the fear of unknown, fluctuating ability to see and rather being on an emotional roller coaster.  Losing vision is akin to a grief reaction where the loss is mourned by the person. More than 30% of people who develop blindness due to medical reasons develop depressive symptoms.

In comparison to medical conditions, people who lose their eyesight due to a traumatic injury inflicted on them, like the pellet guns, are highly likely to develop severe psychological problems. This is due to the trauma they experience and their final memory of seeing the world shattered by a pellet. The visual loss also happens within seconds of the injury, giving the individual little time to get used to the change in comparison to the loss of vision due to medical reasons. Suddenly young people find themselves blind, maimed and in pain facing a very bleak future. The uncertainty around recovery, multiple surgeries, inadequate treatment and subsequent poor prognosis further worsens the emotional health.

Such victims of the brutal blinding violence are likely to develop post traumatic stress disorder, depression and other anxiety disorders.  The sudden loss of functional life, almost negligible prospectus of future and inadequate support systems, in the long run, makes their situation more miserable. The victims get some attention in the immediate aftermath from doctors, their families and society.  But in the long run, they are forgotten and left to grieve on their own. They often become hostages in their own heads.  Sadly this is followed by stigma from their families and friends.

Apart from a lack of proper treatment in the acute aftermath, there are no support systems to help them to adjust to the change.  They not only need physical rehabilitation but also psychological rehabilitation and training so that they are able to adjust to the catastrophic change which has overpowered them without any warning.  Unfortunately, no such facilities exist in Kashmir valley. The local doctors, psychiatrists and civil society need to support the victims even after the acute phase is over, or else they may curse themselves wishing it is better to lose life than light. Counselling and rehabilitation services need to be established in all hospitals to help such victims cope with the loss of vision, life skills training and treatment of psychological problems.

The hospitals would need to be funded properly and appropriate infrastructure developed to deal with such injuries in future. For now, the state has a responsibility to fund their treatment in appropriate centres across India or even abroad if needed.   Finally, the use of such lethal weapons needs to be stopped immediately as no amount of justification makes them nonlethal.

http://healthanalyticsindia.com/healthopinion.php?id=221 

Ramadan and Corruption

A few decades ago, while filling the board examination forms for 12^th class, we were asked to pay five rupees extra by the clerk in our school.  One of my friends initially refused to pay but agreed on a condition that he will be provided with a receipt for the five rupees.  Many of us at the time thought his reaction was odd and uncool.  Trust me he was not poor and could have paid it easily.  Many years later, the same friend stormed the Vice Chancellors office at the University of Kashmir as money was being demanded by the examinations section for his marks sheet.  While he was trying to meet the VC, the police guards kept laughing at him and made him wait for hours, but he did not give up and made it through.  Did he achieve anything better by living a principled life in a corrupt society?  

When it comes to corruption in our state, we have accepted it in all forms possible.  It is no longer a taboo, but usually a path to success and respect in the society.  Those who do not play by it are often labelled as dry, eccentric or commonly ‘Khowshikh’.  Corruption has become the backbone of our black and white economy.  Without any exaggeration, it’s morally, socially, culturally and religiously accepted.  Paying in cash or in kind is not the only forms of corruption our society suffers from, but sufarish, crony-capitalism, phone calls, VVIP culture, yesmanship, and who’s who are few other examples and the list goes on.

One could assume that during the holy month of Ramadan when we fast to control our inner self, discipline our evil side and live like true Muslims, there would be an automatic end to the corrupt practices in offices, on the roads, in hospitals, and one can’t be but naïve to believe that.  The files do not move from table to table, as the so-called weight is missing and some prefer to delay it after Iftar, like somehow taking bribes on a full stomach makes it Islamic.  We spend hours in mosques when we are being paid to work somewhere else.  Some even completely give up work as it seems to them that they can’t take bribes during the holy month, so why to bother. Do we stop taking the salary?

I remember a revenue official, who was religious and practising Muslim from his outlook.  He had even sent one of his sons to a religious school to become Hafiz-e-Quran. He demanded five thousand rupees bribe from a poor father for the issuance of a backward area certificate.  The irony, it was Ramadan, he was on his prayer mat, giving the final verdict that nothing less than five thousand rupees will do- Allah-u-Akbar, leaving the humble guest bewildered.  I am not taking a dig on religion or religious practices, I am just trying to make a point that we have religiously accepted corruption and it is no longer a sin for us, although most of us have heard that ‘both the receiver and giver are buying a ticket to hell’.

During my college days, one of our friends wanted to get married.  One Friday, we ended up in a mosque in the heart of Jammu city to meet a Mufti.  His sermon was mesmerising and many people were in tears.  When we disclosed the purpose of our visit, to my surprise, the Mufti gave a long discourse how youth should marry by their own choice even in secret, than to convince us to get families on-board.   Without much persuasion, he agreed to perform the Nikah, though I was expecting he may object as there was no representative from the girl’s side.  He even arranged witness on her behalf.  How much will he charge? In my naivety, I replied that it is up to us.  Not convinced my friend blurted the question.  Respected Mufti shocked us by saying that the matter is complex and would cost a minimum of five thousand rupees.  Subsequently, he started demanding more money, and when finally he completed the formalities, he refused to hand the papers, brazenly asking for money first.  I will leave you to judge the moralities here.  The point being it was for money; he went ahead, gave a sermon and did not bother to even question what was happening, and such examples are ample in our neighbourhoods.

Any doctor will tell you how during the MBBS training, they are also taught the holy business of corruption from the day they enter the academic section. There is a surplus charge for everything and within few months the whole idea seems normal and rather essential.   When I started working as a doctor, my salary was not being released.  It was only after my friend pointed out if I had met the Madam.  He further advised me to gift a dress to her from my wife’s wardrobe as he had done the same.  I met the madam, made peace with her and henceforth my salary was always on time.  She was even saving my income tax and when I told her that I want to pay than to produce fake certificates; she was surprised and rather laughing on my judgement.  On a positive note, one of the cashiers in the directorate of health services office works honestly and he categorically refused to take anything.  But by that time, I had gone into the default societal mindset aka ‘corrupt-mode’ and now I felt that he should take some chai-pani from me.  So how does one protect oneself in not getting indoctrinated into this business of the give and take and normalisation of corruption, which has essentially taken over our society as cancer?   

I came across a recent Facebook update; talking about how in a government higher secondary school in Islamabad (Anantnag), students need to pay to sit exams. “Students are shortlisted as per shortage in their school attendance, on the instructions of administration, which is reportedly constituted of few clerks, teachers, and lecturers, who have been posted in the same higher secondary school for past 10 to 12 years.  These students are barred from submitting the examination form on the basis of a shortage of attendance, and then charged a bribe of Rupees 500 to 1000 from each of them.  This has been a practice for years now and nobody can even complain as no one wants to put his career at stake.” Further the update mentions, “I don’t have a sum of rupees 500, and I can’t ask my parents for the same; these people have asked to arrange the money before Eid, or they will cancel the admission.  I have asked my cousin to lend me the sum, and I shall return his debt after Eid from my Eidhi.” The other fellow with disgust replied, “They don’t even stop it in Ramadan; they pray- I see them going to the mosque every day but- of what use- they are a bunch of wolves.”  Hopefully, the director school education will do something about it, as he stands informed from the social media already.

These are just a few examples and one can write an encyclopaedia.  As a rule, we all are corrupt unless proved otherwise.  The fact remains that may it be education, health, other civil services, recruitment, and even religious services, unfortunately, corruption is a norm than an exception.  It has reached a level where the more corrupt are seen as role models and people work hard or pay for such jobs or posts, may it be civil service, police or revenue. Similarly, when it comes to postings within the departments, there is a defined rate for plush postings.  People who are honest are the odd man out and posted to places considered punishment by the mainstream.  Hence, an honest engineer would be posted to civil secretariat or an honest police officer to an airport, as the means of extra income are limited in such places. The corruption starts top down and no one is allowed to challenge it.

Finally, the question remains, why these students wouldn’t become corrupt on their way up.  If corruption is systemic and being practically taught at homes, in schools, offices, and mosques, why are we pointing fingers at each other when it comes to other social evils of no significance? Why do we blame our daughters for natural disasters?  Does this mean that we as a society have become so rotten that our noses have given up smelling the putrefaction? Others may not have as much integrity as my friend and even he is struggling to keep his head above the water in a toxic environment. The ball is in our court and we cannot blame others for our downfall.  The money which pays for the Sehri and Iftar cannot be from unfair means, nor do the times spend in the mosque when one is supposed to be working.  And please let us not fool ourselves that taking a bribe after Iftar or Ramadan is approved.  Are we starving for sixteen long hours for nothing? 

http://www.risingkashmir.com/news/ramadan-and-corruption 

Festivity not Radicalisation

By eating in secret, pulling down the curtains on restaurants, taking bribes after Iftar, a woman covering up in Hijab or playing spiritual records than Bollywood songs in the buses, is not hyper-religiosity but simply a mark of respect towards the holy month of Ramadan. Those who fail to understand this and blame all such acts on radicalisation should see a mirror. This does not mean that people will change forever, or not sin or a woman may again give up her headscarf. But let's respect the essence of this holy festival and not mock those who try to observe it.

Also, those of us living in the West may fail to understand that the Ramadan is like a festival and there is a change in overall societal mood. The children are excited and elders in humility. Those who believe seek forgiveness and refuge. Those in ill health seek to get well.

PS: The teacher has every right to suddenly wear an Abaya and remove it as well. This is a simple act of respect for the Holy month and nothing more. She may choose not to use it later or may continue wearing it, but let there be no coercion or denigration for what one does of their own free will. The school should have apologised to her than to those who are making hue and cry.

©Mudasir Firdosi 

Tale of a Doctor

I was lost for words. He sounded desperate, helpless and fed-up.  He wants to serve his people to the best of his expertise but has become a victim of an unhealthy health care system, losing his skills with every passing day.  Though he never thought of leaving his home, he is even considering moving out of the valley.  As he narrated his ordeal, I kept thinking of hundreds of sincere doctors in his shoes, who want to alleviate the suffering of their community but are rendered unworkable by a corrupt and badly run health department.  This is how the story unfolds.

After completing his MBBS, he decided to become a child specialist. While training as a paediatrician, he would often feel helpless seeing the pitiable state of neonatal care in the Valley.  You may recall the headlines of hundreds of neonates dying not that long ago.  There is not only lack of infrastructure and equipment but also a dearth of trained professionals like neonatologists and allied specialists.  With this in mind, he decided to become a neonatologist. He left valley joining a specialist centre for a period of 3 years.  That meant leaving his family and a few months old son at home. He missed his son’s babbling and the first steps.  Whenever he would visit home, his son would refuse to play with him, taking him for a stranger.

While in the far off land, he used to dream day and night that once back; he will serve his people by starting a new era of neonatology in the Valley.  He would often talk about the feats he was able to do in a properly run system, how even a few hundred grammes premature neonate, is saved by right equipment and professional help. But once back, things did not work as planned.  He gathered that health authorities are more interested in the head count than competence and training of a professional.  He was even not posted to a place which caters to children, nor has any equipment or infrastructure to allow him to do his job.  Probably he is just supposed to collect his salary at the end of the month.  Who cares about neonates or their worried parents? Moving from pillar to post, requesting and pledging the top officials in the department, he went unheard.  Why would a highly trained professional, who declined job offers from across the world, be posted in a place where he will even forget his basic training? ‘Kareh Najjar Badasteh Gilkar’.  Let me remind you that J&K was awarded for the best healthcare in India.  You are free to believe.

Keen to serve and learn, he visited many health care facilities across the valley and interacted with his colleagues to understand how to work.  But apart from disbeliefs, he did not achieve much.  It became clear to him that postings and transfers are not done using any method, taking into consideration the qualifications or the training of the doctor or need of a particular area. It is usually based on who knows whom, sufarish, crony capitalism or the mood of the official at the time.  No one thinks of the poor patients or the doctor in question.  It does not matter if practically an unqualified person is treating you.

Many buildings along the national highway have been named as Trauma Hospitals. Interestingly, there is no trained doctor to manage trauma.  Glorified load-carriers driven by untrained personnel are called as ambulances.   A room, named as the neonatal intensive care unit, has a warmer, weighing machine, and zero number of support staff.  He also came to know that a brilliant surgeon was transferred from a district hospital to a far-flung village, not because of his inefficiency but being upright who was trying to do good for his patients.  A dermatologist was forced to manage complicated pregnancies and then blamed for the adverse consequences.  There are hundreds such examples of a square peg in a round hole.

 He came to know that wounds are being stitched with bare hands, putting both the doctor and patients at risk of infections like hepatitis C and B.  When he suggested asking patients to buy gloves from the market, he was advised that “the vigilantes from the revenue department will be dispatched within a jiffy on the directions of the local henchman, to cut doctors to size".    Who is at fault here, administration or the civil society is for you to judge.  I am not advocating patients should buy anything when the healthcare is allegedly free.  But who pays the cost for the treatment of rampant hepatitis C cases? Unsurprisingly, some do ask medical representatives to supply gloves and other equipment, as hospitals are always in shortage.  Whom would you blame for the alleged doctor –medical representative (MR) nexus?

A consultant friend was encouraging him to join his native district.  When they met last, he found his friend distraught.  His friend had been lobbying to procure some equipment for the hospital, with intensions that a maximum number of patients will benefit from the latest technology.  He was warned by a class fourth employee from the administration that he is a non-entity and should refrain from defaming the hospital.  Trying to improve the facilities is taken as defamation; some would say it as progress.  When he mentioned his plans (rather dreams) of starting a neonatal intensive care unit (NICU) to his colleagues, having trained in latest technology including use of high-end ventilators, there was a loud laughter, whether on him or his naivety, one cannot be sure.   

Finally, he reached back to Srinagar rather dismayed.  While lost in his thoughts, he boarded a bus.  He had thought that buses are obsolete now and probably not many people use them.  Within no time, there were more people standing in the middle than those apparently seated, and more people hanging by the doors than those trying to stand relatively straight, and sandwiched in the middle.  He thought, contrary to popular belief as our leaders often claim, most are still economically deprived and socially unprivileged.  How can people afford healthcare if boarding such unsafe is a norm?

The bus conductor was shouting at the top of his voice to get more passengers on board. Within no time the conductor started yelling at the passengers, who were virtually hanging, to close the door. How can we close the door when there is no space inside, someone shouted back? Despite knowing everything, the conductor kept on insisting on packing more people into the bus. When the bus reached its final destination, surely many people had their backs and knees in a condition needing repair. Once off the bus, he could relate the condition of the health department to this bus in the 21^st century.  Our health system is like an overloaded bus, and those supposed to administer the department, hardly care to change it.

One would have thought that administration is paid to improve the system and not just rule and control people by punitive postings and transfers.  Isn’t it is up to the civil society to hold health authorities accountable than getting fooled by false promises of new hospitals which then fail to deliver for obvious reasons? It is time to get a proper system in place which is patient centred, professionals working as per their competence, and are held accountable for their actions.  The department needs to utilise doctors as per their expertise, encourage and reward them than to punish them for not having right contacts.  Let paediatricians look after children and ophthalmologists treat eyes, by forcing them to treat heart attacks or conduct deliveries, you will not only kill the patients but loose doctors as well.  The opening of new medical colleges or announcements of model hospitals only makes sense when right people are chosen for right jobs.  Otherwise, constructing concrete jungles only helps a few people to get rich and nothing more.  Big buildings do not make good hospitals, but the professionals working in them do.

http://www.risingkashmir.com/news/tale-of-a-doctor 

Open Debate – Is NEET good enough?

A common entrance test (CET), also called National Eligibility-cum-Entrance (NEET) test was proposed by the Medical Council of India (MCI) in 2012 for the admission to MBBS, BDS and postgraduate courses (MD/MS) in all colleges across the country.  Many State governments opposed the proposal and moved to court with the plea that NEET infringes upon their right to keep education as a State subject.  NEET was declared unconstitutional by the Supreme Court in 2013.  The private medical colleges were completely opposed to the idea as they seemed to be the biggest losers if NEET is implemented.  Recently, the Supreme Court of India ordered the implementation of NEET overturning its previous directive.  The MCI claims that NEET will improve the process of admissions, bring transparency and remove observed malpractices.  It is thought that many States do not have a robust mechanism of admissions and situation is worse when it comes to the private medical colleges.  There are often allegations of corruption and favouritism.

The aspiring candidates, medical students and doctors mostly welcomed the NEET.   On the positive side, candidates can just appear in one exam and this will save their time and money. They do not have to apply at various places and pay every time.  The allocations can be done with ease choosing their favourite colleges depending on merit.  The psychological stress of appearing in multiple examinations will be lessened.  On the other hand, the sudden introduction of the NEET meant that some candidates may be at a disadvantage due to their background or the way they were preparing for the exam etcetera.  Candidates from Jammu and Kashmir will lose the advantage of filling all the seats in the J&K Medical colleges, as non-State subjects are not allowed admission.   The fifty percent reservation for women in government colleges will also be lost in J&K.

Coming to a bigger question, is NEET the only solution to the declining standards of medical education in the country?  What else has MCI done so far to advance the medical education? It is a welcome first step towards the long awaited reforms.  It will make the life of the aspirant’s easy; avoid unnecessary bureaucracy and red tape.  The NEET is a multiple choice examination (MCQs), which is the gold standard for entrance examinations in India.  In view of the prevalent crony capitalism and corruption, an MCQ type of exam is the best option to cut down fraud and favouritism.  As there is no interview, it limits any outside interference.

Across the globe, the methods of admission, teaching and assessment have advanced keeping up with the developments in medicine and technology but India is still stuck in the early fifties of the twentieth century.  The MCI has proved to be a big disappointment due to its inability or rather inaction to reform the medical education over last six decades.  It is a shame that the MCI has not even been able to put together a proper syllabus and curriculum.  Every medical college trains and teaches, depending on the beliefs and whims of the faculty and there is no uniformity or standard across the country.

Becoming a doctor is not an easy task and apart from the academic qualifications and merit, one needs to have right aptitude and personality.  This cannot be examined by a simple multiple choice examination.  The overall personality, career goals and resilience to stand the gruelling exams and responsibility which comes with the job need to be kept in mind.  In the United Kingdom, admissions to medical colleges are done by a multistage process.  Aspirants with good grades in A-levels (10+2) are eligible to apply to the medical schools of their own choice. There is an initial longlisting process.  There is no MCQ type exam and they do not have to waste time revising and cramming the 10+2 syllabus again.  UK applicants must take one of three additional tests- the UK Clinical Aptitude Test (UKCAT), the Biomedical Admissions Test (BMAT) or the Graduate Medical School Admissions Test (GAMSAT).  The candidates have to demonstrate suitability for becoming doctors by working with charities, hospitals or simply shadowing doctors, so that they can test themselves in real life situations and make an informed decision to enter the medical profession.  Such work experience is scored in the shortlisting process.

Candidates who are shortlisted are invited for interviews by the medical schools.  Interviews are a complex process of assessment (Multiple Mini Interviews-MMI) comprising of multiple stations in which various attributes of the candidate like attitude, ethics, compassion, resilience, and conscientiousness etcetera are assessed.  They are given clinical scenarios and asked to comment and give their opinion.   Interestingly there is hardly any stress on the theoretical knowledge as it is presumed that candidates have already done well in the 10+2 examinations and there is no need to assess the rote memory again.  Compare this to the MCQ type of examination.  Apart from testing the rote memory, there is hardly any emphasis on testing other attributes. While as the candidates in the UK make an informed choice to join medicine, many of our candidates sit the entrance because of social pressure.  Such candidates often become frustrated in the future leading to dangerous consequences like suicide, as there is usually no going back due to pressure from family and stigma. 

It is too ambitious to suggest switching from the MCQ type exam to this multi-stage assessment, but more needs to be done if we want to produce high quality and safe doctors. Having a common exam like NEET is a good start, but much more needs to be done if the deteriorating situation has to improve.   MCI needs to reform the curriculum and subjects taught in medical schools on a war footing.  The focus needs to shift from reading thick books and theory to practical skills, empathy, ethics and accountability just to name a few.  There needs to be a common minimum standard of doctors passing out of the medical colleges.  If the MCI is not able to deliver, then it may be better to start with disbanding the monster as recommended by the parliamentary committee.  The Committee on petitions (Lok Sabha) has already invited views/suggestions on the petition “Medical reforms in the country” which is a good start and may hopefully lead to some positive changes.  Interestingly, due to pressure from various state governments, the central cabinet passed an ordinance postponing the implementation of NEET by one year.  Only time will tell if it will be implemented or not and who’s interests will be dearer to the politicians running the country.

http://healthanalyticsindia.com/healthopinion.php?id=198 

The murky business of grooming

Lately, there have been many reports about the trafficking of young girls and children, abused, being sold into domestic slavery and prostitution. It is not only the local children who are being targeted but young girls are being imported from various parts of India.  Children are targeted by professional agents who groom them and then coerce into a dangerous future.  A decade ago the valley was hit by the infamous sex scandal in which many powerful people were involved.   Whatever comes into the public domain is just a tip of the iceberg. Unfortunately, there is no mechanism or agency to monitor such heinous crimes. 

Grooming is a sinister act of befriending vulnerable and not only abusing their trust but using them deliberately for wicked purposes.   It is mostly done by sexual predators who target the vulnerable and young children.  Grooming is also defined as someone building an emotional connection with a child to gain their trust for the purposes of sexual abuse or exploitation.  Any age group can be groomed but people on the two extremes, young and older, are particularly vulnerable.

In the current times, there are multiple channels to groom, may it be face to face, phone and online.  It is not easy to detect grooming and even the victims fail to see any wrongdoing at the start. The predator can be known or unknown to the victim, mostly a stranger but sometimes a family member, family friend or a professional with an easy access to the children. Groomers can be male or female of any age.

Groomers are shrewd and take their time to win the trust of the vulnerable person. They usually target those who are weak and prone to suggestibility.  Groomers’ study their victims thoroughly, find their weaknesses and then target them using the same.  Children and young people are not able to understand that they have been groomed, or that what has been happening is abuse.  It is usually late when they realise that they are being used and abused.  Once the groomer has gained enough trust of their victims, they try to isolate them from their family, friends and neighbours.  They are made to feel dependent. They use any means of power or control to make their victims believe that they have no choice and have to do what is being ordered. Groomers often use ‘secrets’ they have gained from the victim to control and frighten them in future. It often ends as blackmail, and subsequently making the victim feel guilty and ashamed to stop them divulging the abuse to anyone else.

Online grooming is very common and most difficult to detect for any parent.  Groomers often use fake accounts, names and ages to befriend the vulnerable.  They often study the online behaviour, profile and updates of their victims and then use the same as bait. Groomers may not always meet their victims in person but often involve them in an online sexual activity like sending explicit messages, asking for nude pictures or have sexual conversations online or by text messages.  They often use the same conversations as evidence against their victims as a threat if the victims refuse to comply or if they try to seek help. Children do not disclose such liaisons because of shame, guilt, threats, unaware that they are groomed and at times they really believe in the relationship.  As per some studies, sexual grooming of children over the internet is most common in the age group of 13–17 years followed by 13–14 year.  The majority of the victims are girls.  The mobile phone is used in most cases of victimisation and children with behavioural issues are highly vulnerable.

War and conflict zones are particularly known for grooming and human trafficking and there is enough evidence from the published literature.  Grooming gets murkier when it is used by states and agencies to gather information and intimidate.  Hence, any war or conflict zone in the world becomes a hell for children and those who are not able to protect themselves.  Grooming not only puts lives at risk, but can lead to perpetual abuse and human trafficking. Women and young children are often the first targets.  The secrecy and the fear make the situation worse.  Unfortunately, Kashmir is one such place and grooming is common.   The situation is made worse by poverty, joblessness, broken families and orphans in thousands.

Once a child is groomed, it does not take long to get the family coerced into the same as poor people have hardly any escape and non-cooperation is dealt with threats and intimidation. Mind you if they have groomed a child, they would keep all the evidence like phone calls, text messages, and online chat etcetera and if the child or the family wants to backup, they would use the same on them and force them to do things they may not do otherwise. The abuse usually starts with friendly talk, exchange of petty favours, mobile phones till the groomer gains enough power over the victim.  Unfortunately, this not only leads to sexual abuse but often ends up them being used for information gathering and spying on their own family, relatives and neighbours.  Often the victims end up as accused when things come out by an accident leading to devastating consequences not only for the abused but society at large.

It becomes imperative on parents and guardians to remain mindful of their children’s activities both in the real world and online.  It is not uncommon for the groomers to befriend the families to get access to the children.  Similarly, schools though mostly safe cannot be ignored and any sign of unusual behaviour in a child should be taken seriously.  If a child is using a phone or the internet, parents need to know what is going on, what online sites the children are accessing and whom they are talking to. If your child comes with a new phone, gifts or anything you believe they cannot afford, it should never be ignored.  With all good cultural practices, we do have a problem of open door access to anyone and in the current age, this may not be the best idea and seeking permission to enter is not rude but recommended.  Anyone may it be your neighbour or a friend, visiting your home more often that necessary should be taken with caution.

There is no specific law in relation to sexual grooming.  While children in Indian states are safeguarded by the Protection of Children from Sexual Offenses Act (POSCO 2012), Jammu and Kashmir has not bothered to introduce it yet and there is no equivalent law as well. POSCO 2012 applies to children under the age of 18 years and gives protection from sexual abuse and intends to protect the child through all stages of judicial process giving paramount importance to the principle of “best interest of the child”. The State Commissions for Protection of Child Rights (SCPCR) are empowered under this law and need to be informed within 24 hours of any report of abuse. This may be one of the safeguards Jammu & Kashmir state can introduce to protect young children.

The Criminal Law (amendment) Act, 2013, was passed by the Indian Parliament in the aftermath of the Delhi gang-rape. The J&K assembly adopted the amendments in March 2016 but left intact the impunity for the prosecution of public servants. Which essentially means any act of sexual abuse or related acts by the security forces will not be prosecuted.  Ironically the only thing assembly has advocated is that the driving licence of the accused should be suspended and if proved guilty should have no right to drive.

J&K Juvenile Justice (Care & Protection) Act 2013 as implemented in Jammu & Kashmir is also silent about sexual abuse and related issues and seems mostly brought into force to justify the detention of juveniles, defined as children under the age of 18 years.  It defines a child in need as someone who is being or likely grossly abused, tortured or exploited for the sexual abuse or illegal acts, or who is being inducted into drug abuse or trickling,  or who is being abused or likely abused for unconscionable gains.  But when it comes to safeguarding and prevention of such crimes, the Act 2013 is silent and hence of no use.

It is the responsibility of everyone to be aware of such acts, people and safeguard children and families. The State needs to make adequate legal provisions including the introduction of POSCO or equivalent law with the establishment of Children’s Commission.  Keeping in view the age of mobile phones and the internet, the law needs to keep pace with the time.  The civil society also needs to look after those who being victims of the conflict are dependent and vulnerable so that they do not fall into this trap.  Finally, the anti-human laws giving impunity to any individual need to be scrapped as there is no justification for allowing abuse and trafficking of children.

http://www.risingkashmir.com/news/the-murky-business-of-grooming  

Just Drive- A Reflection

Many years ago, when I started taking driving lessons in Srinagar, the instructor gave me only one advice.  Just drive.  He had an old Maruti 800 and while driving on the chaotic roads of downtown Srinagar, he would say just drive, doesn’t matter who comes in front of you. ‘This is my car, and I don’t mind you damaging it’.  I suppose he was trying to take the fear out of me (though I doubt I was ever fearful).  After only having a few such lessons I bought a car.  You can imagine my driving skills apart from ‘Just drive’.

I remember one day I asked my friend let’s go for a drive to SKIMS Soura from SMHS doctors hostel at Karan Nagar.  I was barely able to use first and second gear of the car. I think it took us few hours to reach SKIMS, and although I tried my best, I could not get into 3rd gear. I suppose one cannot drive going forwards only and when it came to reversing, I was not able to manage that either but somehow turned around. 

Looking back on this experience, although at the time it was probably thrilling and exciting, it surely was a blunder and risk not only to me and my friend, but others driving and walking on the road.  I don’t know whom to blame, myself, the driving instructor who taught me ‘just drive’ and nothing more or the licensing department who issue licenses without proper tests.  But at the end of the day, it was me who made the decision to drive when I knew I should not have.

Many years later, when I had to take a driving test in the United Kingdom, I realised the importance of the driving rules and necessary training.  Believe me, the driving test was the toughest exam of my life (though I can’t remember how many exams I have taken by now), even though I had driven more than 100000 miles before.

We should never take driving lightly, life is precious and any vehicle is a potential weapon which can kill and disable.

©MudasirFirdosi

A curios case of moral hypocrisy

The British Raj created a special service to rule the undivided India after the rebellion of 1857. The sole purpose of this new service was to rule, control and extort taxes, on behalf of the British monarchy. It had nothing to do with serving common people. The commonly known Indian Civil Service (ICS) was actually created in 1958 as the Imperial Civil Service. Sooner it became the steel backbone of the British Raj. At one point, a small cadre of little over thousand people ruled more than 300,000,000 Indians. Each officer had an average of 300,000 subjects, and virtually controlled every aspect of their subject’s lives. Hence, with a handful of clever, shrewd and rather ruthless people, a small country like England was able to control a vast and populous country like India.

At the time of the partition, there were 980 ICS officers consisting of 468 Europeans, 352 Hindus, 101 Muslims, and the rest from other communities. The service was divided into the Indian Administrative Service (IAS) and Civil Service of Pakistan (CSP). The British Empire has gone but it left behind one of its biggest legacies or curses. The first Prime Minister of India is known to have ridiculed the service and noted that someone had defined the service as, “with which we are unfortunately still afflicted in this country, as neither Indian, nor civil, nor a service”. Gradually, the service became untouchable and all-powerful, taking the shape of a coloniser within. The governance and democratic institutions having become its slave, we have thousands of monarchs in today’s time working on the same old colonial principles with total domination. Has the British legacy succeeded and brought the country to its knees? Has the service maintained its glory till date by doping the common people?

A friend from Bihar told me that parents are happy to fund their children as long as they are preparing for the civil services exam. The brightest brains with professional degrees from institutes like IITs, IIMs, and medical schools are sucked in. What makes IAS so prestigious? Is it the average salary? No, I do not think so. Professionals can make much more by honest means. Does the type of work and contribution to society make it desirous? One has to be a fool to believe that. The perks and the secondary, side sources do make it attractive as long as one is ready to compromise one’s integrity. Any graduate, with an average intelligence, can perform the said duties as there is hardly anything professional or technical about it. With a few months of training, you are supposed to run any department and that is why any graduate from any background can apply to join.

This brings us back to the societal hypocrisy contrary to the values we try to teach our children. We still love and respect people who rule us than those who serve us. There are unlimited opportunities for corruption once you are an alleged civil servant. A recent survey showed India to be among the worst corrupt countries due to this rigid and self-serving bureaucracy. The crony capitalism is another gift of the service. The service still commands the power which it had during the colonial times and has made sure that every aspect of your life is hostage to its interference. The power strangely comes with respect, maybe out of fear or the hangover of the slave mentality. Hence, professions like teachers, nurses and academics hardly matter in our kind of society, as corruption and power is what people aspire to. By qualifying an exam, a person suddenly becomes a VVIP, an elite and ultimately out of reach to a common man. Why is that? And how is it compatible with justice and principles of democracy?

How can you afford the lavish lifestyle of one class of employees and fail to pay even basic salary to the front line workers? You may be able to punish politicians by sending them out of power at the next election, but there is no way of holding Babus accountable. The failure of various public services and institutions run by these generalist elites is no secret. They may have been relevant and effective a century ago, but in the current age, institutions and services ought to be run by technocrats, engineers, scientists, and academicians, who actually have the knowhow of respective fields. Is it not scandalous that important services like health and education are failing us for this simple reason? If by some chance a department is managed by experts in the field, they are hardly allowed to function independently. All this is done to command power and keep control, doesn’t matter what the cost.

“Time and again, questions have been raised about the imperviousness, wooden-headedness, obstructiveness, rigidity, and rule- and procedure- bound attitude of the bureaucracy. Indian bureaucrats are said to be a power centre in their own right at both the national and state levels, and are extremely resistant to reform that affects them or the way they go about their duties’’, notes a study from IIM Ahmedabad. Hence the business of never ending files finding it hard to move from table to table. What is the contribution of the civil service to society? Try to make a guess. Are we not losing best brains to a service which is meant to do more harm than good? The same job can be done by an average graduate on a much less expense and better efficiency. If the service was any good, why didn’t the British take it home?

I am in no way trying to take a dig at those who join the service and why wouldn’t one aspire to be elite more so when there are hardly any jobs around. The problem is with our collective hypocrisy, the societal attitude and how it has glorified a service beyond its merits without any real reason. Our Media goes amok for weeks once someone, as they call it ‘cracks’ the said exam. A public figure and celebrity is born overnight. But I wonder why? What do people think will change by someone qualifying an exam and taking a managerial position? Compare this to a scholar, who is awarded a degree. The poor fellow has to pay for a small press release on page three. No one is ready to write a few lines unless in exceptional circumstances and people hardly take notice. Some employees being special than others just because the service used to rule on behalf of a monarchy centuries ago is preposterous. Doesn’t it speak volumes about our collective moral bankruptcy?

In the context of Jammu & Kashmir, it is not hard to imagine the service doing exactly what it used to do for the British. A local Babu with whatever beliefs and values, signing the detention papers of a juvenile, supervising and at times covering up incidents of human rights abuse is no secret. I read recently on social media that one of the Deputy Commissioners has a fetish for using PSA on local youth. The argument that locals in the civil service is good for native population is mere rationalisation as they have to prove loyalty to their masters by going the extra mile which at times means legitimising the brutalisation and occupation. It hardly matters how well-meaning one may be, the system has to be obeyed without any ifs and buts. It demands absolute surrender, loyalty and there is no room for doubt or questioning. Guess who is pulling the trigger and who is in command?

So when people talk about serving humanity, earning an honest living, the betterment of the society, ending poverty, the alleged civil service is hardly the way to go. I am no way against people joining the civil service, but it should not be at the cost of false morality, making role models of people who are simply an extension of a failed and corrupt self-serving service. I do not have to explain how various departments function once such officers take charge no matter how well-meaning they may be. People need to think long and hard how they make gods out of ordinary people and in return make their own lives hell. It is time to rethink this colonial system if the society has to come out of the clutches of corruption, crony capitalism, and VVIP menace. You may be thinking how will the system function without these elite officers? But THE question you should be asking instead is; is anything working now?

http://www.risingkashmir.com/news/a-curios-case-of-moral-hypocrisy 

KASHMIR WHATABOUTERY

Kashmir has been simmering with violence for a long time now. The recent escalation and killing of civilians in Handwara brought in a fresh wave of grief for most Kashmiris. The feelings of helplessness, hopelessness and frustration again surged to a peak. As usual, the deliberate apathy from authorities, criminal silence from most media houses and hardly any noise from international community came as no surprise. While all this was happening, there were many people who started condoning the brutal acts. Some could not hide their joy as evident from the social media responses and sadly among these people were some fellow Kashmiris.

One could understand that Indians who are constantly fed lies by the media and politicians in the alleged national interest may not show any sympathy but it is hard to understand why would a Kashmiri of any faith, knowing what is going on, even think of condoning cold blooded murders. People take to the propaganda channels and shamefully defend what is being done under the garb of draconian laws. Surprisingly, most of these people are well educated and liberal in their beliefs when it comes to matters other than the plight of common Kashmiri. Before I say any further, let me make it clear that I am not trying to generalise or paint everyone with the same brush. Most people irrespective of their faith are humane and feel the pain of other human beings. There are many Indians and fellow Kashmiris from every background who condemn the brutality on civilians and share the common grief.

The army and state machinery actively shifted the blame and attention to the minor girl and all sorts of excuses started coming through. But whatever the situation, there is never any justification for killing unarmed civilians that too by armed forces of a democracy apparently proud of its secular constitution. It is not the first time when gross excesses and use of undue force has been excused by the very same reasonable people who leave no stone unturned to seek justice, provided it is not about Kashmir. By using various buzzwords like global terrorism, Pakistan, Islamophobia, and whataboutery every attempt is made to justify the brutalities on the civilian population.

One can still understand or dismiss such evasion by those ignorant of facts or those with malice of any kind. But things really get bizarre when some fellow Kashmiris start with ‘as you sow, so shall you reap’ argument. Lately, this has become a common discourse on social media. This has put me in a moral dilemma. Should I respond using the same very rhetoric, what bad things have you done that lead to migration from the homeland? Would that be a reasonable argument? I do not think so and I believe few of bigoted minds do not represent the whole community. What are they actually trying to achieve by telling a mother that your son died because of your sins and not a bullet from Indian army? Many things can be disputed but the fact remains that Jammu and Kashmir was divided amongst themselves by India and Pakistan and the local population on every side of the divide deprived of a dignified existence. They are even excluded from being a party to their own destiny. Hence this mouthful of ‘as you sow, so shall you reap’ does not hold any ground as lives of Kashmiris were taken over long back by neighbouring countries and whatever is happening now is just a manifestation of a long unresolved dispute.

All Kashmiris have suffered whether Muslims, Pandits, Sikhs or others. We are being used against each other and some of us are so gullible that we fail to see the deception. Whenever there is a brutality by the armed forces or police against common people, many armchair intellectuals come up with counter arguments of whataboutery to justify the acts. What about Kashmiri Pandits? This is the most abused question in our history. It is often asked for justifying de-humanisation, brutal attacks, rape and torture of common Kashmiris. Do you not think it is the time tested divide and rule policy? Does it not trivialise the suffering of Kashmiri Pandits that they are being used to defend horrific human rights abuses by the Indian forces towards a particular population? Unfortunately, many of the Kashmiri Pandits themselves have become victims of this whataboutery and refuse to see beyond hate and revenge politics. I do not understand how the suffering of one human being can be used to justify atrocity on another human being. Do these champions of whataboutery think of those Pandits who decided to stay in the valley? During the devastating Kashmir floods in 2014, when people were crying for help and millions were submerged under water, the same argument of ‘what about Kashmiri Pandits’ was often used by some of our brethren to cover the failure of state machinery. Sadly this question has been asked so many times even on petty issues that probably people do not take it seriously anymore. I wonder how long will the well-educated and intellectually rich community allow such people to belittle their suffering and continue to act as a political punch bag. Is this not creating further division among Kashmiris? Are they not poisoning the thoughts of their own children? How would there be any trust if people are not mindful of each other’s pain?

You do not condemn what happened to Pandit community is another common rhetoric to condone whatever is going on. It is a fair question and no words are enough to condemn the black spot on our history. But can you talk about it every time some brutality is inflicted on Kashmiris? Leaving one’s home is terrible and hard to put in words. At the same time living in a perpetual state of fear not knowing when the next bullet may hit your son is not easy either more so when you have nowhere to go even if you want to leave your homeland for the safety of your children. Should a grieving mother first condemn other wrongs before being allowed to mourn her loss?

I fully respect if someone wants Jammu and Kashmir as part of India. But how does it justify brutality on those who do not share the same vision? Just brushing everything as a creation of Pakistan in Kashmir is obviously an absurdity. A Pandit Prime Minister of the erstwhile Jammu and Kashmir was dismissed as he favoured joining Pakistan and a Muslim leader chose to trust India for help because he wanted the state independent and hoped a democracy will do justice and keep its word. History is witness to how we got here and how tactics of deceit, corruption and brutal means left us with nothing. Let us not mislead out children by giving a religious colour to the historical dispute.

Is it not time the two communities try to bridge gaps than create further division? The generations born in last few decades may fear each other; see others as monsters and probably murderers. Not that it is their fault but it is the lies which have been fed to them for one reason or other by the hyper-nationalist Indian media and confabulating writers. Some grew up away from Kashmir seeing their elders longing for homeland and some grew up under the shadow of the gun under dehumanising circumstances. Our elders have a big role to play in educating the future generations that we share same past and future.   Unless people meet and mix, talk to each other, reflect and empathise, this divide is not going to get any better.

The rhetoric of healing touch for Kashmiris living across the state and outside has failed as India is still not sincere in resolving the long-standing dispute. But let us not kill more of our children and at the same time get used by the Indian propaganda machinery for justifying such acts. Let us be fair to condemn what is wrong and give up blinding sympathy of any kind, may it be nationalism or religion. Hope Kashmiri Pandit suffering is not trivialised anymore to justify brutalities of the army and let no more blood be spilt to remove a bunker. It is time that some cogent steps are taken to recognise the human rights abuses and the dispute resolved peacefully by respecting the aspirations of the people of Jammu and Kashmir. India and Pakistan cannot play with lives of people of the Jammu and Kashmir just to keep their naïve voters busy with politics of hate forever. The resolution of the dispute is the only way all Kashmiris can get justice otherwise, the blood game is going to deprive countless mothers of their children and many more of their humanity.

Originally published in RAIOT.in

http://raiot.in/kashmir-whataboutery/