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South Asia

Jane Parry: Organ donation is an emotive topic, and rightly so

28 Apr, 16 | by BMJ

jane_parry3Recently, there was a very moving piece in The Guardian about a doctor’s experience of a family donating their dead child’s organs for transplant. It got me thinking about organ transplantation here in Asia, specifically in Singapore, and why donation rates there are so low.

Singapore has an opt-out organ donation policy: a 2009 amendment to the Human Organ Transplant Act (HOTA) allows for “the kidneys, liver, heart, and corneas to be recovered in the event of death from any cause for the purpose of transplantation, applicable to all Singapore Citizens and Permanent Residents 21 years old and above, who don’t have mental disorders, and who have not opted out.” Opting out of HOTA means that you are lower priority on the waiting list for an organ transplant. more…

Vivekanand Jha: National dialysis programme in India—how to get it right

15 Apr, 16 | by BMJ

vivek_jhaWith the announcement of a National Dialysis Service, India is set to join the growing list of nations that provide free or highly subsidised treatment to patients with end-stage kidney failure.

Dialysis is expensive—it consumes 2–6% of the healthcare expenditure [1], even though end stage kidney disease (ESKD) patients account for only 0.1–0.2% of the total population. Any proposed service must therefore be cost efficient. The proposed service focuses on haemodialysis (HD), while neglecting other options such as kidney transplantation, and peritoneal dialysis (PD), which is cheaper to the healthcare system and can be done at home, hence it is the preferred treatment modality for state-funded dialysis programmes [2]. more…

Meena Putturaj: The art of data collection in health systems research

11 Apr, 16 | by BMJ

meena_pData collection is a crucial aspect of any research project. Depending on the nature and scope of the research question, collecting quality data requires considerable investment of time and resources. Indeed, any research endeavour is handicapped without the relevant data.

During a recent health systems research project, I had to collect a lot of information from government agencies, which turned out to be no cake walk. There were occasions when I had to wait for hours at a time to collect documents, to meet officials, and to conduct interviews. Those waiting periods gave me sufficient time to observe and reflect on the functioning of some of the government agencies in India. more…

Soumyadeep Bhaumik’s review of South Asian medical papers—April 2016

7 Apr, 16 | by BMJ

soumyadeep bhaumikDespite the enormous diversity that South Asia encompasses, it has its fair share of common problems in which there is a need for greater co-operation and learning. A key issue is the neglected problem of arsenic groundwater contamination. A study from the Gangetic plains of India found that 100% of the samples analyses had higher than normal levels of arsenic in hair, nail, and urine samples. Another study estimated that more than 13 million people are exposed to higher than normal arsenic levels in drinking water around the course of the Indus river in Pakistan. There is no dearth of such studies from Bangladesh including the one published this month which studied the relation between cognitive scores in Bangladeshi children and elevated blood lead and arsenic and manganese exposure in drinking water. Irrespective of the country, the response has been suboptimal and much more needs to be done to improve the provision of “clean water” in the region. more…

Yogesh Jain: Hippocratic crime

1 Apr, 16 | by BMJ

saibal_janaLast month police in India arrested Saibal Jana, a doctor with 35 years’ experience caring for patients from indigenous and other marginalised rural communities. The arrest was made on the grounds that he absconded by not attending hearings for a court case filed 24 years ago. The case involved 52 people implicated in an agitation for workers’ rights during which the police had opened fire, killing 18 people. Jana’s wife described the allegation as “ridiculous” when contacted by The Hindu newspaper as she and her husband “hardly went out of Dalli Rajhara” [a city and a municipality in Balod district in the state of Chhattisgarh], in the past two decades.

At the time Jana was tending to the injured as a doctor at the Shaheed (martyrs) Hospital. The hospital was planned, constructed, and run by the progressive workers’ union, and it was this union that led the fateful struggle that left 18 people dead.

Sunil K Pandya: The Indian Medical Council’s new code of ethics favours industry

15 Mar, 16 | by BMJ

The Medical Council of India is entrusted with the task of maintaining high standards in medical education and practice. Its code for professional conduct was recently modified. One would expect an improvement, but the Council, has again decided to prioritise those with clout in the medical profession, in the form of doctors’ professional associations, and industry over good medical practice and ethics.

A clause in the code (clause 6.8), last modified in 2009, forbade individual medical practitioners and professional associations of doctors from receiving any gift, travel facilities, hospitality, cash, or monetary grants from industry or their sales people or representatives. The clause also specifies the conditions under which research projects can be funded by industry. more…

Soumyadeep Bhaumik’s review of South Asian medical papers—March 2016

10 Mar, 16 | by BMJ

soumyadeep bhaumikCan direct observation of treatment (DOT) for childhood TB be done by a family member instead of the current system where it is done by healthcare workers in DOTS facilities? A trial in India aimed to answer this question which might have a significant impact on overburdened health systems and on the economic costs associated with travelling to DOTS facilities.


Prashant Jha: The BMJ’s free access trial for South Asian content

9 Mar, 16 | by BMJ

prashant_jhaIn 2015, at the BMJ South Asia Awards in Mumbai, we announced a plan to open up access to content relevant to South Asia for readers of The BMJ from the region. Since November 2015, online readers from any of the eight countries in the South Asian region (Bangladesh, Bhutan, India, Maldives, Myanmar, Nepal, Pakistan and Sri Lanka) have unrestricted access to articles relevant to a South Asian audience. more…

Oommen C Kurian: Should India lift its ban on prenatal sex testing?

16 Feb, 16 | by BMJ

oommen_kurianBeti Bachao Beti Padhao (BBBP), the flagship scheme of India’s ministry of Women and Child Development (WCD), is trying to address a declining child sex ratio—919 females per thousand males in 2011—by focusing on the worst-performing states across the country. Earlier this week, the ministry announced a substantial expansion of the scheme, now covering quarter of the country. Revitalising the implementation of the pre-conception and pre-natal diagnostic techniques (PCPNDT) Act, which prohibits doctors from telling parents the sex of a foetus is a main component of BBBP. In the last decade, only 206 doctors have been convicted by courts across the country under the Actmore…

Soumyadeep Bhaumik’s review of South Asian medical papers—February 2016

3 Feb, 16 | by BMJ

soumyadeep bhaumikWe are now officially in a new era of global health—the era of the Sustainable Development Goals. The month of January saw the publication of some papers from South Asia which provides an opportunity to learn from the previous era of Millennium Development Goals. more…

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