Feeds:
Posts
Comments

Archive for the ‘The Hindu’ Category

Women in the Army

By Rasana Atreya

Published nationally in The Hindu

LAST MONTH a woman army officer, Sushmita Chakraborty, ostensibly disillusioned with Army life, took her life. Everyone rushed to pass judgment on her suicide, which could well have been due to extremely personal, non-disclosed reasons. In a bid to distance itself from the situation, the Army rushed to release private psychiatric records of the officer.

As if this were not bad enough, the Vice-Chief of the Army, Lieutenant General S. Pattabhiraman, jumped into the fray claiming “the force could do without women.” This of course promptly politicised the whole sordid mess by drawing in Sushma Swaraj of the BJP and also the National Commission for Women, and ticking off a whole bunch of women in the process. There are a few different issues involved here which are worth a look.

Image takes a beating

First, the public image of the Army has taken a beating after this incident, not necessarily as a result of the suicide, but as a result of the utterances of its Vice-Chief. Possibly to divert attention from the General’s statement, the Army released the mental health records of Chakraborty.

By doing this, not only did the Army fail this officer by neglecting to take her concerns seriously (she had already attempted suicide once before), but in the process also breached the tenet of medical ethics that requires that medical records be kept completely confidential. An unintended consequence of this blatant disregard for medical confidentiality could be that it might discourage other similarly disturbed armed forces personnel from seeking medical or psychiatric help.

Secondly, the issue here should have been suicide by any officer, and not just that of a woman officer. In this, the General did his fellow officers a grave disservice. In a less sensationalised account of male officer suicides (tucked away in the back pages, as opposed to the front page article on Chakraborty), The Times of India reported that a staggering 430 personnel, both officers and other ranks, have committed suicide in the armed forces since 2002. Neither the armed forces nor the Army Vice-Chief seem to have felt the need to explain away those other suicides.

The third issue here is the presence of women in the armed forces. Very obviously there is a problem with the integration of women in the Forces if the top brass is not able to reconcile itself to the fact. Since women have been inducted only into the “non-combatant” divisions of the armed forces, there is an inference right off the bat that the women officers are simply not good enough, even though the General himself admits that there is little doubt about the abilities or merit of the women officers.

The problem therefore lies not with the women themselves, but with the attitude of the male officers. One of the reasons the forces were forced to take on women (no pun intended) was because, by the General’s own admission, not enough qualified men were coming forward. Because of his statements the General might now have discouraged women from joining up.

As for sceptics of women’s place in the Army, it was not too long ago that women were not deemed fit enough for the work force, or to drive or even have a vote. What is needed is a sincere effort to resolve issues involved with men and women working together, as in any other field. Because discipline is a major issue in the forces, male personnel need to be given gender sensitisation training to pre-empt insubordination.

From all accounts, Sushmita Chakraborty was unhappy with her work in the Army. Yet no attempt seems to have been made to resolve this by giving her an alternative assignment. Discipline in the Army is one thing, rigidity of thought quite another. The Army brass needs to realise that what cannot bend often breaks, as happened in the case of Chakraborty.

The Forces have taken the first welcome step toward gender equalisation by accepting women officers. It now needs to move forward by not putting them under the microscope, but treating them as just other army officers. The forces could even take this a step further by opening up to not just officers, but even to other ranks.

If the armed forces were not quite as insulated from the real world, it might be able to help its personnel come to terms with the new reality (i.e. women now are part of the armed forces) faster. And lastly, the first beneficiary of the gender sensitisation programme could be the General himself.

Published in The Hindu, all editions
Sunday July 9, 2006

http://www.hindu.com/op/2006/07/09/stories/2006070901371400.htm

Read Full Post »

Flawed system shelters incompetence

By Rasana Atreya

Published nationally in The Hindu

ARUNA CHANDARAJU’S article (“Do not doctor yourself,” The Hindu, January 14), while informative, brings up other issues I would like to address.

Lots of doctors actually prescribe unnecessary medication. A case in point — I was five months pregnant when I had a major bout of food poisoning. As a precautionary measure I went to a gynaecologist in Hyderabad. She prescribed 10 medicines without asking about my medical history, what other medicines I was taking (to prevent adverse reactions) or whether I was allergic to any medication. When I asked her why I needed to use so many medicines, she said she was covering all bases. I got a second opinion from a respected gynaecologist who asked me to throw all those medicines out!

Anyone who has had prenatal checks in the West will tell you that doctors are very reluctant to prescribe medication to pregnant women because a lot of times they have no idea how it will affect the baby. In the last two weeks of my second pregnancy in the U.S. I had a pelvic bone fracture. The doctor strongly advised against potent painkillers as well as x-ray, but said that the choice was mine to make. Though in excruciating pain, I accepted the doctor’s advice.


Informed consent

In India doctors expect you to take the prescribed treatment on faith. You are rarely told about the various pros and cons, or allowed to choose a treatment plan with side effects that you can live with. More often than not, the doctor decides for you.

Aside from the fact that giving the patient the right to accept or decline treatment (called informed consent) is the right thing to do, it is also a legal requirement in the U.S.

To quote another instance, I was prescribed an antibiotic for a sprained ankle in Pune. I asked the doctor why the antibiotic was necessary. He said people come in expecting lots of medicines, especially antibiotics; so if he did not satisfy them, they would just go to the doctor across the street. He said since the doctor across the street did the same thing anyway, he would rather not lose patients!

This doctor said that abuse of antibiotics is a “Western notion” not applicable to India. The Centers for Disease Control and Prevention (USA) sees it differently; it calls antibiotic resistance (caused by indiscriminate prescribing) one of the world’s most pressing public health problems.

In the U.S., it is very common for patients to ask doctors questions; in fact questions are encouraged because the doctors want you to make an informed choice. In India it has been my experience that doctors do not think that you are asking questions because you want to know what is happening to your body; they feel you are questioning their judgment.

But we need to remember that medical errors can and do happen. No one is infallible, least of all doctors. In November 1999, the American Institute of Medicine published a report saying that as many as 98,000 people die in American hospitals each year as a result of medical errors!

In the U.S. you can call the State Medical Board to see what qualifications the doctor has, how many malpractice complaints there have been against him/her, etc. In India doctors are not required to post their license number in their clinics, or on their prescription pads. They are not even required to periodically update their medical knowledge and get tested for it.

An additional safeguard in the U.S. is that your pharmacy’s computer keeps track of the medicines you have taken previously. The pharmacist will often warn you about medicines that have a potential to interact.

Finally, I have never forgotten a line I read in the Reader’s Digest a long time ago, “Even the guy who graduates at the bottom of his class gets to call himself a doctor.” This is especially worrisome to me because in India we have no way of tracking medical incompetence.

I am not trying to say that U.S. doctors are superior. Indian doctors are as good as their American counterparts, if not better. What I have a problem with is our flawed medical system.

Published in The Hindu, all editions
Sunday, Jan 28, 2007

http://www.hindu.com/op/2007/01/28/stories/2007012800051400.htm

Read Full Post »