Young people should refrain from tobacco use

“Majority of the tobacco use begins before the age of 18 years. That is why young people should be well informed about life-threatening ailments attributed to tobacco use, and refrain from tobacco use” said Professor (Dr) Rama Kant, Head of the Department of Surgery, CSM Medical University (erstwhile King George’s Medical College – KGMC). Prof Rama Kant is the World Health Organization (WHO) Director-General’s International Awardee (2005) and was recently conferred upon the Amrit Lal Nagar Samman 2010. Read more

Prof Rama Kant was addressing the students of Formative Day College, Lakshmanpuri, Faizabad Road, Lucknow. The Principal of Formative Day College, Ms Archana Saxena, said “young people must stay away from tobacco use – it is in their long-term interest.” She ensures tobacco-free environment in her campus, informed Ms Saxena.

“Controlling the epidemic of tobacco among young people is an important part of any comprehensive tobacco control strategy” said Prof Rama Kant.

“Tobacco kills more than 10 lakh people in India every year. Young people should not fall in the trap of common misconceptions about tobacco use, like those wrongly associating tobacco use to glamour and lifestyle – and realize the deadly face of tobacco addiction – which is linked to life-threatening diseases and disabilities” said Prof Rama Kant.

“About half of all tobacco-related deaths occur at ages 35-69 years, making tobacco the most important cause of premature death in developed countries. Many of those who die from smoking were not particularly heavy smokers, but most of them did start smoking in their teenage years. Smokers in their thirties and forties have five times as many heart attacks as non-smokers. Heart attacks and tobacco related cancers are the main ways in which tobacco use kills young tobacco users. In industrialized countries, tobacco is responsible for 75-80% of all heart attack deaths in young smokers under the age of 50” said Prof Rama Kant, who was also awarded by the National Ministry of Health & Family Welfare, Government of India in 1997 for his Hindi book on tobacco hazards “Rakh Ke Dher Par”.

 “Especially troubling is the rising prevalence of tobacco use among girls. The new WHO report, Women and health: today's evidence, tomorrow's agenda, points to evidence that tobacco advertising increasingly targets girls. Data from 151 countries show that about 7% of adolescent girls smoke cigarettes as opposed to 12% of adolescent boys. In some countries, almost as many girls smoke as boys” shared Prof Rama Kant from latest WHO data on women and tobacco.

“Tobacco use could kill one billion people during this century. Recognizing the importance of reducing tobacco use among women, and acting upon that recognition, would save many lives” said Prof Rama Kant.

A documentary film (Hindi version), “A Heavy Price” which has personal testimonies from survivors of tobacco-related cancers and other health hazards, was also screened for students.

How Safe Are Our Hospitals? The Stark Reality

[Based on an interview given to CNS Editor Shobha Shukla by Dr Sudhir Krishna, consultant pediatric surgeon at Fortis Hospital, New Delhi and Chairman of the working group on scientific evaluation of sterilization practices in India, constituted by the Office of Principal Scientific Adviser to Govt of India. To listen to audio podcast, click here]
Infection and communicable diseases form a large part of the health care burden in India, despite the ongoing progress made to combat and control life threatening diseases. Amongst these, the most difficult to treat infections are those that the patients pick up while in a hospital. Read more
Despite major developments, surgical treatments are still associated with considerable complications arising out of hospital-acquired (nosocomial) infections, which remain a major killer in most hospitals --whether it be a 5 star hospital or a small town government hospital and/or private clinic. These infections can enter the body of the patient through surgical instruments, linen/cotton/gauze, unsterile commercially available disposables and human factor, due to improper sterilization situations in operation theatres, hospital wards and clinics.

Many research papers have documented increased hospital stay, morbidity, and increased cost of treatment as a result of these infections. Lack of antiseptic measures and poor instrument sterilization practices stand out as sore thumbs in the back drop of surgical advancements.
Lack of awareness about the ways in which infection can enter the body and lack of awareness of sterilization protocols, are the major road blocks in our journey towards making health care ‘infection free’ in our country. It is believed that the current infection rate in many Indian hospitals can be as high as 70%-80%

There is a crying need for 100% sterilized and infection proof medical devices in India. Gauze and cotton as is available and used, is a source of life threatening infections. Autoclaving, as done in our country, has no effective controls or checks which can ensure that the end product is totally infection free and safe. These products are accepted “sterile on assumption”.

Autoclaving is the process where saturated steam is used under pressure to kill micro organisms. It is one an efficient and economical means of sterilization used in health care facilities for sterilization of surgical instruments, medical devices, gauze, cotton and linen. But it has now become suspect due to extremely poor quality control of the steam and sterilization strips used. Also the items for steam sterilization have to be packaged properly in permeable material for loading into sterilizers. Traditionally, wrapping material for surgical trays, instruments, table tops, dressing sets is green linen. But generally this of very poor quality and gets contaminated with blood and pus stains due to poor washing and drying techniques. Again, all autoclaved products, wrapped in cloth have a shelf life of 48-72 hours only. Unfortunately, this fact is not known to most medics and para-medics. These packs are often stored on racks for weeks together.
So, the next best alternative is steel drums, trays and boxes. But sufficient steam cannot penetrate these containers, even through the inlet vents (which are often not opened). So the end products are actually unsterile.

Gauze and cotton are an integral part of all hospitals, clinics and nursing homes. They constitute the very basis of surgical and medical care. Yet they are the worst perpetrators of infections. They are manufactured under deplorable conditions with scant regard for their bio chemical impurities. In the hospitals they are cut to size/requirement under extremely unhygienic conditions and then overstuffed in steel drums for autoclaving. Moreover, unused gauze and cotton is not discarded but is recycled and reused, causing infection. They breed very potent heat resistant organisms. Ideally speaking, they should be packed in disposable pouches made of sterisheets, sealed and gamma irradiated.

There are no regulatory laws in India for sterilization and packaging of medical devices. These include a huge variety of consumables like implants, knee/hip joints, plates, screws, valves, mesh, shunts, tubes, catheters, urinary bags, etc. The list is endless. These medical devices are freely available in the market and claimed either ETO sterilized or gamma radiated. Unfortunately there are no regulatory laws to check the veracity of the stamp put on them by the manufacturer. Products are often falsely labelled as gamma sterilized, without actually being so.

ETO is a toxic gas which is not only hazardous for health, but also depletes the ozone layer. It is a cheap and most commonly used method of sterilization of commercially available medical devices in India, although they are being phased out worldwide. In most cases, ETO leaves a heavy residue on the sterilized products causing general and allergic reactions. It can be a potential threat to human life, as most of the ETO installations do not follow stringent regulations.

Dr Sudhir Krishna advises that proper autoclaving having high quality soft water steam is good for sterilizing linen and heat/moisture tolerant instruments. But for heat and moisture sensitive instruments, the low temperature Hydrogen Peroxide Gas Plasma Sterilization is highly recommended. It can be effectively used to sterile metallic and no metallic devices, and can make ‘infection free surgery a reality’. This would go a long way in fighting the war against infection and in reducing the harmful dependence on antibiotics.

Another very efficient (perhaps the best) method is sterilization by gamma radiations. It ensures completely safe bulk sterilization, as it is a cold process, which is fully controlled and automated.

According to Dr Sudhir Krishna “safe sterilization is the single most important factor responsible for safe surgery and is one area which cannot be ignored by doctors and health care administrators. The right to safe and infection free surgery should be the right of every Indian patient and strict punitive action should be taken against health care providers and hospitals that ignore this basic requirement. It is high time that the medical personnel were educated at all levels about sterilization methods. First rate sterilization systems in hospitals and at the manufacturers’ level will ensure better survival rates for patients dying because of infections contacted inside hospitals. At the level of the patient, one needs to become aware that it is not only a good doctor, but also a caring medical system which assures the sterility of products used.”

The time is ripe to take positive action and to launch a nationwide awareness campaign to demand simple solutions to the complicated problems of life threatening and cost escalating hospital infections. Investment in best practices in sterilization will definitely yield rich dividends, by way of saving human lives.

Shobha Shukla
(The author is the Editor of Citizen News Service(CNS), Director of CNS Diabetes Media Initiative, has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

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Teens capture their neighbourhood

July 2008 was memorable for Mani, Saraswathi (Sarasu for short), Santhosh and their friends. Teenagers from Sudarshan Layout in Gurupanpalya, a very low income neighbourhood in southern Bangalore, they had inaugurated the Ambedkar Community Computing Centre (AC3) near their homes. Teaching themselves and children around them about the immense possibilities of free software, they aroused the curiosity of its pioneer, Richard Stallman. After hearing about them at a free software conference in Thiruvananthapuram, he visited AC3 in December 2008. Committed volunteers with Stree Jagruti Samiti, AID-Bangalore, Free Software Movement Karnataka and Ambedkar Yuva Sangha who have been assisting them throughout, catalyzed this. (Geeta Menon, Balaji Kutty, Senthil Sundaram, Pulkit Parikh, Aravind Rajaram, Nitin, Ravi et al are among those who started a tutoring centre with the kids which grew into AC3.) Read more

Earlier this year, the children responded eagerly to the idea of photographing their world. Learning the basics, they caught on camera their realities and that of others (especially in their area) over two months. Knowing their enthusiasm and abilities, I was delighted to see these children Born into an UnEqUaL World present their creations during the National Conference on Free Software held in Bangalore on 20th and 21st March 2010.

"Each picture tells a tale of a child caught in the limbo of the now and the tomorrow. They are beautiful yet starkly contrasting, innocent yet riddled with hard experience, bleak sometimes but hopeful mostly", summed up Lavanya Devdas who has contributed her might to this initiative along with Balaji, Senthil and others.

Sarasu, in the bottom right frame (of the second photo), is a nineteen year old undergraduate studying Commerce. When she is not at college, she divides her time between household chores and managing AC3 which she co-founded. Exuding confidence and often guiding and helping younger kids, she has broken the gender barrier to independence and education that existed in her family.

Asha (with some of her work below), a seventeen year old pre-university student was always interested in photography but never had access to a camera. She loved this opportunity and plans to continue clicking if possible. "I was keen on depicting how we cope with minimal water supply. I also want to portray the lives of children forced to work", she said. She was excited when I suggested to her to try shooting moving objects to challenge herself and better her skills. Arumugam, a nineteen year old, dropped out of school in his early teens and works in a shoe factory. Although he take did not take too many pictures, he enjoyed participating in this project.




Mani, an eighteen year old high school student draws and paints by hand or using software like GIMP. A co-founder of AC3, he inspires the young and old moving around deftly in his wheelchair or with his friends' help. He has been exhibiting and selling his paintings (like the ones at the end) at conferences that focus on promoting open source software, the politics of copyright, developmental issues, etc. Interestingly, he usually donates his earnings to the AC3 or children in need, despite his own financial constraints.

Let Jill And Jack Play And Eat Well

With increasing affluence and socioeconomic changes, India, like the rest of the world, is witnessing an obesity epidemic, especially in children and adolescents. According to one study, the percentage of overweight/obese children in Delhi has increased from 16% in 2002 to about 24% in 2006. Read more
There is every reason to believe that this figure would have gone up further by now. In fact according to the latest study (mentioned below), obesity among both adolescent girls and boys in Delhi, has increased according to the measurement of parameters like BMI (body mass index), WC (waist circumference), W-HR (waist to hip ratio). The situation is not likely to be better in other parts of the country as well.

Consequently, obesity related conditions like metabolic syndrome, and hypertension are becoming common in children. The long term consequences of adolescent obesity include Type 2diabetes and coronary heart disease. According to one estimate, if the present situation is not controlled, then India stands to lose USD 237 billion over a period of 2005 – 2015.

A study was conducted by some doctors of DFI (Diabetes Federation Of India) and AIIMS (All India Institute Of Medical Sciences) on children of two schools in Delhi, to assess and compare the trends over 5 years (2003-2008), in anthropometric and biochemical parameters among urban Asian Indian adolescents, matched for gender, age, school grade and socieconomic strata, living in north India. In girls, a significant increase in obesity was noticed by way of increase in BMI (5%), WC (11%), whereas in boys, a marked increase in prevalence of obesity was seen according to the measurement of triceps fold thickness only (8.8%). In boys, a significant decrease of 9.1% was noted for HDL-c (high density lipoprotein cholesterol or the good cholesterol) as compared to 1.2% in girls.

These results are startling indeed and give a clarion call for immediate and sensible action. The culprit seems to be the increasing consumption of energy dense snacks and meals, coupled with decreased physical activity. Increased urbanization and industrialization has resulted in rapid nutrition transition, leading to excess consumption of high fat foods and soft drinks with high sugar content, causing imbalance of specific nutrients. Add to this the devastating effects of Trans Fatty Acids (which are present abundantly in fast foods, bakery items, and various fried snacks bought from the market), and the scenario becomes very grim. The sedentary life style of most of our school going children, only adds fuel to the fire of the poor and disease prone health of our youngsters.


As reported recently in news papers, our Sports Minister M S Gill has admitted that sports have remained a neglected area in schools. He wants that physical education and sports are given at least one period everyday compulsorily in school curriculum, beginning from elementary school onward. Perhaps the cause of his worry is that even though the country has a population of one billion, it fails to win Olympics gold medals or give great players to the world because over the years games and sports have got very little attention at the school level. Nonetheless, his insistence that adequate open grounds be provided for playing fields is in the interest of our children’s health. It is unfortunate that most schools have few sports facilities and/or trained sports teachers. Even parents are more worried about the facility of a computer lab, rather than a play ground. Students tend to treat the games period as a free period. Our former Health Minister, Anbumani Ramadoss also had stressed upon having compulsory Yoga classes in schools, with a view to curb the rising trend of obesity and Type2 diabetes in children.

Unless suitable measures are taken for the promotion of healthy nutrition and physical activity, the present trends are likely to cause a serious economic burden in terms of premature development of non communicable diseases in adulthood. School based educative intervention programmes seem to be the most cost effective way to prevent this obesity epidemic in risk prone adolescents. School children, their parents and teachers need to be sensitized on this issue. Nutritional and physical activity education can be given through lectures, focussed group discussions and other activities. Perhaps, more schools should join programmes like MARG (medical education for children/adolescents for realistic prevention of obesity and diabetes and for healthy ageing), and CHETNA (children health education through nutrition and health awareness), which are currently being run in a few schools of some cities thanks to the initiative taken by the eminent diabetologist Dr Anoop Misra, with support from the World Diabetes Foundation.

As right minded parents and educators, we need to join hands in the effort to promote healthy and active living. Parents will have to develop in their children a liking for wholesome and tasty food. The school managements and staff can support this endeavour by promoting the use of healthy food and creating awareness for making a conscious choice to avoid/ limit junk food, and increasing their physical stamina by making them run, march, jog, and play every day. Then we will not have students fainting due to fatigue, during the morning assembly. We may also be able to curb their aggressive and violent behaviour, as it has been scientifically proved that eating of junk food and overuse of internet abets abnormal behavioural tendencies.


Shobha Shukla
(The author is the Editor of Citizen News Service(CNS), Director of CNS Diabetes Media Initiative, has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

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Narmada Control Authority accepts Sardar Sarovar oustees' demands: Medha Patkar

NCA ACCEPTS AND FORWARDS SARDAR SAROVAR OUSTEES’ DEMANDS TO STATES
After 13 days stay and struggle at the Office of the Narmada Control Authority (NCA), Indore, hundreds of adivasis and farmers, with fisher people and potters from the Sardar Sarovar affected villages in the Narmada valley moved to Bhopal. They left NCA’s headquarters after Mr. V.K. Jyoti, Executive Member and Mr. Afroz Ahmed, Director (Rehabilitation) admitted that the people’s demands are within the framework of the Narmada Water Disputes Tribunal ward (NWDTA), state’s R&R Policies and the Supreme Court’s Judgments. Read more

SSP, Jobat dam osutees and the canal-affected farmers and adivasis of Indira Sagar and Omkareshwar canals decided to challenge NVDA on various issues including land-based rehabilitation and non-compliance concealed to push the SSP dam height and the legality and logic of destroying prime agricultural lands. Despite the non-receptive attitude of NVDA officials, the people made their way into the ‘Narmada Bhavan’ today afternoon and had an intense face-to-face on the burning reality of submergence with no rehabilitation and massive corruption. The Vice-Chairman Mr. O.P. Rawat had to come down and dialogue with the people for an hour and he said that he will try to look into the concerns raised. People asserted that the Vice-Chairman must listen to their issues and grievances and resolve them at the earliest, else they would have to launch a do-or-die battle.

Andolan, through their hours long dialogue with the NCA officials and meetings at the Ministry of Social Justice and Empowerment (MSJE) and Ministry of Environment and Forests (MoEF) held by a delegation that went to Delhi last week received assurances that there is no decision as yet to erect the gates on the 122 mts high dam.

The Environment Sub-Group of NCA led by the Secretary, MoEF has taken a position that since the Central Water Commission (CWC) has not given in writing that there would be no additional submergence due to erection of gates, no final clearance is granted by the Environment Sub-Group. The Social Justice Ministry has also assured that when no rehabilitation with land to at least 5000 eligible families, fisheries rights to the fish workers and river bank land to the potters is yet ensured, the issue of granting clearance to increase the dam height further by the R&R Sub-Group does not arise.

After the people’s action, the NCA had to take cognizance and write to all the three states to take action. The oustees’ have asserted that for those who have lost their agricultural land in 1990’s when the dam height was below 80 mts and others who are in the submergence at the present height, have the right to ‘rehabilitation villages’ with a farmland and house plots with all civic amenities.

The project-affected families specifically demanded that the Madhya Pradesh Government must purchase private land, as is being done in Maharashtra and Gujarat and the NCA has in turn written to the NVDA, M.P. This letter by the NCA, to the Vice-Chairman, NVDA was read out before the Sardar Sarovar and Jobat affected adivasis and farmers at 7:45 a.m. today morning when the people warned them of all the pending tasks relating to rehabilitation and environmental compliance and the fact that there are still 2,00,000 and more people living in the submergence area in the hilly communities and the densely populated villages. They also reminded them of the NCA’s powers under the Narmada Tribunal Award, the Narmada Water Scheme, 1987 and the Supreme Court’s Judgement of 2000.

The State can’t permit anyone’s land and property to be submerged without full and fair rehabilitation, people asserted. SSP is at a standstill since 2006 and has to remain so, even now, until all the conditions on rehabilitation and environmental mitigation are fulfilled.

The adivasis of Jobat dam have also risen up and asserted their right to land and the duty of the NCA to monitor their full and fair rehabilitation in a situation where no land but meager cash and no resettlement sites are provided to them, till date.

All these adivasis, farmers, fisher people, potters from the Narmada valley have warned the NCA and the NVDA that if they do not take up the promises and the process forward towards full compliance, the people will come out of the valley and plunge into the ultimate battle to attain their constitutional,
legal and human rights.

Surbhan Bhilala    Janaki Gulalia     Madubhai Machuara   
Pushpa Prajapati   Tekambhai     Kailash Awasya     
Ashish Mandloi     Kamla Yadav       Yogini Khanolkar
Medha Patkar

Beware The Trans Fatty Acids

[To listen to the audio podcast with Dr Anoop Misra, click here]
The National Diabetes, Obesity and Cholesterol Foundation (N-DOC) under the leadership of Dr Anoop Misra, with support from the Department of Science & Technology(DST), Ministry of Science & Technology, organized a symposium on “Trans Fats: Global and Indian Perspectives,” with a view to promote healthy living. Doctors, scientists, nutritionists, dietitians, and researchers, as well as representatives from food industry, gathered on one platform to discuss the adverse effects of Trans fats in the Indian scenario, with focus on the current status and future implications of reducing the intake of Trans fatty acids. Read more

Dr Vinita Sharma, Advisor, DST, initiated the deliberations by making a fervent appeal to eliminate TFAs from our diet, not just by creating consumer consciousness, but also by interventions at the government, industry and scientists’ levels.

Mrs Rekha Sharma, Chief Dietician at Medanta, rued the fact that economic prosperity has resulted in our consuming more fats than carbohydrates, and even the latter are more of the refined type. The burgeoning middle class now has greater access to commercially available foods, which includes fried and baked food items. Most of these contain high amounts of Trans Fatty Acids (TFAs), as they are cooked in widely available partially hydrogenated vegetable oil (PVHO).

Eating out has become a status symbol and sedentary life styles a helpless outcome of today’s fast pace. Thus obesity is on the rise and is proving to be the mother of all diseases. Even rural folk are moving away from nutritious traditional cuisines.

TFAs are the most important type of ‘bad fats’ in our diet and their negative effect on our body is much more than any other dietary constituent (just like cigarette smoking). Major source of artificial TFA in our diet are the PVHO, the most common example in India being Vanaspati, and margarine and shortening in the West. Small amounts of TFAs are naturally present in diary foods and animal products, but these are not harmful.

TFAs pose a higher risk of heart disease than saturated fats as they not only raise total cholesterol levels, but also reduce the good cholesterol (HDL). A 2% increase in daily energy intake of TFAs (which could be a small helping of French fries/two and a half samosas/one plate bhatura) is associated with a 23% increase in cardiovascular risk. Other health hazards associated with them are diabetes, insulin resistance, metabolic syndrome, infertility and certain type of cancers.

Dr Ahmed Ibrahim, scientist at National Institute of Nutrition, Hyderabad, informed that in 2006 WHO recommended the global phasing out of Trans fats. Several countries like Canada, Australia, New Zealand, Denmark and USA have introduced regulatory norms to restrict the intake of TFAs. In fact Canada was the first country to introduce TFA content labelling on packaged food, followed by USA. Denmark has gone ahead even further by banning all oils/fats having TFA content>2%. New York city has banned it completely in schools.

India awakened somewhat to the menace of TFAs only around 2006, due to some awareness generated by the media and some health conscious Samaritans. Still, several commercial food items with high content of TFAs are commonly sold in hotels, restaurants and by street vendors. In the absence of any government regulations and absence of social accountability, from high profile hotels/ Multinational food chains to roadside eateries – almost all are using oils full of TFAs with scant regard for human health.

Food manufacturers in India prefer to use TFA containing cooking oils as these have a longer shelf life, lower cost, preserve the taste, and give good texture and flakiness to bakery items. Vanaspati is the main source of TFAs in India .it accounts for 10% of total production of edible oils, with a maximum consumption of 20g per person per day in north India.

There needs to be a three pronged attack to protect the health of our population from the hazards of TFAs, at the government, industrial and consumer level. The symposium recommended that at the
Government level- (i) Regulatory measures, by legislative action, be adopted to put a threshold limit of TFAs levels<10% of the total fat content in Vanaspati and <5% in margarines (bakery fats), for the time being, and eliminate them totally from the diet within a period of two years. (ii) Process to produce ‘zero trans’ fats be allowed and encouraged. (iii) Food labelling in all packed food items and edible oils giving TFA, as well as saturated/unsaturated fatty acid, content per serving/per packet be made mandatory. (iv) Mandatory disclosure of the types of dietary fats and oils used for food preparation in packaged items and foods served in restaurants. (v) Prohibit the usage of Trans fat free, heart healthy or cholesterol free logo if the food product contains even 0.1g of TFA per serving and is high in total fat.

Industry level –
(i) TFAs in the industrial food supply should be eliminated (as was claimed by two industry representatives present at the symposium, for their bakery products). TFAs in popularly consumed snacks like chips, French fries etc should be decreased by using healthy oils or healthy cooking methods like barbequed chips, baked potato wedges etc.

(ii) All packaged food items/ edible oils should clearly mention all the ingredients, along with the type of fats used in preparation of the product.

Consumer level – (i) Avoid use of Vanaspati and margarine in food preparation at home, and substitute it with liquid oils like mustard oil. (ii) Avoid high heating and reuse any oil which has been heated for more than 6 hours. Remember that shallow frying on low heat is worse than deep frying. Broiled ,steamed, and grilled food is anytime better than fried food. (iii) Avoid /limit the consumption of ready to eat foods, fast foods and bakery products. Avoid samosas, fried chaat, kachori, fried namkin, etc from road side vendors/restaurants, as most of them are cooked in TFA rich medium. (iv) Check the ‘nutrition facts’ label on packaged food items for TFA content, and if present do not use it. (v) Spread awareness in your peer group about the ill effects of TFA containing products.

In this context, the message of consumer activist, Mr Bijon Misra, is simply to ‘Go Back To Your Basics’; to harmonize with global standards without leaving our traditional cuisine and cultural habits; and to shun the TFA laced food products.

In the words of Dr Anoop Misra, "after the ban on cigarette smoking, restriction on TFA content of foods would be the most important public health initiative, benefitting millions of Indians, and would help curb the epidemics of the metabolic syndrome, diabetes and heart disease. If TFA content is restricted to less than 10% in PVHOs (at present it is 40%), it is estimated that that the risk of cardiovascular disease and diabetes would reduce by 20%".

Shobha Shukla
(The author is the Editor of Citizen News Service(CNS), Director of CNS Diabetes Media Initiative, has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

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'Counting Malaria out' on World Malaria Day

World Malaria Day April 25th 2010
Malaria is a preventable and treatable disease which half of the world's population is at risk of getting. It kills around 1 million people with most of these deaths occurring in Africa. This third World Malaria Day is set to be even bigger and better than last year. The ongoing Roll Back Malaria (RBM) Partnership campaign 'Counting Malaria Out' aims to intensify global efforts to reach important milestones set by the Global Malaria Action Plan (GMAP). We have less than a year to meet the 2010 target of universal mosquito net coverage for all populations at risk and a reduction in the number of malaria cases and deaths by 50%. World Malaria Day is a time to mobilise civil society in the fight against malaria. Read more


The main objective of the Roll Back Malaria (RBM) partnership is the scaling up of interventions at country level to ensure wide spread coverage, particularly to population groups most vulnerable. There is a need to strengthen support for coordination amongst country health partners. The identification of support needs are to be led and designed locally, with support from other levels as appropriate for the country context and capacity and the stage of policy development and implementation.


For more information on World Malaria Day, 25 April 2010, click here and for more details on Roll Back Malaria, click here

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Widespread support to Narmada strengthens people's resolve

Supporters from Pune demand justice to Narmada ‘andolankaris’ as struggle enters 13th day in Indore
As the indefinite and resolute dharna of the kisan and adivasis of the Narmada Ghati entered its 13th day today, representatives of people’s organizations from Pune extended their full solidarity to the lawful assertion of the thousands of people from the valley that the Sardar Sarovar Dam should not be pushed ahead when the rehabilitation is far from complete and further environmental damage is imminent if the conditions are not complied with. They agreed with the people that the Narmada Control Authority, which is an inter-state statutory and monitoring body must fully use its teeth to direct the state governments to fully comply with the law and policy and provide land to the people. Read more


“Why is the State thick-skinned and non-responsive when it comes to giving the adivasis and farmers their due share of land, even after a 100 dharnas, whereas it acquires large tracts of agricultural land to give away to SEZs and corporates on a ‘single-window clearance’ basis”, questioned Manav Kamble, prominent social activist of Visthapan Virodhi Sangharsh Samithi (Pimpri Chinchwad) and Maruti Bhapkar (Nagari Hakk Suraksha Samiti).

Later in the evening, the Indore Solidarity Group held its special meeting at the dharnasthal today in which senior activists and other concerned citizens including Shri D.K. Arun, noted environmentalist, Alok Khare, Shri Tapan Bhattacharya, social activists, Comrade Vineet Tiwari, Pramod Bagde and many other saathis participated and resolved to stand by the struggle and also garner more support for the movement from the city. In addition to the hundreds of people who are staying put at the dharna site, there are also many people from the villages of Nimad who are regularly visiting the dharna and actively participating. The canal-affected farmers and fishermen from the valley came in good number today.

The people’s Andolan has been receiving letters and messages of solidarity and support from various quarters. Father Thomas Kocherry, World Forum of Fisher people, Shri Amit Badhuri, noted economist, Jawaharlal Nehru University, Madhu Ramaswamy, well-known journalist, Sagari Chhabra, prominent film-maker, M.P. Mathai from Kerala, Ravi Thakur, Haimalayan Buddhist Society Jispa Lahoul Spiti, Dr. Meher Engineer, President, Indian Social Science Congress, Sergio Scapagnini, prominent Italian film-maker, Ashok Jain President, Damodar Valley Engineer’s Association, Siddhartha Khan, Kolkatta State Bank Employees Union and many others who have stated that the voice of the valley is the voice of the struggling masses and nature-based communities of the world and it is in the interests of long-term democracy and peace that the State respects and responds to people’s legitimate demands.

An interactive and informative session on the National Employment Guarantee Act was held at the Dharna site today by Kailash Awasya, Siyaram Padvi and and Kamleshbhai from Nagda.

As the ‘Chula’ is all set to burn today evening, the fire in the adivasis bellies and hearts is also burning, who are determined not to rest without their share of land.

The relay fast entered its 4th day with the fasters raising slogans that this is a do or die battle for the people of the valley and the struggle shall continue until the just demands of the people are met: Those on fast today were:

Sl. No.         Name                          Village
1.              Gangaram Solanki         Bhadal
2.              Narlia Solanki               Bhadal
3.              Ratan Solanki               Sugat
4.              Delabai Sasthiya           Sugat
5.              Sidabai Sasthiya           Sugat
6.              Kathibai                       Sugat
7.              Sunil Badole                Machaliya
8.              Khema Vestha             Jobat
9.              Thunya Vastha            Chimalkhedi
10.             Dadla Solanki             Bhadal
11.             Jadla Pawra                Cholvad
12.             Gangesh                     NBA and NAPM
13.             Vijaya Pawar              Indore Solidarity Group

Will Ramu Mishra get justice?

It's the final countdown for 24 year old Ramu Mishra who had allegedly suffered serious injuries and was rendered a invalid with 100 percent paralysis striking him when he was allegedly shot at by Kuldeep Sachan, Ram Babu Gupta and Sarvesh Srivastava on October 23, 2006 in Kanpur. Read more


For four long years Ramu and his family have lived a life of misery having faced corruption, police brutality, medical negligence and even the judgment meted out to their case by a lower court in Kanpur didn't do justice to them.

Today on his death bed at a hospital in Kanpur, his family after months of pleading for help and justice from the Government of Uttar Pradesh (UP) and the UP Governor RL Joshi, have now been brought to a stage where they have to watch their son die a painful death with both his kidneys having failed.

This family has not only faced injustice on every front but have also been denied justice by whomsoever they approached.

Ramu Case is testimony to a shameful end to one family’s heart rending efforts to save their son and not being able to simply because the State of UP has no sympathies with those stricken by tragedy such as theirs.

While Ramu lies waiting his last moment in the hospital his family can do nothing to save his life as they have lost every penny fighting for justice. And today can't afford to pay for the operation that will save his life.

What is even worse is that not a single funding agency both government or non-government has come forward to offer financial aid for the life saving operation of their son.

Though the case has been handled by Saaksham Foundation, the organization has faced disappointment on all levels when they tried to contact a number of funding agencies to support Ramu Mishra financially so that he can have the kidney operation that he needs urgently.

Ironically when the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) relief fund for the poor was approached they too were not able to help saying it is on the discretion of the panel members to decide who to release medical aid for.

While Ramu Mishra would be needing a substantial amount for his operation SGPGI Relief is not in a position to release beyond a few thousand of rupees and that too when an appeal is made, a strange condition to set before a person who is virtually on his death bed.

The request to waive of the treatment cost in this case too was not considered.

Basanti Devi, Ramu Mishra's mother is distraught, "We have lost all faith in the judiciary, police in UP, the government and even the medical fraternity only because we have seen how facts are distorted only to cover up the truth. In our case even the treating doctor who was presented before the court to testify against the accused who shot my son was an impostor. The real doctor was replaced by someone who was claimed to be the treating doctor. I kept shouting in court that he is not the real doctor but no one listened to me. Even the government counsel who we approached for free legal aid demanding Rs 11000 to take up our case, when I told him that government lawyers do not charge a fee from the clients he lost his temper and said we should fight our own case then. But now all is lost as the son for whom I was fighting is breathing his last and I can't do anything but watch in sheer desperation."

With similar story with every funding agency, there is no alternative in sight for the unfortunate boy. We would thus request an appeal be made calling for public support in this matter through media agencies.

Brief Background: Ramu Mishra's unfortunate tale began when he was reportedly shot at in front of his mother's eyes but instead of arresting the accused who were alleged to be Samajwadi Party workers the police released them within five minutes of the FIR being lodged in 2006.

On July 31, 2009 when Ramu lost the case in the lower courts in Kanpur Rural he and his family gave up all hope and decided to seek justice from the Governor of the state of Uttar Pradesh, RL Joshi. They came with a written application and reached the Governor house Lucknow on 1st August 2009.

But instead of being given a hearing the family was allegedly brutally beaten by police personnel of the Hazratganj thana and forcibly driven out of Lucknow. With police threatening to kill his younger brother in a false encounter if the family tried to appeal again to the UP Governor.

The matter was presented before the UP State Legal Services Authority in Lucknow on 12 August 2009 by Saaksham Foundation who had been approached by Ramu Mishra's family after they faced severe police brutality when they approached the Uttar Pradesh Governor with a petition seeking justice.

Saaksham Foundation, had argued then that the abuse of power in giving out judgments and enforcing the law is becoming increasingly common in Uttar Pradesh which is not a very heartening situation.

It also demanded immediate action against those guilty of such incidences who must be identified and punished immediately. Following which UP SLSA's decision to support Ramu Mishra's case came as a very encouraging decision then.

An application was then moved on 12 August 2009 by Saaksham Foundation on behalf of Ramu Mishra before the then Member Secretary UP State Legal Services Authority, Sudhir Saxena, who went through the facts of the case.

After going through the judgment copy as well UP State Legal Services Authority’s support of the decision of Ramu Mishra to appeal for the revision of judgment at the Allahabad High Court.

Following which the thana staff at Bhoglipur Kotwali continued to tamper with facts in the FIR and also threatened Ramu Mishra, a bed ridden invalid to stop asking for a re-trial.

The family had faced similar harrassment when they filed a case in the lower courts in Kanpur but lost the case on 31 July 2009 after judgment was given in favor of the accused following tampering of evidence and presentation false medical reports.

As per promise made by UPSLSA then, “UP State Legal Services Authority will not only facilitate the filing of the appeal for revision of the Judgment in this case but it will also provide Ramu Mishra completely free legal aid including lawyers who will fight this case totally free of cost. Justice will be done and the guilty punished if the findings of the Allahabad High court reveal so.”

But today months later no decision has come on the case and Ramu may die without receiving justice that was promised to him. And now on his death bed he has no hope of seeing justice done as his chanced of survival are bleak owing to paucity of funds for his life saving operation.

Thus Saaksham Foundation on behalf of Ramu Mishra and his family would request the media fraternity in Lucknow to write about this injsutice done to them. We would also request an appeal to be made to the public through your publication to offer some support to this family so that their son can have one last chance at survival.

Anjali Singh
(The author is a Special Correspondent to Citizen News Service (CNS) and also the Director of Saaksham Foundation. Email: anjali@citizen-news.org, website: www.citizen-news.org )

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Time to rethink the development paradigm on Earth Day (22 April)

22 April 2010 is Earth Day
Not only modern lifestyles are causing un-brindled exploitation of natural resources upsetting the ecosystem and upping the global warming, but also the national policies in India related to environment are not in tune with International mandate to save the planet Earth. Read more

"Corporatisation of natural resources is bad for people and environment. The impact of abusing environment (most of which is a fall-out of corporate exploitation of natural resources) is most severely faced by tribals and the poor who are dependent on natural resources for sustaining their daily life and livelihood. Depriving them of their basic human rights is exacerbating the inequities and causing irreparable damage to the environment" said SR Darapuri, who is a retired Inspector General (IG) police and a prominent social activist with National Alliance of People's Movements (NAPM). SR Darapuri is also the Lok Rajniti Manch (People's Politics Front) candidate for Lok Sabha elections from Lucknow this year.

"We need to change our lifestyles and come up with sustainable ways of development and living to save the planet Earth. The present development model is dangerous as it not only damages the environment irreparably but also is promoting corporate exploitation of natural resources thereby worsening the prevalent inequities for and increasing the marginalization of the most poorest communities who in fact had been guarding these resources." said Arundhati Dhuru, who leads the National Alliance of People's Movements (NAPM) and is a veteran anti-dam activist with Narmada Bachao Andolan (NBA).

She further added it is no exaggeration to say that ecological crisis have affected women more deeply than men.The experiences documented throughout the world have pointed out again and again that women are the worst victims of ecological deterioration since their working days has been drastically lengthened by scarcity of water,fuel and fodder, and their traditional skills and occupations have been adversely affected by new technoloies in agriculture,artisanal work and marketing while new opportunities have not sufficiently developed.My contention is that tackling the ecological crisis is pertinent not only because environmental destruction is close to reaching a level where it is irreversible but its threatening the very survival of human being.

For example, private companies are siphoning away the groundwater in making their bottled water or soft drinks. "Civilazations have been built around drop of water, we will loose our right over this most precious resource when we make water as marketable commodity." said Gurudayal Singh Sheetal of Prakritik Manav Kendrit Andolan.

"Petroleum and natural gas reserves are already depleting fast and the need to find alternative, sustainable and environment-friendly sources of energy is compelling," says Arvind Murti, who is a senior social activist with NAPM in Mau. "Bio-energy, solar energy, wind energy and other sustainable and environment friendly forms of energy need to be promoted to save the planet" said Arvind Murti.

"Our living should be such as to reduce non bio-degradable garbage" said Prabha Chaturvedi, President of Exnora Lucknow. "Bio-degradable garbage should be buried in the Earth to make fertilizers" added Prabha.

Countries like Japan have committed themselves to become 'carbon zero' by 2050. India should also commit and take leadership in not only making promises but capping the irreparable damage corporations and urban lifestyles are causing to the planet.

"Unless sustainable ways of development and living are not evolved, it will be very difficult to sustain the prevalent kind of urban lifestyle where exploitation of natural resources goes on unabated by the nexus of private corporations and the state" said Anjali Singh, Director of Saaksham Foundation.

The overriding question is how to create a mode of production which does not depend on the expliotation of nature and labour power but which, in harmony with nature , provides for the survival needs of all.

[This article was originally written on 22 April 2009, to mark Earth Day. We are reproducing this on 2010 Earth Day (22 April) as issues highlighted have become more severe and pronounced, instead of getting addressed as the year went by. To read the 2009 article, click here]

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Dam and Canal affected farmers and adivasis demand right to life and land

The indefinite Jeevan Adhikar Yatra taken up by the adivasis, farmers and fish workers of Sardar Sarvoar, Jobat Dams and Indira Sagar (ISP) and Omkareshwar IOSP) canals proceeded in full swing today, as it criss-crossed through various villages of the Narmada region, echoing slogans of “Narmada Ghati ko dubaane ka faisla radd karo” (Take back the decision to submerge the Narmada Valley) and “Rehne do Jeene do, Maa Narmada ko behne do”…(Let us live, let us stay, Let Mother Narmada flow in all her majesty). Read more

Thanking the villagers of Chhota Barda, who hosted them for the night, the andolankaris crossed the Narmada in boats and canoes and rallied into the villages of Semalda and Karoli in Manawar Tehsil of Dhar District that are facing the challenge of their prime agricultural land (which is already affected by the Sardar Saovar dam) being gobbled up by the huge canals of the Indira Sagar and Omkareshwar. The villagers asserted in unison that that they will not permit the Government to destroy their lands that is already irrigated by the Narmada and demanded an immediate review of the projects, as directed by the Jabalpur High Court.

Led by octogenarian Gandhian and Samajwadi leader Shri Shambunath Gupta from Hoshangabad, the rally marched on foot for the second day as well with the hundreds of adivasis women braving the heat of the sun and the might of the state to demand their rights. “Whether the Government will allow these struggling women and men to tread the peaceful path of Gandhi, Mahavir and Buddha or will it close its doors to dialogue, forcing people to challenge the State, the people of the valley and the nation demand an answer”, said Guptaji.

Addressing the farmers of Karoli, Fagram Bhai from Adivasi Kisan Sanghthan warned that the people will have to face the fate of the Tawa dam displaced who stand already submerged, without any land in return, where in fact new projects are coming up today if they do not stop this unjust and unnecessary displacement. “You still have time to wake up and it will be too late, if you don’t fight today, here and now, he said. He also questioned the sensitivity of the State which has projects and schemes to save tigers (which is certainly needed), but none to ensure that the displaced get land and regain their livelihood with dignity, which is unfortunate and in fact unconstitutional.

From Karoli, the yatra trucked towards Manavar tehsil where a huge public meeting was called, where many farmers affected by the SSP and the ISP-OSP canals spoke and affirmed their resolve to fight for their land and rights.

Prasad Bagve from Pune struggling against the Karla SEZ questioned as to how the State has thousands of hectares of land to dole away to profit-making corporates while it always gives a negative and even violent response to the adivasis demanding a patch of earth, their rightful share?!

Naani behen, fish worker from Kaorli roared, “Is the State so incapable that it cannot even guarantee to me my right of fish? Following her was Kunwar Singh, affected by the Jobat dam said, “After all these years of unjust displacement, we ask straight questions and demand specific answers from the State”, leading the gathering into loud slogans of “Sawaal lekar aaye hain ..Jawaab lekar jaayenge. Surbahn Bhilala from Kakrana in Alirajpur condemned the Madhya Pradesh Government that is going ahead submerging more and more people, without providing them land, after more than 15 years of submergence.

He rebuked the State that is sitting on a mountain of unchecked corruption by officials and touts, depriving the displaced.

The Jeevan Adhikar Yatra is on its way to address the villagers of Bakaner and Dharampuri tehsil and will then proceed towards Dhamnod where a large public meeting is to be addressed by various activists and members of people’s organizations today evening. The yatra will later proceed on foot and in trucks towards Rahu and reach GPO, Indore tomorrow morning where large a large gathering of supporters from Indore will welcome the march. The people will then walk towards Vijay Nagar to seek answers from the Narmada Control Authority and the rationale of displacing 2 lakh people when the costs of the dam have increased ten time with just 10% benefits.

The Indefinite action towards true development and against unjust displacement goes on.

Narmada displaced people demand for justice

The displaced adivasis and farmers affected by the Sardar Sarovar Project staged a demonstration before the office of the Narmada Valley Development Authority (NVDA) in Indore today morning. The Vice-Chairman of the NVDA, OP Rawat who was scheduled to meet the displaced postponed his visit, but the people have strongly resolved that they shall continue to assert their rights in a militant albeit peaceful way so long as a written response is not given to all the issues raised by them and until such time that the unjust and illegal attempts to push the dam are not given up. Read more

The resolute people embarked on a Jeevan Adhikar Yatra from the Narmada river bank at Rajghat (Badwani) and reached Indore on the 13th of April and have been on an indefinite protest ever since. The people have been protesting the unjust political expediency to raise the SSP dam from its present height of 121.92 mts to the final height of 138.68 mts by installing the 17 mts high radial gates,
even when there are 2 lakh people in the submergence area yet to be rehabilitated with land, alternative livelihood and rehabilitation villages and despite the fact that many environmental safeguard measures are yet to be fully complied with, as pointed out by Dr. Devender Pandey Committee (February 2009
and 2010).

NBA expresses its dismay that though the SSP and Jobat dam affected people expressed their willingness to have a constructive dialogue with the NVDA officials today, the latter did not show an inclination towards the same. Instead, the police were deployed in a good number to prevent the people from entering the NVDA premises. The Commissioner and the Deputy Commissioner almost
pleaded ignorance about the Vice-Chairman’s planned dialogue with the Andolan!

The Vice Chairman, Mr. Rawat excused himself from meeting the displaced by stating that he had to attend the Cabinet meeting at Bhopal and had to go to Delhi. He has promised to meet the people upon his return from Delhi.

The action at the Dharna site continued in its usual mood of hope and perseverance today as well. Jamsingh, Lalsingh and others of Bhadal village, making a piercing statement on the ‘freedom of the adivasis in independent India’ stated that when the British Government itself had granted pattas to
their ancestors, the NVDA is plotting to declare them as ‘ineligible’ and deny them their just and legal rehabilitation entitlements. Dadubhai of village Malangaon said that despite his village being marooned (tapu-affected) due to the Maan river and a large drain, his village has been declared as ‘unaffected’. On the other hand, hundreds of ineligible and even those living outside the affected villages have received crores of rupees R&R grants from the state rehabilitation fund as a result of the ‘grand nexus’ of corruption between the officials, agents and touts.

Medha Patkar stated that the NVDA should have the moral fibre to check corruption that has so extensively and deeply embedded itself within the Authority, but the even at the highest levels, there is a serious absence of political and bureaucratic will to address this virus. Instead the NVDA is
spending lakhs of rupees in engaging lawyers to shield the guilty officers, instead of using that amount to speed up the fair process of rehabilitation of the oustees, (particularly by purchasing private land) who are in a serious state of deprivation.

In the past one weak, the displaced and the activists of the Andolan have had two lengthy and informed rounds of dialogue with senior officials of NCA, VK Jyothi (Executive Member) and Afroz Ahmed (Director, Rehabilitation), but feel that there is a need for a further dialogue to clarify on many a issues and get concrete written assurances. NBA demands that the NCA must to take a strong and truthful position on the reality of poor rehabilitation and serious environmental non-compliance and issue firm directives to the NVDA to comply with the Narmada Tribunal Award, clearances, Rehabilitation Policy and Supreme Court’s Judgements.

Enormous support for the people’s cause continues to pour in from various supporters in Indore and elsewhere. The real struggle lies in the days ahead and the displaced are keen not to give up before asserting and attaining their rights.

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Symposium on Trans Fats: Global & Indian Perspectives

The National Diabetes, Obesity & Cholesterol Foundation (N-DOC), with support from the Department of Science & Technology, Ministry of Science & Technology, is organizing a symposium on “Trans Fats: Global & Indian Perspectives” on 24th April 2010 in New Delhi, with a view to promote healthy nutrition and generate awareness on Trans Fatty Acids among health professionals and general public. The purpose of the symposium is to discuss the adverse effects of Trans fats in the Indian scenario with focus on the current status and future implications of reducing the intake of trans fatty acids. Read more

This symposium could not have been better timed. We are currently going through a phase of dietary transition; higher economic growth has resulted in a burgeoning middle-class having greater access to commercially available foods, which include fried and baked food items. Most of these foods contain high amounts of Trans fatty acids (TFA) through the partially hydrogenated vegetable oil (vanaspati) which is used for its low cost and longer shelf life. Multiple scientific studies have reported that TFAs can adversely affect LDL and HDL cholesterol levels and also increase the risk of developing coronary heart disease, type 2 diabetes and elevated inflammatory markers.

But unfortunately, there is no data on either the content of TFA present in fried and baked food items or their consumption by children and adults in India. Most importantly, the Indian consumer today lacks the knowledge and understanding of the adverse effects of TFAs on insulin resistance, heart and other organs of the body. Owing to the effect of TFA on health, governments across the globe have set limits for TFA and made it mandatory to label the TFA content on commercially prepared and packaged food items. But in India, several commercial food items with high content of TFAs are being sold with impunity (and savored by us), with even the roadside vendors selling food items which are replete with TFAs.

The symposium aims to provide an interactive forum for experts to discuss the adverse effects of TFAs especially in relation to non communicable diseases like diabetes, obesity, heart disease and metabolic syndrome. It also intends to focus on collaboration between the food industry, and health/nutritional experts and to deliberate upon the permissible levels of Trans fats with special reference to Indian diets.

The need to decrease intake of TFA has to be balanced with the reality that India is dependent on the import of vegetable oils to meet its edible oil requirement. Thus any solution for TFA elimination must be reconciled with this reality.

With the incidence of non communicable diseases being on a constant rise in India, it is high time that we become aware of the consequences of our modern-day dietary preferences and seek feasible alternatives.

Shobha Shukla
(The author is the Editor of Citizen News Service(CNS), has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

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