हात धुण्यामुळे त्रास होत असल्यास सध्या वारंवार हात धुणे व हँड सॅनीटायजर चा वापर करणे कोरोना टाळण्यासाठी आवश्यक आहे. पण वारंवार हात धुण्याने अनेकांच्या हाताला कोरडेपणा ( ड्रायनेस ) येऊ लागला आहे. याचे एक कारण असे ही आहे कि या पूर्वी आपल्याला हात धुण्याची सवय नव्हती. यासाठी हात धुतल्या नंतर लगेचच मुलायम कपड्याने पाणी पुसून घ्या व त्यानंतर लगेचच कुठले ही मॉईस्चरायजर लगेचच हाताला लावावे. ते ही नसेल तर डोक्याला लावायचे खोबऱ्याचे थोडे तेल हाताला लावले तरी चालेल. रात्री झोपताना तिळाचे तेल हाताला लावून झोपावे.
हात धुण्यामुळे त्रास होत असल्यास हँड सॅनीटायजर मध्ये अल्कोहोल असते व अनेकांना त्याची अॅलर्जी असते. काहींना त्यामुळे हात चुरचुरण्याचा त्रास होतो. असे होत असल्यास आणि नियमित हात धूत असल्यास हँड सॅनीटायजर वापरला नाही तरी चालेल. कोरोना साठी मुख्य प्रतिबंधक उपाय हा साबणाने हात धुणे हा आहे व हँड सॅनीटायजरचा वापर हा एक आधार आहे. जिथे बाहेर गेल्यावर हात धुण्याची सोय नाही तिथेच त्रास होत असणाऱ्यानी हँड सॅनीटायजरचा वापर करावा.
हात धुण्यामुळे त्रास होत असल्यास हात धुण्याविषयी एक मानसिक समस्या वाढल्याचे ही मानसोपचार तज्ञांचे निरीक्षण आहे. एखादी गोष्ट इच्छा नसताना वारंवार करण्याची नियंत्रित न करता येणारी भावना मनात येण्याची एक मानसिक समस्या असते. यात सर्वाधिक प्रमाण हे हात धुण्याची आणि स्वच्छतेची सवय असते. सध्या भीती पोटी गरजे पेक्षा जास्त वेळा हात धुण्याची इच्छा होण्याची मानसिक समस्या काहींना भेडसावते आहे. कोरोना टाळण्यासाठी हात धुणे आणि वारंवार उगीचच हात धुणे यात फरक आहे. हा फरक स्वतःला व कुटुंबातील इतरांना ही लगेच लक्षात येईल. असे होत असल्यास मानसोपचातज्ञांचा सल्ला घेणे गरजेचे आहे.
ही हिरकणी आपल्या बाळांपर्यंत पोहोचण्या आधीच वाहून गेली !
सध्या राज्यात किचन ओटा किंवा बेसिन धूत असताना, बारीक कीटक ड्रेनेज मध्ये वाहून जातात त्याप्रमाणे माणसे वाहून जात आहेत. नुकत्याच पुण्यात आलेल्या पुरात, धायरी पुलावरून घरी जात असलेली ‘अमृता सुदामे’ ही वाहून गेली. एक मैत्रिणीकडून तिचा सगळा वैयक्तिक तपशील कळाला तेव्हा ‘या व्यवस्थेत बदल घडवण्यासाठी आपण काय करतोय?’ या हतबलतेने अमृताच्या चीतेत आपण जिवंत जळतोय अशा वेदना झाल्या!
एका डायग्नोस्टिक सेंटरवर रीसेप्शनीस्ट म्हणून काम करणारी ‘अमृता’ ही तरुणी रात्रभर घरी पोचत नाही. आणि रात्री पासून बेपत्ता असलेल्या अमृताचा शोध शेवटी ससूनच्या शवागारात संपतो! त्या शोधासोबतच उन्मळून पडतो, एका अख्ख्या कुटुंबाचा आधारवड!! आपल्यासाठी ‘पुरात एका तरुणीचा मृत्यू’ एवढ्या बातमीवर विषय संपतो. ती कोणा मंत्र्याची–सत्ताधाऱ्यांची किंवा हाय-प्रोफाइल समाजातील कुणाचे मुल बाळ नातलग नसल्याने, तिच्या मृत्यूची मोठी बातमी होत नाही आणि ती कोण होती यावर रकाने लिहून येत नाहीत. कोण होती ही ‘अमृता’ ??
इयत्ता आठवी आणि शिशू वर्गातील दोन मुलींचं एकल पालकत्व निभावत काबाड कष्ट करत जीवनसंघर्ष चालू ठेवणारी एक माता… २ वर्षापूर्वी वडिलांचा मृत्यू झाल्यावर कँन्सरग्रस्त आईची जबाबदारी पेलणारी एक लेक. परिस्थितीसमोर हात न टेकता उलट तिच्याशी दोन हात करून आलेला दिवस समर्थपणे झेलणारी एक रणंगिनी…! जाऊ नको, रात्री इथेच थांब असे सांगूनही, “मी गेले नाही तर माझ्या मुलींकडे या भयाण रात्री कोण पाहणार ” असे म्हणत, पाण्यातच दुचाकीने घरी निघालेली ‘आधुनिक हिरकणी’! कामावरून धो धो पावसात बाहेर निघेलेली आणि पापांनी दुथडी भरून वाहणाऱ्या नाल्यांच्या प्रवाहात लेकरांसाठी घरी निघालेल्या अमृताचे हेच वाक्य शेवटचे वाक्य ठरले!
अशी ही परिस्थितीशी झुंज देणारी अमृता त्या रात्री व्यवस्थेशी संघर्ष करू शकली नाही आणि शेवटी या व्यवस्थेने तिचा जीव घेऊनच तिचा संघर्ष संपवला.
‘एका महिलेचा पुरात वाहून मृत्यू’ या बातमी मागे उघडे पडलेले एक कुटुंब आणि एवढी करूण कहाणी असू शकते याची जाणीव ही न ठेवता वर्तमानपत्रांची पाने आपण उलटत असतो, सोशल मिडिया खाली खाली स्क्रोल करत जातो.
हिची संघर्षगाथा ऐकून आमच्या मित्राने आजच्या युगाची हिरकणी गेली अशी प्रतिक्रिया नोंदवली. शिवाजी महाराजांच्या काळात आपल्या बाळासाठी गड चढून गेलेल्या हिरकणीची कथा आपल्याला माहित आहे. ‘माझी मुले घरी एकटी आहेत मला घरी जावेच लागेल’ या ओढीने घरी निघालेली ही हिरकणी मात्र आपल्या बछड्यांपर्यंत पोहोचूच शकली नाही! आज शिवरायांच्या नावाने यात्रा, राजकारण करणाऱ्यांना या घटनेची लाज वाटली पाहिजे. अनेक वर्षे शिवछत्रपतींचे दाखले देणाऱ्यापर्यंत कदाचित अमृताची ही गोष्ट पोहोचणार ही नाही, कारण सध्या प्रचार सुरु आहे ना! कोण जिंकणार, कोण हरणार , कुठल्या मतदार संघात मराठा किती, दलित, माळी, धनगर, मुस्लीम मतदान किती …? त्यावरून कुठल्या जातीचा उमेदवार द्यायचा याच्यातून सत्ताधरी, विरोधकांना वेळ कुठे आहे. काही वर्षांपूर्वी पुण्यातील एका इंजिनिअर मित्राने सांगितले कि, पुण्यात ड्रेनेजसाठी जे खड्डे आणी त्यावर जाळी दिसते त्यात अनेक ठिकाणे फक्त खड्डे आणी त्यावर जाळी आहे .खाली त्यांना जोडणारी पाईपलाईन अस्तित्वातच नाही. आपण नागरिक म्हणून हे खड्डे कधी उघडून बघितले आहेत का ? पुण्यात अनेक नाले बुजवून त्यावर इमारती उभ्या राहिल्या आहेत. यात घरे विकत घेणाऱ्याला ही आपण अशा अनेकांचे जीव धोक्यात घालून उभे राहिलेल्या इमारतीत राहणार आहोत हे माहित नसते. स्थापत्य अभियंते , बांधकाम व्यवसायिक, राज्यकर्ते यांच्या संगनमताने अशा विकासाचे आपण सगळे भागीदार आहोत. पण तो विकास ‘अमृता’ सारख्यांच्या थडग्यांवर उभा आहे … फरक इतकाच आहे … हे थडगे आज अमृताचे आहे … उद्या तुमच्या आमच्या पैकी कोणाचे असेल सांगता येत नाही … कारण संधाकाळ पर्यंत कुठलीही सूचना नसताना भर शहरात अचानक घुसलेले पाणी वाहून नेताना कोणात ही भेद करत नाही ….!
Prime Minister Narendra Modi, in his usual style, appealed to the nation about Population control from Red Fort in his Independence day speech that “Family planning is itself a patriotism” After Sanjay Gandhi’s compulsory sterilization program which gulped the power of Congress, the same fear loomed over successive governments, and they never dared to touch the population policy. This electoral fear of implementing population control strategy has resulted in a population growth that can make India most populous country on the Globe. It is less likely that the masses will respond to a patriotic plea of The Prime Minister, and Contraception will be accepted like demonetization or become a mass movement like Swach Bharat or Yoga Day. Apart from linking Contraception to patriotism in speeches on popular forums, much more needs to be done on war footing level.
Every family and in the long run country needs to decide on concrete population strategy considering which stage our country falls. Presently India is in late expanding phase of the population which results from decreased death rate but birth rate falling at a slower pace. This stage where the birth rate is more than the death rate is such that a better population control strategy can result in an ideal stationary phase of population. At the same time, a neglected population policy can push the country in an Early expanding stage worsening the situation. Our population strategy never crossed the line of advertisements of Mala D and slogans like ‘Hum do hamare do’. In the course of time even these campaigns also gradually faded. An ordinary citizen is miles away from Economic or Foreign policy, and population policy cannot be another addition to be implemented in isolation. Population policy is something that begins and ends in bedrooms. It makes the arena extremely sensitive and intricate. The complexity of the issue demands a definite answer to the question of whether we are planning to control the population through public awareness or law and regulations. This debate is similar to the Tilak – Agarkar school of thinking, arguing on freedom first or social reform first. Some grass-root observations of doctors need to be considered to give a verdict on the debate,
Its High Time to Act Now
Today very few married couples are aware of the best and most efficient mode of contraception after a single child and after having two children. In a country with the vast majority of illiterates and oppressed, even if some weak soul desires to get information about this, there is no reliable and easily accessible source of information. A family cant decides on its family size because it has never heard of the country’s policy on the best family size and never been convinced about this. R. D Karve was probably the last social reformer who dared to talk openly about contraception. After the 15 august statement of Prime Minister Modi about family planning, it would be a great social move if he talks about the contraceptive methods in the next few episodes of Man Ki Bat. Most of the masses know very less about the best contraceptive methods and their knowledge is limited to condoms and vasectomy popularly called nasbandi. In the eighties when private players jumped into condom sale, they very well marketed it as a medium of sexual pleasure when no such connection exists. Condom with a maximum failure rate of 14 % grabbed a significant position in the minds of people, and this shadowed other valuable modes of contraception. Copper T, Oral contraceptives, and injectable depo preparations are some of those who lost relevance in comparison to condoms. Although all these modes seem to be female-centric, this keeps the decision of contraception in the hands of female, and this is very important in a male-dominated society with violated reproductive rights of women.
Today, if we have to formulate a successful population policy, two couple should be targeted. The first is the one with one Child and later is with two children but who haven’t yet resolved to limit the family. The illiterate and the oppressed neither return to the hospital for contraception nor do they have access to a health facility for termination of an unplanned pregnancy. Even though they are not determined to have a child after the first one they get trapped in a positive feedback cycle of Conception – Poverty – Child malnutrition – maternal illness. The best way to break this cycle is the immediate insertion of copper T in the delivery room as soon as the child is born. Counselling of The couple on antenatal visits for this contraception will strengthen the practice. Since it’s an arduous task to get this mother back to the hospital, this is the best mode and most effective way to limit family. The contraception will offer protection against pregnancy for the next five years. But this way has received less attention at the level of policymakers and authorities. Population policy is never pondered so deeply and micro-planning of such efforts done. The couple with two children are in a different position.
Terminal sterilization methods tubectomy and
vasectomy are best at this point. We don’t have moral right to convince them
for terminal sterilization since cant assure this couple healthy under-five
children. Hence Copper T or subcutaneous injectable contraceptives which are relatively
painless. But all these modes have not yet geared up. For terminal sterilization,
vasectomy for males is a far better and cheaper alternative as regards to
public health. The jargon Nasbandi conveys a negative impact, and rural males
associate this with sexual weakness.
Contrary to popular belief, this can be beneficial
on the sexual front as fear of conception is an essential cause of performance
anxiety. This surgery needs an urgent name change operation. BJP should recruit
some of its branding experts working on famous slogans to suggest a better name
for this surgery. Prime Minister should declare this name in a national address
as was done on the eve of demonetization.
We can debate whether the nation needs to have legislation for population control. China has suffered a social set back due to the one-child policy. Mimicking the same would be throwing the baby out with the bathwater. But at least a two-child policy and refusal of government schemes, subsidies for couples with three children or a positive reinforcement with additional benefits for those who comply with the policy. Social and educational upliftments are vital prongs of the multipronged approach of population control. But they will happen at their own pace. Apart from these gradual social changes, revamp and thoughtful additions to the population control policy are need of the time.
The suicide of Dr Payal Tadvi, a resident doctor from BYL Nair hospital, has opened a can of worms for the medical community. Primary investigation in Dr Payal Tadvi Case says that the suicide was committed due to ragging. The matter is under investigation and whether Payal’s suicide was a result of casteist taunts is yet to be proved. Considering all the possibilities, the suicide of Payal should compel every element of the society and the proficient’s to ponder upon.
Dr Payal Tadvi Case
If the slightest possibility of any casteism involved is found in Dr Payal Tadvi Case of suicide, it should always be strongly condemned. But at the same time, sufficient care to be taken while discussing this issue that it doesn’t further ignite the communal emotions and give birth to an apartheid system in the medical community, which never existed till now. Open communal war and ‘an eye for an eye’ cannot be a solution to any issue particularly for intellects like doctors. Since postgraduate reservations are the talk of the town in the medical field, the last few months have shown a huge communal split in the medical field. Such split in the doctors community, who are the highly polished intellectual professionals definitely proves a bad omen and predicts a possibility of social chaos. Fluctuating policies about postgraduate admissions and reservations are leaving unreserved categories with hardly one or two seats, violent exchanges between the reserved and unreserved categories on social media has lead to serious unrest in the medical field. Reservation is a controversy to be discussed separately. Although everyone has a right to fight for their rights in a democratic way, one should think with his/her discriminative intelligence too. Every doctor should remember that we are all children of Mother Medicine, and the patient is our religion, beyond our own caste, creed and religion. This issue is also a learning lesson for the government. Any social change by the government has to be brought gradually and slowly for it to be socially acceptable. Particularly issues like that of reservations in higher education can have social repercussions and lead to a communal discord.
Beyond the caste / communal angle to this unfortunate incidence, some more serious issues should not be overshadowed. Issues like stressful situations and work overload of resident doctors in the medical colleges, discrimination done at different levels due to various reasons, inter-personal relations among the doctors, poor management of human resource and the workplace in medical colleges are some important things that should not be overlooked in this case. Considering communal angle to Payal’s suicide it must be a precipitating factor in all this stress that made her feel alienated and compelled her to commit suicide. The whole system is equally a failure resulting in a feeling of helplessness and alienation among residents like Payal. Every doctor has his own tale of such instances of his postgraduate medical education. Each one of us has faced mental and physical stress leading to burnout during our residency years. Every year, at least two residents end up with tuberculosis in BMC hospitals. Sion hospital orthopaedic department has a record of at least one resident discontinuing the PG education, as they are not able to sustain the work pressure. MARD strikes are often knee jerk reactions to such stressors. A department in a medical college is a flood of many negative emotions like fear, hate, resentment, rivalries, leg pulling etc. Although the truthful motive of us doctors is to give the best possible service to our patients, this takes a toll on our psyche. Casteist slurs or torture of juniors by seniors ultimately create a lot of stress. This makes even a kind and compassionate person bitter towards his/her subordinates and at some point of time an innocent soul like Payal gives up exposing the ugly face of the situation comes in the society. We must never forget that medical education is not just to make intelligent doctors with a long line of degrees but we are supposed to produce compassionate, empathetic and kind humane doctors. We should also aim to produce doctors who will not just effectively cure an illness but, will also offer ethical leadership to the society as sensitive human beings. The medical education department needs to revamp the system for better management of medical colleges and human resources. Medical education also needs to teach students about better interpersonal relations and empathy. A better understanding of each other as doctors is the first step towards successful personal and professional life.
The medical field is facing a major ethical crisis today. The issue of reservation in higher medical education, cutthroat competition, work pressure in medical colleges has added fuel to the fire. An unfortunate incidence like Dr Payal Tadvi Case of suicide further increases the unrest. This is not just an internal blow to the entire medical community but also poses a challenge to the public image of the medical community. All these issues must be handled with the utmost care by the government, society and the medical community. A long term solution to such issues should be implemented than temporary solutions. Looking at the plight of health in our state, an emotionally stable doctor is need of the hour. This is not a time to portray anyone as a villain but to sit back and introspect about each and every element in society.
You can also read Marathi translation of this article on Dr Payal Tadvi Case was published in Lokmat Mumbai Main Edition on 30 May 2019.
नायर रुग्णालयात वरिष्ठांच्या त्रासाला कंटाळून डॉ. पायल तडवी या निवासी डॉक्टरने आत्महत्या केल्याने मोठे वैचारिक वादळ आले आहे. ही आत्महत्या रॅगिंगमुळे झाल्याचे प्राथमिक अहवालात समोर आले आहे. यात पायलला जातीवाचक मानसिक त्रासाला सामोरे जावे लागले का , यावर अजून चौकशी सुरु आहे. सगळ्या शक्यता गृहीत धरल्या तरी ही घटना केवळ वैद्यकीय क्षेत्रालाच नव्हे तर समाजातील बौद्धिक धुरिणांना आत्मचिंतन करायला लावणारी आहे.
डॉ. पायल तडवी साठीचा जनआक्रोश
जर डॉ. पायल तडवी च्या मृत्यूत जातीचा संदर्भ असेल तर या गोष्टीचा निषेध करावा तितका कमीच आहे. पण त्याच वेळी दोषींवर कायदेशीर कारवाई सुरु असताना आपण सगळ्यांनी याची चर्चा बौद्धिक वर्णभेद भडकणार नाही अशा दृष्टीने व ‘डोळ्यासाठी डोळाच’ अशा प्रकारे दोन वर्ग एकमेकांसमोर उभे टाकणार नाहीत याची काळजी घेणे ही गरजेचे आहे. त्यातच पदव्युत्तर शिक्षणामध्ये आरक्षणाचा मुद्दा सध्या तापत असताना गेली काही महिने वैद्यकीय क्षेत्रात प्रथमच जातीच्या मुद्द्या वरून उभी फुट पडलेली दिसून आली. वैद्यकीय क्षेत्रा सारख्या थेट जगण्या मरण्याशी संबंधित क्षेत्रात अशा प्रकरे बौद्धिक वर्णभेद भडकणे हे समाजाच्या दृष्टीने अत्यंत घातक व अराजकाला आमंत्रण देणारी गोष्ट आहे. पदव्युत्तर शिक्षण प्रवेशात आयत्या वेळी होणारे बदल, खुल्या वर्गासाठी राहिलेल्या एक दोनच जागा, आरक्षित वर्गाचा आपल्या हक्का साठी लढा यातून कधी नव्हे ते समाज माध्यमांवर वैद्यकीय क्षेत्रात दोन वर्ग एकमेकांना भिडताना दिसत होते. आरक्षण हवे नको हा वादाचा मुद्दा बाजूला ठेवला तरी आपल्या हक्कांसाठी सनदशीर मार्गाने लढा देत , आपल्या क्षेत्रात व एकूणच समाजात सहिष्णुता टिकून राहावी यासाठी प्रत्येकाने आपला विवेक जागा ठेवायला हवा. त्यातच पायल तडवी सारख्या तरूण डॉक्टरचा जीव जातो तेव्हा आपण सगळे एकाच वैद्यक मातेची मुले आहोत व जात, धर्मा पलीकडे डॉक्टर आहोत व रुग्ण आपला पहिला धर्म आहे हे विसरता कामा नये. तसेच कुठला ही बदल आणताना तो अचानक आणला तर समाज कशा प्रकारे ढवळून निघतो व त्यातून असा बौद्धिक वर्णभेद भडकू शकतो हा धडा ही शासनाने यातून घ्यायला हवा.
या पलीकडे जाऊन या घटने मध्ये वैद्यकीय क्षेत्रात अत्यंत मानसिक व शारीरिक तणावाचा पदव्युत्तर शिक्षणाचा काळ, कमी निवासी डॉक्टरांची संख्या, वैद्यकीय महाविद्यालयातील कामाचा ताण, अनेक पातळ्यांवर, अनेक कारणांनी होत असलेले भेदभाव, डॉक्टरांचे आपापसातील संबंध हे सगळे कांगोरे ही तपासून त्यावर उपाय योजना करणे गरजेचे आहे. डॉ. पायल तडवीच्या आत्महत्येत जाती चा संदर्भ तिच्या नैराश्यात भर घालणारा सगळ्यात मोठा घटक असला तरी तिच्यावरील ताण ही नाकारला जाऊ शकत नाही. तसेच काहीही कारण असले तरी सोबत काम करणार्या कनिष्ठ , वरिष्ठांमध्ये तिला निराधारपणाच्या तीव्र भावनाने पछाडले हा सगळ्या कारणां पलीकडे आपला दोष आहे व व्यवस्थेचेही मोठे अपयश आहे. पदव्युत्तर शिक्षण घेत असताना आम्हा प्रत्येकाने तीव्र मानसिक , शारीरिक ताणाचा सामना केल्याची प्रत्येक डॉक्टरची कहाणी आहे. दर वर्षी केईम, सायन, नायर येथील तीन – चार निवासी डॉक्टरांना टी.बी चा संसर्ग होतोच. सायन अर्थोपेडीक विभागात दर वर्षी एखादा तरी निवासी डॉक्टर ताणा पायी पदव्युत्तर शिक्षणच सोडून जातो. मार्डच्या संपातून हा संघर्ष अधून मधून तात्पुरता उफाळून येत असतो. प्रत्येक विभागात राग, द्वेष, मत्सर, सिनियर – ज्युनिअर संघर्ष, भीती अशा नकारात्मक भावनांचा पूर वाहात असतो. यात रुग्णांना चांगली सेवा मिळावी ही भावना असली तरी त्यातून कामाचे व्यवस्थापन व काम करणाऱ्या डॉक्टरांची मानसिकता बिघडत जाते. जातीवाचक शेरे म्हणा, किव्हा कनिष्ठांना अमानुष त्रास म्हणा हे सगळे या ताणातून आलेल्या विकृत मानसिकतेतून जन्म घेते व पायल सारख्या निरागस डॉक्टरच्या अत्म्हत्यातून कधीतरी समाजा पुढे येते. वैद्यकीय शिक्षणातून आपल्याला फक्त भल्या मोठ्या डिग्रीची रांग नवा मागे असलेले हुशार डॉक्टरच नव्हे तर चांगला संवेदनशील माणूस व समाजाला दिशा देऊ शकणारे विवेकी बौद्धिक नेतृत्व ही तयार करायचे आहे हे वूसरून कसे चालेल. यासाठी वैद्यकीय शिक्षण विभागाला वैद्यकीय महाविद्यालयांच्या कामाच्या तासांचे , मनुष्यबळाचे योग्य व्यवस्थापन ही करावे लागणार आहे. तसेच काही ही झाले तरी समोर आलेल्या आपल्या कनिष्ठ – वरिष्ठ, जात – धर्म हे भेदभाव सोडून आपल्या सहकारी डॉक्टरशी प्रेमाने व सह –वेदनेची ( एमपथी ) भावना ठेवून वागण्याचे धडे गिरवावे लागणार आहेत. आपल्या सहकार्यासाठी माणुसकीची भावना हीच रूग्णा साठी प्रेमाची आणी पुढे आपल्या व्यक्तिगत, व्यवसायिक यशाची पहिली पायरी आहे.
आज वैद्यकीय क्षेत्र मोठ्या नैतिक पेचातून जाते आहे. त्यातच पदव्युत्तर वैद्यकीय क्षेत्राचा आरक्षण लढा, तीव्र अतर्गत स्पर्धा, वैद्यकीय महाविद्यालयातील कामाचा ताण अशा अनेक कारणांनी आज सर्वसामान्य डॉक्टर अस्वस्थ आहे. अशा स्थितीत डॉ. पायल तडवी सारखी घटना या क्षेत्राला व पर्यायाने सर्वच बौद्धिक व्यवसायिक क्षेत्रांना मोठा हादरा देणारी ठरते. यामुळे वैद्यकीय क्षेत्रातील अंतर्गत अस्वस्थता वाढीला लागतेच नव्हे तर समाजाचा या क्षेत्रा विषयीचा दृष्टीकोन हि पणाला लागतो. या सर्व गोष्टींची वैद्यकीय क्षेत्राने व शासनानेही विचार पूर्वक हाताळणी करण्याचा हा क्षण आहे. तसेच या वर केवळ तात्पुरत्या मलम पट्ट्या नव्हे तर याच्या मुलभूत कारणांचे समाधान करणे गरजेचे आहे. राज्यातील आरोग्याची दयनीय स्थिती पाहता मानसिक दृष्ट्या सशक्त डॉक्टर तयार करण्याला प्राधान्य द्यावेच लागेल. पायल च्या आत्महत्येने प्रत्येक घटकाने यावर आत्मचिंतन करावे .
सदरील लेख ३० मे, २०१९ रोजी लोकमत च्या मुंबई आवृत्तीत प्रकाशित झाला आहे. लोकमत वृत्तपत्रात हा लेख वाचण्यासाठी क्लिक करा.
Dr Payal Tadvi, a resident doctor from Topiwala National Medical College & Nair Hospital committed suicide as she could not take the pressure and mental torture from her seniors anymore. This cannot be termed as just ‘Ragging’. As ragging, as we all know is just a jovial gesture during the first three or four months of any college that culminates into friendship with seniors.
The suicide of Dr Payal Tadvi is definitely a result of something more than that. It’s needed that we all should ponder on this and peep into our hearts as to why a doctor should be a reason for such a sad end of another doctor. Although we doctors fall into the group of professional minorities, we are still one of the most intelligent classes of society. In spite of being aware of this fact, why does the vanity or self-regard of being a doctor, doesn’t unite us all? Just like in a case of Saas–Bahu enmity, although being a female they are the reason for each other’s distress, why on the same lines doctor – doctor enmity is many times seen ruining lives of doctors, Payal Tadvi being a representing example. Everyone in some or the other way experiences betrayal by fellow doctors or seniors like in case of Payal Tadvi. It may be professional rivalries leading to fake PCPNDT complaints against fellow beings or impediment by a government doctor or sadist attitudes of seniors, HODs during residency. This raises a million-dollar question in my mind, in spite of being in quite a prosperous profession, although not much respected these days, why do we behave this way with our fellow doctors? Why do we turn so bitter when it comes to our own medical community? In our professional arena, we all know very well that everyone will get his/her share. Still many times it is seen that we leave no stone unturned to expose other’s mistakes or get professional mileage out of it. Even when we have to face a government official who is a doctor, he will never go an extra mile for a doctor and it never reminds him that we are children of same mother Medicine. Gone are those days when treating a doctor free was a principle religiously followed by the medical field. Of course, charging anyone is a very personal and professional matter. Nevertheless, we have also miserably failed to build a positive united fraternity like IAS, IPS, IITians have done over the years. ‘Lobby’ is a cruel word for this symbiosis based on professional self-regard. It’s not just about covering up for each other but it’s about professional and personal osmosis for the betterment of each of us. It’s my observation that an IAS will always respect the request of another IAS when it comes to anyone’s administrative work. Manohar Parrikar regularly visited IIT campuses and reassured young IITians that they can anytime knock his door for any help. Even in an institute like Harvard, the alumni network is a way ahead and Harvardians help each other at many levels. Even in politics, opposition party leaders are always helped by ruling ones to get homes in Delhi as Member of Parliaments. If we deeply analyse the case of death of Payal Tadvi, we will get answers to the marginalisation of doctors and the medical community in the society.
It’s not about being portraying ‘Holier than thou’ image. But why do we forget that being placed by destiny in the medical field, we are dealing with life and death? To be chosen as the most adorable children of God, we carry great responsibility on our shoulders. He has chosen us for a work directly connected with him. Isn’t being good first to our professional fellows and then to others is the first step to our professional and personal success? All this philosophy aside, isn’t a compassionate attitude towards our fellow doctors is an essential tool for our emotional and physical well-being? We are, what we are today because of our teachers in medical school. I have seen this world standing on the shoulders of my seniors, teachers and doctor friends. We have to give back to our medical community by being human to other doctors. Every doctor should shed at least one drop of tear for Dr Payal Tadvi whom we lost at the hands of other doctors. We should give a message to our future generations that, the medical field is one where every fellow doctor is treated with respect and compassion. Or else Payal Tadvi’s soul will never forgive us.
The direction of the thoughts of prominent leaders as well as the common voters becomes decisively important during this crucial period of the parliamentary elections. The politics of power always witnesses radical upheavals after a spell of every five years. The previous government resigns and a new government is formed. But what remains constant are the problems confronted by the country. The grim reality of the problem of health becomes more serious when it appears nowhere on the agenda of the electoral campaign of the political parties nor does it come to the lips of the leaders busy in delivering fiery speeches. What is most saddening is that, nobody cares to utter even a single word about the ‘Health Policy’ of this country in the midst of all this milieu. Not a single leader, on the national or the state level, is willing to make a key statement that will give a significant direction to the efforts to solve the health problems of this country. The voters are not yet sufficiently mature to expect that the elections will revolve around the problem of health. It is this problem which actually brings us to the threshold of life and death. But the voters are not sufficiently aware of it such that they will raise questions to their constitutional representatives about the ‘Health Policy’. Similarly, the society at large is also not yet keen to demand a statement about such a policy before the actual voting takes place. The reality is that the serious problems of health are knocking on our doors for one reason or the other. Yet the voters are themselves ignorant about the fact that the health of this country itself is on deathbed today. Needless to say, thanks to the attitude of seeking easy solutions, even the politicians, infected by the epidemic of populist policies, are ignorant about this horrifying reality.
The position accorded to the problem of health in the electoral proclamations of all the leading parties makes it clear that these parties have made only a superficial study of this problem and their policies are devoid of the wisdom needed to undertake the right steps to address it. Therefore, this is indeed the right time to make an emphatic appeal to the voters that they should first raise questions about the wrong policies of health adopted throughout last seven decades and then they should cast their votes only to such candidates who are willing to implement a policy of ‘Health for All’ and who will demand a comprehensive ‘Health Policy’ for this country.
Fundamentally, it is necessary to first understand the
confusion being made between the two concepts of ‘Health’ and ‘Health
Services’. The medication offered to ailing person is ‘Health Service’ and the
measures adopted to ensure healthy life of the people means ‘Health’. This
necessarily means that making provisions for ‘Health Services’ is merely a
small part of ensuring ‘Good Health’ of the people. Making a provision of
various ‘Health Insurance Schemes’ meant for a variety of medical treatments is
indeed necessary but it is wrong to assume that the health problem of the
country will get solved by introducing such schemes. Therefore, it must be
highlighted that conducting dazzling inaugural ceremonies of super-specialty
hospitals does not mean satisfactorily addressing the problem of ‘Health’. We
have forgotten that ‘Curtailing the need for Health Services’ should be the
pivotal factor while designing the health policies. Therefore what is necessary
is to implement a two-fold policy that focuses on the basic elements like
healthy maternal and child health along with a health policy that concentrates
over providing primary and preventive medical services. Today this pyramid of
health has become exactly opposite of what it should be. Through a long period
of last seventy years our population continued to grow steadily but how far did
the number of primary health care centres grow? Two significant questions are
decisive for judging the progress of the health sector of any country. Those
are, the rate of women dying during pregnancy and the proportion of infant
mortality. Today, everyday 174 women are dying during the process of giving
birth to their infants or within the first week of delivery. The causes of
these fatalities are also easily avoidable. Our country aims at reducing this
number to 30 in as late a year as 2030. Since majority of these 174 women
belong to the poor economic strata ,the health and nutrition of their newly
born infants also gets buried in the dark fathoms of the abyss of their
uncertain destiny. What this clearly means is that we do not possess any
national policy that can be vigorously implemented to save the lives of 348
citizens of this country hanging precariously on the edge of uncertainty. Not a
single leader of any political party is either willing to confidently declare
that he or she won’t let any women going through her pregnancy die. Nor is he
or she willing to talk about what program has been designed to ensure the
reduction in this number of pregnant women meeting their untimely death. Even
small countries like Thailand or Sri Lanka have already successfully reduced
this national average of women dying during their pregnancy to 20 and 30. But
in our country 40 children out of every thousand are dying even before their
first birthday on account of insignificant and easily avoidable factors. The
healthy growth of the 50% of the children who are born in this country gets
arrested on account of malnutrition. This essentially means that their death is
guaranteed if their physical weight does not increase urgently. And yet we are
not having any defined national level policy or a program to address this
problem. Even after 70 years of independence we have not yet been able to
protect 62% of the children using the vaccines available free of cost. Not a
single Member of Parliament has the courage to make a public declaration that
he will strive to make all the children of his constituency free from the
problem of malnutrition. Besides, no Member of Parliament also has the guts to
see that the vaccines do not lie idle in the refrigerators of public hospitals,
that they will get used before their expiry date. Worse still, none of the
voters seem to be interested in compelling the candidates contesting the
elections to take an oath in this regard. What should be the task of a highest
priority on the agenda of the upcoming government? The next government should
dare to come out with a white paper to declare the true rate of malnutrition in
our country and it should also convene a special session of the parliament with
the exclusive purpose of eliminating the problem of malnutrition and launching
a war-like drive to address this problem.
What we have forgotten over the span of last 70 years
is that ‘Health’ is one of the fundamental rights blessed upon us by our
constitution. It is essentially a right to live and it is also the duty of any
government. We take immense pride in claiming our democracy to be the largest
democracy in the world but it is awful that this largest democracy spends only
1.1% of its GDP for the purpose of health. When all the backward countries are
already spending 5% of their national income, we are being told that this
expenditure will be increased merely up to 2.5% till the year 2022. No voter is
keen to ask even a simple question such as ‘How much is the government willing
to spend to ensure my good health?’ because nobody tries to understand the
economics behind this. In all the developed countries, next to spending for the
needs of national security and safety of their citizens, funds are generously
made available for the purpose of health and education because they know that physical health is fiscal health. People
popularised this slogan in the developed nations , and even politicians, policy makers responded
to this sloganeering. While citing the glorious examples of economic growth to
us it must be noted that the financial loss we have suffered in this decade on
account of four serious ailments viz. heart diseases, diabetes, cancer and
stroke amounts to a whopping 16,500 lakh crore rupees.Throughout last several years nobody has tried to take up the problem of population control. Vasectomy is indeed as necessary as demonetisation but it cannot be imposed dictatorially nor can it be implemented as a ‘revolution’. Public health changes need to be a evolution rather then revolution. Several problems of health will get addressed if a national policy which addresses this problem through mass public education is rendered in a manner such that vasectomy will prove to be a voluntary result of an evolutionary process resulting into an automatic curtailment of the growing population. Today 70% of the fiscal spending in the health sector is taking place on providing medicines. The situation is so alarming in the domain of granting permissions to manufacturers of medicines that if the dark secrets of this sector get exposed not only will it result into anarchy but the agitated people will also come to streets just as a political volcano had erupted when the realities of banking sector were exposed.
Sharad Joshi, the founder of the farmers’ union i.e. ‘Shetkari Sanghatana’ used to assert that the problems confronting the farmers won’t get solved till such time they are not brought on the central stage of the politics of this country and as long as the prevailing politics of this country does not revolve around the problems of farmers. I have started feeling the same about the health , that health issues should become a political priority to get solved. As long as the electoral representatives of the people who guarantee the ‘Right to Health for Everybody’ do not emerge and as long as the voters keen about the ‘Health Policy’ do not appear on the horizon, nobody will even dream of the necessity of addressing this problem. Therefore, there is no escape from the idea that politics must revolve around ‘Health’.
Every Indian Pediatrician and Parents must know about this Influenza vaccine Update from World Health Organisation (WHO). This YouTube video will certainly contribute to the knowledge of Doctors who are providing vaccinations in India. I am sure this video on Influenza Vaccine update will change the fate of every Child, Parent and this country. How Many Parents know that flu vaccine for kids is available and regularly monitored by WHO through a seperate program Global Influenza Surveillance and Response System (GISRS). Previously influenza vaccination was optional, now it has become mandatory vaccine for influenza virus. Many doctors and parents are unaware of the fact that which type of the influenza virus vaccine should be used, that is being sold in India by vaccine manufacturers.
Watch this four-minute video that tells you the important update about influenza vaccination. Share this video with your doctor friends as well as with other parents and protect ypurself from flu. These four minutes can change the fate of every child in our country …!
For regular updates from Dr. Amol Annadate like announcements, youtube videos and articles stay tunned.
सर्दी खोकल्याच्या लसी विषयी म्हत्वाचे … जे प्रत्येक भारतीय डॉक्टर आणि पालकाला माहित असायला हवं!
हा युट्युब व्हिडीओ भारताच्या प्रत्येक डॉक्टरच्या ज्ञानात मोलाची भर टाकणारा आणी प्रत्येक बाळाचे , पालकाचे, या देशाचे भवितव्य बदलून टाकणारा व्हिडीओ आहे. सर्दी खोकल्या साठी लस उपलब्ध आहे हे किती पालकांना माहिती आहे. आधी ही लस ऑप्शनल म्हणजे पर्यायी होती, आता ती अनिवार्य लस झाली आहे. यात लस बनवणाऱ्या कंपन्यांकडून भारतात ज्या सर्दी-खोकला म्हणजे ‘फ्लू’ ची लस विकली जाते, ती भारतासाठी नेमकी कुठली लस वापरायला हवी, या बाबत अजून अनेक डॉक्टर, पालक अनभिज्ञ आहेत. त्या विषयी महत्वाची गोष्ट सांगणारा हा चार मिनिटांचा व्हिडीओ जरूर पहा. आपल्या डॉक्टर मित्रांशी तसेच इतर पालकांशी जास्तीत शेअर करा. ही चार मिनिटे आपल्या देशातील प्रत्येक बालकाचे भवितव्य बदलवू शकतात … !
Home Remedies for Bedwetting is made in Marathi. In this video, parents will get an idea about How to Stop BedWetting with Home Remedies for Nocturnal Enuresis. Bedwetting problem in children can be solved without medicine. Here are 6 home remedies for Enuresis.
5 Easy Home Remedies for Bedwetting Solutions for Child below five years. This video shows How to Stop Bedwetting i.e. Nocturnal Enuresis in the kids. Parents will understand these home remedies can be used to solve the problem of bedwetting without medicine. Here are 5 home remedies for Enuresis. An initiative by Famous Pediatrician Dr Amol Annadate for Social Health Concerns!
Limit tea, coffee after 6 p.m
Limit water intake up to 250 ml after 6 p.m
Awaken the child after 2 hours and make him pass urine.
STAR TECHNIQUE
Don’t scold the child and discuss too much with him about the problem Change the clothes, bedsheet without getting annoyed and involve him in this Contact your paediatrician if you don’t get results out of this for up to 6 months have Patience.
लहान मुलांमधील झोपेत अंथरून ओले करण्याच्या सवयीवर उपायांसाठी हा विडिओ बनवला आहे. या व्हिडिओमध्ये पालकांना न्युट्रनल एनरिसिससाठी घरगुती आणि साध्या उपायांसह बेडवेटिंग कसे थांबवायचे याबद्दल कल्पना मिळेल. मुलांमध्ये लघवीची समस्या औषधाशिवाय सोडवता येते. Enuresis साठी येथे 5 घरगुती आणि साधे उपाय देत आहोत. सामाजिक आरोग्य चिंतांसाठी डॉ. अमोल अन्नदाते यांनी हा पुढाकार घेतला आहे!
५ वर्षां पर्यंत उपचारांची गरज नाही, ५ वर्षांनंतर आठवड्यातून दोनदा सलग तीन महिने मुल ओले करत असेल तरच उपचारांची गरज आहे
संध्याकाळी सहा नंतर चहा, कॉफी नको तसेच पाण्याचे प्रमाण या वेळेनंतर कमी
रात्री झोपताना एक संकल्प करायचा – आज रात्री मी अंथरून कोरडे ठेवेन. नीट लक्ष दया – हे रेझोल्युशन
आई – वडील झोपण्या अगोदर मुलाला झोपेतून उठवून लघवी करायला लावणे
स्टार टेकनिक
या बाबत मुलाला रागवू नका , सकाळी त्याला न रागावता बेडशीट बदला कपडे बदलणे , बेडशीट बदलणे यात न रागवता मुलाला सामील करून घ्या
