Editorials/Opinions Analyses for UPSC – 15 May 2021

Contents

1. The crime of enforced disappearances must end
2. Reforming medical education

The crime of enforced disappearances must end

Context:

• After the February 2021 military launched a coup d’état to overthrow the democratically elected government in Myanmar, the democracy movement in Myanmar is at a critical juncture with the military committed to suppressing the people’s movement and the police carrying out unimaginable acts of violence and oppression against those demanding freedom of expression and the restoration of democracy.
• Since the coup, the United Nations Working Group on Enforced or Involuntary Disappearances (WGEID) has received reports of enforced disappearances from the family members of victims.
• The Working Group has serious concerns about the impact of COVID-19 on enforced disappearances

Relevance:

GS-II: Social Justice (Population related issues)

Mains Questions:

Cases of enforced disappearances are not decreasing, with domestic criminal law systems insufficient to deal with this atrocity. Discuss. (10 marks)

Dimensions of the Article:

1. Understanding Enforced Disappearances
2. Enforced Disappearances in the recent times
3. Remedial measures
4. International Convention for the Protection of all Persons from Enforced Disappearance in 2006
5. Way Forward

Understanding Enforced Disappearances

• Enforced disappearance occurs when a person is secretly abducted or imprisoned by a state or political organization, or by a third party with the authorization, support, of a state or political organization, followed by a refusal to acknowledge the person’s fate and whereabouts, with the intent of placing the victim outside the protection of the law.
• Enforced disappearances became widely known to the world in the 1970s and the early 1980s during the ‘Dirty War’ in Argentina.
• Dirty War, also called Process of National Reorganization, was a infamous campaign waged by Argentina’s military dictatorship against suspected left-wing political opponents.

An enforced disappearance is defined by several constituent elements:

1. Deprivation of liberty: where persons are arrested, detained or abducted against their will or otherwise deprived of their liberty.
2. Governmental responsibility for the act: in enforced disappearances, there are grounds for seeking governmental responsibility for the act, including of officials of different branches or levels of government or by organised groups or private individuals acting on behalf of, or with the support, direct or indirect, consent or acquiescence of, the government.
3. State’s refusal to take relevant action: such an act typically occurs in the context of a state’s continuous refusal to take relevant action, including refusal to disclose the fate or whereabouts of the persons concerned or refusal to acknowledge the deprivation of their liberty, which places such persons outside the protection of the law.

Enforced Disappearances in the recent times

• The Myanmar military is committed to suppressing the people’s movement, and the police are carrying out unimaginable acts of violence and oppression against those demanding freedom of expression and the restoration of democracy.
• In China, under the pretext of re-education to prevent terrorism, Uyghur minority ethnic group members are forcibly sent to what Chinese authorities call ‘vocational education and training centers’, with no information on their whereabouts.
• Sri Lanka has experienced more than three decades of domestic conflict accompanied by various forms of enforced disappearances.

Remedial measures

• Under the Declaration on the Protection of all Persons from Enforced Disappearance (1992), the Working Group works to assist families of disappeared persons to ascertain the fate and whereabouts of the disappeared and to assist and monitor states’ compliance.
• Additionally, with the assistance of the secretariat members based in Geneva, the Working Group monitors states’ compliance, and documented cases of enforced disappearance.
• The Working Group receives individual petitions from victims’ families and civil society members, and channels them through to the relevant governments to demand searches for the disappeared persons, investigations, and punishment for those responsible.
• The WGEID also presses states to offer remedies, including compensation and a guarantee of non-recurrence of the violations.
• Since its inception, the Working Group has transmitted a total of more than 50 thousand cases to more than 100 states – Unfortunately, the number of cases of enforced disappearances in Asian states is not decreasing and we are seeing a rapid increase in some countries.

International Convention for the Protection of all Persons from Enforced Disappearance in 2006

• International Convention for the Protection of all Persons from Enforced Disappearance in 2006, aimed at protecting the right to be free from enforced disappearances, became effective in 2010 and the Committee on Enforced Disappearances (CED) was established.
• CED and WGEID coexist side by side and seek to collaborate and coordinate their activities with a view to strengthen the joint efforts to prevent and eradicate enforced disappearances.
• The number of participating states in the International Convention for the Protection of all Persons from Enforced Disappearance in 2006, is still very low compared to other treaties.
• Among 63 member states of the treaty, only eight states from the Asia-Pacific region have ratified or acceded to the treaty.
• Only four East Asian states — Cambodia, Japan, Mongolia, and Sri Lanka have ratified it. India has signed the International Convention for the Protection of all Persons from Enforced Disappearance in 2006 but not ratified it.

Way Forward

• Enforced disappearance is a serious crime that goes against humanity. The pain and suffering of the family members do not end until they find out the fate or whereabouts of their loved ones.
• Asian countries should consider their obligations and responsibilities more seriously and reject a culture of impunity in order to eradicate enforced disappearances.
• The domestic criminal law systems are not sufficient to deal with the crime of enforced disappearance. It is a continuous crime that needs a comprehensive approach to fight against it.
• The international community must strengthen its efforts to eradicate enforced disappearances at the earliest.

-Source: The Hindu

Reforming medical education

Context:

• India’s health systems have been confronting numerous challenges. In order to effectively address these challenges, our health systems must be strengthened.
• NITI Aayog’s recently put across a proposal for allowing private entities to take over district hospitals for converting them into teaching hospitals with at least 150 seats. 

Relevance:

GS-II: Social Justice (Social Sector & Social Services, Education and Health related Issues)

Mains Questions:

1. How severe is the lack of sufficient workforce in healthcare sector in India? To what extent will NITI Aayog’s proposal of private involvement in taking over of hospitals to form teaching hospitals address the issue? (10 marks)
2. How has the Covid-19 pandemic affected the adequacy of healthcare workers in India? How can the issue be addressed? (10 marks)

Dimensions of the Article:

1. Current situation of inadequacy in Healthcare workforce
2. Similar Shortage of Engineers and the reform in 2000s
3. NITI Aayog’s proposal and issues with it
4. Way Forward

Current situation of inadequacy in Healthcare workforce

• India’s availability of doctors per thousand population does come close to the World Health Organisation’s prescribed doctor-patient ratio of 1:1000 if we include all the registered allopathic, homeopathic, ayurvedic and unani doctors. But the number of doctors who practise is much lower.
• It is also far lower than many countries including Russia, the USA, and all the European Union countries where the ratio is above 3 doctors per one thousand population. Unless we increase the ratio to the level of better performing countries on the health front, poor people in India will continue to suffer.
• As a major impediment for achieving the health-related Sustainable Development Goals (SDG) there is a serious shortage of health workers, especially doctors, in some northern States.
• Health workers are critical not just for the functioning of health systems but also for the preparedness of health systems in preventing, detecting and responding to threats posed by diseases such as COVID-19.
• The doctor-population ratio in northern States is far short of the required norm, while the southern States, barring Telangana, have enough doctors in possession- hence, the healthcare workforce crisis has been aggravated by the imbalances within the country.
• The problem of shortage of doctors and other support staff has been allowed to linger for the past several decades due to short-sighted policies of the institutions such as Medical Council of India

Medical Education as the building block of Health system

• Medical education is the bedrock on which the needs of ‘human resources for health’, one of the major building blocks of any health system, are met.
• Today’s health professionals are required to have knowledge, skills, and professionalism to provide safe, effective, efficient, timely, and affordable care to people.

Similar Shortage of Engineers and the reform in 2000s

• India faced a similar shortage of engineers through the 1990s when there were only 1,30,000 engineering seats on offer. But in 2000, the government dismantled the stranglehold of the engineering education regulatory body, AICTE, and reworked the regulatory framework that governed opening of engineering colleges. This resulted in an increase in the intake in engineering colleges by four times in just five years.
• Unfortunately, this kind of reform is yet to take place in medical education. As a result, shortages in medical seats still exist and students are, according to one estimate, collectively made to pay nearly 15,000 crores in capitation fee. Thousands of others line up to seek admission in countries such as China, Russia, Australia and many others, paying millions of dollars.

NITI Aayog’s proposal and issues with it

• NITI Aayog’s proposal for the taking over of district hospitals for converting them into teaching hospitals by private entities has reasons to be deeply concerned.
• The most important concern is that the private sector in medical education will be encouraged by the implementation of such a policy. Private players treat medical education as a business.
• It will also directly aid the corporatisation processes of healthcare provisioning while the under-resourced public health system will be a collateral damage.
• District hospitals are considered as the last resort for the poor.
• The corporatisation will make the services very costly and exclude them from getting care.
• Even from the perspective of producing more doctors to meet the shortages in under-served areas, this is unlikely to yield the desired result.
• Additionally, the medical graduates trained in such private sector ‘managed’ medical colleges will prefer to find employment in corporate hospitals and not in rural areas to regain their investment.
• Further, this proposal is not aligned with India’s national health policy goals like achieving universal health care and health equity. Instead, it will widen health inequalities further.

Way Forward

• The 500+ medical colleges in India have only over 75,000 seats for the MBBS course and only half these seats are in state-run medical colleges. If India has to achieve the doctor-patient ratio of 1:1,000, we need nearly 20 lakh more doctors by the year 2030.
• Time has come that we reform the medical education system, end the pervasive corruption in these regulatory institutions and ensure that we carry out the expansion in such a way that we produce the required number of doctors to look after our population.
• Today’s medical education should be able to groom such professionals to face medicine of the 21st century. The Lancet report, ‘Health Professionals for a new century: transforming health education to strengthen health systems in an interdependent world’ (2010) outlines key recommendations, to transform health professional education, needs to be looked upon.
• Extending teaching privileges to practising physicians and allowing e-learning tools will address the shortage of quality teachers across the system. Together, these reforms could double the existing medical seats without compromising on the quality of teaching.
• There should be a substantial step-up in public investment in medical education.
• By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to medical education.
• Besides, it must allocate adequate financial resources to strengthen the overall capacity of existing medical colleges to enrich student learning and improve output.

-Source: The Hindu