Sunday, 16 November 2014

059. WHO IMF IBRD And ADB Money To India Health Finances Human Rights Violations And Corruption

WHO IMF IBRD And ADB Money To India Health Finances Human Rights Violations And Corruption

P.S.Remesh Chandran
Kerala Health Research Online

Editor, Sahyadri Books & Bloom Books Online, 

13th Nov 2014 
Columns & Opinions

(You can read and download this article as Flip Book, E-Book or PDF in Internet Archives, US Library of Congress. It is released into Public Domain by the author)  Link: 

Child birth scenes captured through mobile phones reaching internet for public to enjoy is one of the major crimes in medical field. People are always anxious about government storing their clinical medical data. The Indian Medical Association justified three Kerala doctors arrested for capturing and circulating delivery scenes in Whats App and is now accessory to crime. This story has serious implications world over. We will follow this story through news reports, comments and documents. 

People who give money have the right to know how it is utilized and if there is transparency and fairness at the receiving end.

Title Of A Coming Book

The news was reported by regional, national and international news media like India Vision Malayalam Channel, Times of India and Wall Street Journal. The comments appended were written and published by P.S.Remesh Chandran in these media, using Face Book Log In. India, especially the State of Kerala, receives billions of dollars as financial assistance, grants and loans for development in the health sector, from such international agencies as the World Health Organization, International Monitory Fund, International Bank for Reconstruction and Development and Asian Development Bank. All this money belongs to the world’s people and when it reaches India, it is squandered 95 percent through corruption, unaccountability and human rights violation. People who give money for good purposes have the right to know how it is utilized and if there is transparency and fairness at the receiving end. Without ensuring these conditions, no one will give money to anyone as assistance, grant or loan. And no one will give money to gross corruptors and human rights violators.

Doctors butcher patients in surgeries, steal uterus, bones and tissues and sell kidneys.

A New Book By P S Remesh Chandran

The WHO, IMF, IBRD and ADB do not care whether countries at the receiving end have transparency, accountability and the integrity to uphold the dignity of human rights. These international financial institutions continue to spend billions of world people’s money each year blindly, for financing and promoting corruption, unaccountability and human rights violations, in countries such as India. It indeed is a grave allegation but the facts and evidence are undeniable and cannot be over-looked. It is time the world’s people, the owners of the money these organizations spend, interfere and stop exporting funds to unaccountable and corrupt countries, India included, especially to the Health Services Department of Kerala which is one of the largest beneficiaries. Unaccountability, corruption, lack of control, indiscipline and non-transparency in this largest department in Kerala which is at the receiving end has gone to such extreme that doctors who stole patents’ delivery scenes from labour rooms and circulated them through Whats App were not only let free by the Director of Health Services, but were justified by the Indian Medical Association also.

Health gets the bulk of world’s assistance and Kerala is the state the highest literate in India.

International Funds Passes Through Incompetence

This article examines how rampant human rights violations are and how darkened transparency is in the organization which is standing at the receiving end of world people’s money through WHO, IMF, IBRD and ADB assistances, grants and loans, gulping down the bulk of this international assistance. The field selected is health sector in India and the organization selected is health services department of Kerala which is for two reasons: Health is the sector which receives the bulk of these assistances and Kerala is the state with the highest literacy in India, for illustration purposes. The article has two parts- the state of human rights violations in the health sector in India and the state of non-transparency in the highest literate state of India. Human rights violations in Kerala Health are traced through a single incident of the gravest act of capturing patents’ delivery scenes from hospital labour rooms in mobile phones and circulating them in Whats App, how ineffective and biased are investigations, and how large and influential organizations are supporting culprit doctors and helping them escape clean without punishment. Incidents of human rights violations in health sector from the states of Tamil Nadu, Rajasthan and Chhattisgarh have also been mentioned, under proper documentation. Non-transparency at the receiving end of world peoples’ money is documented through the single incident of a citizen seeking specific information from the seat of Kerala’s ultimate health control station and how that citizen is not only denied information but shamelessly ridiculed also by the senior-most officials in the Directorate of Health Services and Government. Screen prints of concerned department’s relevant web site pages and scan copies of questions and answers under the Right to Information Act of India are included, and they are self-explanatory. Though distributed throughout the article, the images belong to specific paragraphs in the article and they may please be viewed or waived as such by readers.


$330 For Bearing Surgeon's Knife For 20 Years

News 1: Delivery scenes circulated in Whats App; case against hospital.

India Vision Tele Vision on September 21, 2014 reported that a case was registered against Payyannur Taluk Hospital for capturing delivery scenes in the hospital and posting them in Whats App, following a complaint from a lady alleging that delivery scenes from the hospital were circulating in Whatts App. Kannur DMO asked for report from hospital authorities and said, action would be taken without prejudices. The Cyber Cell was approached by Police for obtaining technical evidence and for ascertaining whether scenes are those of the complainant.

Comment On September 21, 2014

Delivery Scenes Captured And Circulated By Doctors

Child birth scenes captured through computer applications finally reaching internet for public to view as objects to watch and enjoy is one of the major crimes in the medical field, and in this particular case, the sole responsibility rests with the Medical Superintendent of Payyannur Taluk Hospital, the District Medical Officer of Kannur and the Director of Health Services of Kerala. There is no relevance in the DMO who is responsible himself conducting enquiry. Even the Additional Director of Health Services, Vigilance, is not qualified or empowered to conduct such an enquiry. The first thing that has to be enquired by whoever would come to be empowered by statute is, how much this Payyannur Taluk Head Quarters Hospital is connected and linked to the new E-Health Project being implemented by the Kerala Health Services Department with Central Government Assistance, directly or through agencies taking part in this project, for during the same period this agency was in the process of distributing medical data collection apps to doctors. It was only this project which was given authority to collect patient medical data in Apps, with the collaboration of associated, dubious, service providers and agencies. Perhaps, they were just testing the readiness of their new infra structure. Even from the beginning of this E-Health Project, it was predicted by learnèd quarters that things like this would happen in Kerala. If anyone has doubts, read the internet article, Kerala’s E-Health In Dark Shadows, which was published first by Kerala Health Research Online and then by Trivandrum Social Research Institute. E-Health is a digital project, much feared even in advanced countries for its openness for patient data abuse and misuse, trying to be implemented by the incompetent Health Department, through its ignorant staff, aimed at digitally inter-linking all government hospitals in the state, collecting vital medical data through Industrial Apps, and selling them to whoever are interested, including those in the field of insurance and pharmaceuticals. This project was got sanctioned and brought to Kerala at the same time as the Solar Scam which rocked the state and that is why the implementers of Kerala’s E-Health Project fear to disclose the names of people associated with this project and who expressed interest in this 96-crore project, which is more lucrative and comparatively easier to loot than the solar project. Probably the same persons were involved in both. What happened now at Payyannur is collecting patient data digitally through Apps and releasing them illegally, or even selling them, which in plain terms is ‘Medical Data Theft’. Department’s enquiries would only be directed at proving there was no connection between this hospital, these doctors and the e-health project. Privacy of a citizen is of paramount importance. One can ask, if sacrificing personal privacy for the privileges of an advanced medical technology for the benefit of the entire state is not desirable? The answer would always be ‘no’. It is government’s job to ensure that citizen’s right to privacy and his right to advanced medical treatment do not come face to face. As men are not yet gods, implanted, hand-held and mounted medical devices can, not only collect and transmit data from human body but in the hands of wicked persons such as these can reverse engineer them also to sabotage the very same human body.

News Link: പ്രസവചിത്രം വാട്സ്ആപ്പില്: ആശുപത്രിയ്ക്കെതിരെ കേസ്

News 2: Incident of releasing delivery scenes in internet; Special Investigation Team to investigate.

Botched Sterilization Ends In Death, Shock, Trauma

India Vision Tele Vision on September 22, 2014 reported that a Special Investigation Team would be formed and the doctors questioned, and that the investigation by Kannur District Medical Officer had not found doctors guilty.

Comment On September 22, 2014:

A Doctor Stole Kidney And Another Wombs

People have always been anxious about their clinical medical records stored by government. Their concern over the possibility of this data being stolen, traded or misused has led to law courts’ intervening to define which data can be stored and how much of it can be used by government, but demarcations remain still ambiguous, for electronic medical data storage is new to the world. Governments and private medical companies collaborating with government in implementing government’s various e-health governance schemes try their best to establish larger and larger medical data bases, and this collaboration- in some countries shameless fusion and amalgamation- has only increased the intensity and magnitude of people’s fear and their eventual resistance to collection of their data and its storage in electronic networks. (See the book ‘E Health Implications And Medical Data Theft’ soon to be released). Governments’ unlimited access to medical data and the resultant people’s vulnerability to bureaucrats’ and industrialists’ selfish motives in using this data have only emphasized the need for people’s increased and concrete resistance to this unholy connection of governments and private companies collecting and using patients’ electronic medical data. In the beginning of this century, people certainly had their right to control who can access their data, how much, and for what purpose. But the need of rich companies and greedy politicians to amass whatever medical data they can before the whole world becomes alert against medical data theft and abuse, has led to billions of money being transferred to legislators for enacting laws one after the other for forceful collection of people’s medical data and making them available to anyone who has signed a Memorandum of Understanding with government or government’s private partner. As more and more laws came to be passed in more and more countries, this people’s control over their medical data gradually weakened in strength and is only a shadow of its former self now, existing only in law books and law court judgements, which governments do not mind anymore. Chief Ministers, Health Ministers and Health Secretaries in provinces and states are the ones who are expected to tell these things to people but they stand on the other side of the battle field, heavily armed, bribed and corrupted.

News Link: പ്രസവദൃശ്യം പ്രചരിപ്പിച്ച സംഭവം: പ്രത്യേക അന്വേഷണ സംഘം രൂപീകരിക്കും

News 3: Delivery scenes released in Whats App: Indian Medical Association justifies doctors.

A Directorate For Human Rights Violation Services!

India Vision TV on September 25, 2014 reported from Cochin that the Indian Medical Association appeared on the scene and justified the three doctors who were suspended for circulating delivery scenes in Whats App. A committee delegated by IMA claimed that pictures of babies born in an extra ordinary delivery were only captured and no privacy of the lady was violated. The IMA added that generalizing isolated incidents like this, this way, is equal to tarnishing the medical field.

Comment September 25, 2014:

Pay Compensation To Victims At International Rates

The Indian Medical Association is just an association, a registered gathering of doctors, formed to protect the interests of doctors, not of patients or the health field. It is not an authority; Indian Medical Council is the authority. Indian Medical Council’s top-ranking officials were questioned by the Central Bureau of Investigation of India and their offices and homes raided for evidence, in connection with corruption involving crores of rupees. It is not strange that this case related to illegally favouring and helping a Trivandrum Medical College in getting a few Post Graduate medical seats sanctioned by overlooking criteria, was clearly routed through Kerala’s medical associations. Now that even the Medical Council of India has been implicated in corruption and favouritism, who is here remaining in the medical field beyond corruption and favouritism? The IMA Kerala Chapter in its long history has never condemned a single doctor, charge-sheeted or got involved in malpractice, medical crimes, theft of department funds, or willful violation of patients’ rights. In fact, whenever such doctors were booked, they were found to be office-bearers or members of doctors’ associations. The first and major example was the doctor from Vilappil Primary Health Centre in Trivandrum District who stole nearly 32 lakhs from State Treasury through bogus bills, caused the death of many including his wife and children and him in a hotel room, with bundles of currency notes burned and scattered around the bodies. People have not forgotten this incident and the stolen money could not be recovered still. Doctors’ associations conveniently forget such several incidents and the young bloods among them do not like to remember anything at all from history. Now they have come forward to claim that delivery scenes were taken by doctors in Payyannur Taluk Hospital using personal cameras as it was an extra-ordinary delivery to be recorded for posterity! What extra-ordinary? Do they ever see the web sites of famous university medical schools? Who authorized government doctors in Kerala hospitals to take pictures of delivering females? Did the Health Secretary of Kerala, Director of Health Services, Medical Council of India, Ministry of Health and Family Welfare of Government of India, or even the World Health Organization, permit that ever? The IMA admitted those doctors’ taking pictures, only when the bright and alert tech-savvy officers of Kerala Police collected evidence and proof against them, and not before. What they committed is a crime in India, warranting cancellation of Medical Council Registration, heavy fine and long imprisonment. When the IMA justified this medical crime, they became accessories and accomplices to crime according to Indian Law; the law is clear. They are trying to put pressure on Health Secretary, DHS and investigating officers, to let the doctors go free. They are plainly putting pressure on police-investigation and criminal justice-administration, creating a clever precedent, to be used later by the other criminals among them who already might have put similar videos and pictures in internet sites. The IMA’s long history indicates that they always stood for criminals every time a doctor involved in a criminal case was booked. There is no light viewing of the seriousness of this crime committed on an unwary female patient by unscrupulous doctors, in a state hospital. Did anyone verify their school, college records and medical qualification certificates?

News Link: പ്രസവദൃശ്യം വാട്സ് ആപ്പില്; ഡോക്ടര്മാരെ ന്യായീകരിച്ച് ഐഎംഎ

News 4: 11 Women died in India after botched sterilizations, 7 battling for life and 40 in shock and trauma due to blood loss.

Tell Information Act To Go To Hell

Wall Street Journal on November 11, 2014 reported from Mumbai that eight women were dead and dozens of others were hospitalized after they underwent sterilization surgery as part of India’s population-control programme. Public-health authorities said the women suffered fevers and pain after a surgical team performed a laparoscopic procedure on 83 women on Saturday at a hospital in the central Indian state of Chhattisgarh. The deaths and complications are under investigation.

Times of India on November 12, 2014 reported from Bilaspur that bungled sterilization at a government health camp in Kanan Pendari village in Bilaspur district of Chhattisgarh triggered the worst-ever medical tragedy in the state, with 11 women dead, seven battling for life and 40 in shock and trauma triggered by loss of blood and that as many as 83 tubectomy operations were performed in three-and-a-half hours, with one doctor and his attendant spending, on average, two minutes per surgery.

Comment On November 12, 2014:

DHS Web Site On 11.11.2014. Page 01

When surgeries fail and patients die, doctors are suspended, state conducts inquiry, Indian Medical Association interferes and culprits are let go free. Not one doctor in India has ever been dismissed for the death of a woman or child in a government hospital in India. In Kerala, actually, a lady doctor who caused the death of a woman and a child through a Post Partum Surgery was promoted five times and made Director of Health Services of the state. Tens of thousands of women die in and after simple procedures like PPS in India but the Union Health Ministry, Cabinet of India and World Health Organization never care. Actually it has become the greatest human rights violations in India. Medical Superintendents of the concerned hospitals would always say, ‘those doctors were well trained and brilliant and I wonder what went wrong’! Everything went wrong! The surgeries were done in open camps as part of political campaigns for publicity. There was no clinical cleanliness and hygiene maintained. Things put into abdomen were not taken out. Scissors and knives remained inside peritonis membrane, patients began to show signs of fits, had to be re-admitted, and died of peritonitis. Doctors who did surgeries got medical school admission through capitation fees payment and were not qualified for admission normally. There might have been urgent demand for vital organs which could be removed stealthily from women’s bodies only in the guise of post-mortem examination for which they had to be killed. Uterus, bones, kidneys- anything could have been removed after death by greedy doctors, or patients deliberately had to be caused to die to keep in balance the demand and supply for human organs. No one needs wonder if such things could happen. Tamil Nadu State Human Rights Commission in 2008 ordered government to pay compensation of 25000 rupees to Coimbatore Veera Keralam Thentral Nagar-native Mohanraj’s wife Nandini for carrying for 20 years a surgeon’s knife inside her abdomen, deposited there and neglected to be taken out in a PPS operation. In July 2012, Reuters reported from Raipur that doctors from this very Chhattisgarh state illegally removed wombs from poor women in hysterectomy surgeries, to claim $540 on account of each patient from the national insurance scheme to help poor families to pay for expensive surgeries. The Press Trust of India in July 2012 reported from Jaipur that a doctor was arrested in Rajastan for stealing a kidney from a two-year-old child which led to his death. How many doctors were dismissed and imprisoned for all these crimes by the India Government? None! Not only that, the government skillfully escaped also from paying compensation in ten thousands of hospital deaths of women and children in India. It is the world people’s money coming to health sector in India as assistances, grants and loans from WHO, IMF, IBRD and ADB that is being misused to finance these kinds of human rights violations and subsidize the setting up of necessary infra structure for carrying out these gruesome businesses at government expense. It is time world’s organizations interfere and investigate every child and woman death in Indian hospitals. Our women and children are no more safe in our hospitals. 

News Links: 

Eight Women Die in India After Botched Sterilizations: Wall Street Journal 

Botched govt. sterilization kills 11 women in Chhattisgarh: Times of India 

India reached Mars but Indian Prime Minister’s website does not even have a link for people to submit complaints!

DHS Web Site On 11.11.2014. Page 02

We will live in this world only once and we can sympathize with those in distress only once and we too can report these kinds of atrocities to authorities and demand immediate action and exemplary punishment. It is things started by individuals, not organizations, which cause changes in this world. Never hesitate to report human rights violations because the victims themselves can’t do it, for they would already have lost their will power and mind to respond. We are here to act for them. You can directly upload and report to web sites of organizations in the field or send emails. Most human rights organizations in the world are with links to donate money, to receive which is their sole purpose. Do not waste your time there. Even Green Peace and Amnesty International may not care unless there is scope for good publicity for them. Perhaps if you contribute money, such organizations might look into things and take up. Or you can experiment by interacting with organizations like Human Rights Data Analysis Group, Human Rights First, The Carter Center, World Organization Against Torture, Front Line or Civil Rights Defenders. Some of them are just research organizations who do not take action and some others are mostly regional which may or may not be effective, depending on the geographical location of the origin of the complaint. A few others are arrogant organizations who would either respond to only the privileged or not respond at all. Some move only against governments and some do not move against governments for fear of exposure and examination of accounts. Considering the population of the world and the number of human rights violations occurring every year, it can be said that there are barely enough number of organizations and agencies in this world to attend to all complaints. In countries like India, complaint links in even the Labour Ministry will not open when we click. They are not meant to open but to track who clicks. India reached Mars but Indian Prime Minister’s website does not even have a link for people to submit their complaints to! Only the President’s website has it, and it is prompt in action too.

Never hesitate to report human rights violations you learn about, experience or witness: we all are noble.

RTI Application To DHS 06.10.14 Page 01

As we have seen, victims of human rights violations will not be able to report incidents themselves, as they would be maimed, stained, oppressed, tormented, traumatic, shocked, exhausted and energy-drained to do this. Goodness and goodwill of others is their only hope and salvation. After experiencing horrible acts from other human beings, they would only be wanting to go away from this world and say farewell. It is us who have to pull them back to life and dignity through noble interference. This is the basic principle of all human rights protection and legislation; one needn’t necessarily be the victim to report a human rights violation. If you see otherwise anywhere, never trust that establishment, organization, entity or person. There are a number of establishments, governmental and non-governmental, which are bound to record incidents reported by individuals in their data banks and take immediate action. The first and foremost is the United Nations Human Rights Council where only countries can make complaints. But the United Nations Human Rights Committee will record incidents reported directly by individuals from anywhere in this world. You can report here: . Another is, the United States State Department which records human rights violations from anywhere in this world, directly into their website, as part of the proclaimed democratic policies of America, a model to the world. Remember that India’s Prime Minister was denied US Vista for ten years on account of his alleged involvement in human rights violation in the Gujarat Riots in 2002, which was relaxed and visa granted only when he became Prime Minister in 2014. It is believed that America can deny vista to any concerned official from violator countries whose names shows up in their data banks in connection with human rights violation. If it is true, it is a majestic and grand gesture by the Americans, just like their first experiment with democracy two centuries earlier which kindled hopes of people’s rule in so many countries and made democratic freedom a reality in those countries later. Suppose severe human rights violations are reported from the health sector in India and they record them in their data bank, and supposing this data comes up when Indian health officials apply for US Vista to attend WHO meetings, how can Indian health officials secure WHO grants? If used the right way, visa denials can bring down habitual human rights violators and rogue governments. 

In India, the national agency for reporting human rights violations to is the National Human Rights Commission in New Delhi where you can upload your report directly to You needn’t necessarily be the victim. In Kerala, there is the State Human Rights Commission at and you can email your report to

Constitution of which country allows human rights violators to set foot in their land?

RTI Application To DHS 06.10.14 Page 02

Countries like US can deny visa as part of exerting international pressure against human rights violators or revoke an already existing visa, if one was reported to be responsible for wrong performance of a state institution in his own country. It is a symbol of world’s resistance to human rights violations and non-transparency, prompted into legislation by the ideals the people in those countries uphold and cherish. If even an Indian Prime Minister could be denied visa in foreign soil for ten years due to alleged involvement in human rights violations, why would anyone hesitate to deny landing permission to faceless health officials with score records of thousands of human rights violations against women and children in government hospitals in India behind them, after receiving billions of world people’s money as assistance each year? Constitution of which country allows human rights violators to set foot in their land? 65 Parliament Members from India writing to US President against human right violations in Gujarat was not considered an unpatriotic act. That is what the world has become today. Anyone can interfere in human rights violations in any country. It is now everyone’s right. The world has already become one. Even Inter-American Commission on Human Rights will some day soon have to cross continental barriers and take up protection of human rights in countries on the other side of the world also. 


RTI Reply From DHS 14.10.2014

When India learned that enactment of transparency and right to information legislation could not be delayed at the risk of not continuing to get international grants and loans in the changing world of information revolution, the bureaucracy of the country hastily opened websites for giving information where links won’t open, and reluctantly enacted Right to Information 30 years after all the world had done it, where there are only loop holes. In India, this law remains in a ridiculous and laughable state of condition in which arrogant officers still deny information and challenge people as if they are monarchs. As health service is one of the largest recipients of world people’s money as grants and loans, we shall examine the state of conditions existing in the Directorate of Health Services in Kerala state, the state with the highest literacy rate in India. See the Right To Information link in this directorate’s website where none of the officers mentioned as Public Information Officers and Appealing Authorities work there now and most of them have retired long ago. 

No transparency in government offices; officers are angry and they hate information-seekers.

RTI First Appeal To DHS 29.10.2014

See how the very senior gazetted staff of this office reacts out of sudden anger, ignorance and stupidity to people’s applications seeking information under the RTI Act. Almost all the Senior Superintendents there do not know the official language English, and are recruited not through Public Service Competitive Tests but on compassionate grounds as dependents of relatives who died while in service. Even graduates among them do not know how to read and write in English. It is inconceivable that all of them passed tough departmental tests and secured several promotions unless they used other people’s test results and certificate numbers. Most of them possess dubious certificates and qualifications and scrutiny is lax. Almost all of them skillfully use the famous delay tactics to prepare grounds for bribes and corruption. The director of health services cannot control any of them or take action because that post is filled up through communal and caste rotation, not based on qualification, service and seniority. Which people in this world who give money to governments will believe things are this loose in a country which successfully sent space vehicles to million-miles-distant Mars?

Reply to an application made under the RTI Act to the DHS is scanned and posted here, which is signed by one Ms.S.Kumari, typed in Malayalam which was not the language in which the original application was made. She is supposed to be a Senior Superintendent but doesn’t seem to know what was asked and what was to be answered. She doesn’t even seem to know the difference between appointing authority and posting authority. No one asked her reasons for delay; she was asked only information. A crude translation of her letter from Malayalam to English is here: ‘The information requested vide letter referred to are appended hereunder: In the applications you submitted to this office several times through the DMO and otherwise for various purposes, original documents were not enclosed. Therefore action could not be taken on that application. Therefore, as per NDis. ED2-64625/14/2005/HSD Dated: 07-10-14 the copy of which is enclosed, application for each purpose with original documents is to be submitted to District Medical Officer who is your appointing authority. Yours Faithfully, Sd/- S.Kumari, Public Information Officer, ED Section, Directorate of Health Services, Trivandrum.’ This is the level of public awareness of Senior Superintendents in the Establishment Section of a State Directorate, a section which controls the life and services of thousands and thousands of brilliantly qualified surgeons and physicians, and nurses and technicians, throughout the state. What might have been their untold experiences with these half-baked brains!

Officers who cannot read or write English handle international affairs, funding and spending!

RTI Reply From Chief Secretary 28.10.2014

They cannot understand what information a citizen is asking for, and they believe what they believe is what the citizen is asking for. There is no controlling authority, there is not an educated appealing authority anywhere and there is not even a Chief Information Commissioner for the country, for that matter. We have seen just one application made by a citizen and the irresponsible and arrogant reply given by a Gazetted Senior Superintendent. She escaped without punishment. She does not know to read and write in the official language and that is why the reply is in Malayalam, the only language she knows, in violation of the mandate that the reply should be in the same language as the application and should strictly be in the prescribed format. This is the state of condition in the entire state, and the office of the Chief Secretary to Government of Kerala is no different. The same application was sent to him also and the reply from his office was equally irresponsible too, which is reproduced here. So, the question is, why should the world’s people entrust their money to these corrupt and non-transparent people, for whatever good purposes?

Pictures Courtesy: Sahyadri Books Archives Trivandrum

Meet the author

P S Remesh Chandran

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of 'Swan, The Intelligent Picture Book'. Unmarried and single. Born and brought up in Nanniyode, a little village in the Sahya Mountain Valley in Trivandrum, Kerala.

Dear Reader,
If you cannot access all the articles of P.S.Remesh Chandran, access them via the link provided here:

For more factual evidence on the collapse of governmental health infra- structure in Kerala, Visit Kerala Health Research Online and Trivandrum Social Research Institute at
Visit author's own Blog: Sahyadri Books Online Trivandrum 


A D B, Atrocities Against Women, Bloom Books Trivandrum, Essays Columns Opinions, Health Corruption, Health Financing, Health Research Online, Health Scandals, Human Rights Violation, I B R D, I M F, India Health, International Financing, Kerala Health News, Kerala Public Health, P S Remesh Chandran, Patient Abuse Kerala, Patients Deaths, Right To Information, Sahyadri Books Trivandrum, Transparency In Government, 

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Sunday, 9 November 2014

058. Open Letter To WHO On Pentavalent Vaccine Related Deaths In India

Open letter To WHO On Pentavalent Vaccine-Related Deaths In India

Pentavalent vaccine was introduced in two states of India last year by the World Health Organization (WHO). Several alleged deaths occurring due to the vaccine, prompted the All India Drug Action Network to write to WHO asking for a re-evaluation of the introduction of the vaccine.

By All-India Drug Action Network


Dr. Margaret Chan,
The Director General,
World Health Organization, 

Dear Dr Margaret Chan,

All India Drug Action Network (AIDAN) is a network of not-for-profit civil society organizations that has been campaigning and working for rational use of medicines, largely in the Indian context. We have written to you in the past. We would like to bring your attention to the Pentavalent (DPT + Hib + Hepatitis B) vaccine related deaths in India.

According to the Brighton classification of ‘Adverse Events Following Immunization’ (AEFI), re-challenge and recurrence of symptoms in the individual is needed for classification of AEFI as ‘certainly related to vaccine’. Such re-challenge is impossible if in the first instance, AEFI results in death. In the absence of proof from a re-challenge experiment, deaths caused by vaccines can only be classified as ‘probably related to vaccine or possibly related’ to the immunization.

As you would know, there have been several Pentavalent vaccine related deaths in Sri Lanka, Bhutan and Pakistan. Using the WHO approved classification of AEFI many of these deaths are ‘probably related to the immunization’ because no alternate cause for the adverse events has been found. However an expert panel looking at the deaths in Sri Lanka deleted ‘probably related’ and ‘possibly related’ from the classification of Brighton for purposes of their evaluation report, and then certified that the vaccines were ‘unlikely to be due to the vaccines’. This report (Expert Panel Report 23 December 2008 Sri Lanka) is available on the World Wide Web.

One by one the WHO has de-listed a number of brands of pre-qualified Pentavalent vaccine, but the problem has refused to go away. Pentavalent vaccine was introduced in two states in India on 14th December and 17th December 2011, to evaluate the safety of the vaccine in India.

According to an affidavit filed in the Kerala High Court by the Government of Kerala India, there have been four deaths in less than two months since it was introduced in the public health system. For your information the full text of the submission by Kerala government can be accessed here.

The reactions in India suggest that the cause of the problem is unrelated to the brand or manufacturer or lot of the vaccine. It appears to be a form of ‘hypersensitivity reaction’ as described in the post mortem report on one of the children in Kerala.

The vaccine can be administered to many patients without problems and there is no available method at present to predict which infant will react adversely.

The US FDA has pointed out that vaccines are aimed mostly at healthy individuals for prevention of diseases to which an individual may never be exposed. Unlike conventional drug treatments meant for the management of existing disease, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause death of healthy children cannot be recommended.

Pentavalent vaccine is at present recommended by WHO and its introduction is supported by Global Alliance on Vaccines and Immunization (GAVI) funds. Given these circumstances the WHO needs to re-evaluate the recommendations. We propose to copy this letter to countries supporting the GAVI initiative so that they may be able to initiate action in a responsible manner.

Looking forward to your early action in the regard.

1. Dr Jacob Puliyel, Drug Action Forum– Karnataka (DAF-K), New Delhi

2. Dr Mira Shiva, Medico Friend Circle, New Delhi

3. Dr Gopal Dabade, DAF-K, Dharwad

4. Mr Srinivasan. S, LOCOST, Vadodara

5. Mr Naveen Thomas, Headstreams, Bangalore

6. Mr Prasanna Saligram, AID India, Bangalore

7. Dr Anurag Bhargava, JSS, Chattisagarh

March 12, 2012.

Republished here on public interest by courtesy of All-India Drug Action Network


Pentavalent Vaccines Promoted by WHO Despite Deaths of Healthy Children – Part I, Asia


Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

057. Kerala’s Everyday Drink Of Vaccine Cocktails

Kerala’s Everyday Drink Of Vaccine Cocktails

India serves up costly cocktail of vaccines

By Ranjit Devraj

Source: Inter Press Service News Agency,
New Delhi, India.
Saturday, November 9, 2013.

Ignoring widespread concern over the safety, efficacy and cost of pentavalent vaccines, India’s central health ministry has, this month, approved inclusion of the prophylactic cocktail in the universal immunization programme in seven of its provinces.

Pentavalent vaccine doses, a cocktail of five antigens in a single shot, confers immunity against five paediatric diseases – diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza type b (Hib), with the last one considered particularly problematic by some experts.

Pentavalents, produced by several manufacturers and promoted by the Global Alliance on Vaccines and Immunization (GAVI), has had a history of causing adverse reactions and deaths in India’s neighbouring countries like Bhutan, Sri Lanka and Pakistan.

In 2010, the National Technical Advisory Group on Immunization (NTAGI), a body of experts selected by the Indian government, recommended limited introduction of pentavalents in southern Kerala and Tamil Nadu and evaluation of results over a year before extension to other states.

Pentavalents were launched in Kerala and Tamil Nadu in December 2011, but the results were not encouraging. Kerala recorded four infant deaths following vaccination, with symptoms similar to what were seen in other South Asian countries.

Public health activists in Kerala, a state with 100 percent literacy and human development indices similar to those of advanced Western countries, quickly filed a public interest litigation (PIL) in the Kerala High Court asking for intervention in having the programme called off and a return to the existing health plan.

But despite infant deaths and two pending PILs (with yet another being heard in the Delhi High Court) against pentavalents, the health ministry announced on Apr. 16 that pentavalents would be introduced in five more states – Gujarat, Haryana, Karnataka, Goa, Jammu and Kashmir and Puducherry in October.

In making the decision, the government overlooked the NTAGI, which has not even been convened since August 2010 when the body suggested limited introduction to Kerala and Tamil Nadu as the two states have good adverse event following immunization systems.

“Going by what we have seen in the neighbouring countries and now in the state of Kerala, pentavalents can, without warning, cause children (to suffer) hypersensitivity reactions and death,”

Jacob Puliyel, an eminent paediatrician at St. Stephen’s hospital in New Delhi and member of the NTAGI, told IPS. Puliyel likened the situation to penicillin sensitivity and said it bordered on criminality to be administering pentavalents without first testing a child for hypersensitivity. “Every child that is being given a dose of pentavalent vaccine is a potential victim of the adverse reaction,” he said.

Puliyel was among the many eminent physicians and public health activists in India who wrote to World Health Organization (WHO) director-general Margaret Chan on Apr. 3 asking the health body to “re-evaluate” its recommendation of pentavalent vaccines on the grounds of safety.

Another signatory, Dr Meera Shiva, an expert on pharmaceutical drugs attached to the voluntary Medico Friends Circle, told IPS that WHO had to de-list a number of brands of ‘pre-qualified’ pentavalent vaccine, “but adverse reactions persist and we have surely not heard the last of them.”

The letter to Chan, written under the aegis of the All-India Drug Action Network, an umbrella of public health activist groups, suggested that the cause of the vaccination- related deaths was likely to be “hypersensitivity reaction as described in the post mortem report on one of the children (who died) in Kerala.”

“Unlike conventional drug treatments meant for the management of existing diseases, in prophylaxis with vaccines, safety is of paramount importance. Vaccines that frequently and unpredictably cause the death of healthy children cannot be recommended,” the letter to Chan said.

Policy analysts specializing in vaccines said they were dismayed at the move to approve pentavalents in as many as seven of India’s states, which account for 340 million of India’s 1.2 billion people.

“Pentavalents are a test case for India’s new policy on vaccines that is in keeping with liberalization and openly favours pharmaceutical majors at the cost of India’s public sector vaccine units,” said Madhavi Yennapu, a scientist who specializes in vaccines at the central government’s National Institute of Science, Technology and Development Studies.

Twenty of India’s 23 public sector vaccination units, once the mainstay of the country’s immunization programme, have been shut down one after another over the last four years on the grounds that the quality of their products was suspect.

Yennapu pointed to the draft National Vaccination Policy, released last year, for clues on why the government has not made any serious attempt to revive the vaccine- manufacturing units by enforcing quality standards, for instance.

The new policy demands that the “risk of manufacturing vaccines by private manufacturers must be cushioned by assistance from (the) government” and suggests that it be made mandatory for the government to support vaccine producers with advance market commitments (AMCs).

Madhavi explained that AMCs provide guaranteed markets for a vaccine even before trials are conducted, with the government committed to paying a supporting minimum price.

“Even if the vaccine turns out to be less efficacious than the existing one the government must honour the AMC by buying the new vaccine at the agreed price.

“This means that AMC funds must be deposited with the World Bank ahead of vaccine delivery by countries that GAVI is supposed to be helping with the introduction of new vaccines,”

Madhavi told IPS:

“Naturally, GAVI would be looking at large countries like India, Brazil and China to provide the AMCs.” For a country like India, what is important is to “see how many vaccines are needed to prevent how many deaths and at what cost, rather than throw out tried and tested vaccines in favour of a cocktail (pentavalent) which not only has doubtful advantages but has been shown to cause adverse reactions,” Madhavi said. According to Madhavi, there is no hard scientific evidence to show that India needs the Hib vaccine .“It is clearly piggybacking on other vaccines and the public made to pay for it.” The existing diphtheria, tetanus, pertussis (DPT) vaccine costs about 30 cents for all the doses needed to immunize a child, while immunization with pentavalents will cost more than 10 dollars. “We need to ask ourselves if introducing the new vaccine is really worth all the public money being spent on it,” Madhavi said.

Republished here on public interest by courtesy of Inter Press Services

Saturday, November 9, 2013

Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, pentavalent vaccines, Antigen, Paediatric disease, Infant death,

056. Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Kerala Health Department Severely Accused By CAG On Account Of Sickle Cell Anaemia

Comptroller and Auditor General of India raps Kerala health department

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness

Press Trust Of India, Thiruvananthapuram
June 22, 2014

The Comptroller and Auditor General (CAG) has expressed concern over the failure of the public health system in Kerala to tackle the prevalence of sickle cell anaemia among the tribal population in Wayanad, home to nearly 31 per cent of Adivasi communities in the state.

According to a recent CAG report, out of the 85 per cent of tribal population screened by health authorities in the district, a total of 706 persons were found to be affected with the disease while 6,992 showed its traits.

Quoting a survey by the National Rural Health Mission (NRHM) from 2007-08 to 2012-13, it said as many as 312 of those suffering from the "life-long inherited disease" were in the age group of 18-40 and 262 in the school-going age of 5-17.

Sickle Cell Anaemia is an inherited disease characterized by red blood cells that assuming a sickle shape making normal life difficult in later stages of the sickness.

The NRHM had recommended grant of incentives to the school going students to continue their studies and for preferential treatment and temporary and contract jobs to those patients in the age group of 18-40, it said. However, the government and district administration did not initiate steps to implement this, the report said. The report also found fault with the state health department for not completing the disease screening to cover the entire tribal population in the region.

"No special efforts have been made by the Health Department to extend help to the identified patients to lead a normal life," it added.

Republished here on public interest by courtesy of Business Standard Dot Com


Tags: Kerala Health News, Health Research Online, Public Health Kerala, Health News, Kerala Health Service, India Health, Health Department, Sickle Cell Anaemia, CAG, NRHM, Adivasi, Wayanad, Tribal

Sunday, 26 October 2014

055. Who Will Catch Fake DMOs Who Catch Fake Doctors?

Who Will Catch Fake DMOs Who Catch Fake Doctors?

By Special Correspondent
Kerala Health Research Online

A District Medical Officer of Kerala caught a fake doctor in the private sector. But who will catch fake DMOs in the Kerala State Health Services Department? Justice M P Menon Commission that enquired into the fake mark list and MBBS certificate cases in the 1980s concluded its report by saying that the Commission, with its limited resources, time and staff, could only catch and expose a few fake doctors and the majority of them might still be working in the Health Services Department as Assistant Surgeons and Civil Surgeons. No follow up action was ever ordered and undertaken by the Chief Ministers, Health Ministers, Health Secretaries or the Directors of Health Services of Kerala. Most of them were duly promoted and some may have eventually become DMOs and other key Programme Officers. And it is, was, not the end of faking certificates and bribing for appointments. Things became only easier since then with the advent of computers, laser printers and other advancements available to those who want to fake things. Where do they actually verify the certificates a person claiming to be a doctor produces? There are three major recruiters in government sector- the Kerala Health Services Department, the Kerala Medical Education Department and the new, free, liberal and open route, National Rural Health Mission. In the last, anything is possible with its non-accountability. In the first two, there is no initial verification before appointment; everything is taken as gentleman’s word. After appointment, when the supposed doctor goes to the concerned institution to join is the SSLC Certificate and MBBS Certificate physically verified for proof of age and entry qualification, by a lowly clerk. They rarely hand over these to the clerks but just ask them to prepare a covering letter to the Accountant General without seeing them. A clerk in Trivandrum District once reported this to his superintendent and the superintendent said: ‘this person, from Sooranad, did not show them to even me, then how would to you? Anyway, give him the covering letter.’ SSLC Book of another doctor from Karunagappalli revealed that she secured 5 marks for English I Paper and 8 marks for English II Paper in Eighth standard. How will she ever become a doctor? When these facts were reported to higher authorities, the then Deputy DMO, DMO and DHS were very, very, very eager to suppress news; after decades, they sent this clerk away without four higher grades, promotion as UD Clerk on attainment of 50 years age, gratuity or even a pension, even though he had a corruption-less service of 32 years and was recruited through PSC. (Documentations are available online). They are such long-remembering and spiteful. So, before arresting others for faking, every doctor in the Kerala Health Services Department in Kerala, including the Director, has to prove before the public that they are not fakes. Let them put relevant details with scan copies of certificates in their official website and let people verify. Let IMA and KGMOA officials do it first.

Link to news article:

കൊച്ചിയില്‍ 20 വര്‍ഷമായി ചികിത്സ നടത്തുന്ന വ്യാജ ഡോക്ടര്‍ അറസ്റ്റില്‍

Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Fake Doctors, Illegal Medical Practice, Kerala Health Department, DMO, DHS, IMA, KGMOA, MBBS,

054. Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments.

Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments

'Kasaragode General Hospital spent 50,000 rupees for drawing 30 pictures of Micky Mouse, Tom & Jerry and Donald Duck in the walls of the children’s ward. The hospital superintendent Dr. Narayana Naik told Indian Vision Channel that this was made possible with the help of Hospital Development Committee, and as the next step, every wall in the hospital would be painted and filled with colourful pictures.' (News reported by India Vision Channel Live on 14th September 2014)

Special Correspondent
Kerala Health Research Online

According to health and revenue authorities, Hospital Development Committees in Kerala are outdated and long due for reconstitution. No one cared to regularize and develop them as societies fit enough to hold enormous sums in custody. Kasaragode District Hospital’s HDC is no exception. The District Collector of Kasaragode has full responsibility for the money-spending of this HDC which seems to have unlimited funds accumulated through years but no sense of destination. The politicians in this retired committee are spending money lavishly and foolishly. Indian hospital rooms have their long-approved colour patterns- green below and white above- to create pacifying, soothing effect. Nobody will paint them in red, pink and violet- angry colours. Normal stay for a child in hospital is three days. On the first and second days, the children won’t see practically anything for they would be in pains. On the third day, the day of their discharge, they do not need see anything; they just wish to go home. If they have to stay for more than three days in Kasaragode District Hospital, this hospital is bad in administration, cross-infectious, useless and risky. Because there is money, we cannot spend it; it is our reserves. When large amounts of money needed for a pediatric ward cannot be obtained from government, then, and then alone, can we spend HDC funds. Somebody must tell the Hospital Superintendent and the District Collector of this truth. Does this hospital have enough Pediatric Exam Tables and Scale Tables? Do they have Neonatal Infant Care Infant Warmers? How many working Transportable Infant Incubators do they have? How many Portable Vital Signs Monitors, Hand-Held Pediatric Vital Signs Monitors and Oximeters? How many Baby Finger Print Pulse Oximeters? Do they have Automated External Defibrillators, Fetal Monitors and Fiber-optic Phototherapy Systems? Have they ever demanded these from the Director of Health Services or Medical Services Corporation or have ever written to government requesting these. Have this committee ever discussed these basic necessities of children’s ward in meetings and recorded in minutes? There is a limit to ignorance, negligence and incompetence. Either leave decisions to doctors and other medically-qualified professionals or resign decently from this ornamental committee. Only in hospitals would this cheap political power play become possible. Will Kasaragode District Collector allow and tolerate a politically constituted Collectorate Development Committee imposed upon him, making him a puppet in taking decisions? If this committee, which knows nothing about children’s treatment other than how to make children, want to know about what are needed in pediatric wards, come down from the skies and ask the B.Sc. and M.Sc. Nursing-qualified staff who will tell them to purchase Electric Cots, Mobile Aneroid Stand With Cuffs (Rs.20000/-), Hand-Held Oximeters (Rs.60000/-), Portable Pulse Oximeters With Finger Sensors (Rs.80000/-), Gamma XL Patient Monitor (Rs.300000/-) or even a Da Vinci Robotic Surgical System which will cost only £500,000. Let this HDC prove their mettle.

Mobile Aneroid Stand With Cuffs is a Blood Pressure Machine with reusable blood pressure cuffs of varying sizes to suit any child. Hand-Held Oximeters are used to monitor oxygen levels in babies to prevent damage to vital organs due to lack of oxygen. Portable Pulse Oximeters With Finger Sensors are hand-held devises to monitor pulse and oxygen level while child patients are moved from place to place. Respiratory Humidifiers heat and moisturize the oxygen that is being delivered to children during mechanical ventilation, to prevent them from becoming cold, thick airway secretions from building up, breathing tubes from blocking up and the little lungs from collapsing, based on the principle that humidified and heated oxygen will make children recover faster. Vital Signs Monitors in pediatric and neo natal wards and emergency wards reads, registers and provides all necessary vital signs of the sick child. Gamma XL Patient Monitor can be purchased for Rs.300000/- which will watch all vital signs including Pulse Rate, Temperature, Blood Pressure and Cardiac and Pulmonary functions, replace all other equipments and prevent children from being moved to different monitoring levels, floors or rooms. The latest thing to present a children’s ward in a hospital with is the Da-Vinci Robotic Surgical System which ensures more accuracy in surgery, lesser pain, smaller scars and quicker discharge. The surgeon at the console sees 3D images of internal organs, makes tiny incisions, manipulates miniature instruments and performs surgery. These are becoming popular now- U.S. has 300 0f them and U.K. 1. Why don’t Kasaragode try? Anything is possible, and do not tighten purses where children are concerned. Also take care of a few other things. How many High Dependency Unit Beds, Electric Cots, Pediatric Nurses, Consultant Pediatricians and Anesthetists trained in Pediatric Care are there? Is there a Children’s Ambulatory Care Ward, so that children needn’t stay even a day for surgery? Are cots, waiting room chairs, and equipments including thermometers and birthing-baths beyond or with in Accepted Infection Control Parameters and Standards? Are all beds provided with oxygen space and access to oxygen outlets? What about prevention of cross-infection? Are medical and surgical patients separated? What about cleanliness in children’s baths, toilets and closets?