The Indian Express (Delhi Edition)
MH370 hunt dives deep into ocean’s secrets
SINCE THE time the Mental Health Bill was introduced in Rajya Sabha in 2013, decriminalisation of suicide has been its calling card. However, the legislation travels beyond just that colonial era relic, assuming a rightsbased approach to mental healthcare, and creating circumstances for removal of the stigma that is the lot of mental health patients. It is a paradigm shift that the National Health Policy passed by the Union Cabinet earlier this month, shied away from.
Rights-based approach
The Act lays down that “Every person shall have a right to access mental health care and treatment from mental health services run or funded by the appropriate government. The right to access mental health care and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically, without discrimination on the basis of gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class, disability or any other basis and provided in a manner that is acceptable to a person with mental illness and their families and care-givers.”
The range of services specified in the Act includes outpatient and inpatient services, half-way homes, sheltered accommodation, supported accommodation, and provisions for child and old-age mental health services. The Act also contains a provision for the notification of a list of essential medicines, providing which will be the obligation of the relevant government.
The importance of a government making mental healthcare a statutory obligation in a country riven with social taboos and superstitions, and where the idea of dignity for the mental ill is mostly absent, cannot be overstated. Once the Bill receives the President’s assent and becomes law, the central government and state governments will be required to place in Parliament and state legislatures an annual report on the progress in achieving universal access to mental healthcare. At the heart of the Bill is the idea that every person with mental illness has the right to live in, and be part of society, and should not have to live in a mental establishment merely because s/he does not have a family, or the family is not willing to accept him/her. It will be the responsibility of the government to house such a person within a reasonable time in a community-based establishment.
This rights-based approach is a far cry from the “assurance-based approach” of the new National Health Policy, which essentially perpetuates the status quo, pleading that given current constraints of infrastructure and resources, the government cannot institute a “right to health” on the lines of the Right to Education.
Challenges in the way
ON MARCH 8, 2014, Malaysia Airlines Flight 370 vanished with 239 passengers and crew aboard as it crossed the Indian Ocean, triggering a massive search for its remains that lasted nearly 3 years. As a byproduct of the tragedy, scientists have gained access to more than 100,000 sq miles of seafloor mapped at a level of detail that provides a rare look at the ocean’s geological processes.
“It’s an incredible trove of data,” said Millard F Coffin, a marine geophysicist from the Institute for Marine and Antarctic Studies at the University of Tasmania in Australia. “I’ve been working in this part of the Indian Ocean for 30-plus years and over many voyages in the eastern Indian Ocean I’ve never seen this level of resolution.”
Dr Coffin worked with a group of about 10 scientists from Geoscience Australia, the national geosciences agency in Australia, to analyse data from the search. They were given access to high-resolution sonar information collected on ships, and data obtained by remotely operated vehicles and autonomous underwater drones. The information was provided by the Australian Transport Safety Bureau, which led the search.
Previous satellite data provided scientists with information about the Indian Ocean at
This is not to say that the government’s arguments against a right to health do not apply to the right to mental health. Between 2% and 5% of Indians are said to be suffering from mental illnesses — in a country of 125 crore, that would be between 2.5 crore and 6.25 crore people. By contrast, the number of trained psychiatrists in the country is between 4,000 and 4,500. And this number is unlikely to go up in a hurry — psychiatry is taught in fewer than 300 medical colleges at the undergraduate level and in 184 at the postgraduate level. Across the country, there are 502 seats in MD Psychiatry. There are no PHD courses in psychiatry, and a little over 100 seats in diploma courses.
Back in 2009, E Mohandas of the Elite Mission Hospital in Koorkkenchery, Thrissur, wrote in the Indian Journal of Psychiatry , “A meta-analysis of 13 epidemiological studies consisting of 33,572 persons reported a total a resolution of about 5 sq km. Instruments on the search ships have now collected information at a resolution of metres and, at some locations, using remote operating vehicles morbidity of 58.2 per 1,000. Another meta-analysis of 15 epidemiological studies reported a total morbidity of 73 per 1,000. The saddest aspect is that the bulk of the affected falls in the 15 to 45 year age group. The existing facilities in the country fall short of the required norms, which makes the situation still worse. The number of psychiatric beds in the country is only about 0.2 per 1,00,000 population and there are only two psychiatrists per 10 lakh population. The major share of psychiatric facilities lies with the government sector (especially mental hospitals), which is centred on certain areas of particular states. The psychiatric services have not yet been integrated into the primary health care system and this leaves large populations in dire need of such facilities, with no hope of effective treatment.”
According to conservative estimates, India needs 12,500 psychiatrists to meet international standards. There is also a shortage of trained psychiatric nurses — just about 3,000 nurses and 2,000 clinical psychologists cater to the entire population of the mentally ill. Another article in the IJP put India’s unmet mental healthcare need at anywhere between a third to half the population. The need of psychiatry paramedics is estimated to be upwards of 50,000 if all patients are to be addressed.
Mental Health Authority
The Bill gives a person suffering from mental illness or anticipating such a disease the right to decide in advance how s/he wants to be treated — including the right not to be treated. The decision is to be certified by a doctor and a mental health board. All mental health establishments have to be registered with central and state mental health authorities. There is also a quasi-judicial body called the Mental Health Review Commission to review advance directives, and to advise the government on the implementation of the Act. and underwater autonomous vehicles, centimetres. The search has helped create three-dimensional maps of the ocean floor that reveal its topographical complexity, and will allow researchers to further investigate unique features like the oceanic plateau called Broken Ridge, and its southern-flank Diamantina Escarpment. The Flight 370 search also provided information about tectonic and volcanic activity, Dr Coffin said.
The team plans to release more detailed looks into its findings later in the year, and the full data set from the search will be made available in the middle of the year.
Walter H F Smith, a geophysicist with the National Oceanic and Atmospheric Administration (NOAA), said the hunt for the lost jetliner highlighted how little we know about the oceans. The lack of this knowledge, he said, can hinder how experts predict tsunamis, understand ocean currents, make climate forecasts, study marine life and search for missing planes.
Previous studies have suggested that only 8% of the world’s oceans have been mapped, meaning that a ship measured an area’s depth and recorded it in a scientific database. Before Flight 370’s disappearance, only 5% of the southeast Indian Ocean had been mapped, Dr Smith said.
THE NEW YORK TIMES UNTIL 2012, a “sweep” — winning by a twothirds majority — was a rarity in Assemblies. Not anymore. Two weekends ago, the twothirds electoral majority (as opposed to a post-poll majority) became the norm rather than the exception across Assemblies the size of Delhi or larger.
Out of 20 Assemblies with at least 70 seats, 12 have now been elected with a majority of nearly two-thirds or more. The massively onesided verdicts in UP, Uttarakhand and Punjab — where the Congress is just 1 seat short of two-thirds — carried Indian Assemblies collectively across the threshold on March 11.
This is the first time in the last 20 years, probably more, that the number of twothirds electoral majorities has exceeded smaller majorities and hung verdicts among the larger Assemblies.
This search of election data went back until 1993 to account for the results of 110 elections leading to the formation of these Assemblies — earlier 17, now 20 excluding Telangana — as they stood at various stages from 1997 onward. Telangana does not qualify as an independently elected Assembly; its members were chosen in an election that took place in undivided Andhra Pradesh.
In the last 20 years until March 11, 2017, when the results of the elections in 5 states including UP, Punjab and Uttarakhand were declared, the highest number of Assemblies with a two-thirds majority at any given time was 8 out of 17. This happened between May 2001 and February 2002, when Chhattisgarh, Jharkhand and Uttarakhand had not yet held elections as independent states, although the interim government in Uttarakhand did have a two-thirds majority. In February 2002, Punjab dropped out of the list of two-thirds majorities, followed by
DISSECTING ASSEMBLY ELECTION VERDICTS