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Keynote Address at FOGSI Convention, Ahmedabad, 24th Jan 2017

Ladies and Gentleman,

It is indeed a matter of great privilege to be in the midst of this illustrious gathering of my professional community.  To deliver an address to the knowledgeable congregation largely of female professionals is indeed a huge challenge and a tough task. But in all humility I take the onus of venturing in with whatever little courage and conviction at my disposal.

Health has been a matter of paramount importance for men and mankind ever since antiquity. The trends and transitions on the same have several ‘benchmarks’, which stand out as speaking monumental ‘milestones’. One of the important aspects under the said rubric definitely pertains to ‘Women’s health’.

In the context of this stark reality I had flagged the same in my presidential address delivered at the Global Assembly of World Medical Association in Taiwan, whereat I took over the reins of presidentship of the same. I categorically brought out that “in the backdrop of deafening slogans of gender equality, every day about 830 women die due to complications of pregnancy and childbirth. Maternal mortality is a health indicator that shows very wide gaps between rich and poor, both between countries and within them. Should the pregnant mothers be left to die or should it not be realistic human touch to reach them in a ‘handy, accessible, timely and affordable’ manner, which would be in the interest of mother, the child and resultantly all humanity”.

However, the material reality, which plagues a vast part of the Globe as of now is that the desired healthcare to the women is a distant reality. She was, is and perhaps would continue to be a neglected lot on one or several counts. But then this is a great slur on not only the reach and direction of the healthcare delivery system but it goes to stigmatize the humanity as a whole.

The problem is not just limited to the health concerns of the women folk being marginalized but is compounded by rampant pursuits of selective sex determination and ending up in female foeticide, which perhaps is the greatest cruelty that stands committed and the most brutal blow to the suffering womanhood.

As such, it is not only desirable but should be taken as a mandate that all NMAs have a ‘zero tolerant’ policy against those health care providers committing sexual violence, sex selective abortions and such unethical practices. They need to be dealt by law in an exemplary and deterrent manner, so that the desired signals stand strongly conveyed to all concerned.

Likewise, one cannot turn a blind eye to the Sex selective abortion and falling sex ratio, which is a vital concern in many countries including India. In the fitness of things all the professional associations including Indian Medical Association by an appropriate resolution in a deterrent manner must terminate the primary membership of any member indulging in such sex selective abortions and not venture in to provide cushions to their fallacies and insulation to their unpardonable deeds. This I have been advocating to all concerned with all might at my end.

As a matter of fact, I would like the professionals to go a step further in as much as that apart from avoiding themselves into indulgence into these inhuman and non-permissible forays, but they should go in for exposure of the guilty and also ensure that they are appropriately booked, so that the required deterrence stands created on this vital count.

It would not be just catering to the mothers health which would render the desired results that have been contemplated in terms of achieving the set benchmarks by the World Health Organizations and also the millennium development goals. It has to be strongly supplemented with diligent care and concern for the health of the adolescent females. This would inevitably mandate that they are not only trained, oriented and counselled on health, hygiene, nutrition, mental counselling, menstrual handling but also need to be counselled on various other vital associated arenas which have a material bearing on their health including their ‘do’s and don’ts’.

There is an imperative need for starting ‘Adolescent clinics’ to cater to this domain of health requirement. This would not only go as an important aspect of not only ensuring ‘promotive’ health but also cater to the ‘preventive’ aspect as well. 

The counselling so desired has to be invoked through appropriate modules and integrated participation of the Obstetricians and Gynaecologists along with the paediatricians, physicians and surgeons as well.  The modular approach resulting in mass awakening and awareness would be the real route to manage this vitally desired but significantly neglected area.  

It is no secret that the image of the medical profession has suffered, and continues to suffer a serious dent to its image and a severe beating to its credibility. This is basically due to the unchecked rampant practice of kickbacks, cuts and commissions amongst the fraternity medical professionals. No amount of excuses would put us in a position to defy the reality that these black spots do exist on the face of the profession and it is in the full knowledge of the people and society at large. As a result of this, the credibility of the profession has been eroded very badly. The respect that the profession and professionals used to command amongst society at large turns out to belong to the remote past. This has to be dealt with an iron hand and determined will.

I am of the considered opinion that while expecting health professionals to dispense their onus and responsibilities with passion and commitment it is inevitably necessary that they are provided due protection from the unprovoked violence that is inflicted on them at the drop of the hat and also the various draconian provisions of law that make their professional life difficult.

However, one of the major issues faced by Obstetricians in the country is regarding criminalization of clerical errors under PCPNDT Act.  In the last 2 years, I had personally spoken to Health Minister of India on this subject. Also an inter Ministerial Committee was formed with 3-Members from IMA and 1-Member from MCI.  I have been informed by both MCI and IMA  that on principle, the Govt. has agreed to decriminalize clerical errors.

I also hail the Delhi High Court Order, which was filed by IMA and which has clarified the issue of 6 months training in Ultrasound and whether non-pelvic ultrasound needs to come the ambit of PCPNDT Act. 

With great sense of responsibility I salute Pradhan Mantri Surakshit Matratav Abhiyan (PMSMA) started by Hon’ble Prime Minister of India, Shri Narendra Modi ji, should be supported at every level at FOGSI with IMA.

I wholeheartedly endorse the Campaign “99999” of IMA which is on 9th of every month,  for the next 9 months.  Look for 9 antenatal parameters, involving paediatrician on 9th month of  pregnancy and sex of the child to be known only after the 9th month is over.

To reduce maternal mortality, I appreciate the campaign of  FOGSI to have Haemoglobin of 12 by age 12 and now supported by IMA. If all FOGSI and IMA doctors in the country give weekly folic acid tablets to every adolescent girl, the maternal mortality can be reduced to a substantial number.

The Medical Council of India should also venture into ensuring that these vital areas are appropriately included in the curriculum at various levels so that the graduates and post graduates are adequately trained in the required competencies. Likewise, the continuing medical education programmes must be worked up in a manner that they cater and contribute in this vital areas so that the professionals at large stand updated on these desired councils.

FOGSI & IMA should work together in many fields of common interest including the most vital programme of ‘Saving the Girl Child’.  The common campaign on hygiene, involving sexual hygiene and uniform health friendly life style can go a long way in preventing both the cervical cancer and breast cancer. I am of the firm opinion that we should have a uniform life style which can prevent all the life style disorders. Let us through holding of hands venture into these arena in order to make the dream of feminine health a living reality.