CNS coverage from TB and Poverty sub-working group meeting of the Stop TB Partnership (29-30 October 2010)

CNS provided on-site coverage from TB and Poverty sub-working group meeting of the Stop TB Partnership (29-30 October 2010) held in Gurgaon, India. The secretariat of the TB and poverty sub-working group of the Stop TB Partnership has now moved to the south east Asia regional office of the International Union Against Tuberculosis and Lung Disease (The Union) since September 2010. Read more

Addressing poverty in TB control: The Thailand experience
Online at: http://www.citizen-news.org/2010/11/addressing-poverty-in-tb-control.html

Poverty increases vulnerability to TB
Online at: http://www.citizen-news.org/2010/11/poverty-increases-vulnerability-to.html

Poverty impedes access to existing tuberculosis (TB) care services
Online at: http://www.citizen-news.org/2010/11/poverty-impedes-access-to-existing.html

TB and poverty: India has third of world's poor and highest TB burden
Online at: http://www.citizen-news.org/2010/11/india-has-third-of-worlds-poor-and.html

The deadly mix: TB, tobacco, diabetes and poverty
Online at: http://www.citizen-news.org/2010/11/deadly-mix-tb-tobacco-diabetes-and.html

Tuberculosis and poverty: Partners by default
Online at: http://www.citizen-news.org/2010/11/tuberculosis-and-poverty-partners-by.html

People with diabetes at 2-3 fold higher risk of TB
Online at: http://www.citizen-news.org/2010/11/people-with-diabetes-at-2-3-fold-higher.html

47 per cent TB patients remain unreached in Chhattisgarh
Online at: http://www.citizen-news.org/2010/11/47-per-cent-tb-patients-remain.html

Innovative approaches to address poverty in TB programmes of Jharkhand
Online at: http://www.citizen-news.org/2010/11/innovative-approaches-to-addressing.html

Poor people are most hard-hit by TB, COPD and tobacco
Online at: http://www.citizen-news.org/2010/11/poor-people-are-most-hard-hit-by-tb.html

Addressing poverty in TB programmes of Bihar
Online at: http://www.citizen-news.org/2010/11/addressing-poverty-in-tb-programmes-of.html

Addressing poverty in TB programmes of Tamil Nadu
Online at: http://www.citizen-news.org/2010/11/addressing-poverty-in-tb-programmes-of_10.html

TB and poverty: a dangerous mix in hilly Uttarakhand
Online at: http://www.citizen-news.org/2010/11/tb-and-poverty-dangerous-mix-in-hilly.html

From Fit To Fat

World Diabetes Day is on 14th November
Diabetes, one the four priority non-communicable diseases (NCDs) identified by the World Health Organization (WHO), remains a misunderstood and neglected epidemic with numbers increasing alarmingly in every region of the world. According to the International Diabetes Federation (IDF), there are over 300 million people with diabetes worldwide with low- and middle- income countries account for 4 out of 5 cases of diabetes. There are 50.8 million people with diabetes in India and 92.4 million in China. To add fuel to fire, India seems to be at a threshold of an 'outbreak' of obesity, more so in urban Indian cities. Read more

Obese children and adolescents are at an increased risk for the development of early-onset type-2 diabetes mellitus (T2DM) and coronary heart disease (CHD). This phenomenon is accelerated by nutritional westernization and sedentary lifestyle. There is a near global consensus amongst doctors and scientists that healthy dietary and lifestyle practices should be inculcated in children to prevent future development of T2DM and CHD.

Unless preventive measures are taken, obese and insulin resistant children will get affected with T2DM and CHD in young adulthood.

According to Prof (Dr) G Choudhuri, Professor and Head, Department of Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, "The age of onset of diabetes is decreasing, and it is occurring at a younger age these days. Diabetes has a strong genetic component but gets unmasked with disorganized lifestyle and eating habits. The 2 important lifestyle issues of concern are increased body weight and lack of exercise. Indians, especially urban ones, are particularly predisposed to exercise deficient lifestyle. These changes are being increasingly observed now in urban children, and nearly 20% or more school kids are overweight or obese, and are potentially at risk of developing diabetes."

Prof Barry M Popkin, a professor of nutrition at the University of North Carolina rues that, "some children, including very young children, snack almost throughout the day. Such findings raise concerns that more children in the world are moving toward a dysfunctional eating pattern-one that can lead to unhealthy weight gain and obesity."

According to Prof (Dr) Anoop Misra, former Professor, Department of Medicine, All India Institute of Medical Sciences (AIIMS) and Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals (New Delhi and Noida), who is also the Director, Diabetes Foundation (India): "Trans fatty acids are one of the strongest poisons affecting human metabolism today." Trans Fats are found in fast food products made with hydrogenated oil in an unregulated market, a time bomb waiting to explode, even as the Indian Union Health Ministry is contemplating for processed food manufacturers to list the Trans-fat content on nutrition basis.

Diabetes Foundation (India), with help from other global agencies, is striving to create awareness about lifestyle related diseases in children and adolescents through three major community centric health initiatives involving the education of schoolchildren, teachers and parents regarding diabetes and obesity. These are:-


Project MARG (Medical education for Children / Adolescents for Realistic Prevention of Obesity and Diabetes and for a Healthy Aging), which focuses on primary prevention of not only obesity and diabetes, but also of non-communicable diseases in general, by targeting school children in several cities of India.

Project CHETNA (Children's Health Education Through Nutrition and Health Awareness), which aims at prevention of obesity, diabetes, and heart disease, in order to inculcate healthy lifestyle and nutrition habits in school children.

Project TEACHER (Trends in childhood nutrition and lifestyle factors in India) which covers 4 major cities of India to obtain in- depth understanding of nutrition and lifestyle behaviours that affect the health and well being of urban Indians , particularly children, through detailed knowledge attitude and practice survey questionnaires, group discussions and anthropometric measurements of children and their mothers.

Project HOPE (Health Oriented Programmes and Education) with Prof (Dr) G Choudhuri as its founder member - has been concentrating on lifestyle as one of its thrust areas and targeting diabetes prevention as one of its goals. Its mission is to promote health awareness in schools throughout the city of Lucknow. It recognizes that healthy children learn better and that school based programmes can help to influence the health of students.

More such initiatives are needed to encourage our children/adolescents to eat a nutritious diet and increase physical activity. Schools can be targeted to become harbingers of this change by increasing sports activities in their premises and by monitoring the food/snacks preferences of the students. Some schools have indeed changed the school canteen menu to a tasty health menu and have stopped the sale of cola drinks on the campus. It is worth mentioning here that a single serving of soda or other sweetened soft drink contains between 120 and 200 calories of sugar, equivalent to a man's recommended intake for a full day and exceeding the recommended daily intake for a woman.

According to a study conducted by researchers from the University of California, the booming popularity of sugary soft drinks has led to 6,000 more deaths, 14,000 more cases of heart disease and 130,000 new cases of diabetes in the past 10 years. "We can demonstrate an association between daily consumption of sugared beverages and diabetes risk," researcher Litsa Lambrakos said. "We can then translate this information into estimates of the current diabetes and cardiovascular disease that can be attributed to the rise in consumption of these drinks."

What better way to celebrate India's Children's Day this year on 14th November (which coincides with the World Diabetes Day, 14th November), than us parents, teachers, school authorities and youngsters to join hands in this noble endeavour of going from fat to fit, by saying no to colas/ junk food and yes to healthy snacks, and hop/skip /jump/ swim/ cycle/ dance to a diabetes free world.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Gender Initiative and CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. Email: shobha@citizen-news.org, website: www.citizen-news.org)

Decreasing hunger, increasing health: Promoting awareness and accessibility to food and care

It is common knowledge that food grains rot and waste in government warehouses while millions of Indians starve or subsist on extremely little. This directly impacts their physical, mental and emotional health and very often their survival. Further, due to the rampant corruption in the public distribution system (PDS), the economically marginalized barely get their due from the 'fair' price shops. The integrated child development scheme (ICDS), anganwaadis, balwadis and government schools which are supposed to provide nourishment along with education, child and health care, are gradually heading the same way. Read more


Many non-governmental, not for profit institutions like the Ramakrishna Mission, Missionaries of Charity founded by Mother Teresa and organizations such as the Aashayein Foundation play a stellar role in reducing the number of the famished. Although some of these and others like the Belaku Trust also provide basic health care through free or low cost guidance, clinics, doctors and medicines they are not substitutes for the state. However, the latter is conveniently relinquishing its responsibility to them, although the non-profits simply cannot match the scale of the government.

While there are some non-governmental, not for profit institutions focussing on feeding, treating and guiding the poor, others like the Community Health Cell (CHC) go a step forward. A functional unit of the Society for Community Health Awareness, Research and Action (SOCHARA) the CHC conducts periodic advocacy and training programmes on the connection between food, health and overall well being. It also contributes to framing and critiquing policy and monitoring and reporting on implementation. The CHC has been actively involved in the initiatives of the Jana Arogya Andolana, Karnataka (JAAK), the state affiliate of the Jan Swasthya Abhiyan, a member of the global People's Health Movement (PHM) in India. With the conviction that the right to health is a human right, the JAAK, a forum of various NGO's, CBO's, groups and individuals working to strengthen the health sector in the state, initiated a movement in 2004 to “REVITALIZE PRIMARY HEALTH CARE IN KARNATAKA”. As part of this, the Andolana monitored the health systems in the districts, identified problems and gaps in them, brought it to the notice of the government and built pressure to ensure that the relevant departments took appropriate action to deal with the issues. In early 2008, the JAAK also drafted the Karnataka State Health Policy Brief, a short paper that conveyed urgent health policy concerns in the state and demanded courses of action to resolve them.

In addition to the above, the CHC has also been offering various training courses on public health, health and human rights, women's health empowerment and nutrition, life skills education et al in English and Kannada. These are open to graduates in medicine and allied disciplines, social science students as well as social and community health workers, activists, marginalized women and youth. The objective of these programmes is to create an awareness of the rights and entitlements of poor and socially excluded people specifically in rural and semi urban locations, with regard to food, water, community health and sanitation and the challenges in accessing these fundamental necessities.

Here is an extract from the reflections (obtained from the May 2010 CHLP newsletter on the SOCHARA website) of Malvika Thirukode, an intern with the 2009-2010 batch of CHC's Community Health and Learning Programme (CHLP). "Meeting with professionals and volunteers working with marginalised groups such as migrant workers, I realised their lack of identity. I also began to take notice of the sights and sounds of Bangalore city less heard and seen. Towards the last few weeks we worked towards raising awareness on the 'Right to Food' bill on Independence Day. Talking to the youth about the issue and interactions with activists were valuable insights into the shaping of movements, the importance of national policy and the role of people led groups in bringing to notice the need to look into issues in its totality.”

If Food Security and Health for All are to become a reality, any number of legislations, schemes and policies will not suffice. There must be concerted and relentless will and effort to ensure that these prerogatives reach those regularly denied them, whether in the remotest regions or the largest metropolises. After all, one may not live to eat but one must eat to live!

References: http://www.sochara.org 

Pushpa Achanta
(The author is a freelance writer, a Fellow of Citizen News Service (CNS) Writers' Bureau, and a community volunteer based in Bangalore, India)

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Up to 1-in-5 TB deaths attributed to tobacco use

With the 41st Union World Conference on Lung Health hardly two weeks ahead of us, the issues which emerged at the 39th Union World Conference on Lung Health in Paris, France, where CNS was present, are worth re-visiting. With 50% of all deaths from lung disease linked to tobacco use, control of the tobacco related substances was high on the agenda of the 39th Union World Conference on Lung Health in Paris, France (2007). This year 2010, is also declared as Year of the Lung. Read more

"Up to one in five TB (tuberculosis) deaths could be avoided if TB patients were not smokers," Dr Nils Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), had said in 2007 Union conference.

Smoking is also associated with recurrent TB and people with the disease who smoke have a higher risk of mortality than non-smokers with TB. The scaling-up of tobacco cessation services for people with TB is therefore a clear priority.

Dr Mario Raviglione, Director of the Stop TB Department of WHO had discussed the Practical Approach to Lung health (PAL) with delegates at the 2007 39th Union World Conference on Lung Health. The approach focused on comprehensive treatment for all respiratory conditions and diseases, not just TB.

About 80% of smokers live in low and middle-income countries and 520 million people will die from tobacco-related illnesses in the next 50 years, according to available data. By 2030 the annual number of deaths from tobacco will increase from five million to more than eight million.

The Union has helped raise awareness of tobacco hazards, encouraging its partners to play an active role in tobacco control and recognize the link between tobacco and TB.

It has also promoted effective tobacco control policies through technical resources, training a new generation of managers and practitioners and supporting effective programs through grants.

WHO and The Union had published and released a joint monograph on TB and tobacco control in 2007 and key elements of the policy include the identification and offers of counselling for smokers assessed for TB or other respiratory diseases.

The monograph also called for the operation of smoke-free public health centres and the training of health workers to deliver smoking cessation treatment.

Concerns over the high rates of tobacco use among doctors and healthcare providers in high TB-burdened countries were also raised during discussions at the conference. In some regions more than 50% of healthcare workers use the drug, making it difficult for them to play a genuine role in tobacco cessation programs.

Bobby Ramakant - CNS 


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Piles to Smiles Clinic: Treating piles without surgery

Piles to Smiles book launched

Treating Piles without surgery is a reality now. With latest techniques and competent well-trained staff, getting relief from haemorrhoids (or piles) without surgical incision is a possibility. Patient's hospital stay is very brief, and clinical outcome outstanding. Noted Lucknow Surgeon Professor (Dr) Rama Kant who is a faculty at the forthcoming XII Annual Conference of Association of Surgeons of India (ASI), Haryana Chapter, and Northern Region CME of ASI in Post Graduate Institute of Medical Sciences, Rohtak, Haryana, will also deliver a guest lecture on managing haemorrhoids (piles) without surgery by DGHAL/RAR technique. Read more


"It is surprising that piles or haemorrhoids have not been high up on the public health agenda despite of the incredibly high prevalence and practical approaches to prevent or manage them" said Prof (Dr) Rama Kant who is currently the Managing Director of “PILES TO SMILES” Clinics which runs at two centres presently: (i) Rama Consultations and Training Centre, C-2211, C-Block Crossing, Indira Nagar, Lucknow, and (ii) SIPS Hospital, Shahmeena Road, Chowk, Lucknow. Prof (Dr) Rama Kant is the Professor-Director at SIPS Hospital, Chowk. He is the former Head of Surgery Dept, CSMMU (erst KGMC) and former Chief Medical Superintendent of Gandhi Memorial & Associated Hospitals, CSMMU.

"According to varying estimates 50-85% of the world’s population suffers from piles or haemorrhoids at some stage in their lives, especially the risk to develop piles alarmingly increases between 50-70 years of age" informed Prof (Dr) Rama Kant, who is the current President of Association of Surgeons of India, UP Chapter (2009-2010) and is the ASI governing council member (2010-2012).

"This guest lecture in PGI Rohtak will feature a unique non-surgical technique for the management of Piles like Doppler-guided haemorrhoidal artery ligation (DGHAL) and Recto-Anal Repair (RAR). The beauty of this procedure lies in the fact that the patient is discharged within a few hours and is back to work, the very next day" said Prof (Dr) Rama Kant, who is also a recipient of World Health Organization (WHO) Director General's Award in 2005 and lead author of the book 'PILES TO SMILES'.

"There are known lifestyle and dietary factors that aggravate the risk to piles significantly" added Prof (Dr) Rama Kant.

Piles are swellings that develop from the tissues that line the anal canal or back passage. The tissue of the anal canal is rich in blood vessels. If these vessels become dilated and swollen, they may project into the anal canal or out of the back passage (known as a prolapse) to form visible swellings.

Piles tend to be caused by factors that cause the blood vessels to swell, including anything that increases pressure inside the abdomen such as constipation, pregnancy or being overweight. Prevalence of piles is higher in pregnant women than in non-pregnant women of the same age group.

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Alarm on diabetic foot: "People with diabetes take care of feet"

Prof (Dr) Rama Kant awarded Jharkhand Presidential Oration on diabetic foot
Professor (Dr) Rama Kant was awarded the prestigious Presidential Oration by Association of Surgeons of India (ASI) Jharkhand in Hazaribagh on 24th October. Prof (Dr) Rama Kant is currently the Managing Director of Piles to Smiles Clinic at Rama Consultations and Training Centre (RCTC), C-block crossing, Indira Nagar and also the Professor-Director at SIPS Hospital, Shahmina Road. He is the former Head of Surgery Dept, CSMMU (erst KGMC) and former Chief Medical Superintendent of Gandhi Memorial and Associated Hospitals, CSMMU. Read more


Prof (Dr) Rama Kant was awarded the Jharkhand Presidential Oration at the JASICON 2010 in Hazaribagh on diabetic foot. “People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness - loss of feeling - in the hands, arms, feet, and legs” informed Professor (Dr) Rama Kant, who is the current President of Association of Surgeons of India, UP Chapter (2009-2010) and is the ASI governing council member (2010-2012).

“The foot of the patient with long-standing diabetes is often the site of neuropathic and vascular growth which poses a considerable threat, not only to the lower limb but also to the life of the patient” warns Prof Rama Kant, who is also the recipient of the coveted World Health Organization (WHO) Director-General’s Award for the year 2005.

Relatively diabetic foot is one of the leading causes resulting in long hospital stays for people with diabetes. It demands much care and attention by both the patient and healthcare personnel. Two major problems which predispose the patients with diabetes to amputation are the development of neuropathy due to uncontrolled diabetes over several years while result in damage to the nerves in the feet leading to the loss of sensation. They also develop certain high pressure points under the feet which result in the formation of callus which later turns in to an ulcer. In addition cigarette smoking will lead to nerve damage and reduced blood flow in the feet.

With increasing age, people with diabetes may develop diminished sensation and decreased peripheral circulation in the feet, and thus are at a heightened risk of developing foot infections.

Prof Rama Kant lists some ways people with diabetes can take care of their feet:
1. Keep feet clean – wash them regularly.
2. Use only lukewarm water – no hot water, heating pads, hot water bottles, iodine or alcohol.
3. Keep the feet dry – especially between toes-use unscented lotion or cream to keep skin soft.
4. Use only medicines recommended by your doctor
5. Cut toe nails straight across, not deep into the corners to help avoid ingrown toe nails.
6. Never use razors, knives or corn caps to remove corns.
7. Wear shoes or slippers at all times -never walk bare foot even at home.
8. Wear good fitting shoes/slippers - not tight or worn-out ones. Boots should be used only for short periods.
9. Check your feet daily and see your doctor immediately about foot problems.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Gender Initiative and CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. Email: shobha@citizen-news.org, website: www.citizen-news.org) 


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Tobacco Industry Interference in implementing global tobacco treaty in Thailand

Dr Prakit Vathisathokit

During the 10th International Week of Resistance to Tobacco Transnationals (IWR) during 4-8 October 2010, civil society groups from around the world told the world: how tobacco industry interferes in the implementation of the global tobacco treaty, formally known as the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Thailand, was one of the countries where veteran tobacco control stalwarts like Professor (Dr) Prakit Vathisathokit, shared how tobacco industry interferes in the implementation of global tobacco treaty and also in enforcing their domestic tobacco control policies in the country. Prof (Dr) Prakit is the Executive Secretary of ASH Thailand. Read more


"When we made a decision to increase the size of pictorial warning on tobacco packages in Thailand, tobacco companies had some movement against us. These companies sent the letter to object to this move to increase size of pictorial warnings, and asked for the supportive evidence to prove that the bigger size of pictorial warning will help people quit tobacco use" Prof (Dr) Prakit said. Professor (Dr) Prakit Vathisathokit is also a Bloomberg International Awardee on pictorial warnings (2009).

According to Prof (Dr) Prakit, over 6 million Thai people have quit smoking during 1996 - 2006. Referring to the Baltimore study, he points out that around 1.6 million Thai people didn't begin to smoke because of the effective pictorial warning on the cigarette packages.

"Another case is the 'Article 9: Regulation of the contents of tobacco products' of the WHO-FCTC, which is about disclosing the ingredients of a tobacco product on the pack. The tobacco transnational companies mobilized the tobacco growers around the world against implementing Article 9 of WHO-FCTC and even in Thailand, we are yet to reach a conclusion owing to this interference" said Prof (Dr) Prakit. In the forthcoming Conference of the Parties (COP-4) meeting of the WHO-FCTC in Uruguay (15-20 November 2010), this is going to be one of the contentious issues on implementing Article 9 of WHO-FCTC.

"Even though the law doesn't allow it, we often see that the tobacco transnational companies have tried to interfere indirectly in health policy, by exploiting the loopholes in the law, using the name of the company to support activities with school or other events, and often sponsor the concert which is illegal. They don't want to let Thai government come up with a more effective law that will strengthen the tobacco control" said Prof (Dr) Prakit.

Prof (Dr) Prakit said: "This [known examples of how tobacco industry is interfering in implementation of global tobacco treaty] is what we have seen often in our country, but how about the other things that we don't know [on how tobacco industry is interfering in implementing the global tobacco treaty."

The 10th International Week Resistance to Tobacco Transnationals (IWR) reminds us that a lot more needs to be done to ensure that the governments around the world put people before profit, and protect public health policy from tobacco industry interference. Maybe it's time for us to monitor tobacco transnational companies more vigilantly and put more pressure on the law enforcement agencies for closing the loopholes in the existing tobacco control laws.






Jittima Jantanamalaka - CNS
(The author is the Managing Director of Jay Inspire Co. Ltd (JICL), produces radio programmes in northern Thailand and writes for Citizen News Service (CNS). She is also the Director of CNS Diabetes Media Initiative (CNS-DMI) in Thailand. Website: www.jay-inspire.com, Email: jittima@citizen-news.org)


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Narmada Bachao Andolan (NBA) to complete 25 years of struggle

National Alliance of
People's Movements (NAPM)

National Alliance of People's Movements (NAPM) is organizing its Eighth Biennial Convention in the Narmada Valley, at Badwani, Madhya Pradesh, from 24-26 October 2010. Narmada Bachao Andolan (NBA), which is entering in 25th year of struggle, and is one of the founding members of NAPM will be hosting the convention this time. The journey that started in 1992 and took the shape of NAPM in 1996 has today reached a critical stage. Read more

"We started when the processes of Liberalisation, Privatisation and Globalisation were beginning to take shape, Hindu Right was picking steam in the shadow of Babri Masjid demolition and  TINA – There is No Alternative, was propounded as the mantra for the time. Since then we have come a long way and have waged important struggles along with many other movements, voluntary organisations, federations and forums, sympathetic intellectuals, artists, students and others against WTO, World Bank, Enron, SEZs, big dams, rural and urban evictions and displacements, atrocities against women, adivasis, and Dalits and communalism" said Medha Patkar, national convenor of NAPM.

"In 2003 we undertook Desh Bachao Desh Banao (Save the Nation – Build the Nation), a nation-wide campaign, aimed at evolving a national movement, to bring the ideal of an alternative world into reality, as a collective peoples political force, seeking to challenge and transform the existing political system that promotes a development paradigm that is anti-poor and anti-development. In 2007, Sangharsh / Action process was launched involving many other alliances, forums and federations which was another step in the direction of achieving a better world" said Medha Patkar.

"A decade after we met in the Narmada Valley, we are meeting again at a time, which is the 'best of the times and worst of the times'. The process of neo-liberalism which started then has now started showing its true colours, Corporations, Public and Private both, are not only grabbing the resources but the political space and even power through market and related mechanism. The investors – national to multinational have "privatized" each and every dimension of our society, polity and economy. Transformation is today a much greater challenge to the imagination, because Global Warming and the Energy crisis are much more visible too" said Medha Patkar.

The State has become a mere mediator and given away the mask of welfare and benevolence, political class and a more articulate middle class has been completely sold to the ideology of market and neo-liberal models of economy and growth. "We are witness to increased informalisation of labour as a result, 96% of workers today are in the unorganised sectors of work and there is enormously rising polarisation between the rich and the poor and a steep rise in food prices, together with loss of food security and attack on agriculture" said Medha Patkar.

The political class rarely resolves the people’s issues but rather exploits those towards vote banking, more crudely now than ever. Public space, public interest, public domain and priorities are shrinking to the detriment of basic need fulfillment jeopardizing not only the present but also the future. However, we cannot also forget that there is this growing trend towards "war on terror", militarisation and violence unleashed by the State making non-violent mass struggles more difficult, but at the same time making them more relevant too.

These times are not that bleak either, our collective efforts have not only led to enactment of progressive legislations like Right to Information Act, Mahatma Gandhi National Rural Employment Guarantee Act, Forest Rights Act etc. but also created a situation where people on the ground have challenged every single attempt at grabbing of our land, water, forests, minerals etc. We are standing amidst the victory of people's movements at Singur, Nandigram, Niyamgiri, Sompeta, Karla, Chengara and many more such places of resistance.

The question of justice and equity have come to the fore like never before and the 'rights to and control over natural resources' become the focal point of contestation today amidst, people, state and corporations. NAPM is not the only alliance today and there is a large biradari (family) beyond our fold all engaged in struggles and reconstruction through alternatives, committed to challenge the corporatization and globalization in the face of corruption, criminal acts and callousness of both the State and the corporates. We have always strived to create spaces for dialogue and coordination between them and also provide adequate space to diversity of resistances and ideologies existing in the country.

On a more positive note it can also be considered our collective victory that today social activists and human rights activists have become threats to the State and to their corporate designs, so much so, that they are falsely framing them as 'Maoists' or 'Terrorists'. The bogey of communalism has seeped through the veins of society and governance in numerous ways and demands a different understanding and strategy to fight them.

The armed conflicts imposed upon us by the state and counter violence by non-state and private vigilante forces are also creating a situation which is threatening the lives and livelihood of the millions of those living at the margins of this development process. Together the forces of communalism,

corporatisation, and veiled casteism and patriarchy are not only threatening the framework of democratic society but has become an impediment to our collective efforts towards building a truly people's democracy unlike the existent bourgeois democracy.

The coming decade will see the fierce battles and struggles for asserting rights and control over land, water, forests, minerals and thereby making it more difficult to ensure justice to dalits, adivasis, women, minorities, workers, landless peasantry and others who are considered 'out-castes of the development'. We continue to defy the principle of 'eminent domain' of State and challenge its power even when it has merely become a negotiator for the corporations and appropriate military strength to protect their capitalist interest. Whether it is land acquisition, displacement or rehabilitation- most issues today are politicized and polarized yet there is an urgent need for movements and supporters to evolve consensus on development planning to ensure equity and justice, through peace and democracy…hence the alliance !

For more information about the 8th Biennial Convention of NAPM, write to: nba.badwani@gmail.com, 25yearsofnba@gmail.com

Medha Patkar

Will Asia resolve to strengthen democracy on this year's UN Day?

24 Oct: UN Day

24 October is UN Day

On the anniversary of the entry into force of the United Nations (UN) Charter on 24 October 1945, (UN Day), and to mark the UN Disarmament Week (24-30 October 2010), the key question to measure effectiveness of such initiatives is: will the governments of countries, say in regions like Asia, begin to act upon in a way so as to strengthen democracy and scale up disarmament? Read more

Peace activists in South Asia who have been involved with "Visa Free Peaceful South Asia" campaigns and other peace initiatives over the past years, say: "we appeal to the governments of Asian countries to strengthen pro-democracy struggles, stop human rights abuses against social activists and support nuclear disarmament for a peaceful continent."

They call upon the Chinese government for an immediate and unconditional release of the detained Chinese Nobel Peace Prize winner Liu Xiaobo. Liu, 54, is the co-author of Charter 08, a petition calling for democratic reforms in one-party China that has been circulated on the Internet and signed by thousands of people. He was jailed in December 2009 for 11 years for subversion, and the award of the Nobel prize earlier this month provoked furious denunciations from Beijing.

They appeal to the Chinese government to comply with the International Treaty obligations, release Liu, and send a positive message to the world on democracy and human rights. They also appeal to China to support nuclear disarmament.

Similarly in Myanmar (Burma), pro-democracy leader of National League for Democracy, Aung San Suu Kyi, is under arrest despite of winning elections in 1990. She has remained under house arrest in Myanmar for more than 14 out of the past 20 years. Aung San Suu Kyi was the recipient of the Rafto Prize and the Sakharov Prize for Freedom of Thought in 1990 and the Nobel Peace Prize in 1991. Activists appeal to the government of Myanmar for an unconditional release of the pro-democracy leader Aung San Suu Kyi.

The governments of India and Pakistan, should step forward to support strengthening democracy in the areas where communities are facing human rights abuses like those in Kashmir Valley, North-East India, North-West Frontier Province of Pakistan, Chhattisgarh, among others. Both governments should commit themselves to nuclear disarmament, to stop arms race in the sub-continent and to demilitarize its borders. The movement of people between the two nations for trade or personal visits should be made easier, without visa or passport requirements. One of the key human rights crusader in India, Irom Sharmila, who has been fasting since 2000, and is under arrest since then, must be released unconditionally and her appeal heard of abolishing Armed Forces Special Powers Act (AFSPA) and other such Acts that give unquestioned power to kill to authorities.

Hope the governments are listening!

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State Journalists' body resents atrocities on media

Uttar Pradesh (UP) State Accredited Correspondent Committee (UPSACC) expressed its strong resentment during the press briefing of the Home Department at media Centre before Home Secretary Dipak Kumar and ADG (Law and Order) Mr Brij Lal over police attack on the Kanpur office of the Hindustan Times and Dainik Hindustan, illegal detention of the mother of Yashwant Singh, Editor, Bhadas4media.com, at Nandganj Police Station of Ghazipur District, and no action taken against Imam Bukhari who thrashed a journalist in police presence during his press conference. Mr Brij Lal assured action in all the three issues raised at this meet. Read more



Terming such incident as cowardly, unlawful and unbridled act of terror to curb freedom of press which is duty bound to inform its readers true and correct state of affairs, the President of the UPSACC Hisamul Islam Siddiqui, Vice President Mudit Mathur and Secretary Yogesh appealed to the journalists to act in solidarity with the journalists' fraternity who are committed to bring out the truth before public despite pressures from all the corners.

The UPSACC officers expressed displeasure that Lucknow Maulana Bukhari and his supporters who abused, threatened and thrashed a journalist at a press conference in police presence and despite criminal offence duly registered against him, were allowed to go scot-free and no action was taken against them.

Now in Kanpur the police themselves attack the Hindustan Times office, stopped distribution of newspapers, detained staff and seized their vehicles. Journalists working in the field feel helpless due to indifferent attitude of their Unions, Editors and Proprietors which is enhancing threat to freedom of expression in our civil society.

The third incident reported from Ghazipur District where mother of the Editor of  Bhadas4Media.com Yashwant Singh was unlawfully detained  whole night without any fault. It is really painful to see institutions like Press Council of India, National Human Right Commission and National Women Commission are silent on such issues concerning freedom of the press and a common citizen. Such incidents are posing great threat to the democracy as well as independence of journalism that is in peril in Uttar Pradesh where no journalist could seek an interview with the Chief Minister due to apparent bureaucratic censorship, said a UPSACC communiqué.

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Activists criticize attack on Hindustan Times and demand justice for the child

KANPUR: The activists of the National Alliance of People’s Movements (NAPM), Asha Parivar and Lok Rajniti Manch, have strongly condemned the attack by police on the offices of Hindustan Times and Dainik Hindustan in Kanpur. Instead of the police acting against those responsible for the alleged sexual assault and death of the child, police is harassing media agencies like HT that have boldly come out in support of justice for the child, said Dr Sandeep Pandey, Ramon Magsaysay Awardee (2002) and member, national presidium, Lok Rajniti Manch. Read more


As per newspaper reports and other input from Kanpur residents, the police-led investigation into bringing those responsible for the sexual assault and death of the child to account, is not sincere – there are reports that police version is not congruent with the report from the medical panel – and that the police is harassing even some family members of the victimised child instead of acting against those accused.

When the newspapers like Hindustan Times and Dainik Hindustan brought these issues to the light, police attacked their office premises.

"We are very concerned with this act of police – and demand that the state government should not let those responsible for such heinous crimes manipulate the police" said Dr Sandeep Pandey, who also leads the National Alliance of People's Movements (NAPM).

Bobby Ramakant - CNS 


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HIV activists help push tuberculosis awareness

Tallinn, Estonia: The call for a better, integrated approach to HIV and tuberculosis (TB) care has been getting louder worldwide in the past years. Equally, in terms of advocacy integration of the two diseases is gradually growing. People living with HIV speaking up on TB increasingly help put tuberculosis higher on the agenda. Read more


HIV and TB are the two deadliest infectious diseases globally, yet the attention given to and the awareness for the diseases remain largely unequal. Most of the spotlights are on HIV, not least because of strong activism for the disease. Advocacy for TB – though growing – remains much weaker. But TB's profile can be raised through the voices of those especially vulnerable to it: people living with HIV.

People who are HIV positive and infected with TB are 20 to 40 times more likely to develop active TB than people not infected with HIV. TB is a leading cause of death among people living with HIV, who have weakened immune systems. 
"Statistics show that especially in high burden countries people living with HIV are likely to get tuberculosis at least once in their lifetime. In some places co-infection is as high as 50% and mortality because of TB up to 60%," says Vivek Dharmaraj, project leader of Advocacy to Control TB Internationally (ACTION) Project / Global Health Advocates (GHA) India.

Engaging the HIV community is an area that ACTION/GHA has focused on. In India, they have worked extensively with the Indian Network for People living with HIV/AIDS (INP+) – a network of over 200,000 people in 24 states of India. "Advocacy is about education, empowerment and engagement," Dharmaraj explained at the sidelines of the Second Global Forum on TB Vaccines in Tallinn, Estonia, last month.

"Because this community is at such risk, they understand how serious TB is and how great the need is to have access to treatment. It is a matter of life and death," he continues. "TB is not easily diagnosed in the HIV patients; if undetected and not put on treatment early, tuberculosis can be quickly fatal in this co-infected condition. Apart from the need to know if they have TB, it becomes even more imperative that people living with HIV determine right at the start whether the tuberculosis is drug-resistant. As the community is educated and empowered in the area of tuberculosis they become engaged in advocacy. They can passionately advocate for better diagnostics tools, faster acting, less toxic drugs and vaccines."

"We have modules on TB, HIV-TB co-infection, treatment, what is freely available and then help them come to an understanding of what more is needed - diagnostics, drugs, etc," Dharmaraj says. "We encourage them to engage and advise their community, their local leaders, the politicians - who should be there for them. Not to blame but to go and share their knowledge and worries. They are often courageous and bold enough to speak up on TB as they have already taken the first step of coming out on their HIV status."

"HIV activists already deal with a lot of stigma," Claire Wingfield, TB/HIV project coordinator at TAG (Treatment Action Group) agrees. "And those with HIV/TB co-infection get the double stigma." In 2002 TAG, an HIV/AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS, included TB in its advocacy priorities because "we realized the people with HIV were at increased risk of developing and dying of TB." People living with HIV make loyal activists, Wingfield comments. "People get HIV for life, which means they are activists for life. When TB patients are cured, they are often no longer activists."

She sees the number of TB activists among people living with HIV growing. "It is great to see that for some TB is even their first issue now. They are absolutely raising the profile of TB. But it doesn’t have to be either TB or HIV. You can raise awareness for both, encourage discussion, make a difference."

Still, empowerment of TB patients has a long way to go, Wingfield stresses. "TB has such a public health approach, compared to the individual approach with HIV. There is not a lot of empowerment with information, neither among patients nor among health workers. The DOTS (Directly observed treatment, short-course) strategy is incredibly infantilizing, with people having to take medicine under observation of a healthcare worker. Where many HIV patients can exactly name their medicines, TB patients can often only say they take a yellow pill, a diamond shaped pill, etc. TB suffers from the white coat phenomenon: just take your medication because I said so."

"In India there has been some awareness among communities in the past few years. But some people still think TB is no longer a problem; that it is an old or only a poor person's disease or has even been eradicated," Dharmaraj of ACTION/GHA adds. "So a lot more has to be done to clear the air; we still need a bigger push to get the wider population involved more actively. We have to make sure to the disease is kept near the top of health agenda."

Wingfield hopes also activists from field other than HIV will increasingly address TB. "For mining communities, mother and child healthcare activists, labor unions, TB is a cross sector issue. It is important activists from other fields talk TB too."

Babs Verblackt - CNS(The author is a freelance journalist, a Fellow of CNS Writers' Bureau and Associate Communications atTuBerculosis Vaccine Initiative – TBVI) 


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World Spirometry Day: Breathe Well To Live Well

2010 is Year of the Lung

Lung diseases are a leading cause of death worldwide, killing more than 10 million people each year. With a view to focus on the importance of breathing, the International Union Against Tuberculosis and Lung Disease (The Union), celebrated the first World Spirometry Day on 14 October 2010, to raise awareness of the toll of suffering and death caused by lung disease – and to promote spirometry as a simple test that can reveal early warning signs of it. Read more


On this day, free spirometry tests were performed on 38,821 persons from 183 events worldwide. In India also, these tests were done free of cost on some patients at Bangalore Allergy Centre,and  M S Ramaiah Hospital with help from European Respiratory Society and European Lung Foundation.

“We all know that we have to breathe to live. Nevertheless the central role of the lung is neglected in basic health care,” says Dr Nils E Billo, Executive Director of the Union, which, as part of the Forum of International Respiratory Diseases (FIRS), is one of the organisers of the 2010 Year of the Lung.

The Year of the Lung aims to raise awareness about lung health among the public, initiate action in communities worldwide, advocate for resources to combat lung disease including increased investment in basic, clinical and translational research to improve patient care, convey that prevention of respiratory diseases is far more cost effective than their treatment, and spread the message that clean air is a fundamental human right.

The most prevalent and debilitating lung disease, COPD (chronic obstructive pulmonary disease) is under-diagnosed in 75% of cases, and global figures show that 50% of the patients remain un-diagnosed. Widespread under-diagnosis means sufferers only realise they have a serious lung disease once it is too late to prevent major damage, leaving them unable to carry on a healthy and active life. Women are as at risk as men, with those most at risk being over 40 and current or ex-smokers. While COPD can’t be cured, regular and early lung testing helps people to identify this and other potentially debilitating lung conditions before too much damage is done.

As a blood pressure test provides a simple screening method for cardiovascular disease, a spirometry test can help to unmask the early symptoms of a variety of lung diseases before any more obvious signs appear. Consequently the tests are being championed as a way to overcome the widespread under-diagnosis of serious lung conditions, such as asthma and chronic obstructive pulmonary disease (COPD).

Spirometry is a simple, non-invasive test which involves having a patient breathe deeply in and out for a spirometer machine, and measures the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. It measures how much air the lungs can hold and how well the lungs are able to move air in and out. As breathing in and out can be affected by lung diseases, the test can diagnose at an early stage whether a patient has COPD, asthma, pulmonary/cystic fibrosis or other respiratory problems.

According to international footballer Cristiano Ronaldo, "Healthy lungs are essential to breathe and be able to surpass the goals which we set ourselves every day. I support this cause so that everyone understands the importance of evaluating the health of the lungs regularly."

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Gender Initiative and CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. Email: shobha@citizen-news.org, website: www.citizen-news.org) 


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Badaun shows way for scrapping inhuman manual scavenging practice

Urging media to help focus the attention of society on the inhuman practice of manual scavenging, UNICEF Water, sanitation and hygiene (WASH) specialist Mr Amit Mehrotra, said that, proper and sustained sanitation drives will surely help in eradication of many killer diseases, including diarrhea, typhoid, jaundice and most importantly polio. Read more

"It may shock you to know that one gram of human excreta might contain one core virus and bacteria including polio virus," said Mr Mehrotra, while addressing the monthly media sensitization programme Media for Children (M4C), organized by Media Nest at Uttar Pradesh Press Club. M4C which will be completing two years this November 2010 is supported by UNICEF.

All praise for the district Administration Budaun, which took up the campaign of turning the dry toilets in their district into pour flush one. Mr Mehrotra shared with the media the turnaround story of the district which lags behind on all development parameters and is one of the high risk polio district in the state. Present along with him was the District Panchayat Raj Officer (DPRO), Mr R K Chaudhuri and three rehabilitated manual scavengers from Budaun.

Mr Mehrotra said that UNCEF have initiated a campaign in Budaun for the removal of dry toilets (toilets where faecal matter is disposed within the courtyards of people households).

"As per a survey there are about 60,000 such toilets in Budaun out of which about 20,000 toilets have been converted into pour flush toilets from July 2010 till now. The campaign is on" said Mr Mehrotra adding that this is a massive campaign which is contributing in polio eradication efforts in the district. Also, 200 manual scavengers have also been rehabilitated by linking them with various social development schemes.

"99 per cent manual scavengers are females from the age group of 16 to 70 years. They have been thoroughly exploited over generations. For all the dirty labour that they have been doing for centuries they were handed over some food, and that also from a distance. It is a sad story that has to be felt and told," said Mr Chaudhury who proudly quoted figures to tell how they all worked hard to take Budaun district out of the mess that it was in.

He described the great difficulties that came in the way.

"Neither scavengers nor their families were convinced that rehabilitation was a good solution to their problem. Thoughts of what they would do after they left this work made them afraid to come out in support of the programme and we had to find ways to address their fears," said Mr Chaudhuri.

The first step was to get scholarship forms filled for their children, ensure enrollment and try to push discrimination, Below Poverty Line (BPL) cards were also provided to them, vocational training camps were also organized where they were taught how to make zari embroidery, carpet weaving etc. This gave the women confidence and nearly 2000 quit the dirty work that they and their families had been doing for generations.

"I have left the dirty work, now I feel like a human being, I appeal to all women of my community to do the same," said 18 year old Babita who had come from Budaun. Babita does not even remember from what age she was initiated into this trade of carry human excreta.

For 30 year old Beena who had never done this work before her marriage at the age of 14, life was hell at her husband's house. She was beaten black and blue when she refused to support the family and join the other female members in this dirty trade.

"It has just been two months since I left the dirty work and I already feel as if I am also a part of this society, I enjoy being treated as a human being, I will never allow my daughter (one year old gudiya in her arms) to suffer what I did," said Beena as she interacted with the media persons.

Kulsum Mustafa - CNS

(The author is a senior journalist and also serves as the Secretary-General of Media Nest) 


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