More than 200 people write to PM Modi opposing the IMA demand to rewrite NCERT textbook
To
Shri Narendra Modi,
Prime Minister of India,
Prime Minister of India,
South Block,
Raisina Hill
New Delhi 110 011
Subject: Letter opposing the Indian Medical Association’s (IMA) demand to rewrite / delete the Chapter 2 Social Science textbook on Social and Political Life (SPL) for Grade 7
We, the undersigned, medical professionals, educationist, academics, teachers, civil society organisations and other concerned individuals are writing to express our deep concern vis-a-vis the recent demand by the Indian Medical Association (IMA) for “immediate remedial action” on content included in the National Council of Educational Research and Training (NCERT)’s Social Science textbook on Social and Political Life (SPL) for Grade 7. The IMA’s demand to rewrite or delete the chapter is clearly unreasonable and unacceptable, as are the threats that the IMA has issued against the NCERT and the authors.
Chapter Two on “Role of the Government in Health” in the above-mentioned textbook, sections of which the IMA is raising objections to, is part of a series of textbooks that were developed through a consultative process initiated by the NCERT, involving academics, teachers, researchers, government school teachers and civil society organizations with substantive experience and expertise in the thematic areas covered in the textbooks during 2005-08. These textbooks also underwent an independent process of systematic review prior to publication.
The SPL textbooks, as the name suggests, focus on themes related to social, economic and political life in contemporary India building on the well-recognized pedagogic principle that children learn best through concrete examples. The SPL textbooks aim to develop the abilities of children to critically engage and analyze these realities in keeping with the tenets of the Constitution of India. The chapter that is under contention, focuses on the critical role that equality exercises in Indian democracy and each of the five units of the book highlight a particular issue related to elucidating this theme. Health is one of the issues discussed and is included in Unit 2 on ‘State Government’, which contains two chapters on the “Role of the Government in Health” and “How the State Government Works”.
As the titles make clear, these chapters aim to present and discuss the government’s role and responsibilities around providing quality health care for all in a democracy.
Specifically, the chapters attempt to get students to begin thinking critically about inequities in health care, including concerns of availability, accessibility and quality. In presenting these concerns, the chapter includes a discussion of the private and public facilities, which comprise the health sector in India. The objective of the chapter is not a comparison of the public and private health care sectors, rather the chapter seeks to reiterate the state’s responsibility in a democracy and emphasize the implications of the withdrawal / insufficient provisioning by the government for public goods, namely health care. Reference to this central idea can be found in the “The Story of Hakim Sheikh”, where many government hospitals refused to admit him for treatment. This real case study is used as a running thread through the chapter and illustrates that denial of health care violates the constitutional provision for the right to life. This landmark judgment by the Court would encourage the student to think of the wider public interest and not accept the implications of these situations as natural.
The IMA’s allegations and demands are unfortunate and based on a selective reading of the chapter. The IMA has raised objections to a couple of lines regarding the costs of treatment in the story board – however, following the story board are questions that invite students to look at it in an open ended manner, relate to the social context and bring their own experience in an illness to the classroom. The storyboard is an important educational tool that facilitates students’ understanding of the diversity and inequalities evident in access to health care (not a simple public versus private distinction as has been understood by IMA); and the government’s role in health care provisioning, governance and accountability.
Further, abundant evidence exists that indicates the severe costs of health care in the private health care sector. It is a known fact that private health care is largely unaffordable for the vast majority of Indians. Indeed, out of pocket expenditure on health in India is one of the highest in the world, and health care costs contribute to indebtedness for a significant portion of our population. According to the World Health Organization (WHO) India National Health Accounts (NHA) data for 2013, out of pocket (OOP) expenditure as percentage of Private Health Expenditure in India, was 86 percent. On average, a much higher amount (four times) is spent for treatment per hospitalized case by people in the private (INR 25850) than in the public (INR 6120). The average cost of hospitalization for childbirth in rural areas is Rs. 1587 and Rs. 14778 and in the urban areas Rs. 2117 and Rs. 20328 in public and private hospitals respectively (NSSO). Health Surveys have also pointed to, for example, that the number of caesarean deliveries in private hospitals was almost three to 10 times more as compared to government hospitals (AHS2012-13). A World Health Organization study, which reviewed 1,10,000 births from nine countries in Asia including India in 2010, revealed more than 60 per cent of the hospitals studied, where these C-sections took place, did it for financial gains and not because it was required. (http://www.
The IMA’s objections to sentences, which discuss the private sector and state, “In order to earn more money, these private services encourage practices that are incorrect. At times, cheaper methods, though available, are not used. For example, it is common to find doctors prescribing unnecessary medicines, injections or saline bottles when tablets or simple medicines can suffice.” Evidence of such practices is widely available including in a recently released book based on interviews with 78 doctors across India also includes narratives of “widespread irrational drug prescribing, kickbacks for referrals, and unnecessary investigations and surgical procedures”. (Voices of Conscience from the Medical Profession (SAATHI); http://live.
Further, IMA’s allegation that students will be “brainwashed” against the private health sector, is unfortunate and unfounded. It has been long established that students, however young, bring to the classroom knowledge and experience that the classroom process needs to facilitate as part of the process of learning. The IMA’s objection to one frame from a storyboard is not only disingenuous but completely misunderstands and disregards the educational requirements of textbooks.
Undoubtedly, there are doctors who conduct ethical private practice, as there are government hospitals that are run effectively. The chapter as currently written provides enough questions in the text to enable students to engage in a discussion based on their health care experiences thereby allowing them to agree or contend with the information that the chapter makes available and to understand that there are implications for society that faces such inequality in access including costs for a basic need, especially given the current environment that is encouraging of privatization- indeed corporatization of health.
As the above data show, a large section of society in our country is denied basic health care. The demand by IMA will result in students receiving a distorted and incorrect representation of issues that the Indian health care sector continues to grapple with. It would also work to stymie the development of critical thinking skills in students through engaging difficult concepts like ‘equality’ and ‘democracy’ through their own experiences. Sound and proven educational principles should not be allowed to be jettisoned by particular interest groups, irrespective of their political and ideological position.
We, therefore, reiterate the unacceptability of the demands by IMA and oppose any attempts to undermine the intent of these textbooks. We urge you to reject the demand by IMA to rewrite or delete Chapter 2 on ‘Role of the Government in Health’ in the Social and Political Life Class 7 textbook.
Signed by the Textbook writing team for the SPL textbook for Grade 7:
Dr.Sarada Balagopalan (Chief Advisor), Arvind Sardana (Advisor) Dipta Bhog,
N Sarojini, Malini Ghose, Prof Krishna Menon, Prof Mary John, Prof Anjali Monteiro and Sukanya Bose (Members)
Endorsed by:
- Medico Friend Circle (MFC)
- Jan Swasthya Abhiyan (JSA)
- Forum for Medical Ethics Society (FMES)
- Prof. Imrana Qadeer
- Prof Anita Rampal, New Delhi
- Prof. Uma Chakravarti, New Delhi
- Dr. Mira Shiva, Initiative for Health and Equity in Society, Diverse Women for Diversity, New Delhi
- Prof Jayati Ghosh
- Prof. Krishna Kumar, New Delhi
- Dr. Amar Jesani, Editor, Indian Journal of Medical Ethics
- Dr. Abhay Shukla, Pune
- Dr. Amit Sen Gupta, New Delhi
- Dr. Devaki Jain
- Prof. Nandini Sundar, New Delhi
- Prof. Vijaya Mulay, New Delhi
- Dr Syeda Hameed, New Delhi
- Adv. Veena Johari, Mumbai
- Prof. Ghanshyam Shah
- Dilip Simeon, New Delhi
- Prof. Zoya Hasan, New Delhi
- Dr. Dhruv Mankad
- Dr. Vandana Prasad, New Delhi
- Dr. Anant Phadke, Pune
- Prof Nivedita Menon, Jawaharlal Nehru University, New Delhi
- Prof. Nandini Manjrekar, Tata Institute of Social Sciences, Mumbai
- Dr Poonam Batra, Central Institute of Education, Delhi University
- Admiral L Ramdas, Alibagh
- Dr. C. Sathyamala
- Dr Aditya Nigam, The Centre for the Study of Developing Societies (CSDS), New Delhi
- Harsh Mander, New Delhi
- Himanshu Srivastava, Homi Bhabha Centre for Science Education
- Uma Sudhir, Eklavya
- Prof. Kamal Mitra Chenoy, New Delhi
- Dr Sadhna Saxena, CIE, Delhi University, New Delhi
- Gagan Sethi, Janvikas, Ahmedabad
- Prof. Rajni Pailriwala
- Dr. Rakhal Gaitonde, Parent of Class 7 student, Chennai
- Kavita Srivastava, Jaipur
- Suhasini Mulay, New Delhi
- Ravi Duggal, Mumbai
- Dr Sanjeevani Kulkarni, Prayas Health Group, Pune
- Dr. S.V. Nadkarni, Ex Dean L.T.M. Medical College, Mumbai
- Dr. Shree Mulay, Canada
- Prof. Susie Tharu, Co-editor Towards a Critical Medical Practice
- Dr. Veena Shatrugna, Former Deputy Director NIN, Hyderabad
- Prof. Mohan Rao, New Delhi
- Prof. Sujata Patel, University of Hyderabad, Hyderabad
- Prof. Janaki Nair, New Delhi
- Pamela Philipose, New Delhi
- Prof. Padmini Swaminathan, TISS, Hyderabad
- Prof. Rama Baru, New Delhi
- Vimala Ramachandran
- Farah Naqvi, Writer and Activist, New Delhi
- Kalpana Mehta, Manasi Swasthya Sansthan, Indore
- Deepa V., Sama Resource Group for Women and Health, New Delhi
- Dr Monisha Behal, North East Network
- Sheba George, SAHR WARU, Ahmedabad
- Nirantar Resource Centre, New Delhi
- Shabnam Hashmi, ANHAD, Delhi
- Prof. Gita Sen, Bengaluru
- Vani and Ashima, Saheli Women’s Resource Centre, New Delhi
- Mujahid Nafees, Education Activist, Gujarat Right to Education Forum
- Asha Mishra, Bharat Gyan Vikas Samiti
- Disha Nawani, Tata Institute of Social Sciences, Mumbai
- Amman Madan, Azim Premji University
- Meena Saraswathi Seshu, SANGRAM, Sangli
- Dr R Srivatsan, Hyderabad
- R Nagaraj, Indira Gandhi Institute for Development Research
- Bhupendra Yadav, Azim Premji University
- Manisha Gupte, Pune
- Simantini Dhuru, Avehi Abacus
- S. Srinivasan, Vadodara
- Dr Anita Dighe
- Arundhati Dhuru, Lucknow
- Dr. Narendra Gupta, Prayas, Rajasthan
- Prof. Purendra Prasad, University of Hyderabad
- Kiran Shaheen, Writer and Anti Poverty activist
- Dr. Sagari Ramdas, Sovereignty Alliance
- Prof. Sheela Prasad
- Gargee Guha, Swayam, Kolkata
- Renuka Mishra, New Delhi
- Dr. N Raghuram, GGS Indraprastha University, New Delhi
- Lalitha Ramdas
- Dr. Dinesh Agarwal, New Delhi
- Dr. Gopal Dabade, Drug Action Forum- Karnataka
- Prof. Rachana Johri, Delhi
- Biraj Patnaik, New Delhi
- Prof. Atul Sood, New Delhi
- Bittu K, University of Hyderabad
- Prabha Nagaraja, TARSHI, New Delhi
- Aatreyee Sen, Forum for Human Rights and Justice
- Dr. Joe Verghese, New Delhi
- Dr. Abhijit Das, New Delhi
- Dr. Prabir Chatterjee
- Virginia Saldanha, Secretary, Indian Christian Women’s Movement
- Dr. Amrita Chhachhi
- Satinath Sarangi, Sambhavna Trust, Bhopal
- Prof Veena Poonacha
- Sumi Krishna
- Bijoya Roy, New Delhi
- Ranjan De, Delhi
- Rupsa Malik, CREA, Delhi
- Esha, Health Watch Forum, Uttar Pradesh
- Kalyani Menon Sen, New Delhi
- Dr. V Suresh, Jan Swasthya Abhiyan, Andhra Pradesh
- Sulakshana Nandi, Chhattisgarh
- Dr. Navsharan Singh, New Delhi
- Kumkum Roy, Jawaharlal Nehru University (JNU), New Delhi
- Manish Jain, Ambedkar University, Delhi
- Dr. Ramani Atkuri, Bhopal
- Dr. Varsha
- Dr. Ramila Bisht, New Delhi
- Suhas Kolhekar, Jan Swasthya Abhiyan and National Alliance for People’s Movements (NAPM)
- Vrinda Marwah, New Delhi
- Chayanika Shah, Teacher, Activist, Researcher, Mumbai
- Simran Sawhney, New Delhi
- Kamal Mahendroo, Vidya Bhawan
- Arunan M C, Homi Bhabha Centre for Science Education (HBCSE)
- Sanjai Sharma, Human Rights Law Network (HRLN), New Delhi
- Priya Ranjan, New Delhi
- Amulya Nidhi, Indore
- Nazia Hassan, New Delhi
- Neeraj Malik
- Nimisha, Olakh, Vadodara
- Koninika, National Federation for Indian Women (NFIW)
- Sunita Bandewar, Pune
- Rashida Bee, Bhopal Gas Peedit Mahila Stationary Karmchari Sangh, Bhopal
- Gurumurthy Kasinathan, IT for Change
- Mina Swaminathan
- Shikha Sen, Documentary Editor, New Delhi
- Rachna Dhingra, Bhopal Group for Information and Action
- Trupti Shah, Sahiyar, Vadodara
- D. W. Karuna, Historian, Chennai
- Pramada Menon, New Delhi
- Abha Bhaiya, Himachal Pradesh
- Sonia Jabbar, New Delhi
- Neha Madhiwala, Mumbai
- Sana Contractor, New Delhi
- Aswathy Raveendran, PhD Student, Homi Bhabha Centre for Science Education (HBCSE)
- Dr. Vinay Kulkarni, Prayas Health Group, Pune
- Helen Saldanha
- Sheba Chhachhi, New Delhi
- Kamayani Bali Mahabal, Feminist and Human Rights Activist, Mumbai
- Almas Shamim
- Balkrishna Namdeo, Bhopal Gas Peedit Nirashrit Pension Bhogee Sangarsh Morcha
- Nawab Khan, Bhopal Gas Peedit Mahila Purush Sangarsh Morcha
- Dr. Sunita Reddy, New Delhi
- Dr. Abhijit More, Pune
- Ameer Khan, Chennai
- Adsa Fatima, New Delhi
- Gouranga Mohapatra, Bhubaneshwar
- Malini Aisola, New Delhi
- Sunita Chowdhury, New Delhi
- Nandita Bhatla, Delhi
- Anjali Shenoi, Pune
- Askari Naqvi, Lucknow
- Gracy Andrew
- Preeti Nayak, Bhubaneshwar
- Purwa Bharadwaj, New Delhi
- Prof. Bal Chander, Himachal Pradesh
- Meera Samson
- Padma Deosthali, Mumbai
- Disha Mallick, Delhi
- Satnam Singh, Rohtak
- Rohini Hensman, Writer and Researcher
- Runu Chakraborty, Delhi
- Mary Scaria
- Nandini Rao, Activist, New Delhi
- Vaibhao Ambhore, New Delhi
- Soma K P, Researcher and Advisor, New Delhi
- Rohini Kandhari, New Delhi
- Uma V Chandu
- Mahesh Daga, New Delhi
- Sabala, Mumbai
- Kranti, Mumbai
- Uma Maheshwari Bhurugubanda
- Shalini Joshi, New Delhi
- Juhi Jain, New Delhi
- Bindhulakshmi Pattadath, TISS, Mumbai
- Dr Roshmi Goswami
- Purnima Gupta, New Delhi
- Pallavi Gupta, New Delhi
- Mehzabeen Hussain, New Delhi
- Kalyani Badola, New Delhi
- Maimoona Molla, Delhi
- Jagdish Patel, Vadodara, Gujarat
- Prof. K.S. Jacob, Christian Medical College, Vellore
- Sudha Nagaravarapu
- Kashi Nath Chatterjee, BGVS
- Anuradha, Freelance Development Professional
- Ritwik De, New Delhi
- Tarang Mahajan, New Delhi
- Satish Singh, New Delhi
- Devaki Nambiar, Delhi
- Jaya Sharma, New Delhi
- Sangeeta Dasgupta
- Anuradha De, New Delhi
- Poonam Arora, New Delhi
- Sudeshna Sengupta, Alliance for Right to Early Childhood Development
- Rupamanjari Hegde, Delhi
- Bishakha Datta, Mumbai
- Deepika Singh, Ahmedabad
- Sharad Behar, Bhopal
- Dr Varsha Deshmukh, Detroit
- Shailla Baidya, Dubai, School teacher
- Khursheed Mehta, Mumbai
- Gopika Chowfla, Graphic Designer, New Delhi
- Anu Gupta, Dewas
- Dr Thelma Narayan, Bengaluru
- Madhavi Kuckreja, Lucknow
- Susheela Singh, New Delhi
- Malini Subramaniam
- Shaila Mallik
Contact:
Arvind Sardana 09425605395
Malini Ghose: 09899019421
Dipta Bhog: 09891400302
Sarojini N: 0918664634
Sarada Balagopalan: 033-24664733
email: spl7textbookncert@
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