Thai Rock Band Urges Youth to stay away from Cigarettes

Thai Rock Band Urges Youth to stay away from Cigarettes
Jittima Jantanamalaka



A Thai Rock Band group by the name of Mulatto is really creating waves these days in Thailand. It can really be called a smoke free and environment friendly band, as all its members are non smokers. They come from different backgrounds but all have one thing in common – none of them ever liked the smell of cigarettes. It always made them feel dizzy, and not euphoric, as their music does.

Rock band members are generally supposed to be ‘cool guys’ and are very often role models of the youngsters. Well the four members of this band are musicians with a mission --- the mission to spread awareness about the lethal hazards of smoking.

Despite growing up in a society which thrives on cigarettes, they have shunned this evil since their childhood. They were drawn to music instead, since early childhood.

The singing voice of the band, Nat Sonkasertrin (M), was brought up in a slum, which abounded with smokers. Yet from his early childhood he decided not to smoke as the cigarette smoke always irritated his eyes and throat.

His father was a confirmed smoker; puffing away two packs a day, since the age of sixteen. By the time he was 50 years old, he developed lung cancer and has hence been deprived of one of his lungs. His sufferings proved to be a blessing in disguise for his son M, who vowed never to light a cigarette.

Ton, the drummer had childhood friends who smoked. Once, one of his friends was injured, along with many others due to an accident caused by smoking.

This year on ‘World No Tobacco Day’, the WHO has focused its attention on pictorial health warnings on tobacco packs, as 5.4 million people worldwide continue to be snapped down by preventable diseases caused by smoking. In fact, this year the ‘Action On Smoking and Health Foundation’ (ASH) from Thailand was awarded internationally for its efforts in enforcing pictorial warnings on cigarette packs. Yet, according to the Ministry of Health Thailand, the country has 9.5 million smokers, out of which 1.27 million are youths. Increasing the price of cigarettes too has not been much of a deterrent. But perhaps gory pictures on cigarette packs will have more profound effect on the smokers’ psyche.

Bands like Mulatto can really act as brand ambassadors for anti smoking campaigns. Its members mince no words when they compare cigarettes to narcotics, and one of them feels that smoking should be made illegal. Despite the high risks involved, adolescents continue to be drawn to smoking, sometimes due to peer pressure and sometimes to simply make a fashion statement, thinking it is cool to smoke. Movie stars shown smoking in films, (like the one named 2499, about Thai mafia) add fuel to the desire of smoking, as the youth always try to emulate them.

Mulatto carries its message to all its concert shows, asking the young audience, in a very subtle way to quit smoking. Rather than condemn or force, they talk to them with sincerity. They tell them, ‘We care about you and we love you. So for the sake of friendship please do not smoke.’ Beautiful thoughts indeed! Since they are in a very cool and happening profession, their abstinence at once awes and inspires their audience.

Let us hope on this No Tobacco Day that there will be more such dedicated artists, urging people to make music instead of smoke.

Jittima Jantanamalaka

[The author is the Director of Jay Inspire, Thailand]

Related clip by Jay Inspire, Thailand:
World No Tobacco Day 2009: Youth & Tobacco Health Warning(with English sub-title)

Thai Rock Band Urges Youth to stay away from Cigarettes

Thai Rock Band Urges Youth to stay away from Cigarettes
Jittima Jantanamalaka



A Thai Rock Band group by the name of Mulatto is really creating waves these days in Thailand. It can really be called a smoke free and environment friendly band, as all its members are non smokers. They come from different backgrounds but all have one thing in common – none of them ever liked the smell of cigarettes. It always made them feel dizzy, and not euphoric, as their music does.

Rock band members are generally supposed to be ‘cool guys’ and are very often role models of the youngsters. Well the four members of this band are musicians with a mission --- the mission to spread awareness about the lethal hazards of smoking.

Despite growing up in a society which thrives on cigarettes, they have shunned this evil since their childhood. They were drawn to music instead, since early childhood.

The singing voice of the band, Nat Sonkasertrin (M), was brought up in a slum, which abounded with smokers. Yet from his early childhood he decided not to smoke as the cigarette smoke always irritated his eyes and throat.

His father was a confirmed smoker; puffing away two packs a day, since the age of sixteen. By the time he was 50 years old, he developed lung cancer and has hence been deprived of one of his lungs. His sufferings proved to be a blessing in disguise for his son M, who vowed never to light a cigarette.

Ton, the drummer had childhood friends who smoked. Once, one of his friends was injured, along with many others due to an accident caused by smoking.

This year on ‘World No Tobacco Day’, the WHO has focused its attention on pictorial health warnings on tobacco packs, as 5.4 million people worldwide continue to be snapped down by preventable diseases caused by smoking. In fact, this year the ‘Action On Smoking and Health Foundation’ (ASH) from Thailand was awarded internationally for its efforts in enforcing pictorial warnings on cigarette packs. Yet, according to the Ministry of Health Thailand, the country has 9.5 million smokers, out of which 1.27 million are youths. Increasing the price of cigarettes too has not been much of a deterrent. But perhaps gory pictures on cigarette packs will have more profound effect on the smokers’ psyche.

Bands like Mulatto can really act as brand ambassadors for anti smoking campaigns. Its members mince no words when they compare cigarettes to narcotics, and one of them feels that smoking should be made illegal. Despite the high risks involved, adolescents continue to be drawn to smoking, sometimes due to peer pressure and sometimes to simply make a fashion statement, thinking it is cool to smoke. Movie stars shown smoking in films, (like the one named 2499, about Thai mafia) add fuel to the desire of smoking, as the youth always try to emulate them.

Mulatto carries its message to all its concert shows, asking the young audience, in a very subtle way to quit smoking. Rather than condemn or force, they talk to them with sincerity. They tell them, ‘We care about you and we love you. So for the sake of friendship please do not smoke.’ Beautiful thoughts indeed! Since they are in a very cool and happening profession, their abstinence at once awes and inspires their audience.

Let us hope on this No Tobacco Day that there will be more such dedicated artists, urging people to make music instead of smoke.

Jittima Jantanamalaka

[The author is the Director of Jay Inspire, Thailand]

Related clip by Jay Inspire, Thailand:
World No Tobacco Day 2009: Youth & Tobacco Health Warning(with English sub-title)

Strictly enforce smoke-free policies! Quit tobacco before it’s too late

Strictly enforce smoke-free policies! Quit tobacco before it’s too late

There was a growing consensus to strictly enforce smoke-free policies at the public symposium organized by the department of Surgery, Chhatrapati Shahuji Maharaj Medical University to mark the World No Tobacco Day. Vice Chancellor Prof (Dr) Saroj Chooramani Gopal and Justice Shabibul Hasnain were the chief guests, and Superintendent of Police (SP) City Harish Kumar was the guest of honour.

“Scientific evidence has unequivocally established that tobacco consumption and exposure to tobacco smoke causes death, disease and disability. There is clear scientific evidence that prenatal exposure to tobacco smoke causes adverse health and developmental conditions for children. Secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults. Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%.There is no risk-free level of secondhand smoke exposure. India enforced the ban on smoking in public places on 2 October 2008 and we must join hands to implement it effectively” said Prof (Dr) Saroj Chooramani Gopal.

“Effective pictorial warnings can save lives” said Professor (Dr) Rama Kant, Head of Surgery Department, CSMMU and a World Health Organization (WHO) International Awardee for the year 2005 on tobacco control.

“Pictorial health warnings are most effective way of broadcasting health messages across wide spectrum of population about the adverse health effects of tobacco use. Pictorial warning labels detract from the glamour and appeal of tobacco products and help to create an environment where ‘tobacco-free’ is the norm” said Prof Rama Kant.

“Effective warning labels increase knowledge about risks associated with tobacco use more effectively than text-only warnings. In a country like India where one-third of the population is illiterate, pictorial warnings can communicate health messages effectively and prevent uptake and motivate tobacco user to quit” further added Prof Rama Kant. “Countries with strong and effective pictorial warnings are experiencing major reduction in tobacco use” explained Prof Rama Kant.

However in India the pictorial warnings that are going to be implemented from 31 May 2009 are mild, weak and not field tested, said Professor (Dr) Rama Kant. As per the new rules notified on May 3, 2009, pictorial warnings would be displayed only on the 40% of the principal display area of the front panel of all tobacco packs (only ONE side of tobacco pack).

“Tobacco use is the leading preventable cause of disease and death in the world. According to the World Health Organization, each year 5.4 million lives are lost all over the world because of tobacco use. Out of these 9 lakh deaths occur in India alone. 2500 Indians lose their lives each day because of tobacco use. India has the highest number of oral cancer cases in the world and 90% of all oral cancers are tobacco related and 40% of all cancers in India are due to tobacco use” said Dr Vinod Jain, Assistant Professor in Surgery department, CSMMU, and Vice-President of Indian Medical Association (IMA) Lucknow.

Posters on grow without tobacco theme were also displayed. An elocution engaging school students against tobacco took place as well. Many NGOs including Bharat Vikas Parishad, UP Voluntary Health Association, Abhinav Bharat Foundation, Samadhan, Asha Parivar, Indian Society Against Smoking (ISAS) and others too part.

Strictly enforce smoke-free policies! Quit tobacco before it’s too late

Strictly enforce smoke-free policies! Quit tobacco before it’s too late

There was a growing consensus to strictly enforce smoke-free policies at the public symposium organized by the department of Surgery, Chhatrapati Shahuji Maharaj Medical University to mark the World No Tobacco Day. Vice Chancellor Prof (Dr) Saroj Chooramani Gopal and Justice Shabibul Hasnain were the chief guests, and Superintendent of Police (SP) City Harish Kumar was the guest of honour.

“Scientific evidence has unequivocally established that tobacco consumption and exposure to tobacco smoke causes death, disease and disability. There is clear scientific evidence that prenatal exposure to tobacco smoke causes adverse health and developmental conditions for children. Secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults. Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%.There is no risk-free level of secondhand smoke exposure. India enforced the ban on smoking in public places on 2 October 2008 and we must join hands to implement it effectively” said Prof (Dr) Saroj Chooramani Gopal.

“Effective pictorial warnings can save lives” said Professor (Dr) Rama Kant, Head of Surgery Department, CSMMU and a World Health Organization (WHO) International Awardee for the year 2005 on tobacco control.

“Pictorial health warnings are most effective way of broadcasting health messages across wide spectrum of population about the adverse health effects of tobacco use. Pictorial warning labels detract from the glamour and appeal of tobacco products and help to create an environment where ‘tobacco-free’ is the norm” said Prof Rama Kant.

“Effective warning labels increase knowledge about risks associated with tobacco use more effectively than text-only warnings. In a country like India where one-third of the population is illiterate, pictorial warnings can communicate health messages effectively and prevent uptake and motivate tobacco user to quit” further added Prof Rama Kant. “Countries with strong and effective pictorial warnings are experiencing major reduction in tobacco use” explained Prof Rama Kant.

However in India the pictorial warnings that are going to be implemented from 31 May 2009 are mild, weak and not field tested, said Professor (Dr) Rama Kant. As per the new rules notified on May 3, 2009, pictorial warnings would be displayed only on the 40% of the principal display area of the front panel of all tobacco packs (only ONE side of tobacco pack).

“Tobacco use is the leading preventable cause of disease and death in the world. According to the World Health Organization, each year 5.4 million lives are lost all over the world because of tobacco use. Out of these 9 lakh deaths occur in India alone. 2500 Indians lose their lives each day because of tobacco use. India has the highest number of oral cancer cases in the world and 90% of all oral cancers are tobacco related and 40% of all cancers in India are due to tobacco use” said Dr Vinod Jain, Assistant Professor in Surgery department, CSMMU, and Vice-President of Indian Medical Association (IMA) Lucknow.

Posters on grow without tobacco theme were also displayed. An elocution engaging school students against tobacco took place as well. Many NGOs including Bharat Vikas Parishad, UP Voluntary Health Association, Abhinav Bharat Foundation, Samadhan, Asha Parivar, Indian Society Against Smoking (ISAS) and others too part.

Pictorial Health Warnings on all Tobacco Products in India from May 31, 2009

Pictorial Health Warnings on all Tobacco Products in India from May 31, 2009

India would be joining the league of public health champions by implementing pictorial health warning on all tobacco product packages from May 31, 2009, which also coincides with World No Tobacco Day and its theme “Show the Truth, Picture Warnings Saves Lives”.

Pictorial health warning labels effectively communicate the risks of tobacco use. Extensive research from across the globe has established that effective health warnings increase knowledge about risks associated with tobacco use and can decrease intentions to use tobacco among vulnerable youth and persuade tobacco users to quit. Graphic warnings have a greater impact than text-only ones and can be recognized by low-literacy audiences and children-two vulnerable population groups. The warnings have been introduced in several developing and countries such as Thailand, Singapore, Brazil, Chile, South Africa and others.

According to Ms. Monika Arora, Director-HRIDAY (Health Related Information Dissemination Amongst Youth), a member NGO of AFTC (Advocacy Forum for Tobacco Control), engaged in youth centric tobacco control awareness and advocacy campaigns, and Convenor AFTC- “To save lives of millions of people from tobacco related deaths and diseases, AFTC has been instrumental in undertaking collaborative advocacy campaign with Parliamentarians at the center for effective implementation of pictorial health warnings on all tobacco products. As a run up to the World No Tobacco Day, which also coincides with India’s deadline to implement pictorial health warnings on tobacco products, AFTC has undertaken a concerted advocacy campaign in 12 states of India to advocate this issue at the state level by interacting with policy makers, opinion makers and general public. AFTC is advocating for support from these important stakeholders at each state level to support effective implementation of pictorial health warnings in India through effective enforcement and monitoring procedures and emphasizing the need for stronger, field tested health warnings in the next round due in May 2010.”

Indian Society Against Smoking (ISAS) on behalf of a coalition of 56 pan-India organizations working for tobacco control in India, the AFTC, has released an information package to state level policy makers, opinion makers and leading regional newspapers. This package comprises of cards with pertinent information regarding burden caused by tobacco in India, international obligations and global best practices and also scientific data that pictorial health warnings have proved to be in interest of public health, in the countries wherever they have been implemented.

The intent of the AFTC advocacy campaign is to support the effective implementation of the current notified warnings as well as to implement stronger warnings in the next round. The present set of notified warnings are mild, diluted (occupies 40% of the front panel) and moreover they are not field tested. India requires stronger and field tested warnings to reduce tobacco related deaths and diseases.

Pictorial Health Warnings on all Tobacco Products in India from May 31, 2009

Pictorial Health Warnings on all Tobacco Products in India from May 31, 2009

India would be joining the league of public health champions by implementing pictorial health warning on all tobacco product packages from May 31, 2009, which also coincides with World No Tobacco Day and its theme “Show the Truth, Picture Warnings Saves Lives”.

Pictorial health warning labels effectively communicate the risks of tobacco use. Extensive research from across the globe has established that effective health warnings increase knowledge about risks associated with tobacco use and can decrease intentions to use tobacco among vulnerable youth and persuade tobacco users to quit. Graphic warnings have a greater impact than text-only ones and can be recognized by low-literacy audiences and children-two vulnerable population groups. The warnings have been introduced in several developing and countries such as Thailand, Singapore, Brazil, Chile, South Africa and others.

According to Ms. Monika Arora, Director-HRIDAY (Health Related Information Dissemination Amongst Youth), a member NGO of AFTC (Advocacy Forum for Tobacco Control), engaged in youth centric tobacco control awareness and advocacy campaigns, and Convenor AFTC- “To save lives of millions of people from tobacco related deaths and diseases, AFTC has been instrumental in undertaking collaborative advocacy campaign with Parliamentarians at the center for effective implementation of pictorial health warnings on all tobacco products. As a run up to the World No Tobacco Day, which also coincides with India’s deadline to implement pictorial health warnings on tobacco products, AFTC has undertaken a concerted advocacy campaign in 12 states of India to advocate this issue at the state level by interacting with policy makers, opinion makers and general public. AFTC is advocating for support from these important stakeholders at each state level to support effective implementation of pictorial health warnings in India through effective enforcement and monitoring procedures and emphasizing the need for stronger, field tested health warnings in the next round due in May 2010.”

Indian Society Against Smoking (ISAS) on behalf of a coalition of 56 pan-India organizations working for tobacco control in India, the AFTC, has released an information package to state level policy makers, opinion makers and leading regional newspapers. This package comprises of cards with pertinent information regarding burden caused by tobacco in India, international obligations and global best practices and also scientific data that pictorial health warnings have proved to be in interest of public health, in the countries wherever they have been implemented.

The intent of the AFTC advocacy campaign is to support the effective implementation of the current notified warnings as well as to implement stronger warnings in the next round. The present set of notified warnings are mild, diluted (occupies 40% of the front panel) and moreover they are not field tested. India requires stronger and field tested warnings to reduce tobacco related deaths and diseases.

Large comprehensive pictorial warnings on tobacco products are more effective

Large comprehensive pictorial warnings on tobacco products are more effective

An advocacy card in Hindi language for pictorial warnings on tobacco products was released by Professor (Dr) Rama Kant, Head of Surgery Department, Chhattrapati Shahuji Maharaj Medical University (CSMMU) at the UP Press Club in Lucknow today. Professor (Dr) Rama Kant is also a World Health Organization (WHO) International Awardee for the year 2005 on tobacco control.

This advocacy card produced by Indian Society Against Smoking, Asha Parivar with technical help from HRIDAY, advocates that large and comprehensive pictorial warnings on tobacco products are more effective.

“In Australia, the pictorial warnings on tobacco products are 90% back and 30% front of tobacco packs, in Brazil it is 100% either of the sides, in Canada and Thailand it is 50% on both sides, in UK pictorial warnings are on 43% of front and 53% of back sides of tobacco packs” said Professor (Dr) Rama Kant.

However in India the pictorial warnings that are going to be implemented from 31 May 2009 are mild, weak and not field tested, said Professor (Dr) Rama Kant.

As per the new rules notified on May 3, 2009, pictorial warnings would be displayed only on the 40% of the principal display area of the front panel of all tobacco packs (only ONE side of tobacco pack).

“India ratified the Framework Convention on Tobacco Control (FCTC), the first international public health treaty of the World Health Organization (WHO) in February 2004 and is a Party to the convention. According to FCTC, the deadline for India to implement pictorial health warning was February 27, 2008. But still the tobacco products in India do not carry any pictorial health warnings. Also FCTC recommends 30 % as minimum size of display of pictorial health warnings i.e. 30% front and 30% back, which India has again not complied with” said Professor (Dr) Rama Kant.

“Tobacco use is the leading preventable cause of disease and death in the world. According to the World Health Organization, each year 5.4 million lives are lost all over the world because of tobacco use. Out of these 9 lakh deaths occur in India alone. 2500 Indians lose their lives each day because of tobacco use. India has the highest number of oral cancer cases in the world and 90% of all oral cancers are tobacco related and 40% of all cancers in India are due to tobacco use” said Professor (Dr) Rama Kant.

Large comprehensive pictorial warnings on tobacco products are more effective

Large comprehensive pictorial warnings on tobacco products are more effective

An advocacy card in Hindi language for pictorial warnings on tobacco products was released by Professor (Dr) Rama Kant, Head of Surgery Department, Chhattrapati Shahuji Maharaj Medical University (CSMMU) at the UP Press Club in Lucknow today. Professor (Dr) Rama Kant is also a World Health Organization (WHO) International Awardee for the year 2005 on tobacco control.

This advocacy card produced by Indian Society Against Smoking, Asha Parivar with technical help from HRIDAY, advocates that large and comprehensive pictorial warnings on tobacco products are more effective.

“In Australia, the pictorial warnings on tobacco products are 90% back and 30% front of tobacco packs, in Brazil it is 100% either of the sides, in Canada and Thailand it is 50% on both sides, in UK pictorial warnings are on 43% of front and 53% of back sides of tobacco packs” said Professor (Dr) Rama Kant.

However in India the pictorial warnings that are going to be implemented from 31 May 2009 are mild, weak and not field tested, said Professor (Dr) Rama Kant.

As per the new rules notified on May 3, 2009, pictorial warnings would be displayed only on the 40% of the principal display area of the front panel of all tobacco packs (only ONE side of tobacco pack).

“India ratified the Framework Convention on Tobacco Control (FCTC), the first international public health treaty of the World Health Organization (WHO) in February 2004 and is a Party to the convention. According to FCTC, the deadline for India to implement pictorial health warning was February 27, 2008. But still the tobacco products in India do not carry any pictorial health warnings. Also FCTC recommends 30 % as minimum size of display of pictorial health warnings i.e. 30% front and 30% back, which India has again not complied with” said Professor (Dr) Rama Kant.

“Tobacco use is the leading preventable cause of disease and death in the world. According to the World Health Organization, each year 5.4 million lives are lost all over the world because of tobacco use. Out of these 9 lakh deaths occur in India alone. 2500 Indians lose their lives each day because of tobacco use. India has the highest number of oral cancer cases in the world and 90% of all oral cancers are tobacco related and 40% of all cancers in India are due to tobacco use” said Professor (Dr) Rama Kant.

SMS helpline for Free TB support service in India

SMS helpline for Free TB support service in India

A Short-Message-Service (SMS) helpline was launched in New Delhi, India to provide round-the-clock free tuberculosis (TB) support service to TB patients. This SMS helpline is being managed by ex-TB patients.

Earlier on World Health Day (7 April 2009), a unique partnership was forged in a community of India's capital to improve TB responses (read more). The residents of south Delhi and healthcare providers in this area participated in an open dialogue to identify key challenges that people faced in accessing the health services, and came up with effective solutions that can potentially improve the quality of care for all residents. This new Community Care Club in the Lado Sarai area of South Delhi (India), has been working to improve the health of people in the diverse district by bringing together consumers and care-providers in a dynamic 'partnership in health'. Led by local former TB patients and people living with HIV (PLHIV), this is an initiative to empower not only themselves, but also to empower and mobilize a broad base of the community including the private and public sectors.

The SMS helpline was launched in another follow-up meeting of Community Care Club on 26 May 2009. Breaking new ground, from the bottom up, people living with the diseases and those most affected had reached out to raise the standards of care, driving forward on securing their Rights and fulfilling their Responsibilities, as outlined in the Patients' Charter for Tuberculosis Care.

The World Care Council, an international NGO of activists living with HIV and/or TB, is beginning to roll out a series of projects in India. As TB is the greatest killer of PLHIV, and almost half a million Indians die annually from this curable disease, the World Care Council is striving to build a mechanism for empowerment for all those either with TB or most at risk, applying many lessons learned from the last 25 year of HIV/AIDS activism and other social movements.

Over the last few months, the World Care Council's Indian branch has organized patient support groups, trained a team of TB activists to get local Clubs going, and conducted Outreach for Input events to build stake-holding on the ground in two pilot projects in New Delhi and Goa, with the support of the United States Agency for International Development (USAID). The first seeds for growing social mobilization have been planted, nurtured and are ready to blossom. Now, the outreach is underway to forge dynamic partnerships with key elements of civil society and to strengthen existing collaborations with the Revised National TB Control Programme (RNTCP), National AIDS Control Organization (NACO) and State Governments.

On 26 May 2009, a meeting was held in the LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, and on 27 May 2009, another meeting was held in Lado Serai Community Hall in South Delhi.

These series of meetings are particularly important because for the first time in the history of India's TB control efforts, the TB patients themselves are taking centre-stage in driving mobilization and advocacy for scaling up TB care to improve services and prevention for themselves, their peers and their neighbours.

The Revised National Tuberculosis Control Programme (RNTCP) of the Government of India, now includes the Patients' Charter for Tuberculosis Care (PCTC, The Charter). The Charter is also a part of the global Stop TB Strategy, and lays out the rights and responsibilities of people with TB, and how the Charter is a tool to effectively achieve the implementation of the International Standards of Tuberculosis Care (ISTC).

However, implementing the Charter on the frontlines of TB care, raising awareness about rights and responsibilities, and using it as an empowering tool for people with TB and their community in order to improve the quality of care services, is certainly a daunting task.

The SMS helpline managed by ex-TB patients is certainly a step forward in responding effectively to the challenge. The SMS helpline number is (0) 99710 43320.

- Bobby Ramakant, HDN Key Correspondent

SMS helpline for Free TB support service in India

SMS helpline for Free TB support service in India

A Short-Message-Service (SMS) helpline was launched in New Delhi, India to provide round-the-clock free tuberculosis (TB) support service to TB patients. This SMS helpline is being managed by ex-TB patients.

Earlier on World Health Day (7 April 2009), a unique partnership was forged in a community of India's capital to improve TB responses (read more). The residents of south Delhi and healthcare providers in this area participated in an open dialogue to identify key challenges that people faced in accessing the health services, and came up with effective solutions that can potentially improve the quality of care for all residents. This new Community Care Club in the Lado Sarai area of South Delhi (India), has been working to improve the health of people in the diverse district by bringing together consumers and care-providers in a dynamic 'partnership in health'. Led by local former TB patients and people living with HIV (PLHIV), this is an initiative to empower not only themselves, but also to empower and mobilize a broad base of the community including the private and public sectors.

The SMS helpline was launched in another follow-up meeting of Community Care Club on 26 May 2009. Breaking new ground, from the bottom up, people living with the diseases and those most affected had reached out to raise the standards of care, driving forward on securing their Rights and fulfilling their Responsibilities, as outlined in the Patients' Charter for Tuberculosis Care.

The World Care Council, an international NGO of activists living with HIV and/or TB, is beginning to roll out a series of projects in India. As TB is the greatest killer of PLHIV, and almost half a million Indians die annually from this curable disease, the World Care Council is striving to build a mechanism for empowerment for all those either with TB or most at risk, applying many lessons learned from the last 25 year of HIV/AIDS activism and other social movements.

Over the last few months, the World Care Council's Indian branch has organized patient support groups, trained a team of TB activists to get local Clubs going, and conducted Outreach for Input events to build stake-holding on the ground in two pilot projects in New Delhi and Goa, with the support of the United States Agency for International Development (USAID). The first seeds for growing social mobilization have been planted, nurtured and are ready to blossom. Now, the outreach is underway to forge dynamic partnerships with key elements of civil society and to strengthen existing collaborations with the Revised National TB Control Programme (RNTCP), National AIDS Control Organization (NACO) and State Governments.

On 26 May 2009, a meeting was held in the LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, and on 27 May 2009, another meeting was held in Lado Serai Community Hall in South Delhi.

These series of meetings are particularly important because for the first time in the history of India's TB control efforts, the TB patients themselves are taking centre-stage in driving mobilization and advocacy for scaling up TB care to improve services and prevention for themselves, their peers and their neighbours.

The Revised National Tuberculosis Control Programme (RNTCP) of the Government of India, now includes the Patients' Charter for Tuberculosis Care (PCTC, The Charter). The Charter is also a part of the global Stop TB Strategy, and lays out the rights and responsibilities of people with TB, and how the Charter is a tool to effectively achieve the implementation of the International Standards of Tuberculosis Care (ISTC).

However, implementing the Charter on the frontlines of TB care, raising awareness about rights and responsibilities, and using it as an empowering tool for people with TB and their community in order to improve the quality of care services, is certainly a daunting task.

The SMS helpline managed by ex-TB patients is certainly a step forward in responding effectively to the challenge. The SMS helpline number is (0) 99710 43320.

- Bobby Ramakant, HDN Key Correspondent

Nip The Problem In The Bud - Nay The Leaf - in lead up to World No Tobacco Day (31 May) -

- in lead up to World No Tobacco Day (31 May) -
Nip The Problem In The Bud - Nay The Leaf

Tobacco is the only consumer product which is grown and available legally and is lethal for human beings. At the current rate, the number of smokers dying every year in the world is likely to reach (10 million) 1 crore by 2020.

In India tobacco kills 1 million (10 lakhs) people annually.

Tobacco definitely is a global health epidemic, whose rapid spread around the world presents daunting challenges to policy makers and people engaged in public health concerns. Yet one finds an unacceptable contradiction here. Tobacco control policies and tobacco promotion measures seem to be coexisting comfortably. On one hand we have governments all over the world, initiating well deserving measures to combat tobacco consumption, while on the other hand, they continue to promote cultivation, sale, trade and export of tobacco and its products.

While I was in Mumbai attending the 14th World Conference on Tobacco or Health (WCTOH), I met a noted writer who said she was unable to understand the logistics of tobacco control. She echoed the sentiments of several others that the best solution to the problem would be to stop growing tobacco and stop manufacturing its products. Why produce the poison and then go all out to prevent its usage?

India is one of the signatories to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), thereby agreeing to implement its provisions. FCTC is the first global corporate accountability and public health treaty. As a Party to the treaty, India is obligated to take measures to bring down the consumption and production of tobacco in the country. It is the latter, which merits serious attention in order to achieve the former.

It makes sense that the strong legislative efforts of our government to curb tobacco use, sale and advertising need to be supported by proper and stricter enforcement. But far more important is to back these measures by comprehensive policies that have far reaching effects on tobacco cultivation and on manufacturing of all tobacco products like cigarettes, bidis, chewing tobacco, snuff and other localized versions. There is no safe way to use tobacco – whether inhaled, sucked, sniffed or chewed, and there are no safety levels.

The main reasons cited for this dual behaviour are the economic dependence of the tobacco growing farmers and the bidi rollers on this activity and of the government on the revenue collections. But if we delve a little deeper in the issue, then the reality will be different from these arbitrary assumptions. The task to overcome these ‘obstacles’ should not be as formidable as it appears to be.

Tobacco cultivation in India , especially the Flue Cured Virginia (FCV) tobacco used for cigarette making, has been enjoying government support for decades.

The area under tobacco cultivation is presently 368.5 thousand acres, which is less than 0.3% of the net sown area in the country. Around 3 to 5 lakh farmers are engaged in this activity. Tobacco farming is seasonal and restricted to a few states only, with Andhra Pradesh, Karnataka, Gujarat, Maharashtra and Orissa accounting for more than 90% of the total tobacco cultivation. It is easy for government to intervene as around 35% of tobacco crop area is governed by the rules of Tobacco Board, Government of India.

Case studies/experiments carried out by tobacco research centres suggest alternative crops like soybean, groundnut, different varieties of gram, maize, paddy, mustard, sunflower, cotton, sugarcane etc. which yield almost similar returns and are far more eco and health friendly. In fact, in some states tobacco has sadly replaced cultivation of food crops like jowar, maize and ragi - which were once called the poor man’s food, and are now high even on the health conscious’ diet chart. This shift from growing tobacco to something healthier can only affect the economic status of the farmers in a positive way. Of course, the government will have to provide them incentives by way of technical know how, seeds and marketing links for the alternate crops.

Supply of tobacco products from external sources, both legal and illegal will also have to be controlled. India is a lucrative market for foreign cigarettes and cigars. The government would therefore need to ban the import of tobacco products and foreign direct investments in the tobacco sector.

Another populist argument given in favour of tobacco production is the dependence of about 4 lakh people (two thirds of whom are women) on bidi rolling as a major economic activity. But the ground reality is that bidi manufacturing is the most exploitative work, wherein most of the workers (more than 50%) do not get even the minimum wages. This industry is largely in the unorganized sector. Manufacturers easily resort to all sorts of underhand dealings to evade excise duty as well as circumvent the minimum wages act. Many children are also engaged in this activity in direct contravention of the Child Labour (Prohibition) Act.

A recent study, initiated by Voluntary Health Association of India (VHAI), on the bidi workers from the districts of Murshidabad in West Bengal and Anand in Gujarat has brought out their dismal health and socio economic conditions. The study revealed that most of the respondents (more than 76%) earn a measly sum of Rs.33 per one thousand bidis that they rolled in more than 12 hours. This is much below the minimum wage of Rs.40 per day. Coupled with poor wages are the deplorable working conditions. The bidi workers are constantly exposed to the grave risk of contracting tuberculosis, asthma, lung disease and spinal problems. Women who carry their infants to work expose them to hazardous tobacco dust and fumes. Occurrence of asthma and respiratory / skin diseases is very common in children engaged in bidi manufacturing. Moreover, they have to juggle school with bidi rolling, and often discontinue after the primary level (especially the girls) to engage full time in bidi rolling to augment family income.

A whopping 95% of the respondents wanted to shift from their present occupation, to some other livelihood, with some external support.

Regarding the fiscal benefits accruing to the government from revenue collection, here again facts are very different from fiction. According to a study reported in the January 2009 issue of Tobacco Control (a publication of the British Medical Journal), India spends more on treating tobacco related diseases than it collects by way of taxes from the tobacco industry. The study used the data from the National Sample Survey conducted in 2004.

The total economic cost of tobacco use in India (direct and indirect) amounted to US $1.7 billion in 2004. This is 16% more than the total excise tax revenue of $1.46 billion collected from all tobacco products in India in the same period. It is also many times more than the expenditure on tobacco control measures.

Global tobacco production has almost doubled since the 1960s. In 2006, world tobacco production totaled nearly 7 million metric tones, with 85% of the leaf grown in low and middle resources countries. Even the Tobacco Atlas published by the American Cancer Society recognizes that tobacco agriculture creates extensive environmental and public health problems. The WHO agrees that tobacco cultivation creates extensive environmental and public health problems. Pesticide/fertilizer run offs contaminate water resources. Curing of tobacco leaf with wood fuel leads to massive deforestation. Agricultural workers, even if they do not consume tobacco, suffer from pesticide poisoning, green tobacco sickness and lung damage from particulate tobacco smoke and field dust.

The FCTC rightly calls for financial/technical assistance to tobacco growers, so that they may shift to nutritious, economically viable and environmentally sound livelihood alternatives. Unskilled bidi workers will have to be found alternate employment with the help of public – private partnership. The time is ripe to focus not only on reducing tobacco consumption but also to question state support to tobacco cultivation. Tobacco control cannot be effective unless its supply is restricted and gradually stopped altogether. India cannot afford to continue exhibiting the dual policy of control of tobacco consumption and promotion of tobacco cultivation / production of tobacco products, side by side. Tobacco kills 1 million people in India annually.

A planned and phased reduction in tobacco production is going to benefit all. People employed in retailing, processing and in industries manufacturing cigarettes / chewing products can get alternate employment. In fact, most of the tobacco multinationals have diversified into other businesses and should be encouraged to close down their ‘poison manufacturing units’ in the name of corporate social responsibility.

Let the Asian Tiger take the lead in this matter for the rest of the world to follow.

Shobha Shukla

(The author is the Editor of Citizen News Service (CNS) and also teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

Nip The Problem In The Bud - Nay The Leaf - in lead up to World No Tobacco Day (31 May) -

- in lead up to World No Tobacco Day (31 May) -
Nip The Problem In The Bud - Nay The Leaf

Tobacco is the only consumer product which is grown and available legally and is lethal for human beings. At the current rate, the number of smokers dying every year in the world is likely to reach (10 million) 1 crore by 2020.

In India tobacco kills 1 million (10 lakhs) people annually.

Tobacco definitely is a global health epidemic, whose rapid spread around the world presents daunting challenges to policy makers and people engaged in public health concerns. Yet one finds an unacceptable contradiction here. Tobacco control policies and tobacco promotion measures seem to be coexisting comfortably. On one hand we have governments all over the world, initiating well deserving measures to combat tobacco consumption, while on the other hand, they continue to promote cultivation, sale, trade and export of tobacco and its products.

While I was in Mumbai attending the 14th World Conference on Tobacco or Health (WCTOH), I met a noted writer who said she was unable to understand the logistics of tobacco control. She echoed the sentiments of several others that the best solution to the problem would be to stop growing tobacco and stop manufacturing its products. Why produce the poison and then go all out to prevent its usage?

India is one of the signatories to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), thereby agreeing to implement its provisions. FCTC is the first global corporate accountability and public health treaty. As a Party to the treaty, India is obligated to take measures to bring down the consumption and production of tobacco in the country. It is the latter, which merits serious attention in order to achieve the former.

It makes sense that the strong legislative efforts of our government to curb tobacco use, sale and advertising need to be supported by proper and stricter enforcement. But far more important is to back these measures by comprehensive policies that have far reaching effects on tobacco cultivation and on manufacturing of all tobacco products like cigarettes, bidis, chewing tobacco, snuff and other localized versions. There is no safe way to use tobacco – whether inhaled, sucked, sniffed or chewed, and there are no safety levels.

The main reasons cited for this dual behaviour are the economic dependence of the tobacco growing farmers and the bidi rollers on this activity and of the government on the revenue collections. But if we delve a little deeper in the issue, then the reality will be different from these arbitrary assumptions. The task to overcome these ‘obstacles’ should not be as formidable as it appears to be.

Tobacco cultivation in India , especially the Flue Cured Virginia (FCV) tobacco used for cigarette making, has been enjoying government support for decades.

The area under tobacco cultivation is presently 368.5 thousand acres, which is less than 0.3% of the net sown area in the country. Around 3 to 5 lakh farmers are engaged in this activity. Tobacco farming is seasonal and restricted to a few states only, with Andhra Pradesh, Karnataka, Gujarat, Maharashtra and Orissa accounting for more than 90% of the total tobacco cultivation. It is easy for government to intervene as around 35% of tobacco crop area is governed by the rules of Tobacco Board, Government of India.

Case studies/experiments carried out by tobacco research centres suggest alternative crops like soybean, groundnut, different varieties of gram, maize, paddy, mustard, sunflower, cotton, sugarcane etc. which yield almost similar returns and are far more eco and health friendly. In fact, in some states tobacco has sadly replaced cultivation of food crops like jowar, maize and ragi - which were once called the poor man’s food, and are now high even on the health conscious’ diet chart. This shift from growing tobacco to something healthier can only affect the economic status of the farmers in a positive way. Of course, the government will have to provide them incentives by way of technical know how, seeds and marketing links for the alternate crops.

Supply of tobacco products from external sources, both legal and illegal will also have to be controlled. India is a lucrative market for foreign cigarettes and cigars. The government would therefore need to ban the import of tobacco products and foreign direct investments in the tobacco sector.

Another populist argument given in favour of tobacco production is the dependence of about 4 lakh people (two thirds of whom are women) on bidi rolling as a major economic activity. But the ground reality is that bidi manufacturing is the most exploitative work, wherein most of the workers (more than 50%) do not get even the minimum wages. This industry is largely in the unorganized sector. Manufacturers easily resort to all sorts of underhand dealings to evade excise duty as well as circumvent the minimum wages act. Many children are also engaged in this activity in direct contravention of the Child Labour (Prohibition) Act.

A recent study, initiated by Voluntary Health Association of India (VHAI), on the bidi workers from the districts of Murshidabad in West Bengal and Anand in Gujarat has brought out their dismal health and socio economic conditions. The study revealed that most of the respondents (more than 76%) earn a measly sum of Rs.33 per one thousand bidis that they rolled in more than 12 hours. This is much below the minimum wage of Rs.40 per day. Coupled with poor wages are the deplorable working conditions. The bidi workers are constantly exposed to the grave risk of contracting tuberculosis, asthma, lung disease and spinal problems. Women who carry their infants to work expose them to hazardous tobacco dust and fumes. Occurrence of asthma and respiratory / skin diseases is very common in children engaged in bidi manufacturing. Moreover, they have to juggle school with bidi rolling, and often discontinue after the primary level (especially the girls) to engage full time in bidi rolling to augment family income.

A whopping 95% of the respondents wanted to shift from their present occupation, to some other livelihood, with some external support.

Regarding the fiscal benefits accruing to the government from revenue collection, here again facts are very different from fiction. According to a study reported in the January 2009 issue of Tobacco Control (a publication of the British Medical Journal), India spends more on treating tobacco related diseases than it collects by way of taxes from the tobacco industry. The study used the data from the National Sample Survey conducted in 2004.

The total economic cost of tobacco use in India (direct and indirect) amounted to US $1.7 billion in 2004. This is 16% more than the total excise tax revenue of $1.46 billion collected from all tobacco products in India in the same period. It is also many times more than the expenditure on tobacco control measures.

Global tobacco production has almost doubled since the 1960s. In 2006, world tobacco production totaled nearly 7 million metric tones, with 85% of the leaf grown in low and middle resources countries. Even the Tobacco Atlas published by the American Cancer Society recognizes that tobacco agriculture creates extensive environmental and public health problems. The WHO agrees that tobacco cultivation creates extensive environmental and public health problems. Pesticide/fertilizer run offs contaminate water resources. Curing of tobacco leaf with wood fuel leads to massive deforestation. Agricultural workers, even if they do not consume tobacco, suffer from pesticide poisoning, green tobacco sickness and lung damage from particulate tobacco smoke and field dust.

The FCTC rightly calls for financial/technical assistance to tobacco growers, so that they may shift to nutritious, economically viable and environmentally sound livelihood alternatives. Unskilled bidi workers will have to be found alternate employment with the help of public – private partnership. The time is ripe to focus not only on reducing tobacco consumption but also to question state support to tobacco cultivation. Tobacco control cannot be effective unless its supply is restricted and gradually stopped altogether. India cannot afford to continue exhibiting the dual policy of control of tobacco consumption and promotion of tobacco cultivation / production of tobacco products, side by side. Tobacco kills 1 million people in India annually.

A planned and phased reduction in tobacco production is going to benefit all. People employed in retailing, processing and in industries manufacturing cigarettes / chewing products can get alternate employment. In fact, most of the tobacco multinationals have diversified into other businesses and should be encouraged to close down their ‘poison manufacturing units’ in the name of corporate social responsibility.

Let the Asian Tiger take the lead in this matter for the rest of the world to follow.

Shobha Shukla

(The author is the Editor of Citizen News Service (CNS) and also teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

Malaysian surgeons to learn piles management from Prof Rama Kant

Malaysian surgeons to learn piles management from Prof Rama Kant
[To read this post in Hindi language, click here]

The Department of Surgery, University of Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia has invited noted Surgeon Professor (Dr) Rama Kant, Head of Surgery Department at Chhattrapati Shahuji Maharaj Medical University (CSMMU) to deliver a talk on haemorrhoids (piles).

CSMMU surgeons have been doing pioneering work in management of piles or haemorrhoids by DGHAL and RAR techniques.

Professor (Dr) Rama Kant shall be delivering a guest lecture in Malaysia on “Revolution in management of haemorrhoids by DGHAL and RAR – can it write off surgery?” Established in 1965, University Malaya Medical Centre (UMMC) is the premier teaching hospital in nation's capital of Kuala Lumpur, Malaysia.

“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. 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” said Professor (Dr) Rama Kant, who is also a recipient of World Health Organization (WHO) Director General’s Award in 2005.

Prof Rama Kant was elected as President of Association of Surgeons of India (ASI), UP and also chairs the Lucknow College of Surgeons (LCS).

“There are known lifestyle and dietary factors that aggravate the risk to piles significantly” said Prof 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.

Malaysian surgeons to learn piles management from Prof Rama Kant

Malaysian surgeons to learn piles management from Prof Rama Kant
[To read this post in Hindi language, click here]

The Department of Surgery, University of Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia has invited noted Surgeon Professor (Dr) Rama Kant, Head of Surgery Department at Chhattrapati Shahuji Maharaj Medical University (CSMMU) to deliver a talk on haemorrhoids (piles).

CSMMU surgeons have been doing pioneering work in management of piles or haemorrhoids by DGHAL and RAR techniques.

Professor (Dr) Rama Kant shall be delivering a guest lecture in Malaysia on “Revolution in management of haemorrhoids by DGHAL and RAR – can it write off surgery?” Established in 1965, University Malaya Medical Centre (UMMC) is the premier teaching hospital in nation's capital of Kuala Lumpur, Malaysia.

“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. 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” said Professor (Dr) Rama Kant, who is also a recipient of World Health Organization (WHO) Director General’s Award in 2005.

Prof Rama Kant was elected as President of Association of Surgeons of India (ASI), UP and also chairs the Lucknow College of Surgeons (LCS).

“There are known lifestyle and dietary factors that aggravate the risk to piles significantly” said Prof 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.

Penniless Plight

Penniless Plight
Anjali Singh

Lucknow: When tragedy strikes children of underprivileged homes whom do they turn too? Victims of unfortunate circumstances they are forced to be deprived of the their basic right to survival.

Worse still their families have no answers to questions like where do poor families who cannot afford treatment seek financial help? Who is responsible for the welfare and protection of such sick and hurt children?

Does the state taking note of its responsibility as seriously as it should where these children are concerned?

With no answers to such questions for children like baby Bitta, a five month old victim of a brutal acid attack , the wait seems endless to get financial assistance for the long and cumbersome treatment prescribed to her by doctors of the Department of Plastic Surgery, Chhattrapati Shahuji Maharaj Medical University (CSMMU), Lucknow.

Having to undergo skin grafting and surgery for the next fifteen years the child’s parents are at their wits end. The cost being too high for them to afford coming from a lower income group, they have no means to manage Rs one lakh every six months for the treatment.

Ironically they have applied to relief funds set up by government for such patients including the Welfare Society Fund running within the hospital the child is being treated at and even tapped the Chief Minister’s Discretionary Fund but they have faced rejection at all levels.

Says Vijay Kumar, Bitta’s distraught father, “I have sold of every bit of land I had and have nothing more to sell off. But still I have not been able to manage the money for the next phase of treatment for my daughter. I have no idea what will happen to her now.”

“It has been a nightmare-first the tragedy then the high medical expenses we are saturated. We are a poor farmer family, we have already spent Rs one lakh we cannot afford anymore,” adds Krishna Gopal, the uncle of Baby Bitta.

Yet till date despite all recommendations, no financial assistance has come their way although the provisions exist for patients like their child.

Though Saaksham Foundation, an NGO working for the rights of children, has been trying to get funds as soon as possible for the child, it is indeed tough specially with no consideration being given to the child on humanitarian grounds.

Explains A Singh, Director Saaksham Foundation, “In special cases like Bitta’s the very fact that we have to argue her case is shameful. The child is an obvious case where entitlement to state financial aid is her right, more so on humanitarian grounds. Yet applications after applications are being rejected even by Welfare Society, CSMMU which has been set up to address cases like that of Bitta. But they are not ready to consider the case even when the treatment of the child id on at their medical university. The Chairman of the Welfare Society who is the vice-chancellor (VC) of the medical university has rejected the Child Welfare Committee’s (CWC) strong written request to take note of the child’s plight.”

But then Bitta is not alone who is suffering on account of lack of money for treatment.

Sri Ram, a daily wage labour and his disabled wife have just had a daughter. But their joy on becoming parents of 7 day old Sunita was short lived when they were told the baby had a huge perforation in the intestines and would die if not operated upon immediately.

Rues Sri Ram, “The estimate given to us for a single operation is Rs 50,000 and that does not include post operative care and follow up treatment. I am not even able to manage one square meal a day from where will I get Rs 50,000 for my daughter’s treatment?”

Both he and his wife being illiterate they are clueless on how to fill up the cumbersome forms needed to seek financial aid from state government funds. While the child has been operated upon by the hospital’s doctors after some social activists managed to collect donations and fund the operation. The rest of the amount for treatment of the child is still not arranged for.

But why are these parents up against a dead end when their BPL (Below Poverty Line) status makes them eligible to get access to all treatment free of cost?

Explains Dr Brigeetha VV, Chairperson, Child Welfare Committee Lucknow, “I have not seen a single BPL patient availing free treatment for a serious medical condition or being given immediate financial assistance. So what does one do when they are faced with a crisis? Medical treatment does not just end after the operation, the patient needs blood, medicines, post operative care and number of things to manage the malady. Yet there is no emergency funds for children that can be tapped for providing financial aid within 24 hours in case of accidents and or life saving operations if required.”

But the situation is not surprising as the condition is deplorable when it comes to the budget allocation for children. Ironically when it comes to the health sector a dismal 0.61% is what has been allocated on average between 2005-2008.

This is despite the fact that there has been an increase in the allocation of the health sector from Rs 402.1546 crores (in 2004-05) to Rs 612.0040 crores (in 2007-2008). In addition there has been a fall in allocation of health sector for children as compared to the allocation in other sectors like social sector.

While the state agrees that the allocation of a budget exclusively for children in distress and who need immediate medical help but can’t afford it is a must, no initiative has been taken by them till date.

On the other hand while child rights activists feel that creation of such a fund should be the government's responsibility but they maintain that the fund should be managed by NGOs working in the field. Whether that is that is possible is anyone's guess.

Nevertheless Dr Brigeetha stresses that though CM’s funds are applied for but in most cases the poor don’t get access to it as the procedures are cumbersome and they have no way of fulfilling it.

She says, “The cases that we pursue as well don’t get 100% relief only 50% or even lesser which does not solve their problem. Thus a need right now is to develop a emergency funds that can be created by funding NGOs who can collaborate with each other and manage a sum of a few lakhs raised to institutional or individual donations. This fund can then be used to provide financial aid to children who really need it. The aim should be to cut down paper work and try and release the money for treatment with 5-6 hours after the application from patient’s family is received.”

Agrees Chandra Kishore Rastogi, President, Hari Om Sewa Trust, an NGO that works at CSMMU helping arrange funds and medicines for the needy free of cost, “The situation is quite serious as our society has become quite insensitive. It is of utmost importance that an alternative funding source be developed for children who need emergency care or else a lot many innocent lives will be lost.”

A fact that is corroborated by SK Jaitley , Executive Member, Kalyanam Karoti, an organisation that provides the handicapped free medical aid and helps funds eye and limb operation of the underprivileged. “To expect that the government will do everything is just wishful thinking. If children facing an emergency situation have to benefit from any kind of financial aid on humanitarian grounds then it should reach them within six to seven hours of placing the request. This is not possible in the present government set up with tedious paperwork involved at every level. So an alternative system has to be devised.”

So True. But who will take the initiative for such a fund is a point to reckon.

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)

Penniless Plight

Penniless Plight
Anjali Singh

Lucknow: When tragedy strikes children of underprivileged homes whom do they turn too? Victims of unfortunate circumstances they are forced to be deprived of the their basic right to survival.

Worse still their families have no answers to questions like where do poor families who cannot afford treatment seek financial help? Who is responsible for the welfare and protection of such sick and hurt children?

Does the state taking note of its responsibility as seriously as it should where these children are concerned?

With no answers to such questions for children like baby Bitta, a five month old victim of a brutal acid attack , the wait seems endless to get financial assistance for the long and cumbersome treatment prescribed to her by doctors of the Department of Plastic Surgery, Chhattrapati Shahuji Maharaj Medical University (CSMMU), Lucknow.

Having to undergo skin grafting and surgery for the next fifteen years the child’s parents are at their wits end. The cost being too high for them to afford coming from a lower income group, they have no means to manage Rs one lakh every six months for the treatment.

Ironically they have applied to relief funds set up by government for such patients including the Welfare Society Fund running within the hospital the child is being treated at and even tapped the Chief Minister’s Discretionary Fund but they have faced rejection at all levels.

Says Vijay Kumar, Bitta’s distraught father, “I have sold of every bit of land I had and have nothing more to sell off. But still I have not been able to manage the money for the next phase of treatment for my daughter. I have no idea what will happen to her now.”

“It has been a nightmare-first the tragedy then the high medical expenses we are saturated. We are a poor farmer family, we have already spent Rs one lakh we cannot afford anymore,” adds Krishna Gopal, the uncle of Baby Bitta.

Yet till date despite all recommendations, no financial assistance has come their way although the provisions exist for patients like their child.

Though Saaksham Foundation, an NGO working for the rights of children, has been trying to get funds as soon as possible for the child, it is indeed tough specially with no consideration being given to the child on humanitarian grounds.

Explains A Singh, Director Saaksham Foundation, “In special cases like Bitta’s the very fact that we have to argue her case is shameful. The child is an obvious case where entitlement to state financial aid is her right, more so on humanitarian grounds. Yet applications after applications are being rejected even by Welfare Society, CSMMU which has been set up to address cases like that of Bitta. But they are not ready to consider the case even when the treatment of the child id on at their medical university. The Chairman of the Welfare Society who is the vice-chancellor (VC) of the medical university has rejected the Child Welfare Committee’s (CWC) strong written request to take note of the child’s plight.”

But then Bitta is not alone who is suffering on account of lack of money for treatment.

Sri Ram, a daily wage labour and his disabled wife have just had a daughter. But their joy on becoming parents of 7 day old Sunita was short lived when they were told the baby had a huge perforation in the intestines and would die if not operated upon immediately.

Rues Sri Ram, “The estimate given to us for a single operation is Rs 50,000 and that does not include post operative care and follow up treatment. I am not even able to manage one square meal a day from where will I get Rs 50,000 for my daughter’s treatment?”

Both he and his wife being illiterate they are clueless on how to fill up the cumbersome forms needed to seek financial aid from state government funds. While the child has been operated upon by the hospital’s doctors after some social activists managed to collect donations and fund the operation. The rest of the amount for treatment of the child is still not arranged for.

But why are these parents up against a dead end when their BPL (Below Poverty Line) status makes them eligible to get access to all treatment free of cost?

Explains Dr Brigeetha VV, Chairperson, Child Welfare Committee Lucknow, “I have not seen a single BPL patient availing free treatment for a serious medical condition or being given immediate financial assistance. So what does one do when they are faced with a crisis? Medical treatment does not just end after the operation, the patient needs blood, medicines, post operative care and number of things to manage the malady. Yet there is no emergency funds for children that can be tapped for providing financial aid within 24 hours in case of accidents and or life saving operations if required.”

But the situation is not surprising as the condition is deplorable when it comes to the budget allocation for children. Ironically when it comes to the health sector a dismal 0.61% is what has been allocated on average between 2005-2008.

This is despite the fact that there has been an increase in the allocation of the health sector from Rs 402.1546 crores (in 2004-05) to Rs 612.0040 crores (in 2007-2008). In addition there has been a fall in allocation of health sector for children as compared to the allocation in other sectors like social sector.

While the state agrees that the allocation of a budget exclusively for children in distress and who need immediate medical help but can’t afford it is a must, no initiative has been taken by them till date.

On the other hand while child rights activists feel that creation of such a fund should be the government's responsibility but they maintain that the fund should be managed by NGOs working in the field. Whether that is that is possible is anyone's guess.

Nevertheless Dr Brigeetha stresses that though CM’s funds are applied for but in most cases the poor don’t get access to it as the procedures are cumbersome and they have no way of fulfilling it.

She says, “The cases that we pursue as well don’t get 100% relief only 50% or even lesser which does not solve their problem. Thus a need right now is to develop a emergency funds that can be created by funding NGOs who can collaborate with each other and manage a sum of a few lakhs raised to institutional or individual donations. This fund can then be used to provide financial aid to children who really need it. The aim should be to cut down paper work and try and release the money for treatment with 5-6 hours after the application from patient’s family is received.”

Agrees Chandra Kishore Rastogi, President, Hari Om Sewa Trust, an NGO that works at CSMMU helping arrange funds and medicines for the needy free of cost, “The situation is quite serious as our society has become quite insensitive. It is of utmost importance that an alternative funding source be developed for children who need emergency care or else a lot many innocent lives will be lost.”

A fact that is corroborated by SK Jaitley , Executive Member, Kalyanam Karoti, an organisation that provides the handicapped free medical aid and helps funds eye and limb operation of the underprivileged. “To expect that the government will do everything is just wishful thinking. If children facing an emergency situation have to benefit from any kind of financial aid on humanitarian grounds then it should reach them within six to seven hours of placing the request. This is not possible in the present government set up with tedious paperwork involved at every level. So an alternative system has to be devised.”

So True. But who will take the initiative for such a fund is a point to reckon.

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)

Size of Pictorial Warnings: Large and Comprehensive Warnings are more effective

Size of Pictorial Warnings: Large and Comprehensive Warnings are more effective
International Best Practices









Australia
Front: 30%
Back: 90%








Brazil
100% either of the sides










Canada
Front: 50%
Back: 50%








Thailand
Front: 50%
Back: 50%








UK
Front: 43%
Back: 53%

Size of Pictorial Warnings: International Best Practices
• 60% New Zealand (30% of front, 90% of back)
• 56 % Belgium (48 % of front, 63% of back, including border)
• 56 % Switzerland (48 % of front, 63% of back, including border)
• 52 % Finland (45% of front and 58% of back, including border
• 50 % Singapore (50 % of front and back)
• 50% Uruguay (50 % front and back)
• 50 % Chile (50 % front and back)
• 50 % Venezuela (100% of either front or back)
• 48 % Norway (43 % of front, 53 % of back, including border)

Indian Scenario
Pictorial Warnings previously notified by the Government
Strong and effective – field tested




























In the earlier set of rules, pictorial warnings covered 50 % of the front and 50% of the back on all tobacco products.

Pictorial Warnings coming into force from May 31, 2009
Mild and weak – not field tested






















As per the new rules notified on May 3, 2009, pictorial warnings would be displayed only on the 40% of the principal display area of the front panel of all tobacco packs.

International Obligation: India ratified the Framework Convention on Tobacco Control (FCTC), the first international public health treaty of the World Health Organization (WHO) in February 2004 and is a Party to the convention. According to FCTC, the deadline for India to implement pictorial health warning was February 27, 2008. But still the tobacco products in India do not carry any pictorial health warnings. Also FCTC recommends 30 % as minimum size of display of pictorial health warnings i.e. 30% front and 30% back, which India has again not complied with.
----------------

Credits: this advocacy card is published and distributed by Indian Society Against Smoking (ISAS), Asha Parivar. We acknowledge the financial contribution received from Bloomberg Initiative to Reduce Tobacco use and technical contribution received from HRIDAY on behalf of Advocacy Forum for Tobacco Control - AFTC (Delhi).

Address: C-2211, C-Block Crossing, Indira Nagar, Lucknow-226016. India. Ph-fax: 2358230
Email: ramakant@ramakant.org, website: http://tambakooKills.blogspot.com