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Friday, August 4, 2017 B DECCAN HERALD 11

Panorama Cognizant June quarter


net up 86%. P12

Death knell for citizen-led lake governance


By Sharachchandra Lele and lakes were transferred from Bangalore long as lakes are managed in conformity managed as per the citizensneeds. actions of BWSSB, BBMP and other agen-
Veena Srinivasan Development Authority (BDA) to Bruhat with these regulations or standards, the Secondly,lakes often dry up becausethe ciestoaddressBellandurLakesproblems.
Bengaluru Mahanagara Palike (BBMP), interests of offsite/downstream stakehold- storm water drains (SWDs) that bring wa- How will bringing in the MID help?

B
engaluru has become a bit notorious the urban local body. ers will be protected. ter to the lake are choked or encroached. In fact, it is possible that a state agency
globally as videos of Bellandur lake This volte face has been justied on the So protecting lakes requires control over likeMIDmay havedifferentinterestsfrom
catchingfireanditsfrothblockingro- grounds that neither BBMP nor BDA Mismatched skills solid waste disposal and encroachments, those of Bengalurus citizens. There are
ads overthepastcoupleof years havegone have funds and manpower to maintain all It is true that almost all the lakes in Ben- which only BBMP has. already plans to transport Bengalurus
viral.ButBengaluruslakesarealsofamous the lakes and that the Minor Irrigation galuruwereoriginallyirrigationtanks,and Thirdly, the bigger problem with Ben- treated sewage to irrigation tanks in Kolar
for another reason: the enormous citizen Department is in a better position because the MID is the government department galurus lakes is that the SWDs carry un- andChikkaballapura,wheregroundwater
activism that has led to the protection, re- ithandleswaterbodiesalloverKarnataka. that manages these tanks. But even the treatedsewageandalsothattheBangalore levels have dropped precipitously due to
juvenationandbeautificationofmanyofits But in fact, the transfer to MID is neither MIDhasstruggledtomaintainthesetanks WaterSupply&SewerageBoard(BWSSB) over-pumping.
lakes, and the continued citizen efforts to legally tenable nor practically benecial. and attempts were made to devolve their allowsseveralsewerstoemptydirectlyinto While Bengalureans may want to re-
save and revive the remaining ones. Principles of decentralised governance management to panchayats. lakes or rivers. use the water stored in their lakes, MID
While Hebbal highlights citizen resist- tell us that one should not centralise those Butmoreimportantly,Bengaluruslakes Solving this problem requires a say in may want to address its rural constitu-
ance to lake privatisation, lakes such as activities that can normally be handled at order requiring setting up of ward com- do not function as irrigation tanks any- how BWSSB manages sewage. Treated ency, resulting in a conflict of interest.
Kaikondrahalli, Puttenahalli and Jakkur the lower level. Devolution of power to lo- mittees. The right to manage local water moretheyprovideenvironmentalamen- sewage can be a boon to lakes that do not Bengalurus lakes, like its parks, water
have become success stories of partner- cal elected bodies will result in governance bodies for providing locals environmental ities, recreation, recharge and possible get enough storm runoff, but this is also and sewage, must be managed by Ben-
ships between the municipal government that is more transparent and responsive to amenities and functions is partly the right repositories for treated sewage. The MID currently in BWSSBs jurisdiction. The galureans in as participatory a manner as
and local citizen groups, where the former localneedsandconditions.Localbodies,in of local bodies. Handing over lakes from hasnofamiliaritywithorskillsrequiredfor MID can do no better than BBMP in terms possible, within the limits of existing envi-
contributes resources and the latter con- turn,canusevariousmethodssuchasward a municipal body to a state-level agency this multi-functional management. of inuencing BWSSB. ronmental and water-sharing regulations.
tribute location-specic ideas, awareness committees and MoUs with citizen gro- violates this principle. Indeed, once the lake bunds and walk- Indeed, Bengalurus lakes are already The best way that the state government
building and monitoring. ups to further enable citizen participation. The governments often justify not wayshavebeenrebuilt,theirmanagement managed by too many different agencies. can help matters today is by keeping the
Unfortunately, the state government This not only strengthens democracy, devolving control over environmental does not require major engineering skills The catchment and SWDs are managed lakes with BBMP, providing more lake-
seems bent on destroying this slow pro- but it also makes governance more effec- resources such as forests and water by nor huge resources. It requires rst of all by BBMP, the sewage by BWSSB, the sh specic resources to BBMP, continuing to
gress towards decentralised and demo- tive,becausecommunitiescandeploytheir pointing out that these resources have off- people skills and simple green space man- are owned by the Fisheries Department, encourage citizen engagement and ensur-
cratic environmental governance. Last localised knowledge and monitoring abili- site or downstream stakeholders too. But agement,likeinBBMPparks.TheBBMPs while the Karnataka Lake Conservation ing that BWSSB is more transparent, ac-
week, it announced that all of Bengalurus ties in the planning, design and implemen- devolution is never unfettered. In the case lakes wing had demonstrated some of and Development Authority is still trying countable and cooperative in its handling
lakes would be handed over to the Minor tation of any activity. This is the core logic of lakes, laws such as the Wildlife Act, the these skills. And by entering into MoUs to gure out its role. of sewage and treated water.
Irrigation Department (MID). This move behind the 73rd and 74th amendments to Water Act and orders of inter-state water with citizen groups, BBMP has harnessed Nowonderthegovernmenthadtosetup (Theauthorsarefaculty,CentreforEnviron-
comes barely a year after more than 100 our Constitution and the recent high court disputes tribunal will continue to apply. As theirskillsandensuredthatthoselakesare aMonitoringCommitteetocoordinatethe ment & Development, ATREE, Bengaluru)

To lead Pakistan, Doctors in


dire straits

Imran Khan no shoo-in


By Dr Vasundhra Atre The call was made at three
in the morning, I wonder. Are

T
he last five decades have doctors not human? Do they
been one of change. We not have a family? Can they not
have travelled from the be going through a personal
black and white TV to the crisis - a loss, a member of their
curved LEDs, the wired big familyunwell,andhospitalised,
black telephone has been re- too? Do they deserve the work
He has no experience with governing and has shown an aptitude for street agitation. placedbymobilephoneswhich
disappear into the palm, the
life balance that everyone talks
about? Where are we headed?
mobile wallets have replaced The patients visiting the
By Salman Masood paper money; the list is endless doctor generally have under-
These 50 years have also lying health problems which

I
n 1992, when Pakistan won its only cricket seen exponential medical de- can predispose to and/or com-
worldcup,PrimeMinisterNawazSharifwas velopment.Theadvancements poundhealthissues.Especially
askedbyatelevisionhostiftheteamcaptain, have been phenomenal the today, every family has a mem-
Imran Khan, a national heartthrob, would be introduction of antibiotics be- ber suffering from diabetes,
right for his party if he went into politics. ginning with penicillin in 1940 hypertension, a problem with
I offered him a long time ago, but he de- to the introduction of imaging the heart, kidney etc. The new-
clined. I dont know why, Sharif said, patting technology like CT and MRI er issues like Dengue or H1N1
Khansshoulderaseveryonewhohadgathered which have revolutionised are taking their toll, purely be-
around burst into laughter. the way in which the body is cause of either the aggressive
Khan,acharismaticathletewellknownthen scanned todetect disease, anti- nature of the infection or un-
for his playboy image and affairs with British TB therapy, anti-viral therapy derlying health condition. The
socialites, did go into politics a few years later for HIV, kidney dialysis, angio- doctor can do just so much.
through his own party, Pakistan Tehreek-e- plasty, endoscopy and laparo-
Insaf (PTI). scopic work, inhaled therapy, Avoiding complications
Last Friday, the countrys Supreme Court organ transplantation etc. All a doctor wants to do is di-
ruled that corruption accusations against Sha- With new developments, we agnose correctly and advise
rif, 67, a veteran politician who thrice served encountered new challenges. the appropriate treatment. No
as prime minister and has dened Pakistans Medical professionals have doctor would like any com-
politics for decades, were sufcient to remove moved away from practising plication in his patient. He
him from ofce. traditional medicine. There only wants his patient to get
For Khan, 64, the moment was sweet. He was a need to stay abreast of well and go home. Results are
had been the main petitioner before the court the developments, the need sometimes beyond the control
and fomented widespread street protests to invest time and money in of the doctor.
against Sharif, emerging as the strongest chal- specialising, acquiring new Trends are changing. The
lenger to the former prime minister and his skill sets and nding ways to doctor is no longer going to ad-
political legacy. introduce a new methodology. vise what he feels is medically
ButKhanspathtovictoryinthenextgeneral Many travelled overseas to best. He will give options. It will
election, set for mid-2018, is far from assured, work with pioneers in the eld. be up to the patient and the
according to analysts, including Moeed Yusuf, They returned with knowledge family to choose and commit
associate vice president of the Asia Centre at and skills which they shared their choice on paper. To cite
the United States Institute of Peace, whose with their colleagues. The a case, a friends ve-year-old
research and work centres on Pakistan. journey has not been easy. The daughter had a fall and sus-
In some ways, this is a clear victory; there IN THE SPOTLIGHT: Opposition leader and head of the Pakistan Tehreek-i-Insaf party, Imran Khan, at a press conference in Islamabad. De- treatment options, diagnostic tained a cut on the scalp.
is no question about that, Yusuf, who is cur- spite his huge urban base, Khan is struggling to prevail over Nawaz Sharifs Pakistan Muslim League-Nawaz party, especially in Punjab. AFP tools and skills that are taken She was advised that she
rently visiting Pakistan, said in an interview. forgrantedtoday,aretheresult couldletitbeanditwouldclose
Sans Panama Papers scandal, Pakistan Mus- Not until 2011 did Khan nd himself in cen- polls. The situation was made more difcult longtime observer of Pakistani politics. He ofperseveranceandhardwork. naturally, or get stitches put
lim League-Nawaz party (PML-N), the ruling trestageashecapturedthepublicimagination by Sharifs constant friction with the powerful is mercurial and unpredictable. It took the Karl Marx said: Medicines or have staples put. On ques-
party, was sitting pretty for the next elections. and began drawing hundreds of thousands of military, elements of which favour Khan. generals two decades to cut Sharif to size after healdoubtsaswellasdiseases. tioning as to what was the best
The scandal he referred to comprised dis- Pakistanis to his political rallies. Soon after the elections, Khan accused Sha- theycreatedapoliticalcareerforhim.Theywill Unfortunately, the progress in option, she was advised that he
closures in last years leaked Panama Papers Mostpeopleintheaudienceswereeducated, rif of vote rigging. In 2014 he led thousands of not make the same mistake again, of helping medicine has been coupled could only offer options, the
that Sharif and his children hid much of their urban youth, disgruntled with the system and protesters in a siege of Islamabad, the capital, someone they cannot control. with growing distrust of the decision had to be hers. The
enormous wealth in offshore bank accounts energised by Khans populist, anti-corruption for months. Shortly after the Panama Papers Khan, too, faces cases in the Supreme Court medical professionand profes- doctor has obviously had a
and related investments. and anti-American message. The party also revelations, Khan again tried to lay siege to and the election commission, stemming from sionals. This was formalised problem with a patient before.
Still, Yusuf said, he did not believe Khan was picked up vast support among the Pakistani Islamabad in November 2016. He forced the accusations of hiding assets and of foreign when doctors were brought This is what we are pushing the
closer to a victory in the elections than he expatriate community, and Khans supporters Supreme Court to take up the corruption case funding of his political party. There has been under the Consumer Protec- medical profession to do.
had been before the ouster. Whether he gets are dominant on social media. against Sharif, which culminated in the prime speculation that the courts could bar him from tion Act (CPA) 1986. Action and reaction are
closer or not depends on his own behaviour Despitehishugeurbanbase,Khanhasfound ministers ouster on Friday. Parliamentovertheseaccusations,speculation Though they say that doc- equal and opposite. Today, par-
and whether Nawaz overplays his hand and it hard to prevail over Sharifs Pakistan Muslim that Khan laughs off. tors practising ethically and ents are questioning their deci-
what Accountability Court does. League-Nawaz party, especially in Punjab, the Khan is not corrupt How can I be disqualied?he said in an in- honestly should not have any sion to enrol their children for
The Supreme Court has directed the Ac- former prime ministers power base, and two Khan has no experience with governing and terview.Iwasneverapublicofceholder.The reason to fear, the fact is today medicine.Theycalculatethein-
countability Courts to decide corruption cas- other provinces. has shown an aptitude more for street agita- whole world knew I was playing cricket. I have most doctors are being driven vestment in terms of long years
es against Sharif and his family within in six Sharif remains deeply entrenched through tion than working with Parliament to bring given my whole money trail to the Supreme towards defensive practice. of study, wherein some institu-
months. But there is scepticism that the courts a vast network of political patronage. His party about change. Many diplomats expressed Court. It is just blackmail. Following inclusion in the tions dont even have habitable
will reach a decisive verdict against the Sharif won the 2013 general elections with an over- shock at what they see as his disregard for the Yusuf, of United States Institute of Peace, CPA, the number of litigations quarters, the long gruelling
family and speculation that even if Sharif can- whelming majority. Khans party currently parliamentary process. said he, worried that this could be Imrans against doctors went up. Think work hours, meagre pay and
notrunagain,hisPML-Npartywillcontinueto holds just 33 of the 342 seats in the National But enamoured supporters say Khan is not Trump moment. about it, once a doctor advises most importantly the safety of
dominate Parliament. Assembly. corrupt like traditional politicians and point to What I mean is that you are a leader of investigations,thespeculations their child while at work.
On Sunday evening, Khan was to address a Butsincethelastelections,Khanhasbeenat hisphilanthropicworkasaproofthathewilldo a party or campaign and you have basically begin: doctor is getting a cut, Where is our next genera-
large political rally in Islamabad, in hopes of the forefront of political opposition to Sharif, more good for the country. deed all odds to secure a major political vic- so sue him. If there is a delay tion of doctors? We are nipping
kick-starting a new round of rollicking opposi- portraying him as the face of status quo and Husain Haqqani, the director of Hudson tory, he said, and now you could be in a in diagnosis: the doctor should theminthebud.Beforeassault-
tion to the governing party. corrupt practices that have gnawed at the Institute and a former Pakistani ambassador situation where you feel you do not have to have advised the investigations ing a doctor, breaking up a hos-
When Khan started the PTI party in 1996, he political system. in Washington, described Khan as an instru- take counsel from the people who are going to onmyrstvisit.Doctormessed pital, maligning or suing a doc-
wasconsideredapoliticalnobodyandsquirmed In many ways, Khan did not let Sharif settle ment to force Sharif from power but not to advise patience, advise taking the long course, up, so sue him. The doctor did tor- pause, think and refrain.
on the sidelines for decades. His party had just intoofce.Hispopularagitationkepttheprime succeed him. rather than declaring victory and overplaying not answer my phone at three (The writer is medical director,
one seat in Parliament after the 2002 elections minister perpetually unsettled and ghting to Heisnotthekindofmantheestablishment your hand. in the morning, so I suffered Fortis Hospitals, Bannerghat-
and boycotted the 2008 elections. gain traction despite his partys success at the would like to be in charge, said Haqqani, a International New York Times mental agony, sue him. ta Road, Bengaluru)

WHATS THE BUZZ

Blind population to and age, the number of people affected has in- Ebola can persist in survivors Of the 149 men who provided samples, 13 that develops within a
creased globally. Their numbers rose from 30.6 tested positive for Ebola virus RNA. Of these 13 deep vein in the body,
semen 2 years after infection
triple by 2050 globally million blind people in 1990 to 36 million in
2015, and from 160 million to 217 million people
with moderate to severe vision impairment. The deadly Ebola virus can persist in the se-
men, 11 had positive results even two years after
the onset of Ebola infection.
Our nding of long term persistence and
usually in the leg, and
causes swelling, aching
and difculty walking.
The number of blind Also, the prevalence rates could see an upturn men of survivors for more than two years after intermittent detection of viral RNA in semen It can be caused by
people across the by 2020 (to 0.50% for blindness and 3.06% for the onset of infection, a study has found. suggests we need to change how we think about prolonged periods of immobility, such as after
world is set to triple vision impairment). It also predicts further in- Researchers at the University of North Caro- Ebola, said researcher William A Fischer. surgery or during a long ight. If the clot becomes
from about 36 million creases in the number of cases by 2050 if treat- lina at Chapel Hill also detected Ebola virus dislodged it can travel to the lungs and block a
to 115 million by 2050,
due to a growing age-
ment is not improved with almost 115 million
cases of blindness and 588 million people with
RNA in the semen of men who had previously
had a negative test of their semen in some cases. Common anti-allergy drugs blood vessel causing pulmonary embolism.
Researchers turned off the gene that is respon-
ing population, a study warned today.
Researchers led by Anglia Ruskin University,
moderate to severe vision impairment.
Even mild visual impairment can signi-
The ndings led the team to suggest revi-
sion of the 2016 WHO guidelines relating to the
may treat deadly blood clots sible for producing mast cells. They found that the
mice which were decient in mast cells were pro-
UK, analysed the prevalence of blindness and cantly impact a persons life, for example reduc- sexual transmission of Ebola. The guidelines call Common anti-allergy medicines could prove tected from DVT. They also found that mast-cell
vision impairment in 188 countries between ing their independence in many countries as it for men who survive Ebola Virus Disease (EVD) to be an effective treatment for potentially decient mice had normal haemostasis, tackling
1990 and 2015, as well as providing projections often means people are barred from driving, as to undertake measures such as abstinence and fatal blood clots in the legs, researchers from the bleeding side-effects possible with treatments
for 2020 and 2050. well as reducing educational and economic op- the use of condoms for at least 12 months after University of Birmingham in the UK claim. such as warfarin. Researchers now hope to vali-
With most vision impairment being a result portunities, said Professor Rupert Bourne, of the onset of EVD or until their semen has tested The study could lead to new treatments that date the ndings in humans, by testing samples of
of ageing, as the population continues to grow Anglia Ruskins Vision and Eye Research Unit. negative for Ebola virus RNA twice. prevent deep vein thrombosis (DVT), a blood clot blood from people with and without DVT.

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