Neglected Villages

One thing is common in every village in India. The gutter flows in the middle of the road! You will find that every household has a water tap just outside its main door. Obviously, when the water comes, most of the activities connected with water takes place just outside the main door – filling drinking water, cleaning of clothes and utensils and taking water in buckets for water storage inside the house. Since there are no drainages water flows in the middle of the road and over a period of time takes the shape of a gutter.

The funniest part is that villagers just do not mind it. Otherwise they would have done something about it. Just the excitement of getting water at the door step is so high, they are happy to live with the gutter in the middle of the road.

This causes no problem to the bullock cart or the tractor. Those who have motor bikes they enjoy the adventure ride of finding their way out of the mess.

This open gutter is the happy living habitat for mosquitoes. Villagers do not mind them as well. Because many of them are just not aware that this is the cause of illness prevailing in their village.

Young people who have got exposure to towns and cities move there. They find that the living conditions are little better (at least there is no gutter in the middle of the road, they have been pushed to the sides of the road).

Government officials are just not concerned with this state of affairs. They have their own problems. They are busy in getting a posting to headquarters or bigger towns.

Even today more than 50% of people in India live in villages. Rural infrastructure which serves these people, that is half of the country, is in total disarray. 

Rural infrastructure comprises of small local projects with long gestation periods. Whenever we talk about villages we tend to confuse the issue with agriculture and start talking about irrigation projects, animal husbandry, soil conservation, cropping pattern, irrigation techniques and more such things. What about the people who live there?

People living in the cities view the villagers as only the producers of agricultural goods. Some of us think that villages are good places because there is no pollution. There is a kind of glamour associated with the concept of a village. It is alright to go to a village for a few days and return. How many of us would really stay back in villages – given the living conditions.

You ask anyone to talk about villages and they will say villages are the strength of our economy. You can live without technology but not without food.

Are we doing anything for the villagers who live there? Do we really care for them?

You will find that children in villages are malnourished. There are no good hospitals around. If anyone falls sick there are no doctors – sometimes up to 50 kilometers. There are no educational institutions in a cluster of villages. Children have to walk many kilometers to go to a school. Access roads are in bad shape. Transportation and communication facilities are worse. It is fashionable to point out a mobile in the hands of poor villagers, but what about the network? What about electricity to charge the mobile?

One of the most important aspect of life in a village is the dominance of rich farmers and their terror. There is hardly any policing in many of these villages. Villagers live in abject fear of these new lords. Freedom of expression and right to live are the words they have never heard of.

There is a total polarization in the name of caste and religion. Identity politics is at the forefront of a villager’s life. What have we done to free villagers from the clutches of this identity politics? Politicians from the city are happy to exploit and play vote bank politics when elections come.

People in the cities have a kind of patronizing attitude towards villagers. When students from villages go to nearby cities and towns they are made fun of because of their simple way of living and thinking.

If we continue to neglect villages, the migration from the village to the city will increase many fold. Already our cities are bursting at the seams. There is not enough infrastructure to support citizens who are already living there. It is better to provide a good life in the villages so that reverse migration takes place. No one living in the slums is enjoying the sub-human conditions of life there. They will go to their villages where they have their land and family properties. What they do not have is the liquid cash which they so easily earn in cities.

We need to provide employment opportunities in the villages where they can supplement their agriculture income with other means of livelihood. The talent in the villages, if properly honed, can bring a revolution in the economy.

There is a need to provide low cost and clean homes to people living in a village. How long they will live in ill designed mud houses? There is a clear need for innovation here where bright students of IITs and NITs design affordable houses for the poor using locally available resources. The size and scope of the market is very big. Where are our incubators who will promote innovative businesses? This is one sector where big builders of cities will never venture.

Villagers suffer because of mindless deforestation. They suffer because they are never taken into account while setting up industries in their vicinity, or starting some mining activities. They are not made partners in the development process. They did not know that they were sitting on a gold mine. Their lands are purchased at throw away prices using political reach and new buyers make money. A son-in-law of our national leader had been occupying eyeballs lately on television channels for the same reason.

Development of villages does not mean urbanization of villages. Development of villages means providing them with basic education and healthcare facilities, giving them hygienic living conditions and creating employment opportunities there. They are not asking for food security and free medicines. They want to live in dignity.

Currently what is going on is the exploitation of villages. How long they will suffer and provide you with food security?

There is an urgent need to bridge this gap between urban India and rural India – popularly known as the gap between India and Bharat. It is not ‘India that is Bharat’ but it is ‘Bharat that is known as India’ to the outside world. The mindset of ‘India’ has converted ‘inlands’ of Bharat into killing fields.

As long as we have leaders who are comfortable in the environments of United Nations and IMF we will continue to increase this gap. We need son of soils to lead this country. We do not leaders who blame the whole world for bad economic conditions and corruption in the country. We need leaders who understand our ‘inlands’ and take care of them.

Let the care revolution for the ‘Bharat’ begin, NOW!

Health care hazards

I was told in my childhood, ‘health is wealth’. I remember my father was so strict about daily exercise that if we brothers do not go for morning jog we were not allowed to take breakfasts. Based on our stamina he had assigned a number of rounds for us and we were to complete those many rounds. No excuses were acceptable. We were fortunate to live in Gandhi Sagar, Madhya Pradesh in a government colony and we were brought up in a very healthy, hygienic and serene environments of Chambal Ghati.

For past 32 years Mumbai has become my home. I live in Juhu scheme which is supposed to be one of the best areas in Mumbai to live in. It is surrounded by Mumbai’s jewels of slums and nallahs. These nallahs make their presence felt and even from a distance of 500 meters you can smell them. But there are people who just do not mind these smells and have occupied both the banks and have created their hutments. There are more people living in those hutments than people in high rise buildings. I am sure their hygienic condition is world class and no one in the government is worried about their health!

In our country the word ‘hygiene’ has no meaning. We do not teach our students about hygienic living conditions neither we teach our children the importance of hygienic living. It is only when we are accompanied by some foreign nationals we become embarrassed when they notice these conditions. But we applaud when someone makes a movie ‘Slum-dog millionaire’ and goes on to win Oscar award.

If you just take an aerial survey of Mumbai you will find that more than 70% of human habitat is made of slums and hutments with no concern for health and hygiene. I am sure every other city in India is competing with Mumbai in creating bigger and better slums!If this is the condition of ‘glamour city’ Mumbai we can imagine what is going on in other towns and villages. And Modiji wants to convert these unhygienic cities and towns into ‘smart cities’!!

Talking about health care in such living conditions may seem like a propaganda. There are always long queues of patients in the clinics near slums with basic ailments like diarrhoea, cold, fever. We have created the best conditions for mosquitoes to thrive and then we complain about malaria!

But there is a health ministry in the government and they are duty bound to spend money allocated to them in the annual budget. Therefore we have government hospitals, municipal hospitals where in the name of health care some activities are done sometimes without medicines. The poor state of governmental healthcare system has been the result of total apathy over the years. This is a clear case of bad monitoring and "corruption" in the system.Government of India considers as its duty to provide primary healthcare to its citizens. In the scheme of things it is the duty of the state governments to provide this service. Central government is supposed to contribute to family welfare and disease control programs. When we look at the role of the government in health care, we find three clear deficiencies. First, there has been absolutely inadequate investment in the public health infrastructure which provides a very low coverage to the poor.

Secondly, government has failed to monitor the operations of dispensaries and hospitals run by it. There are few doctors in the hospitals and those who are recruited have their priorities elsewhere. They are happy to provide consultancy in their private capacity and in their private time but are not willing to show the same level of skill during their duty hours. Third, due to lack of qualified doctors in interior areas of the country, quacks have a field day. There is no efficient and effective mechanism to get rid of these quacks. They are accepted in the system because they fill the gaps in the healthcare system.

These three things have ruined the health and economic conditions of the rural poor. They spend from whatever resources they have for their health but suffer due to incompetence of the system. They get hit in both ways: by the continuation of their illness and total economic ruination.

It is not that people who are entrusted with this responsibility do not know about it. They simply do not care. They have a pensionable job and good enough resources to take care of their family needs. They are not worried by the repeated visits these rural poor make to various hospitals and finally landing in the trap of a private hospital. They take pride in the long queues of the government hospitals because it inflates their number to be submitted to the government. That they are providing health care to so many people.

A poor patient, without any connections to the influential, waits for registration, faces the impact of inadequate supply of drugs and lack of treatment facilities. Staff in these hospitals come and go at their own free will and remain indifferent towards poor patients.There is no stated policy for the role of private sector in the provision of health care. Private practice by doctors, private health care clinics and super-speciality hospitals have grown in a big way to fill the void created by inefficient government sector. Most of the private practice is in the hands of doctors who treat this as another profession to make money and have created systems of cut-practice (sharing money on referrals). If any patient reaches them for health problems he gets treatment but at a higher cost – because he is the most welcome source for funding EMIs for the car and house.

Private hospitals and nursing homes run like business ventures. They look at the occupancy levels of their beds like a hotel. Because occupied beds generate revenue for the doctors and the hospital itself. They will go to any extent to keep these occupancy levels high – even admitting patients when clearly not required.

There is a network of private practitioners, diagnostic centres and private hospitals who feed each other. They thrive on the need of the patients. These patients cough up huge amounts of money for basic health care. It does not matter to those who can afford the cost. They would never visit a government or a municipal hospital because there is a huge difference in the level of cleanliness and hygiene in the private hospitals and government hospitals.We can see the tremendous gap in the healthcare services available to rural and urban Indians. We can see world-class five-star hospitals in various cities across the country. We can hear the talk of encouraging medical tourism for the foreign nationals. At the same time facilities in rural India deteriorates.

The rural healthcare service delivery has been severely compromised. Major advances in medical science have hardly touched the rural poor. They continue to die in large numbers from preventable illnesses like tuberculosis, gastroenteritis and malaria.

Most of this private practice is concentrated in big cities because it provides a good catchment area for doctors where patients have paying capability. Rarely will we find qualified and good doctors practising in villages and tribal areas. Poor in villages can hardly afford the cost of hospitalization. One major illness in the family destroys the financial security of the whole family. Many farmers have committed suicide because they could not pay back loans which was utilized for taking care for the sick in the family rather than for productive purposes. One major illness pushes the family in the debt trap. The lack of trust between patients and doctors/hospitals has reached alarming proportions. No doctor can survive in practice today without insuring his practice. Governments need to create a good infrastructure to bridge this trust deficit.

There is a need to involve private sector in a big way in creation of health care infrastructure which provides health care facilities at the affordable cost. There are industries in many districts of the country. These people have created hospitals and dispensaries for their own staff. These business houses may be involved to support cluster of villages and district hospitals. With the passing of new companies bill in the parliament where there is a provision of corporate social responsibility, companies may be asked to participate in this private-public health care system.

Companies will benefit by earning goodwill of the local population. The country will get an affordable and efficient health care system.

All these efforts will be of hardly any use if we continue to have lack of good sanitation and safe drinking water. There is a need to distinguish between health and health care. If we do not provide healthy living conditions – which is the precondition to good health, all efforts in providing good health care would remain inadequate.

If we do not make our health care system affordable soon we will be in the trap of health insurance companies. Insurance business can expand only if the health care is too expensive. If governments do not create affordable health care service now they will be forced to pay for insurance of people below poverty line. The money which could be used for creating infrastructure will be sucked into financing the health care system.

Because health care has not been an election issue, politicians once elected rarely pay any attention to it. Citizens will have to be aggressive to bring ‘Achche Din’ in the health sector. They need to pressurize political leaders to create well maintained, well-staffed and functioning health infrastructure at all levels. This only can help break the cycle of poverty and disease. Greater access to health care facilities will help improve health as well as economic conditions of the poor. The time has come to reclaim public health and make a paradigm shift from a policy-based entitlement for healthcare to a rights based entitlement. And please do not enact another law for ‘right to health’. We have to create sensitivity in the minds of the political class. We do not want health care on the paper but on the ground.

We don’t want to convert demographic dividend into the largest sick reserve of the world. We must grasp the urgency to provide a good health care and hygienic environment to all the citizens of the country. This is the only way to bring ‘Achche Din’ for good health of Indian citizens and overcome health care hazards.

Change, We Must

Change, we must if we have to survive as a nation. We have to change the ways of looking at things. Then only we will be able to bring ‘Achche Din’. Only people with frog-in-the-well mentality would not attempt to change even now.

The question is: how we can bring about this change? Is it possible to change when various interest groups are operating at various levels? How do we overcome personal, community and organizational barriers? How do we overcome the impulses to go on rampage and destroy public property when we are in a mob?

Today, we find that people are willing to go to any length to subvert the system for selfish gains even at the cost of national interest. The dominant mode of thinking today is power acquisition and money accumulation. This change has not happened overnight. This was a slow and continuous process and if we look back it will be difficult to isolate a single reason responsible for this change.

Somehow we have failed to create a framework for a strong nation made of a caring society, a caring business, a caring police force, a caring leadership, a caring motorist and even a caring neighbourhood. Today, every citizen of this country is looking for a turn around – the ‘Achche Din’. One can see a visible expression on every body’s face, in their body language: CARE FOR ME.

India needs to do something to get out of this rut. The mindset of each citizen has to change from ‘I don't care to I do’. India's agenda has to change. India needs a care revolution, NOW!

The care revolution is essential to bring in ‘Achche Din’, to usher an era of economic development, poverty eradication, reducing social tensions. Even though wrecked by political perplexity and global pressures, our nation can display a remarkable resilience, provided we care.

We will have to look within and do what we can. India's cultural roots have caring as its ethos. India and her people are famous for tolerance because they care about others. The caring attitude of us Indians manifest itself in our day - to - day family life. The point is, can we bring this caring attitude in the open?

‘Achche Din’ would be possible if we all take initiatives. A caring attitude will enable Indians to win whatever be the emerging opportunities. We will have to overcome the tendency to have quick-fix solutions to every problem. Fire fighting is often due to carelessness, poor housekeeping, and a chaotic style of functioning.

The society must enable the individual to carry out his/her obligations to the society by properly educating him/her. Care has to become integrated to strategic plans in all spheres of our life. Managing with care would become a way of life in every function and at every level. We will have to overcome the attitude of indifference and eliminate the associated costs. The desire to give our best has to be paramount.

The role of the government would be to create a conducive environment for this care revolution, setting a kind of example for others to emulate. Corporate houses have responsibility to the environment and the society in which their companies operate. Farmers and villages, where the plants exist, view the business house as a monster who would eat up their land. This can be overcome by the commitment to the rural development. The confidence and trust of the villager is very crucial.

The life of the common man can become easier if following points are taken care of immediately:

· Reduce paper work to make it easier.
· Reduce the time spent while waiting in offices.
· Identify steps that can be merged or eliminated altogether.
· Provide information and reduce transaction times.

There is no doubt that we can bring ‘Achche Din’ – with Mr. Modi or even when he is not around. The government, industry and education managers in India have open minds and the ability to comprehend. There is no problem with the individual Indian either. They are bright and quick. Any people who can make lunch box distribution scheme in Mumbai successful can compete anywhere.

The agenda for the nation would be that the leaders in government become personal example of care. That they create facilities where there is scarcity of basic services. That they provide education to all. That they create infrastructure for nation’s development. That they become facilitators - not administrators - in economic progress.

That the leaders in business issue care policies for their organizations saying, “We will deliver products and services to our customer on-time, as promised and with care. That they provide education and training to the people working with them. That they go back to their cultural roots and recognize the concept embedded in “Atithi Devo Bhava”.

With the support of universal knowledge and our heritage, we shall create a caring society which will excel all its past glories and will enable every citizen in its fold to develop his or her manifold latent potentialities. We will have to undertake the task of awakening our nation’s soul. The care revolution would give us strength to succeed in this task.

And this will bring ‘Achche Din’ for all of us, the eternal hope shall be fulfilled.

The Eternal Hope

‘Achche Din Aane Waale Hain’ said Dr Manmohan Singh on January 8, 2014 while addressing a gathering of non-resident Indians in Delhi. Actually he said it in English - "Yes we are facing bad days now but the good days will be coming in soon”. Mr. Narendra Modi, while speaking to the same audience next day, used the Hindi version. At that time even he did not know that this slogan is going to impact the outcome of coming parliamentary election in a big way and raise the hopes and aspirations of 125 crore Indians. He could not foresee that the same slogan would become the biggest handle to run him down and will be used derisively against him by his opponents and critics.

Achche Din – the eternal hope means to anticipate a future with a confident expectation of its fulfilment. But hope alone cannot make this anticipated future possible. Narendra Modi appeared to be a Messiah who would make this future possible. We all need to contribute to make this possible. Mr. Rahul Gandhi’s words seem prophetic when he said, “one man alone cannot bring this change”.

I am sure people realize the enormity of the task at hand. I can feel what must be going through the mind of Mr. Modi when in spite of working so hard, he has to face this criticism. I became Director of a management institute at around the same time Mr. Modi took over the rein of the country. The Institute was in doldrums, even the trustees of the Institute would not recommend this place to their friends for higher studies. After working on the infrastructure, the changes in the faculty, training of the faculty, changing the mindset of students who would not care less – I realize that it will take another 3-4 years for actual outcomes to show a significant difference and influence the ranking of the institution. And Mr. Modi is running a country with problems inherited since last 1000 years, let alone 68 years of mostly Congress government!!

We know that indifference and corruption is ruling the roost in our country. Indifference is destroying government offices and government supported infrastructure. Indian business is mired in mediocrity. Indifference is sucking away corporate profits. When we look within, we find that a set of habits and practices cultivated over a period of time has shaped the performance of individuals and organizations in independent India. We find that procedures and systems have developed in a way to sustain inefficiency and a casual way of looking at things. The public behavior of Indian people in modern India gives rise to a question - Do we have any system or any concept of public and community living?

How long can Indian people tolerate this terrible indifference? How long will it take for Indian companies to be elbowed out altogether by multinationals who use management principles which we have not yet even begun to grasp? How long will it take for all our systems to collapse?

What can India do to change the perception that 'Indians just don't care'?