Sunday, April 18, 2010

India-Pakistan Peace Caravan 2010 - अमन के बढ़ते क़दम

[To read this article in HINDI language, click here]
Probably nowhere in the world are people of two countries as emotionally entwined as are the people of India and Pakistan, and yet there is an enmity thrust upon them. The cruel turn of the wheel of history resulted in political separation, leading to a blood-spattered migration of countless people on an unprecedented scale, severing of family ties, and deep scars that have left an indelible imprint on the collective consciousness of the two nations.

Post-Partition, our tumultuous history has been interspersed with four wars and loss of innumerable innocent lives. Kashmir continues to be a sore point in our relations, threatening to take the two countries on a course of self-destruction. Fundamentalist groups within the religious and political space of South Asia continue to ensure that the fires of animosity are kept alive and take a heavy toll on both sides.

Targets of violence and of an atmosphere of antagonism, common people on both sides of the border want peace, friendship and normal relations to be established between the two countries. Read more

The ruling elites of the two countries are usually suspicious of each other, but whenever the common people of India and Pakistan get to meet, all reservations they might have about each other collapse and warm emotions of mutual affinity surge forth, very much like people of the same family meeting each other after years of separation. Enmity, hatred and distance melt away, warmth and friendship take over. In spite of the geographical boundaries forced upon us by historical circumstances, our common customs and traditions endure – our language, our music, our food and cuisine, the very mode of living on both sides of the border leaves no scope for scepticism in terms of our shared values and issues of common concern. The people are divided by borders but their hearts are one

We feel that if real peace and friendship has to be established between the two countries, the initiative will have to be taken by the people themselves. Various such initiatives have been witnessed over the last many years, the Indo-Pakistan Delhi to Multan Peace March in 2005 being one of them. Sufi saints and poets sang the song of love. The indelible imprints of this deep-rooted tradition are enshrined in the hearts and souls of the populace on both sides of the border. In consonance with this tradition, the March started from the dargah of the Sufi saint Hazrat Nizamuddin Auliya in Delhi , and culminated at the shrine of saint Bahauddin Zakariya in Multan , taking the message of love and brotherhood to the towns, cities and villages of the two countries. Subsequent to that, widening the scope of the initiative, a `Nuclear-Free, Visa-Free South Asia Convention' was held in Delhi in August 2005, and in Lahore in 2007. Attempts to make it an annual affair have met roadblocks, the biggest being the prevalent visa-passport regime between the two countries.

Sustained efforts at the grassroots are required to bring about a change in mindset at the governmental levels. The problems and challenges we face are common – poverty, unemployment, the onslaught of globalisation and economic liberalisation endangering our economies, the dire need to look to the sectors of health and education. A loosening and gradual removal of barriers of trade and commerce, increasing movement of people across borders is bound to benefit both the countries.

Economically strong India and Pakistan can bring about an era of peace and prosperity for the whole of South Asia . A spirit of give and take, of mutual co-operation, of creating an environment of friendship and peace rather than of jingoistic nationalism can see the two countries moving apace on a path of progress and development.

The last few years have seen the two governments taking steps for peace but these have been slow and intermittent, blow hot-blow cold attempts rather than being steady, continuous and sustained. The felt need of renewed efforts to pressurize the governments to listen to the voice of the peace-loving peoples of the two countries now emboldens us to take up another joint people-to-people peace initiative - the Indo-Pakistan Peace Caravan, Amn ke Badhte Qadam, from Mumbai to Karachi. This Peace Caravan will provide an opportunity to the peace-loving people of both countries to give voice to their urge for peace and friendship, and help build an atmosphere that should ultimately persuade the two governments to listen to the voice of sanity.

In the course of this Peace Caravan, we seek the support of people on the following points :
1. The movement of people across the borders should be made easier. At present there are all sorts of restrictions on such movement, some of which are apparently ridiculous. We would like these restrictions to be removed, for the people on both sides of the border have an intimate attachment with each other. There exists an emotional bond between the two – very much unlike the sense of animosity and mistrust that is reflected in the attitudes of the two governments. Due regard should be given to the wishes and aspirations of the people by the two governments, and they should be allowed to freely and easily meet, and inter-act with each other. In fact, the visa-passport regime should be done away with.
2. India and Pakistan must establish unconditional friendship forthwith respecting the wishes of common people of both countries and then try to resolve the issues. A solution to all contentious issues between India and Pakistan should be found peacefully through mutual discussions around the table. These issues include the issue of Jammu and Kashmir (which, in our view, should be resolved by taking into consideration the wishes and aspirations of the people of Jammu and Kashmir ), and the issue of terror-related activities on account of which the people of both countries are suffering.
3. India and Pakistan should dismantle their atomic-nuclear establishments at the earliest. Both countries should destroy landmines laid in the border areas and send their forces back to the barracks. We want that both countries should stop wasting their valuable resources in the name of defence-budget, and plan for these resources to be used for the eradication of poverty in the sub-continent. Those who are a part of the Peace Caravan believe that real security lies not in the piling of arms and ammunition but in building a relationship based on mutual trust and faith. Notwithstanding claims to the contrary, the fact is that underground landmines and nuclear bombs rather than causing damage to the `enemy', only end up causing much greater harm to your own people. It would, therefore, not be inappropriate to call these weapons anti-people.
4. The two countries must end proxy and/or low intensity wars against each other forthwith and restrain their intelligence agencies from fomenting trouble across the border.

Peace and development are possible only in an environment of trust and mutual goodwill : this, indeed, is the message of this Peace Caravan. We very well understand that our aims and objectives cannot be achieved through just this effort. We also believe that this Peace Caravan is just one element in the many initiatives being taken up by the two peoples for Peace. Let us, then, join hands for the SUSTAINED creation and development of an environment of mutual trust, goodwill and peace between the two countries – indeed, peace in South Asia as a whole.
*********************


dear friends,

DailySouthAsian yahoogroup was created when india pakistan peace march was taken out in 2005 from delhi to multan. now it is time for another caravan. the details are being finalized but it'll take place in last week of july and first half of august of this year, 2010.

we're now seeking organizational endorsements for this caravan. friends who are interested in participating in the peace caravan on the other side of the border must send their passport details no later than april last week to saeeda diep in pakistan (saeedadiep@yahoo.com) and rajeshwar ojha in india (rajeshwar.ojha@gmail.com) in the following format:

Name (as in Passport):
Father's Name:
Passport Number:
Citizenship:
Date of Birth:
Place of Issue:
Date of Issue:
Date of Expiry:

citizens of other countries are also welcome to join this caravan. those interested in being part of the peace caravan please subscribe to indopakpeacecaravan@yahoogroups.com or send mail to bobby ramakant (bobbyramakant@yahoo.com).

love,

sandeep [Dr Sandeep Pandey]

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Saturday, April 17, 2010

Heal Thyself With Oxygen

Hyperbaric oxygen therapy (HBOT) is a medical treatment for wound healing, that involves intermittent inhalation of 100% oxygen at higher than normal atmospheric pressure, inside a special treatment chamber. Normal atmospheric pressure is 1 Bar, which is equivalent to 76 cm of Hg pressure at sea level. So any pressure greater than this can be called hyperbar. This oxygen at high pressure is called Hyperbaric Oxygen or HBO, said Dr Tarun Sahni, Senior Consultant, Apollo Indraprastha Hospital, New Delhi, during a conference on 'High Risk Diabetic Foot' in Kanpur, India, jointly organized by the Indian Podiatry Association, UP Chapter of Association of Surgeons of India (ASI), and Hyperbaric Society of India. Read more

Dr Sahni explained that HBOT increases dissolved oxygen in the plasma which is responsible for its effects. Blood normally carries 19ml of oxygen with Haemoglobin (Hb) and 0.3ml of it is dissolved in plasma. If a person breathes 100% oxygen, then its level in Hb increases to 20ml and that in plasma to 1.5ml. But with HBO, Hb is saturated with oxygen and the amount of oxygen carried in the plasma increases to 6ml. It is this increase in the dissolved oxygen which is good for the body.

HBOT for wound care is based upon sound physiological principles. Without adequate oxygenation, normal healing process cannot take place. Wound healing has been found to improve at increased ambient pressures, as has been seen in the case of divers. Oxygen plays a pivotal role in almost every major component of wound healing. Increasing the wound oxygen tension/pressure enhances the healing process.

Dr Sahni informed that adequate tissue oxygen is an essential factor in wound healing. A significant increase in tissue oxygen promotes wound healing by directly enhancing fibroplast replication and neo vascularisation; increasing leukocyte/bacterial activity; helping in bone formation and stem cell stimulation. During HBO, due to higher pressure, the oxygen dissolves more in the liquid part of the blood and its level increases 10 to 20 times the normal value. This oxygen reaches all areas of the body – even those places where it was not reaching earlier due to inadequate blood supply or less haemoglobin.

Conditions benefitting from HBOT are:
(i) wounds – in diabetic patients, arterial and venous ulcers, accident wounds, burns, gangrene, bone infection or osteomyelitis and other non/ slow healing wounds
(ii) Oncology – radiation tissue damage
(iii) Primary treatment of carbon monoxide poisoning, smoke inhalation
(iv) Sudden deafness, vertigo, tinnitus
(v) Neuro rehabilitation – head/spinal injury, stroke, cerebral palsy, Bells palsy.

Patients with diabetes, peripheral vascular disease, traumatic injury and infections are more susceptible to problem wounds. Wounds may not heal due to many reasons, the major one being poor supply of oxygen. Lack of oxygen results in swelling of tissues; which increases the distance for oxygen to travel; which further reduces oxygen supply; finally resulting in tissue destruction. According to specialists, when the tissue oxygen tension drops to less than 30mm of Hg pressure, healing by cellular division is significantly reduced and may even stop. In such an environment, fibroplasts and leucocytes are not capable of functioning.

HBO can be administered in Mono Place Treatment Chamber, wherein a single patient is placed in the chamber pressurized with 100% oxygen. Or it can be given in Multi Place Treatment Chamber where many patients can be treated at the same time. These chambers are pressurized with compressed air, and the patient breathes 100% oxygen at that pressure, through special masks or oxygen hoods. Apollo hospital in Delhi uses the latter type. It is perhaps the only hospital in India, apart from one other at Ahmadabad, which boasts of an HBO Clinic.

As it takes approximately one hour to saturate the tissues, most treatments are set at 90 minutes of oxygen breathing. Thus a single treatment session lasts for two hours, giving 30 minutes for preparation before and observation after the therapy. An average of 30 sessions (one per day) is required, though it may go up to 100 sessions in some acute cases, said Dr Tarun Sahini.

HBOT is a relatively new concept in India though very popular in countries like China (it has more than 2500 HBO clinics) ,Russia (2000 clinics), USA (400 clinics) and UK (200 clinics). But Dr Sahni feels that it is gaining acceptance as it not only saves and preserves the quality of life, but also reduces high cost of disability arising out of amputation, shortens the healing time and reduces costs of repeated surgery. This therapy has proved to be very good in the treatment of severe ischemic diabetic foot ulcers and soft tissue infections, and many patients have benefited from it. All diabetic wounds in lower extremity benefit from hyperbaric oxygen.When combined judiciously with standard orthopaedic and vascular treatments, it would go a long way in reducing morbidity and mortality.


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

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Wednesday, April 14, 2010

Narmada Jeevan Adhikar Yatra storms NCA Indore Office for justice

Sardar sarovar and jobat displaced storm NCA office to demand their rights
Indore citizens express full solidarity with Narmada Jeevan Adhikar Yatra
After two full days of non-stop action and travelling through various villages and towns creating awareness on the enormous social and environmental impacts of large dams in the Narmada Valley, the indefinite Jeevan Adhikar Yatra of the thousands of adivasis, farmers, fish workers affected by the Sardar Sarovar and Jobat Dams reached Indore today morning. At every village and in every meeting,
the people raised pressing issues concerning their fundamental right to life and livelihood and challenged the State, asserting that it cannot move ahead, even an inch, with these ‘monuments of mismanagement and injustice’ if it fails to ensure land and livelihood to the affected people. Read more



Slogans of “Narmada Ghati ka ek hee naara, nahi, chodenge narmada Kinaaraa” (The only slogan of Narmada Valley – We shall not leave the river bank) and “Vikas ke naam par Gaaon ka katl-e-aam band karo” (The State must stop massacre of villages in the garb of development) rent the air as the Yatra trucked through in 16 vehicles with blue buntings of the Andolan from Dhamnod to GPO, Indore where it received an encouraging welcome from the Indore Solidarity Group, a network of numerous citizens’ organizations, academics, intellectuals and professionals.

Addressing the large gathering at the GPO Ground, Dr. Bharat Chaparwal, Former Vice Chancellor of Devi Ahilya Vishwaya Vidyala, Indore, conveyed his full support to the people in their genuine struggle and assured that their non violent way to assert their rights will surely earn them more support from the civil society and the State will have to relent. Shri Kalyan Jain, Former Member of Parliament, Samajwadi Party expressing his full solidarity with the struggle said that there was never an iota of misgiving in his mind about the Andolan which has been raising very pertinent issues concerning people’s rights and the environment and it is in fact in the best interest of the State
that these issues are resolved at the earliest. Shri R.D. Prasad, senior academic said that the Sradar Sarovar Dam has been totally exposed today and the government’s own Reports such as the Devender Pandey Report on environmental non-compliance is highly damaging. The Government cannot go ahead with raising the dam height in this stage and if it still does, the people have no other alternative but to give an open challenge and get on to the streets and the common citizens will support them. No one can dare stop this.

Dr. Ranjana Sehgal and Dr. Mahesh Shukla , Professors at the Indore School of Social Work and the National Association of Professional Social Workers (Indore Chapter) who are actively supporting the people’s struggle along with their students said that the movement of the common masses is itself a university of learning and values for those in the academic circles. Shri Tapan Bhattacharya from the Association of Voluntary Agencies for Planning and Development also expressed his solidarity with the people. Dr. Arun Kumar, Lecturer of Political Science from Kerala and students from Madurai also joined the action today.

NBA storms NCA Indore Office: Demands Immediate Justice
Marching ahead, the Yatra resumed from GPO to Vijay Nagar, where the Narmada Control Authority (NCA) is head quartered, passing through the main streets of Indore and spreading its message to thousands of the city’s denizens. Not surprisingly, the gates at NCA were barricaded beforehand, displaying the defensive attitude of the State. However, the people asserted that they will have to be heard and made their way into the main verandah of the Office. Upon entering, the people were told that the senior officials were not present and briefly interacted with the Deputy Director, Mr. Ashish Fulandikar.

NBA expresses its dismay at the fact that the senior officials of the NCA i.e. the Directors of Rehabilitation and Environment could not make themselves available for a dialogue with the hundreds and hundreds of people who had come from the three states of Gujarat, Madhya Pradesh and Maharashtra, despite having been informed of the same well in advance. In any case, the people have
come prepared for an indefinite action and shall not budge without meeting up with the concerned authorities and seeking answers that shall determine their right to life.

Addressing the gathering of the fiery adivasis and farmers inside the NCA premises, Vimal Bhai of Matu Jan Sanghatan working with the Tehri and Bhagirathi dams displaced condemned the recalcitrant attitude of the State in forging ahead with giant projects on virtually every single river, thereby
killing the riverine communities and causing permanent damage to the ecology.

People in every single river valley are facing this challenge today to save their livelihoods and the valley and we shall together fight until our last breath, he said. Suniti S.R. from Visthapan Virodhi Sangharsh Samiti, a coalition of people’s struggles against displacement in Pune congratulated
the Andolan for its unflinching faith in the peaceful way of struggle to achieve its natural and human rights despite heavy odds by the State and its inability to engage with social movements that are raising right (though uncomfortable) questions which is only towards facilitating positive alternative change.

The Andolan is thankful to senior freedom fighter Shambhunathiji who has been travelling with the Yatra for the past three days, Shri Anil Trivediji, senior advocate and activist for his guidance and support despite his ill-health, Pairindaji, Johar Chand Dasaneji, Kumar Siddharth, Samyak and Chinmay Mishraji from Sarvoday Press Service, the small railway caterers, including Jitubhai and
all saathis of Indore Solidarity Group and also who are actively supporting the people’s just cause in different ways.

Marking Babasaheb Ambedkar Jayanthi tomorrow, the people will take an mass Sankalp at Ambedkar Pratima statue tomorrow at 11 in the morning re-affirming their vow to strive for their constitutional right to life.

The struggle from the valley has moved to Indore and will not go back without justice…

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Tuesday, April 13, 2010

Making Open Source Drug Discovery a Reality in TB Treatment Research

"...diseases like TB with high mortality but low profitability are neglected by the current system of pharmaceutical research"
The Indian government's Open Source Drug Discovery (OSDD) initiative released the results of its 'Connect 2 Decode' (C2D) project to re-annotate the biological and genetic information relating to the Mycobacterium tuberculosis (Mtb) genome at a conference. This is the first time that a comprehensive mapping of the Mtb genome has been compiled, verified and made publicly available. C2D's findings may contain critical data to unlock previously undiscovered details of tuberculosis (TB); resulting in development opportunities for urgently needed new TB drugs in India and other developing countries. Read more


World Health Organization (WHO) reports that 1.7 million people die annually from TB and that in some areas of the world, one in four people with TB becomes ill with a form of the disease that can no longer be treated with standard drugs regimens. Despite this public health emergency, TB research funding remains alarmingly inadequate, particularly for research into new drugs.

In addition, conventional market-based patent incentives are ineffective in addressing public health needs in developing countries with only 1% of newly developed drugs targeting neglected diseases.

"We need to have a balanced view between health as a right and health as a business. It is because there has been imbalance in this view, that diseases like TB with high mortality but low profitability are neglected by the current system of pharmaceutical research," said Dr Samir K Brahmachari, scientist and Director General of the Indian organisation Council of Scientific and Industrial Research (CSIR). "As virtually no new TB drugs have been developed since the 1960s, OSDD's model in particular holds great promise for the scientific community by stimulating the development of better drugs and diagnostics for patients."

With children and people living with HIV in India and other developing countries bearing the greatest burden of the disease, as well as the emergence and spread of TB that is resistant to treatment by the standard anti-TB drugs, there is an urgent global, but unanswered, need for new drugs.

"For us the irony is that with the availability of drugs for HIV and particularly of safe and affordable Indian generics, we are living with HIV but dying of TB," Loon Gangte of the Delhi Network of Positive People, a support group of people living with HIV/AIDS, said. "TB research has yet to see any great progress as we struggle to pull ourselves out of a system that places profits before people's lives. India's OSDD project holds immense hope for my community."

Under the C2D project, researchers and students pooled their time and skills using online tools to provide insights into 4000 genes of the deadly pathogen. The researchers also mapped the genes as they relate to functional interactions and pathways. Their work is held in a shared database, which OSDD will share through a globally accessible database to any research institutions involved in TB research through its open portal (www.osdd.net).

C2D demonstrates the power of people to connect through the internet, particular young people, and accomplish complex research tasks. It is also a distinct move from a hierarchical based model of doing science towards one of equal collaboration.

OSDD was launched in September 2008 by CSIR. It is a USD 35 million (Rs 146 Crores) collaborative research effort that focuses primarily on TB. OSDD's objective is to accelerate research and development (R&D) for TB drugs. With a global community of nearly 3000 members from 74 countries, OSDD brings together scientists, doctors, students, policy experts, software professionals and others to work on TB research.

OSDD is the first project of its kind by any government.

About a decade ago, the genome sequence of Mtb was deciphered, triggering intense research on the pathogen. Along with it came the first annotation, providing the first "parts list" of the microbe. A re-annotation carried out subsequently identified a more parts, completing the list of proteins coded by the genome.

To get a systems view of the microbe, however, we need to move on from the "parts list" towards how these parts are "assembled" in the cell. To do this, the description of each part must be as complete as possible.

The first, called TBGO, has obtained associations for each gene with functional ontologies, thus getting first clues of the functions of the various proteins. Second, each protein is studied at high resolution by modeling their three dimensional structures, through which, higher order clues about their functional roles are obtained. Third, proteins which interact with various sugars or carbohydrates in the cell are deciphered; these are believed to be important for the signaling events in the cell, somewhat akin to the switches. Fourth, the assembly of the parts has been sought out by identifying those parts that talk to each other directly and those parts that talk to others through mediators, such as metabolites.

Integrating data from all the angles, or network of the parts list is reconstructed, in which functional modules (or biochemical pathways) are also identified. The network helps in understanding how metabolism takes place in the bacterial cells, how it compares with human and other bacteria and helps in answering questions about what strategies should be adopted to kill the bacteria, eventually useful for new drug discovery.

A fifth theme that has been pursued in this project is to identify proteins that contain antigenic parts in them that could trigger immune responses in the host and thus ultimately help in rational vaccine design.

The C2D project has attempted exactly this from four different angles.

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Monday, April 12, 2010

Don't always have your noses up. Look down at your feet too!

Click here to listen to AUDIO PODCAST of interview with Dr APS Suri
(here is another audio podcast featuring Dr APS Suri)
On an average, a person walks a distance of more than three trips round the earth in one life time. With such high demands on our dainty feet, quality foot care is essential. This is exactly what the recently organized midterm Continuing Medical Education (CME) meeting on the ‘High Risk Diabetic Foot’ was about. It was a meeting of the brains, to deliberate about the feet. Read more
The meet was organized in Kanpur, India, jointly by the Indian Podiatry Association, UP Chapter of Association of Surgeons of India (ASI), and Hyperbaric Society of India, with a view to discuss the latest happenings in the field of diabetic foot care.

Hyperbaric oxygen therapy is a very new but exciting technique in diabetic wound healing. Dr Tarun Sahni of Apollo Hospital, New Delhi (who is also President of Hyperbaric Society of India) gave interesting insights in the use of high pressure oxygen for treatment of all sorts of wounds, including diabetic foot ulcers.

Dr APS Suri, who has done pioneering work in the field of podiatry in India, and is the President of Indian Podiatry Association, spoke on the management of diabetic foot and the role of various techniques, including stem cell therapy, in Diabetic Foot Care. He was of the opinion that the beauty of feet should last forever. We need to walk better and live better. And to achieve this, health professionals, as well as patients, need to be trained.

Dr Anil Gombar, Senior Physician at Max Hospital, New Delhi, kick started the discussion by acknowledging that we are indeed living in a diabetic world. Diabetes is a disease of the whole body, affecting the brain, eyes, heart, kidneys, and the peripheral nervous system.
One in every six diabetic patients suffers from a foot ulcer, and every 30 seconds a foot is lost to diabetes somewhere in the world.

Comprehensive foot care programmes can reduce amputations by 45% to 85%.
So, a multidisciplinary approach is required. According To Dr A.K.Khanna, head of surgery department, BHU, infection of the diabetic foot is like a snakes and ladders situation. We try to heal the wound, but infection changes the scenario. The deeper the wound, more are the chances of an infection.
The goal of surgery should be to save the foot. The three pronged strategy should be to prevent, identify/ treat and educate. We have come a long way from the days when Hippocrates had said that for an obstinate ulcer, sweet wine and lots of patience should be enough.

Dr Rishi Shukla, Endocrinologist at Regency Hospital, Kanpur, minced no words when he candidly accepted that a majority of the lower limb amputations due to diabetes are preventable. But the main hurdle is the virtual non existence of screening programmes, coupled with a lack of multi disciplinary team work. He rued the fact that diabetes management is mostly restricted to digital management. Patients, rural as well urban, are generally ignorant about the importance of feet, which are generally kept unclean. Even the clinicians do not look at the feet. Those who do examine them are indifferent towards implementing the findings. So, medical attention is generally confined to managing blood sugar levels.

Professor (Dr) Rama Kant, a world renowned surgeon, and presently Head of the Department of Surgery, CSMMU, Lucknow, stressed upon (i) a proper examination of foot and footwear (which should include probing), (ii) meticulous diabetes control, (iii) prompt control of poly microbial infections, and (iv) surgical management by aggressive debridement. He said that good podiatry was the need of the time and the key to success. He also cautioned that diabetic foot wounds need to be irrigated and not merely cleaned. Prof Rama Kant is the Head of Surgery department at CSM Medical University (upgraded King George's Medical College - KGMC) and President of ASI, UP.

There are many barriers to foot care. But the biggest one is ignorance. Shortage of podiatrists in the country adds to the problem. Team work and care can reduce ulcer formation and amputation.
Intensive patient education regarding proper foot care is the need of the hour.

People with diabetes should make it a matter of habit to inspect their feet daily, and immediately report to the doctor at the slightest sign of an ulcer or callus. There are special mirrors available, to check for feet ulcers. Feet need to be washed, dried and lubricated (but not between toes) daily. Dry and cracked skin leads to ulcers. Barefoot walking is a big NO, even on clean and smooth floors. Temperature extremes are to be avoided. There was an example of a patient who came very near to amputation just because he enjoyed a steam/sauna bath in a 5star hotel.

A whopping 41 million Indians (14% of urban people and 3% of villagers) are at risk of diabetic foot. So it is important to discuss the role of preventive and therapeutic foot wear. Such footwear is required to (i) prevent amputation, (ii) protect the skin from external trauma, and (iii) protect the insensitive foot from plantar pressure.

Optimal and comfortable footwear (which does not include the popular Hawaii chappals), should be worn at all times. Neuropathic shoes, having shear- reducing and/or rocker soles are now available in the market. Evenings are the best time to buy shoes, as the feet are swelled to the maximum then. Shoes of black colour, or with pointed toes, or slip-ons should be avoided. Care of socks is equally important. It is best to buy cotton socks which are white in colour, so that any bleeding ulcer can be detected immediately. These days, cheap, seamless and silver impregnated socks are available. These are ideal for people with diabetes. Else, wear the normal cotton socks turned inside out.

Dr Sanjay Kala, Associate Professor at GSVM Medical College Kanpur, was rightly of the opinion that amputation is not the answer. We have to preserve the foot. This can be achieved by a comprehensive team approach of multispecialty experts including vascular surgeons, pedorthotists, plastic surgeons, podiatrists, psychologists, nurse educators and expert dressers working together, with the cooperation of the patient. Only then can the present number of over 80,000 diabetes related amputations done annually in India, be brought down substantially.

In the words of Dr Jean Claude Mbanya, President of the International Diabetes Federation (IDF), “With relatively low investment, it is possible to advance education and prevention that will result in lower rates of amputation, and better quality of life for people with diabetes. The time to act is now!"

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

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Sunday, April 11, 2010

Adivasis and Women launch Indefinite Narmada Jeevan Adhikar Yatra

More than two thousand adivasis, farmers, fish workers, labourers, potters and other Sardar Sarovar Project affected persons from the Narmada Valley assembled at Rajghat today morning to embark on an indefinite Jeevan Adhikar Yatra to challenge unjust political moves to push the giant dam ahead despite the failure of the dam having been fully exposed and also in the face of gross environmental non-compliance and unprecedented corruption, causing forced and illegal displacement of the two-lakh population in the valley. Read more

Led by determined women from the hilly adivasis regions of Madhya Pradesh, Maharashtra and vasahats of Gujarat as also from the plain areas of Nimad in M.P., the people challenged the political expediency to raise the height of the SSP by installing the 17 mts high gates, when thousands of them have not yet been ensured their legal entitlement of land and livelihood based rehabilitation, while on the other hand, the Government seems to be actively festering the menace of thousands of crores corruption in the name of ‘rehabilitation’ of their families.

Women, men, adivasis, farmers, fish workers, old and young took an enmasse ‘Sankalp’ (vow) on the river bank to struggle against destruction of the valley and save their rights and the ancient Narmada civilization from doom.

Leading the Sankalp and later addressing the struggling people, veteran freedom fighter and Samajwadi leader Shri Shambunath Gupta from Hoshangabad, who has been a long-time associate of non-violent people’s movements assured the people that their struggle will not go in vain and the Government cannot have its way violating the Constitution and people’s inalienable rights.

Ultimately, the people’s voice will have to be heard and in the case of SSP, this has already started to happen, he said.

Not heeding the scorching heat, the villagers from adivasi and Nimadi villages such as Anjanwara, Kakrana, Sugat, Jalsindhi, Chimalkhedi, Danel, Chhota Barda, Semalda, Karoli, Manawar, Bakaner, shouted slogans ‘Amu Akkha ek se’ (We all are one) and ‘Narmada Ghati kare Sawaal – Jeene ka haq, ya maut ka jaal? (Narmada Ghati seeks an answer – Right to Life or Death Noose?). Taking their banners, slogans and demands, the people marched ahead as a huge rally towards Badwani where a public meeting with representative of people’s organizations and prominent citizens of the town was held.

Former Chairperson of Badwani Municipality, Rajendra Mandloi said the decision to increase the dam height lacks both wisdom and sensitivity. He assured the people that the district of Badwani is fully in solidarity with their struggle.

Calling the recent move to grant environmental clearance to the SSP, as ‘Tuqlakhi decision’, senior leader Shri Nanaksingh Gandhi invited people to disown the same. The very fact that the well-studied Report of Dr. Devender Pandey Committee of Experts which has recommended no further reservoir filling has been set aside proves that the decision to push the dam is based purely on political machinations, he rued. Farmer’s leader Chandra Shekhar Yadav condemned the decision to cause further displacement and expressed his oneness with people’s unflinching resolve to fight for their constitutional rights.

The gathering was later addressed by senior Gandhian Pushpa Behan and youth Congress Vivek Sharma.

Medha Patkar, leading the people’s peaceful struggle in its 25 year said, “With just 30% of the canals having been built over 30 years, only 7% reservoir water being used, meager irrigation attained by submerging thousands of adivasi families and diverting water to industries, when Gujarat’s own farmers are unwilling to give land for the canals and when its own organizations have exposed this ‘monument of mismanagement’ ,if Gujarat is to celebrate the death-knell of the nature-based communities and wastage of thousands of crores, criticized even by the CAG, as ’50 years of its success’, it is a shame and fraud on the Constitution and a mockery of the Supreme Court. People will challenge and overturn such political decisions, she assured”.

After paying a brief homage to monument of adivasi dignity at Karanja in Badwani, the people walked further towards Anjad town place where one more public meeting would be held in the evening. They would then move towards village Chota Barda where crores of rupees corruption has been unearthed, which money could have been used by the State to purchase land for the adivasis. Two huge bells, Narmada Ghati ka Mrutyu Ghanta, symbolizing the death-noose that has encircled the lives of the 2 lakh people in the valley is travelling along with the Yatra.

Adivasis and farmers displaced by the Jobat dam and Indira Sagar, Omkareshwar canals also participated in huge numbers and were joined by activists from social groups and journalists. Nasreen Behan and Atikbhai from Ghar Bachao Ghar Banao Andolan, Mumbai also extended solid support to the people by their presence.

The resilient adivasis from the numerous villages in Badwani and 17 villages of Alirapjur district in M.P. and the Nandurbar district in Maharashtra that have faced the brunt of displacement and food insecurity since 1994 vowed together that they will not sacrifice the interest of the valley at the altar of
politics and asserted that the Government will have to open its eyes and ears and review the whole project, which is not just in the interest of the valley, but also in the best interest of the people of Gujarat and the whole nation. If the Government wants to test the patience of the people by such illegalities, it will have to pay cost, they warned.

The Jeevan Adhikar Yatra is to hold meetings and proceed via Anjad town place, village Chota Barda (Badwani) Semalda, (Manawar) Dharampuri & Dhamnod (Dhar) on foot, trucks and boats and reach Indore on the 13th morning, where the people would launch an indefinite sit-out before the Narmada Control Authority. The struggle and challenge continues ….


Medha Patkar

Saturday, April 10, 2010

70% of lower extremity amputations happen to people with diabetes: IDF

"Over one million lower extremity amputations are performed each year, 70% of which happen to people with diabetes. In India, almost 40,000 legs are amputated every year as a consequence of diabetes" said Professor Jean Claude Mbanya, President of International Diabetes Federation (IDF) in his message to the mid-term continuing medical education (CME) meeting on "High-risk diabetic foot" organized by the Association of Surgeons of India (ASI), UP Chapter and Indian Podiatry Association (IPA) in Kanpur on Sunday, 11 April 2010. Read more


Dr Mbanya's message was read out by Editor CNS Shobha Shukla in the Kanpur CME and handed out to the media. "The latest data from the International Diabetes Federation indicates that diabetes affects 285 million people around the world, and is increasingly on the rise. Of the many serious complications that can affect individuals with diabetes, it is the complications of the foot that take the greatest toll" further added Dr Mbanya in his message to this CME.

"Many of these amputations can be prevented. Better education and improved management of foot care can be performed at relatively low costs and have been shown to reduce the number of lower extremity amputations by 50-85%" said Dr Mbanya.

"It is time for the global diabetes community to engage in a concerted effort to increase awareness among carers at all levels of healthcare services worldwide. It is time to reduce the unnecessary suffering that foot complications can bring. With relatively low investment, it is possible to advance education and prevention that will result in lower rates of amputation, and better quality of life for people with diabetes. The time to act is now!" added Dr Mbanya, who is the Professor of Medicine and Endocrinology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon. Dr Mbanya is also the Director of the National Obesity Centre University of Yaounde, Cameroon and Chief of the Endocrinology and Metabolic Diseases Unit, Hospital Central in Yaoundé, Cameroon.

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