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obstetric care than physical maturity alone (almost 48 % of adolescent women have at least one major problem in accessing medical care) .it is found that girls with higher/secondary education married later than those have less or no education. So, the immaturity and lack of education of a young mother undermines her capacity for nurture. Not until the ‘demographic transition’ is relatively advanced, child survival adequately assured, and education valued, do families see the births of many children as a drain on resources rather than an asset. Until that time, women are under pressure to produce large numbers of children. Population and family planning policies from years have tried to reduce large family size, focusing on the social, economic and environmental costs to countries that lack the resources to ensure a good quality of life. Marriage can be said to have profound social and economic consequences for society as a whole. These consequences are reinforced by the fact that the children of young and illiterate mothers tend to face the same cycle of childhood deprivation and damage experienced by their mothers. The most important thing is that the law alone cannot control the social practice of child marriage. Women education and empowerment are the two best way to cure this practice.

Fact : According to UNICEF, 47% of all Indian marriages from 20002008 were child marriages.

THE CAMPAIGN SES has history of working on health related issues. The journey has begun with creating awareness regarding iodine deficiency disorder in 13 blocks of district Siddharthnagar. The programme also motivates people to buy & use iodized salt in their daily diet. Organization has worked on reproductive & child health (RCH programme , prevention of parents to child transmission of HIV , prevention on iron deficiency disorder, awareness programme on encephalitis, safe drinking water & sanitation, clinical based RCH services, action & research on livelihood & health. SES is working on various health issue which are targeting- women& child, youth (male & female both), school children as well as teachers. Sure start programme focuses on improvement of maternal & new born health status through effective community

action. The target area is Campierganj, Khajani & Sahjanwa block of district Gorakhpur. Another programme with support of Hope Initiative is focusing on raising awareness on hepatitis, encephalitis& sanitation in 50 schools of district Siddharthnagar. In 2010, Organization is also taken up 50 schools in district of Gorakhpur for awareness programme. With support of Mamta , organization is working on reproductive health of youth in Jogia block of district Siddharthnagar. Programme also focus on prevention of early marriage & early pregnancy. The intention of programme is to raise awareness of situation & stimulate action where it is necessary. SES has also organized media sensitization workshop at state capital Lucknow successfully. The objective of workshop was to undertake media advocacy for meaningful participation of media houses to generate public opinion on appropriate age at marriage & delayed pregnancy. SES strongly believes that person having health, has hope & he who has hope, has everything.

RSBY GETS GOING… RSBY became operational from 1st April 2008. Till date, 26 out of 29 State Governments have initiated steps to implement the scheme. Smart cards have also started rolling out in 22 of them. By July this year , more than 17 million cards, providing health insurance cover to around 70 million persons, have already been issued. Around 700,000 persons have already availed of free hospitalization facility.Lately, the scheme s been taken to extend the scheme to categories beyond BPL like building and other construction workers. The Finance Minister has also said that extension of RSBY benefits to such MNREGA beneficiaries as have worked for 15 days or more during the previous year. The Railway Minister has announced similar benefits for railway coolies and vendors. The World Bank has called it “one of the most promising efforts in India”. It has commented that “the program is now internationally recognized for its innovative approach to harnessing information technology to reach the poor.”

ECHO SES TEAM: DR. B. C. SRIVASTAVA , DR. AJAY KUMAR SRIVASTAVA & PRABHAKAR PRATAP SINGH REGIONAL OFFICE: D-41, GROUND FLOOR, SECTOR K, ALIGANJ, LUCKNOW, UTTAR PRADESH ,INDIA PHONE: 0522-4025846 Website: http:// sesindia.org

ECHO

SES

Volume 1, Issue 4

A Quarterly Newsletter AUGUST 2010- OCTOBER 2010 FROM EDITOR`S DESK

Dear Reader,

If you have to make choice of breaking news from two - “Health Insurance firms' stopped cashless facility of top hospitals” or “5000 children below five years die every day in India”, what would be your choice?? First one was breaking news on almost all news channels in first week of July, not because it affect common people but business of health sector .The mushrooming PR culture in India has changed priorities of everyone .Death of 5000 children is considered as part of “Chalta hai” culture & wouldn't matter other than statisticians or armchair policymakers. This chalta hai culture has made health infrastructure and the health scenario in India very bleak. We are getting used to it- if Doctor doesn't go to hospital; there is shortage of MESSAGE FROM SECRETARY medicines or unhygienic condition in hospitals. The Reality of gigantic economy of India is 17 lakh children in the country die annually before reaching their first birthday. Our country accounts for one fifth of global disease burden: 23 % of child death, 20 % of maternal deaths, 68 % of leprosy cases and 14 % of HIV cases. Out of 2 million deaths from TB, 421000 are in India. There is shortage of 20846 sub centers, 4477 PHC & 2337 CHC. Only 13 % of rural residents have access to PHC, 33 to sub centers & 9.6 % to hospitals. The supply demand of human resource of health has made situation pathetic. There are average vacancies of 18 % doctors, 15 % nurses & 30 % paramedics. The number of physician per 1000 population of world is 1.5 while of india-0.6. Against world average of 3.98 hospital beds/1000 population. In India, it is 0.9. The average spending on public healthcare has been only about 0.9 % of GDP( 0.29% by state & 0.61% by states). Making matters worse are the sky high prices of various medical tests from the basic X-rays, blood tests, to various other complicated tests and the ever increasing price of drugs. An average Indian cannot afford such expensive tests and medicines, let aside the operational costs, and other expenditures, therefore poor people left with no other option but to go to local healers, who sometimes act as life takers rather than givers. People who can afford it, and are lucky enough to get into a good hospital, pay through their nose and end up losing all their savings on treating themselves or their family members/relatives. However, the rich has option of private health care system and it will translate into more options for them. But it will be cost effective or not if still a question! Government needs to increase the number of MBBS seats from a paltry 1398 to a more substantial number so that it is able to achieve more qualified doctors. Also best education opportunities for MBBS students' needs to be ensured by our Government. It should reduce the price of medical tests and medicines, without compromising on quality. They should initiate tax reduction or better still tax waivers for the drugs and other medical expenditures. If the Government denies it should learn something from Mr. Devi Shetty of Narayana Hrudayalaya(A world class hospitals offering their its services at affordable MESSAGE FROM SECRETARY rates). By his effort, an Insurance scheme “Yashasvini” world's cheapest insurance has also been started. It is a comprehensive health insurance scheme at just Rs.5/- per month premium. This brings us to the debate as to why can't the Government provide such cheap services and a proper medical insurance for the whole population of India? The need of hour is to rise above grandiose plan & policies. Government has to increase number of hospitals in rural as well as urban areas, reduce price of medical equipment, test etc. They need to bring health security policy & bring in an affordable health insurance scheme for all citizens. Gautama Buddha said - : Every human being is author of his own health or disease.” But what if it lies in hands of other. Life of an individual is most valuable asset. If India truly wants to achieve status of developed nation, it needs to make its priorities right along with HRH. With Regards,

Sandeep Srivastava

Fact : Over $2.7 trillion were spent on health care globally. Source: Economic Survey Of India -2009-10, True Health

Adulteration of Food: A Deep Rooted Social Evil In 1998, Delhi was affected by adulteration of mustard oil that affected the health of thousands and killed many. After one decade of the unfortunate incident ,The adulteration has reached to its pinnacle- everyday we hear adulteration news .Everyone work hard day and night for two time nutritive food but we are not sure of what we eat, than what are we working for? We may be eating a urea, dye, sawdust, soap stone, Aluminum foil. Adulteration of food causes several heath problems. Some of the health hazards include

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stomach ache, body ache, anemia, abortion, paralysis, and increase in the incidence of tumors, pathological lesions in vital organs, abnormalities of skin and eyes. Hence food adulteration should be given great importance due to its effect in the health significance of the public. Someone said that - to protect himself, consumer should avoid buying loose edible items from the markets, and go for packed items on which proper informative labels are displayed, which includes the date of manufacture and expiry as well. They should stress on products with F.P.O., I.S.I. or AGMARK certifications. Though, The middle-class or the upper class can save themselves but what about the people at bottom of the society,-the laborers, the poor class who cannot afford to buy expensive packed items, who have to purchase only in small loose quantities daily due to prevalent hand to mouth economy. T h o u g h , We d o h a v e t h e standards for food articles under Prevention of Food Adulteration Act, 1954. It looks enforcing authorities or the said departments act only when mass death occurs do our authorities act and swing into action and start haphazardly banning items and articles and cause inconveniences to the public. But all the legislation cannot fully solve the problem of food contamination and adulterations unless the consumer himself becomes conscious of the hazards to their health. Consumers need to teach the provisions of the Food Laws and Regulations and how they are protected under the said Law. Until

FEEDBACK

people are aware of their rights to demand pure and nutritive food and start consumer movements, they have to bear the brunt and suffer quietly .they need to take us traders or manufacturers by way of filling of PIL (Public I n t e r e s t Litigation) in the c o u r t s o r dragging them to consumer courts, will such serious social evils of food adulterations which has deep roots in our society can be uprooted and eradicated. At least, it can abate to a certain extent or else our future generations are certainly going to pay the price for our careless, negligent and easygoing approach . OBESITY: A MENACE

In a country where the Global Hunger Index shows that nearly half of all children are malnourished, many of India's well-off citizens are now seeking treatment for obesity. According to National Family Health Survey indicates that more than 20 percent of urban Indians are overweight or obese. If current trend persists, obesity along with climate change & water scarcity will be one of the biggest problem for India. There is something real about obesity – linked disease and their prevalence in India. There are already 37 million diabetic people in India (WHO) and 30 t0 40 percent of all diabetes have been noticed to have chronic kidney disease. 60 percent of world heart patient are in India. Obesity & diabetes are also linked to rural to urban migration. This is seen as change in diet & behavior .Rising Income and urbanization lead to substitution of servants or

appliances for physical work. Employed people take desk job, While children do not have time to play or exercise in fierce academic competition. In the age of globalization, people like to buy a greasy lunch at restaurant rather than of having healthy food at home. Though, India has strong vegetarianism inclination, only 150 gm of intake is of vegetable & fruits in their diet. It is found that many of them are unaware about fat things. Though, there is technique of obesity surgery but only rich can afford that. On Preventive measure, nutritional education should be a compulsory part in schools & for parents, development of park & play should increase. encourage healthier food and make some change in agriculture & food price policy. Yo u n g p e o p l e c o n t r i b u t e significantly to population of India. If it is not controlled today, India will lose advantage of demographic dividend. Obesity should be tackle as public health issue rather than of personal problem. Fact : The states which ranks the rate of obesity are: Punjab - 30.3 % Males , 37.5 % Females, Kerala 24.3 % Males, 34 % Females, Goa 20.8 % Males, 27 % Females

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WHO se Line Is It Anyway? A large number of dengue cases in the country could be going unreported. Reason being that they do not meet the criteria for various stages of dengue fever

Dear sir, The quality and content of your newsletter are outstanding and IT helps readers to be in touch with social issues in the country. The design and front cover of the newsletter are very attractive and are at par with any international magazine. Thanks, Manish Kohli, Agra, send your feedback at feedback@sesindia.org (Mention Subject: ECHO SES)

fixed by the World Health Organisation (WHO). Notably, figures from the National Vector Borne Diseases Control Programme website show that over 2,000 dengue cases were reported in the country between January and May this year. By using WHO criteria of dengue haemorrhagic fever (DHF) on Indian patients, all severe cases of dengue cannot be correctly classified. A new definition of DHF that considers geographic and age-related variations in laboratory and clinical parameters is urgently required.’’ The study included 145 clinically suspected cases of dengue infection of all ages. Dengue was confirmed by serological methods which involve examining blood samples under a microscope. Clinical and laboratory parameters were compared between dengue patients with bleeding and those without bleeding. The WHO criteria were applied to classify dengue positive patients into dengue fever (DF), Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Out of 50 serologically positive cases enrolled in the study, only three met the WHO criteria for DHF and one met the criteria for DSS. However, 42% cases had one or more bleeding manifestations. Earlier, allegation was made that Swine Flu has been intentionally bioengineered in laboratories. Since the WHO changed its definition of a pandemic in order to falsely create a pandemic, the WHO could force everyone in the 194 countries who comprise it to forcibly take vaccinations, impose quarantines and restrict travel. All was in interest of large pharmaceutical companies. The 'global war on terror' has repeatedly proven to be nothing more than one major fraud that has resulted in the genocide of Iraqis and the killings of thousands of U.S. armed forces. In this case, a pandemic is being used to justify a global public health emergency

Award For NRHM The Vice President of India Shri M. Hamid Ansari presented the "National Rural H e a l t h Mission ( N R H M ) awards to the States for their success in implementati on of the Mission at a function to commemorate the 'Five Years of NRHM' organized by the M/o Health & Family Welfare At the function, the vice president of India M Hamid Ansari presented the 'National Rural Health Mission (NRHM) awards' to the States for their successful implementation of the mission. Assam has won the best performing state award for implementation of National Rural

Health Mission among North Eastern States. Rajasthan was adjudged the best performing state among the High Focus States while Tamil Nadu claimed the award among other states category. M i z o r a m , M a d h y a Pradesh and Haryana were placed second i n t h e i r respective categories. The main aim of the mission is to establishes a functional, community owned, and decentralised health delivery system with inter-sectoral convergence so that parallel action on a wide range of socio-economic determinants like gender, social e q u a l i t y, w a t e r s a n i t a t i o n , education etc. is undertaken. It thus marks the shift from a program/scheme mode to a health system mode.

Fact : UP has been ranked the lowest among all states with shortfall of overall 5800 rural health care centre.

on humanitarian grounds. In this case, the 'pandemic' was illegally manufactured .The question arises how relevant & healthy is World Health Organisation today? Source: Times Of India. American Chronicle

A CURSE THAT STILL PREVAILING IN INDIA

Though, marriage is regarded as a moment of celebration and a milestone in adult life. Sadly, the practice of early marriage gives

no such cause for celebration. In case of India, there are eight states and ten states with more than 50 % & 25 % percentage of girls married by 18 year of age respectively. It means that a girl or boy’s childhood is cut short and their fundamental rights are compromised. The risks of early pregnancy and childbirth are well known, it also increase risk of dying, increased risk of premature labour, complications during delivery, low Pregnancyrelated deaths are the leading cause of mortality for 15-19 yearold girls (married and unmarried).Mothers in this age group face a 20 to 200 per cent greater chance of dying in pregnancy than women aged 20 to 24. Those under age 15 are five times as likely to die as women in their twenties. Part of this heavy toll has more to do with those who are poor in socio-economic status and lack of ante-natal and

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VOLUME I ISSUE IV