Refusing to accept the apathy and ignorance of children’s rights globally, Kailash outlined his dream by asserting, “My only aim in life is that every child is free to be a child; free to grow and develop; free to eat; sleep, see daylight; free to laugh and cry; free to play and learn; free to go to school, and above all free to dream.”
In today’s world, he said, “There is no greater violence than to deny the dreams of our children” and held that “the biggest crises knocking on the doors of humanity today are fear and intolerance.” Reiterating the power of education he said, “Rights, security and hope can only be restored through education”.
“Urgency in the key word. Adults can wait our time has passed, but children who’s time is here and now and in the future, cannot wait,” was call from Mr Kailash Satyarthi.
Today, around 215 million children are employed throughout the world–many of them forced to work long hours as full-time laborers. In many developing nations, these children lack access to education, proper nutrition, and health care. Stripped of their right to a childhood in order to help their families put food on the table, more than half of them are fall prey to the worst forms of child labor, exposed to hazardous environments, slavery, drug trafficking and prostitution, and armed conflict. (Source: United Nations) Official figures for India, alone, indicate there are over 12 million child laborers in the country. Though many NGOs estimate that the more accurate figure is a staggering 60 million children, a majority of whom work in dhabas or roadside restaurants/hotels, and factories, specifically textiles and firecracker (matchstick) factories, where the conditions are appalling and hazardous. And while a 2006 law mandated that no child under fourteen works, like many laws in India, it is rarely enforced: Two years after the ban, the Labor Ministry carried out 12,000 operations but made only 211 prosecutions.
According to UNICEF, State of the World’s Children 2010, an estimated 12 percent of children in India ages 5-14 are engaged in child labor activities. Stripping these children of the right to education strips them of a chance to ever better themselves,
and instead perpetuates a vicious cycle that condemns them to a life of poverty, where they are forced to live without the basic human needs that many of us take for granted. And while it would would cost $760 billion over a 20-year period to end child labor, the estimated benefit is six times that—over $4 trillion in economies where child labor is prevalent (ILO, Investing in Every Child, 2003).
ISSUES OF CONCERN
1. CHILD LABOUR & RIGHT TO EDUCATION
2. CHILD MARRIAGE
3. CHILDREN WITH DISABILITIES
4. MISSING CHILDREN
5. CHILDREN LIVING WITH AIDS
6. CHILD LABOUR
7. CHILD TRAFFICKING
8. CHILDREN WITHOUT PARENTAL CARE
9. CHILD HEALTH AND NUTRITION
10. STREET CHILDREN
11. CHILDREN IN POVERTY
12. SEX-SELECTIVE ABORTION
13. CHILD SEXUAL ABUSE
1. CHILD LABOUR & RIGHT TO EDUCATION
The worst forms versus all forms of child labour
Because many people mistakenly assume that child labour is a ‘necessary evil’, only the worst forms of child labour, such as prostitution and slavery, are usually addressed. Indeed, it is easy for everyone to agree that these should be abolished. But this does not help children who carry out work that is labelled as less harmful. About 70% of child workers work on the land or in the household. These children, too, are seriously damaged, although it is perhaps less visible. Sometimes they do go to school but also have to work before and after school or only in certain seasons, such as harvest time. But their performance at school can actually suffer from this, as can their health, well-being and future prospects.
It should also be borne in mind that child workers cannot be easily classified into groups. Children could still be doing other work. They could be working in a mine during part of the year and on the land during the harvest season. Even if it were possible to draw a dividing line between the worst forms of child labour and less severe forms of child labour, it would still be pointless. What’s more, children aren’t interested in these labels. Is it fair when a child who had to forge iron with glowing coals does eventually go to school while his sister at home who is supposedly doing less damaging work is overlooked? She, too, has a right to education. It is clear that focusing on the worst forms of child labour leads to ad hoc solutions, replaces one group of children with another group and simply perpetuates the problem. This is why Stop Child Labour is calling for the elimination of all forms of child labour that prevent children from getting an education.
Informal part-time versus regular full-time education
Focusing on the worst forms of child labour can also lead to a two-tier society in which children carrying out the worst forms of child labour are put into regular full-time education while children who continue to work informally are offered part-time (evening) education so that they can combine work and school. As long as it is assumed that children have to work to survive, this seems the highest goal attainable. But the quality of informal education often leaves much to be desired. Moreover, it is questionable how much children can actually learn after a hard day’s work. Ultimately, informal education does not truly help them and they remain disadvantaged in comparison to their more privileged peers who have regular full-time education.
An additional problem is that informal education by private organisations is more likely to be limited to temporary projects. When lenders withdraw, everything stops. Moreover, it takes the responsibility for education out of the government’s hands. Yet ultimately, only governments are capable of developing and providing a sustainable system of education for all children. The often moderate or poor quality of regular full-time education is not a reason to set up an alternative system for working children but a reason to improve the quality of the education system as a whole. This way, all children can benefit. Stop Child Labour believes that focusing on the worst forms of child labour offers no structural improvement. A more effective approach is to tackle all forms of child labour that prevent children from going to school at the community level and – together with the government – to ensure that all children can follow regular daytime classes.
International agreements and conventions
The above vision and promising practices are in fact a logical consequence of agreements made at the international level (UN). Under the “Convention on the Rights of the Child”, which has been ratified by most countries, states are required to provide compulsory and free primary education. In addition, states commit themselves under this convention to implement appropriate sanctions and other measures to ensure that children are protected from economic exploitation, dangerous work and work that hinders their participation in education.
There are two important ILO (International Labour Organisation) Conventions relevant to the fight against child labour. ILO Convention 182 against the Worst Forms of Child Labour prohibits dangerous and unhealthy work for children and adolescents up to 18 years of age. This Convention has now been ratified by 174 countries. ILO Convention 138 on the ‘minimum age for work’ states that the minimum age for work should not be lower than the age at which compulsory education ends, with a lower limit of 15 years of age. Developing countries may opt for a minimum of 14 years. The number of countries that have signed this convention has risen sharply in recent years and now stands at 1618.
As for universal education: 155 countries at the World Education Forum in Dakar in 2000 decided that by 2015 all children should have access to primary education. This is one of the generally accepted Millennium Development Goals which government leaders agreed on in 2000 to help rid the world of poverty.
When it comes to children’s rights in Africa it is also important to refer to the African Charter on the Rights of the Child. This charter obliges governments to take measures to protect and advance the rights of children – including the right to education and protection against child labour. It states that governments should protect children against harmful social and cultural practices. This includes all forms of work and practices, such as child marriage, that hinder children’s right to education.
This combined mandate gives rise to the basic premise: ‘Every child has the right to regular full-time education, and no child should carry out work that hinders that education and/or is dangerous’. The agreements and conventions provide clear guidelines for policy and programmes, but unfortunately they are not complied with in many countries. Stop Child Labour continues to refer to these agreements and conventions to call on governments to fulfil their responsibilities.
The Right of Children to Free and Compulsory Education Act or Right to Education Act (RTE), is an Act of the Parliament of India enacted on 4 August 2009, which describes the modalities of the importance of free and compulsory education for children between 6 and 14 in India under Article 21a of the Indian Constitution. India became one of 135 countries to make education a fundamental right of every child when the Act came into force on 1 April 2010.
The Act makes education a fundamental right of every child between the ages of 6 and 14 and specifies minimum norms in elementary schools. It requires all private schools to reserve 25% of seats to children (to be reimbursed by the state as part of the public-private partnership plan). Kids are admitted in to private schools based on economic status or caste based reservations. It also prohibits all unrecognised schools from practice, and makes provisions for no donation or capitation fees and no interview of the child or parent for admission. The Act also provides that no child shall be held back, expelled, or required to pass a board examination until the completion of elementary education. There is also a provision for special training of school drop-outs to bring them up to par with students of the same age.
The RTE Act requires surveys that will monitor all neighborhoods, identify children requiring education, and set up facilities for providing it. The World Bank education specialist for India, Sam Carlson, has observed: “The RTE Act is the first legislation in the world that puts the responsibility of ensuring enrolment, attendance and completion on the Government. It is the parents’ responsibility to send the children to schools in the US and other countries.”
The Right to Education of persons with disabilities until 18 years of age is laid down under a separate legislation – the Persons with Disabilities Act. A number of other provisions regarding improvement of school infrastructure, teacher-student ratio and faculty are made in the Act.
Education in the Indian constitution is a concurrent issue and both centre and states can legislate on the issue. The Act lays down specific responsibilities for the centre, state and local bodies for its implementation. The states have been clamoring that they lack financial capacity to deliver education of appropriate standard in all the schools needed for universal education. Thus it was clear that the central government (which collects most of the revenue) will be required to subsidize the states.
A critical development in 2011 has been the decision taken in principle to extend the right to education till Class X (age 16) and into the preschool age range. The CABE committee is in the process of looking into the implications of making these changes.
The Ministry of HRD set up a high-level, 14-member National Advisory Council (NAC) for implementation of the Act. The members included Kiran Karnik, former president of NASSCOM; Krishna Kumar, former director of the NCERT; Mrinal Miri, former vice-chancellor of North-East Hill University; Yogendra Yadav – social scientist. India
Sajit Krishnan Kutty, Secretary of The Educators Assisting Children’s Hopes (TEACH) India; Annie Namala, an activist and head of Centre for Social Equity and Inclusion; and Aboobacker Ahmad, vice-president of Muslim Education Society, Kerala.
A report on the status of implementation of the Act was released by the Ministry of Human Resource Development on the one year anniversary of the Act. The report admits that 8.1 million children in the age group 6-14 remain out of school and there’s a shortage of 508,000 teachers country-wide. A shadow report by the RTE Forum representing the leading education networks in the country, however, challenging the findings pointing out that several key legal commitments are falling behind the schedule. The Supreme Court of India has also intervened to demand implementation of the Act in the Northeast. It has also provided the legal basis for ensuring pay parity between teachers in government and government aided schools. Haryana Government has assigned the duties and responsibilities to Block Elementary Education Officers–cum–Block Resource Coordinators (BEEOs-cum-BRCs) for effective implementation and continuous monitoring of implementation of Right to Education Act in the State.
It has been pointed out that the RTE act is not new. Universal adult franchise in the act was opposed since most of the population was illiterate. Article 45 in the Constitution of India was set up as an act: The State shall endeavour to provide, within a period of ten years from the commencement of this Constitution, for free and compulsory education for all children until they complete the age of fourteen years.
As that deadline was about to be passed many decades ago, the education minister at the time, MC Chagla, memorably said: “Our Constitution fathers did not intend that we just set up hovels, put students there, give untrained teachers, give them bad textbooks, no playgrounds, and say, we have complied with Article 45 and primary education is expanding… They meant that real education should be given to our children between the ages of 6 and 14” – (MC Chagla, 1964).
In the 1990s, the World Bank funded a number of measures to set up schools within easy reach of rural ommunities. This effort was consolidated in the Sarva Shiksha Abhiyan model in the 1990s. RTE takes the process further, and makes the enrolment of children in schools a state prerogative.
2. CHILD MARRIAGE
“Premature pregnancy and motherhood are an inevitable consequence of child marriage. Girls under 15 are five times more likely to die during pregnancy and childbirth than women in their twenties.” -State of the World’s Children 2007, UNICEF.
UNICEF defines child marriage as marriage before 18 years of age and considers this practise as a violation of human rights. The harmful consequences of child marriage are segregation from family and friends, limiting the child’s interactions with the community and peers, lack of opportunities for education. Girl children often face situations of bonded labour, enslavement, commercial sexual exploitation and violence as a result of child marriage. Because of lack of protection child brides are often exposed to serious health risks, early pregnancy, and various STDs especially HIV/AIDS. There are many reasons why parents consent to child marriage such as economic necessity, male protection for their daughters, child bearing, or oppressive traditional values and norms. Globally more than one third of the women between the ages 20-24 were married before they reached the age of 18. Approximately 14 million adolescent girls between the ages 15-19 give birth each year. Girls in this age group are twice more likely to die during child birth than women in their twenties. Rate of child marriage are higher in sub-Saharan Africa and South Asia.
According to the 2001 census there are 1.5 million girls, in India, under the age of 15 already married. Of these, 20% or approximately 300,000 are mothers to at least one child. The 2001 census also estimated the average age of marriage has risen to 18.3 for females. The male average is 22.6 years. But child marriage is still widespread across the nation. States like Rajasthan, Uttar Pradesh, Madhya Pradesh, Jharkhand, Chhattisgarh, Bihar and Andra Pradesh still have average age of marriage below the legal age of eighteen for females. Because of the early and often closely timed pregnancies before their bodies are able to handle the stress of pregnancy, adolescent mothers give birth prematurely or to low weight babies. The health of the child and mother are at risk and often they do not survive. Child marriage also makes girls more vulnerable to domestic violence, sexual abuse and inability to complete primary education. It is also found that infant mortality rates are higher than the national average in the states where child marriage is highly prevalent.
According to NFHS-III survey 47.3% of women aged 20-24 were married by age 18. Of these, 2.6 percent were married before they turned 13, 22.6 percent were married before they were 16, and 44.5 percent were married when they were between 16 and 17. In some states the percentage is quite high: Rajasthan 65.2%, Uttar Pradesh 58.6%, Madhya Pradesh 57.3%, Jharkhand 63.2%, Chhattisgarh 55%, Bihar 69% and Andra Pradesh 54.8%.The states where prevalence is low are Himachal Pradesh 12.3%, Punjab 19.7%, and Kerala 15.4%.
Child marriage in India has grave implications for population control as adolescent brides are likely to have high fertility and a number of unwanted pregnancies. States where child marriage is most prevalent is also where there is the highest population. Child marriage is low among women who have had access to higher education and secondary education. Marriages in India are often unregistered, and are socially binding if not legally, which makes it hard to survey.
In 2006 the government of India updates legislations regarding child marriage and passed the Prohibition of Child Marriage Act, 2006.
3. CHILDREN WITH DISABILITIES
According to UN Enable, around 10% of the world’s populations, 650 million people, live with disabilities. Women and girls with disabilities are particularly at a risk of abuse. According to a UNICEF survey, 30% of street youth are disabled. Some countries where IMR rates are high, mortality rates for children with disabilities is as high as 80%. Some suspect that children with disabilities are being purposely weeded out. 90% of children with disabilities worldwide do not attend school. Conflict areas find that for every one child that is killed, three are injured and permanently disabled. Children with disabilities are at a 1.7 times greater risk of being subjected to some form of violence.
According to CRIN over 150 million children worldwide have a disability. 50% of children with a hearing impairment and 60% of those with an intellectual impairment are sexually abused. There are many medical professionals who kill children with disabilities and right them of as mercy killings. 90% of the children with disabilities will not survive pass twenty years of age. Children with disabilities face discrimination not only in services but also in the justice system as they are often not considered credible witnesses.
In India children with disabilities mainly comes under the purview of the Ministry of Social Justice & Empowerment. Some of the issues are dealt with by the health ministry. But no single ministry has been assigned the protection of these children, which leads to varying data about occurrence of disability amongst children. In India 1.67% of the 0-19 population has a disability. 35.29% of all people living with disabilities are children. Other estimates say that India has 12 million children living with disabilities. Only 1% of children with disabilities have access to school and one third of most disabilities are preventable. Under-nutrition is a severe problem with children who suffer from cerebral palsy. In India 80% of children with disabilities will not survive past age forty.
Many of the causes of disability are preventable by providing expecting mothers will better prenatal and post natal care as well as proper nutrition for infants and mothers.
The main causes of disability in children are
• Communicable disease
• Infection in early childhood
• Early motherhood
• Nutritional deficiencies
• Insufficient or inaccessible health care services
• Inadequate sanitation
• Inter-family marriages
There are many protection issues that also lead to disability, especially mental disabilities. Children who are trafficked, abused and sexually exploited are at risk for psychological effects as well as physical retardation. Other forms of violence against children can also lead to a disability such as corporal punishment in schools, children living on the streets, and purposefully created disabilities for begging. Children from poor families face a double disability.
Disability in India is still functioning in the realm of social welfare instead of a rights perspective. Teachers are not trained and schools don’t have the infrastructure to deal with children with disabilities. Neither are paediatric wards of hospitals equipped to deal with them. There is not enough data on the number of children living with disabilities to allow the government to provide the necessary services. Mental health disorders account for one sixth of all health disorders yet India spends 0.83% of its health budget on mental health. Child labourers are also at a higher risk of becoming disabled especially in hazardous industries.
In 2008 A NGO published a study on Mentally Challenged Children in Sholapur District, Maharashtra. The study looks at information at all three levels: village, taluka and district. Key findings of the study were that in 24% of the mentally challenged children, one of the parents were mentally retarded. 11% of mothers of mentally challenged children were below eighteen years. 36% of mothers reported complications during pregnancy while 41.2% reported stress. Only 8% of mentally challenged children attended school past II grade pr up to VII grade in normal schools. 33% of parent didn’t allow their children to interact with other children due to fear of them being teased, accidents, aggressive behaviour, etc.
Children with disabilities are covered under the Persons with Disabilities (Equal Protection of Rights and Full Participation) Act 1995.
4. MISSING CHILDREN
A countless number of children go missing every year. The category of missing children include a number of problems including abduction or kidnapping of children by family members and by non-family members, run-away children or those forced to run away by family and surrounding circumstances, children who are in a difficult or aggressive environment, trafficked children, and lost children. Because of this wide array of problems it is hard to survey the number of missing children. Often cases are not reported to the police. In 2005 National Human Rights Commission (NHRC) informed that on an average 44000 children are reported missing every year. Of these, as many as 11,000 remain untraced.
Children who go missing may be exploited and abused for various purposes from camel jockeys in the Gulf countries to victims of organ trade and even grotesque cannibalism as reported at Nithari village in Noida. There are also a large number of children who run away from homes after dropping out of school or facing difficulties at home. They usually run away to the glamorous big cities where they fall prey to exploiters and are employed in tea stalls, brothels, beggary, etc. Most of the children come from poorer families who do not have access to police services or whose reports are not taken seriously.
When a child goes missing there no FIR filed as there is no cognizable offence committed. Hence only an entry is made into the General Station Diary at the concerned police office. Information of the missing child is forwards up to the Chief of police as well as locally police officers generate awareness through the media. The police headquarters of each state has a missing person bureau. A database of missing persons is maintained by the Missing Persons Wing at the National Crime Records Bureau (NCRB) in New Delhi.
Some recommendations/suggestions of the NHRC Committee made to state and union governments:
• Missing children should become a priority issue with state and union governments and law enforcement agencies.
• Every police station should have a special squad and missing person’s desk dedicated to tracing missing children. Special Juvenile Police Unit can also be used in this purpose.
• Reiterate the High court decision to establish a missing children’s cell in the CBI
• District administrators are responsible for keeping tabs on the number of working children in his/her district. He/she is required to make regular inspections of these spaces
• All missing children cases nationally should be reported to the National Commission for Protection of Child Rights (NCPCR)
• Missing children’s investigation should include the help of the Panchayat and community.
• NGO’s can also assist in reporting and investigating missing children
• NCRB needs to set up a system/database so that all missing children cases are available to local authorities.
• Government is required to give ample support to the emergency helpline CHILDLINE 1098
• It is advisable that FIRs be filed in the case of missing children.
A CHILDLINE report on missing children discusses the relation of trafficking to missing children. It reports that on average 44,475 children go missing every year. The data also shows an increase in missing children over the years, an increased in untraced cases and increase of cases of missing children in certain metropolitan cities and states led my Maharashtra at a yearly average of 13,881. The report states that children are often kidnapped or trafficked for prostitution, organ donations, employment, and such activities.
To read more trafficking please visit the section on Trafficking.
5. CHILDREN LIVING WITH AIDS
Children are not only personally affected by HIV/AIDS but it is also affecting their families and their right to a parental care and affection. UNICEF finds that infection can lead children to drop out of school; infection of parents can lead children to engage in child labour in order to survive. Many children are orphaned and highly exposed to abuse, exploitation and neglect because of a loss of a parent(s) or guardian. It is estimated that a child looses a parent to AIDS-related infections every 14 seconds, mostly in Sub-Saharan Africa. Many situations also put children at higher risk of getting infected such as recruitment into armed conflict, trafficking, displacement, etc. In 2005 UNICEF estimated the number of children below 15 infected with HIV to be 2.3 million. Approximately 570,000 children were found to have died from AIDS at the time of the study. 80% of children orphaned by AIDS live in Sub-Saharan Africa.
According to UNICEF India there are 220,000 children infected by HIV/AIDS in India. It is approximated that every year 55,000 to 60,000 children are born to mothers who are HIV positive. 30% of these children are likely to be infected themselves.
According to a publication of NACO and MWCD there are 2-3 million people in India living with HIV/AIDS. It is estimated that 70,000 children below the age of 15 infected with 21,000 children being infected through mother-child transmission every year. HIV infection in extremely young children is especially fatal. Young children progress through the disease at a much faster rate. 33% of children with HIV die within the first 12 months, 50% by 24 months and 60% by 36 months. For young children early detection, nutritional supplements and medical treatment especially antiretroviral therapy is essential for survival. Children living with the disease experience a great deal of social stigma and discrimination. This results in children being marginalised from essential services such as education and health.
An approximation for the number of children affected by AIDS varies greatly. The number of children infected with HIV/AIDS varies from 55,000 to 220,000. Roughly 1,500,000-2,500,000 children have been orphaned by AIDS and another 6,000,000-10,000,000 children have a positive parent. The highest cause of child HIV/AIDS is mother to child transmission (MTCT). Other than MTCT other ways of contracting the disease among children has been sexual contract including sexual abuse, blood transfusion, unsterile syringes, and intravenous drug use.
Some areas of concern are the discrimination faced by orphaned children of HIV/AIDS parents, lack of funding or utilization of funds in giving treatments, unsafe health care practices, and lack of attention to HIV/AIDS amongst children in health policy. Child affected by AIDS need medical treatment, counselling, support from extended families, and other non-institutional care, and help with medical care for parents so as not to create debt and need for child labour. As part of an attempt to help children living with HIV/AIDS, UNICEF in collaboration with national organisations and the Government of India have put children on the agenda of the National Aids Control Plan III. The aim is to prevent parent to child transfer of the disease, and provide care and medical treatment to children infected with HIV/AIDS.
6. CHILD LABOUR
“Out of school children comprise the workers and non workers. In our view they together signify a measure of deprivation among children and can be considered as a potential labour pool always being at the risk of entering the labour force” – NCEUS, 2007
India is sadly the home to the largest number of child labourers in the world. The census found an increase in the number of child labourers from 11.28 million in 1991 to 12.59 million in 2001. M.V. Foundation in Andhra Pradesh found nearly 400,000 children, mostly girls between seven and 14 years of age, toiling for 14-16 hours a day in cottonseed production across the country of which 90% are employed in Andhra Pradesh. 40% of the labour in a precious stone cutting sector is children. NGOs have discovered the use of child labourers in mining industry in Bellary District in Karnataka in spite of a harsh ban on the same. In urban areas there is a high employment of children in the zari and embroidery industry.
Poverty and lack of social security are the main causes of child labour. The increasing gap between the rich and the poor, privatization of basic services and the neo-liberal economic policies are causes major sections of the population out of employment and without basic needs. This adversely affects children more than any other group. Entry of multi-national corporations into industry without proper mechanisms to hold them accountable has lead to the use of child labour. Lack of quality universal education has also contributed to children dropping out of school and entering the labour force. A major concern is that the actual number of child labourers goes un-detected. Laws that are meant to protect children from hazardous labour are ineffective and not implemented correctly.
A growing phenomenon is using children as domestic workers in urban areas. The conditions in which children work is completely unregulated and they are often made to work without food, and very low wages, resembling situations of slavery. There are cases of physical, sexual and emotional abuse of child domestic workers. The argument for domestic work is often that families have placed their children in these homes for care and employment. There has been a recent notification by the Ministry of Labour making child domestic work as well as employment of children in dhabas, tea stalls and restaurants “hazardous” occupations.
Bonded child labour is a hidden phenomenon as a majority of them are found in the informal sector. Bonded labour means the employment of a person against a loan or debt or social obligation by the family of the child or the family as a whole. It is a form of slavery. Children who are bonded with their family or inherit a debt from their parents are often found in agricultural sector or assisting their families in brick kilns, and stone quarries. Individual pledging of children is a growing occurrence that usually leads to trafficking of children to urban areas for employment and have children working in small production houses versus factories. Bonded labourers in India are mostly migrant workers, which opens them up to more exploitation. Also they mostly come from low caste groups such as dalits or marginalised tribal groups. Bonded child labourers are at very high risk for physical and sexual abuse and neglect sometimes leading to death. They often are psychologically and mentally disturbed and have not learnt many social skills or survival skills.
In 2000 the ILO estimated 5.5 million children had been forced in labour in Asia, while the Bonded Labour Liberation Front placed 10 million bonded children in India alone. In 1998 the government of India labelled bonded child labour as a marginal problem with only 3000 or so cases. A survey in Tamil Nadu in 1995 found 125,000 bonded child labourers in the state alone. Child bonded labour in India is mostly in the agricultural sector but has in recent times been moving into other sectors as well such as beedi-rolling, brick kilns, carpet weaving, commercial sexual exploitation, construction, fireworks and matches factories, hotels, hybrid cottonseed production, leather, mines, quarries, silk, synthetic gems, etc.
Child labour in India is addressed by the Child Labour Act, 1986 and National Child Labour Project.
7. CHILD TRAFFICKING
“Approximately 600,000 to 800,000 victims are trafficked across international borders annually, and between 14,500 and 17,500 of those victims are trafficked into the United States each year. More than half of these victims worldwide are children!” – Child Victims of Human Trafficking, Department of Health and Human Services, USA and the U.S. Department of State
Human trafficking is the third largest profitable industry in the world. Child trafficking unlike many other issues is found in both developed and developing nations. Trafficked children are used for prostitution, forced into marriage, illegally adopted, used as cheap or unpaid labour, used for sport and organ harvesting. Some children are recruited into armed groups. Trafficking exposes children to violence, abuse, neglect and exploitation. According to UNICEF a child victim of trafficking is “any person under 18 who is recruited, transported, transferred, harboured or received for the purpose of exploitation, either within or outside a country”. Trafficking is one of the hardest crimes to track and investigate hence data is hard to obtain. The latest figures estimate that 1.2 million children are trafficked worldwide every year. Child prostitution has the highest supply of trafficked children.
India is a source, destination, and transit country for trafficking for many purposes such as commercial sexual exploitation. Majority of the trafficking is within the country but there are also a large number trafficked from Nepal and Bangladesh. Children are trafficked to Middle Eastern countries for sport such as camel racing. There are no national or regional estimates for the number of children trafficked every year. But 40% of prostitutes are children, and there is a growing demand for young girls in the industry.
There is a rising demand for live-in maids in urban areas. This has resulted in trafficking of girls from villages in West Bengal, Jharkhand and Chhattisgarh to live under extremely poor conditions first in “placement agencies” and later in the employers homes. Placement agents keep the girls in small unhygienic rooms packed together. They are often made to do the placement agent’s household work and subjected to sexual abuse. Smita a sixteen year old girl was taken from her village in Jharkhand and subjected to various forms of sexual abuse and exploitation at the hand of her employers including rape. When rescued her parents refused to take her back since she had been tainted by rape. Falling sex ratios in Haryana and Punjab has led to a need for trafficking of brides from villages in Orissa, Jharkhand, Bihar, Assam and West Bengal, who have been sold off by the parents. Jyoti, age fourteen, was sold and married to a 40-year old man for Rs 15,000 in order to produce a mail heir.
India has legal provisions to counter trafficking as per the Immoral Traffic Prevention Act 1986.
8. CHILDREN WITHOUT PARENTAL CARE
According to UNICEF, children worldwide lose their parents in conflict, or due to poverty, disability, HIV/AIDS. Hence there is a large population of children that grow up without one or both of their parents. Children without parental care are at a high risk of abuse, exploitation and neglect. Large numbers of children end up in institutional care. Inadequate individual care of institutions can socially and emotional impair children. About 1.5 million children in the Central and Eastern Europe and the Commonwealth of Independent States live in public care institutions. In Europe and Central Asia, over 1 million children live in residential institutions. In 2003 there were an estimated 143 million orphans in 93 countries of sub-Saharan Africa, Asia, and Latin America and the Caribbean. Asia has the highest number of orphans due to all causes, with 87.6 million children.
Children may be destitute, for the interim or permanently of parental care for many reasons including the illness, death or imprisonment of parents, separation due to migration or armed conflict, the removal by child welfare authorities and/or the courts based on the child’s best interests, detention of the child, or following the child’s own initiative to leave home.
In India the child parent relationship is often seen as one of obedience of a social order more so than a right of the child. Hence when a child is separated from his/her parent it is not viewed as the duty of the state to provide that child with a family environment. None the less adoption is supervised by the state, but India does not have a long term foster care or alternate care system outside of institutionalisation.
UNICEF estimates that there are 25 million orphaned children in India in 2007. Another study estimates there are about 44 million destitute children and over 12 million orphan and abandoned children in India, yet there are only 5000 (0.04%) adoptions every year. The institutions for children in conflict with the law host about 40,000 children. The wide gap that exists in the knowledge of and attitude towards child adoption and intention to adopt a child between people from different socio-economic backgrounds exposes the need of the state to initiate promotion of child adoption and creating a system of non-institutional care for children above the adoption age.
Adoption in India comes under the provisions of three acts and is carried out centrally by CARA
• The Hindu Adoption and Maintenance Act 1956
• The Guardian and Wards Act 1890
• The Juvenile Justice Act 2000
9. CHILD HEALTH AND NUTRITION
According to the World Health Organisation (WHO) globally, 30% of children under five are estimated to be stunted and 18% have low weight-for-height, and 43 million children are overweight. Optimal breastfeeding could save the lives of 1.5 million children under five every year. Nearly nine million children die every year from preventable diseases and infections: the largest killer being Diarrhoeal disease. There are over 2 billion cases of diarrhoeal disease every year and is the leading cause of malnutrition amongst children under five.
In India 84% of all health care expenditure is out of pocket. This places a great number of families at risk of falling into poverty due to high health expenses. Millions of children are at risk of becoming malnourished. Every third child in India is malnourished. Infant and child mortality rates still remain very high about the MDG. They are lowest among marginalised groups such as scheduled castes and tribes, and females. Discrimination in food based schemes and in society in general leads to starvation deaths among women and children of the Scheduled Castes and Scheduled Tribes. Muslim children have the highest rate of stunting and second highest rate of being underweight. There are almost no services or programmes for children with mental health issues. Children with disabilities, HIV/AIDS and mental disorders are stigmatized and hence have little access to health facilities.
India has one of the poorest health records in the world with the highest TB prevalence, every three out of four children have anaemia, and polio eradication is actually backsliding. With varying social sector budgets, health indicators differ greatly across the country. Kerala is best off with only 21% stunted children. Uttar Pradesh has the worst record with 46% of the children being underdeveloped. Girls are at a higher risk of not being able to access health care. The mental health budget remains at 1% of the total health budget.
According to UNICEF India over two million children die every year from preventable diseases. IMR in India is 63 deaths for every 1000 live births. Of these 47% of the deaths occur within the first week after birth. Measles is the largest cause of death among children which can be prevented by a vaccine. Tetanus in newborns remains a major problem Uttar Pradesh, Madhya Pradesh, Rajasthan, West Bengal, and Assam.
Breastfeeding is the first crucial step to ensuring good health in infants. According to NFHS-3 data 24.5% of new mothers initiated breastfeeding in the hour after birth, 46.4% breastfed exclusively the first six months and 56.7% nursed beyond six months with the introduction of complementary food. This results in more than 50% the child population below five being underweight. 44.9% of the children under three are stunted and 22.9% of children under three are wasted. Less than 50% of children receive full immunization during infancy. This number has been dropping significantly over the years indicating a problem with the universal immunization programme.
10. STREET CHILDREN
The issue of street children is considered to be an urban problem. Children can be found in railway stations, near temples and durgahs, in markets, under bridges, near bus deports and stops, etc. Hence the definition of street is not in the literal sense, but refers to those children without a stable home or shelter. There are three major categories of street children:
1. Children who live on the street with their families and often work on the street. There may be children from migrated families, or temporarily migrated and are likely to go back to their homes.
2. Children who live on the street by themselves or in groups and have remote access or contact with their families in the villages. Some children travel to the cities for the day or periods of time to work and then return to their villages.
3. Children who have no ties to their families such as orphans, refugees and runaways.
According to UNICEF street children fall under two categories: On the street and Of the street. “Children of the street” are homeless children who live and sleep on the streets in urban areas. They are on their own and do not have any parental supervision or care though some do live with other homeless adults. “Children on the street” earn a livelihood from street such as street urchins and beggars. They return home at night and have contact with their families. The distinction is an important one because children of the street lack emotional and psychological support of a family.
It is the second and third category of children who are most vulnerable as they are easy victims of abuse, and inhuman treatment. They often engaged in petty theft or prostitution for economic survival. Children runaway from their homes for a variety of reasons. Some may have faced traumatic experiences in their homes. Their parents may be abusive or have problems with alcoholism, poverty and unemployment. Some children leave home drawn by the glamour of the big cities.
Street children vary across cities and regions. But a majority of these children are boys. It is also important to note girl street children are often not found in visible spaces and hence hard to trace. Age wise 40% of the street children are between 11-15 years while another 33% are between 6-10 years age group. A study found that majority (89.8%) of children live on the street with their parents/family.
There are a number of factors that lead children to living on the street. One root cause that has been identified is poverty. But poverty alone does not result in this problem. Other factors to be taken into consideration is the expansion and growth of cities, over-population, family disintegration, inadequacy of formal school institutions leading to large numbers of dropouts and failures, inability of institutions to deal with these problems, etc.
Street children mostly live in open air spaces. There are few to no shelters available in the cities for homeless children. Some may live in a temporary constructed hut or the house of their employer. Majority of street children work. Almost 50% of street children are self-employed as rag-pickers, hawkers, and shoeshine boys, while others work in shops and establishments. Their work hours range between 10-13 hours a day. These children are exposed to high health hazards as population and unhygienic conditions of living. Having no shelter they are constantly exposed to environmental conditions of heat, cold and rain.
Many street children also face harassment by municipal authorities and police. One -third of street children complain of persecution by such authorities. Street children also face abuse from their family members, employers and other people. The right to play of a street child is almost nonexistent as they do not have access to recreational facilities and often venture into activities available to them on the street such as drug abuse, gambling, drinking, etc.
In 2003, UNICEF estimated that there were at least a 100 million street children in the world, but though this figure is commonly found it is not seen to be based on any actual studies or surveys. In 1994, UNICEF estimated that there were 11 million street children in India. This number is said to be a drastic under-estimation. The Indian embassy estimated 314,700 street children in cities like Bombay, Calcutta, Madras, Kanpur, Bangalore and Hyderabad and around 100,000 street children in Delhi.
In the 2007 MWCD report on child abuse, the study found 65.9% of the street children lived with their families. Out of these children, 51.84% slept on the side-walks, 17.48% slept in shelters and 30.67% slept in other locations such as under flyovers and bridges, railway platforms, bus stops, parks, market places, etc. 66.8% of children reported being physically abused by family members and others. To download the full report please visit the Abuse and Violence section.
Because of a lack of permanent shelter and the fact that the number of street children is not recorded in any national survey or study street children are often called the ‘hidden children’. Being hidden, they are at a higher risk to being abuse, exploited and neglected. Another group that is at risk of ending up on the street are migrant children. Children come to cities in hope of finding new jobs and opportunities for their families. Unfortunately increasing populations in the cities, children that come to the cities face meagre incomes, poor housing and usually end up on the street. The Indian embassy estimated 314,700 street children in cities like Bombay, Calcutta, Madras, Kanpur, Bangalore and Hyderabad and around 100,000 street children in Delhi.
11. CHILDREN IN POVERTY
A condition that puts a lot of children at risk for many of the issues listed in this section is poverty. Lack of access to basic requirements such as food, shelter and clothing are the underlying cause of poor child health, poor child nutrition, child labour, child marriage and various other issues. It widens the economic, social, cultural, and gender disparities already present in society. Poverty essentially threatens every child right: survival, development and protection. Poverty follows a vicious cycle as poor children grow up to be poor adults who then pass on debt to their children.
Children experience poverty differently from adults as it creates an environment which is harmful to their mental, physical, emotional and spiritual development. It can not be simply understood in terms of household income or household consumption. UNICEF defines as “Children living in poverty experience deprivation of the material, spiritual and emotional resources needed to survive, develop and thrive, leaving them unable to enjoy their rights, achieve their full potential or participate as full and equal members of society.”
In a study on poverty faced by children, UNICEF found that children face seven areas of severe deprivation: adequate nutrition, safe drinking water, decent sanitation facilities, health, shelter, education and information. The study found that half the child population of the world suffers at least one form of deprivation. The nature of deprivation is such that one deprivation reinforces others. Lack of access to safe drinking water can affect a child’s health, education and nutrition. Rural children in poverty are twice as likely to suffer some form of deprivation as their urban peers.
Child poverty is not an issue only in low income nations but it found in many middle income nations as well. For example Columbia and Namibia have similar levels of per-capita income but yet Namibia has more severe deprivations. Namibia’s children suffer deprivations closer to those of Togo’s, a much poorer country. Child poverty is also high associated with gender discrimination. How income or resources are earned, distributed and valued depends on the power relations between men and women in the family and in society in general.
Children in poverty experience more then simple material poverty. The lack of material security exposes children to all forms of abuse and exploitation. It creates economic need that pushes children into child labour, and hence forsakes their right to education and recreation. Hence children experience an emotional and mental poverty as well. This in turn produces further material poverty, creating a generational cycle of poverty.
The most popular international estimation of poverty is given by the World Bank at 1.4 Million people living below the poverty line in 2005. In 2008 the World Bank set the poverty line at $1.25 a day using 2005 Purchasing Power Parity terms and price data from the International Comparison Program 2005. This line is based on the mean of national poverty line from various poor countries.
The below poverty line in India is determined by the Planning Commission for the purpose of Central sponsored programmes in the rural areas and urban areas. The tenth five year plan calculated the poverty line by thirteen parameters, with a 0-4 score for each parameter. Families with a score less than 15 out of 52 possible marks are considered to be below the poverty line (BPL). The government caps the number of families in this category at 3.26 lakhs in the rural area and the BPL survey found a total of 3.18 lakhs families in 2002. The thirteen parameters include land holding, type of house, clothing, food security, sanitation, consumer durables, literacy status, labour force, means of livelihood, status of children, type of indebtedness, reasons for migrations etc. In the urban BPL survey poverty is calculated by seven parameters: roof, floor, water, sanitation, education level, type of employment & status of children in a house. In 2004 the survey found 1.25 lakh urban poor families below the poverty line. State governments use their own criteria for BPL calculation for the state schemes.
Poverty estimation covers a much larger population than the below poverty line. There are various differing opinions on poverty estimation in India. There are four main sources of poverty estimation in India.
• Planning Commission 2004-05 estimates: the National Sample Survey Organization (NSSO) with the use of the Consumer Price Index of Agricultural Labourers for rural poverty line and Consumer Price Index for Industrial Workers (CPIIW) for urban poverty lines, calculated the percentage of poor in the nation. Rural poverty was estimated at 28.3% and urban poverty was estimated at 25.7% as per the Uniform Recall Period consumption in which the consumer expenditure data for all the items are collected from 30-day recall period. Mixed Recall period estimates are slightly lower as MRP indicated consumer expenditure data for five non-food items, namely, clothing, footwear, durable goods, education and institutional medical expenses are collected from 365-day recall period and the consumption data for the remaining items are collected from 30-day recall period.
• The Arjun Sengupta Report on conditions of work and promotion of livelihoods in the unorganised sector’: estimates the 77% of the population, that is there are 836 million people with the purchasing power income of less than two dollars. Based on NSSO data the committee categorizes poverty into four distinct groups: The extremely poor are people who survive at 0.75 of the official poverty line (PL) (which is at approximately Rs. 10 per capita per day). The poor subsist between 0.75 PL and PL. The marginally poor are slightly better off as their daily consumption rests between PL and 1.25PL. And lastly the vulnerable group who is in danger of becoming poor live on 1.25PL to 2PL (which is approximately Rs 20.3 per capital per day).
• The Saxena Committee Report: In August, 2009, The Saxena Committee, which was commissioned by the Ministry of Rural Development to advice on a methodology for conducting the Below Poverty Line (BPL) census for the 11th five year plan. The committee aimed at three things; to automatically exclude non-poor families from the survey, automatically include extreme poor families and grade the rest of the families according to fare criteria. The Saxena Committee estimates the 50% of the population would be included in the BPL list.
• The Tendulkar Committee Report: In November 2009, the Tendulkar Committee, which was appointed by the Planning Commission of India as an expert group to review the methodology for estimation of poverty, produced a report. The committee suggests it is best to continue calculating the poverty line according to private household consumer expenditure of Indian households from data connected by NSSO. Hence according to this report the urban poverty headcount ratio is 25.7 % as calculated previously. But there has been a change in the rural national poverty headcount ratio which was originally calculated to be 28.3 %. It is now estimated at a much “higher and accurate” ratio of 41.8%. This means that according to the report, 37.2% of the population is considered to be below the new poverty line. The new all India poverty line is set at Rs. 446.68 in rural areas and Rs. 578.8 in urban areas.
12. SEX-SELECTIVE ABORTION
“Diagnostic teams with ultrasound scanners which detect the sex of a child advertise with catchlines such as spend 600 rupees now and save 50,000 rupees later.” – IndianChild.com
The girl child’s discrimination begins before birth in the form of female foeticide. Sex selection has been argued as the consequence of technology. But simply because it is a consequence it does not excuse the fact that between the years 1981-1991 a whopping 11 million girls joined India’s missing women a group of 35 and 40 million. According to Amartya Sen there are more than a hundred million women missing in the world of which India has 37 million missing women by 1986.
Another figure as recorded by UNICEF, said that in 1984 in Bombay out of the 8,000 abortions that took place, 7,999 of them were girls. Girl children are murdered shortly after being born when the family comes to know the sex of the child or killed slowly through neglect and abandonment. In 1993 in Tamil Nadu 196 girls died in suspicious circumstances. “Some were fed dry, un-hulled rice that punctured their windpipes, or were made to swallow poisonous powdered fertilizer. Others were smothered with a wet towel, strangled or allowed to starve to death”. The larger consequence to both female feticide and infanticide has been the sharply declining sex ratio. The adult sex ratio fell from 972 females for every 1000 males in 1901 to 927 in 1991. Only recently has the ratio increased to 933 in 2001, but the child sex ratio (ages 0-6) have dropped from 945 in 1991 to 927 in 2001.
According to the United Nations Cyberschoolbus paper on the girl child out of the 130 million children not in school, almost 60% of them are girls. By the age of 18 girl children have received on average 4.4 years less education than boys. In India, the Ministry of Human Resource Development showed the average enrolment rate of girls, ages 6-14 and 14-18, as 93.47% and 36.77%. But they also show the 61.5% of girls drop out of school before completely class XII.
According to a special report on the girl child and labour by International Labour Organisation (ILO) more than 100 million girl children between the ages of 5 and 17 are engaged in child labour, out of which over 50% of them are in hazardous industries, and 20% of those are below twelve years old. It is hard to get correct statistical information about girl child labour since the kind of the work girls undertake is more invisible than that of boys. For example agricultural work, domestic work and working in home based workshops. Many girls are engaged in active labour which is disguised as household chores. ILO shows that 10% of girls are engaged in “household chores” for more than 24 hours in a week which is twice as much as boys. One of the most gender specific forms of child labour is child prostitution.
According to United Nations Cyber school bus paper on the girl child at least one in three girls and women worldwide has been physically harmed or sexually abused in her lifetime. Female genital mutilation though not common in India affects millions of girls and women every year. Sakshi a Delhi based NGO conducted a survey of 357 school girl children: 63% have experienced serious sexual abuse or rape; 29% had forced oral sex, squeezing of breast, and genitals. In 30% of all cases, the person behind the act was a family member. There is also a rise of sexual abuse in schools, where teachers molest their students sometimes in the presence of other children.
The issues surrounding a girl child have been discusses in national child policies and laws and addressed in a few programs.
• The National Policy for Children, 1974
• The National Plan of Action for Children, 2005
• The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994
• The Immoral Traffic (Prevention) Act 1986
• The Juvenile Justice Act of 2000
• Indian Penal code
Campaigns promoting the rights of the girl child are found both nationally and internationally. The Government of India has started a “save the girl child” campaign with the slogan “A happy girl is the future of our country”. The UN has many initiatives that aim at the welfare of the girl child. The most significant one is the UN Girls’ Education Initiative launched in April 2000, at the World Education Forum in Dakar, by United Nations Secretary-General Kofi Annan. Plan U.K (n.d.) has launched a campaign called “Because I am a Girl”. The two major objectives of their campaign is to create a forum in the UN for complaints against governments of countries and to ensure that the British governments aids for education to developing countries and given equally to boys and girls. Population First started a girl campaign called ‘Laadli’, which addresses the issue of the falling sex ratio in Mumbai. The aim of the campaign is to create a positive public image for girls in society and hence change the perceptions and values of families that opt for boy children. In 2004 the Nike Foundation was founded with the aim of addressing developmental issues of the adolescent girl. They released a series of videos and created a sub web page for their campaign: “The Girl Effect”.
13. CHILD SEXUAL ABUSE
“My mom would drop me off in the evening with her older sister (my aunt) to spend the night while she would go out. In most cases, this would be a safe haven babysitter for a child, Right? Wrong! My cousin was 18/19 years old at the time and addicted to drugs. In the small house in which they lived, I was always put in the cousin’s bed to go to sleep prior to him getting home from a “night out”. I vividly remember the first time it happened. I went to bed, asleep by myself – 6 years old – only to be woken up by being raped by my cousin. I remember having my face shoved into a pillow so my screams and cries for help wouldn’t be heard by anyone. When it was over, I was told if I ever mentioned it to anyone, he would kill me – and I believed him.”
I was eight when it happened. My older brother had made a bet with me and I won. He said I got to pick a dare. I thought it would be funny if I saw his underwear and sung the song “I see London, I see France, I see your underpants”. He said we’d do it later. Next thing I know he’s in my room when I was getting ready for bed and he said I’ll show you mine if you show me yours. I said “That’s not fair, but he insisted I do it, and I did. The next night he came in my room while I was in bed and he reached down my pants touching me. I kept my eyes shut because I thought it would help me escape. For many weeks it would happen sometimes randomly, but then every night. He touched me, and took my hand and made me hold and stroke his penis”
These are not random cases of CSA that have been mentioned. CSA is prevalent not just in India but all around the world in alarming figures. According to the first ever National Study on Child Abuse in April 2007, covering 13 states in India and a sample size of 12,446 children, a disturbing number of 53.3% children reported sexual abuse. The survey also found that boys and girls were equally at risk. The most frightening aspect was that 50% of the abusers were known to the children and the children trusted them.
Stages of Child Development
According to Erickson psycho social stages of development the child passes through various stages which help him to become mentally and emotionally strong as an adult. The major developmental task in infancy (0-1year) is to learn whether people, especially primary caregivers, regularly satisfy basic needs. If caregivers are consistent sources of food, comfort, and affection, an infant learns trust- that others are dependable and reliable. If they are neglectful, or perhaps even abusive, the infant instead learns mistrust- that the world is an undependable, unpredictable, and possibly dangerous place. From 2-3 years if caregivers demand too much, ridicule early attempts at self-sufficiency, children may instead develop shame and doubt about their ability to handle problems. During 4-5 years the children are realizing for themselves if they are good or bad and may develop guilty feelings for actions for which they feel they are to blame. The later stages (6-11 years), help the child develop a sense of worth self confidence, a sense of loyalty, his identity and purpose in life (12-19 years). However these ages are not fixed and can overlap and gratification in each stage effects the development of the other.
Any trauma or distress during any of the stages can result in the child being maladjusted or having a problem in some sphere of his life. CSA always impacts a child but in varying degrees. Childhood is the stage when our personalities and beliefs are being formed and any trauma at this stage does impact the psychological and emotional development. No child can be unaffected by the abuse. However not all are affected to the same degree. A child who is severely abused over many years may be affected differently from a child who has been abused once. Also a child who has been abused by a person whom he trusts and loves would be affected differently from a child abused by a stranger.
Indicators of abuse
There is no one single identifiable sign or symptom that all children will have. They may have very subtle or very pronounced symptoms. Most often the abusers are known to the children so there is little or no use of force. Hence the physical evidence of abuse becomes difficult to spot. There may be urinary infections, bleeding from the vagina or anus, STDs, pain in genitals specially during urination, difficulty in walking or sitting, throat infection (due to oral sex) or pregnancy.
Behavioral changes in the child may be subtle or very prominent but will always be there. Children often do not tell with words that they have been sexually abused. Usually a child hardly talks about his abuse and even if s/he does, no one takes him seriously and that further creates more problems in the child increasing his feelings of shame, guilt and the feeling that he is responsible for the abuse. A child could show any of the followings symptoms, but having any, does not necessarily mean the child is abused. The reason for the behaviour must be explored.
• Waking up in the night screaming, nightmares or other sleeping problems
• Showing an unusual fear of certain people, places or things
• A reluctance to be with a certain person
• Loss of appetite or trouble eating, eating disorders
• Fear of the bathroom
• Excessive crying, depression, anxiety
• Mood changes, anger outbursts or withdrawal or fear
• Becomes worried when clothing is removed
• Wearing layers of clothing to hide injuries or provocative clothing
• Knowledge of sex which is age inappropriate
• Imitating sexual acts with other children or toys, such as dolls
• Withdrawing from activities they used to be involved in
• Academic problems
• Lowered self esteem
• Symptoms of Post Traumatic Stress Disorder such as panic attacks
• Regressive behavior like bedwetting (after being potty trained)
• Having new words for private body parts
• Excessive masturbation, addiction problems.
Any sudden changes in the behavior of the child along with physical symptoms must be taken seriously and is a warning signal. It is necessary for the primary caretaker to be vigilant and alert to any changes in the behavior of the child and also to be aware of what the child may be trying to convey verbally though indirectly. One common feeling that most children and adolescents have is of guilt and shame. Children usually feel a sense of guilt over the abuse that occurred. It is important to remember that under no circumstance is the child ever responsible for what happened to them. There is a sense of betrayal as the abuse is often by a person whom they trust and love. It is crucial that “re- victimization” does not happen.
Some ways a child can be re- victimized is by saying to the child: “Uncle, or Grandpa would never do that to you, why are you lying?” or “It couldn’t have been that bad or you would have told me sooner”.
The Silent Problem
As we can see that the children are traumatized so why is it that they still don’t tell and talk about their abuse. Especially in India, the children are taught to respect their elders come what may, the elders know what is good for you and they are never wrong.
Other reasons why the children keep quiet is because of their relationship with the offender, they do not want to put the abuser into trouble, their sense of loyalty towards the abuser or at times even to protect another who is not an abuser. The child is confused between the behaviors of the adult who is caring at times and abusive otherwise and hence cannot distinguish who the real adult is. Abusers may offer a combination of gifts and threats about what will happen if the child refuses or tells someone. Threats include physical threats or what will be lost in the form of family breaking up. The child’s fear is played upon by the abuser. At times the child may experience a physical pleasure or arousal and this confusion makes it difficult for the child to speak up. Very often the child thinks he is to blame for being bad and is being punished this way. He is too ashamed or embarrassed to tell anyone. He feels no one will believe him. The reasons may differ depending on the age of the child at the time of abuse and who the abuser is.
Consequences of CSA
Child sexual abuse victims usually carry this trauma with them for the rest of their lives. Depending on the seriousness, duration and type of abuse, the effects can vary in intensity but mostly do affect all victims in some aspect of their lives and are manifested in psychological, social, sexual or physical problems. I realize that I build walls between myself and people who love me, including my wife – it’s the only way I know to protect myself from getting hurt.
I don’t know how to let someone love me. My wife has gotten tired of running into that wall. I realize that the long term affects of child abuse has caused me to form defensive personality traits which make it difficult to have adult relationships. I feel as though I am damaged, I have no self esteem / confidence, everyone else is “better” than me. My life has been moulded by the abuse and hurt I suffered as a child and I make those around me miserable as a result.
1. Psychologically the person can report panic attacks, depression, fears, panic attacks, sleeping problems, nightmares, irritability, outbursts of anger and sudden shock reactions when being touched. They have low self esteem and little confidence and respect in themselves. They may resort to self-destructive behaviors like addictions, prostitution. Socially they are not able to trust others and do not have satisfying relationships. They may deliberately get into relationships where they will be abused as they see themselves as. damaged goods. Sexually they may not want to be touched as it brings back memories, or have problems with pain and orgasms or be averse to any particular act like oral sex. This affects relationships as the partner does not understand what is happening.
Many psychosomatic illnesses may occur which could include eating disorders, inexplicable aches and pains and may suffer from post traumatic stress disorder.
Role of a Trusted Adult
The foremost thing that an adult can do is to believe the child. Children rarely make up stories about sexual abuse. However vague or imaginative the narration may be, the child is entrusting you with a part of himself that is sore, painful and terrifying and embarrassing. Let the child know that you are willing to listen patiently to whatever the child has to say however painful it may be. Here is a person the child can trust, feel understood and not betrayed. Validate the child’s feelings of anger, pain, fear, helplessness as the child needs to express them and be heard. Be genuine in your response even if it is of outrage but do not make your feelings overwhelm the child’s. If for some reason you are unable to handle it and are extremely upset or defensive, it may be from a feeling you have repressed from the past, in which case you can encourage the child to speak with someone else whom they see as trustworthy.
Most importantly, view the person as someone strong who has come for help rather than as a victim. It is important for the child to be helped to overcome the abuse by trained professionals who in an unthreatening atmosphere help the child to regain control over his life. This is done through various play methods or through the creative arts like dance, drama or drawing. No child should be made to go through the trauma and suffer all his life for a fault which is not his.
Parents/teachers need to educate the child about CSA, how to prevent it and what the child needs to do. They need to be given age appropriate sex education and explained about appropriate touch and inappropriate touch. Remember – No child seduces an abuser. Children ask for attention and affection not abuse.
Police Public Cell
POLICE PUBLIC CELL
Human Rights are something we cannot live without. Only by the virtue of being human, we all are equal in dignity and rights, each of us is worth of being honored and living with full enjoyment of life, liberty, equality and dignity no matter how one’s race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other status are distinct.
These rights are build based on first – Universality which says we all are equal in dignity and rights irrespective of race, religion, creed, language, geographical condition etc.; second – Democracy that implies human rights and related legal instruments should be of the consent and the mandate of the people; and third Guaranty that fixes the obligation that human rights are given by the State or Government and so is the main responsibility of the protection is should be of the government. Human rights involve a notion of a contract between the State and its Citizens that encoded in its constitution and other legal instruments for protection and deliverance.
These two key points, Guaranty and Contract are the enormous binding forces in the policing domain. It is our common understanding that principal objective of having the system called police is to ensure all the members of our society safety with a sense of environment of secure.
Police are here to protect our lives and property. For this reason to enable them to carry out their duty effectively they have been given some responsibility and some powers. But that does not mean that the police are above the law. They are in fact bound by the law and have to act in accordance with the law. However in order to ensure that police do not abuse the powers given to them it is necessary and rather important for us to know our rights vis-à-vis the police.
Police are important building block of the criminal justice system that supposed to be worked in accordance with the rule of law. The credibility of the criminal justice system depends on the relative strength or weakness of the laws and procedures established for the police, the prosecution and the court system. The police are an arm of the State vested with the primary responsibilities of law enforcement and prevention of crimes against the State and private citizens.
Helping Human Rights Foundation in order to ensure the non- violation of human rights in criminal justice system, settled a cell where relationship of police and public are being watched in its various aspects. The primary issues of concern are:-
1. About arrest
2. About illegal detention
3. About illegal handcuff
4. About illegal encounter
5. Post -arrest
6. Pre –arrest
7. Arrest without a warrant
8. Medical attention to the person arrested.
9. Detention and torture
10. Protection of Women
11. Discriminating citizens on the basis of cast
12. Custodial deaths/rapes
1. Ensure that no person is deprived of his/her right to life or personal liberty,except in accordance with the procedure established by law (Art. 21 of the Indian Constitution).
2. Ensure that the identity of the police officer effecting arrest is clearly indicated
by means of a name plate and rank. (Guidelines on Arrest : DK Basu vs State of West Bengal AIR 1997 SC 610).
3. Ensure that the arrestee is informed of the full particulars or the grounds of arrest (Art 22 of the Indian Constitution).
4. Ensure that a relative or a friend of the arrestee is informed about the fact of arrest and the place where he/she is being detained (Section 50A (1) Cr. PC)
5. Ensure that information regarding the arrest and the person informed about
the arrest is recorded in the designated register kept in the police station(Section
50A (3) Cr.PC).
6. Ensure that if some injuries are found on the body of the arrested person at the time of arrest, the same are specified in the Arrest Memo and the arrested person is medically examined.
7. Ensure that no woman is arrested after sunset and before sunrise, other than in exceptional circumstances (Section 46(4) Cr. PC).
8. Ensure that a woman police officer is associated while effecting arrest of a
woman (Section 46 (4) Cr. PC).
9. Ensure that no force or beating is administered under any circumstances while effecting arrest of a juvenile or a child. Respectable citizens may be associated while arresting juveniles and children.
10. Protect the human dignity of the person being arrested. Public display or parading of the person arrested should not be permitted.
11. Conduct search of the arrested person with due respect to his/her human dignity. Avoid unnecessary use of force and respect his/her right to privacy. Searches of women should be conducted only by other women, with strict regard to decency (Section 51(2) Cr.P.C.)
12. In case of a bailable offence, inform the arrested person of his/her entitlement to be released on bail so that (s)he may arrange for sureties.
13. Inform the Police Control Room and the District/State Headquarters about the arrest and the place of detention.
1. Do not arrest a person without warrant, unless there is a reasonable satisfaction, on the basis of investigation done, about the person’s involvement in a cognizable offence and there is a need to affect his/her arrest. (Section 41, Cr. PC).
2. Do not arrest a person unless the commission of an offence cannot otherwise be prevented (Section 151, Cr.PC).
3. Do not use more force than is necessary to restrain an arrested person (Section 49 Cr.PC and Art. 21 of the Indian Constitution).
4. Do not summon to police station, a woman or any male person, below 15
years of age associated with a case. The questioning of any such person may be
done by the police officer only at the place of residence of such woman/minor.
(Section 160 (1) Cr.PC).
5. Do not detain any arrested person beyond 24 hours without the express
Order of a Magistrate (Section 57 Cr.PC).
6. Do not use handcuffs or fetters on arrested person unless you have recorded reasons and obtained orders of the Court for such use.
A person detained by the police, whether for questioning, for the purpose
of verification of identity, to test alcohol level, or any other purpose may be, comes under the custody of police and is, therefore, under the care of the State. It is the responsibility of the State to ensure protection of the human rights of all persons in its custody.
a. Ensure that a written order is sent to any person who may be required to come to the police station for the purpose of questioning. (Section 160(1) Cr.PC).
b. Ensure that family members or friends of any person detained by the police are aware of his whereabouts.
c. Ensure that whenever any person is detained in the police station, proper entry is made in the General Diary.
d. Ensure prompt medical attention for anyone detained by the police, in case
the need so arises.
e. Treat all detainees with the dignity due to any human being.
f. Do not subject any person in detention to torture, or to any cruel, inhuman or degrading treatment or punishment.
g. Do not compel a person in detention to confess, to otherwise incriminate him/her or to testify
against any other person.
h. Do not detain anyone for a prolonged period in the name of interrogation as this may amount to
harassment and wrongful confinement.
Handcuffs are used frequently during transportation of prisoners from the jail to court, of accused from the site of the alleged crime to the police station or to court, and from the jail/police station to the hospital. During these movements, the use of handcuffs is supposed to be the exception, not the rule.
However, in a large majority of cases, the escorting authorities admit that judicial permission is not received and the reasons for using restraints are not documented in the police station diary.
- Restraints are sometimes necessary for legitimate security reasons.
- Police work can be dangerous, and a small minority of arrestees and detainees are desperate and violent.
- Political considerations also play a vital role in some case.
- They are used many a times by the police personnel, both publicly. and privately, to humiliate, debase and intimidate arrestees and detainees.
- Power and corruption also lead to cases of human rights violations
The Law says:
The Supreme Court of India has repeatedly condemned the unnecessary use of handcuffs by the police as a violation of the right to personal liberty guaranteed by Article 21 of the Constitution of India. The landmark Supreme Court case on handcuffing is Prem Shankar Shukla v. Delhi Administration (1980). In this case, the validity of certain clauses of the Punjab Police Rules, which made handcuffing mandatory during arrest, was challenged. In his opinion, Justice V R Krishna Iyer eloquently stated: “The guarantee of human dignity which forms a part of our constitutional culture . . . spring[s] into action when we realize that to manacle man is more than to mortify him, it is to dehumanize him and, therefore, to violate his very personhood too often using the mask of dangerousness and security.” In Prem Shankar Shukla and other leleading cases, the Supreme Court has laid down strict procedural guidelines specifying both when and how the use of handcuffs is appropriate. According to the Court, handcuffing is legal only if the arrestee is –
(a) Involved in serious non-bailable offences; and
(b) Previously convicted of a crime, of desperate character, likely to commit suicide, or likely to attempt to escape. The use of handcuffs and the reasons for their use must be recorded. It is illegal to walk fettered political prisoners through the streets. Furthermore, the police
Must gain judicial permission before they use restraints during an arrest or on a detainee.
The human rights-conscious court summed up its opinion of handcuffs in Sunil Batra (II) v. Delhi Administration (1980):
“To fetter prisoners in irons is an inhumanity unjustified, save where safe custody is otherwise impossible. The routine resort to handcuffs and irons bespeaks a barbarity hostile to our goal of human dignity and social justice.”
The Police Commission Reports and the State Police Manuals too emphasize, that the human rights of prisoners during escorting and handcuffing should be taken care of. The following guidelines must be observed:
• No person shall be handcuffed who, by reason of age, sex or infirmity can be kept in custody without handcuffs.
• Under trial prisoners and other accused persons should not be handcuffed and chained unless there is reasonable doubt that such persons will use violence or attempt to escape. The police escort must be sufficiently strong to prevent escape.
• In no case should prisoners or accused persons, who are aged and bed-ridden in hospitals, or women or juvenile or civil prisoners, be handcuffed or fettered.
Encounter Killings are unfortunately a common practice to wipe out the terrorist outfits, local gangsters, and the easiest way to close the long pending criminal records and most commonly to revenge political rivalry in India and in most South Asian Countries. Most encounters are staged to ingeniously justify the Police actions against the criminals. There were several reports that the government and its security personals committed unlawful killings of suspected criminals and insurgents, especially in areas of conflict such as Kashmir, Punjab, Maharashtra, the Northeastern states, the Naxal belts of Ranchi, Bihar, Orissa and Andhra Pradesh.
Encounter killings are pre-planned and authenticated murder. International Human Rights Law prohibits the arbitrary deprivation of life of any person under any circumstances. Article 3 of UDHR and Article 6 of ICCPR states that ‘everyone has the right to life’ and it shall be protected by law. Right to Life is ensured in Article 21 of the Indian Constitution. Depriving of life in any form is a violation of human rights.
Encounter killing is total violation of our Constitution and deprives a person of his right to life. No one who respects human rights would ever agree to this form of extra-judicial killing. Unfortunately our courts which are supposed to be guardian of our Constitution often accept uncritically the police version of encounter killing. The police often argue, there was encounters, the ‘criminal’ fired and police returned firing killing the person. The police never gets even bruised, let alone hurt.
As a rule of force should be avoided while effecting arrest. However, in case of forcible resistance to arrest, minimum force to overcome such resistance may be used, care must be taken to ensure that injuries to the person being arrested, visible or otherwise, is avoided. The dignity of the person arrested should be protected. Public display or parading of the person arrested should not be permitted at any cost. Searches of the person arrested must be done with due respect to the dignity of the person, without force or aggression and with care for the person’s rights to privacy searches of women with strict regard to decency. (s.51(2)cr.p.c.). The use of handcuffs or leg chains should be avoided. As far as practicable women police officer should be associated where the person or persons being arrested are women. Where the arrested is without a warrant, the person arrested has to be immediately informed of the ground of the arrest in the language he or she understands. Again, for this purpose, the police, if necessary may take the help of respectable citizens. The grounds must have already been recorded in writing in police records. The person arrested should be shown the writings reasons as well and also and given a copy on demand. (s.50(1)cr.pc) A person can, on a request made by him or her demand that a friend relative or other person known to him be informed of the fact of his arrest and the place of his detention. The police should record in a register the name of the person so informed. If a person is arrested for a bailable offence, the police officer should inform him of his entitlement to be realized on bail so that he may arrange for sureties. Apart from informing the person arrested of the above rights, the police should also inform him of his rights to consult and be defended by a lawyer of his choice. He should also be informed that he is entitled to free legal aid at state expense.
When the person arrested is brought to the police station he should, if he makes a request in this regard, be given prompt medical assistance. He must be informed of his rights. Where the police officer finds that the arrested person is in a condition where he is unable to make such request but is in need of medical help, he should promptly arrange for the same. This must also be recorded in a register. The female requesting for medical help should be examined only by a female registered medical practicener.
Information regarding the arrest and the place of detention should be communicated by the police officer affecting the arrest without any delay to the police control room and district/state headquarters. There must be a monitoring mechanism round the clock. As soon as the person arrested, police officer effecting the arrest shall make a mention of the existing or non-existing of any injury(s) on the person of the arrestee in the register of arrest. If any injuries are found on the person of the arrestee, full descriptions and other particulars as to the manner in which the injuries were caused should be mentioned in the register which entry shall also be signed by the police officer and the arrestee. At the time of realize of the arrestee a certificate to the above effect under signature of the police officer shall be issued to the arrestee. If the arrestee has been remanded to police custody under the orders of the court the arrestee should be subjected to medical examination by a trained medical officer every 48 hours during his detention in custody by a doctor on the panel of approved doctors appointed by director, health services of the concerned state or union territory. At the time of his real ease from the police custody the arrestee shall be got medically examined and a certificate shall be issued to him, stating therein the factual position of the existence or on- existence of any injuries on his body.
The person under arrest must be produced before the appropriate court before 24 hours of the arrest. The person arrested should be permitted to meet his lawyer at any time during the interrogation. The interrogation should be conducted in a clearly identifiable place, which has been notified for this purpose by the government the place must be accessible and the relatives or friend of the person arrested must be informed of the place of interrogation taking place. The methods of interrogation must be consistent with the recognized rights to life dignity and liberty and rights against torture and degrading treatment.
ARREST WITHOUT A WARRANT
The power of arrest without a warrant should be exercised only after a reasonable satisfaction is reached, after some investigation, as to the genuineness and bonafide of a complaint and a reasonable belief as to both the person’s complicity as well as the need to effect arrest. The arrest cannot be justified merely on the existence of the power, as the matter in law, to arrest without a warrant in a cognizable offence.
MEDICAL ATTENTION TO THE PERSON ARRESTED
When the person arrested is brought to the police station he should, if he makes a request in this regard, be given prompt medical assistance. He must be informed of his rights. Where the police officer finds that the arrested person is in a condition where he is unable to make such request but is in need of medical help, he should promptly arrange for the same. This must also be recorded in a register. The female requesting for medical help should be examined only by a female registered medical practicener. If the arrestee has been remanded to police custody under the orders of the court the arrestee should be subjected to medical examination by a trained medical officer every 48 hours during his detention in custody by a doctor on the panel of approved doctors appointed by director, health services of the concerned state or union territory. At the time of his real ease from the police custody the arrestee shall be got medically examined and a certificate shall be issued to him, stating therein the factual position of the existence or on- existence of any injuries on his body.
DETENTION AND TORTURE
The trauma and agony of an accused Undertrial prisoner and of his family members is beyond to be described and no amount of money compensation can bring back the valuable years of the innocent accused. The damage inflicted by unlawful detention is massive and ruthless. It bleeds the soul of the victim and may occasion the loss of livelihood of a family resulting in trap of ugly poverty.
In the historic judgment of Hon SC in D K Basu Vs State of West Bengal, among other things, directed-
1) That Policemen must wear visible and legible identification when arresting a person and when carrying out interrogation. Names and Particulars of police personnel handling interrogation must be recorded in the register.
2) It is the right of every person detained or questioned by Police to know the grounds for detention or questioning.
3) The Person arrested must be made aware of his right to have someone informed of his arrest Or detention as soon as he is put under arrest or detention.
4) A person arrested must be produced before a Judicial Magistrate/ Judge within 24 hours of his/her arrest.
5) A person arrested should be medically examined at the time of arrest and major & minor injuries on arrested person be recorded in Inspection Memo duly signed by both Police Officer carrying out the arrest and the person arrested and the copy of this memo be provided to the person arrested.
6) Any person arrested must be medically examined by a doctor from an independent and approved panel of doctors, every 48 hours during detention.
7) Arrest or Search of women should only take place in presence of Women Police Officers and it should not take place in night. And women should be detained separately from men.
8) While an accused is in Police custody, his lawyer should be permitted to visit him.
9) Information of the arrest of accused person should be given to the district Control Room and the State Police Headquarters.
In the words of Justice MN VENKATACHALLIAH in Joginder Kumar Vs State Of UP – 1994 “No arrest can be made because it is lawful for the police officer to do so. The existence of the power to arrest is one thing. The justification for the exercise of it is quite another”.
The police officer must be able to justify the arrest apart from his power to do so. Arrest and detention in police lock-up of a person can cause incalculable harm to the reputation and self-esteem of a person. No arrest can be made in a routine manner on a mere allegation of commission of an offence made against a person.
It would be prudent for a police officer in the interest of protection of the constitutional rights of a citizen and perhaps in his own interest that no arrest should be made without a reasonable satisfaction reached after some investigation as to the genuineness and bona fides of a complaint and a reasonable belief both as to the person’s complicity and even so as to the need to effect arrest.
Denying a person of his liberty is a serious matter. The recommendations of the Police Commission merely reflect the constitutional concomitants of the fundamental right to personal liberty and freedom. A person is not liable to arrest merely on the suspicion of complicity in an offence.
There must be some reasonable justification in the opinion of the officer effecting the arrest that such arrest is necessary and justified. Except in heinous offences, an arrest must be avoided if a police officer issues notice to person to attend the Station House and not to leave the Station without permission would do.“
PROTECTION OF WOMEN
Police cannot summon to police station, a woman or any male person, below 15 Years of age associated with a case. The questioning of any such person may be done by the police officer only at the place of residence of such woman/minor. (Section 160 (1) Cr.PC).
Ensure that no woman is arrested after sunset and before sunrise, other than in exceptional circumstances (Section 46(4) Cr. PC). Ensure that a woman police officer is associated while effecting arrest of a Woman (Section 46 (4) Cr. PC). Any search of women strictly is conducted by a female police officer. There shall not be any arresting of women after the sunset, except the procedure laid in the law.
According to S. 51(2) when it is necessary to cause a female to be searched, the search shall be by another female with strict regard to decency.Body searches of females should only be carried out by women and with strict regard to decency.
The Hon’ble Supreme Court in Sheela Barse vs St. of Maharastra, it was held that It is the duty of the police officer making arrest to see that arrested females are segregated from men and kept in female lock-up in the police station. In case there is no separate lock–up, women should be kept in a separate room. According to Proviso, Section 160(1) Code of Criminal Procedure, 1973, Women should not be called to the police station or to any place other than their place of residence for questioning in as much as it says that no male person under the age of fifteen or woman shall be required to attend at any place other than the place in which such male person or woman resides.
Women should be guarded by female constables/police officers. They must be questioned in the presence of policewomen.
All necessary pre-natal and post-natal care should be provided to females who are arrested. Restraints should only be used on pregnant women as a last resort. Their safety or the safety of their fetus should never be put at risk. Women must never be restrained during labour.
According to Section 53(2) of Code of Criminal Procedure, 1973. and 10 Basic Standards for Law Enforcement Officials Proposed by Amnesty International, Medical examination of women should be carried only under the supervision of female medical practitioners.
DISCRIMINATING CITIZENS ON THE BASIS OF CAST
India is indeed incredible in a way it treats its vulnerable citizen particularly lower caste and poor people. Discrimination, torture, enforced disappearance, police injustice, impunity cases of arbitrary detention are rampant and enough to substantiate. Universal Declaration of Human Rights (1948) in article 5 stress on “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment”. Further this element of rights solidifies in International Covenant on Civil and Political Rights (1976) article.7 which illustrates “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment”‘. However, Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment clearly elaborates that “Each State Party shall take effective legislative, administrative, judicial or other measures to prevent acts of torture in any territory under its jurisdiction (art. 2(1))” Even Convention forbids the practice of torture in every circumstance including emergency (art.2 (2)) and no public authority can justify torture (art. 2(3). Nonetheless, on discrimination, Universal Declaration of Human Rights (1948) says ‘All human beings are born free and equal in dignity and rights…” (art.1). Further, Convention on the Elimination of All Forms of Racial Discrimination in its various articles (art.1 (2), art. 2(1(a). art.4) condemn the practice of discrimination.
However, article 15 of the Indian constitution prohibits discrimination on grounds of religions, race, caste, sex or place of birth. The Indian Constitution outlaws caste based discrimination as well as practice of “untouchability”. In addition, under ‘article 21’ no one shall be deprived of his life or personal liberty. But there are many examples where discrimination on the basis of human rights found to be a regular exercise of police administration which is a gross violation of HUMAN RIGHTS.
A total of 14,231 persons i.e. more than four persons per day died in police and judicial custody in India. From 2001 to 2010. This includes 1,504 deaths in police custody and 12,727 deaths in judicial custody from 2001-2002 to 2009-2010 as per the cases submitted to the National Human Rights Commission (NHRC). The failure of the Ministry of Home Affairs to introduce the Prevention
of Torture Bill drafted by the Rajya Sabha Select Committee headed by Shri Ashwani Kumar, the Minister of State for Planning, in December 2010 in the parliament session beginning on 22 November 2011 demonstrates India’s lack of political will to stamp out torture.
During 2001-2010, Maharashtra recorded the highest number of deaths in police custody with 250 deaths; followed by Uttar Pradesh (174); Gujarat (134); Andhra Pradesh (109); West Bengal (98); Tamil Nadu (95); Assam (84); Karnataka (67); Punjab (57); Madhya Pradesh (55); Haryana (45);
Bihar (44); Kerala (42); Jharkhand (41); Rajasthan (38); Orissa (34); Delhi (30); Chhattisgarh (24); Uttarakhand (20); Meghalaya (17); Arunachal Pradesh (10); Tripura (8); Jammu and Kashmir (6); Himachal Pradesh (5); Goa; Chandigarh and Pondicherry (3 each); Manipur, Mizoram and Nagaland (2 each); and Sikkim and Dadra and Nagar Haveli (1 each).
About 99.99% of deaths in police custody can be ascribed to torture and occur within 48 hours of the victims being taken into custody. Though Maharashtra has a total population of 112 million in comparison to 199 million in Uttar Pradesh according to 2011 census, the fact that 76 more persons were killed in police custody in Maharashtra shows that torture is more rampant in police custody in Maharashtra than Uttar Pradesh.
Custodial rape remains one of the worst forms of torture perpetrated on women by law enforcement personnel and a number of custodial rapes of women take place at regular intervals. The NHRC recorded 39 cases of rape from judicial and police custody from 2006 to 28
Private defence or murder:
As a necessary corollary to such defence it is imperative that there is a registration of a First Information Report (FIR) considering such a death as murder or culpable homicide not amounting to murder. In order to claim a right of private defence to cause death, the person must show that there were circumstances giving to reasonable grounds for apprehension that death, or other acts described earlier would have resulted if the right was not exercised. Courts have held that if medical examination of the person reveals superficial or simple injuries, there can be no right to private defence. The violence used to defend oneself must not be unduly disproportionate to the injury that is sought to be averted and should not exceed its legitimate purpose.
But in order to prove that it was a legitimate exercise of the right, it is necessary to have an investigation with the burden of proof shifting to the person who claims this right. This right to private defence cannot be used to punish a suspect.
However FIRs, in most encounter cases, invariably state that on seeing the police the other party opened fire with a view to kill or threatened to kill. The issue of considering whether the death was a result of private defence or was one of murder is never factored in the FIR. Family members of the deceased or human rights activists who wish to reopen such cases find it an uphill task to get even a death certificate or post-mortem report and are thwarted at every stage, often facing threats to their life.
In response to a complaint from the Andhra Pradesh Civil Liberties Committee (APCLC) relating to encounter killings of suspected members of the Peoples’ War Group (PWG), the National Human Rights Commission (NHRC) issued a series of guidelines that required all police stations to immediately record such deaths and hand over investigation to an independent agency such as the CID if the persons concerned were from the same police station. The NHRC guidelines also directed that in cases of specific complaints of fake encounters it was necessary to register and investigate the case by a special agency such as the CID. Family members of the deceased are required to be associated with the magisterial enquiry that must be conducted in encounter deaths and prompt disciplinary action must be taken against errant officers.
While these guidelines were issued in 2003, the commission now seems to be condoning such violence. Recently, the Chairperson expressed his view that extrajudicial executions could solve law and order issues and cited examples of “encounter” deaths of persons suspected of being members of the Mumbai underworld and Maoists.
Tamil Nadu and filed a public interest litigation seeking the appointment of a retired High Court Judge to investigate “encounter deaths” in Tamil Nadu and to register a FIR in every such case. The writ is still pending.
A lay person faces a trial if claiming right to private defence if it results in death. But despite being trained in combat and armed with weapons, those who indulge in encounters do not even face an investigation. Hence, the test for “reasonable apprehension” of imminent danger cannot be the same for such persons and needs to be addressed with a categorical shift in burden of proof in cases of such custodial violence.
Women Cell Issues
WOMEN CELL ISSUES
Many of those women who could grab the oppor¬tunities extended to them have proved that they are capable of discharging the responsibilities assigned to them on par with men. The nation which neglected almost 50% of its population for several centuries has now understood the necessity of giving equal rights and opportunities to its womenfolk.
These developments boosted the morale and self-confidence of women. As a result, Indian women now feel that they too have their own individuality, personality, self-respect, talent, capacity and efficiency.
The Constitution of India provides equal rights and opportunities to women. It does not make any discrimination on the grounds of sex. Indian women are also responding positively to this changed socio-political situation. This does not mean that our women are completely free from problems. On the contrary, the changing situation is causing them new problems. They are now beset with new stresses and strains. Some of the major problems haunting the modern women may briefly be analyzed here.
1. Increasing Violence against Women.
2. Gender Discrimination.
3. Problems of Female Education.
4. Problems Relating to Employment and Unemployment of Women.
5. Harassment of Women at Work Place.
6. Exploitation of Women in the Media.
7. Divorce and Desertion.
8. The Problem of Dowry.
9. Decline in the Political Participation of Women.
1. Increasing Violence against Women:
i. Violence is almost universal:
Most societies exhibit violence in one way or another. Violence against men or women is a social problem because; a large number of people are affected by it almost every day. Each of us is affected in countless ways by the climate of violence. Violence disrupts society.
Every society creates institutions designed to achieve certain ends. Violence cuts short normal institutional functions. Every act of violence, from assault to armed revolution, detracts to some degree from the authority normally vested in society.
ii. Women as Victims of Violence:
Who is most likely to be victimised by violent crime? Women are less likely to be victimised by violent crime than men, though or some crimes and among some groups of women, victimisation is higher than men. Violence against women is not a new phenomenon in India. “Women in Indian society have been victims of ill-treatment, humiliation, torture, and exploitation for as long as written records of social organisation and family life are available.
These records are replete with incidents of abduction, rape, murder, and torture of women. But, regretfully, female victims of violence have not been given much attention in the literature on social problems or in the literature on criminal violence.
iii. Increasing Crimes against Women:
Crime against women is an ever-increasing problem. This problem has been growing more and more acute in India during the recent years. Crimes against women include violence against women, rape, molestation, dowry harassment, wife-battering, kidnapping female children to be sold into brothel homes, forcible embracement, forcible religious conversion, cheating young women with a promise to marry them or fetch them a job and various types of sexual harassments and abuse of women including eve teasing.
Violence against Women within and Outside Family:
In a male dominated society like India violences against women are unfortunately increasing at an alarming rate. Such violences can be grouped into two types: (a) violence against women within the family, and (b) violence against women outside the family.
(a) Violence against Women within the Family or Domestic Violence:
Women are often subject to violence within the family, a place which is expected to protect their dignity and assure their safety. This type of violence includes crimes such as — dowry related harassments including death, wife-battering, marital rape, sexual abuse of female children and women of one’s own family, deprivation of sufficient food to female members, committing incestuous offences, inducing female members of the family to resort to sex-trade, female genital mutilation, abusing female servants of the family, and so on.
(b) Violence against Women outside the Family or Social Violence:
Kidnapping, raping and murdering women are very serious offences. The society at large itself is to be blamed for many types of violence’s that are committed against women especially outside the family.
Such violence’s include compelling women for abortion and to undergo tubectomy operation, eve-teasing, kidnapping girls of pre-matured age and forcing them to marry, sexual harassment of women employees in work place, immoral trafficking in women and girls, forced prostitution, kidnapping and mutilating the organs [such as hands, legs, ears, nose, etc.] of female children to use them for the purpose of begging, resorting to forcible religious conversion of young women, blackmailing of women, throwing acid at the faces of girls who refuse to marry, the police and the jail personnel committing sexual crimes against female prisoners, the police, armed forces and the border security forces committing sex crimes against the female citizens in the border areas and so on.
2. Gender Discrimination:
Gender discrimination refers to “the practice whereby one sex is given preferential treatment over the others. The practice of giving social importance to the biological differences between men and women is there everywhere. In some societies, these differences are very much pronounced while in others, they are given less importance. Even the Indian society is not an exception to this.
Different Faces of the Practice of “Gender Discrimination”:
In comparison with some other social problems, “gender discrimination!’ does not “appear” to be a serious problem in India. It “appears” to be so because; it has not been made a very big social issue so far. But in reality, it has weakened the strength of the female community of India.
Though constitutionally men and women are equal, socially men are given priority and importance sometimes to the disadvantage of women. There are various areas wherein this discrimination is apparent.
(i) Discrimination in Socialisation:
In our socialisation process female children are becoming victims of discrimination. In the Indian social context even today male children are preferred to female children. Hence, female children are subject to discriminatory treatment. Male preference and female negligence has almost become a working policy especially in the rural areas.
Discrimination between male and female children is made in matters relating to food, dress, health, education, domestic work etc. The policy of male preference and female negligence has led to what is known as “female disadvantages “. In India, mothers show preferences for male children.
They give them importance because – males are wanted during their old age to offer protection, males have greater scope than women and occupational avenues are also wider for males than for females.
This male preference has led to the abuse of advanced technology. The sophisticated scanning and supersonographic equipments are being misused to find out the sex of the child; that is to go for abortion if the child is found to be an unwanted female child.
These medical tests which would cost between Rs. 80/-to 800/- are within the reach of the middle class and even the upper-lower class resulting in the killing of the female foetuses in large number. Between 1978 and 1982 more than 78,000 foetuses were killed mainly because of these medical tests.
(ii) Discrimination in the Distribution of Power and Work:
Most of the Indian families are patriarchal. Hence, the philosophy of equality of sex is not acceptable to them. Domestic works such as – cooking, looking after the children, washing clothes and vessels, keeping the house neat and clean, looking after the domesticated animals, serving family members like a nurse on all days and especially when they fall sick, etc., are branded as “women’s work”. Very rarely men do these works.
But when the question of exercising power comes, it is always the man who dominates. His decisions are final and his orders are ultimate. The female voice is always suppressed.
(iii) Women’s Health is ignored:
Women suffer from some distinctive health problems from which men are free. Women have to undergo the distinctive biological process of pregnancy, or child-bearing, delivering, nursing, feeding, child-caring or rearing etc. These are their maternal functions. But the insistence on the family planning has posed many health hazards.
The use of contraceptives, Copper-T, sterilisation, abortion and hormonal drugs has an adverse effect on health. Those who make use of them suffer from problems such as bodily weakness, bloodlessness, high bleeding, fatness, problems in uterus, discomfort in breast, chronic backpain, etc. As Neera Desai and Vibhuti Patel have criticised, the advocates of family planning do not seem to bother much about these problems.
a. Women neglecting their Own Health:
Studies have revealed that our women themselves are neglecting their own health. Normally Indian women consume less food [that is, on an average 100 calories a day] and spend more energy on work. Women toil for the good of the family and children even at the cost of neglecting their own health.
Women very rarely complain about their ill-health because of their virtue of “self-denial”. The records in the health centres reveal that women are lagging behind men [that is, 1:3, meaning one woman taking medical help for every 3 men] even in matters of availing of medical help.
b. Women have their own reasons to neglect their health:
Not finding free time to go to health centres because of heavy work at home; non-availability of proper medical facility to test the health or ill-health of the mother and the child especially in the primary health centres; inability to walk a long distance to reach a well equipped health centre in the absence of proper transportation facility; non-availability of female doctors in the nearby health centres, etc., are some such excuses.
(iv) Decline in the Female Population:
Normally, in the population of any country, male- female ratio remains more or less the same, that is, 50:50. In India as the census reports reveal female population has been steadily declining ever since 1901.
It is for this reason Neera Desai and Vibhuti Patel raised the point whether the womenfolk in India represent a “declining sex”. According to 2001 Census, there is a deficit of 35 million women as compared to 3 million in 1901. For every 1000 men, we have only 933 women at present as against 972 women in 1901.
The male preference has led to the abuse of technology. Thousands of “unwanted female” children are killed at the stage of foetus itself. It is said that in India, out of 12 million female children born every year, around 25% of them die before they attain the age of 15. Of the children who die every year, about 3 lakh female children, that is, more than the number of male children, die for one or the other reason. Of the children which die every year in India, the 6th child dies due to gender discrimination.
(v) Gender Discrimination in Occupations and Public Life:
Women workers are paid less than the male workers for the same type of work. Much labour is extracted from women by giving them very minimum wages. In matters of giving treatment, promotion, increment, facilities, etc., discrimination is normally made. In public life also men are given priority.
Excepting the glamorous film actresses and politicians, in all other fields, women are not given importance on par with men. Government officials also practise this discriminatory treatment in dealing with the people.
3. Problems of Female Education:
Social reformers and social thinkers believe that in a nation like India giving education to women in as large a number as .possible can prove to be a panacea for many of the problems of women.
Accordingly, much attention is paid to the education of women after independence. The female literacy level is also increasing steadily. It has increased from 18.7% in 1971 to 39.42% in 1991 and to 64% in 2001. In spite of this change in the trend towards literacy, some problem has cropped up. We find glaring differences between the level of education of men and women. For example,
i. It is found that girls are being discouraged to go for higher education and also for professional and technical education.
ii. There are regional imbalances also. In states like Kerala, Karnataka and Maharashtra, female education is encouraged and given almost equal importance. Whereas in states like Bihar, Orissa, Madhya Pradesh etc. education of girls is neglected even today.
iii. Increasing drop-out of female children from schools is another problem. Though female children are getting admitted to primary, middle and high schools in a substantial number, many of them drop out of the school in the middle without completing the course.
For example, as per the data furnished by the Ministry of Education [New Delhi], in 1984-85 the number of female children enrolled at primary school crossed the figure of 34.2 million, and at middle school level the enrolment crossed 9.2 million. More than 74% of these female children, between the age-groups of 6-14 years, quit schools and lapsed into ignorance.
iv. Admission to School: Even in the matter of admitting children to school at elementary level, female children are discriminated against male children. For example, in 1984-85, the admission of male children to school was around 90%, the percentage of female children was only 66.2. It means complete awareness is not there among people regarding female education.
4. Problems Relating to Employment and Unemployment of Women:
In the economic field the situation is such that majority of women who are ready to work are not finding suitable work to their satisfaction. Those who are in the employment sector are becoming the objects of exploitation and harassment.
Though an increase in the female literacy level and extensions of employment opportunities for women in the non-agricultural sector, have added to the trend in favour of female employment, these two problems continue to exist.
i. Large Number of Employed Women is Illiterate:
Of every 100 women employed, 52.59% of them are illiterate and 28.56% of them have studied only up to elementary level. Of every 100 women working in the rural areas, 88.11% are illiterate.
These illiterate women in the unorganised sector are totally exploited by their employers. Women working in factories, mining industries, building construction process, in dams, bridges and road repair or construction work are not only paid less but also made to work in unhealthy surroundings.
ii. Decreasing economic participation of women:
Technological development seems to have a negative effect on employment opportunities of women. Studies conducted between 1975-85 have revealed this fact. Application of new technology in agrarian sector, textiles, mines, jute, pharmaceuticals, small scale industries like coir, handloom, weaving, spinning, cashew, fisheries, tobacco, animal husbandry, fruits and vegetable processing etc. rendered many women jobless. Computerisation has also adversely affected the job prospects of women as clerks, typists and accountants.
5. Harassment of Women at Work Place:
Women constitute an important labour force in all the countries. During the recent years there are an increasing number of women especially in the Indian context, who are working outside the family to get more income for the family. In fact, “the term working woman ” refers to one who works outside the home for a wage or salary”.’
Nearly 1/3 of our labour force [32%] consists of women. Working women constitute 16.43% of the female population of the country. As per 1991 Census, the number of working women was around 278.35 million, representing a growth rate of 26.12% over the previous decade.
The percentage increase of working women during the last decade was double that of male workers. The main problem with these female workers is that they are harassed in work place in different ways. “Harassment” refers to the basic violation of an individual’s rights. Not only the rights of working women are violated, they are often sexually harassed also.
i. Economic Exploitation:
Women workers are given much work but are paid less wages or salary especially in the unorganised sector. “Equal pay for equal work” remains only a slogan. “EqualRemuneration Act, 1976 has proved to be a dead letter in this regard. There are also sufficient instances of such exploitation even in the organised sector.
ii. Threat of Removal from Job:
In the Indian context, majority of women go for work not for fun but out of necessity. Some are compelled to work because of poor family conditions. Employers who are aware of the helplessness of these female employees exploit them in all the possible ways. They do not tolerate any type of opposition or protest from the side of the female workers. Due to the fear of losing the job, women bear all the exploitations, and do not protest.
iii. Women are given More Work:
Women normally work with devotion, seriousness and sincerity. This commitment to work is proving to be a big disadvantage for them. Hence, every time they are given more and more work which is not duly rewarded.
iv. Discrimination in Giving Opportunities:
In spite of the hard work which women do, many employers consider these working women as “non-serious workers”. They are also regarded as “non- permanent employees” especially in the case of unmarried female workers. They are discriminated with regard to recruitment, promotion, increment, training, over-time allowance, facilities at work place, and so on. Male workers are given preference in these matters.
v. Sexual Harassment of Women:
Sexual harassment of women at workplace refers to giving indecent treatment to women workers by violating all the norms of modesty. Many female workers have complained of such harassments during the recent years.
This harassment by men includes – continuous staring at women, making women the targets of lewd remarks, dirty jokes, repeated invitation to meals and outings, offers to drop them home, making unwanted comments about dressings, making “accidental” touches and dashes, making them stay back in the work spot even after the working hours, male bosses calling smart female employees to their chambers and making unwanted “advances” towards them, molesting women workers and so on.
6. Exploitation of Women in the Media:
The mass media such as the radio, television, news papers and the cinema play a vital role in social change and social development especially in the modern societies. But unfortunately, the media has not been playing a positive role in the case of women. The media is even condemned of exploiting and misrepresenting women.
(i) Journalism as Print Media and Women:
Newspapers, weeklies, monthlies or other types of magazines seem to be interested in increasing their circulation by rousing the cheap emotions of the people. “They target the woman’s body to get their things done.” Papers no doubt give due publicity to some unfortunate events under the captions such as “Atrocity against Women”, “Dowry Costs A Woman’s Life”, ‘Mass Rape of a Woman’, ‘Sexual Harassment of Women’, etc. But in doing so they give the least information about the culprit of the crime. On the contrary, they take more interest in weaving stories about the victim of the event which often amounts to character assassination.
(ii) Visual Media and Women:
Since about 35% of the people in our society are illiterate, visual media such as television and the cinema have a greater impact on people. The Indian visual media is a failure in playing a positive role in educating people and enriching their knowledge.
Like the newspapers, they also exhibit the female body and make it their main capital to mint money. Modern movies believe in achieving success by portraying more and more sex, violence and murder. Women are shown as targets of attack, sex, rape and such other exploitations.
Unfortunately, our T.V. is also following the example of the movies. With the invasion of our skies with a number of T.V. channels, the choice of T.V. viewers has greatly expanded. T.V. channels such as the Star Plus, MTV, Asian TV Network, Zee TV, and other Cable channels, are promoting a lifestyle which is totally alien to us. As usual women are presented in these channels in an indecent manner. Indian movies and T.V. serials are playing havoc with our values and morals.
(iii) Advertisements and Women:
Advertisements whether in newspapers or T.V. play no less an important role in debasing women. Advertisement firms also make use of female body in a cheap manner to get publicity for things.
(iv) Media and Women Movements:
Media has an important role to play in strengthening women’s position. While pronouncing women’s weaknesses, it must also emphasise their strength. It must awaken women from the slumber of centuries, inform them, mobilise them and motivate them whenever required. It must give due publicity to women’s struggle for justice, equality and fairplay. This will help them in regenerating power. The present role of the media in this regard is not that encouraging, but disappointing.
i. Legislation to Regulate the Media:
The Government had passed as early as in 1986 a legislation namely; “The Indecent Representation of Woman [Prohibition] Act, (1986) in order to prevent the media from misrepresenting the women. Any attempt to degrade and discredit women, insult and humiliate them, assassinate the character of women, and present them in an indecent manner is declared punishable. The provisions of this Act are applicable to all the means of the mass media and also to advertisements, books, handbills, posters, etc. Violation of this Act is liable for punishment, which amounts to 2000 Rs. fine and 2 years imprisonment.
7. Divorce and Desertion:
During the recent years, instances of desertion and divorce are increasing making the lives of many women very miserable.
(a) The Hardship of Desertion:
Desertion is defined as “deliberate abandonment of conjugal relationships.” As a matter of fact, desertion may take place at the behest of any one of the two, or both together. In actuality, in the Indian context, it is mostly the husband who goes away from the family leaving the wife and children at home to fend for themselves.
Desertion causes lot of hardships especially for women. It immediately drives a woman to a state of uncertainty and helplessness. Deserted women belonging to poor families all of a sudden become orphans especially when they are disowned by their own parents. Some of them may resort to immoral activity, some others fall prey into the hands of anti-social elements, while a few of them may commit suicide.
(b) The Agony of Divorce: Divorce is “…an institutional arrangement for terminating marital relationship…”
Causes of divorce are many:
Sociologists like Damle, Fonseca and Chaudhary together conducted a study in India which revealed the following causes of divorce : marital disharmony, sexual conflicts, maladjustments between husband and wife, marital desertion, husband’s cruelty, prostitution on the part of wife, sexual impotency, severe and unmanageable clashes with the in-laws, mother-in-law’s harassment, including dowry harassment, illicit sex relationship on the part of either the husband or the wife, irreparable health hazards, mutual distrust, total irresponsibility of the husband or wife towards the family matters and so on.
Divorce causes lot of hardships especially for the women. It damages the social image of the wife. It becomes a permanent stigma in her life. Many sensitive women find it difficult to come out of the shock of divorce. The impact of divorce on children is also very severe.
The burden of protecting and rearing of children also lies on the wife. Jobless and resourceless divorced women find themselves in a big economic crisis. Young and beautiful divorced women find it difficult to suppress their sex urge. They are often forced to resort to illicit ways of satisfying it. It usually leads to family disintegration.
8. The Problem of Dowry:
Dowry is both a practice and a problem associated with the Indian marriage. Though it was more in practice among the Hindus, it has now spread to almost all the religious communities of India.
i. Dowry refers to “….the property, money, ornaments or any other form of wealth which a man or his family receives from his wife or her family at the time of marriage.”
The age-old practice of dowry has now assumed the form of a social evil because the bride’s family is compelled to give some dowry as a price for marriage. It has become a social bane and a kind of bargain.
It has caused unhappiness, misery and ruin of the bride’s family. Huge amount of money is demanded at the time of marriage and the failure to give the promised amount would make the bride to suffer the consequences at the hands of her in-laws and also the husband.
ii. Dowry harassments are many. Women are ill-treated, disrespected, man-handled, tortured and subject to all sorts of cruelties in the name of dowry. Very often, our daily papers flash news about the tragic results of the dowry system, in which the newly married girls are always the victims of harassment, violence, murder and suicide. Dowry is demanded as though it is a fundamental right of the bridegroom.
Violence against women who bring less dowry or no dowry include – wife battering, emotional neglect / torture, verbal abuse, refusal of sufficient food, imposition of heavy physical work, severe physical harassments to the extent of killing the victim, and so on.
In spite of the legislation against the practice of dowry, it persists. Demands for dowry have even caused dowry deaths. According to an estimate, as many as 4148 dowry deaths were reported in the year 1990 and it increased to 4366 in the year 1993, and to 6205 in the year 1994, that is, at the rate of one dowry death for every 17 minutes.
iii. Dowry leads to the degradation of women. Prevalence of the practice of dowry reflects the inferior status of women in society. It makes a girl a great liability on her family’s resources. Some unscrupulous and money minded young men contract more than one marriage just for money.
It disturbs the normal relationship between the married women and her in-laws in the husband’s family. Some poor parents, who cannot pay a huge amount as dowry, are often compelled to arrange the marriage of their daughters with old men, or physically or mentally handicapped persons. Such marriages prove to be miserable for women.
As early as in 1961 itself, The Dowry Prohibition Act was passed in order to prevent the practice of dowry. It was amended in 1986 to make its provisions more severe and stringent. In spite of this Act, the practice continues to be in vogue.
9. Decline in the Political Participation of Women:
Participation of women who constitute 50% of our total population in politics and public life is very much negligible in India. We find only a negligible number of women in prestigious positions like those of Central and State cabinet ministers, governors, secretaries and legal advisers to the governments, ambassadors to other countries, IPS, IAS, IFS officers, judges in courts, mayors of big cities, office bearers of all-India parties, etc. No political party of India has given position to women in accordance with their number in the total population. In some areas seats are reserved for women as we find in Gram Panchayat, Jilla Panchayat, University Senate, etc. Even in these areas women have not constituted themselves into a “pressure group “. Hence in our political life, we have caste lobbies, linguistic lobbies, capitalist lobbies, minority lobby, etc. but we do not have “-women lobby ” to bring pressure on the government.
i. Increasing Violence and Terrorism in Politics:
Political corruption, criminalisation of politics, erosion of political values, disappearance of political decency, instability, lawlessness, terrorism and confusion have been increasing in our public life since 1980s. This state of confused political situation has discouraged women from taking active role in politics.
ii. Minimum Representation of Women in Lok Sabha:
The representation of women in Lok Sabha has been very poor since 1962 elections. For ex: there were only 33 elected women members in the third Lok Sabha [out of 494 members] after the 1962 elections. In the 6th Lok Sabha out of 544 elected members there were only 19 women members and their percentage was only 3.4. In the 10th Lok Sabha [1991 Elections] there were 39 elected women members and their percentage was 7.4.
iii. In the 1996 Elections for the 11th Lok Sabha though the total number of women voters increased to 28.24 crores [47%], only 477 women candidates as against 14,250 men candidates contested for 543 seats. [In the 1991 Elections for the 10th Lok Sabha 325 women candidates contested as against 8,374 men candidates for 521 seats]. These figures reveal that only a small number of women are interested in political life.
iv. In the 1999 General Elections for the 13th Lok Sabha also women’s participation was the poorest one. Though political parties were speaking vociferously in terms of 33% reservation for women in legislative bodies including the Parliament, no political party had given tickets to women in more than 10%. In some parties, the percentage of women candidates was not even 2 to 3.
v. Poor Participation of Women in the Party Politics:
Not only in the legislative bodies but even within the framework of the political parties also the participation of women is very poor. Political parties are still male-dominated and unwilling to give sufficient representation to women.
For example, at present, [that is, in 2001] the Congress Party has only 3 women in its 20-member Working Committee. In the BJP Working Committee, out of 75 members there are only 8 women, and in its 650 member National Council, there are only 150 women.
The Communist Party [Marxists] has only 12 women in its 150 member National Council, and 3 women in its 21 member National Executive. Though theoretically women’s representation in politics is regarded as the first step towards women empowerment, the socio-political atmosphere has not yet become conducive for that.
RTI act has always been a vital tool for the social reformers In India and Helping Human Rights Foundation considers this cell as the basic cell to exercise the rights of countrymen and to raise the issues. Right to Information (RTI) is act of the Parliament of India to provide for setting out the practical regime of the right to information for citizens and replaces the erstwhile Freedom of information Act, 2002. Under the provisions of the Act, any citizen of India may request information from a “public authority” (a body of Government or “instrumentality of State”) which is required to reply expeditiously or within thirty days. The Act also requires every public authority to computerize their records for wide dissemination and to proactively certain categories of information so that the citizens need minimum recourse to request for information formally.
The redressal forums are available in India such as State and Central Information Commission if the information sought has not been made available to the activist.
1. RTI is a Fundamental Right (FR) guaranteed under Part 3, Article 19(1)(a) of the Constitution of India.
2. Further it is a Constitutional Right (CR), as all FR are constitutional rights but not vice versa. Example: Article 300A – Right to Property is a CR but not FR. It was once a FR under Article 19(1)(f) which was omitted by 44th Constitutional Amendment Act 1978.
3. Going further it is a Legal Right (LR) as all CR are LR but not vice versa. Example: Right to Vote is a LR under Section 62(1) of Representation of People Act 1951 but not CR.
So RTI is a FR, a CR and a LR. RTI act 2005 is merely a statutorily sanctioned procedure to exercise FR to Information under Article 19(1)(a).
The human right to health means that everyone has the right to the highest attainable standard of physical and mental health, which includes access to all medical services, sanitation, adequate food, decent housing, healthy working conditions, and a clean environment.
• The human right to health guarantees a system of health protection for all.
• Everyone has the right to the health care they need, and to living conditions that enable us to be healthy, such as adequate food, housing, and a healthy environment.
• Health care must be provided as a public good for all, financed publicly and equitably.
The human right to health care means that hospitals, clinics, medicines, and doctors’ services must be accessible, available, acceptable, and of good quality for everyone, on an equitable basis, where and when needed. The design of a health care system must be guided by the following key human rights standards:
Universal Access: Access to health care must be universal, guaranteed for all on an equitable basis. Health care must be affordable and comprehensive for everyone, and physically accessible where and when needed.
Availability: Adequate health care infrastructure (e.g. hospitals, community health facilities, trained health care professionals), goods (e.g. drugs, equipment), and services (e.g. primary care, mental health) must be available in all geographical areas and to all communities.
Acceptability and Dignity: Health care institutions and providers must respect dignity, provide culturally appropriate care, be responsive to needs based on gender, age, culture, language, and different ways of life and abilities. They must respect medical ethics and protect confidentiality.
Quality: All health care must be medically appropriate and of good quality, guided by quality standards and control mechanisms, and provided in a timely, safe, and patient-centered manner.
The human right to health also entails the following procedural principles, which apply to all human rights:
Non-Discrimination: Health care must be accessible and provided without discrimination (in intent or effect) based on health status, race, ethnicity, age, sex, sexuality, disability, language, religion, national origin, income, or social status.
Transparency: Health information must be easily accessible for everyone, enabling people to protect their health and claim quality health services. Institutions that organize, finance or deliver health care must operate in a transparent way.
Participation: Individuals and communities must be able to take an active role in decisions that affect their health, including in the organization and implementation of health care services.
Accountability: Private companies and public agencies must be held accountable for protecting the right to health care through enforceable standards, regulations, and independent compliance monitoring.
ISSUES OF CONCERN IN THIS CHAPTER ARE:
1. Right to life
2. Right to health
3. Universal access to treatment
4. Free access to treatment
5. Universal access to essential drugs
6. Right to informed consent
7. Medical negligence
8. Reasonable care
RIGHT TO LIFE
Public authorities must take steps to protect an individual’s life, in almost all circumstances, and must not take away a persons life except in very limited circumstances. For example, when lawfully defending someone from violence.
This protection requires that there should be an official investigation into deaths resulting from the states failure to protect life or use of force.
RIGHT TO HEALTH
The human right to health is recognized in Article 25 of the Universal Declaration of Human Rights (UDHR) and in numerous other international instruments. Prime among them being the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR), the 1965 International Convention on the Elimination of All Forms of Racial Discrimination (ICERD), the 1979 Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the 1989 Convention on the Rights of the Child (CRC). No government hospital shall deny the treatment of patient at any cost whatsoever. According to a report by the IMS Institute for Healthcare Informatics titled “Understanding Healthcare Access in India”, rural areas remain significantly underdeveloped in terms of health infrastructure, with about half the people in India and over three-fifths of those who live in rural areas forced to travel beyond 5 kms to reach the nearest healthcare centre. It clearly shows that physical accessibility of public and private healthcare facilities is a major challenge in rural areas. The report also shows that availability of healthcare services is skewed towards urban centers with these residents, who make up only 28 per cent of the country’s population, enjoying access to 66 per cent of India’s available hospital beds, while the remaining 72 per cent, who live in rural areas, have access to just one-third of the beds. Similarly, the distribution of healthcare workers, including doctors, nurses and pharmacists, is highly concentrated in urban areas and the private sector. The National Human Rights Commission’s core group on health has observed rights perspective is missing from the draft National Health Policy, 2015.
The aim is to support better understanding of human rights law for health and social care professionals and explain how it can be used to ensure that patients and care recipients receive a service based on fairness, dignity and respect.
UNIVERSAL ACCESS TO TREATMENT
The physical accessibility of pubic or private healthcare facilities is a challenge in rural areas.
• The implication of traveling large distances to access a healthcare facility in rural areas is that an individual potentially loses their day’s worth of earning and may also select facilities that may not be the most cost effective for the treatment they seek.
• A larger proportion (+10%) of people traveled less than 5km to access private healthcare facilities for OPD (out-patient department) services as compared to public facilities.
• Similar differences were observed across urban and rural segments, and also across acute and chronic segments.
Increasing proportion of people are using private healthcare facilities over public facilities for both IPD (in-patient department) and OPD (out-patient department) treatment.
There has been a steady increase in the usage of private healthcare facilities over the last 25 years for both OPD and IPD treatment, across urban and rural areas.
FREE ACCESS TO TREATMENT
Over one million HIV/AIDS patients in India are without access to the much-needed anti-retroviral (ARV) treatment, a new international report said today, suggesting that India should consider issuing compulsory licensing for increasing availability of drugs.
The joint report issued by the World Health Organisation, UNAIDS, and UNICEF said India had made progress in scaling up access over the years, but said given its robust generic drug industry it could have done better.
“India has done well in scaling up access to the ARV therapy over the last seven years,” says a senior WHO official, suggesting there is still a huge gap to address.
The universal gap between those needing urgent ARV treatment for HIV/AIDS the world over and those unable to have any access climbed to over 15 million people and there is an urgent need for funds to the tune of USD 10 billion, says Rifat Atun, a senior official of the Global Fund which is the main provider of assistance to countries afflicted with HIV/AIDS, Tuberculosis, and Malaria.
India now ranks third in scaling up access, after South Africa and Kenya during the last five years.
However, it needs to cross some distance for ensuring universal access for all its HIV/AIDS patients.
Around 3,20,074 have received ARV therapy in India at the end of last year as compared to 2,34,581 patients to the previous year. Between 1.1 and 1.4 million HIV/AIDS patients have no access for ARV therapy in India.
Given the number of health professionals and the state of the art generic drug industry in India, the performance on the HIV/AIDS front could be far better in comparison with other low-income countries in Southern Africa.
India must consider issuing compulsory licenses for ensuring free access to second and third-line treatment for all patients.
Compulsory licensing enables a national government to revoke a license issued to a patent holder and thereby, allow other parties to produce and sell a patented product for non-commercial purposes.
Several industrialised nations resorted to compulsory licensing to enable their national health departments to procure medicines at low prices so as to provide free of cost in government hospitals.
India is yet issue a compulsory license despite its rising HIV/AIDS patients who now need second and third-line treatment.
In 2006, Thailand issued compulsory license for the production of patented drugs for for its HIV-infected population. Later, Brazil also issued compulsory license for the production of patent-drugs produced by an American pharmaceutical company despite enormous pressure from the US.
Heart disease is particularly endemic in India, where a genetic trait renders Indians three times more vulnerable than Americans or Europeans. While the average age for a heart attack in London is 65, in India it is 45 years. One in four Indians gets a heart attack before retirement and about 25 percent of all heart-disease deaths happen to those under the age of 40. As a result of this higher prevalence, the Indian subcontinent alone accounts for 45 percent of coronary artery disease worldwide.
In the face of such high demand, India’s healthcare system faces great difficulties in serving people’s needs. On average, there is one doctor per 2000 people, 70 percent of which live in urban areas. Thus, access to care is determined by the convenience and affordability of travel. Even when people can get to a hospital, 50 percent of patients seeking cardiac care at a district hospital before 2001 would die before they could get specialist help.
Like many other countries, cost is the biggest barrier to medical treatment in India. Of the 22.5 million Indians in need of heart surgery annually, less than 3.5 percent can afford it. The ripple effects are enormous: when a poor family loses its primary breadwinner, the whole family is made destitute. In other words, affordability of healthcare is a pre-requisite for emerging out of poverty. But less than 15 percent of Indians have access to health insurance, including the 2 percent that can afford private insurance.
Furthermore, led by developed economies, the trend in healthcare has been moving away from large hospitals to smaller clinics that provide a more tailored and unique experience, in addition to a stronger focus on new technologies, vaccines, and “wonder drugs”. While it is an exciting time in global healthcare since most diseases are curable, treatment remains prohibitively expensive, excluding most poor people from the healthcare system. In fact, 100 years after the first heart surgery, only 8 percent of the world’s population can afford one.
UNIVERSAL ACCESS TO ESSENTIAL DRUGS
Access to essential medicines as part of the right to the highest attainable standard of health (“the right to health”) is well-founded in international law. The right to health first emerged as a social right in the World Health Organization (WHO) Constitution (1946) and in the Universal Declaration of Human Rights (1948). The binding International Covenant on Economic, Social, and Cultural Rights (ICESCR) of 1966 details the progressive realization of the right to health through four concrete steps, including access to health facilities, goods and services.
The authoritative General Comment 14 (2000) further applies the principles of accessibility, availability, appropriateness and assured quality to goods and services, which include essential medicines “as defined by the WHO Action Programme on Essential Drugs”.
In India, a silent crisis in access to essential medicines confronts most patients who seek treatment of acute and chronic diseases. Close to 40% of Indians live on less than US $1 per day and most of them pay out of pocket for using healthcare. Out-of-pocket spending in India is over four times higher than public spending on healthcare. Unexpected illness can have a catastrophic effect on the family of the ill person: direct out-ofpocket payments could push 2.2%% of all healthcare users and one-fourth of all hospitalised patients, into poverty in a year
In addition, most Indians pay for medicines – a key factor that can contribute to the impoverishing effect of out-of-pocket payments for healthcare. According to the World Health Organization (WHO), an estimated 649 million people in India do not have regular access to essential medicines. Public provision of these medicines is poor; the median availability of 30 essential medicines in six states in India varied between 0% and 30 %. Patients are forced to buy medicines from the private market, a compulsion that often spells calamity for those who can ill afford the twin burdens of sickness and healthcare costs.
For example, India has the largest number of patients with diabetes in the world. A study has shown that patients belonging to the low income group in urban India were spending 27% of their annual income and those in rural India 34% of their annual income on diabetes care; most of this was spent on purchase of medicines . A recent study calculated the expenditure incurred on outpatient treatment of community-acquired pneumonia as a proportion of the mean per capita expenditure on food. Urban patients spent 17.6 % of their mean per capita expenditure on food (rural patients spent 23.4%) on the medicines prescribed for communityacquired pneumonia . Studies have also shown that of the rising out-of-pocket expenditures on healthcare, which push an estimated 32-39 million people below the poverty line annually more than 70% of expenditure was incurred on purchase of medicines .
The reality of healthcare in India is that the private sector now caters to 80% of outpatient and 60% of inpatient care. Patients are therefore forced to purchase medicines from the market, which functions (and is being allowed to function) in a manner antithetical to India’s public health needs. Not only do public health systems fail to provide essential drugs to patients, but the Indian pharmaceutical market is flooded with overpriced medicines that are inappropriate and irrelevant to the public health needs of the country.
The lack of access to essential medicines — 348 drugs are listed in the national list of essential medicines of India is the result of the inadequate budgetary provision for healthcare, the lack of a comprehensive policy on medicines in India, and a weak regulatory framework which allows medicines to be produced, promoted and prescribed without assurance of their rationality, quality or reasonableness of price. To reduce healthcare costs, it is important that people are able to access medicines of assured quality that are efficacious, safe and affordable. These essential medicines must satisfy the priority healthcare needs of a majority of the population and must be available as part of a basic healthcare system .
Government announcement on free generic and essential medicines
Some activities in 2012 suggest that this scenario might change. In February 2012, partly as a response to the persistent demands of civil society and the recommendations of the High Level Expert Group of the Planning Commission, the government announced plans to increase the outlay for health to 2.1% of the gross domestic product by the end of the 12th Five Year Plan (2012-17). The President’s speech in the budget session of 2012 referred to plans by the government to ensure universal access to free generic essential medicines in public health institutions in a time-bound and phased manner. This plan was also referred to by the Prime Minister in his 2012 Independence Day address. This was a welcome announcement (even if long overdue) articulated at the highest level of the government, although a year later the scheme has still not received adequate budgetary allocation to allow for its launch. If translated into reality by exercise of political will, good governance and allocation of adequate resources, it can revitalise the public health system in India.
1. Mistaken notions of ‘branded’ and ‘generic’ medicines in India
In India, confusion and misinformation about generic medicines abound. The confusion is spread across stakeholders including the public, prescribers, policymakers and pharmaceutical trading agencies.
In their 2012 addresses to the nation, the President and the Prime Minister emphasised the importance of access to generic medicines, and rightly so, because worldwide, generic medicines are being seen as an answer to soaring healthcare costs. For example, in the US, not only are six of every 10 prescriptions filled with generic medicines , but pharmacists are also allowed to replace branded medicines with generic ones. By contrast, in India, home of one-fifth of the world’s production of generic medicines, a consumer finds it difficult to access low-cost generics. We explain this paradox by clearing the misinformation about branded and generic medicines in India.
A generic drug is defined as a drug product that is comparable to brand/reference listed product in dosage form, strength, route of administration, quality and performance characteristics, and intended use. In countries where product patent laws are in effect, the originator firm holding the patent markets the medicines under a trademarked name with no competition for a period of up to 20 years. In these countries, generic medicines are low-cost versions of the innovator product, produced by a number of manufacturers after the patent on the medicine expires. Thus generic medicines are off-patent medicines made by companies other than the originator company, and may be marketed under a trade name (branded generic) or under the international nonproprietary name, or INN (unbranded generic). For example, Paracetamol is marketed as Crocin, Calpol, or Metacin (branded generic), or simply as Paracetamol (unbranded generic). Generic versions of the original patented drug, chemically identical to the originator product, are required by law to satisfy the same standards of quality, and are similar in safety, efficacy, risks, benefits, and intended use. Sceptics often raise the issue of bioequivalence and therapeutic equivalence of generic and brand/reference products. Actually, drug products are considered bioequivalent if there is no clinically significant difference in their bioavailability (as measured by extent and rate of absorption, and maximum blood concentration) . Generic drugs are identical and bioequivalent to an innovator brand . In the case of oral drugs, if the blood concentrations of two drugs are the same, then their concentration at the site of action and their effectiveness are also considered to be the same . There are few cases in which two drug products with the same active ingredient in the same dose may have different bioavailability. In all other circumstances, generic and brand name drugs can be considered interchangeable. A systematic review of 38 randomised controlled trials of generic and brand named cardiovascular drugs concluded that they were clinically equivalent.
The term generics are understood differently in India. In India, there was no patent protection for medicinal products before 2005 (only processes for manufacture of medicinal products could be patented); and the term generic medicines was used for those medicines which were marketed under the generic name (INN). A recent term for generic medicines used by the WHO is multi-source pharmaceutical products , which avoids the prevailing confusion between generic medicines (which can be marketed under a brand name), and the generic (non-proprietary) name of a medicine . In countries like the USA, prescriptions for unbranded generics predominate, while branded generics are a small part of the market — 58% of the dispensed prescriptions were for unbranded generics compared to only nine per cent for branded generics .
We use the term generic in line with its global usage to denote medicines which are off patent. The term used in this sense would represent virtually all the drugs in the Indian pharmaceutical market, since few enjoy patent protection. In India, the basic division is therefore not between medicines under patent and off-patent medicines, but between unbranded medicines (generic in the Indian sense) and branded medicines. Branded drugs in India are actually branded generics which are often misunderstood by patients, or even the media, as patented medicines , which they are not.
The brand scam
Drug makers and pharmaceutical trading agencies create an impression that branded generics are vastly superior to unbranded generics (which are often procured in the public health system and are available to patients free of cost). Even medical professionals consider unbranded generics to be substandard medicines. To add to the confusion, branded generics in India have been artificially divided by academicians and policymakers into two categories: branded products, which apparently refer to drugs made by reputed companies and promoted through doctors, and so-called branded generics , drugs apparently made by less reputed companies and promoted through retailers . Patients value quality, safety and cost-effectiveness of a medicine; it matters little to them whether the medicine is branded or unbranded and whether it is promoted through the retailer or the doctor. All drugs in India also have to meet the same requirements with regard to quality, irrespective of whether they are marketed under the INN or trade name, and regardless of the route of promotion.
Drug makers and pharmaceutical trading agencies aggressively promote their brand name drugs, often using dubious means. Each brand claims superiority over competing brands or unbranded medicines. The top 50 companies spent Rs 5,840 crore on drug promotion in a single year. This practice and cleverly created myths have made it difficult for patients to access low cost medicines in India. The argument that brand A is better than brand B does not hold for a number of reasons.
First, drug makers often market the same molecule under a variety of brand names and at widely differing prices. For example, Ranbaxy uses two brand names to market ciprofloxacin: Cifran (the best-selling brand) and Ciproace (the lesser-known brand). A tablet of Cifran (500 mg) costs Rs 9.90; that of Ciproace Rs 6.20. Does it mean that Cifran kills bacteria faster than Ciproace does? How would Ranbaxy justify the difference in the prices of its two brand names?
Second, drug makers also market both so-called brands and branded generics. A recent study did not find any difference in quality between brands and so-called branded generics made by the same company , yet the difference in price is substantial.
Third, medical professionals often indicate that they trust drugs made by highly reputed companies. Their trust is misplaced because reputed companies in India often do not manufacture but only market medicines (which may range from vitamins to very expensive antibiotics). The medicines marketed by reputed companies are actually manufactured by so-called less reputed companies. For example, Glaxo Smith Kline (GSK) is well known for its brands such as Zevit (multivitamin with zinc), Augmentin (amoxicillin-clavulanate: an oral and parenteral antibiotic), and Esblanem (Meropenem: an antibiotic costing Rs 1,200 per gram). Little do the doctors and public know that GSK gets them manufactured by less well-known companies such as Remidex, Medreich and Hospira and merely markets these brands (information from product packages). This is true for hundreds of other companies as well.
Fourth, the companies argue that drugs promoted through chemists are cheaper than those promoted through doctors, because they do not have to offer the incentives and freebies that they routinely offer to doctors. This argument also does not hold because companies promote medicines to doctors as well as chemists.Wh ile doctors are offered gifts and even incentives , chemists are also offered bonuses on brands and hugely discounted prices on commonly used drugs. Recent studies have shown that trade margins in India for branded drugs can vary from 200% to over 1,000% . Self-medication practices are widespread across the different socio-economic groups in India, as is the practice of over-the-counter drug dispensing. For minor ailments, consumers often do not see a doctor and prefer to medicate themselves. Blissfully unaware of the profit margins on simple antibiotics, cough syrups, painkillers or anti-histaminics, they end up paying exorbitant prices for the over-the-counter drugs they buy from local chemists. Abroad, generics are much cheaper than the originator product . Not so in India. The so-called branded generics have a printed maximum retail price which is sometimes even higher than that of so-called branded product .
We wish to emphasise that the Indian pharmaceutical market is entirely a generics market, one in which a few branded generics, masquerading as innovator products, monopolise the market. There are thousands of brand name drugs in this market and patients have little access to low-cost branded or unbranded medicines. For patients to access low-cost generic drugs, it is important that drug companies reduce their profit margin, pharmacies stock and promote them and prescribers start writing them. Although the Medical Council of India’s code of ethics for doctors explicitly mentions that Every physician should, as far as possible, prescribe drugs with generic names, this practice is seldom followed.
We believe that doctors must write drugs by generic names in both public and private sectors. To begin with, public health facilities must enforce this practice because unbranded medicines are procured and dispensed in these institutions. The usual practice of patients seeking healthcare in the public health facilities being forced to buy brand name medicines from private chemists must be checked . The generic-name prescriptions in the private sector haven’t succeeded because private pharmacies either do not stock them or the pharmacists replace low-cost drugs with expensive branded ones. Therefore the government’s advice to all doctors to prescribe by generic name cannot be translated into practice. Also, when doctors prescribe fixed dose combinations (FDCs), they always choose brand name drugs. They argue that because FDCs have multiple ingredients, they find it difficult to prescribe them by their non-proprietary names. Prescribing by generic name in India will take root only when doctors prescribe unbranded single ingredient medicines, and take irrational FDCs off their prescriptions.
The drug regulatory agencies in developed countries like the US, Canada, the UK and Australia promote the use of generics and highlight their therapeutic equivalence to brand name originator products. In India, most prescribers do not know there is no difference, in pharmaceutical terms, between unbranded and branded medicines, or between brands, and the drug regulatory authorities make no effort to educate them. Both doctors and patients prefer brand name drugs over generic drugs because the latter, in their eyes, are low quality and substandard — if not counterfeit — drugs. Patients prefer to spend on brands they can trust, and consider a company’s visibility and corporate image as a proxy for authenticity and quality control.
If the government were to provide quality assurance of all medicines available in the market, then a truly competitive market for generics competing on the basis of price could emerge in India which would immensely benefit the consumer. There would be increased prescriber support for unbranded generics in India and a better performance of schemes like the Jan Aushadhi stores which aim at providing good quality low-priced, unbranded medicines from five public sector companies . Our own experience of running pharmacies at secondary and tertiary care institutions, based on low cost, unbranded as well as branded, generics sourced from carefully chosen drug companies, has been very positive in terms of savings in cost to patient and patient outcomes.
Brand name medicines in India cause the cost of treatment to spiral and are also a frequent but under-reported cause of medication errors. More than 60,000 brands exist in the Indian market but there is no registry of these drugs. As a result, brand names of medicines with dissimilar therapeutic effects (lookalike or sound-alike drugs; Table 1), result in serious medication errors. In our clinical practice, almost every day we see dozens of patients who are unable to find the drugs their doctors have prescribed, because the brand name drugs in the prescription they carry are available at only a few select shops close to their doctor’s clinic.
2. Overpricing of medicines in India: the imperative for price regulation
Price regulation has been a key element of India’s pharmaceutical policy since 1970. Prices of medicines have however been rising over the past few decades due to progressive dismantling of the system of price regulation. The Drug Prices Control Order (DPCO) initially placed price limits on 348 medicines deemed essential in India, a number that shrank to just 74 drugs by 1995. Most drugs required to treat diseases of public health importance were either underrepresented in this list or were not represented at all. The list did not include vaccines, oral rehydration salts, drugs for cancer or coronary artery disease, and included very few drugs for respiratory diseases, hypertension, and diabetes.
The government tried to justify its lax control over regulation of drug prices by arguing that competition alone was enough to control their prices, an expectation belied by subsequent developments. Drugs not listed in the DPCO started getting costlier, and the rise in drug prices consistently outstripped the prices of all other commodities (37). For 17 years — 1995 to 2012 — the number of drugs under price control did not change.
A public interest litigation filed in the Supreme Court of India is seeking to re-introduce price regulation of all the medicines in the National List of Essential Medicines (NLEM). At the behest of the court, the NLEM was recently revised (10) and a revised National Pharmaceuticals Pricing Policy is on the anvil (39)
The government, however, intends to switch to a market based pricing formula which, if implemented, will either only marginally reduce drug prices, or may actually increase them (40, 41) Several publications have pointed out that the new policy may adversely impact public health in India (42, 43, 44) An analysis of the top-selling 300 brands suggested that 62% of them contained medicines outside the NLEM, and of the 115 FDCs only 20% could be considered rational. These medicines and such combinations would be outside the purview of price control, and this would reduce the efficacy of price control as an intervention to reduce healthcare-related costs.
Are price differentials ethical?
Medicines are overpriced in India. In India, the pharmaceutical sector shows three types of price differentials which reflect this overpricing. The first differential is the greater than 10-fold difference in the maximum retail price of different brands of the same medicine which is seen in the market (Table 2). Differences between retail prices of perhaps a lesser magnitude are seen across therapeutic categories of medicines in India. The disconcerting fact is that in India the market leader in a particular therapeutic segment is also the price leader, or amongst the highest priced medicines in that segment. For example, Atorva, an anti-lipid brand name drug, outsells hundreds of brands, some of which are 10 times cheaper (Table 2). This is clearly an indication that market forces fail to regulate drug prices, as was naively assumed by the government over the years. This state of affairs exists because patients pay but do not decide, while doctors – the key players who are often heavily influenced by the pharmaceutical companies – decide but do not pay. In such a situation, patients with diseases like diabetes, hypertension or cancer pay substantially more if their doctor prescribes the more expensive brand for each of these conditions.
The second inexplicable difference in prices is between the price to retailer and the price to consumer for branded generics. A study found trader margins for the branded generics promoted through retailers of the order of 201-1,016% . These enormous trade margins have been known to the government since 1998 as pointed out by the Drug Price Indian Journal of Medical Ethics Vol X No 2 April-June 2013 Control Review Committee. This vast differential points to the enormous mark-ups which exist in drugs and which are being pocketed either by the pharmaceutical trader or the company (hospitals and doctors who dispense the drugs also share the profits). If drug makers agree to reduce the exorbitant profit margins, and drug prices are tightly regulated, all drugs might become available at affordable prices. while there are 131 brands of thiazides in combination with other medicine
The final revealing differential is between the price paid for purchase of medicines in pooled public procurement programmes in Tamil Nadu and other states which buy quality assured medicines, and of the brands which sell in the market. For example, Tamil Nadu procured 10 tablets of Omeprazole (a commonly used drug for acid peptic disease) for Rs 2.4 while the market leader sells at Rs 39.7 for 10 tablets. Similarly, Tamil Nadu procured human insulin at nearly a third of the prevailing market price. The variation in retail prices, the margins offered to the traders, hospitals and doctors who dispense the drugs and the difference between retail prices and prices in pooled procurement are unique to the pharmaceutical sector.
These differentials raise an ethical question for public policy. These price variations may not be illegal, but are they morally right? Are these wide variations in drug prices – which have no parallel amongst all other commodities – ethically acceptable when access to medicines can constitute the difference between life and death? Should the government not intervene to ensure that patients are not at the mercy of the prescribers’ whims and the vagaries of the market? Should the ambit of price regulation not cover all medicines as suggested by the National Commission of Macroeconomics and Health, rather than just the 348 medicines mentioned in the NLEM? Won’t this control of prices, limited to those of essential medicines, induce the industry to migrate from production of price-controlled medicines to those outside control? This selective approach to price control could ultimately promote the production and marketing of medicines which are not in the NLEM.
3. The need for evidence-based drug approval and improved access to essential medicines
India and its pharmaceutical industry have acquitted themselves very creditably on the global platform. Indian generics account for about 40% of the anti-retroviral medicines provided globally. Worldwide, these low-cost high-quality medicines are a lifeline to millions of people. There are an estimated 10,563 manufacturers in India, and more than 65,000 formulation .
These numbers look impressive but the paradox is that, at home, large portions of the population lack access to even the most essential drugs. The limited funds available are frequently spent on ineffective, unnecessary, or dangerous medications. The money spent on overpriced medicines is very often also a waste of precious resources. This is because the Indian pharmaceutical market is full of ineffective, unnecessary medicines. Since these medicines outnumber those which are cost-effective, they directly impact the availability of and access to essential medicines .
Lack of essential medicines in the market
Iron deficiency anaemia is an important public health problem in India, associated with low birth weight in infants, pregnancyrelated deaths, and decreased work capacity. Ferrous sulphate and ferrous fumarate – low cost medicines recommended for treatment of iron deficiency which are distributed free of cost in public health facilities – are not available in most drug stores in India. The July 2012 edition of Current Index of Medical Specialities (CIMS), a prescriber handbook, does not mention a single preparation which contains ferrous sulphate in the dose mentioned in the NLEM 2011. Hundreds of iron preparations are available in the market they contain salts with poor efficacy or co-existing with other nutrients (vitamins, minerals including zinc, amino acids) which do not increase their efficacy. Yet they cost much more than simple iron preparations and push up the cost of treatment of iron deficiency anaemia as much as 70-fold, according to an estimate. We are unable to understand why such ineffective and irrational preparations continue to be in the market and why iron pills are not under price control.
Dexorange was a market leader for the treatment of iron deficiency anaemia. Although this drug contained a poorly absorbed salt of iron and haemoglobin that came from slaughterhouse blood, it enjoyed a lot of support from medical professionals between 1970 and 2000 (when the use of haemoglobin in anaemia preparations was finally banned). This combination had no parallel anywhere in the world. Similarly, the market is flooded with irrational fixed dose combinations to treat infectious diseases, as well as “me-too” drugs — members of the same group as essential medicines which do not confer any therapeutic advantage but are more expensive. It is a moot point whether the 11 calcium channel blockers available in the Indian market fulfil any therapeutic need. On the other hand, essential medicines are scarce. Thiazide diuretics are amongst the cornerstones of treatment of hypertension. However, there were only five brands of thiazides listed in CIMS , while there are 131 brands of thiazides in combination with other medicines .
Unnecessary and irrational fixed dose combinations
Fixed dose combinations (FDCs) are combinations of drugs, used in situations where such a combination is pharmacologically justified. More than 40% of the formulations in India are composed of FDCs, a proportion which is unprecedented. For example the NLEM which lists 348 medicines has only 15 combinations of medicines. In contrast, in the market there are more than 15 combinations of paracetamol alone.
FDCs are justified when the combination of the active drugs increases efficacy, decreases adverse effects, reduces the risk of drug resistance, lowers prescription cost, simplifies therapy or promotes adherence to therapy. Such combinations with a Indian Journal of Medical Ethics Vol X No 2 April-June 2013 therapeutic advantage are therefore justified (some examples are oral contraceptives, anti-malaria therapy, anti-TB drugs, HIV therapy, and drugs for asthma, hypertension and diabetes). A basic requirement is that the drugs comprising the FDC should have compatible pharmacokinetics and pharmacodynamics. The major disadvantage of FDCs is an inability to vary the dose of the individual components of the combination, and increased incidence of adverse effects.
In India, the FDCs often lack pharmacological justification. India’s most widely available antibiotic combination of ampicillin/amoxicillin and cloxacillin is pharmacologically irrational , compromises the treatment of staphylococcal infections because the dose of cloxacillin in the FDC is half of what it ought to be, and promotes the development of drug resistance. The use of other FDCs of antibiotics like ciprofloxacin + metronidazole has contributed to increasing resistance in enteric infections like typhoid fever.
FDCs often also contain chemicals which lack efficacy but increase the cost of therapy. For example, an FDC of painkillers with serratiopeptidase, a drug isolated from silkworm intestine, is commonly prescribed in India. This drug was voluntarily withdrawn from the market in Japan by its manufacturer Takeda in 2011, when clinical trials failed to show evidence of its efficacy compared to placebo, but continues to be popular in India.
A number of FDCs are downright hazardous. The European Medicines Evaluation Agency approved Nimesulide only for restricted and short term use in adults. The agency warned that combination of this drug with other painkillers like paracetamol could adversely affect the liver. Yet, several leading Indian companies (Lupin, IPCA, and Dr Reddy’s Laboratories) market such FDCs in India.
Table 3 lists the irrational FDCs made in India. Indian pharmaceutical manufacturers have WHO good manufacturing practices certification and a number of them have US FDA approval. Is it not axiomatic that the content of medicines manufactured be also such that would stand the scrutiny of an agency outside India? The presence of unnecessary and ineffective drugs makes the process of drug regulation even more daunting as the authorities waste their time and resources fixing the prices or monitoring the quality of preparations which should not have been manufactured in the first place. For example, the National Pharmaceutical Pricing Authority has determined prices for 78 formulations of cloxacillin, a medicine which is under price control. All these 78 formulations are irrational as they contain combinations of cloxacillin with various other antibiotics (ampicillin, amoxicillin, cefixime, cefpodoxime), and varying concentration of lactobacillus spores (20-60 million) .
The drug approval process in India and its lacunae
Drug regulatory agencies all over the world approve medicines for use in their countries on the basis of an evidence-based process which evaluates the data on their efficacy (obtained through randomised controlled trials) and safety. In India in light of the public health problems that we face, the widespread poverty and high out-of-pocket expenditure incurred by patients, the drug regulatory authorities have an additional responsibility: to ensure that the medicines being approved for manufacture serve the public health needs of the country and are cost-effective.
The Drugs Controller General of India (DCGI) heads the Central Drug Standards Control Organization (CDSCO) which oversees the process of approval of medicines for India. This process needs to be rigourous, transparent and evidence-based, as is the case with drug regulatory agencies in the developed countries. The website of the CDSCO should list the approval letters, approved indications, and information for patients who are to use the product.
However, the drug regulatory agencies in India have paid inadequate attention to rigourous, impartial review of the scientific evidence, public health relevance, transparency and public disclosure before approving a drug. A parliamentary committee report on the functioning of the CDSCO in 2012 observed: A review of the opinions submitted by the experts on various drugs shows that an overwhelming majority are recommendations based on personal perception without giving any hard scientific evidence or data. Such opinions are of extremely limited value and merely a formality. Still worse, there is adequate documentary evidence to come to the conclusion that many opinions were actually written by the invisible hands of drug manufacturers and experts merely obliged by putting their signatures.
The issue of irrational FDCs in India is a pointer to the lacunae in the drug approval process. The genesis of many irrational FDCs has been at the state level where the state licensing officers in contravention of the amended Drugs and Cosmetics Act were found to be issuing licenses to companies for the manufacture of FDCs. The DCGI issued a directive in 2002 to all the state drug controllers to refrain from issuing any new drug licensing for the manufacture of FDCs. But as was noted by the parliamentary committee, no action has been taken in the past 11 years on this issue .
In response to a public interest litigation the DCGI’s office had identified 294 FDCs which had been sanctioned by the state licensing authorities without its approval. Such FDCs are illegal and could have been banned immediately, but even these have yet to be withdrawn. One example from this list of FDCs that was approved by a state licensing agency, though classified as ‘absurd’ by the DCGI, is a combination of non-steroidal anti-inflammatory drugs and other drugs, chlorzoxazone + Ibuprofen+Paracetamol+diclofenac+Oxyphe nbutazone+Magnesium hydroxide.
While state drug controllers can be blamed for many irrational FDCs, irrational FDCs have been approved in recent years by the CDSCO. FDCs of antibiotics are clearly dangerous to public health – as pointed out in the recent parliamentary committee report. For example, the DCGI has approved an Indian Journal of Medical Ethics Vol X No 2 April-June 2013 FDC of Moxifloxacin with cefixime for the treatment of lower respiratory tract infections (Table 3). Moxifloxacin is a newer generation fluoroquinolone and one of the few orally effective drugs for multi-drug resistant tuberculosis. Such a combination, if used frequently to treat pneumonia, could further complicate the problem of multi-drug resistant TB.
Need for transparency in the approval process
In its report, the parliamentary committee drew attention to a collusive nexus between drug manufacturers, some CDSCO functionaries and some medical experts which resulted in irregular drug approvals. On the issue of irrational FDCs, it stated in very clear terms, The Committee is of the view that Section 26A is adequate to deal with the problem of irrational and/or FDCs not cleared by CDSCO. There is a need to make the process of approving and banning FDCs more transparent and fair. In general, if an FDC is not approved anywhere in the world, it may not be cleared for use in India unless there is a specific disease or disorder prevalent in India, or a very specific reason backed by scientific evidence and irrefutable data applicable specifically to India that justifies the approval of a particular FDC. The Committee strongly recommends that a clear, transparent policy may be framed for approving FDCs based on scientific principles.
Irrational FDCs continue to thrive because drug companies take advantage of the lengthy litigation in Indian courts. In such cases the onus of proof – that the FDCs are harmful – lies on the complainant. With virtually no system of post-marketing surveillance, it is nearly impossible to gather evidences of harm against FDCs in India.
Lessons from successful initiatives in improving access to essential medicines
As the government endeavours to improve the availability of medicines in public health facilities, it would be beneficial for it to incorporate lessons from some successful initiatives in improving availability of essential medicines. Beginning October 2, 2011, Rajasthan state has started supplying free medicines at public health facilities. Since 1994, Tamil Nadu Medical Services Corporation has ensured ready availability of all essential drugs and medicines in the government medical institutions throughout Tamil Nadu by adopting a streamlined and transparent procedure for their procurement, storage and distribution. This quality-assured process of pooled public procurement has several features worthy of replication at the national level. A similar initiative has been implemented in Delhi state.
These initiatives have succeeded in procurement of unbranded essential medicines at very low prices, eliminating irrational medicines and unscientific fixed dose combinations. They have shown that given political and administrative will, it is not difficult to gather support from healthcare professionals for improving access to healthcare and decreasing the burden of expenses for patients, while achieving substantial savings in cost for the public exchequer.
The common people who purchase medicines at nearly half a million chemist shops in India, every day, await a similar exercise of political and administrative will of the government to improve access to low-cost drugs in the public health facilities. As this article goes to press, the quantum of funds for the free generic medicines scheme is not known as it did not appear in any line item in the budget for 2013-2014.The Working Group on Food and Drugs Regulations for the 12th Plan has estimated that an allocation of just Rs 5,000 crore per year would suffice to fulfil the central government’s share (85%) of the cost of the ‘free medicines for all’ scheme.
Direct out-of-pocket payments push one out of 45 healthcare users into poverty in a year; this number would fall to just one of 200 if healthcare users do not have to pay out-of-pocket for purchase of medicines. Reduction of this out-of-pocket spending on medicines which is impoverishing people by the millions is an ethical imperative for public health in India.
In conclusion, the plan to improve access to essential medicines through improved provisioning in public health facilities is a welcome initiative. However, given the current realities of the healthcare system in India and the catastrophic effects of out of- pocket payment on purchase of medicines being borne by the poor, making essential and rational medicines affordable in India is also an urgent imperative.
The government must correct the present distortions around the concept of generic medicines in India by providing quality assurance of medicines, emphasizing the equivalence of different branded or unbranded medicines, and allowing the emergence of a true generics market, where different products can compete on price rather than on brand image. Prescription by generic name in all public health facilities should be mandated. The market should be made to move towards single ingredient, unbranded medicines.
To address the anarchy of drug prices which is impoverishing people, we need a comprehensive cost-based system, and not the market-based system of price regulation. The drug approval system in India needs to be overhauled on the lines suggested by the recent parliamentary committee which looked into the functioning of the CDSCO. The process of drug approval needs to be rigourous, evidence-based, transparent, and in line with the interests of public health in India. The government should address the lack of single-ingredient essential medicines in India for priority health conditions. All FDCs which lack a pharmacological rationale, contain ineffective or hazardous combinations, or are illegally approved by state drug controllers need to be removed from the market. The present predicament, of poverty of access to medicines amidst a plenty of overpriced, non-essential medicines which worsen poverty, should not be allowed to continue to imperil the lives and health of Indians.
RIGHT TO INFORMED CONSENT
Informed consent is an ethical and legal requirement for research involving human participants. It is the process where a participant is informed about all aspects of the trial, which are important for the participant to make a decision and after studying all aspects of the trial the participant voluntarily confirms his or her willingness to participate in a particular clinical trial and significance of the research for advancement of medical knowledge and social welfare. The concept of informed consent is embedded in the principles of Nuremberg Code, The Declaration of Helsinki and The Belmont Report. Informed consent is an inevitable requirement prior to every research involving human being as subjects for study. Obtaining consent involves informing the subject about his or her rights, the purpose of the study, procedures to be undertaken, potential risks and benefits of participation, expected duration of study, extent of confidentiality of personal identification and demographic data, so that the participation of subjects in the study is entirely voluntary.
For a drug to get approved and enter into the market it has to prove its safety and efficacy in clinical trials. Clinical trial is a term used to describe all research related activities, which use human being as subjects. As no individual has right to infract fundamental rights of another person for the sake of fulfilling his own purpose, so an important tool called “informed consent” came into existence.
The informed consent is described in ethical codes and regulations for human subject’s research. The goal of the informed consent process is to provide sufficient information to a potential participant, in a language which is easily understood by him/her, so that he/she can make the voluntary decision regarding “to” or “not to” participate in the research study.
Conventionally informed consent is thought to be in terms of the documents signed and dated by participants, setting forth the purpose, benefits, risks and other study information necessary to allow the participants to make an informed and voluntary decision to participate in the clinical study. In reality, informed consent is the process that applies to each communication to participants, commencing with the subject recruitment material and the initial telephone screening of potential subjects through the conclusion of the study. It also describes the obligation of the investigator to inform the subject about personal benefits and risk, individual faces in study.
Informed consent is not only required for clinical trials but is an essential prerequisite before enrolling each and every participant in any type of research involving human subjects including; diagnostic, therapeutic, interventional, bioequivalence, social and behavioral studies and for all research conducted domestically or abroad. Obtaining consent involves informing the subject about his or her rights, the purpose of the study, the procedures to be undergone, the potential risks and/or benefits of participation and alternative treatments available if any. Subjects in the study must participate willingly only after consenting based on the information given
BASIC ELEMENTS FOR WRITTEN INFORMED CONSENT DOCUMENTS
a) A statement that the study involves research;
b) An explanation of the purpose of research and the expected duration of the subject’s participation;
c) A description of the procedures to be followed and identification of any procedures that are experimental;
d) A description of any foreseeable risks or discomforts to the subject, an estimate of their likelihood and a description of what steps will be taken to prevent or minimize them;
e) A description of any benefits to the subject or to others that may reasonably be expected from the research. Monetary compensation is not a benefit;
f) A disclosure of any appropriate alternative procedures or courses of treatment that might be advantageous to the subject;
g) A statement describing to what extent records will be kept confidential, including a description of who may have access to research records;
h) For research involving more than minimal risk, an explanation and description of any compensation and any medical treatments that are available if research subjects are injured; where further information may be obtained and whom to contact in the event of a research-related injury;
i) Information on the amount of remuneration/compensation, if any, that will be provided to subjects;
j) An explanation of whom to contact for answers to pertinent questions about the research and the research subject’s rights (include the clinical center’s patient representative and telephone number);
k) A statement that participation is voluntary and that refusal to participate or discontinuing participation at any time will involve no penalty or loss of benefits to which the subject is otherwise entitled.
INFORMED CONSENT PROCESS FLOW
Notes to Flowchart
Source documents must reflect that consent was obtained before the start of study treatment and procedures
A copy of the signed consent form must be kept at the site
All versions of approved consent forms must be kept in the site study file; only the current Institutional Review Board (IRB) approved version may be used to consent new patients.
WAIVERS TO INFORMED CONSENT
A. A waiver of informed consent under 45 Code of Federal Regulations (CFR) 46.116 (d)
B. An alteration of consent under 45 CFR 46.116 (d)
An IRB may waive the requirements to obtain informed consent provided the IRB finds and documents that:
• The research involves no more than minimal risk to the subjects;
• The waiver or alteration will not adversely affect the rights and welfare of the subjects;
• The research could not practicably be carried out without the waiver or alteration and
• Whenever appropriate, the subjects will be provided with additional pertinent information after participation.
C. A waiver of parent/guardian permission under 45CFR 46.408 (c)
D. A waiver of assent under 45 CFR 46.408 because the minors are not capable of assent
E. A waiver of assent under 45 CFR 46.408 because the research holds out a prospect of direct benefit that is available only in the context of the research
CHALLENGES IN INFORMED CONSENT PROCESS
It is assumed that the individual who signs the consent form does so with full understanding of what is stated on the consent form. However, it is very difficult to evaluate their viewpoint about trial since there is no established method to measure the level of understanding that a participant has about the information given. Thus, it can be assumed that there is a degree of misunderstanding that occurs. Misunderstandings can occur because of incorrect or inadequate language translations. Many individuals sign the consent form without being fully aware of what they are signing, which results in withdrawal of subject at later stages of ongoing clinical studies. Hence, the responsibility of researcher enlarges when a study is performed in multilingual subjects.
The informed consent process is designed to give every participant the liberty to decide whether to accept or refuse the recommended medical treatment. Sometimes their decision for participating in researcher projects is influenced by the religious beliefs. It is commonly observed that how the methodology of the experiment come into conflict with the rules of behavior set by a participant’s religion.
Even when there are no language barriers or religious impediments to hinder the communication relationship between researcher and participant, misunderstanding can still occur due to participants false expectations of the experiment outcome. Some patient fear of being treated as mere “experimental model” for the studies while others refuse to take part because of historical evidences of clinical trial fraud and misconducts known to them.
Most patients believe that, trials will put extra burden on them. They assume that the conventional treatment is best and they are afraid of the unknown side-effects of new treatment. Convincing and receiving an informed consent from such patient is most difficult. In some case disclosing too much information of the potential side-effects may unnecessarily scare the patient away from a potentially life-saving or life-enhancing surgery or procedure.
Where research involves children (under the age of 18) consent/permission has to be obtained from parents. If the child is above 7 years of age then “child assent” is also mandatory. It is arguable that children are capable of being partners in research and that they have rights to receive information, to be listened to, have their wishes and feelings taken into account and to give or withhold consent if judged competent to do so. Difficulty arises when parents give their consent while child refuses to assent.
Vulnerable People and Groups
Vulnerable groups include the person who is absolutely or relatively incapable of protecting their interests. Obtaining informed consent is critical when working with them, specifically with some groups like people with learning disabilities. There may be potential problems of understanding what the research is about, what their role in the research will be and how the research will be used. Hence, obtaining informed consent can be difficult and special care needs to be taken to develop the appropriate strategies for communicating the implications of involvement in research.
In countries like India, the clinical investigations are based on regional values and practices, the concept of disease as perceived through social values and power hierarchies in family of villages based on cultural systems. To get a meaningful and ethical informed consent in these settings become challenging due to differences in cultural values in western countries and local customs in developing countries including India. In a study by DeCosta that was carried out in a village of Haryana state of India, the majority of respondents interviewed by them could decide on clinical trial participation after discussing with community members. Another important factor emerged from this study, which showed an implicit trust by respondents in the medical system and ignorance about the information that should be known before consenting to be a part of the research study. These factors put a huge responsibility on the part of the investigator to get informed consent. The investigator must explain in most comprehensive and complete manner the risks involved in participating in the research study. Thus, investigator should have the patience to get informed consent from these subjects allowing them to discuss with other family and community members. The ethical principles of western countries require all adults to be the primary decision makers of their participation, which may not be applicable in Indian system, which is culturally and socially different from the western world. Another important aspect of informed consent arises in psychiatric clinical studies. As large numbers of psychiatry studies are conducted in India, these studies present complex and unique challenges in Indian context. These issues include risk of worsening of illness, use of placebo and validity of informed consent. The informed consent procedure requires patient to be of sound mind and in understanding the information presented and make a sound judgment regarding participation. Assessment of consent capacity may be difficult due to fluctuation in illness, which requires continued assessment of consent capacity. Thus, conducting clinical trials and obtaining informed consent for psychiatry studies is difficult and raises a doubt on the conduct of clinical trials due to lack of trained researchers. The guidelines are prepared keeping in mind the western culture and may not replicate the same results due to cultural variability in non-western countries like India. The dilemma in obtaining informed consent from subjects with cognitive impairment includes validity of informed consent by subject, implications and validity of third party consent, protection of human subjects. Regulations don’t provide information and guidance on ethical issues of psychiatry research.
Though enveloped by challenges, informed consent is an important tool in clinical trials, which facilitates the entry of new therapeutic interventions into the market. No research activity involving human subjects can be conducted and proceed unless informed consent is completely sought. The responsibility of conducting trial ethically and genuinely lies in the hands of those involved in it. Everyone must understand their obligations and should not misuse their power for own benefit. Rights, safety and well-being of trial subjects should always prevail over the interest of science and society, so that a layman never feels being deceived off in name of a social cause. The issue of informed consent in India is a challenge on the part of investigator as a lot of complexities arise. Further, regulations are based on the western guidelines, which do not necessarily reflect the requirements of India. The guidelines on informed consent in India should be based on complex factors such as culture, level of education, demographics and risks involved during the study.
Recently, Indian Society is experiencing a growing awareness regarding patient’s rights. This trend is clearly discernible from recent spurt in litigation concerning medical professional or establishment liability, claiming redressal for the suffering caused due to medical negligence, vitiated consent, and breach of confidentiality arising out of the doctor patient relationship.
What Is Medical Negligence?
Negligence is simply failure to exercise due care. The three ingredients of negligence are as follows:
1. The defendant owes a duty of care to the plaintiff
2. The defendant has breached this duty of care.
3. The plaintiff has suffered an injury due to his breach.
And in case of medical negligence mostly the doctor is the defendant. Negligence is predominantly a theory of liability concerning allegations of medical malpractice, making this type of litigation part of the Tort Law.
Civil Liability and Medical Negligence
Negligence is the breach of a legal duty to care. It means carelessness in a matter in which the law mandates carefulness. A breach of this duty gives a patient the right to initiate action against negligence.
Persons who offer medical advice and treatment implicitly state and undertake to have the skill and knowledge to do as under:
• To undertake particular job.
• To decide whether to take a case or not ,
• To decide the treatment suitable for particular case
• To administer that treatment.
This is known as an “implied undertaking” on the part of a medical professional.
However, no human being is perfect and even the most renowned specialist could make a mistake in detecting or diagnosing the true nature of a disease.
A doctor can be held liable for negligence only if one can prove that she/ he is guilty of a failure that no doctor with ordinary skills would be guilty of if acting with reasonable care. An error of judgment constitutes negligence only if a reasonably competent professional with the standard skills that the defendant professes to have, and acting with ordinary care, would not have made the same error.
Doctors must exercise an ordinary degree of skill. However, they cannot give a warranty of the perfection of their skill or a guarantee of cure. If the doctor has adopted the right course of treatment, if she/ he is skilled and has worked with a method and manner best suited to the patient, she/ he cannot be blamed for negligence if the patient is not totally cured.
Certain conditions must be satisfied before liability can be considered. The person who is accused must have committed an act of omission or commission; this act must have been in breach of the person’s duty; and this must have caused harm to the injured person. The complainant must prove the allegation against the doctor by citing the best evidence available in medical science and by presenting expert opinion.
Criminal Liability and Negligence
Indian Penal Code 1860 sections 52, 80, 81, 83, 88, 90, 91, 92 304-A, 337 and 338 contain the law of medical malpractice in India.
A physician can be charged with criminal negligence when a patient dies from the effects of anesthesia during, an operation or other kind of treatment, if it can be proved that the death was the result of malicious intention, or gross negligence. Before the administration of anesthesia or performance of an operation, the medical man is expected to follow the accepted precautions.
In such cases, the physician should be able to prove that he used reasonable and ordinary care in the treatment of his patient to the best of his judgment. He is, however, not liable for an error judgment. The law expects a duly qualified physician to use that degree of skill and care which an average man of his qualifications ought to have, and does not expect him to bring the highest possible degree of skill in the treatment of his patients, or to be able to guarantee cures.
“Gross Lack of competency or gross inattention, or wanton indifference to the patient’s safety, which may arise from gross ignorance of the science of medicine and surgery or through gross negligence, either in the application and selection of remedies, lack of proper skill in the use of instruments and failure to give proper attention to the patient.” (Hampton v State; State v Lester)
When Does The Liability Arise In Case Of Medical Negligence?
The liability of a doctor arises not when the patient suffers injury but when the injury results due to the conduct of the doctor, which was below reasonable care. Hence once there exist a duty which has to be established by the patient, then the next step is to prove breach of such duty and the causation.
Normally the liability arises only when the plaintiff is able to discharge the burden on him of proving negligence. However, in some cases the principle of “res ipsa loquitor” which means the thing speaks for it might come into action. Mostly the doctor is liable only for his own acts. However in some cases a doctor can also be made vicariously liable for the acts of another. The example of such a situation is when a junior doctor assisting the senior doctor commits a mistake it becomes the duty of the senior to have supervised him hence vicariously liable.
Proof of Medical Negligence
It has been held in different judgments by the National Commission and the Hon’ble Supreme Court that a charge of professional negligence against a doctor stood on a different footing from a charge of negligence against a driver of a vehicle. The burden of proof correspondingly greater on the person who alleges negligence against a doctor. It is known fact that things can go wrong even wit the best doctor. And the guilt or the negligence should be established beyond all reasonable doubts that his skill fell below reasonable care that he ought to take during the treatment/ surgery.
Steps/ Procedure to File Complaint Pertaining To Medical Negligence
Medicine is a noble profession and practitioner must bring to his task a reasonable degree of skill and knowledge and must exercise reasonable degree of care. Neither the very highest nor a very low degree of care and competence, judged in the light of the particular circumstances of each case, is that the law requires.
1. Damage to organ due to negligence.
2. Wrong treatment due to wrong diagnosis.
3. Money receipt or prescription or discharge summary or test reports when not provided.
4. When treatment not chosen as accepted and established in medical norms /as per medical research/available medical literature.
5. Theory of res ipsa loquitur [a thing speaks of itself] – in case any instrument left in the body, a wrong part removed, allopathic treatment given by a homeopathic doctor etc.
6. Govt Hospital liable if contribution from the employee’s salary deducted OR Payment made by insurance company.
7. Negligent if three steps necessary are not observed by the medical practitioners.
First – To decide whether he has to take up the case or not:Third- Whether the treatment given as per the diagnosis made.
8) Hospital can also be negligent if ‘it is a case of non- availability of oxygen cylinder either because of the hospital having failed to keep available a gas cylinder or because of the gas cylinder being found empty.
The Indian health system includes public and private hospitals as well as specialised Ayurvedic hospitals offering this traditional Indian system of alternative medicine. English-speaking doctors are easy to find, as most Indian doctors speak fluent English. All major cities and medium-sized urban centres have private hospitals that provide an excellent standard of care.
Health insurance only covers hospitalisation and emergency costs. Other care must be paid for upfront, but even privately it is extremely reasonable compared to other countries, so medical costs should not be a significant expense.
Most western expats working in India take out private health cover, either independently or as an employee benefit. As such, foreigners should head to or call a private hospital in an emergency, as the quality of treatment and care is likely to be better than a state hospital.
Publicly funded government hospitals provide basic care only and often lack adequate infrastructure. They can also be crowded and waiting times can be long. Government hospitals are often understaffed, which is why a family member usually attends to the patient during a hospital stay.
Though the cost of care is less at these government hospitals, the standard is inferior compared to private hospitals, and in general western expats opt for private healthcare.
The Private Sector
Most locals and expats prefer to use the services of private hospitals and clinics. These offer a high standard of care that is at the same level as North American and European countries. Private hospitals are modern and well equipped, and the doctors are highly qualified and often trained abroad. The following private hospital groups have good reputations and are located in all major cities:
The cost of medical care is very reasonable compared to other countries. Some hospitals practice double-pricing, with higher fees for foreigners. These fees can be negotiable.
Doctors and Clinics
General practitioners are available in hospitals, clinics and in private practices. The best way to find a doctor is to ask for recommendations from friends, co-workers or neighbours. Embassies and consulates can also provide a list of recommended doctors.
There are hundreds of medical facilities across the country. Your health insurance provider will normally provide details of the options in your locality. In addition, the following links provide contact information for a range of hospitals and clinics.
• The Health section on the India government website provides details and directories of a number of health care options.
• For lists of contact details for selected hospitals and clinics.
All types of prescription medicines and health care products are available in India at a very low cost. Doctors provide prescriptions for certain medications but some pharmacies do not always ask for them.
Pharmacies are easily found in almost every street in all Indian cities. These can be simple roadside stalls or bigger shop-like businesses. Some may display green or red crosses.
There are many qualified dentists in India operating in private practices offering high-quality dental care and procedures at very reasonable rates. Health insurance does not cover dental care but if a dental procedure requires hospitalisation, this may be covered.
Again, ask for recommendations for a dentist from friends, co-workers or neighbours. Always check that the dentist has the correct qualifications.
The detrimental effects of environmental pollution are a great concern for the health of the planet, especially current and future generations of human inhabitants. As countries progress through various stages of social and economic development, so too does pollution disperse throughout the planet. Air and water pollution, for example, do not respect geographic, political, and temporal boundaries, and can have lingering effects on such aspects of daily life as economic and food security. Individuals, families, and governments alike therefore often face both the direct and indirect costs associated with increased economic and food insecurity. In an effort to combat the full spectrum of environmental harm and its continued presence in the modern world, national governments have taken important, constitutional steps toward mitigating this harm for current and future generations.
Although the real panic in India came to be felt only after the Bhopal gas tragedy in 1984, yet it began concentrating on the problem of pollution soon after the Stockholm conference. India parliament passed many statutes to protect and improve the environment viz. Wildlife (protection) Act, 1972; Water (prevention and control of pollution) Act, 1974; the forest (conservation) Act, 1989; the air (prevention and control of pollution) Act,1981 and above all the Environment (protection) Act, 1986. Further the constitutional (forty-second Amendment) Act, 1976 incorporated two significant articles viz. Article 48-A and 51A (g) thereby making the Indian Constitution the first in the world conferring constitutional status to the environment protection.
THE MAIN ISSUES OF CONCERN INTHIS FIELD FOR THE HELPING HUMAN RIGHTS FOUNDATION IN INDIAN SUN-CONTENTAL ARE:
- Banning of asbestos.
- Pesticides in the environment.
- Pollution and its effect.
- Disposal of bio medical waste.
- The closure of brick kilns in agricultural areas.
BANNING OF ASBESTOS
Primary exposure to asbestos in India can be encountered in the form of asbestos mining, asbestos cement industries, asbestos processing unit and during renovation and demolition of old asbestos cemented roof or other structures as well as modern electrical as well as mechanical appliances in which asbestos is still found. Ultimately construction workers, electricians, vehicle mechanics and other workers in the building trades who are exposed to asbestos inhale hundreds and thousands of amphiboles, which causes lung damage. It is being mined in India at places such as Andhra Pradesh (Pulivendla), Jharkand (Roro), Rajasthan (Ajmer, Bhilwara, Udaipur, Rajsamand) and the common problem faced by the locals are asbestosis through air and fluorosis through drinking water. The problem continues to be in India as well as other developing countries. Also, India import and re-export asbestos to other countries and workers at shipyard, transport of the hazardous material on road and roadside residents all are vulnerable to this uncommon disease. The signs and symptoms generally found with the workers are shortness of breath, persistent and productive cough due to pulmonary fibrosis can show up many years after the asbestos exposure.
Asbestos being relatively inexpensive, and so often called a “poor mans material” is used in a variety of products such as cement roofing panels, insulation, automobile brake linings and so on. Asbestos consists of tiny fibres which get easily released into the surrounding air and therefore get inhaled and enter the lungs causing respiratory diseases and cancer. Asbestos poses dangers at all stages of its extraction and use, from mining where workers get exposed to raw asbestos, to manufacture of products where again workers and others in the work place or its vicinity are exposed to the fibres, and even to the general public using asbestos products such as children in schools with asbestos roofing in classrooms. That asbestos is an extremely hazardous material has long been established by relevant scientific and other bodies.
The World Health Organization (WHO) had categorically confirmed the health hazards especially carcinogenicity of all types of Asbestos going back at least two decades. Noting that studies had shown that there is no threshold or safe limit for the cancer-causing effect of asbestos, WHO concluded that “the most efficient way to eliminate asbestos-related diseases is to stop using all types of asbestos.” The International Agency for Research on Cancer set up under WHO aegis has also concluded long ago that all forms of asbestos are cancer causing and should therefore be completely eliminated. The International Labour Organization (ILO), especially in a special resolution of 2006, has also pronounced on the hazards posed to workers exposed to asbestos in mining, using asbestos for making products and in handling of products made with asbestos, including even family members of asbestos workers who get exposed to asbestos fibres on the clothes of workers.
Other organizations to recognize the dangers posed by asbestos and calling for its eventual total elimination include the World Federation of Public Health Associations, the International Commission on Occupational Health, the Union for International Cancer Control representing 770 member organisations in 155 countries including the Indian Cancer Society, the International Trade Union Confederation and the Indian Association of Occupational Health.
India & Asbestos
In India too, numerous scientific studies and governmental committees have earlier concluded as to the hazards posed by asbestos. The Factories Act 1948 itself recognizes asbestos as a hazardous material. India’s Inventory of Hazardous Chemicals Import in India includes asbestos among 180 hazardous chemicals imported into India, the inventory having been prepared by the Central Pollution Control Board (CPCB) constituted under the Ministry of Environment & Forests.
Back in 1995 the Supreme Court had ruled, in a case filed by a consumer rights organization, that asbestos was clearly a hazardous substance whose adverse impact on human health went far beyond the immediate work place in mines or product making factories and extended well into homes and pubic places wherever the general public could come into contact with the material. The apex Court had then ruled that the Government of India should implement measures to strictly control and regulate use of asbestos, especially by following the guidelines and recommendations issued from time to time by the ILO, with a review after every 10 years.
In 2006 in connection with another case, the Supreme Court noted that more than 15 years had elapsed since its previous order and that the problems posed by asbestos had become more acute and demanded more stringent action. Internationally it had by now come to be recognized that it was virtually impossible to implement measures for “controlled use” of asbestos since even secondary exposure with no threshold limit had been seen to cause all kinds of health problems including cancer. The Court noted that ILO had passed a very specific resolution in 2006 calling for a complete ban on all mining, manufacture, recycling and use of all forms of asbestos.
Following this judgement, the Government had adopted several measures including setting up of an Advisory Committee in early 2012 to go into how the ILO Resolution could be implemented. This Committee had not submitted its Report by the time the UPA government was voted out of power and the new BJP Government has not followed up on it either. The National Human Rights Commission (NHRC) is also pursuing a case seeking compliance with the Supreme Court’s order
Not that no action had been taken in the interim. Due to the sustained campaign against asbestos and various governmental actions, there had been a substantial reduction in use of asbestos and a cessation of asbestos mining in India. Consumption of asbestos in India has dropped by 39% from 2012 to 2013, that is from 493,086 to 302,668 tons, which is still intolerably large. Regrettably, India remains among the world’s highest users of asbestos which is imported from a number of countries that continue to mine and export asbestos such as Canada, Brazil, Russia and China.
Currently a Bill, originally introduced in 2009 under UPA, has been reintroduced in Parliament in November 2014, namely the White Asbestos (Ban on Use and Import) Bill, 2014, seeking use of safer and cheaper alternatives to white or chrysotile asbestos. The Bill calls for “a total ban on use and import of white asbestos in the country and to promote the use of safer and cheaper alternative to white asbestos and for matters connected therewith and incidental thereto.”
In parallel, however, asbestos manufacturers associations and industry lobbies continued putting pressure on government in one way or another not to impose any restrictions or regulations governing the use of asbestos. Whenever an international convention came around requiring Government of India to take a stand, or whenever some executive or legislation action was forthcoming, these industrial lobbies would put out huge advertisements in newspapers and other mass media claiming that asbestos was not harmful, making false distinctions between chrysotile asbestos and other forms of asbestos etc.
All central Trade Unions have also adopted a Resolution demanding a complete ban on all forms of asbestos and introduction of alternative materials, which are well known and widely available, so as not to result in loss of employment to workers in the sector.
India, NIOH Study and Rotterdam Convention
It should be noted that, whereas the growing consensus and momentum in international bodies including ILO, WHO etc as well as among workers’ organizations, think tanks, popular movements and citizens groups were increasingly converging on a total ban on asbestos, the Rotterdam Convention was yet only confined to controlling imports and exports, and required exporters to inform the importing country that hazardous materials listed under the Convention were being exported to that country. Even on this, many countries with vested interests either as exporters or as importers continued to stall the agreement by refusing to endorse it or refusing to add one or other substance to the List. Canada, for instance, despite severely restricting the use of asbestos within that country, exported as much as 95 percent of asbestos mined in Canada, of which almost half was exported to India.
In 2004, India informed the Convention that it would take a stand on asbestos after a study which it had asked the NIOH to conduct. This Report underwent several “reviews” and modifications, and over the years was comprehensively criticized and rejected by think tanks, peoples movements, scientists and others in India and abroad. However, citing this Report, India continued to block inclusion of asbestos in the Convention list as recommended by its Chemicals review Committee in 2004 and 2006.
To everyone’s surprise, however, India reversed its position in 2010 and, to a standing ovation in the 5th Conference of Parties (COP5), agreed to the inclusion of asbestos in the List. But this joy at India going along with world scientific opinion was short lived. Citing the ‘Final Report’ of the NIOH study, in 2013 India once again reversed its position and went back to its earlier stance of not accepting inclusion of asbestos in Annex III of the Rotterdam Convention.
The NIOH study, in direct contradiction to the position of other Indian authorities or relevant bodies, and also contradicting earlier studies by the same Institute as well as the publicly communicated opinion and published papers of its former Directors, essentially stated that asbestos especially chrysotile asbestos was not a hazardous substance and did not pose a threat to the safety of workers or the general pubic. This NIOH study has used deeply flawed methodology and arrived at completely non-justifiable conclusions. The study has collected data from workers classified on the basis of age rather than duration of exposure as should have been done, and has somehow managed to select workers mostly under 35 years of age and who had around 5 years or less of exposure to asbestos. It is well known that asbestosis and related cancers are slow gestation diseases, taking around 20 years to develop and manifest themselves. This is like picking teenagers who have been smoking a little for a year or two and concluding that there is no risk of cancer! There are numerous other and quite fundamental flaws in the NIOH study which make it clear that the very objective of the study was to somehow justify a pre-determined conclusion tailor-made to suit the interests of industry lobbies.
NIOH has done itself no credit whatsoever by conducting and releasing such a study. This has caused great harm to the reputation of not just this institution but of science in India as a whole. As argued in these columns earlier too, if scientific institutions and scientists in India allow themselves to be used in this manner to produce tailor-made studies to suit the powers that be, they will also lose credibility in the eyes of the general public within this country.
This spurious NIOH study needs to be withdrawn by NIOH.
And Government of India needs to agree to inclusion of asbestos in the list for Prior Informed Consent at the forthcoming June 2015 COP of the Rotterdam Convention in Paris.
PESTICIDES IN THE ENVIRONMENT
Although it is well known and acknowledged that pesticides are harmful for the environment and human health, we often do not know how to evaluate and control the extent of the damage.
As the world population is rising, it is causing a steep increase in the demand for food and fibre production. In order to meet this requirement, greater usage of pesticides is observed all over the world, which is a major hurdle in the path towards sustainable agriculture production.
The pesticides used in India can be classified into five on the basis of chemical nature.
1. ORGANOCHLORIDES:- These are organic compounds with several atoms of chlorine per molecule. DDT, BHC, ALDRIN, DIELDRIN and ENDRIN are organo chlorine pesticides. DDT is the oldest and most popular synthetic pesticide. BHC alone represent 50% of the total pesticide volume of pesticide. Aldrin is used in the foundation of buildings to prevent attack by termites. All these chemicals are lipophillc and get bioaccumulated in the fatty tissue of animals.
2. ORGANOPHOSPHATES:- MALATHIION (Flit) used in antimalarial programmes and PARATHION are esters of organic compounds with phosphoric acid. Fenitrethion, malathion and parathion are very effective on the nervous system.
3. CARBAMATES:- These are compounds having a chemical structure similar to acetylecholine. Carbofuran (furadon), propoxur (baygon) are carbamate pesticides.
4. PYRETHROIDS:- These are synthetic products from pyrethin, a plant chemical extracted from chrysanthemum cinerarifolium.
5. TRIAZINES:- These are compound like simazine, altrazine derived from urea. They are effective weedicides (herbicides) used against the weeds of tea, tobacco and cotton.
LIST OF PESTICIDES WHICH ARE BANNED, REFUSED REGISTRATION AND RESTRICTED IN USE:
(As on 01st January 2014)
I. PESTICIDES / FORMULATIONS BANNED IN INDIA
A. Pesticides Banned for manufacture, import and use.
3. Benzene Hexachloride
4. Calcium Cyanide
8. Copper Acetoarsenite
12. Ethyl Mercury Chloride
13. Ethyl Parathion
14. Ethylene Dibromide
16. Lindane (Gamma-HCH)
17. Maleic Hydrazide
21. Paraquat Dimethyl Sulphate
22. Pentachloro Nitrobenzene
24. Phenyl Mercury Acetate
25. Sodium Methane Arsonate
26. TCA (Trichloro acetic acid)
B. Pesticide formulations banned for import, manufacture and use
1. Carbofuron 50% SP
2. Methomyl 12.5% L
3. Methomyl 24% formulation
4. Phosphamidon 85% SL
C. Pesticide / Pesticide formulations banned for use but continued to manufacture for export
1. Captafol 80% Powder
2. Nicotin Sulfate
D. Pesticides Withdrawn
(Withdrawal may become inoperative as soon as required complete data as per the guidelines is generated and submitted by the Pesticides Industry to the Government and accepted by the Registration Committee. (S.O 915(E) dated 15th Jun,2006)
4. Nickel Chloride
5. Paradichlorobenzene (PDCB)
II. PESTICIDES REFUSED REGISTRATION
S.No. Name of Pesticides
1. Ammonium Sulphamate
2. Azinphos Ethyl
3. Azinphos Methyl
5. Calcium Arsenate
7. Chinomethionate (Morestan)
10. Fentin Acetate
11. Fentin Hydroxide
12. Lead Arsenate
13. Leptophos (Phosvel)
15. Mevinphos (Phosdrin)
16. 2,4, 5-T
17. Thiodemeton / Disulfoton
III. PESTICIDES RESTRICTED FOR USE IN THE COUNTRY
Pesticides may cause acute and delayed health effects in people who are exposed. Pesticide exposure can cause a variety of adverse health effects, ranging from simple irritation of the skin and eyes to more severe effects such as affecting the nervous system, mimicking hormones causing reproductive problems, and also causing cancer. A 2007 systematic review found that “most studies on non-Hodgkin lymphoma and leukemia showed positive associations with pesticide exposure” and thus concluded that cosmetic use of pesticides should be decreased. Limited evidence also exists for other negative outcomes from pesticide exposure including neurological, birth defects, fetal death, and neurodevelopmental disorder.
The American Academy of Pediatrics recommends limiting exposure of children to pesticides and using safer alternatives:
The World Health Organization and the UN Environment Programme estimate that each year, 3 million workers in agriculture in the developing world experience severe poisoning from pesticides, about 18,000 of whom die. Owing to inadequate regulation and safety precautions, 99% of pesticide related deaths occur in developing countries that account for only 25% of pesticide usage. According to one study, as many as 25 million workers in developing countries may suffer mild pesticide poisoning yearly.
One study found pesticide self-poisoning the method of choice in one third of suicides worldwide, and recommended, among other things, more restrictions on the types of pesticides that are most harmful to humans.
Pesticide use raises a number of environmental concerns. Over 98% of sprayed insecticides and 95% of herbicides reach a destination other than their target species, including non-target species, air, water and soil. Pesticide drift occurs when pesticides suspended in the air as particles are carried by wind to other areas, potentially contaminating them. Pesticides are one of the causes of water pollution, and some pesticides are persistent organic pollutants and contribute to soil contamination.
In addition, pesticide use reduces biodiversity, contributes to pollinator decline, destroys habitat (especially for birds), and threatens endangered species.
Pests can develop a resistance to the pesticide (pesticide resistance), necessitating a new pesticide. Alternatively a greater dose of the pesticide can be used to counteract the resistance, although this will cause a worsening of the ambient pollution problem.
Since chlorinated hydrocarbon pesticides dissolve in fats and are not excreted, organisms tend to retain them almost indefinitely. Biological magnification is the process whereby these chlorinated hydrocarbons (pesticides) are more concentrated at each level of the food chain. Among marine animals, pesticide concentrations are higher in carnivorous fishes, and even more so in the fish-eating birds and mammals at the top of the ecological pyramid. Global distillation is the process whereby pesticides are transported from warmer to colder regions of the Earth, in particular the Poles and mountain tops. Pesticides that evaporate into the atmosphere at relatively high temperature can be carried considerable distances (thousands of kilometers) by the wind to an area of lower temperature, where they condense and are carried back to the ground in rain or snow.
In order to reduce negative impacts, it is desirable that pesticides be degradable or at least quickly deactivated in the environment. Such loss of activity or toxicity of pesticides is due to both innate chemical properties of the compounds and environmental processes or conditions. For example, the presence of halogens within a chemical structure often slows down degradation in an aerobic environment. Adsorption to soil may retard pesticide movement, but also may reduce bioavailability to microbial degraders.
Alternatives to pesticides are available and include methods of cultivation, use of biological pest controls (such as pheromones and microbial pesticides), genetic engineering, and methods of interfering with insect breeding. Application of composted yard waste has also been used as a way of controlling pests. These methods are becoming increasingly popular and often are safer than traditional chemical pesticides. In addition, EPA is registering reduced-risk conventional pesticides in increasing numbers.
Cultivation practices include polyculture (growing multiple types of plants), crop rotation, planting crops in areas where the pests that damage them do not live, timing planting according to when pests will be least problematic, and use of trap crops that attract pests away from the real crop. In the U.S., farmers have had success controlling insects by spraying with hot water at a cost that is about the same as pesticide spraying.
Release of other organisms that fight the pest is another example of an alternative to pesticide use. These organisms can include natural predators or parasites of the pests. Biological pesticides based on entomopathogenic fungi, bacteria and viruses cause disease in the pest species can also be used.
Interfering with insects’ reproduction can be accomplished by sterilizing males of the target species and releasing them, so that they mate with females but do not produce offspring. This technique was first used on the screwworm fly in 1958 and has since been used with the medfly, the tsetse fly, and the gypsy moth. However, this can be a costly, time consuming approach that only works on some types of insects.
Agroecology emphasize nutrient recycling, use of locally available and renewable resources, adaptation to local conditions, utilization of microenvironments, reliance on indigenous knowledge and yield maximization while maintaining soil productivity. Agroecology also emphasizes empowering people and local communities to contribute to development, and encouraging “multi-directional” communications rather than the conventional “top-down” method.
POLLUTION AND ITS EFFECT
Air pollution in India is a serious issue with the major sources being fuelwood and biomass burning, fuel adulteration, vehicle emission and traffic congestion. Air pollution is also the main cause of the Asian brown cloud, which is causing the monsoon to be delayed. India is the world’s largest consumer of fuelwood, agricultural waste and biomass for energy purposes. Traditional fuel (fuelwood, crop residue and dung cake) dominates domestic energy use in rural India and accounts for about 90% of the total. In urban areas, this traditional fuel constitutes about 24% of the total. Fuel wood, agri waste and biomass cake burning releases over 165 million tonnes of combustion products into India’s indoor and outdoor air every year. These biomass-based household stoves in India are also a leading source of greenhouse emissions contributing to climate change.
The annual crop burning practice in northwest India, north India and eastern Pakistan, after monsoons, from October to December, are a major seasonal source of air pollution. Approximately 500 million tons of crop residue is burnt in open, releasing smoke, soot, NOx, SOx, PAHs and particulate matter into the air. This burning has been found to be a leading cause of smog and haze problems through the winter over Punjab, cities such as Delhi, and major population centers along the rivers through West Bengal. In other states of India, rice straw and other crop residue burning in open is a major source of air pollution.
Vehicle emissions are another source of air pollution. Vehicle emissions are worsened by fuel adulteration and poor fuel combustion efficiencies from traffic congestion and low density of quality, high speed road network per 1000 people.
On per capita basis, India is a small emitter of carbon dioxide greenhouse. In 2009, IEA estimates that it emitted about 1.4 tons of gas per person, in comparison to the United States’ 17 tons per person, and a world average of 5.3 tons per person. However, India was the third largest emitter of total carbon dioxide in 2009 at 1.65 Gt per year, after China (6.9 Gt per year) and the United States (5.2 Gt per year). With 17 percent of world population, India contributed some 5 percent of human-sourced carbon dioxide emission; compared to China’s 24 percent share.
The Air (Prevention and Control of Pollution) Act was passed in 1981 to regulate air pollution and there have been some measurable improvements. However, the 2012 Environmental Performance Index ranked India as having the poorest relative air quality out of 132 countries.
Water is another basic amenity of life. Over the years it has been extensively polluted, mainly due to (1) domestic sewage, (2) industrial waste, (3) chemical inputs of agriculture, and (4) elevated temperatures.
Three major types of pollution of freshwater are: (i) excess of nutrients from sewage and soil erosion causing algae blooms, (ii) pathogens from sewage which spread disease, and (iii) heavy metals and organic compounds which bio-accumulate in aquatic organisms.
Some health hazards caused by water pollution are: (i) spread of epidemics like cholera, jaundice, dysentery, typhoid, gastroentiritis etc.; (ii) nervous disorders and other disabilities caused by mercury, lead, copper, zinc and other metals and their oxides being dumped by the industrial units in the water sources; (iii) disruption of biological processes due to consumption of dyes released by the dyeing industrial units into the water sources.
India has major water pollution issues. Discharge of untreated sewage is the single most important cause for pollution of surface and ground water in India. There is a large gap between generation and treatment of domestic waste water in India. The problem is not only that India lacks sufficient treatment capacity but also that the sewage treatment plants that exist do not operate and are not maintained. The majority of the government-owned sewage treatment plants remain closed most of the time due to improper design or poor maintenance or lack of reliable electricity supply to operate the plants, together with absentee employees and poor management. The waste water generated in these areas normally percolates in the soil or evaporates. The uncollected wastes accumulate in the urban areas cause unhygienic conditions and release pollutants that leaches to surface and groundwater.
According to a World Health Organization study, out of India’s 3,119 towns and cities, just 209 have partial sewage treatment facilities, and only 8 have full wastewater treatment facilities. Over 100 Indian cities dump untreated sewage directly into the Ganges River. Investment is needed to bridge the gap between 29000 million litre per day of sewage India generates, and a treatment capacity of mere 6000 million litre per day.
Other sources of water pollution include agriculture run off and small scale factories along the rivers and lakes of India. Fertilizers and pesticides used in agriculture in northwest have been found in rivers, lakes and ground water. Flooding during monsoons worsens India’s water pollution problem, as it washes and moves all sorts of solid garbage and contaminated soils into its rivers and wetlands.
In India, fresh water in general is slightly alkaline with a pH usually more than 7. Unlike surface waters, subsurface water varies widely from place to place. In coastal Tamil Nadu, intrusion of sea water into the subsurface aquifer makes ground water saline. As ground water is drawn to an excess, the water table falls deeply, and this allows sea water to percolate.
This is a problem in Gujarat also. However, the salinity of ground water depends on other dissolved solids. Health concerns have been aggravated due to high fluoride and/or arsenic content of some ground water.
Wells in several districts in West Bengal and the mining districts of Khetri and Zawar in Rajasthan have high levels of dissolved arsenic. Ajmer in Rajasthan and Anantpur in Andhra Pradesh are two regions with high fluoride content in ground water, and this causes fluorosis.
Solid waste pollution
Trash and garbage is a common sight in urban and rural areas of India. It is a major source of pollution. Indian cities alone generate more than 100 million tons of solid waste a year. Street corners are piled with trash. Public places and sidewalks are despoiled with filth and litter, rivers and canals act as garbage dumps. In part, India’s garbage crisis is from rising consumption. India’s waste problem also points to a stunning failure of governance.
In 2000, India’s Supreme Court directed all Indian cities to implement a comprehensive waste-management programme that would include household collection of segregated waste, recycling and composting. These directions have simply been ignored. No major city runs a comprehensive programme of the kind envisioned by the Supreme Court.
Indeed, forget waste segregation and recycling directive of the India’s Supreme Court, the Organisation for Economic Cooperation and Development estimates that up to 40 percent of municipal waste in India remains simply uncollected. Even medical waste, theoretically controlled by stringent rules that require hospitals to operate incinerators, is routinely dumped with regular municipal garbage. A recent study found that about half of India’s medical waste is improperly disposed of.
Municipalities in Indian cities and towns have waste collection employees. However, these are unionised government workers and their work performance is neither measured nor monitored.
Some of the few solid waste landfills India has, near its major cities, are overflowing and poorly managed. They have become significant sources of greenhouse emissions and breeding sites for disease vectors such as flies, mosquitoes, cockroaches, rats, and other pests.
In 2011, several Indian cities embarked on waste-to-energy projects of the type in use in Germany, Switzerland and Japan. For example, New Delhi is implementing two incinerator projects aimed at turning the city’s trash problem into electricity resource. These plants are being welcomed for addressing the city’s chronic problems of excess untreated waste and a shortage of electric power. They are also being welcomed by those who seek to prevent water pollution, hygiene problems, and eliminate rotting trash that produces potent greenhouse gas methane. The projects are being opposed by waste collection workers and local unions who fear changing technology may deprive them of their livelihood and way of life.
Along with waste-to-energy projects, some cities and towns such as Pune, Maharashtra are introducing competition and the privatisation of solid waste collection, street cleaning operations and bio-mining to dispose the waste. A scientific study suggests public private partnership is, in Indian context, more useful in solid waste management. According to this study, government and municipal corporations must encourage PPP-based local management through collection, transport and segregation and disposal of solid waste.
Noise pollution is another serious threat to the environment. It is generally proved that noise levels below 80 decibels (dB) do not produce any ill effect but if ambient noise exceeds 90 dB, the quality of the environment is said to have deteriorated. Higher levels often cause permanent injury to hearing. Noise affects human beings in the foetal stage itself.
Exposure to noise levels exceeding 75 dB (A) for more than eight hours daily can impair hearing. Other effects are hypertension, disturbances in sleep, speech interference and stress reactions.
Industrial noise can be controlled by using materials that can absorb sound. Workers in noisy surroundings should be provided ear muffs and protection. Their working hours should be adjusted so that they are not exceedingly exposed to noise.
According to CPCB, noise levels up to 90 dB (A) are acceptable for eight hours exposure (Leq 8 hr) per day in industry. For community noise levels, the Noise Pollution (Regulation and Control) Rules, 2000 prescribe the ambient air quality standards in respect of noise in industrial, residential and commercial zones.
A sign of development seems to be the increasing number of vehicles on Indian roads. Vehicular emissions are major pollutants of ambient air quality. Petrol-driven vehicles produce carbon monoxide (CO), hydrocarbon (HC), oxides of nitrogen (NOx), and sulphur dioxide (SO2). Vehicles driven on diesel produce maximum sulphur dioxide followed by the other pollutants produced by petrol-driven vehicles.
These emissions are responsible for the high incidence of a number of diseases and genetic disorders. For example, respirable suspended particulate matter (RSPM) causes respiratory infections such as cough and throat irritation and increases the possibility of lung cancer. Benzene and other organic compounds may cause leukaemia and damage to the central nervous system.
The effects on health associated with the main pollutants emitted by vehicles are listed in the table.
Vehicular pollution is sought to be controlled through progressive tightening of emission norms for new vehicles, introduction of cleaner fuels, effective enforcement of an inspection and maintenance programme for vehicles in use and effective road network and mass transport system and traffic management. Measures have been taken by different ministries and departments in this context.
The Ministry of Surface Transport notified rules for mass emission standards known as India or Bharat 2000 similar to Euro I for all categories of vehicles manufactured on or after April 1, 2000. More stringent emission standards known as Bharat Stage II (akin to Euro II) were put into effect in 2000-2001 for registration of motor vehicles with gross vehicle weight of up to 3500 kg.
As a part of a series of steps aimed at reducing vehicular pollution, petrol stations all over the country began supplying only unleaded petrol from February 1, 2000. Benzene content in petrol was also reduced from 3 per cent in January 2000 to 1 per cent with effect from November 2000 in the National Capital Region (NCR).
The retail sales of ultra low sulphur diesel (ULSD-0.05) through select outlets began in the capital from April 1, 2000. Production and sale of ULSD became necessary as the Supreme Court ruling in 1999 on vehicular emissions stated that all private (non-commercial) vehicles (only passenger cars—not two-wheelers—both petrol-and diesel-driven) in the NCR shall conform to the Euro II norms by April 1, 2000. (See box for Euro norms.)
The introduction of ULSD and low benzene content petrol is expected to go a long way in reducing the prevailing pollution levels. Exposure to acute inhalation of benzene is said to cause drowsiness, dizziness, headaches and unconsciousness, while occupational exposure to benzene has been known to increase the incidence of leukemia.
Delhi is getting special attention on account of its high pollution level. The WHO has classified the city among the ten most polluted cities in the world. And vehicular pollution is the major factor of concern in Delhi.
In the M.C. Mehta vs. Union of India others case, the Supreme Court took cognisance of the extremely polluted air of Delhi and ordered in July 1998 that all diesel-powered buses, taxis and autorickshaws be converted into compressed natural gas (CNG)-fuelled vehicles. The court, acting on the statutory recommendation of the Bhure Lai Committee, gave the ruling that the conversion should be completed by March 31, 2001.
On March 25, 2001, the Court gave an extension till September 30 to the DTC and the private bus operators to ply diesel buses on the condition that they apply for CNG kits or a new CNG vehicle by the March 31 deadline. Another extension till April 14 was then given.
(After an extension granted by the Court, it was on November 30, 2002, that all diesel buses were withdrawn from the NCR and replaced with those run on CNG. Thus Delhi became the first region to have its entire public transport buses switch on to the eco-friendly CNG.
CNG has also been introduced in Mumbai, Baroda and Surat. The central government has also provided indirect fiscal incentives in the form of concessional customs duty on the import of CNG kits and its parts.
The question of the efficacy of CNG as a ‘green fuel’ was hotly debated. In ordering that commercial vehicles running on diesel be converted to CNG mode, the Court had acted on the recommendations of the government-appointed Bhure Lai Committee. The committee recommended CNG because of various factors that were in its favour.
It has been known for some time that particulates in diesel exhaust are often ‘coated’ with the probably carcinogenic polycyclic aromatic hydrocarbons (PAH). Modern diesels emit very small quantities of particulates especially when they run on high quality low sulphur fuel. However, these particles are very small and can penetrate deep into the lung.
On the other hand, benzene and other aromatic compounds in petrol (gasoline) are known carcinogens, so replacement of diesel vehicles with petrol ones is not necessarily a good idea even on environmental grounds. This subject is further complicated by questions involving vehicle maintenance and fuel quality.
Compared to both diesel and petrol engines, emissions from vehicles running on CNG and liquefied petroleum gas (LPG) are very low. In addition, the effects of these emissions are also very low regardless of the weather.
A comparison of pollution performance of different engines operating on diesel, petrol and gaseous fuels such as LPG and CNG shows CNG to be better than other fuels. CNG releases less CO, less NOx, and less particulates (all measured in g/km).
On another count of pollutant effect, it has been shown by studies that CNG creates less smog in both winter and summer, and its contribution in acid formation in the atmosphere compared to other fuels is less than half. In general, gaseous fuels also have an advantage aver liquid fuel because they easily mix with the air in the combustion chamber of the engine and give better performance than die liquid fuel whose mixibllity is not as good.
Neither CNG (which is 80 to 99 per cent methane) nor LPG (mainly propane and butane) contains sulphur that can cause havoc in the combustion chamber. Most important, these fuels cannot be adulterated in the many ways common in India.
In terms of cost, the CNG vehicles cost more. But a CNG bus would meet the emission standards of Euro IV that is to come into effect in Europe in 2005 and in India only in 2008. There are no Euro IV compatible diesel buses commercially available anywhere in the world.
Again, the operating cost of a CNG bus (per passenger per kilometer) is slightly higher due to reduced payload but it is better than that of a “ULSD ran bus since ULSD is more expensive. With respect of safety, CNG is a good option since the gas is lighter than air and quickly disperses to non-combustible levels if it leaks, thus proving itself to be safer than diesel or petrol.
However, while the damage due to petrol and diesel leakage is confined to a small area, CNG may envelop an entire area and explode. This danger, though, may be minimal since CNG ignites at 540°C as compared to petrol which ignites at 232 to 282°C. Nevertheless, some experts and research organisations disagree.
Experts at the The Energy and Resources Institute (TERI) believe that CNG is not the only clean fuel available. ULSD is far better than CNG on many counts. It is pointed out that CNG appears to be better than diesel but actually the comparison itself is faulty.
The comparison should not be between CNG and ‘dirty’ diesel, i.e., diesel with as much as 0.5 per cent sulphur but should be between CNG and ULSD which has a sulphur content of 0.05 per cent and is 100 times cleaner than ordinary diesel. Its viability has been tested by many European countries and it has been found to be very clean.
Moreover, it is pointed out that the data of the comparative ‘polluting effect’ of the fuels are also unreliable since they are based on engine dynamometer tests which do not replicate the stresses and strains of an actual journey. The results of tests done on chassis dynamometer, which mimics a typical bus journey on city roads, are more reliable. Trials commissioned by the London Transport Board using a chassis dynamometer showed that ULSD buses emitted less of every pollutant except nitrogen oxides.
TERI also believed that respirable particulate matters are just 0.02 g in ULSD as compared to 0.05 g in CNG. Even carbon monoxide levels and hydrocarbons are less in ULSD than CNG.
The Bhure Lai Committee also said that CNG was not a clean fuel but it was only environmentally acceptable. According to the committee, electricity is the only ‘clean fuel’. Besides CNG, LPG and propane have also been categorised as ‘environmentally acceptable fuels’ in terms of their pollution potential. However, none of these qualifies as a clean fuel.
“Conventional hydrocarbon fuels are inherently polluting. Be it CNG, LPG, diesel or petrol, these cannot be regarded as clean fuels as they produce exhaust emissions,” the report says. But the report adds: “Among these hydrocarbon fuels, short-chain fuels (CNG, LPG and propane) are much less polluting than long-chain hydrocarbon fuels (diesel and petrol).”
Short-chain hydrocarbon fuels have a lower percentage of carbon as compared to their long-chain counterparts. “CNG has one carbon atom, while LPG has upto three carbon atoms. Diesel or petrol has as many as 17 to 18 carbon atoms, which makes them more polluting than these gaseous fuels,” the report said.
The report did not agree with the claim of the Union government that LSD was a viable alternative. Although it meets the Euro II standards, it has not been defined as ‘environmentally acceptable’ fuel. However, the report says the ULSD with 0.003 to 0.001 per cent sulphur content, when used with exhaust fitments like catalytic regeneration trap (a gadget similar to a catalytic convertor but costing much more), is an environmentally acceptable fuel.
“As of now, ULSD is not available in the country. Either we import the fuel or upgrade the existing refineries,” the report said.
The report also said though CNG had been chosen as the fuel for the public transport, the allied infrastructure was not yet in place. In which case “LSD can be allowed as the transitional fuel for a limited period of time.” Meanwhile, LSD must be improved along with technological upgradation.
The Policy Statement for Abatement of Pollution was adopted in 1992. It provides instruments such as laws and regulations and fiscal incentives to prevent control and reduce pollution of water, land and air. Emphasis is being laid on the promotion of clean and low-waste technologies, minimisation, re-use and recycling of wastes, improvement of water quality, environment audit, natural resources accounting, and institutional and human resource development.
The main idea is to reduce the pollutants at source rather than adopt an end-of-the-pipe treatment. The thrust has, therefore, been towards considering process changes which involve better energy and water conservation.
Polluting units are required to submit an environmental statement (as part of the environmental audit) under the Water (Prevention and Control of Pollution) Act, 1974 or the Air (Prevention and Control of Pollution) Act, 1981 or both.
Efforts are being made to develop and promote cleaner technologies. With World Bank assistance, a waste minimisation programme has been launched for small scale industries. Programmes covering sectors such as textiles, pulp and paper, and tanneries have been identified for action.
Controlling Water and Air Pollution:
Central Pollution Control Board:
The Central Pollution Control Board (CPCB) is an autonomous body of the environment ministry set up in September 1974, under the provisions of the Water (Prevention and Control of Pollution) Act, 1974. It coordinates the activities of the State Pollution Control Boards (SPCBs) and the Pollution Control Committees (PCCs).
The CPCB, SPCBs and the PCCs are responsible for implement¬ing the legislations relating to prevention and control of pollution; they also develop rules and regulations which describe the standards for emissions and effluents of air and water pollutants and noise levels.
The CPCB advises the central government on all matters concerning the prevention and control of air, water and noise pollution and provides technical services to the ministry for implementing the provisions of the Environment (Protection) Act, 1986.
Seventeen categories of heavily polluting industries have been identified, namely, cement, thermal power plants, distilleries, sugar, fertiliser, integrated iron and steel, oil refineries, pulp and paper, petrochemicals, pesticide, tannerier, basic drugs and pharmaceuticals, dye and dye intermediates, caustic soda, zinc smelter, copper smelter, and aluminium smelter.
The CPCB has identified about 2,300 medium and large scale polluting industrial units under these 17 highly polluting categories. The requisite pollution control devices are reported to have been provided in 1,927 units, while 235 have been closed and around 139 are still defaulting. Under the Eleventh Plan, the CPCB will monitor ambient air quality at 308 stations covering 115 cities/towns in 28 states and four UTs to:
i. Determine the status and trend in ambient air quality on significant parameters like benzene and polyaromatic hydrocar¬bons (PAH);
ii. Assess health hazard and the damage to materials;
iii. Develop preventive and corrective measures; and
iv. Understand the natural cleansing process.
The CPCB in consultation with State Pollution Control Boards has identified critically polluted water bodies and areas in the country which need special attention for control of pollution.
These are Vapi (Gujarat), Singrauli (Uttar Pradesh), Korba, Ratiam, Nagda (Madhya Pradesh), Digboi (Assam), Talcher (Orissa) Bhadravati (Karnataka), Howrah (West Bengal), Dhanbad (Jharkhand), Pali and Jodhpur (Rajasthan), Manali and North Arcot (Tamil Nadu), Visakhapatnam and Patancheru (Andhra Pradesh), Chembur (Maharashtra), Najafgarh (Delhi), Govindgarh (Punjab), Udyog Mandal (Kerala), and Parwanoo and Kala Amb (Himachal Pradesh).
The Water (Prevention and Control of Pollution) Act, 1974 regulates water quality through the state pollution control boards. The Central Pollution Control Board (CPCB), under the Ministry of Environment and Forest, has established a nationwide network for water quality monitoring comprising 1019 stations in 27 states and 6 UTs. The monitoring is done on a monthly or quarterly basis for surface water and on half-yearly basis for groundwater.
Under the Eleventh Plan, the monitoring network will cover 200 rivers, 60 lakes, 6 tanks, three ponds, three creeks, 13 canals, 17 drains, and 321 wells. Water samples will be analysed for 28 parameters including physical parameters, nutrients, .major ions, and organic and bacteriological parameters.
The CPCB sees to the monitoring of water quality in a 3-tier system. The first tier caters to the needs of the Global Environmental Monitoring System (GEMS). In tier-2, water quality is monitored under the national programme, Monitoring of India National Aquatic Resources (MINARS). At tier-3, water quality is monitored at state level in addition to the stations set up under GEMS and MINARS.
Monitoring of the Ganga and the Yamuna has been taken up in the Himalayan segments of these rivers. Automatic water quality moni¬toring stations (AWQMS) on River Ganga monitor five parameters, viz. temperature, pH, DO, conductivity and turbidity at one-hour intervals.
Besides the Ganga and the Yamuna, several other rivers (such as Sabarmati, Krishna, and Godavari) have been identified for monitoring polluting sources and stream quality. Ground-water quality is also being monitored at select places.
A programme, National Ambient Air Quality Monitoring (NAAQM), has been in operation. Pollutants such as sulphur dioxide, nitrogen dioxide and SPM, and respirable SPM (RSPM) are monitored.
Besides this, additional parameters such as respirable lead and other toxic trace matters and polycyclic aromatic hydrocarbons are also being monitored in 10 metro cities of the country. The monitoring results indicate that levels of sulphur dioxide and nitrogen dioxide are within the stipulated standards, whereas the levels of SPM and RSPM occa¬sionally exceed, especially in central and northern parts of the country due to natural dust and vehicular emissions.
The air quality of different cities/towns for three critical pollutants has been compared with the respective national ambient air quality standards and has been classified into four broad categories based on an exceedence factor (EF) as calculated by the following ratio:
Exceedence Factor = Observed annual mean concentration of criteria pollutant / Annual standard for the respective pollutant and area class
The four air quality categories are:
Critical pollution (C): When EF is more than 1.5
High pollution (H): When the EF is between 1.0-1.5
Moderate pollution (M): With and EF between 0.5-1.0
Low pollution (L): Where the EF is less than 0.5
Based upon the indicators stated above, a quarterly report is compiled by CPCB in some of the major cities.
Noise Pollution Control:
To regulate and control noise pollution, the government has issued various notifications under the Environment (Protection) Act, 1986.
A Notification on Noise Pollution (Regulation and Control), Rules, 2000 was issued on February 14, 2000 to curtail noise pollution in the country. Accordingly, the use of loudspeakers and public address systems were restricted during night between 10.00 p.m. and 6.00 a.m. except for the closed auditorium, banquet halls, etc.
Owing to various repre¬sentations received from state governments, these rules were amended in October 2002 to permit the use of loudspeakers or public address system during night hours (between 10.00 p.m. and 12.00 midnight) on or during any cultural or religious festival for a limited duration not exceeding 15 days in all during a calendar year.
Noise limits for vehicles at manufacturing stage were to be effective from January 1, 2003. To make these standards commensurate with the emission standards for vehicles, the notified rules have been revised and are phased out in two stages. In the first phase, two wheelers, three wheelers, and passenger cars were to comply with the notified norms from January 1, 2003.
A relaxation of 3dB (A) has been given to passenger and commercial vehicles of various categories and was to become effective from July 1, 2003. In the second phase, noise limits for vehicles at manufacturing stage would be applicable on and from April 1, 2005 which would be at par with EC norms and based on engine power for various categories of vehicles.
The Supreme Court, in September 2001, passed an interim order to comply with the notification of the ministry issued in October 1999 to control noise from the bursting of fire crackers, which shall not exceed 125 dB (AI) and 145 dB (C) peaks. The manufacture, sale and use of fire crackers should be restricted accordingly.
While communicating this order to all State Governments and Union Territories, they have been requested to conduct the surveys to assess the noise pollution before and on Deepawali day. Some of the surveys have been conducted during the years of 2001 and 2002. The findings of the surveys indicate a decreasing trend of noise during the festive season.
According to the Eleventh Plan, an experts’ committee on Noise Pollution Control will formulate suitable legislations on aircraft/airport noise. As a first step, a ‘Draft Procedure for Monitoring Ambient Noise Level Due to Aircrafts’ has been prepared considering prevalent noise monitoring procedure practiced internationally and also based on the results of the detailed noise monitoring conducted in and around IGI International Airport. The main objective of this document is to specify suitable requirements and procedures for airport authorities to monitor ambient noise level due to aircrafts around airports.
The Ministry had also issued a draft notification inviting suggestions for amending the notification on “Noise Limit for Generator Sets Run with Diesel” under Environment (Protection) Rules, 1986. The noise limits for diesel generator sets up to 1000 KVA were notified in 2002 (not to exceed 75 dB (A) at a distance of one metre from the enclosure surface) and are under implementation since 2005. The amendment will make the definition of ‘manufacture’ broad based by including assembles of diesel generators and to facilitate transportation of the sets above 250 KVA capacities without comprising emission and noise norms.
DISPOSAL OF BIO MEDICAL WASTE
Hospital waste is generated during the diagnosis, treatment, or immunization of human beings or animals or in research activities in these fields or in the production or testing of biological. It may include wastes like sharps, soiled waste, disposables, anatomical waste, cultures, discarded medicines, chemical wastes, etc. These are in the form of disposable syringes, swabs, bandages, body fluids, human excreta, etc.
This waste is highly infectious and can be a serious threat to human health if not managed in a scientific and discriminate manner. It has been roughly estimated that of the 4 kg of waste generated in a hospital at least 1 kg would be infected.
These wastes are categorized into 10 different categories as:
1. Human anatomical waste (tissues, organs, body parts etc.)
2. Animal waste
4. Waste sharps such as, hypodermic needles, syringes, scalpels, broken glass etc
5. Discarded medicines and cyto-toxic drugs
6. Soiled waste, such as dressings, bandages, plaster casts, material contaminated with blood etc
7. Solid waste (disposal items like tubes, catheters etc., excluding sharps)
8. Liquid waste generated from any of the infected areas
9. Incineration ash
10. Chemical waste
Surveys carried out by various agencies show that the health care establishments in India are not giving due attention to their waste management. After the notification of the Bio-medical Waste (Handling and Management) Rules, 1998, these establishments are slowly streamlining the process of waste segregation, collection, treatment, and disposal. Many of the larger hospitals have either installed the treatment facilities or are in the process of doing so.
Treatment and Disposal:
1. Bio-medical waste shall be treated and disposed of in accordance with Schedule I, and in compliance with the standards prescribed in Schedule V.
2. Every occupier, where required, shall set up in accordance with the time-schedule in Schedule VI, requisite bio-medical waste treatment facilities like incinerator, autoclave, microwave system for the treatment of waste, or, ensure requisite treatment of waste at a common waste treatment facility or any other waste treatment facility.
Segregation, Packaging, Transportation and Storage:
1. Bio-medical waste shall not be mixed with other wastes.
2. Bio-medical waste shall be segregated into containers/bags at the point of generation in accordance with Schedule II prior to its storage, transportation, treatment and disposal. The containers shall be labeled according to Schedule III.
3. If a container is transported from the premises where bio-medical waste is generated to any waste treatment facility outside the premises, the container shall, apart from the label prescribed in Schedule III, also carry information prescribed in Schedule IV.
4. Notwithstanding anything contained in the Motor Vehicles Act, 1988, or rules there under, untreated biomedical waste shall be transported only in such vehicle as may be authorised for the purpose by the competent authority as specified by the government.
5. No untreated bio-medical waste shall be kept stored beyond a period of 48 hours
Provided that if for any reason it becomes necessary to store the waste beyond such period, the authorised person must take permission of the prescribed authority and take measures to ensure that the waste does not adversely affect human health and the environment.
THE CLOSURE OF BRICK KILNS IN AGRICULTURAL AREAS
Central Pollution Control Board (CPCB) has recognised the brick production industry as a highly resource and energy intensive and polluting industry owing to prevalence of obsolete production technologies. While, the clusters are the source of local air pollution affecting local population, agriculture and vegetation; at a global scale they also contribute to climate change.
The brick industry competes for resources with other sectors, which poses a significant challenge to the sector. Coal is one such resource that is required for the power, steel and other crucial sectors. Also, top soil or land which could be used for agriculture. The traditional kiln unit itself occupies considerable land area and is subjected to high temperature making it unfit for agricultural activities (after the site is abandoned). The fast depletion of arable land thus caused due to brick making is a matter of concern to India regarding food security.
With an average consumption of 18 tonnes of coal per 100,000 bricks, the brick sector consumes about 24 million tonnes of coal per year which is about 8 % of the total coal consumption of the country (third largest consumer after power and steel sector). In addition, it also consumes several million tonnes of biomass fuels. The share of energy in total cost of brick production is 35-50 %.
The large coal consumption of the brick industry is the cause of significant air pollution in terms of carbon dioxide (CO2), carbon monoxide (CO), sulphur dioxide (SO2), nitrogen oxides (NOx) and suspended particulate matter (SPM). The large amounts of coal used for brick firing also leave behind bottom ash as residue. The air pollution and bottom ash generated cause considerable health problems, especially related to respiratory health, while also causing damage to property and crops.
The Supreme Court of India issued a directive for discontinuing the movable chimney kilns and for all brick kilns to conform to new environmental norms. While this signaled a move in the right direction, due to lax monitoring mechanisms such kilns continue to function and flout environmental regulations. Additionally, while kilns with higher production levels and capital have the option to changeover to fixed chimney type BTKs, the small and medium scale brick entrepreneurs are confronted with environmental regulation without having financially viable options to switch and thus continue to run polluting kilns.
Associated Socio-Economic Issues
The workers in the brick industry are subjected to extreme working conditions and poor remuneration. Currently in India, brick manufacturing is a labour-intensive sector, with crude techniques causing considerable worker drudgery. They are also exposed to high concentrations of Respirable Suspended Particulate Matter (RSPM), during monitoring and regulating the fire, as the furnace chamber is covered with ash (ash acts as insulator). As well as during the manual mixing of fly ash and clay and due to the open dumping and storage of fly ash. Transportation of green and red bricks is done by a head load of 9 to 12 kgs causing health problems, especially in women. Even though the brick workers are exposed to these occupational hazards, coverage under any sort of insurance or medical facilities is virtually unheard of.
In the brick sector, labour is brought in through a contractor (from distant places). Since they are not on the payrolls of the kiln owner, they are not covered under the current labour laws, e.g. Minimum Wages Act. The work force is paid on basis of quantum of work and against completion of certain tasks such as moulding of 1000 bricks, transportation of 1000 green bricks etc. The seasonal nature of brick production generates employment for a limited period of six – seven months in a year. Majority of the workforce has no option, but to engage as labourers (generally as agricultural labourers) for the rest of the year.
The nature of the work requires skilled labour especially for moulding and firing. There is large scale migration towards the major brick production clusters every season due to this. These tasks are traditionally handed down from father to son in the communities. The last few years have seen a labour shortage as the newer generation does not want to be associated with the brick sector any longer. A phenomenon observed in certain clusters due to this shortage is the hoodwinking of entrepreneurs by labour by promising their services to multiple owners, taking advances and not turning up. Labour rates have also gone up driving down margins for kiln owners.
Even as brick kilns on the outskirts of town and elsewhere in several district are flouting environmental norms, Government agencies have closed their eyes to the menace.
These kilns which are set up on cropland have been affecting the agricultural production. Toxic gas emitted from the kilns has a bearing on rice and pisciculture farms which are located around these units.
According to official reports, some of the set up have permission to operate. Though they are permitted to produce 20 lakhs bricks in a year, the figure crosses 80 lakhs. But no action is taken against the illegal kilns for the reason best known to the officials concerned.
A farmer Krupasindhu Jena of Naharpatna area here said the farmland which was producing paddy of over 35 quintal per hectare is now yielding less than 30 quintal after a number of brick kilns came up near it.
Sources at the regional office of the Pollution Control Board (PCB) said many brick kilns, which were set up by flouting the guidelines mentioned in the Air (Pollution Control and Prevention) Act, 1981, have been served closure notice. But it is alleged that the district administration has not taken any step to close them down. Locals claimed that no action is being taken on the kiln owners in Naharpatana and Fuladi who have been flouting the environmental norms for several years. Most of the kilns operating in a short distance of one another.“An alarming situation has cropped up as the Budhabalanga has started changing its course due to excess extraction of soil from the land close to it. During flood, the entire area along with the kilns remains submerged for days together. People alleged that a section of officials of the district administration who are hands in gloves were allowing illegal brick kilns to operate.
Though agriculture officials admitted to the fact that several brick kilns had been running on cropland illegally, hampering the agricultural production, they have not initiated any step to close them down.
Helping Human Rights Foundation also looks after to protect the rights of the prisoners in India as death in judicial custody; premature release of the prisoners on the basis of their character rerecords in the Jail. The word prisoner means any person who is kept under custody in jail or prison because he/she committed an act prohibited by law of the land. A prisoner also known as an inmate is anyone who against their will is deprived of liberty. This liberty can be deprived by forceful restrain or confinement. Prisoner’s rights deal with the rights of the inmates while behind bars. Prisoners have basic legal rights that can’t be taken away from them. The basic rights include right to food and water, right to have an attorney to defend himself, protection from torture, violence and racial harassment. Section 1 of the Prison Security Act1992, defines the term prisoner. The word prisoner means any person for the time being in a prison as a result of any requirement imposed by a court or otherwise that he be detained in legal custody. This paper presents the rights of the prisoners in detail with related case laws.
Various fundamental rights under Article, 14, 19, 20, 21 and 22 of the Constitution of India impliedly deal with the rights of prisoners. Article 14 deals with right to equality which provides equality before law and equal protection of law to all persons. Article 21 deals with right to life and personal liberty. Article 20 deals, inter alia, with two things, firstly it prohibits double jeopardy, that is, no person should be convicted for same offence twice. Secondly, it prohibits self-incrimination, that is, no one can be compelled to be witness against himself. Article 22 provides that a person must be produced before magistrate within 24 hours of his arrest and must be provided with a counsel of this own choice. Famous constitutional writer Upendar Baxi has opined that scope of Article 21 is so vast that we do not need any other rights in our Constitution, and in the light of the Supreme Court’s ‘construction’ of the meaning of ‘life’ under Article 21, whereby all the rights such as right to health, right to food, right to shelter, right to bail, right to speedy trial, right to free legal aid, right against custodial violence and death in police lock-ups or encounters, Right to meet friends and family members, Right to reasonable wage in prison, right against cruel and unusual punishment etc., have been included under it.
International human rights laws protect people from racial discrimination, from torture and from enforced disappearances. They also recognize the rights of specific groups of people, including women, children, and people with disability, indigenous peoples and migrant workers. Some of these treaties are complemented by optional protocols that deal with specific issues or allow people to make complaints.
The Prisons Act, 1894:
This act is the first legislation regarding prison regulation in India. The following are some of the important provisions regarding prisoners’ rights:
#Accommodation and sanitary conditions for prisoners.
#Provisions relating to mental and physical state of prisoners.
#Examination of prisoners by qualified medical officer.
#Separation of prisoners for male, female, criminal, civil, convicted and under trial prisoners.
#Provisions for treatment of under trials, civil prisoners, parole and temporary release of prisoners.
It is the duty of the government for the removal of any prisoner detained under any order or sentence of any court, which is of unsound mind to a lunatic asylum and other place where he will be given proper treatment.
#Any court which is a high court may in case in which it has recommended to government the granting of a free pardon to any prisoner, permit him to be at liberty on his own cognizance.
The Supreme Court in US in Manna v. people of Illinois said that life is not merely animal existence. The souls behind the bar can’t be denied the same. The rights guaranteed by Art.21 are for every person and not even the state could deny it. Prisoners also have all the rights which a free man has under some restrictions. Just being in prison does not deprive them from their fundamental rights.
The rights of older persons are the entitlements and independence claimed for senior citizens (i.e. above 60 years of age). Elderly rights are one of the fundamental rights of India. The International Day of older persons is celebrated annually on October 1.
The 2001 census of India demonstrated that aged people in India have crossed over 100 million. Many older people in India are not alert about the human rights of older persons, due to high occurrence of illiteracy and lack of alertness. Elder illiteracy directly contributes to a lack of knowledge regarding the human rights for older people in India, and contributes to the infringement of those rights.
THE ISSUES OF CONCERN IN THIS AREA ARE:
- Live with dignity.
- Personal maintenance & care.
- Right to get maintenance assistance.
LIVE WITH DIGNITY
To maintain the livelihood with due dignity & care government of INDIA enacted a law:
Maintenance and Welfare of Parents and Senior Citizens Act, 2007 is a legislation enacted in 2007, initiated by Ministry of Social Justice and Empowerment, Government of India., to provide more effective provision for maintenance and welfare of parents and senior citizens. This Act makes it a legal obligation for children and heirs to provide maintenance to senior citizens and parents, by monthly allowance. This Act also provides simple, speedy and inexpensive mechanism for the protection of life and property of the older persons. Indian society laid high importance on providing care and protection for parents and elderly. Withering of joint family system has contributed to the challenges faced by elderly. Nowadays they are forced to live alone and are exposed to various kinds of problems such as lack of physical, social, emotional and financial support.
The first case under the act was filed in November 2011 by Siluvai (age 84) and his wife Arulammal (age 80) of Tuticorin against their son and daughter-in-law for neglect, besides taking away their two homes and gold jewelry.
PERSONAL MAINTENANCE & CARE
In today’s state of urbanization in which women are increasingly joining the workforce, the roots of joint family systems are eroding. Higher numbers of older people who have spent most of their life with their joint/extended families may face loneliness and marginalization in their old age. In rural areas the older members of families, (i.e.: people who are above 60 years of age), are respected more and are considered a strong part of the family as the joint family system remains part of their roots. In villages 46.91% of the older men and 50.1% of older women are from joint families. In rural areas 13,560 out of 29,000 rural elderly have joint families.
Difficulties faced by older persons
Health and care
Physical and mental health care availability and community and social care aspects of life for the elderly are key concern Nutritional problems are also a concern.
Income and housing
Access to employment opportunities, transportation, housing and income are key concerns. Inhumane living conditions are also a concern.
Social networks and customs
Poor social interaction with family and friends, poor social networks, and those without families are some difficulties faced by some senior citizens. Social customs based upon elder neglect, which the elderly may internalize as beliefs are topics of concern. Losing the will to live from a lack of social support is another issue.
Educational access and opportunities, the potential for leisure pursuits, consumer protections and having access to information are also key concerns.
A senior citizen including parent who is unable able to maintain himself from his own earning or out of the property owned by him, is entitled to get relief under this Act. Children/grand children are under obligation to maintain his or her parent father, mother or both. Likewise, relative of a senior citizen is also bound to look after the senior citizen. If such children or relative is not maintaining his parents or senior citizen respectively, then the parents/senior citizen can seek the assistance of Tribunal constituted under this Act, to enforce the remedy of maintenance. Such parents/ senior citizen can file an application before the Tribunal, claiming maintenance and other reliefs from their children/relatives as the case may be.
Such application for maintenance can be filed by the senior citizen or a parent himself, or if such person is incapable, then by any other person or any registered organization authorized by him. The Tribunal can also suo motu take cognizance of the case. After receiving the application the Tribunal may issue notice to the respondent-children/relative and provide them time to furnish their reply. Such application for maintenance should be disposed of within 90 days from the date of service of notice of application to the respondent. However, the Tribunal can extend time for a maximum period of 30 days in exceptional circumstances after recording reason. The Tribunal is having power to allow interim maintenance pending disposal of the case. Even though the application can be filed against any of children/relative as the case may be, such respondent-children/relative can implead other people who are liable to pay maintenance.
If such children/relative who is directed to pay maintenance fails to comply with the order of tribunal without sufficient cause, the Tribunal may issue warrant for levying the due amount from them in the manner levying fines and can also sentence the erring respondent to imprisonment that may extend to one month or until payment made whichever is earlier. The Tribunal will not issue Warrant to execute the order of maintenance, if such petition for execution is filed after a period of 3 months from the date on which the maintenance is due. The application under this Act can be filed before the Tribunal in any district, where the applicant resides or last resided or where children or relative resides. The evidence of proceedings shall be taken in the presence of children/relative against whom relief is sought and if such respondent is willfully avoiding service of summons or neglecting to attend the Tribunal, the Tribunal may proceed and determine the case ex parte. If the Tribunal is satisfied that such children/relative against whom such application for maintenance is pending, neglect or refuses to maintain the parents/senior citizens as the case may be, may order such children/relative to pay monthly allowance to such applicant. The maximum amount of maintenance that can be allowed by the Tribunal is Rs. Ten Thousand per month. The tribunal has power to alter, modify or cancel the order in appropriate circumstances. The Tribunal has also power to levy interest on the maintenance amount, which shall be not less than 5% and greater than 18%. Aggrieved by the order of Tribunal, senior citizen/parent can file appeal before Appellate tribunal within a period of 60 days and if the Appellate tribunal is satisfied that there occurred some delay in filing appeal due to sufficient cause, the appeal can be entertained.
Protection of life and property of Senior citizen
If a senior citizen after the commencement of this Act, has transferred his property either moveable or immovable, by way of gift or otherwise, subject to the condition that the transferee shall provide him basic amenities and physical needs and thereafter such transferee reuses or fails to provide such promise, such transfer of property shall be deemed to have been made by fraud, coercion or undue influence and the Tribunal can declare such transfer as void. Before the enactment of this law, a senior citizen’s only remedy in such a case was to approach the court for maintenance from the children to whom he had given the property by way of gift or otherwise and such property would be the exclusive property of the transferee and the senior citizen had no right in such property. But after the enactment of this Act, a senior citizen can reclaim his property from the transferee. The concerned police personnel will also ensure priority in dealing with these types of cases. Representation by lawyers are prohibited under section 17 of this Act. However the Hon’ble Kerala High Court held that legal practitioners also could represent cases under this Act.
Abandoning a senior citizen in any place by a person who is having the care or protection of such senior citizen is a criminal offence and such person shall be punishable with imprisonment for a term which may extend to three months or fine which may extend to five thousand rupees or both.
This Act also provides that state governments may establish old age homes at least one in one district to accommodate indigent senior citizens. State governments may also ensure proper medical care for senior citizens
RIGHT TO GET MAINTENANCE ASSISTANCE
Ageing is a natural process, which inevitably occurs in human life cycle. It brings with a host of challenges in the life of the elderly, which are mostly engineered by the changes in their body, mind, thought process and the living patterns. Ageing refers to a decline n the functional capacity of the organs of the human body, which occurs mostly due to physiological transformation, it never imply that everything has been finished. The senior citizens constitute a precious reservoir of such human resource as is gifted with knowledge of various sorts, varied experiences and deep insights. May be they have formally retired, yet an overwhelming majority of them are physically fit and mentally alert. Hence, given an appropriate opportunity, they are in a position to make significant contribution to the socio-economic development of their nation, The Sections 125 Cr.p.c formulates the Provision for the maintenance for elderly who are dependent, the local District magistrate or any office designated by him are responsible and duty bound to look into the matter.
Problems of the Aged:
Problems of the aged as follows:
(i) Economic problems include such problems as loss of employment, income deficiency and economic insecurity.
(ii) Physical and physiological problems include health and medical problems, nutritional deficiency, and the problem of adequate housing etc.
(iii) Psycho-social problem which cover problems related with their psychological and social maladjustment as well as the problem of elder abuse etc.
The question of ageing was first debated at the United Nations in 1948 at the initiative of Argentina. The issue was again raised by Malta in 1969. In 1971 the General Assembly asked the Secretary-General to prepare a comprehensive report on the elderly and to suggest guideline for the national and international action. In 1978, Assembly decided to hold a World Conference on the Ageing. Accordingly, the World Assembly on Ageing was held in Vienna from July 26 to August 6, 1982 wherein an International Plan of Action on Ageing was adopted. The overall goal of the Plan was to strengthen the ability of individual countries to deal effectively with the ageing in their population, keeping in mind the special concerns and needs of the elderly. The Plan attempted to promote understanding of the social, economic and cultural implications of ageing and of related humanitarian and developed issues.
(i) In 1992, the U.N. General Assembly adopted the proclamation to observe the year 1999 as he International Year of the Older Persons.
(ii) The U.N. General Assembly has declared “Its October” as the International Day for the Elderly, later rechristened as the International Day of the Older Persons.
(iii) The U.N. General Assembly on December 16, 1991 adopted 18 principles which are organized into 5 clusters, namely-independence, participation, care, self-fulfillment, and dignity of the older persons.
(I) Constitutional Protection:
Art. 41: Right to work, to education and to public assistance in certain cases: The State shall, within the limits of economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want.
Art. 46: Promotion of educational and economic interests of scheduled castes, Scheduled Tribes and other weaker sections: The State shall promote with special care the educational and economic interests of the weaker sections of the people , and, in particular, of the Scheduled Castes and the Schedules Tribes, and shall protect them from social injustice and all forms of exploitation.
However, these provision are included in the Chapter IV i.e., Directive Principles of the Indian Constitution. The Directive Principles, as stated in Article 37, are not enforceable by any court of law. But Directive Principles impose positive obligations on the state, i.e., what it should do. The Directive Principles have been declared to be fundamental in the governance of the country and the state has been placed under an obligation to apply them in making laws. The courts however cannot enforce a Directive Principle as it does not create any justiciable right in favor of any individual. It is most unfortunate that state has not made even a single Act which is directly related to the elderly persons.
(II) Legal Protections:
Under Personal Laws:
The moral duty to maintain parents is recognized by all people. However, so far as law is concerned, the position and extent of such liability varies from community to community.
(I) Hindus Laws:
Amongst the Hindus, the obligation of sons to maintain their aged parents, who were not able to maintain themselves out of their own earning and property, was recognized even in early texts. And this obligation was not dependent upon, or in any way qualified, by a reference to the possession of family property. It was a personal legal obligation enforceable by the sovereign or the state. The statutory provision for maintenance of parents under Hindu personal law is contained in Sec 20 of the Hindu Adoption and Maintenance Act, 1956. This Act is the first personal law statute in India, which imposes an obligation on the children to maintain their parents. As is evident from the wording of the section, the obligation to maintain parents is not confined to sons only, and daughters also have an equal duty towards parents. It is important to note that only those parents who are financially unable to maintain themselves from any source, are entitled to seek maintenance under this Act.
(II) Muslim Law:
Children have a duty to maintain their aged parents even under the Muslim law. According to Mulla :
(a) Children in easy circumstances are bound to maintain their poor parents, although the latter may be able to earn something for themselves.
(b) A son though in strained circumstances is bound to maintain his mother, if the mother is poor, though she may not be infirm.
(c) A son, who though poor, is earning something, is bound to support his father who earns nothing.
According to Tyabji, parents and grandparents in indigent circumstances are entitled, under Hanafi law, to maintenance from their children and grandchildren who have the means, even if they are able to earn their livelihood. Both sons and daughters have a duty to maintain their parents under the Muslim law. The obligation, however, is dependent on their having the means to do so.
(III) Christian And Parsi Law:
The Christians and Parsis have no personal laws providing for maintenance for the parents. Parents who wish to seek maintenance have to apply under provisions of the Criminal Procedure Code.
(IV) Under the Code of Criminal Procedure:
Prior to 1973, there was no provision for maintenance of parents under the code. The Law Commission, however, was not in favor of making such provision. According to its report:
The Cr.P.C is not the proper place for such a provision. There will be considerably difficulty in the amount of maintenance awarded to parents apportioning amongst the children in a summary proceeding of this type. It is desirable to leave this matter for adjudication by civil courts.
The provision, however, was introduced for the first time in Sec. 125 of the Code of Criminal Procedure in 1973. It is also essential that the parent establishes that the other party has sufficient means and has neglected or refused to maintain his, i.e., the parent, who is unable to maintain himself. It is important to note that Cr.P.C 1973, is a secular law and governs persons belonging to all religions and communities. Daughters, including married daughters, also have a duty to maintain their parents.
There is great need to work for
the farmers in India the regular suicidal attempt and death taken place accords
the cpiuntry makes us determined to work for the roghts of farmers in India. India is among the first countries in the
world to have passed legislation granting Farmers’ Rights in the form of the
Protection of Plant Varieties and Farmers’ Rights Act, 2001. India’s experience
is important due to its international contribution to negotiations on Farmers’
Rights, its position as a centre of biodiversity, and the complexities of
agriculture in India within which the country is attempting to implement these
rights. India’s law is unique not only because of its far-reaching rights for farmers,
but also in that it simultaneously aims to protect both breeders and farmers.
This attempt to evolve a multiple rights system could, however, pose several
obstacles to the utilization and exchange of plant genetic resources among
farmers. India has framed a unique legislation, but still faces the task of
implementation. This should serve as a signal internationally that establishing
legislation is insufficient to effectively promote Farmers’ Rights. Failing to
implement Farmers’ Rights in India would be a heavy loss for all the farmers
who need Farmers’ Rights to protect their livelihoods, secure their access to
resources, protect their rights to seeds, and, above all, lift them out of
Nine rights are given to farmers
under the PPVFR Act:
- Right to seed: PPVFR Act aims to give
farmers the right to save, use, exchange or sell seed. But, farmer cannot
sell the seeds in a packed form labeled with registered name.
- Right to index own varieties: Just
like commercial breeders even the farmer can get Intellectual property
right over their own varieties. This right is unique to Indian PPVFR 2001
- Right to reward and recognition: The Act
provides for establishment of National Gene Fund through which the work of
farmers is recognized and rewarded.
- Right to benefit sharing: National Gene
Fund authority also facilitates benefit sharing. The Authority is required
to publish the registered varieties and invite claims for benefit sharing.
The rewards from the gene fund can only be given to a farmer/community who
can prove that they have contributed to the selection and preservation of
materials used in the registered variety.
- Right to information and compensation for crop
failure: The breeder must give information about expected
performance of the registered variety. If the material flops to perform,
the farmers may claim for compensation under the Act.
- Right to compensation for private use of
traditional varieties: Sometimes the breeder may not wish to
disclose the use of traditional variety. If the breeder has not disclosed
the source of traditional varieties, even then compensation can be granted
through the Gene Fund.
- Right to sufficient accessibility of registered
varieties: The breeder is required to provide sufficient supply
of seeds to the public at a reasonable price. If after three years of
registration, the breeder could not provide sufficient supply of seeds to
the public at a reasonable price, any other person can apply for license.
- Right to service free of charge: The
PPVFR 2001 Act excludes farmers from paying any service charges. In other
words, the services like registration of varieties, conducting tests on
the registered varieties, renewal of registration are done free of charge.
Moreover, there is no fee for legal proceedings under this Act.
- Protection from legal encroachment in case of lack
of awareness: Considering low literacy levels in the country,
PPVFR 2001 Act provides and safeguards against innocent encroachment by
farmers. Farmers who unintentionally violate the rights of a breeder shall
not be penalized if he/she can show that they did not know about the
existence of breeder’s rights.
‘Farmers Rights’ should be dealt
as intellectual property rights rather than reward mechanism because the
working of the reward mechanism may be ad hoc and may not be transparent. Many
farmers in India feel that they must have some kind of ownership over their
varieties because companies take the original material from farmers and sell
them at a higher rate.
Sometimes even the middlemen
raise the price of fruits/vegetables and sell it at higher prices to consumers,
whereas farmers receive only a meager amount of that price. Farmers should have
ownership rights but it is not easy to produce new varieties. And if money and
opportunity are provided, farmers can also invent and innovate.
The Indian law on Farmers’ Rights
is considered successful at least partially by many stakeholders. Probably, it
is for the first time when the rights of farmers received such wide attention
and debate both within and outside Parliament. Even more government was forced
to initiate as it could not manage to pass the legislation without these
demands being met.
We help consumer to exercise their rights in the light of the law and redressal forums available in their country by raising their voices collectively.
Consumer rights are generally a reference to a body of law that pertains to things the producers of goods must do to protect customers from harm. These laws have come into existence through a series of legal disputes, and have been shaped by the results of those cases. In a few instances, some states have actually codified regulations that they refer to as “consumer rights” laws, but this is not yet the majority practice, and even these codifications may not cover all of the principles that are generally considered “consumer rights”. Discussed below are the fundamental consumer rights.
1. The right to be heard.
Every consumer has the right to be heard after being exploited. An upset consumer should be aware that he/she possesses the right to take the matter to the authorities if the company does not hear them out. The right to be heard is a powerful right at the disposal of the consumer.
2. The right to seek redressal.
Every consumer has the right to seek out for justice. Upset consumers who have been a victim of corporate exploitations can take the matter to the redressal agencies in district, State and National level to file a suit against the insensitive company. This right is often put to ill use by many consumers and is hence a very delicate right.
3. The right to information.
Every consumer has the right to information. Consumers should be amidst truthful and genuine information. Information should not have an ill purpose and should not be incorrect. In other words, consumers have the right to truthful information.
4. The right to protection.
Every consumer has the right to protection. Central Consumer Protection Council, State Consumer Protection Council, District Forum and Consumer Protection Redressal Agencies are at the disposal of the consumers. These institutions aim at protecting Indian consumers from exploitative companies.
5. The right to assurance.
Every consumer has the right to assurance. Assurance of qualitative goods and qualitative services. They also have the right to the assurance of the variety of commodities and services at their disposal.
6. The right to consumer education.
Every consumer also has the right to receive consumer education. This education is often a part of every consumer protection act and amendment. The government should make immense effort to share and spread the consumer rights to every remote area of India. Consumers should also receive the right to get the education on the consumer do’s and consumer don’ts. This is a very informative and knowledgeable right at the disposal of the consumers.
We can conclude that the consumers should be educated and made aware of the rights and responsibilities that are available to them. Various efforts like campaigns, advertisements should be initiated by the government so that more and more consumers are made aware of their rights and responsibilities.
In the Constitution of India from 1950, articles 14-16, 19(1)(c), 23-24, 38, and 41-43A directly concern labour rights. Article 14 states everyone should be equal before the law, article 15 specifically says the state should not discriminate against citizens, and article 16 extends a right of “equality of opportunity” for employment or appointment under the state. Article 19(1)(c) gives everyone a specific right “to form associations or unions”. Article 23 prohibits all trafficking and forced labour, while article 24 prohibits child labourunder 14 years old in a factory, mine or “any other hazardous employment”.
Articles 38-39, and 41-43A, however, like all rights listed in Part IV of the Constitution are not enforceable by courts, rather than creating an aspirational “duty of the State to apply these principles in making laws”. The original justification for leaving such principles unenforceable by the courts was that democratically accountable institutions ought to be left with discretion, given the demands they could create on the state for funding from general taxation, although such views have since become controversial. Article 38(1) says that in general the state should “strive to promote the welfare of the people” with a “social order in which justice, social, economic and political, shall inform all the institutions of national life. In article 38(2) it goes on to say the state should “minimise the inequalities in income” and based on all other statuses. Article 41 creates a “right to work”, which the National Rural Employment Guarantee Act 2005 attempts to put into practice. Article 42 requires the state to “make provision for securing just and human conditions of work and for maternity relief”. Article 43 says workers should have the right to a living wage and “conditions of work ensuring a decent standard of life”. Article 43A, inserted by the Forty-second Amendment of the Constitution of India in 1976, creates a constitutional right to codetermination by requiring the state to legislate to “secure the participation of workers in the management of undertakings”.
Labour law cover three aspects.
• Industrial Relations
• Workplace Health and safety
• Employment standards
Minimum Wages Act, 1948
The objective of this Act is to provide minimum wages to the workers employed in the employments mentioned in the Schedule I of the Act such as employment in any rice mill, flour mill or dal mill or employment in any tobacco manufactory, etc. The appropriate government is empowered under the Act to fix minimum wages and revise them regularly. It also lays down provision for overtime wages. There are penalties under this Act too for non-compliance of the provisions by the employer.
Employees’ State Insurance Act, 1948
The Act lays down provisions for benefits to employees such as sickness benefit, maternity benefit, disablement benefit, medical benefit and funeral benefit. Out of these, medical benefit is extended to the family members of the employee too and the funeral benefit is paid to the eldest surviving member of the family or in his absence, to the person who actually incurs the expenditure on the funeral. It is to be noted that all the benefits under this Act are paid in cash. The Act also provides for the establishment of Corporation, Committee, and Council etc. to implement the provisions of the Act effectively.
Employees’ Provident Funds and Miscellaneous Provisions Act, 1952, Labour Welfare Fund Act (of respective States), Payment of Gratuity Act, 1972 are some other laws which fall under this category.
IT & Event Cell
IT AND EVENT CELL
Helping Human Rights Foundation is very active across the social media and regular events makes awareness in the mass and helps to create a wider group to be more active in social work for the rights related issues. The events also helps to boost the enthusiasm in the volunteers and time to time they are honored for their good works in the society.
These events also help to create some funds if some wants to donate voluntarily.
Helping Human Rights Foundation looks sharply the environmental rights available in the country for the protection of lives in India, whoever the right to life is denied if right to environment is not a constitutional rights and hence we regularly urge to the government to bring it in concrete list. The need for protection and conservation of environment and sustainable use of natural resources is reflected in the constitutional framework of India and also in the international commitments of India. The Constitution under Part IVA (Art 51A-Fundamental Duties) casts a duty on every citizen of India to protect and improve the natural environment including forests, lakes, rivers and wildlife, and to have compassion for living creatures. Further, the Constitution of India under Part IV (Art 48A-Directive Principles of State Policies)
Some of the important legislations for environment protection are as follows:
• The National Green Tribunal Act, 2010
• The Air (Prevention and Control of Pollution) Act, 1981
• The Water (Prevention and Control of Pollution) Act, 1974
• The Environment Protection Act, 1986
• The Hazardous Waste Management Regulations, etc.
The National Green Tribunal Act, 2010 (No. 19 of 2010) (NGT Act) has been enacted with the objectives to provide for establishment of a National Green Tribunal (NGT) for the effective and expeditious disposal of cases relating to environment protection and conservation of forests and other natural resources including enforcement of any legal right relating to environment and giving relief and compensation for damages to persons and property and for matters connected therewith or incidental thereto.
Human Trafficking is a crime and a human rights violation. For a situation to be one of trafficking three distinct elements (act, means, purpose) must be fulfilled:
• The ACT of recruitment, transportation, transfer, harbouring or receipt of persons must be done by
• A MEANS such as the threat or use of force or other forms of coercion, abduction, fraud, deception, abuse of power or of a position of vulnerability or the giving or receiving of payments and it must be for the purpose of
• EXPLOITATION i.e. sexual exploitation, labour exploitation or organ removal.
A child cannot consent to being trafficked.
There is no requirement that a person must have crossed a border for trafficking to have taken place – it can and does take place within national borders.
Where does it happen?
Trafficking is happening worldwide and it exists in Ireland also. People can be trafficked into different types of work including
- Restaurant and hotel work
- Domestic work
- Other forms of commercial sexual exploitation.
Why does it happen?
Trafficking in human beings is a high profit–low risk crime based upon the principles of supply and demand. Criminal networks or individuals take advantage of a series of what are known as ‘Push and Pull’ factors, which explain why vulnerable individuals who lack opportunities and seek better living conditions in their own or a foreign country, end up being part of a human trafficking chain. This, in combination with the demand for cheap labour and sexual services, fuels human trafficking.
Lack of opportunities or alternatives such as little or no education, unemployment or low wage
Gender based discrimination including domestic violence
All forms of discrimination and marginalization
Life with dysfunctional families
Economic imbalance between impoverished and wealthy countries/areas
Impact of political instability and corruption, conflict or transition of countries, especially war.
Expectation of employment and (higher) financial reward
Improved social position and treatment
Access to material benefits associated with “the West”
Demand for cheap labour, provision of sexual services, organs and tissues.
Is people smuggling the same as human trafficking?
No. While people smuggling and human trafficking are linked there are fundamental differences between the two.
• People smuggling involves migrants being facilitated with entry into a State through illegal means whereas trafficking must have the threat of or use of force, coercion or deception against a victim.
• People smuggling facilitates an individual’s illegal entry into the State whereas victims of trafficking can enter into the State both legally and illegally.
• People smuggling must take place across international borders but there is no requirement that a person must have crossed a border for trafficking to take place – it can and does take place within national borders.
• People smuggling, while often undertaken in dangerous or degrading conditions, involves migrants who have consented to the smuggling. Trafficking victims, have either never consented or, if they initially consented, that consent has been rendered meaningless by the coercive, deceptive or abusive actions of the traffickers.
• People smuggling ends with the arrival of the migrants at their destination; unlike trafficking it does not involve the ongoing exploitation of victims.
• People smuggling can lead to trafficking if, for example, the circumstances of the smuggled persons change during the journey or on arrival in the State leading to them becoming victims of violence and exploitation.