My romance with tigers and Tiger Reserves (TR) stayed undimmed. Notwithstanding the unstinted offering of the mother-son duo at Ranthambhore and mother-cub quadruplets at Pench and the charisma they exuded, my mind inexplicably was pinned more on the wild habitats. Long discussions with Rajesh Gopal, SP, and Himmat Negi had helped me appreciate the implications of long term ecological conservation through TRs. I read all that they offered to remove cobwebs in my woolly head. I went back to the Project Tiger (PT)’s origin, among the most ambitious conservation projects the world has seen, which in scale, size, and diversity of field operations and challenges, has no parallel.
It began in the early-1960s to protect tigers and its habitats. But it picked up speed under the then Prime Minister Indira Gandhi. An enthusiastic wildlife lover, she set up a Task Force in 1972 with Dr. Karan Singh as the Chair. On recommendations of the Task Force, 9 tiger reserves were identified and the PT had gotten under way. Today it’s grown into 50 TRs across 18 States encompassing nearly 40,340 sq. km of core and critical tiger habitat in the form of forests, meadows, mountains and scrubland. More than protecting the endangered species, it has morphed into a holistic ecosystem approach defining the core-buffer strategy, encompassing protection and development initiatives, and giving a new perspective to the concept of wildlife management in India. Today, it’s become a role model for conservationists worldwide.
In hindsight, PT was a master stroke. Indira Gandhi was clairvoyant to crystal gaze the implications of sculpting a measure of government-backed conservation of environment in the natural order of things, despite unavailability of firm data. Conservation of tiger has ecological significance transcending state and national boundaries. Tigers sit atop the ecological food-chain; their conservation cascades into overall wellness of all species of plants and animals populating the ecosystem. As territorial animals, tigers serve as barometers of forest ecosystem: a healthy tiger population suggests ecological wellness, much as an unhealthy population index is ecologically worrisome. Four decades since the launch of PT and its success, tigers continue to remain one of the world’s most endangered large predators.
Agricultural expansion and developmental priorities, revenge killings by people as sequel to man-animal conflicts, demand for tigers’ body parts and derivatives in the illegal global market make them very vulnerable. On the flip side, tiger conservation sets off several intangibles and life-supporting benefits. Forests act as carbon sinks, it grants Meso climate; the presence of continuous forest cover to a depth of ten kilometres impacts climate of nearby areas, even to a hundred kilometres – a phenomenon beneficial to both humans and crops as shield from climate extremes. There are several others too.
Image: S. P. Yadav
Problems stay, though. This is natural in a diverse country with a democratic, federal set-up. It takes time and energy to disabuse loads of transferred knowledge to deemed wisdom, when they aren’t necessarily wise or correct. One such is the belief that the traditional resource dependency of forest dwellers is benign. Not always so. Nature has over time changed from its primordial state and keeps changing, little by little, most unobtrusively, as everything else does; it is natural that all stakeholders need to calibrate their responses to these changes. Often with our human endeavor catalyzing changes, several distortions have crept in to misshape the forest dynamics itself. Demographic pressure shows as people chip away at forest’s edges. With just two percent of the world’s forest area, we support 17 percent of the global livestock and an equal percentage of humans. Nothing possibly is more challenging today than sustaining a system of viable protected areas in a country like India.
Developmental activities are another serious worry. It’s no one’s case that development shouldn’t happen. That’s not the issue. The point is how to ensure development without despoiling the ecosystem or if damage can’t be avoided, how about seeking appropriate by-passes to keep them virgin – pristine and viable? Sustainable development, the global much sexed-up term, like statistics, hides more than it reveals. Isn’t the dialectics of development versus environment unequal? Can an intangible environment ace the tangibles of development that you can literally hold in your hands, and even palpate? Given man’s natural impulse to improve his lot, isn’t this a David vs. Goliath dueling? How harshly things are pitted against ecosystems, I silently witnessed in one of the Chai pe Charchas. In the euphoria of government formation, Javadekar, mimicking Modi’s pre-election hype, had instituted a quotidian 9 o’clock morning meeting with Additional Secretaries/Additional DGs and above officers. Charcha (discussion) at 9 was anathema for most senior bureaucrats’ lifetime habits – it affronted their sense of dignity to show up at workplace on time!
The discussion veered around the road-widening and four-laning of NH7 between Kanhaand Pench TRs. Nitin Gadkari, the Road & Highways Minister had called, Javadekar said, enquiring after the status of clearance. Rajesh Gopal told Javadekar that the three suggested underpasses, each of 50 meters, are an apology for animal movement and not acceptable. Javadekar snapped, fraying: “When we can’t feed people, must we bother about wild animals!” A sepulchral silence descended on the assemblage. But Rajesh Gopal, sitting in one corner, held forth – as a true blue-blooded conservationist and India’s foremost hands-on tiger man (he’s presently Secretary General of the Global Tiger Forum, an intergovernmental international organisation, looking after all 13 tiger range countries of the world) would – unyieldingly, not letting go his emphasis on the acute need to protect the iconic tiger corridor, and belabouring the significance of the tiger gene pool.
The issue revolved around prioritising tiger conservation through landscape genetics and habitat linkages. The 150 km area between Pench and Kanha TRs extending eastward to Achanakmar is most critical for tiger gene flow of its population. Camera-trappings since 2006 have yearly recorded tiger dispersing, and with presence of gaur, sambar and chitalaffirming it as a vital tiger movement corridor. Field observers have further confirmed evidence of resident tigers. A sub-adult male tiger photo-captured in Pench TR in 2006 had become the territorial breeding male in Kanha TR in 2010! One study showed significant reduction in gene flow between TR pairs with degraded corridors (Kanha–Satpura, Kanha–Melghat and Melghat–Pench), while there wasn’t any significant change among TRs connected with forest corridors (Kanha–Pench, Satpura–Melghat and Pench–Satpura). With more than 13% of sampled tigers dispersing within the Kanha–Pench landscape in the last decade, developmental projects – widening of national highways and rail lines – will cleave the corridor with permanent barriers and affect connectivity big time. The corridor, an exemplar of two source tiger populations managed as one meta-population, will be dented. Environmentalists and foresters have, naturally, clamoured to ensure green infrastructure mitigation measures to keep it going.
The conversations didn’t go too well that day, but all along I was quietly mulling over the reality. By the time I trudged back to my room after the Charcha my mind was intuiting, seeking an answer. Sadly I realised that in an unequal battle between development and environment, with political parties indulging in hugger-mugger populism and optics, and least appreciating the need to equilibrate, the former shall always prevail. This makes Project Tiger all the more challenging and, paradoxically, also more relevant. The Environment vs. Development debate – exacerbating with bedevilling climate change, and manifesting in Nature’s quirky ways like serial tornados/hurricanes, rise in global temperature, wildfires, and downpour deluging deserts – is bound to surge exponentially in the years ahead.
The expansion of NH-7 on this 10 km stretch of road doubtless will impact Pench TR both in Maharashtra and Madhya Pradesh. It will destroy the corridor between two of India’s iconic TRs, Kanha to Pench – the locale of Rudyard Kipling’s Jungle Book – apart from impacting Navegaon-Nagzira TR, comprising five protected areas (PAs): Nagzira, New Nagzira, Koka, NavegaonNational Park, and Navegaon Wildlife Sanctuary. Around the time the matter was in the Courts, in March 2016 a group of 29 eminent scientists and conservationists, and many among them who had served on various statutory and expert committees, like the National Board for Wildlife (NBWL), NTCA, Forest Advisory Committee, WII etc. for decades, wrote to the NTCA and the WII, flagging critical ecological, legal and policy elements of the NH7 inter alia strongly urging to:
(i) Recommend to the High Court that mitigation measures as per the WII’s original May 2012 report are absolutely necessary and non-negotiable;
(ii) Address the issue where there is no overlap of the proposed mitigation measures with the identified animal crossing zones;
(iii) Recommend that the existing road below the recommended underpasses be decommissioned and the habitat be restored to natural conditions to allow wild animals to use the corridor in an unhindered manner; and,
(iv) Ensure that in the future, the principle of avoidance must be followed as per the NBWL Sub-Committee’s recommendations for roads in Protected Areas.
Image: S. P. Yadav
While work on the NH-7 was stalled by the National Green Tribunal, the Nagpur-bench of the Bombay High Court allowed road widening with the mitigating provision to construct a paltry 1.8 km of road bridges for animal movement. The Supreme Court upheld the High Court order, and in effect went against the recommendations of its own Central Empowered Committee (CEC), which had categorically said that “the ecological cost of the present project is immense and that no mitigation measures are adequate to compensate the same” since it would cause “irreparable damage to a critical wildlife habitat.” The CEC couldn’t have been more forthright. It stressed that the NH-7 work is among the exceptional cases where ecological security must take precedence over developmental concerns, even suggesting that rather than widening this critical stretch of road, the alternative route via Chhindwara could be explored. The moot point is: Can the fidelity of invisible eco-sensitive environmental concerns that may tote up to, say, 10 times more than the cost of developmental work, triumph over return on investment, optics, grandstanding, and instant hyperboles or jumla of perfervid patriotism? My fingers are crossed!
The impassioned plea of environmentalists has improved mitigation measures in this stretch of NH7 road, but only just. The latest information is that the length of animal underpass has been increased to 2,205 metres on Maharashtra side and 2,100 metres in Madhya Pradesh, with the height reduced to 5 metres from the original 7. I checked with eminent animal biologists like Rajesh Gopal who, as the former Field Director Kanha Tiger Reserve and Member Secretary NTCA, knows the terrain and animal behaviour like the back of his hand. They consider it as a compromise. Here was a chance for a country with the largest wild tiger population to demonstrate its commitment to conservation and infrastructure development to go in a complementary manner, but alas the mitigation didn’t happen that way!
Ironically, one such crisis not too long ago had acted the savior for Project Tiger. Sariskahad lost its tigers ostensibly to poaching, circa 2004. No tigers were being sighted in the TR; more alarmingly, there was no indirect evidence of tigers’ presence through pugmarks, scats or scratch marks on trees. Sariska (like Panna TR later) mercifully was successfully repopulated, but the shock rippled out, sounding warning bells in the highest quarters. On recommendations of the National Board for Wildlife chaired by the Prime Minister on March 17, 2005, a Task Force was set up to focus on tiger conservation and suggest improvement measures. The NTCA born in 2006, aimed at ratcheting up India’s confidence in the conservation of tiger, its national animal, was granted statutory and administrative powers, and obligated to submit PT annual report to the Parliament. Despite vicissitudes, it has happily lived up to the confidence reposed on it.
Continuing with Corbett Tiger Reserve (CTR), for me, another highlight was seeing the efficacy of Lantana eradication. Dr. C. R. Babu who joined us the morning next, showed me around the different areas in Dhikala and in Jhirna where Lantana grass, a biological invader, had been successfully eradicated, thereby facilitating habitat improvement and growth of natural grassland, so essential for the herbivores, and kick-starting the cycle of optimal ecosystem services.
Put simply, Lantana camara, the scientific name of Lantana, native to Central and South America, has invaded and wrought havoc across global tropical/sub-tropical regions. It has disrupted ecological services, affectinkng forest ecosystems benefits, and adversely shrunk wildlife habitats. The wild-lifers, if one may say so, have naturally strayed off their habitats, spurring frequent man-wildlife conflicts. Dr. Babu, Chairman of the Ministry’s Centre of Excellence – Centre for Environmental Management of Degraded Eco-Systems (CEMDE) – and his research team, working on Lantana’s taxonomy, biology and ecology, succeeded in evolving a simple but effective management strategy to contain this eco-scourge: extirpation of Lantana through cut rootstock method; weeding out of seedlings/young plants from bird droppings under perching trees and surface run-off channels; and eco-restoration of weed-free landscapes to native grasslands/forests. This was first tried out in CTR, and with resounding success.
Dr. Babu is a byword in the field of Lantana eradication. A month later, on a short visit to the ICFRE in Dehra Dun, after the official engagements, I found a couple of hours to myself. I snuck out to the Rajaji National Park. On the way the traffic slowed us down and by the time we reached the Park, it was pretty dark. In the headlights of the vehicle it was hard to see the habitat I was interested in. Instead, I settled discussing with the officers of the Park. I asked for the Annual Plan of Operations (APO) and browsed through it. Lantana removal was among the important activities in the Park, parenthetically to be carried out through the Dr. C.R. Babu style of Lantana-eradication! I was pleasantly surprised and happy. I came back and called Dr. Babu to compliment him that his Lantana-eradication technique has already been memorialised at the Rajaji National Park!
But staying with Lantana, I must confess that although Lantana is indeed a bio-invader and tells on habitats seriously damaging the grasslands, many wildlife experts evince widely varying sentiments. Foresters in Kanha Tiger Reserve for example seem rather paternalistic about Lantana, because as the story goes, many years ago a tiger had littered amid the Lantana weed and the sanguine sentiment has held. Similar sentiment could be found with others who temper it with obtuseness that of course Lantana, a bio-invader, cannot be allowed to overrun the park, and will need to be managed!
The issue of leveraging solar energy is of much salience in Tiger Reserves as I soon realised while visiting other reserves. Nowhere was its need perhaps more than in the Sunderbans Tiger Reserve (STR), a vast reserve spread across the humongous delta formed by several rivers flowing into the Bay of Bengal. Inscribed a UNESCO World Heritage site in 1997, STR is estimated at about 4,200 sq, km. Of these, about 1,700sq. km are water bodies in the form of rivers, canals and creeks, varying widely from just about a few meters to several kilometres.
The STR is intersected by a complex web of tidal waterways, mudflatsand small islands that are flush with mangrove forests. The interconnected network of waterways makes the mangrove forests – habitat of the eponymous Royal Bengal Tigers – mostly accessible by boats. They serve as crucial bio-protectors against floods and cyclones for inhabitants living in and around this substantial deltaic plateau. Not to forget that the national park sprawled out in this unique ecosystem acts both as lung and kidney in flushing out effluents and pollutants as the rivers drain out into the Bay.
Given the geography and topography of STR, the region seemed hostile in performing the arduous task of tiger protection. The four protection camps I visited – Kendo, Haldibari, Neti-Dhupani, and Dobanki – were way far out in the Bay where Forest Guards and Watchers live and work. Kendo is the last protection camp closest to the Bay of Bengal, about 90 kilometres (two hours by speedboat) away from Sajnekhali, which acts as the gateway to the Sunderbans National Park. Fairly inaccessible and with no population around, the protection camp had just about enough solar PV panels to illuminate the building with a few lights, but not enough to power a few fans.
The place in the midst of water is rather humid except during the winter months; the rest of the year the weather challenges them to their bones. The need to improve the living condition of the people manning these outposts was paramount. This is where solar power can help in a big way. I was pleasantly surprised that despite the inhospitable and challenging conditions, these people live and work day-in and day-out – their spirit was upbeat and their morale high. The Field Director, Soumitra Dasgupta, an Indian Forest Service officer of 1989 batch, [presently IG (Wildlife) in the Ministry of Environment, Forest and Climate Change – just the perfect fit to revamp the Wildlife Division],ever gung-ho, led by example and helped buoy their spirit – his passion and good cheer rubbing off on his officers and staff, and spurring them on.
I came away with the feeling that since these are non-family stations, to mitigate the problems of these personnel, we could consider granting them ration (as done for the police, the armed forces and the Special Tiger Protection Force) and separation/hardship allowances from the project funds. To boost the morale of these personnel, it would help if the possibility of even getting their families over to these places for short durations could be explored. Such inexpensive appliances like Mitti-cool, a refrigerator made of clay, that needs no electricity, could as well be considered to provide cool drinking water to people working in adverse and hostile environment. I am glad that we worked out the details and sanctioned ration allowance within a couple of months.
There was need, too, for a few more Floating Patrolling Camps in this waterscape, where water seemed the defining image in this vast landscape. With rain falling in buckets a good 6-7 months of the year, the difficulties of patrolling the national park seemed a big challenge. Quick and ready access to this remote and inaccessible topography, especially during the monsoon months, posed challenge to patrolling. We discussed this issue at length, almost at every patrol station we visited. Thinking aloud, I even suggested providing financial support for chopper service for monitoring, surveillance, and rescue operations on contractual basis from the PT funds, as and when the need arose.
The Kaziranga National Park (KNP) is yet another unique national park formed by a river – Brahmaputra -when it spills over its banks during monsoon and inundates the park. The receding river water leaves behind in its trail umpteen mudflats. KNP is home to a mega-biodiversity that includes the putative one-horned rhinos and tigers. Unfortunately, the rhinos are poached upon with the intent to harvest their horns that command astronomical prices in the international black market, purportedly for its aphrodisiac property. They are poached on all sides of the park. E-surveillance, the kind started in the Corbett Tiger Reserve to keep vigil 24×7, seems the only way forward here.
Of all the tiger reserves and national parks that I visited, Kaziranga is non-pareil. Standing on a watch tower, I surveyed hundreds upon hundreds of wild animals – rhinos, swamp deers, Hoolock Gibbons, elephants, pangolins, and a score of others I can’t put a name to – on the flat mudflats, as though served on a platter by an unstinting host! It was the closest to any wildlife African safari that any tiger reserve or national park in India could offer and was a feast for the eyes. Only the tiger was missing! And that’s what makes it so elusive and the reason why human beings hanker after it.
My visits to Kaziranga and Sundarbans, preceded by my earlier visit to Corbett, and coupled with my interface with sundry files that came to me in steady, timely schedule and the numerous discussions with the tiger-men helped me appreciate that tiger conservation encompassed a host of benefits not ordinarily known to the common man: clean air, clean water, more fish catch with higher fertility and productivity, employment and poverty alleviation to local population, and forest protection; also, that tiger conservation subsumes conservation of other flagship species like rhinoceros, elephants, and barasingha.
As I wound down my visit to Kaziranga and on the drive back to Guwahati, still rolling and processing my newly-acquired empirical experiences and the teeny-weeny bit I knew about Nature’s requite instinct, for no particular reason that I could figure out, I felt a faint disembodied thought of inadequacy colonising my mind. Hasn’t something inscrutable gone missing somewhere? I tried hard, but couldn’t. And then unbidden, quite serendipitously, it pitter-pattered in my mind; it wasn’t the inscrutability of the wild, but something more earthy and mundane: Ain’t calling our Centrally-Sponsored Scheme (CSS) by the eponymous rubric, Project Tiger, rather inadequate, diminishing the full import of the range of activities done under PT? Was that it? I asked myself. Yes, indeed. Hasn’t the time then come to more aptly call it, possibly even more unreservedly, something like Tiger Eco-System Services (TESS) that faithfully and fulsomely captures the range of activities done under the PT scheme to keep the forest eco-systems alive and uptick? I couldn’t help mutter my thoughts, and also said it in my tour note. I left it to the experts in Project Tiger to reflect over the suggestion.
This article is an exclusive extract from the author’s forthcoming memoir, Environment Through Finance Eyes.
Amid the farrago of lacklustre activities that informed the Ministry of Environment, Forests and Climate Change’s various divisions, with most things trundling along without a goal, there were a few bright spots that lifted my periodic blues. Among the brightest was the Project Tiger under the National Tiger Conservation Authority (NTCA), which continued quietly to do the good work it had been tasked to do the past many years. It was led by Rajesh Gopal, the Additional Director General and the Member Secretary of NTCA, an inspirational leader ably supported by a band of dedicated officers like Satya Prakash Yadav, DIG, and Himmat Singh Negi, IG, at the NTCA headquarters, apart from a string of passionate wildlife forest officers in the field spread across the country in the 50 Tiger Reserves.
Not many people in the Ministry understood what Project Tiger was doing. “Why do we place such an enormous amount of 180-odd crore rupees to care for the tigers?” one senior officer once asked me, out of wide-eyed curiosity and to improve his knowledge on the rationale of governmental spends on plan schemes. What he meant was why must we waste such huge sums feeding tigers – who at times also turn into man-eaters! – when possibly the same money could be better spent on other schemes for the impoverished.
To be fair, he didn’t say exactly that. But I got the drift of his question. I explained to him whatever little I knew. That the tiger is an umbrella species, and as top carnivores they play a crucial role in ordering and preserving landscapes in pristine form in its natural pecking order – thereby maintaining biodiversity. Once you care for the tiger population, other species, including co-predators and preys like smaller carnivores and the varying conglomerate of herbivores in the hierarchy, are taken care of, even down to the habitat and grasslands that herbivores feed off. Tigers in the wild sit atop the food chain, ensuring a bio-eco-balance that sets off a natural cascade among other carnivores (such as leopards), herbivores (like deer, antelopes, wild buffalo) and omnivores (like wild boars), and conserve healthy grassland; it is an evocative symbol of forest protection. Since tigers live in the deep wild, a healthy population of this territorial animal also ensures healthy forests that act as carbon sinks for all living beings on earth.
My words, telescoping vast landscapes with their natural offerings and efficacy on fauna and flora and the planet’s ecosystem to a few bald sentences, would naturally have sounded rather confusing to his disbelieving ears. He veered our conversation off to a different tangent. I wasn’t surprised.
The first time I ventured out to explore and understand Project Tiger in October 2013, I chose the Corbett Tiger Reserve (CTR) in Uttarakhand. It was close to Delhi and I could see the variety it offered to understand what Dr. C. R. Babu, Chairman of the Centre for Environmental Management of Degraded Eco-Systems – one of the Ministry’s Centres of Excellence – had earlier retailed to me: his success story in eradicating Lantana grass in Corbett. Satya Prakash Yadav (‘SP’ to me; ‘SPY’ to his batchmates!) accompanied me.
The Corbett Reserve is spread across 1,300 sq. km with the Ramganga River and two of its tributaries – Sonanadi and Pallain – flowing through it. Arriving at Kalagarh, we took the boat to reach Dhikala. During the monsoon, with this area pounded by incessant rain, Dhikala is completely cut off; the only way to get there from Kalagarh is the waterway. It highlighted the perils for the forest staff during the rainy season – these foot soldiers whose commitment and passion makes the difference in the cause of tiger conservation. Little do babus sitting in air conditioned chambers at New Delhi ever appreciate the efforts put in by these unsung frontline personnel when they seek a visit to the tiger reserves for a couple days to de-stress their minds.
A few things stand out in my memory from this visit. One was visiting the E-Surveillance Control Room at Kalagarh. E-surveillance was an innovative idea where 10 watch towers kept a 24/7 vigil over the area within their range through thermal and infra-red cameras. The pilot project, in its first year, seemed to be bearing fruits from the point of view of surveillance and anti-poaching activities. The Corbett Reserve was the designated field site for this pilot project. The southern boundary of the reserve – between Kalagarh and Dhela– abutting agricultural fields and human habitations, was highly porous. Unauthorised human ingress into these areas, as also of elephants and tigers entering human habitations and farmlands, often led to conflicts.
Once the broad parameters of the project were agreed upon, the Binomial team set upon designing the hardware and software. Detailed field surveys and discussions led to further refinements in system requirements and design. Finally, in 2012, e-Eye was born. The system comprised of a series of short range infra-red night vision and long range thermal camera stations, mounted on high towers. The cameras were connected to a central Control Room using WiMAX and remotely operated by authorised personnel. They had powerful zoom capabilities, panning and tilting and working even in adverse weather conditions. Power requirements were met with solar panels deployed at each tower location.
When the system finally went online, Corbett managers were pleasantly surprised with the outcome. The network of cameras covered an area of about 300 sq. km, tracking movements of any object over 20 kg body weight, and thus capable of detecting human movements as well as that of wild animals. Any kind of suspicious movement generated alerts, which were forwarded to field stations in the Reserve for appropriate action.
E-Eye also generated some fantastic images of various wild animals doing their own things but, more importantly, helped generate several alerts about human activity. Each of these alerts was responded to at the field level by Rapid Response Teams and periodically verified by senior officials, making sure that the integrity of such information was maintained. This was a direct deterrent on criminal activity. People illegally entering the forests could expect a team of field staff to swoop in on them shortly; it served as a huge psychological barrier for criminals. They were jittery of being tracked down and dealt with. This also boosted the confidence of the field staff. And, soon enough, a criminal with a proven track record in the Reserve area tried to damage one of the camera towers! He was caught on camera vandalising, quickly arrested and dealt with.
With an estimated initial cost of around Rs 3.5 crore, though, E-Eye didn’t come cheap. The hardware also needed periodic maintenance and upgrading, even the software required regular upgrades. This involved additional costs. The results though were very satisfactory, encouraging the NTCA to introduce it in Kaziranga Tiger Reserve where rhino poaching is a daily challenge. E-Eye is an excellent example of how scientific tools can be leveraged to strengthen field level protection. True, it is no substitute for traditional foot patrolling but surely can complement it. The fact that cameras keep a 24/7 vigil, regardless of weather conditions, helped monitor larger areas and deploy scarce human resource more strategically. Further, the system had huge potential for exploitation given the high volume of data it generated. It could monitor potential human-wildlife conflict, as also when elephants and tigers moved outside the reserve, alerting villagers of such movements, and with the Rapid Response teams averting any untoward incidents. E-Eye has opened up possibilities; with its unwavering eye, tigers, elephants, rhinos and other endangered animals can now breathe easy and have a run of their habitat!
(Reproduced from the Indus Dictum, where it was first published)
Pause and run the proposed PPP model through a patient’s/caregiver’s lens. The usual gripe against private hospitals holds: all-round over-invoicing, billowing especially during ICU stays when patients are out-of-bounds for caregivers; blood drawn many times over at the same time, expensive medicines administered on the same day/time that impugns maximum prescribed doses; generic drug not administered even when available and branded ones used instead; wanton diagnostic tests, and a plethora of other glaring incongruence that breaches every known medical ethics and moral vocabulary. Hospitals claiming to touch people’s lives indulge in every possible shenanigan and skullduggery to maximise profit. The list is endless. Healthcare today is a smart industry and health-tourism is the buzzword. “Practice two things in your dealings with disease: either help or do not harm the patient” – a part of the Hippocratic Oath – has evanesced, long forgotten. I feel queasy.
Cut to the chase for poor patients. “There will be no reserved beds or no quota of beds for free services,” says the Niti Aayog. “The State Government can refer as many patients as it can up to the capacity available in the Project facility.” How on earth is that going to happen without funds in the government kitty? In effect, the patients fall back on the PHC – now rendered more decrepit before the other PPP-half – for lesser mortals. Two treatment standards, we’re back to square one – India and Bharat!
Interestingly, on the issue of coronary stents brought out in Part-II of this seriesyesterday, with companies manufacturing coronary stents in India reportedly creating an artificial shortage in market/hospitals in the wake of price capping in February 2017, the Department of Pharmaceuticals (DoP) has, in its order of September 27, 2017, invoked Section 3 (i) of DPCO, 2013 that empowers the Government to “achieve adequate availability and to regulate the distribution of drugs, in case of emergency or in circumstances of urgency or in case of non-commercial use in public interest, direct any manufacturer of any active pharmaceutical ingredient or bulk drug or formulation to increase the production and to sell such active pharmaceutical ingredient or bulk drug to such other manufacturer(s) of formulations and to direct formulators to sell the formulations to institutions, hospitals or any agency as the case may be.”
The DoP has directed the companies manufacturing coronary stents in India to:
Maintain production/import/supply of the coronary stents;
Submit a weekly report on coronary stents produced and distributed. They will also submit a weekly production plan for the next week to NPPA and DCGI.
The DoP has also empowered NPPA and DCGI to extend these directions to any other producers of coronary stents in India during this three-month period. This order will be valid for three months (except for Absorb Classic BVS and Absorb GT I BVS stents of Abbott Healthcare) and NPPA and DCGI will recommend withdrawal or extension as the case may be, two weeks before the expiry of the period.
Abbott’s (one of the global behemoths in healthcare) Absorb and Absorb Gt1 Bioresorbable Vascular Scaffold (BVS) is another dodgy saga with safety concerns and issues of clinical trial red-flagged by drug regulators across the world, among them the US, EU, Denmark, Japan and Australia, as widely reported in the media. Adding to this in India was their reluctance to comply with NPPA’s price cap order. To quote a Times of India report of early-September 2017: “A few cardiologists in India, closely identified with promoting these stents, had opposed price control of bioresorbable stents, which sold at about Rs 1.9 lakh before the Rs 31,000 cap imposed by the drug pricing authority. In the US, the price was about $1,500 or about Rs 1 lakh and in Europe it was even lower at about 900 Euros. The use of bioresorbable stents in India was more than five times as high as in developed countries, but there has been no investigation into the safety of patients implanted with these devices.”
Two other different, but related, issues suck. Recall the substantial increase in the Mediclaim premium this year over last year’s rate. So, either the citizen pays directly or the government pays courtesy citizen’s taxes. Add the draft pharmaceutical policy by the department of pharmaceuticals now in the works, with focus not on controllingbut on regulating drug prices – quite in line with the Aayog’s proposal to delink the Drug Price Control Order from the National List of Essential Medicines – and you’ll wonder if World Bank’s unseen hand isn’t on an overdrive. Sylvia Karpagam in a recent piece in The Wire has shown the abysmal failure of the PPP model in Rajiv Gandhi Super-Speciality Hospital for tertiary care in Karnataka’s Raichur district and theKaruna Trust for 80 primary healthcare centres across eight States. Intuitively, our Indian healthcare and compassion – a baffling mix of the sublime, the profane and the gratuitous (avarice) – in times of madcap upward material mobility in a consumerist era trumps doctors’ nobility towards patients. Hippocratic Oath is out the window!
My much-harried friend and batch-mate, a Chief District Medical Officer and a subject specialist, works round-the-clock and earns salary that is less than my government pension. Little wonder the rampant absenteeism of government doctors lies in poor remuneration and the urge to indulge in private practice at sufferance of their job responsibility. Couple this with bureaucratic supremacist spirit – a colonial legacy that epitomises our feudal mindset – which belittles their human dignity, and you’ll appreciate their callousness.
The way to go is to incentivise them “commensurate with existing market conditions” (Aayog’s words, not mine!) and create facilities that private entities would with PPP-pinned funds, rid the chalta hai attitude, invoke an arm’s length system to transparently and measurably monitor, and hold them accountable, and watch the changes. I see no reason why, in the same district locale, they’ll bite WB-Aayog’s PPP bait, not the socially-inclined and socially-respectable governments. With doctor’s commissions for diagnostic tests/procedures de-incentivised, the patients will likely be spared the fleecing that many corporate hospitals indulge in today. And compassion will likely coalesce with healthcare; doctors will heal patients – those God’s children on a worldly visit!
This is yet far from complete. For, unsurprisingly, we have lately added another, a fifth estate to our democratic construct not limited to the putative fifth column of immorality and post-truth – beyond the bought-out press, paid news, fake news, advertorial news – that Gauri Lankesh’s death has driven home: ELIMINATION! No need for hyperventilation in entrepôts of raucous cacophony in select TV studios; extirpate the root, so that the voices of such humans are shushed for good. And all this in times of smart histrionics, of bluff and bluster spoken in high octaves! Goebbels sure will be turning and blanching in his grave for his lack of innate smarts! Are we now living in a new Republic of the Fifth Column! Pity the protagonists do not realise ideas are bullet-proof, amenable to traversing time, space and distance – there for keeps!
Academic plagiarism has assumed menacing proportions. The cases are galore – with the list bearing names of many eminences conferred with Padma awards and more. Modesty forbids me from spelling out the names and their tales. But I must state what I, as a member of the UGC-appointed Committee, recently witnessed firsthand: how plagiarism by the former VC of Pondicherry University (subsequently dismissed) has wrought irreparable damage on a university. The malaise is all over. One wonders how much with growing awareness and vigil, plagiarism detection tools like Turnitin and Copyscapes et al, can fix this malaise.
I am inclined to believe (now more or less convinced) that perhaps the deterrence to such potential recklessness lies in tightening governance’s value system. Maybe, an arm’s-length system and an Ombudsman to oversee operations coupled with zero-tolerance to dishonesty and corruption are necessary to bring about ethics in public governance. Yet, given extant obfuscation and opacity, will it be enough to stymie unholy impulses? Will leveraging contemporary technology to bring citizens face to face with governance help? Will such an interface, not ex-ante but ex-post ‘oversight’ governance, aid stakeholders to see for themselves the processes and rationale of decision-making that is already available under Section 4 of the RTI Act, 2005, as proactive disclosure. Never mind the Delhi High Court’s ruling keeping the Attorney General out of the RTI’s purview and the Supreme Court remaining implacably opposed to render itself transparent on personal details of public interest, as evidenced in smothering CIC’s order to part with information under the RTI Act.
Is transparency, then, the answer? Will it help to offer on a platter official document in public domain post-decisions for citizen ombudsman? Will the fear of exposé – disciplinary action and social disapproval for “wrongful acts” – deter unsavory impulses? Possibly, yes; no one likes to be proceeded against; we live on self-respect and dignity amid a 24/7 media. We’ve the technology and we’ve the besetting issue of dishonesty that refuses to die. Sunlight, it seems, is the best and maybe the onlydisinfectant for public acts.
At the cost of sounding presumptuous, I would say en passant that when I took over as the Controller General of Defence Accounts to helm the Department looking after the financial management and internal audit of the entire Government of India defense budget outlay of approx Rs 3.4 lakh crore, I invoked transparency. All relevant official documents, all pesky issues of officers’ placement and spends from taxpayers’ money were uploaded. It was bloodless; but it had a magical effect. Disaffection with placements was eliminated, with the networkers exposed and running for cover; unnecessary, wasteful expenditures were arrested, with everyone privy to ways of the corrupt and the nepotistic; and with each checkmating the other. Alas, once I moved over to the Ministry of Defence, transparency was given a royal heave-ho and opacity granted its pride of honour!
Leveraging technology to invoke openness and transparency is an option – a culture of transparency seems the viable answer to curb corruption in public life. But it is nuanced, multilayered. It’ll need tempering through accountability, an effective check and balance mechanism, an arm’s length system not open to tweaking by any public functionary, not to forget public discussions to rework and re-engineer the entire architecture of governance processes to introduce the moral vocabulary sorely missing in public governance. Be you ever so high, the law is above you, as the 17th century English church man and historian Thomas Fuller would say. It’ll take time but a beginning must be made. Political will is the key. But will that be forthcoming? And I wonder how relevant our experiential existential formula is today: Experience = CL (Capacity to Learn) x DL (Desire to Learn) x No. of years of service!
