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Indian workers to get safety net

Byoliveridley

This is great news, as long as the program is well administered and transparent (usual caveat that accompanies any new policy announced by the Indian government).

BBC NEWS | South Asia | Social security for Indian poor

The Indian government has announced an ambitious social security scheme which is aimed at benefiting about 390 million poor, non-unionised workers. Once passed by parliament, the scheme will provide the workers with life insurance and disability protection.

Under the new scheme, the non-unionised, casual worker will be entitled to life insurance and health and disability benefits by contributing just one rupee (one cent) a day.

The government says it wants to help the under-privileged

The government and employers will also contribute an equal amount. Those earning less than 6,500 rupees ($160) annually will be designated as living below the poverty line, and their one-rupee share will be paid for by the federal government.

It is estimated that the government will need $22.2bn to implement the scheme.

Assuming a purchasing power exchange rate of approximately 14 for India (year 2000 value), this poverty rate works out to approximatey $1.25 per day, a little more generous than the world bank’s dollar a day PPP adjusted figure, but not really. I would guess that the poor would need a little more help, but it is a start, and a good first attempt to get some kind of safety net for most of the Indian workforce.

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Circumspection on Circumcision – Lessons for India

Byoliveridley

Circumcision May Help Protect Against HIV – washingtonpost.com

Getting circumcised may reduce men’s risk of acquiring HIV, according to a study conducted in Africa. “Our study shows that circumcised men had 53 percent fewer HIV infections than uncircumcised men,” lead study author Robert Bailey, professor of epidemiology at the University of Illinois at Chicago (UIC), said in a prepared statement.

This study, published in The Lancet (registration and kidney donation required!) adds to the growing body of research suggesting that circumcision significantly reduces the incidence of HIV infection. The doubts on circumcision as a protective factor against HIV are falling away.

But, is this a viable public health strategy? In context, the US health and human services reports an 85% reduction in HIV risk through condom usage. This is probably a conservative estimate. There’s no indication yet that the gains from circumcision and condom use together are multiplicative.

Let’s look at India, for instance. Circumcision is not practiced among Hindus. There is no history of circumcision, and when I was growing up, it was clear that circumcision was for Muslims and Muslims only. It was often laughed about and there was a sense of superiority about not having to mutilate. It was a clear distinction setting difference between “us” and “them”. This article by Jaishanker and Haldar provides some perspective on Hindu-Muslim identities.

Apart from that, the other important identity of Muslim males is circumcision. It is found in many riots that Muslims were victimized based on their religious identity. In the riots if the perpetrators or the police are not able to identify victims with their religion they forcefully remove the pants of the victims to check whether they are circumcised or not. Once they find that the victim is circumcised he is targeted without further analysing which community he belongs to.

For example in Bombay riot (1992) there is a case of man who was frisked by the police for assessing whether he was a Muslim. However, out of fear he gave his name as Raju (a Hindu name) the officer made him take out his trousers and, noticed that he was a circumcised Muslim, and fired at him.

No Hindu parent in their right mind would circumcise their male child. It’s that simple. It’s part of the ingrained Hindu psyche that having an uncut member sets us apart from our Muslim brethren.

Nothing has changed about AIDS prevention strategies. But it’s boring to study the same variables all the time, let’s recap them one more time, shall we!

Education and awareness: Look at this picture from India (from the NFHS Survey):
Now tell me that increasing awareness among women and empowering them is not the most important thing you can do!

Condom use = 85% risk reduction

Nothing more to say. Continuing to improve access to condoms is important. Avert indicates that condom use is very state dependent, especially among sex workers, with Tamil Nadu having an 80-90% use rate and Mysore in neighboring Karnataka having a 9% use rate.

Access to antiviral therapy

India is in a lucky position here with a very well established pharmaceutical industry. So, drugs are likely to be available (patent issues notwithstanding). The issue however is with infrastructure, getting the drugs to the right people at the right time. This 2004 paper from the Indian Journal of Medical Ethics indicates that coverage is spotty at best. India’s National AIDs Control Organization (NACO) recognizes this, but in my opinion does not go far enough to provide free/affordable drugs to infected people, especially to prevent mother-child transmission.

So, to cut a long story short, circumcision in India is not likely to be a factor in the pantheon of choices available. We have a long way to go with our other major AIDS prevention challenges, and I hope this circumcision issue does not become an increasing distraction.

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Most random use of global warming as an excuse

Byoliveridley

Anaheim council OKs Disney-adjacent housing development – Los Angeles Times

In a new argument Tuesday, Disney officials provided city officials with an inches-thick packet asserting that the residential project would exacerbate global warming because of the traffic it would generate.

It is nice when Disney expresses concern about global warming, but why???

Over the strong objections of Disney and dozens of tourist officials, the Anaheim City Council voted 3-2 early this morning to approve a controversial residential project in the city’s resort district.

The six-hour public hearing, which began Tuesday night and spilled into this morning, was the council’s second attempt to settle the dispute that had lingered for nearly a year.

About 150 resort workers, many from Disney, attended the meeting in support of the development, some wearing stickers that read “Yes in Mickey’s Back Yard” (YIMBY). The dozen employees remaining at the meeting cheered when the project was approved.

Ah, I get it, they don’t want people working at Disney living near Disney!! So, go ahead, use global warming as an excuse! If it were not disgustingly hypocritical, it would be funny.

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What can the U.S learn from homeopathy?

Byoliveridley

Homeopathy was all around me growing up in India, so I read this article with interest as it jogged many memories of visiting the family homeopath with my parents.

Faith Healing with Homeopathy — In These Times

Homeopathy rests on three unproven tenets: First, “Like treats like.” Because arsenic causes shortness of breath, for example, homeopaths prescribe its “spirit” to treat diseases such as asthma. Second, the arsenic or other active ingredient is diluted in water and then that dilution is diluted again and so on, dozens of times, guaranteeing—for better and worse—that even if the dose has no therapeutic value, it does no harm. And third, the potion is shaken vigorously so that it retains a “memory” of the allegedly curative ingredient, a spirit-like essence that revives the body’s “vital force.”

Fooey, the description of the science is hilariously pseudoscientific, but homeopathy is no laughing matter in India. It is estimated to be a Rs. 250 Crore (that is 2.5 billion rupees or about $58 million) industry as of 2002-2003.  I do not think this includes doctors and clinics. This website lists 158 colleges in India offering the  valid (it is like an MD!) degree of Bachelor of Homeopathic Medicine and Surgery, or BHMS. My parents swear by it, most of my family living in India has either visited, or regularly visit one. It is hugely popular for hepatitis and liver disease, more so than conventional medicine in India.

What’s the deal? Why is it so popular? I think Terry Allen is on the right track, this sentence here, buried in the middle, hits the nail on the head…

Part of the effect comes from the ritual of consultation with a practitioner who treats the patient like a person rather than a body part on an assembly line.

Allen does not quite grasp the significance of this sentence and tracks away into placebo effects and evil pharma. But here’s the deal: A lot of Indians (who can afford $4-$5 consultation fee) visit their homeopath every month. When I tagged along with my parents, we would go on a Sunday afternoon at 2 PM to this homeopath’s office, which was a wing of his house (a big house, I might add!). It was a relaxed and leisurely time, he spent 10-15 minutes with each of us (yes, my parents made me!) talking about the previous month, what we were up to, how stressed we’d been, how our ailments from the previous month were doing, had we noticed any changes to our health over the month, etc. We would be interrupted occasionally by his little kid, or his assistant relaying a message from his wife, it was as far removed from a doctor’s visit as possible. And yes, he would take your blood pressure, run simple blood tests, etc. At the end of it, he would give you little sugar pills/sugar coated powder formulations to take home. The formulations were individually dosed, it was all categorized and labeled for you.

This is like having a mini physical every month. Surely, just the act of talking to someone made you feel better, the act of ritually opening up little packets of “medicine” and following detailed instructions for 5 days helped, surely the homely and relaxing atmosphere of visiting a family friend helped, I don’t know.

Metrics? both my parents occasionally had their hypertension treated with homeopathy. This worked as long as they were borderline, and simple stress management would get the numbers down. This doctor was/is very good at stress management because he talked calmly, yet firmly, he would listen and tease their little everyday stressors out of them and that was probably good for a 10 point reduction. But I remember the homeopath sending mom off to a doctor for a more conventional treatment regimen as soon as she hit 160.

It never ever worked for me because I was way too sceptical to buy into the process, so I would not listen, or relax enough to talk. I would take my pills, but it would make absolutely no difference whatsoever. Of course, he was trying to treat me for severe sinus related issues probably brought on by pollution, and by sleepless nights spent on a beach looking for turtles!

I am sure that for every good homeopath, there were two bad ones who just handed out pills of sugar. But my parents’ homeopath was, and continues to be part Dr. Phil, part candyman, part cheerleader!

Homeopathy probably “works” because it makes people take the time to think about their life and what’s ailing them. It’s a lesson that American primary care providers could do well to learn.

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Eastern United States vulnerable to climate change

Byoliveridley

http://www.eurekalert.org/pub_releases/2007-12/pu-sdn121007.php
6157_rel.jpg
Time to get out of the Eastern United States? A study to be published in the Proceedings of the National Academies of Science tries to quantify the relative risk of climate change using something called a “socioclimatic” risk factor. As always, the redder the worse. A look at the paper would no doubt be more illuminating, but for some reason, press releases about PNAS papers come out way before the papers actually become public. China is in bright red all the way, India in a rather bright orange. Where I live, the Eastern United States, is a nice beet red. No doubt, the unprecedented drought the South is experiencing right now is a nice big red signal.

Interesting stuff, though the actual paper will tell the story. Any technique that tries to integrate all the complex scientific, social and economic variables of climate change into one number is bound to have a flaw or two. But such a metric is useful for estimating relative risk, as the authors themselves say.

He added that the study does not address the absolute degree of impact or risk.

“This study illustrates exposure of one nation relative to another,” Diffenbaugh said. “Thus, it is important to note that a country low on the relative scale could still face substantial risk.”

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Half of India's children are malnourished – Yahoo! News

Byoliveridley

Half of India’s children are malnourished – Yahoo! News

With about 46 percent of children underweight — a negligible improvement over the last survey, conducted in 1998-99 — India is in the same league as nations like Burkina Faso and Cambodia. In China, Asia’s other rising economic power and the country India so often compares itself with, only 8 percent of children are underweight.

The improved infant mortality rate — down to 57 per 100,000 births from 68 in 1998-99 — remains dramatically higher than that seen in Western nations, such the Netherlands, where it is 4.

In every category where a comparison between the health of people in the countryside and cities was offered, those in rural areas lagged far behind. The rural infant mortality rate, for example, was 62 per 100,000, compared to 42 the in urban areas.

Such statistics show India “should be worried,” said Werner Schultink of UNICEF. “It’s going to be difficult for India if wants to use its human resources to develop the nation but does not make improvements.”

I don’t really know what to say, it is depressing, and points to the enormous amount of basic nuts and bolts infrastructure work that needs to be done in India. Back to themes from yesterday’s sewer post, it is basic government work, not sexy, not exciting, not flashy, just plodding mundane get it right kind of infrastructure building. It HAS to be done, there’s no sense in pointing to fancy malls in Bangalore or a super wonderful space program. One day, when I have time, I will convert all these percentages to numbers, percentages are good for comparing data, but to get a true sense of the magnitude, I think numbers are necessary. Quick calculation,the 2001 Indian Census says there were 350 million children (15 years old or less) in 2001, well, that makes 170 million starving (okay, “underweight”) children, it’s a happy place, ain’t it?