28th November 2018
Answer questions in NOT MORE than 200 words each. Content of the answer is more important than its length.
Links are provided for reference. You can also use the Internet fruitfully to further enhance and strengthen your answers.
GS II: SOCIAL-TRIBALS
Q1. Discuss the challenges faced by the Indian government’s policy of “protection” of tribes living in the Andaman and Nicobar Islands.
- The tragic death of a young American adventurer in the protected “tribal reserve” of North Sentinel Island in the Andaman and Nicobar Islands archipelago has triggered global media interest in the region once again. Much of the debates on the alleged killing of John Allen Chau by “hostile” islanders remains focused on the intent, circumstances and tragic upshot of his misadventure, while others raise larger and more disturbing questions about the North Sentinel tribal community at large and the efficacy of the Indian government’s tribal welfare policies.
- Some have asked why the Indian state cannot devise a method by which the Sentinelese could be “pacified” and brought under the welfare net. It goes to the credit of the Indian government that unlike its colonial predecessors it has completely abjured all kinds of coercion against the indigenous communities of the Andaman and Nicobar Islands. Colonial punitive expeditions, kidnappings, forced confinements that devastated the Andamanese populations at large are a thing of the past. Tribal welfare policy in the islands remains committed to protection and clearly “pacification” via coercion is no option. The policy today is to ensure “protection” but also to accept their right to self-determination.
- Yet here’s where the problem begins. Policies of “protection” demand strong surveillance infrastructures, empowered staff, coordination among police, forest and welfare agencies and, more importantly, investment in projects of sensitisation. The settler population on the islands clearly remains conflicted. There is an understanding that the islands’ indigenous communities are sources of tourist interest and potential revenue churners, yet the fact that public monies are invested to sustain them in their habitats remain a source of discomfort. Apart from a small segment of progressive citizens, there are clear marks of stress in settler-indigene relations on the islands.
- It is tensions like these that allow collusive breaches of the law and the undermining of the protective cover for the Sentinelese and other Particularly Vulnerable Tribal Groups (PVTGs) like the Jarawas. What aggravates such tensions are the skewed developmental priorities that mainland India imposes on these islands
- The Andaman and Nicobar Islands have historically been treated as terra nullius, or empty space, wherein mainland governments could inscribe their authority and initiate projects of control. The British initiated these projects treating the islands first as a strategic outpost and then a penal colony. The Indian government gave it a free society but used it as a space to settle its “excess” population. Hence the refugee rehabilitation schemes in the post-Partition years. It is this resettlement of the islands in independent India that demanded a renegotiation of its relations with the Islands’ indigenous communities. They had to be protected and cared for but moved out of their original forest habitats into newly designated “tribal reserves”. As a result of continuous settlement and often ill-conceived developmental projects on the islands over the past six decades, these reserves have become increasingly vulnerable to the intrusions of poachers, encroachers and tourists.
- We should be able to draw a few lessons from the unfortunate death of John Allen Chau and question the ways in which mainland India views the islands from its distant perch in New Delhi. The announcement of new projects for “holistic” development will take a context-sensitive “island view” of development and recognise settlers and PVTGs as equal stakeholders in a common sustainable future.
GS II: SOCIAL-HEALTH
Q2. Discuss the need for India to catch-up on the growing use of technology in healthcare.
- The world as we know it is changing so fast and so much. Global mega-trends only reinforce this fact. The Internet has taken over our lives, smartphone penetration is growing rapidly, demographics are evolving. Healthcare is no stranger to change — in fact, the most impactful transformations in human life have happened in healthcare. Healthcare in India too has been transformed over the last three decades, and as members of this industry, we can be proud of how far we’ve come in terms of improved indices on life expectancy, infant mortality, maternal deaths and quality of outcomes.
- But we cannot rest on these achievements now, because the pace of change is still scorching, and is fundamentally altering disease patterns, patient risk profiles and their expectations. Information technology and biotechnology are twin engines, with immense potential to transform the mechanics of care delivery, the outcomes we can achieve and, above all, the lives we can touch and save.
- There are several examples of the kinds of impact technology and biotechnology can make on healthcare. Telemedicine has already brought healthcare to the remotest corners of the country. The use of artificial intelligence for preventive and predictive health analytics can strongly support clinical diagnosis with evidence-based guidance, and also prevent disease. From the virtual reality (VR) of 3D-printing, we are now moving towards augmented reality (AR), by which, for example, every piece of node in a malignant melanoma can be completely removed, thereby eliminating the risk of the cancer spreading to any other part of the body. Biotechnology, cell biology and genetics are opening up whole new paradigms of understanding of human life and disease, and have made personalised medicine a way of life. India needs to rapidly adapt to, embrace and drive change if it wishes to stay relevant in the global healthcare order.
- India’s change imperative has become even more pronounced with the launch of the Pradhan Mantri Jan Arogya Yojana Abhiyan, or National Health Protection Mission (NHPM), under the ambit of Ayushman Bharat. This major shift in approach to public health addresses the healthcare needs of over 500 million Indians in the first stage through what is probably the world’s largest public health-for-all insurance scheme. The vast scale of the programme requires reimagining an innovative model which will transform healthcare delivery in the country. By leapfrogging through smart adoption of technology and using emerging platforms such as Blockchain, significant improvements are possible in healthcare operations and costs.
- The private health sector is committed to support this programme, and ensure its success, because we are beneficiaries of society’s social licence to operate, and it is our responsibility to make sure this programme reaches the most vulnerable and the under-privileged, for whom it is intended. At the same time, we have a solemn responsibility to ensure that the sector is sustainable in the long term. For India to grow, healthcare as an engine of the economy needs to flourish. And the private sector, which has contributed over 80% of the bed additions in the last decade, needs to earn healthy rates of return on investment to continue capital investment in infrastructure, technology upgrades, and to have the ability to acquire top clinical talent, which can lead to differentiated outcomes. In our quest to achieve low-cost healthcare, we must not inhibit our potential for growth, nor isolate ourselves from exciting global developments.
- We need to achieve a balance between staying at the cutting edge of clinical protocols, technology and innovation and continue to deliver world-class care, while finding increasingly efficient ways of operating to continuously lower the cost of care and bring it within the reach of those who cannot afford it. This is a difficult balance to achieve, but not impossible. And when accomplished, India would have found an answer that can be an example for the rest of the world to emulate.