Wednesday, September 26, 2012

फिर एक बार पंजाब रास्ता दिखा सकता है


राजगोपाल पी वी 
           
पंजाब को नजदीक से समझने का यह पहला अवसर था। दलित दासता विरोधी आंदोलन के कार्यकर्ताओं के साथ दलित बस्तियों से गुजरने का यह अनुभव बहुत दिनों तक मन में बना रहेगा। हरित क्रांति की चर्चा में पंजाब के दलितों का मुद्दा दब गया है। दलित आंदोलन के बारे में आंध्रप्रदेश, महाराष्ट्र और उत्तर प्रदेश से निरंतर सुनते हैं, लेकिन पंजाब से कम सुनते हैं। यह मान्यता बनी हुई है कि पंजाब खुशहाल है और यहां सब लोग किसान है तथा हरित क्रांति का लाभ सबको मिला। जब पंजाब यात्रा करेंगे, तभी सच्चाई की जानकारी होगी। निरंतर सुनने वाली कहानियों से भिन्न है असलियत। दलित समाज बिल्कुल भूमिहीन है और कई जगहों पर बंधुआ मजदूर की स्थिति में है, चूंकि हरित क्रांति करने वाले किसानों को मजदूरों की जरूरत है और दलित मजदूरों को पैसे की जरूरत है। इसलिए बहुत सारे मजदूर कर्ज के दबाव में बंधुआ बनकर किसानों के साथ लगे हुए हैं। कहीं-कहीं पूरा परिवार बंधुआ बनकर किसान के साथ लगे हुए हैं।
 बंधुआ मुक्ति तथा पुनर्वास के कानून के बावजूद पंजाब सरकार इस बात को स्वीकारना नहीं चाहेगी कि उनके प्रांत में कोई बंधुआ मजदूर है। गुलामी प्रथा को समाप्त करने के लिए लाए गए कानून पर्याप्त नहीं हैं, उसके लिए एक  मानसिकता चाहिए। जिस देश को गुलामी पसंद है, उस देश से गुलामी प्रथा या बंधुआ मजदूरी समाप्त करना कठिन है। कुछ हद तक भारत देश अपनी कमजोरियों को छिपाने में ज्यादा समय खर्च कर रहे हैं, न कि सुधारने में। हम सबको पता है कि देश भर में दलित समाज के साथ बराबरी का व्यवहार नहीं हुआ है। हमें यह भी पता है कि भारत में आज भी बंधुआ मजदूरी की प्रथा कई प्रांतों में है। यहां दलितों के लिए उपलब्ध जमीन, बड़ों ने कब्जा कर लिया है। भूमि सुधार की हर प्रक्रिया को नकार दिया गया है, यहां बंधुआ मजदूरी को छिपाने की कोशिश की जा रही हैं। चूंकि हरित क्रांति के कारण जमीन का दाम काफी ऊंचाई पर है। इसलिए हरेक आदमी जमीन पकड़ना चाहता है, जिसके पास जमीन है। जिन मकानों में या  कालोनियों में दलित लोग रह रहे हैं, वह भी उनका नहीं है। इसलिए बैंक से सहयोग लेना, किसी को जमानत पर छुड़ाना, इन गरीबों के बस की बात नहीं है। 
रासायनिक पदार्थ के अति इस्तेमाल के कारण जमीन के साथ-साथ पानी का स्त्रोत भी जहरीला हो चुका है। खाने वाले हर पदार्थ में जहर घुला हुआ है। पैसे की दौड़ में अपने आपको खत्म करने की तैयारी हरित क्रांति ने ढूढ़ लिया है। जैसे-जैसे पैसे की दौड़ तेज होती जाएगी, वैसे-वैसे शोषण की प्रक्रिया भी तेज होगी। शोषण सिर्फ धरती का ही नहीं, इंसान का भी हो रहा है।
भूमि सुधार जैसे महत्वपूर्ण काम से छुटकारा पाने के लिए सरकार ने गरीबी रेखा से नीचे रहने वाले लोगों के लिए कुछ योजनाएं बना ली है। सस्ते दाम में राशन, विधवा पेंशन, विकलांग पेंशन, शादी और मरणी में विशेष सहायता जैसे अनगिनत योजनाएं सरकार ने बना ली है। दुर्भाग्यवश इन योजनाओं पर भी बड़े लोगों की नजर है। इसलिए बहुत सारे लोग अपने आपको गरीबी रेखा में डालना चाहते हैं, ताकि उन सुविधाओं को भी हासिल कर सकें। चूंकि सरकारी तंत्र में अधिक लोग निष्क्रिय और भ्रष्ट हैं। इसलिए राशन हो या पेंशन प्राप्त करना अत्यधिक कठिन है। आवेदन लेकर दफ्तरों में घूमने वालों की संख्या कम नहीं है। समस्याओं के जाल में गरीब लोग इस प्रकार फंसे हुए हैं कि उन्हें यह विश्वास नहीं हो पा रहा है कि कभी इन समस्याओं से मुक्ति होगी। पिछले कई वर्षों से दलित दासता विरोधी आंदोलन जैसे संगठन दलित समाज के बीच सक्रिय हैं, जिनके परिणाम स्वरूप कई बंधुआ मजदूरों की मुक्ति हुई, मजदूरी दर में वृद्धि हुई, कहीं-कहीं सरकारी कर्मचारी गरीबों के हित में काम करने को बाध्य हुए और कहीं पंचायत की जमीन पर मकान बनाने का अधिकार मिला।
 जनसंख्या की दृष्टि से 30 प्रतिशत होने के बावजूद उनके पास पंजाब में डेढ़ फीसदी से अधिक जमीन नहीं है। यह जानते हुए कि यह सरासर अन्याय है, इस व्यवस्था को बनाए हुए है। ये अस्वाभाविक है। समतामूलक समाज की रचना एक कोरे कल्पना के रूप में एक किनारे पड़ी हुई है। इसमें धूल लगने लगे हैं। धीरे-धीरे कूड़ा-कचड़ा बनने की गुंजाइश है। 
पंजाब की यात्रा के दौरान ग्रामीणों ने बार-बार इस बात को कहा कि हमसे सब कार्ड वापस ले लीजिए हमें मनरेगा कार्ड, राशन कार्ड, बी.पी.एल. कार्ड से मतलब नहीं है, हमें सिर्फ एक एकड़ जमीन दे दीजिए। संपूर्ण परिवार के श्रम और जमीन को मिलाकर हम अपने जीवन को खुशहाल बना लेंगे। लोगों में जो राजनीतिक चेतना आई है, उसके परिणाम स्वरूप लोग अपने वोट को जमीन के एजेंण्डा में बदलना चाहते हैं। ग्रामीणों ने कहा कि अब तक अपना वोट एक बोतल शराब और चंद रुपयों में बेच देते थे, अब हम लोग एक एकड़ जमीन के बदले ही अपना वोट देंगे।
 स्वतंत्र भारत में एक मात्र समानता मिली है, वह है वोट। इसे अपने जीवन बदलने की दृष्टि से अब तक इस्तेमाल नहीं किया, अब करेंगे। एक नया नारा गांव-गांव में सुनाई पड़ रहा है। ‘पहले जमीन पीछे वोट, नहीं जमीन तो नहीं वोट’। अगर इस राजनीतिक चेतना का सही इस्तेमाल हुआ तो भूमि सुधार का एजेण्डा भारतीय पटल पर आ सकता है।
दलित और वंचितों की मुक्ति के साथ-साथ पंजाब के किसानों के बारे में बात करना जरूरी है। हो सकता है कि भूमि वितरण के मुद्दे को लेकर हम किसान के साथ नहीं है। कई अन्य मुद्दे हैं जिसमें हम किसान के साथ हैं। हरित क्रांति के नाम पर या खेती को उद्योग बनाने के दौर में किसान कर्जदार हो गए हैं। पूरे देश को खिलाने वाले किसान आत्महत्या करने को बाध्य हो गए हैं। उपलब्ध आंकड़ों के अनुसार छह हजार से अधिक किसान कर्ज से मुक्ति पाने के लिए आत्महत्या कर चुके हैं। अपने उत्पादन का मूल्य स्वयं निर्धारित न कर पाने के कारण किसानों की यह दुर्गति हुई है। दुर्भाग्यवश हर किसान आंदोलन मूल्य वृद्धि पर बात करता है, लेकिन मूल्य निर्धारण की प्रक्रिया पर बात नहीं करता है। 
हरित क्रांति के दौर में तमाम जमीन, पानी, भोजन जहरीला हो गया। उसका परिणाम किसान भुगत रहे हैं। भूमि अधिग्रहण की विषमता मुख्य रूप से किसान ही झेल रहे हैं। इस विषमता से लड़ने के लिए किसान और मजदूर का एक होना जरूरी है। इसलिए इस मौके पर किसान आंदोलन में लगे साथियों को यह समझना और समझाना जरूरी है कि मजदूरों को जल्द से जल्द किसान बनाने से जमीन बचाने की लड़ाई में और ज्यादा से ज्यादा लोग जुड़ेंगे। जैसे कम्पनी के लोग सभी बड़े लोगों को अपना शेयर होल्डर बनाकर यह महसूस कराते हें कि मुनाफे का हिस्सा तुम्हें भी मिलेगा। उसी प्रकार मजदूरों को खेती में शेयर होल्डर बनाने का समय आ गया है। जहां-जहां मजदूर और किसानों ने मिलकर जमीन बचाने की लड़ाई लड़ी, वहां-वहां सफलता मिली है।
पंजाब के हर गांव में जातीय आधार पर गुरूद्वारा या धर्मशाला बना हुआ है।
 अपने-अपने अस्तित्व की तलाश में लोग इकट्ठे हो रहे हैं, जातीय आधार पर इससे संगठनात्मक शक्ति तो बढ़ी है और अपने सम्मान का एजेण्डा मजबूत हुआ है। अब समय आ गया है कि संगठनात्मक शक्ति के आधार पर आर्थिक व्यवस्था पर चर्चा शुरू करें। विनोबा भावे ने यह कोशिश की कि जमीन का मसला समाज के साथ मिल बैठकर हल करें, उसमें सफलता भी मिली, लेकिन सरकार के सहयोग के अभाव में यह प्रयोग समाप्त हो गया। प्रयोग को समाप्त करने में कई ताकतों ने सरकार का साथ दिया। क्योंकि जमीन पर ग्राम समाज का अधिकार जमीन के बाजारीकरण को रोक रहा था। इसलिए आज भी सरकार के सक्रिय सहयोग की भूमिका के बिना समस्या का हल करना संभव नहीं है। 
वर्तमान प्रधानमंत्री तथा योजना आयोग के उपाध्यक्ष दोनों से पंजाब को उम्मीद है, इसलिए उनकी जिम्मेदारी बनती है कि इस प्रांत से गरीबी उन्मूलन का कार्य प्रारंभ करें। इस बात को भूलना नहीं है कि 2015 तक गरीबी मिटाने का वायदा हमने दुनिया से की है। कई बार कई वायदे झूठे साबित हुए हैं। सत्यमेव जयते का नारा लगाने वाला भारत इस बार वायदा झूठा होने से बचे। गरीबी उन्मूलन के लिए गरीब लोग संगठित और तैयार उसी प्रकार बैठे हैं जैसे मरीज आपरेशन टेबल पर तैयार लेटा हैं। अब समाज के बड़े लोगों को, सामाजिक संगठनों को तथा देश को चलाने वाले पार्टियों को यह करके दिखाना है कि ईमानदार संयुक्त प्रयास से भी मरीज बच भी सकते हैं और स्वस्थ हो सकते हैं। 

Monday, September 24, 2012

Out of BPL scheme of things

Sangita Jha/New Delhi

Now, those do not belong to BPL category can also avail many welfare schemes. The govt's flagship rural employment scheme is also one of them   


For long Centre and states have been at the loggerheads over list of people under the below poverty line (BPL). While Centre accuses states of inflating their BPL lists, the latter also blame the former of underestimating the number of the poor. But there appears to be an opening of a window beyond the BPL confines for people to claim benefits under various social sector schemes.
Incidentally, the move to create a window for the non-BPL families to get benefits from the social sector schemes has come for different reason. Gujarat and Punjab along with few districts in Uttar Pradesh exhausted their existing BPL lists under the Indira Awas Yojna (IAY).
So, the Centre was faced with a situation where two major states had no on to cater to under the IAY. Therefore, a sub-plan of the Planning Commission recommended the Ministry of rural development to explore ways to open a window for non-BPL families under the IAY. This can address the issues of the genuine poor, which many experts claim number about 25 per cent across the country, who end up omitted under the BPL list due to various reasons to get the benefits of the welfare schemes. In fact to address the issue of the non-poor getting the benefits of the scheme, the Centre is proposing a cap on banking loan up to Rs 2 lakh only, so that the character of the IAY does not get affected.
Currently, the BPL list is relevant for few of the Central schemes like the Food subsidy, IAY, Old Age pension. The biggest flagship scheme in the form of Mahatma Gandhi National Rural Employment Guarantee Scheme (MNREGS) is universal. There is no bar on people to access MNREGS to get employment.
Similarly, there is a movement being carried out by a section of the civil society to make the Old Age Pension (OAP) universal. The overriding idea is that better off people will not come to OAP to get Rs 1,000 a month. Even the idea, which the Centre is working on is to make the OAP universal and free it from the confines of the BPL list.
So, in the case of the IAY the Centre is working on create a space for 20 per cent of the benefits to go to the non-BPL families. "This will not only help the government to address the issue of the genuine people getting overlooked from the welfare schemes just for the reason that they are not included in the BPL list for various reasons but also revive the IAY overall. The fact is that most of the states have not been able to spend the Central allocation under IAY. The need of the hour is to revive the scheme and also give a boost to the rural housing, which in itself will set in motion a chain of rural economic activities," said a senior official of the ministry of rural development.
The states have also long been complaining that Rs 45,000 being given under the IAY has made the scheme unattractive, as no houses can be built with such a paltry sum of amount. Therefore, the Centre, while acceding to the demands of the state government, has almost doubled the allocation under the IAY. So, Centre hiked allocation of grants for construction of houses under the IAY from Rs 45,000 to Rs 75,000 per dwelling unit. For hilly and Naxal affected areas, the grants for constructing houses under the scheme will go up from Rs 48,500 crore to Rs 80,000.
Giving details, Union minister of rural development Jairam Ramesh said,: "The outlay for IAY in 2012-2013 was Rs 11000 crore and target was 32 lakh houses. Now, Rs 45000 has become Rs 75000. But for hilly areas and Naxal affected areas Rs 48500 will go upto Rs 80000." The IAY, which has been in operation since 1985-1986, would get the hiked allocation effective from April 1, 2013. Further, Mr Ramesh said, beneficiaries will get additional Rs 9000 for constructing toilets. Also, the government has launched a new scheme for providing rural house sites for landless people. In this, the government will provide Rs 10000 for a site of 100 to 250 sq meters, which would be over and above Rs 75000 for the IAY houses.
The minister was candid enough to admit that the IAY is the worst implemented programme of the government. This is not for any reason, as huge unspent balances are lying with various state governments, including Bihar, Gujarat, Karnataka, West Bengal, Odisha, Assam and Uttar Pradesh.
As for the facts, Bihar had an unspent balance of almost Rs 2500 crore, Gujarat of Rs 825 crore, Karnataka  of 581 crore, West Bengal of Rs 550 crore, Odisha of Rs 427 crore, Assam of Rs 420 crore and UP of Rs 200 crore. Clearly, the scheme is not being run as it should have been.
In fact, many civil society activists are arguing the Centre to go beyond the confines of the BPL list and seek universalizing the flagship schemes. Even in the case of Food Security, the ministry of food and consumer affairs has moved a proposal to allow 33 per cent compulsory exclusion, so that the rest 63 per cent are entitled for subsidies food. This proposal seeks to do away with categories of Priority (BPL) households and General households. Clearly, there is an effort going on to make the schemes universal.
Incidentally, the move to make schemes become universal in some limited ways is taking place for another reason, that of the ongoing Socio-Economic and Caste Census (SECC) being nowhere completion, with the Centre becoming skeptical of its completion. The SECC, which will generate data on the basis of which the states will be able to draw their respective BPL lists, has missed several deadlines and the ministry of rural development's report suggest that it would not be completed even this year.
So, there is clear rationale for the government to go beyond the BPL restricted approach. In fact, if officials are to be believed very soon only food subsidy would be linked with the BPL list, with the rest of the scheme becoming universal with conditions to ensure that the better off people do not take the benefits intended for the poor.

Saturday, September 22, 2012

'We tapped on women's commitment to their family to bring change in society'


kulandei Francis won this year's Magsaysay Award for his contribution to the society by way of empowering women in rural Tamil Nadu. He launched an Integrated Village Development Project (IVDP), which helps displaced and impoverished people develop a means of livelihood. Excerpts of an interview with him. 

Tell us more about your project — Integrated Village Development Project — and how did it help women improve their lives. 
The first step I initiated was IVDP with the aim to uplift the rural women from their lives of poverty and misery. The women were crushed by starvation, mass death of livestock, debt which resulted to loss of land and other property, and violence of moneylenders. The women lived a life which constantly denied them of their dignity and eroded their self-confidence. They were left in a hopeless and desperate situation. They had no choice but to migrate with their children who had no other way to survive.

What are the focus areas of your project? 
The IVDP's first aim was to solve the water shortage problem of the village. It brought the villagers together to create check dams which collected water for use in irrigation, agriculture and livestock. Up to 331 of the dams were built over 22 years, significantly increasing the amount of livestock and agriculture production. The villagers were thrilled and elated as a result of the dependable, replenishing water source at their disposal. It is a source of wealth available for the economic well -being of the present and future generations. A deprived village was transformed into a productive community of cultivators.

How did you try to improve the financial condition of rural women?
Women were exploited by the private money lenders and their agents. Peasants availed loans from moneylenders for agricultural work and housing.
The farmers usually mortgage their land and other property. On non-payment of loans and accumulated interests, the money lenders took away  the land, house, ornaments, and cattle of the indebted villager.
The IVDP created Self-Help Groups (SHGs) composed of women to help them and their families obtain the money necessary for cultivation, housing or to start any income generation activity. IVDP had initially created SHG for men, but it encountered numerous difficulties because the men were "disinclined to saving and unwilling to follow the procedures. It was a futile effort to make the men commit to the discipline of the group. Rules were dishonored at will, hence their credit worthiness was an issue with the banks.
We understood that women were very sincere, committed, and they were the only one in the family who had a genuine and indisputable concern for the upward improvement of the family.
Through the SHGs, women got access to loans which helped them improve their lives. They were able to start income generating activities such as cultivation, rearing live stocks, petty shop, canteen, selling of vegetables, fruits, opening a grocery shop, handicrafts, etc.
Loan recovery was 99.9 percent because the money borrowed from SHGs were used to improve their income generating activities. Members are given the opportunity for continuous training and capacity building on maintaining financial accounts. Every 250 SHGs were formed into a Cluster Level Federation and organize an office to manage and train the SHGs. To date, there are 8,231 SHGs with 150,000 members across three districts in Tamil Nadu state.
How was the response from the targeted community?
As soon as the members start earning and contributing to the family, their self-esteem also increases. The women have started making major contributions in the family such as purchasing land, livestock, construction and repair of their dwellings, and acquisition of household articles needed by the family.
The success of the SHGs have shown that the poor are capable of managing their finances effectively and reliable because they are empowered to take care of their own money, he said during the lecture. We want to empower the women so that they can be active in decision-making at home and in the village.
Through the economic and educational empowerment programs of IVDP, women are able to improve their social-cultural status in the rural community.

Saturday, September 15, 2012

Care home delivered


M Suchitra/ Kochi


The palliative movement, Neighbourhood Network in Palliative Care, and started in 2001, has proved a tremendous success in Kerala's primary healthcare sector


unique home-based palliative and chronic care movement is sweeping through Kerala. Thousands of trained citizens are volunteering two hours a week to take care of the chronically ill in villages and cities. Funding for this community-based scheme that has won WHO recognition comes in cash and kind from citizens, including schoolchildren, bus drivers, labourers and others.
The windowless room is dark and dingy, and smells of urine and medicines. For a few moments nothing is discernible. Then, the frail skinny form of 35-year-old Velayudhan lying on a cot becomes faintly visible. Velayudhan is paralysed from the waist down after a fall from a coconut tree five years ago. His twig-like arms and legs stick out from under the sheet covering him. There are sores all over his body. He is all alone in his hut, and looks depressed and gloomy.
"How do you feel today," asks Nishita, a trained nurse working with the Koilandy Palliative Care Society in Kerala's Kozhikode district, with a gentle smile. She and another volunteer, Anitha, start emptying the bedpan, dressing the sores, changing the condom catheter that allows Velayudhan to pass urine, checking the medicines on a nearby table, and dusting the bed -- all the while chatting with him affectionately.
"I can't even imagine what would have happened to me without these volunteers," says Velayudhan in a weak voice. "I would have died long ago." He says the volunteers even help feed him when his wife, a domestic helper, is away on work. According to Nishita, Velayudhan suffered from acute depression and even displayed suicidal tendencies. He recovered only after prolonged counselling by the volunteers.
The palliative movement, called the Neighbourhood Network in Palliative Care (NNPC), and started in 2001, has proved a tremendous success in Kerala's primary healthcare sector. It is a silent social revolution that's spreading fast from village to village, city to city. Participants include schoolchildren, senior citizens, labourers, doctors, farmers, housewives, and even the police.
Under this new initiative, thousands of trained volunteers from different backgrounds spend at least two hours a week on homecare visits, running out-patient clinics, organising family help, and raising funds. Besides dressing wounds and sores, they sit with patients and listen to their problems and fears. They also listen to the concerns of family members and train them in simple nursing tasks like catheterisation. All NNPC volunteer groups are supported by trained doctors and nurses.
The community-based palliative movement was an outcome of the realisation that patients with chronic and incurable diseases need long-term psychological, social and emotional attention alongside medical and nursing care. Each district is estimated to have over 20,000 bedridden patients. The existing hospital-centred services are designed mainly to look after people with acute illnesses; medical institutions alone cannot take up the responsibility of looking after chronically ill patients for very long. Moreover, even the limited services available are not accessible to most, especially the poor.
"The NNPC is an attempt to develop a sustainable, community-led service focusing on the long-term home-based total care of patients with chronic and incurable diseases," says Dr K Sureshkumar, director of the Kozhikode-based Institute of Palliative Medicine (IPM), which spearheads the movement. "The NNPC is a volunteer-driven movement that tries to empower local communities to take care of their own chronically ill patients." Doctors play only a secondary role in the movement.
Born in the early-1990s, the palliative care movement was clinic-based and served only terminally ill cancer patients until it took a major turn, in 1998, with the establishment of a palliative society at Nilambur, in Malappuram district. K M Basheer, a farmer with formal education only up to Class X, and two years experience as a volunteer in another clinic, took up the leadership. Basheer was perhaps the first non-medical person in the world to head a pain and palliative care unit.
He, along with a few friends, went around the locality identifying terminally ill patients. "There were many chronically ill people with all sorts of diseases, apart from cancer," he says. "Most of them were very poor. Prolonged treatment and huge medical bills had broken their families. We had to address the social and financial needs of the families too." Basheer and his team approached as many people as possible for assistance. Everybody was willing to help in one way or another. In just one year he had 60 trained volunteers; the following years he had many more.
With the success of the Nilambur initiative other units were opened in the district; within two years they had achieved 70% home-based palliative care.
Slowly, the movement spread to the neighbouring districts of Kozhikode and Wayanad, and further. Thousands of people volunteered their services. Following the massive community support, a network of palliative societies (the NNPC) was formally launched in 2001.
"It was a spontaneous evolution, not planned by any single individual," says Dr Mathews Numpeli, programme executive of the NNPC. "Many volunteers have much better administrative and organisational skills than the average healthcare professional."
The NNPC has now grown into a huge network of 150 palliative clinics, supported by 10,000 active trained volunteers, 85 doctors and 270 nurses who look after around 25,000 patients at any point of time. Malappuram district alone has 29 palliative care societies, 25 of which have their own clinics with paid part-time doctors, auxiliary nurses and their own homecare vehicles.
Each unit serves four to five village panchayats. Though, initially, the programme focused on patients with advanced cancer, it now includes geriatric problems, degenerative neurological disorders, chronic infectious diseases and chronic psychiatric illnesses.
Thanks to the initiative, the districts of Malappuram, Kozhikode and Wayanad all enjoy around 70% coverage in palliative care; palliative care coverage in Kerala is 20%, in the rest of the country it is just 1-2%, says Dr Anil Kumar Paleri, honorary secretary of the India Association of Palliative Care. He adds: "Under the watchful eyes of the community, the quality of palliative care has also improved." The NNPC's main problem is non-availability of full-time doctors trained in palliative care.
Since most patients are extremely poor, volunteers often have to financially support their families and provide rice, provisions, clothes, books and fees for schoolchildren. "We divide the patients into very poor, poor, middle class and well-to-do groups," says V M Ramla, who has been working as a volunteer in Malappuram district for 15 years. "The first two groups are given all sorts of support. The other two groups are usually provided only medicines, nursing care and emotional support." All services -- including doctors' consultations and medicines like morphine -- are free of cost for all sections of people.

Easy funding
Funding has never been a problem for the NNPC. Most funds come from the community itself through small donations. These may be Re 1 a day, or even less. Tens of thousands of ordinary people -- labourers, headload workers, autorickshaw drivers, government employees, teachers, even schoolchildren -- make small donations to keep the movement going. In Nilambur, for example, the four-person crew of each bus that enters the bus stand donates 50 paise a day. Each day, roughly Rs 500 is collected from this source alone. Employees contribute Rs 10 on salary day, students save Re 1 a month, headload workers leave whatever small change they can spare at the end of the day; even toddy shops have donation boxes!
"On an average, Malappuram district raises Rs 10 lakh every month," says Dr Mathews. "After the initiation of the NNPC there has been a ten-fold increase in funds available for palliative care."
Besides money, support comes in other forms too. Panchayats, municipalities and corporations contribute to the initiative. Individuals and shopkeepers donate rice, provisions, clothes, books and uniforms. Many families keep aside a handful of rice every day. "The Omni we use was donated by a well-wisher," says 27-year-old T K Muhammed Younus, a marketing manager by profession who heads the Koilandy Palliative Society in Kozhikode district.
"People are willing to support us because they know they are the beneficiaries," says Basheer. "They know where the money comes from and where it goes. Everything is transparent." These small donations are not only a stable and sustainable source of support, they are also feedback from the community on the functioning of the NNPC.

Policy matters
Recognising the importance of palliative care, the Kerala government -- in a first for any government in Asia -- came out with a palliative care policy in April 2008. The policy emphasises a community-based approach to palliative care and considers home-based care the cornerstone of palliative care services. It also highlights the need to integrate palliative care with primary healthcare.
"The government has formulated a detailed action plan," points out state health secretary Dr Viswas Mehta. "The emphasis is on training professionals and non-professionals, including volunteers, in setting up palliative care services both in the public sector and in the community, integrating palliative care into the activities of panchayats, and making essential drugs, including morphine, available."
In tune with the state policy, National Rural Health Mission (NRHM) Kerala has started a project for the development of community-based healthcare services for bedridden, elderly, and terminally ill patients. "The Rs 4 crore project is the largest palliative care project in India," explains Mohammed Saif, state manager of the palliative care component of the NRHM. "Also, this is the only palliative project under the NRHM in India." The project aims at awareness and capacity-building among local self-government officials, healthcare professionals, local politicians and students.
Kerala has already integrated the services of around 26,000 ASHAs (accredited social health activists) with the community-based palliative care units. No other state has done this so far, Viswas Mehta points out.
The success of the NNPC has motivated local self-government institutes to come forward with new initiatives. The Malappuram district panchayat has formulated a joint homecare programme with NNPC groups, called Pariraksha (protection), for all chronic and terminally ill patients in the district. The programme, implemented through primary healthcare centres (PHCs), will support 20,000 chronically ill patients, according to Salim Karuvambalam, health standing committee chairman of the district. Gram sabhas too have become more active now, and local bodies consult the NNPC whilst formulating health projects. A stage has been reached where no political party can ignore the people's health movement.
The Kerala model of palliative care has won global recognition, with the World Health Organisation (WHO) promoting it as model for developing countries.
But can the model be replicated in other parts of the country? "Adopting the same model might not work," says Dr Paleri. He points out that Kerala has achieved total literacy and has a high level of social and political consciousness. Caste-class-religious differences are minimal, compared to other states in India. But, Paleri points out, such community-based efforts could be taken as examples and new models developed for other places.

Saturday, September 8, 2012

Staring at bleak future


Dr Nimisha / Chandigarh

Punjab and Haryana knock on Centre's doors to tide over the drough-like situation in these states.

With drought like situation staring at Punjab, the state government says that farmers in the state have suffered a loss of Rs 5,200 crore so far due to deficit rain.
Punjab Chief Minister Parkash Singh Badal and Deputy chief minister Sukhbir Singh Badal have been consistent in demanding central assistance ever since it became clear the their would be a severe shortfall in Monsoon rains.
Parliamentary Secretary, Irrigation, Sohan Singh Thandal said that the Central Government should have discharged its constitutional duty by announcing special economic package for the state but the proposal put forward by Punjab has not yet been considered.
He, in fact, urged the Centre to sympathetically consider the proposal of Punjab and announce special economic package to sustain the agriculture sector.
He said that although some regions of the state had witnessed rain in past few days, but the water level in the main dams is still very low. The water flow in the rivers is 10 per cent low and the generation of the power through the hydro projects had taken a sharp plunge, he added.
Thandal said that due to this natural calamity, the peasantry of the state has been forced to spend more money on diesel to irrigate their fields. He further said that the state incurred Rs 7,000 crore in June and July to purchase power by spending Rs 1,656 crore more than the normal rates.
Bhartiya Kisan Union (Lakhowal) president Ajmer Singh Lakhowal has demanded that centre must pay compensation of Rs.200 per quintal on crop as a draught relief to the farmers of the Punjab.
Lakhowal said that a delegation led by him had met the union Agriculture Minister Sharad Pawar at New Delhi and informed him that Punjab government had purchased power worth Rs.1530 crores to provide power supply to the farmers for the irrigation of paddy crops as such the centre must pay this amount to the state government.
He said that they had also informed the union minister that farmers had spent extra amount of Rs.850 crore on diesel for running the tube wells and Rs. 350 crore for installing deep tube wells in the state as such they must be compensated for the same by making direct payment to them in this regard.
Lakhowal, who is also chairman of Punjab Mandi Board, said that they were contemplating to levy 'Users charges' on vegetable and fruits arriving in the mandis instead of charging market fee.
Punjab Chief Minister Parkash Singh Badal had earlier demanded a relief of Rs 2,380 crore from the Centre. This figure was revised to Rs 5200 crore as most of the areas pf the state had a deficit rainfall upto 50 percent.
Farmers in Punjab say that officials of the Union government frame policies for the country while sitting in their plush air conditioned offices, without caring about the needs and ground realities of the country.
Punjab, known as food bowl of the country, contributes 30 per cent of rice into central pool. Officials say that the current weather conditions was "one of the worst monsoon failures" and the harvest would be poor and uneconomical for the farmers as they had to use excessive diesel to revive the dying crops.
During his visit to Chandigarh, Agriculture Minister Sharad Pawar had reviewed the situation
Haryana
With Haryana facing 50 per cent deficit rainfall during the current monsoon, the state government has asked for an assistance of Rs 4,050 crore from the Centre to bail it out from the "drought-like situation."
State chief minister Bhupinder Singh Hooda also demanded a bonus of Rs 200 per quintal on the Minimum Support Price (MSP) of paddy and Rs100 on other crops.
"Farmers in Haryana have to suffer a huge loss in view of scanty rainfall," Hooda said, adding, the Central Ministers admitted that a drought-like situation prevailed in Haryana.
Haryana Chief Minister Bhupinder Singh Hooda on Tuesday said that the State Government has urged the Central Government to give Haryana a special package to deal with the situation.
Districts like Mewat, Karnal, Kurukshetra and Jhajjar are badly hit due to poor monsoon in the state. The poor monsoon rain is bearing upon the crops in the state. And, the State Government expects that the expenditure is likely to go up in the coming days to provide 'power' to the farm sector for saving kharif crops in the state.
A deficient monsoon pushed up diesel sales by 13 per cent in July at a time when it was needed the most to keep the crops alive due to absence of water in the field. The July 2012 industry sales review report of the Petroleum Planning & Analysis Cell shows that diesel consumption was dominated by the monsoon factor. The rain deficiency was acute in Haryana and Punjab. The two rain deficient States recorded high diesel sales growth as use of pump sets goes up for irrigation. While the growth in diesel sales was 26.6 per cent in Haryana, it was 23.6 per cent in Punjab.

Friday, September 7, 2012

Relief pour down


Sangita Jha/New Delhi

Although late rains have washed away drought fears, inadequate rainfall in some parts of the country may spell trouble for agriculture.

After touring some of the monsoon-deficient states, Union minister Jairam Ramesh commented "drought is good politics". His assertions were due to the fact, that some of the states put demands for relief to the tune of a whopping Rs 45,000 crore. But the monsoon, which is highly unpredictable by character, has showered most parts of the country with heavy rains in August. The August bountiful of rains, however, came after dry spell in crucial months of May, June and July.
Farmers failed to sow their Kharif crops due to lack of rains and hard soil. The damage has been done but late rains will ensure at least that people do not face scarcity of drinking water as has been the concern at the top of the echelons at the Centre.
By the last week of August, monsoon rains this year have been deficient by about 14 per cent. Four states have been worst affected by the below average Monsoon this year. Karnatka, Central Maharashtra, Gujarat and Rajasthan have been hit hard as far as sowing of the Kharif crops is concerned. While the drought conditions in these four states have been sever in the last four decades or so, there has been a little reprieve for India overall. The reason is that India will not see a repeat of 2009 drought at least this year. It's so, as the 2009 drought had taken in its grip a number of states, including Jharkhand, Bihar, Uttar Pradesh, Madhya Pradesh among others. These states are highly populous and thereby the drought conditions had left serious consequences on the people.
But much has changed since 2009. The most defining part of the change has been expansion of areas for foodgrains production.
Some of the foodgrains consuming states like West Bengal, Chhattisgarh, Bihar, Odhisa, North-eastern states have made remarkable progress in catching up with the major foodgrains producing states of Punjab, Haryana, UP and Madhya Pradesh. Clearly, India has got cushion against recurrence of droughts. Incidentally, it has been the North-western states along with Karnatka and Mahrashtra which have been hit hard this year due to deficient rains.
However, the 14 per cent deficient Monsoon this year will surely affect the foodgrains production in the year 2012-13. It will also come in the backdrop of bumper and record foodgrains production in the last financial year, as the total output stood at 258 million tones. The record production in the last year has given India a breather, with officials estimating that the country can rest assure on the food security front for at least two years. So, there is no need to press the panic button immediately.
As far as impact on the sowing is concerned, total area under kharif crops is down at 32.9 million hectare as on August 24, against 34.2 million hectare in the same period last year. Till the third week of August, main kharif crop rice was sown in 32.92 million hectare, against 34.20 million hectare in the same period last year. While area under coarse cereals was down at 16.53 million hectare from 19 million hectare, pulses area was lower at 8.83 million hectare, against 9.98 million hectare in the year-ago period. Area under oilseeds was also down at 16.43 million hectare from 16.99 million hectare in the review period. Among cash crops, cotton acreage was slightly lower at 11.15 million hectare as on August 24, against 11.77 million hectare in the same period last year. However, area under sugarcane was up at 5.29 million hectare, against 5.06 million hectare in the review period.
So, the area of concern is clearly pulses, coarse cereals and oilseeds. India continues to depend on import of pulses and oil seeds to meet its domestic demands. The impact of the likely shortfall in the productions of pulses and oilseeds can easily be seen in the retail prices, which have begun their northward journey. The Centre is in fact working on a proposal to revive the earlier scheme of selling subsidized pulses through fair price shops under the public distribution system (PDS).
The Union agriculture secretary Ashish Bahuguna is of the view that the gap in overall coverage is five per cent of the normal area. He is confident that the September rains will bridge the gap in sowing area shortfall as compared to the last year. But he admits that the last year's foodgrains production would not be met.
"Monsoon has improved and sowing has picked up in some parts of the country. Total output of foodgrains production this year might be slightly lower than the last year's 257.44 million tones. There would be some drop in production of pulses and coarse cereals. With respect to other crops, there should not be any problem," said Mr Bahuguna.
The ministry of agriculture is also of the opinion that with chances of El-nino weather pattern receding, the September rains would be better than the earlier forecast, which would help in bridging the shortfalls in sowing area to some extent.
The optimism in the ministry has come after India Meteorological Department (IMD) early in August had pegged below normal monsoon in September due to likely warming of the Pacific Ocean, popularly known as the El Nino phenomenon. But things appear to have changed midways. "According to IMD's latest update to us, there will not be El nino effect on monsoon as chances of its occurrence is receding. Temperature in Pacific Ocean is okay and in September, rainfall is expected to be better than the IMD forecast," said Mr Bahuguna.
Meanwhile, late August rains continue to play havoc in Rajsthan, where some places beat the previous records and reported flooding. In fact the impact of the rains had been so palpable that Rajsthan has postponed for a while to petition the Centre with its demands for drought relief. Incidentally, the Empowered Group of Ministers (EGoM) on drought too has not met after the first meeting in a move which is being seen as a waiting tactics tp soo the impact of the August rains on the drought like conditions in few of the states.
However, the Centre is gearing up to take measures on price rise of essential commodities as a fallout of the drought like conditions. Union minister of state for food and consumer affairs K. V. Thomas told the Parliament that there could be some impact on prices.
The Centre has put in place the diesel subsidy for farmers upto 50 per cent to ensure that they can irrigate their lands. Further, contingency measures in over 325 districts have been activated.
The Centre has asked the states to focus on fodder cultivation to ensure that there is no adverse impact on the livestocks. As far as the consequent rise in unemployment is concerned, Mr Ramesh had announced during his visit to Gujrat in the comoany of agriculture minister Sharad Pawar, that states can enlist 150 days of works under the Mahatma Gandhi National Rural Employment Guarantee Scheme (MNREGS) against the norms of 100 days, with the Centre bearing the additional cost.
While the August rains have ensured that various parts of the country may not face drinking water scarcity, the upward trend in the foodgrains production has surely been slowed and much efforts may be needed to initiate long term measures to conserve water and put in place extensive irrigatuion infrastructure.