Sunday, March 31, 2013

Good Friday church sitting arrangement

The steward shooed him away to make room for me. I protested but it was too late. So, I sat in the front row. It was Good Friday at church; the day when the death of Christ is remembered. I tried to connect the significance of Good Friday with what the steward just did; and it left me with a feeling much deeper than uncomfortable.
The front rows in our churches have become reserved for the so-called ‘VIPs’ of our society. The social stratification of our society gets played out in our church sitting arrangements. Church has failed to be a place of counter-culture; a place where people feel equal, if only for a few hours every week. So, it is understood and accepted that some people are of more value than others. This value of people is assessed on the basis of possession of material wealth or college degree. Who in heaven or earth has taught us that these are the measuring rods of human worth?

God made us all in his image: the poor and the rich, the educated and the uneducated, the slave and the free, men and women. No one has he made with any special material that they be more valued than others. In sin, we all fell; and so in redemption, Christ died for all without exception.

God knows what we have become. He knows that some people are treated like sub-humans. He sees the injustice, the perpetrators and the oppressed. So, his equal love for all humans turns into his preferential compassion for the downtrodden. His justice for the injustice requires him to go soft on the oppressed and come down hard on the oppressors. Those who seek to know the heartbeat of God will be pained by the things that hurt God and do what God would in the face of such injustice. 

I don't claim moral superiority for I know how often I fall. But after church service, I did apologize to the man who was shooed away.

Tuesday, March 26, 2013

The thought of writing a book

I have written articles, some short and some long. But do I have what it takes to write a book? The question is mind consuming. 

If I think of what I know and write down whatever comes to mind, I can fill up a book. I think I can write a better book than some local people who has books in their names. But that is not what concerns me.

Will I be able to write a book that I would love to read? Can I write a book which is really worth publishing? Can I attain the level that I expect of myself? That is what bothers me. It is not just about having a book in my name. 

To be honest, I really don’t know that much about anything. Take the topic of health, for example. I have written a number of articles on health. But if some readers are to put them together and critically analyze, I have just been revolving around a handful of points. Take another example, Christian faith/theology, the next most common topic I have written on. There too, it is not too many points I keep repeating. I hope some renowned writer will reassure me that this apprehension I have is uncalled-for. I wish they say, ‘we feel the same whenever we start any book project. We start with a blank page’. 

A realistic plan for the nearer future will be to polish and publish this thatched house blog. The cover design will be exactly the blog home page, as it looks in the computer. The articles here will amount to a reasonably thick book. Will it be worth publishing?

Sunday, March 24, 2013

Some blogging tips

‘Go forth and blog’. Pope Benedict to his priests

Blogging is exciting. You have flexibility and total control over your blog. You can blog about anything, at any time, at any length. So, first, there are no rules on blogging. However, I would like to share some tips that I shared with a friend who was considering to start a blog:

1.    Don’t worry what you should blog about. Don’t worry if a thousand books have already been written on the topic you have in mind. No two people read the same book. No two people see the same thing.

2.    First sentence is so important. You can lose readers with a bad first line. OK, you witnessed a shootout on your way to college and you want to share it. If you start by saying how your day began, what clothes you were wearing that day, or what the definition of a ‘shootout’ is; you can make the gunfight seem boring. Instead, you can start with something like ‘Bang bang!’ (Writing a story doesn’t have to always start from the beginning). If you have read Pride and Prejudice by Jane Austen, the first sentence sets the tone for the entire novel.

3.    Write short sentences. A one word sentence can do wonders. If your readers have to catch their breath to complete your sentences, you will exhaust and lose them.

4.    Like a steady stream of water, let a sentence flow to the next. Maintain a flow and carry your readers along. Don’t lose them midway. Try to take them to the end.

5.    Never fall in love with your first draft. Edit, edit, edit. Sleep over it. Edit again.

6.    Don’t just write. Show people. Let readers see, visualize, imagine what you are saying.

7.    Don’t draw attention to yourself. Draw readers to what you are saying. Some writers can be self-centred and write for self gratification than care for the readers.

8.    Be interesting. But don’t try too hard. Trying too hard to be funny can take the life out of a good joke.

9.    Good writing is simple ABC: Accuracy, Brevity, Clarity, says Reader’s Digest. Oh yeah!

10.    Break the rules but after having learned the rules (of grammar/writing). Being too technical or formal, like a government policy document, wouldn’t work well in blogging. But too much slang/over-saturated urban dictionary stuffs will not be taken seriously or enjoyed.

11.    Don’t just present cold facts, for example, that book says that or this place is 1049.01 metres above sea level. Say what you think about them.

12.    But at the end of the day, you have to put it out. Editing can be tiring and you think you are still not ready to post it. Remember, there is no perfectly written piece. Blogs have the option to edit after posting articles.

13.    Post regularly. Readers visit your blog and find nothing new. Next week, no update, and the same the week after. Chances are they won’t visit again. The attraction of facebook is that each time you log in, you find something new.

14.    Have a focus. You can blog about anything under the sun but if you have a specialty or a direction, people will search you for that. A travel blog will be consulted for travel advice; a health blog will be sought for health issues; a fashion blog for the latest fashion trends; a politics blog for political analysis.

15.    You can opt to put advertisements and make money. Promote your blog. But don’t be a spammer.

Happy blogging

Wednesday, March 20, 2013

Learn grammar

(a facebook post for fellow folks)

Learn grammar.

Dear brothers and sisters who are appearing HSLC and HSSLC, ‘what are your plans right after exam?’ Here’s one humble and earnest suggestion:

Learn grammar. Take English grammar tuition.

For the rest of your academic career and beyond, you will be writing and speaking in English. That is inescapable. Science, Arts, or Commerce, you have to write in English for your exams, face interviews in English for your jobs or for admission for higher studies. So, it is important that you learn it fairly well.

Take grammar tuition.

Why right after HSLC/HSSLC? It’s because you won’t find a better time again in life. We learn as we go up in our career, but on grammar, what you learn during school is pretty much how your grammar will be for the rest of your lives. That’s also because there will be no more grammar course in college or university.

Learn grammar.

People make fun of each other’s accent, including the British for their English! Chakhesangs are no exception. It is important to learn to pronounce words but I think having a good grasp of grammar is more important. African English with their heavy accent sounds nice. Even if you have a very stylish accent, if your grammar is bad, people will make fun of you. If your writing is bad in grammar, people may photocopy it and circulate in office for fun. Even if you have important things to say, you may hesitate or people may not take you seriously. Good grammar will boost your confidence.

Learn grammar.

Learning is a lifetime experience. My dad had me take grammar tuition in class VIII, then class IX, and then again in class X; when friends were going for Maths and Science tuitions. Now I know it was worth it. But the learning continues. I proof read an article 20 times. I sleep over it. The next morning I find mistakes. Then it appears in the newspaper and I find some more. So, I know I have a lot of limitations and a lot still to learn.

Learn grammar.

Is it ‘I have finish the work’ or ‘I have finished the work’? When do you use ‘will’ when ‘shall’ seem more correct technically? How is a semi colon different from a comma? You see, writing is an art but grammar can be very technical.

Learn grammar

Is the use of SMS lingo responsible for bad spelling or it is used to hide ignorance of grammar and spelling? Make friend with your dictionary. Learn new words. Use them to help remember them.

Learn grammar.

Some are good in speaking, some in writing. Everyone has his/her weakness and strength. But, be it speaking or writing, every educated person in our society (for this is not France) needs to have a fair, reasonable, acceptable, working knowledge of English grammar.

Thursday, March 14, 2013

Movie subtitle

This is from Ice Age IV. As the 'ice ship' was tossed about in the ocean by a violent storm, Sid cried out this memorable line: If I don't make it, find me a wife, and tell her I love her.

Thursday, March 7, 2013

To the new government on health care in Nagaland

Since the liberalization of the Indian economy in the early 1990’s, government spending on the social sector has been cut in the name of Structural Adjustment Policy. Government spending on health dropped to as low as 0.9% of GDP in 2005. The State Human Development Report 2004, Nagaland showed similar decline in state government’s allocation to health sector as percent of its total expenditure. When government spending on health decreases; private out-of-pocket expenditure increases (which increased to about 80%). This trend results in people falling into debt crisis due to paying of medical bills. Health expenditure is said to be the commonest reason for people falling into indebtedness in India. About 2% of population fall below the poverty line due to spending on health care. There is a partial renewal of government’s commitment to health care. Public spending rose to 1.2% of GDP during 2011-12 and private out of pocket spending stood at 67%. But it is still far from adequate. A High Level Expert Group was formed by the Planning Commission to advice on what should be done to achieve universal health coverage. One of its recommendations is to double government spending by the end of the 12th Plan (2017).
Health is a State subject and there are wide variations in commitment and health outcome indicators across the States. Some States fare much better and are able to achieve standards of health comparable to that of advanced countries while others fall behind. Looking at the experience of other States, one cannot say that the Nagaland government has been committed to improve health care. Being a poor state and dependant on central grants, the purse isn’t big. But it isn’t just the size. It is how much (proportion) of that will be committed to health care and how much to, say, Youths and Sports.

One of the reasons for lower allocation in health and family welfare is the arrival of National Rural Health Mission (NRHM). However, one must remember that NRHM has not come to take over the medical department, but only to act as a supportive arm. The flagship programs under NRHM look huge but the fact is that the major portion of the general health services still lies under the State government. For example, TB control program is a big program but looks only after TB. Likewise, Leprosy program is for one disease, Vector Borne program for three diseases and so on. Each program is limited in scope and specified in interventions. But for the common ailments that our people suffer from, for example, common cold, ARI, peptic ulcer, urinary infection, diarrhea, typhoid, hepatitis, cholecystitis, kidney stone, hypertension, stroke, diabetes, burns, tonsillitis, skin infections; NRHM does not cover! And almost all types of minor and major operations. So, if a TB patient getting free medicine from the program happens to suffer gastritis due to the medication, she has to buy medicine for her stomach on her own. The performance of the NRHM is also dependant on the State contributing its share on a timely manner. The NRHM is a time bound mission and procedural delays affect the functioning adversely. When the State does not give its share on time, central releases get delayed, staff salaries are not paid, works are not done, and the next year’s fund is minimized due to unspent balance.

Below are six suggestions to improve health services that I request the new government to consider:

1.      Increase state budget allocation on Health
Good health is a basic human need and health care should be given more importance. Health is not something optional that you can choose to buy or not to buy from the market, like your car, or cold drink. Even for basic need like clothing, there are options to choose from based on your income. But health care is a matter of life and death. A poor father would do all he can to give the best treatment if that can save the life of his son. So, farmers would sell their paddy fields, and women would die as they cannot afford to come to treatment in Kohima, or Guwahati. The current spending is inadequate to buy essential medicines, hospital equipments, laboratory reagents, cottons and syringes, etc. Since the early 1980s, state government’s spending on health as a proportion of its total expenditure has been decreasing. In 1980-81, Nagaland was spending 9.57% of its total expenditure on health, which dropped to 6.30% in 1990-91 and further reduced to 5.39% in 1998-99. For 2011-12, the figure stood at 3.5%. The Expert Group recommends that the ‘state  should  be  primarily  and  principally responsible  for  ensuring  and  guaranteeing  Universal Health Coverage  for its  citizens’. It clearly mentions that increase in central fund through NRHM should not be an excuse for not raising the state budget on health. ‘States should not only continue to contribute as  much  as  they  do  now  on  health  care,  but  also proportionately  increase  their  budget  allocations  for health  over  the  years.  In  other  words,  the  transfers received from the Central  government along with the matching contribution by the states should constitute additional public spending on health – and should not be  used  to  substitute  spending  from  own  resources by the states.  This is all the more important because, as   noted   earlier,   the   existing   pattern   of   resource allocation  by  India’s  State  and  Central  governments, collectively result in one of the lowest priorities given to health of any country in the world’.

2.      Concentrate on function over structure
There is shortage of health centres. But the more pressing need is to make the existing ones function optimally. There are several reasons why they are functioning sub-optimally or not at all. One is site selection. There are population norms, referral set-up, and connectivity concerns in choosing a site to set up a health centre. But often our health centres are set up through political decision and personal connection. An influential person would like to have a primary health centre in his village, in his land, with a doctor placed there. So, we have many health centres which flout every norm and logic. Then so many Sub Centres are built away from the village which are not accessible. As Chief Minister has rightly said that roads need maintenance fund, buildings cannot deliver services. There need to be a continuous supply of water, electricity, medicines, laboratory reagents and consumables, etc. Therefore rather than setting up structures which wouldn’t work, resources need to be put to make the present ones work. The district hospitals need special attention, so that even if the length and breadth of Nagaland cannot be given comprehensive health coverage, there is one good hospital in each district. Human resource management also needs a thorough recheck, which is discussed in the next point.

3.      Improve the human resource management system
Salary of Grade III and IV staffs is draining a huge chunk of the state budget. Staffs are appointed for the sake of employment and not for need of service. A district hospital may have almost a 100 employees and you’ll see only a handful of them on any day of visit. On the other hand, there is shortage of technical manpower for which there is no post creation. Another important issue is the rational deployment of technical manpower. A Sub Centre covering a single village of about 600 population has 3 ANMs while some covering several villages has only one. Technical guidance is not sought for transfers and they are done at the top for other motives. As a consequence, service delivery suffers. Transfer and posting policy needs to be looked into that all employees are treated fairly and that transfers are based on need assessment. Such policy document for doctors is in place. The doctors’ association has also submitted a very well written proposal for restructuring of district hospitals in Nagaland which has addressed this issue in detail. Political will is needed to implement it. Among others, reasons for staff absenteeism and low performance are the lack of rationality in posting of health personnel and victimization of some in order to help others.

4.      Strengthen drug procurement and supply chain management system
Nagaland has a state essential drugs list and a standard treatment protocol. A procurement system is in place and is functioning. The most pressing need is funding. State needs to increase budget for buying essential medicines which is very inadequate at present. On procurement system, let me humbly put this suggestion. We need to strengthen the drug procurement system by having a procurement policy passed by the government. Variations in medicine prices are so wide that a brand can be a hundred times costlier than another for the same medicine. Actor Amir Khan was right in saying that a one rupee medicine is sold at Rs. 20. Opting for cheap but quality tested generic medicines will tide over the financial constrain. So, if the state commits 10 crores for buying medicine, opting for generic medicines will procure as much as spending over a hundred crores. That has to be a government policy decision to protect the interest of the people’s health. It will meet with objections from various interest groups but it needs to be done, and other states have drawn up such drug procurement policy. Drug testing laboratory needs to be beefed up to test that the medicines procured are of acceptable quality. Cheaper than branded medicines is a category called ‘branded generic drugs’ which can be explored for greater acceptability. To check leakage and rationality of supply and use, a digitalized supply chain management system need to be put in place and standard treatment protocol duly followed. The new medical minister can take this proposal for generic medicines, quality testing facility and supply chain management as a pet project and show that during his tenure, the people of Nagaland received affordable, adequate, and quality medicine supply. 

5.      Need for a State Health Policy
Besides the Five Year Plans of the planning commission, the country has a national health policy which acts as a vision document for the long term. During the period, the planning commission and the ministry of health and family welfare design programs and interventions to meet those goals set in the policy. Short term targets are set to achieve step by step to achieve the long term goals. A similar state health policy is needed as some other states also have. The health needs are not uniform throughout the country. We might have achieved very low infant mortality rate but poor in institutional delivery. The pattern of disease burden in Nagaland is also different. Therefore, there is a need to tackle state specific issues and set goals of our own. A committee may be formed to draft a state health policy and have it passed by the government to function as a vision document for health care delivery in our state.

6.      Improve Inter-sectoral coordination
It is not possible to achieve good health care in isolation. Many of the health challenges are beyond the purview of the health and family welfare department. So, inter-sectoral coordination needs to be strengthened and joint ventures of line departments need to increase. If the Roads and Bridges department does a shabby job, transportation of patients and vaccines become a problem. If ICDS of Social Welfare functions smoothly, fewer children get sick, and so on. We have the ‘year of entrepreneur’ and similar themes that government adopts. Emphasis on a particular theme may be important but each and every sector is interrelated and one cannot progress at the expense of the other. But if some things in life are more basic and we are to prioritize, those which we can’t do without; they are food, housing, good health, education, communication. They are more essential than, say, music and dance.

Wednesday, March 6, 2013

The best part of the day

After a full day’s work, I come home to hold my one month old niece. She doesn’t like lying down. She loves to have her head raised and gentle rocking pleases her. She started responding to music as early as when she  was two weeks old; not to any music but to a particular song. It is a beautiful hymn called ‘Pass Me Not, O Gentle Saviour’.  It became her personal mp3 lullaby. If I were to choose a song for her, I couldn’t have chosen a better one. 

All she does day and night is to sleep, stay awake, feed on her mother’s milk, cry and make sounds which are not yet words. She doesn’t know that people can be greedy and do bad things. I asked her, ‘what type of society are we offering you into?’ She calms by nerves as she seems to say, ‘I already know of a gentle Saviour. He’ll not pass me by’.

Pass me not, O gentle Savior,
Hear my humble cry;
While on others Thou art calling,
Do not pass me by.

Savior, Savior,
Hear my humble cry,
While on others Thou art calling,
Do not pass me by.

Let me at Thy throne of mercy
Find a sweet relief;
Kneeling there in deep contrition,
Help my unbelief.

Trusting only in Thy merit,
Would I seek Thy face;
Heal my wounded, broken spirit,
Save me by Thy grace.

Thou the spring of all my comfort,
More than life to me,
Whom have I on earth beside Thee,
Whom in Heav’n but Thee.