Letters to the Editor

  1. Banking crisis – what is the solution?
  2. Red salute to comrade Lenin
  3. Wellness for whom?

Banking crisis – what is the solution?

Sir, The article entitled `Deepening crisis of the banking system – what is the cause and what is the solution’, carried in the April 1-15, 2018 issue of MEL is particularly important because the working class has to be educated on the basics of economic theory and practice, so that it is armed to take society into the next higher stage. In the present era, which is the monopoly capitalist era, it is important to know what is what, and how the bourgeoisie seeks to mislead the working class and the people of India about the true nature of its institutions.

For the case at hand, it has been portrayed that the the loot of banks by M/s Nirav Modi and Mehul Choksi, and also some time ago by Mr. Vijay Mallya is only an aberration and the result of some fradulent activities by some capitalist hucksters. The bourgeoisie also seeks to promote the line that it is itself capable of bringing such bad apples to book and restore the credibility of the system.

The article here proves the exact opposite. What the article proves beyond any reasonable doubt is that the whole issue of non-performing assets and the banking crisis are part and parcel of the monopoly capitalist system. The bourgeoisie periodically waives its own loans and non-performing assets. The burden of such waiver is passed on to the general public which is finding the concomitant crisis to be an unbearable burden. It is not as if there are no laws on the books or audit regulations that prevent such fraudulent activities. But rather it is the willful participation of those in power that allow these crises to occur from time to time. Furthermore, the government now seeks to throw more dust into the eyes of the public by trying to pass a bill entitled the Fugitive Economic Offenders Bill, and conveniently forgetting that the political parties that form the treasury and opposition benches are themselves beholden to the same Economic Offenders and other members of their class! The availability of cheap credit coming from banks and other financial institutions is necessary for the monopolies to carry on. In fact, there is an unbearable pressure on banks to constantly offer credit and keep money in circulation.

The biggest lie that is being propagated at this stage is that the solution to all the problems of the banking sector is the privatization of all banking activities. Such a `solution’ would lead to an even greater loot of the hard earned money of the public and should be watched out for by everyone. Besides spelling out the dangers above, the article also points out what the real solution is, which is the replacement of the present system of greed and profiteering by a new system where the working class controls the reins of the economy. Only such a farsighted class which is conscious of its historical role of building a new society is capable of rescuing the people from the disasters created by the capitalist class.

Sincerely,

A. Narayan, Bangalore

Red salute to comrade Lenin

I feel compelled to join you in your `Red Salute to Comrade Lenin!’ as expressed in the article in the April 1-15, 2018 issue of MEL. Even today, just as a hundred years ago, the name of Com. Lenin strikes fear in the hearts of the bourgeoisie, who will spare no effort to besmirch his name. On the other hand, the name of Com. Lenin continues to spark revolution in the hearts of the working people across the world and his name and deeds continue to be a beacon for communists all over the world who seek to build a better tomorrow.

Indeed, the people of India have always considered Com. Lenin to be a kindred spirit who was interested in their liberation, through his word and deed. It was the work of Lenin and his comrades that showed that socialism and communism could be built on earth and not only in fantasy. The present article comes at a time when those who rallied around his name and his work for one reason on another in Tripura have lost political power. Those who have now come to power want to say that the name of Lenin is somehow alien to India and Indian people and nothing could be further than the truth. Generations have been and continue to be inspired by the great Bolshevik revolution of which he was the undisputed and first leader. Nothing can change this historical reality. It may also be noted here that in the past and in the present era, disinformation has been a weapon and tool in the hands of the bourgeoisie to disorient and confuse the masses. They also use disinformation to spread terror and wreck mass consciousness. The article carried in the MEL documents very carefully Lenin’s abiding interest in Indian history and in the anti-colonial struggle.

Lenin had a history of speaking out against the crushing of anti-colonial struggles and atrocities carried out against the Indian people. After the revolution, Lenin had extended the hand of friendship and support to Indian revolutionaries who gladly acknowledged it in the form of a resolution, upon which Lenin called for a free Asia. Lenin also had the opportunity to greet and receive several Indian freedom fighters who fill the firmament of India revolutionaries of his era. In the light of all the above, let us today fight the disinformation that is spread about the great revolutionary and let us pay tribute to his memory and his legacy by fighting for revolution.

Sincerely,

S. Nair, Kochi

Wellness for whom?

Sir, I have been working in social development sector and would like share my experience with the readers.

The Health and Wellness Centre was one of the schemes announced by the Modi government as part of the Ayushman Bharat program under the Union Budget 2018. According to the government, this scheme will strengthen the healthcare system in rural areas, by ‘upgrading’ all sub-centres (SC) into wellness centres which would be equipped with all the needed facilities to treat and screen patients suffering from common diseases. The budget allocated Rs. 1200 crore on the upgradation of the 1.65 lakh sub-centres, which are popularly known as Jacha Bacha Kendra.

These wellness centres are expected to provide maternal and child health services. They are also mandated to provide other services, through application of technologies such as tele-medicine, drug vending machines, non-Communicable disease screening (such as for cancer, coronary, diabetes). The Auxiliary Nurse Midwife (ANM) is also expected to counsel persons with mental health problems.

While there is no doubt that primary health management, begins from SC level, as the first check post of the health seeker, this claim that wellness centres are the solution, needs to be examined by looking at some stark facts from the Rural Health Statistics (RHS) 2017 of the government with respect to the various levels of health care institutions.

The shortfall in terms of the number of SCs and PHCs as per the population is 19 percent and 22 percent, respectively.

Graph 1 and 2

It is to be noted that only 11 per cent of the SCs are functioning as per norms of the Indian Public Health Standards (IPHS). If the first post is to be a “wellness” centre, then it should have proper infrastructure. The graph below (Graph 1), shows clearly that at SC level, 24 per cent or nearly 1 out of every 4 SCs do not have electricity, and around 1 in 5 do not have regular water supply. Moreover, only 55.4 per cent SCs have quarters for the ANMs. Amongst these SCs with quarters, in 56.4 per cent of them ANMs are living in those quarters. With no electricity, and irregular water supply, how is the ANM expected to reside in these quarters? The ANM is expected to stay away from her family, and maintain two establishments, one at the SC and one at the block or district level or even outside of the state as the case maybe. And the proposed scheme talks of an additional ANM to be positioned as well as a male Multi-purpose Worker (MPW)!

The situation is worse in tribal areas. There is a shortfall of 6646 or 21.25 per cent SCs against requirement. 23 per cent of SCs have no buildings. As per data available, the vacant ANM posts is 54% in Andhra Pradesh, 21% in Gujarat, 25% in Karnataka, 29% in Manipur, 72% in Rajasthan and 19% in Tripura.

In the above context, how can the government promise that these “wellness” centres will function 24X7?

It is expected that patients will have to be diagnosed and followed up with adequate quality treatment at the PHC. However, PHCs too suffer from vacancies in posts of doctors and lack of essential infrastructure. The graph (Graph 2), shows the state of infrastructure at the PHC level as per RHS 2017.

The RHS report says that 71 per cent of the PHCs have labour rooms. But the report does not say how many of these labour rooms are functional as per IPHS norms and whether they have basic equipment necessary for safe delivery and new born care.

The third level is the community health centre (CHC). The shortage of staff is chronic in case of CHCs. The CHCs in rural India are suffering from ‘missing doctors’ syndrome’. Nearly 82 per cent of the posts of specialists in the CHCs are vacant. Given the shortage of human resources and infrastructure, mere talk of introducing telemedicine and innovative gadgets and equipment at the health centres cannot serve as a solution. Telemedicine of the cheapest and simplest type, with video conferencing platform of screen sharing and video chat capabilities will cost around 10,000-13,000/month. Even if a cheaper version is available, how many of our poor rural patients would be able to answer with confidence and feel empowered to share information with a doctor on screen? This would require additional time and facilitation skills on the part of the ANM, as well as time on the part of the doctor on the other side.

And where would the patient go for additional tests that are prescribed and for the drugs? A drug dispensing machine cannot provide the answer when our drug supply system is in shambles and our front line workers are not permitted to dispense many drugs and medicines.

The installation of such equipment without guarantee of electricity and network facilities (which is the case now even in many urban areas) will only benefit the private companies and unscrupulous money makers that will supply these equipment. It will definitely not benefit those who need such services.

A doctor-patient, or a nurse-patient communication is extremely important in the delivery and process of quality primary health care. Machines cannot replace human interaction that is so vital in primary health care. There is a total absence of patient-centred health care. All the tall claims made by the government about providing for people’s health crumble in the face of the actual condition of our health system. Wellness will elude our people as long as there is no commitment by the state to guarantee universal health care as a right.

Sunita, Delhi

Share and Enjoy !

Shares

Leave a Reply

Your email address will not be published. Required fields are marked *