Sunday, February 26, 2017

No Rehabilitation Medicine specialist (Physiatrist) HoD in PGI Chandigarh since 2009

 No Physical Medicine & Rehabilitation (Physiatrist) specialist HoD in PGI Chandigarh since 2009

If you have suffered from a stroke and need proper rehabilitation, PGI is not your place of care, as there is no physical medicine and medical rehabilitation specialist (PMR)­ HoD physiatrist since 2009. There is an orthopaedician instead. What kind of wheelchair or braces is required can only be recommended by a physiatrist, say experts.

 In fact, the institute had placed an advertisement for the post of professor in the PMR department on April 24 last year and changed the recruitment rules. These rules allowed orthopaedicians with less experience in PMR to join.The recruitment rules were changed after four months on August 6 and the advertisement was withdrawn subsequently .

PGI is not only disabled-unfriendly institute, the rehabilitation services for the disabled has been compromised with new recruitment rules which were accepted in 2016. “There are few physiatrists with requisite experience required all over the country . I had applied for the post of the professor and despite the fact that there was no other such specialists who had over 14 years of experience as I had, the post was left vacant,“ said professor V S Gogia, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow.

As per the MCI and the UPSC rules (a copy of which is with the TOI), which the AIIMS follows, priority is given to a physiatrist with an experience of 14 years. However, if the specialist is not available, MD in surgery , orthopaedics or medicine may apply with same years of experience in PMR. The PGI's new advertisement has relaxed six years for non PMR, while for a qualified PMR, the experience remains 14 years for the post of professor.

Recently , a health activist based in New Delhi, Dr Satendra Singh, had been invited by the Ministry of health and family welfare (GNCTD) after he proposed setting up of a department of physical medicine and medical rehabilitation in all government colleges in Delhi. “The institute in its advertisement has equated physiotherapist with a PMR. The recruitment rules have been reshaped, which is against MCI norms and smacks of vested interests,“ said Dr Satendra. However, PGI officiating director Dr Subash Varma said, “These recruitment rules have been changed before I occupied this post. Even AIIMS has the same rules as we have."
Times of India, Chandigarh, 16 Feb 2017

Following my Facebook post where I wrote an open letter to Health Minister on the neglect of Rehabilitation services in the PGI Chandigarh, TOI Chandigarh carried the above story and also highlighted how there advertisement equated paramedical physiotherapists with MD/DNB Physiatrists. Full letter is reproduced below:

An Open Letter to Health Minister on the PMR mess at PGI
Shri J.P.Nadda ji
The Honorable Health Minister
Government of India
New Delhi

Rehabilitation is a process aimed at enabling persons with disabilities to attain and maintain optimal, physical, sensory, intellectual, psychological environmental or social function levels. At the outset, I declare that I have no conflict of interest. I am a MD Physiology and have no relation to Physical Medicine & Rehabilitation (PMR) or Orthopedic specialty. However, as a doctor with disability and a disability rights activist, I have petitioned State Commissioner (Disabilities), to direct Health Department of the Govt of the Delhi to instruct Medical Directors of the three hospitals under them to set up PMR department at the earliest. I have also written to Medical Council of India (MCI) to start Disability Medicine in medical curriculum and petitioned National Human Rights Commission on the accessibility of medical institutions in the Country.

The Department of PMR at PGIMER Chandigarh was created in 2008 to fulfill the Institute’s mandate of providing skilled manpower in this medical specialty, besides catering to the Persons with Disabilities (PwDs) and patients of functionally debilitating conditions from north India in the PGIMER catchment areas. This had become necessary after, in the back-drop of Persons with Disabilities Act 1995, India became one of the signatories to United Nations Conventions on Rights of Persons with Disabilities (#UNCRPD) and it became a duty of the state to provide Rehabilitation Services to PwDs.

In March 2009, then Professor & Head of the Department repatriated back to his parent Institute (All India Institute of Medical Sciences, Delhi). The Department of PMR at PGIMER has been under part-time, care-taker Head of the department since April 2009. The incumbent part-time, care-taker head of the Department is neither a PMR specialist nor has any previous PMR experience. The department therefore is without full time PMR Specialist HoD since April 2009 and has reduced to just a glorified physiotherapy service only. Even Neurology dept at PGI has been referring patients to PMR Dept of CMC Ludhiana.

The Court of Chief Commissioner for Persons with Disabilities has earlier instructed MCI vide CCPD No.9-3/CCD/2007 dated 15 May 2008 that “doctors not trained on rehabilitation should restrict their treatment of children with disabilities to their medical illness/disease or else action be initiated against such practices under relevant section of MCI.”

The interviews were held for the post of Professor of PMR in 2015 and 2016 but the only candidate having the required PMR qualification and requisite experience was not selected. Moreover, the faculty recruitment rules were changed during the recruitment process last August, as the post was withdrawn (06 October 2016) and re-advertised (07 October 2016) incorporating arbitrary and illogical eligibility criteria against MCI norms for non-PMR specialists.

In the new recruitment rules, for faculty in PMR, MS (Orthopedics) was also added as one of the eligibility qualifications. The experience criteria for MS (Ortho) candidates were also relaxed. A PMR Specialist needs to have 14, 10, 6 and 3 years of experience for the posts of Professor, Additional Professor, Associate Professor and Assistant Professor in PMR respectively, while a non-PMR Specialist (read MS Orthopedics) candidate needs only 8, 5, 3 and 2 years of experience in PMR out of 14, 10, 6 and 3 years for the same posts.

In fact, AIIMS Delhi, UPSC and MCl of India require 2 years of additional PMR training for non-PMR specialists (MS Orthopedics, MD General Medicine, MS General Surgery) to be considered for PMR faculty/consultant posts.

With the passage of the new Disability Act, it has become all the more important that strong PMR Dept be there to cater to the obligations of the state as provided under the RPWD Act 2016 and Article 25,26 of the UNCRPD. It is therefore requested to revive the rehab services at PGI Chandigarh by:
a) Appointing a full time PMR Specialist as Professor and Head of the Department; and
If at all the PMR faculty recruitment rules are to be revisited and modified, the inputs should be from PMR Specialists in other National Institutes (AIIMS/JIPMER/NIMHANS)/medical colleges with PMR teaching departments, and Doctors with Disabilities.

#Disability #CRPD #RPWD #Rehabilitation #Physiatry #PMR

Web Accessibility workshop at the Election Commission of India

Dr Satendra Singh, Amit Verma and Prashant Ranjan Verma at Election Commission of India
 We conducted a Web Accessibility workshop at the Election Commission of India on 1 February 2017. I took the inaugural session then Prashant Ranjan Verma (National Association for the Blind) and Amit Verma helped participants with hands on session on laptops. Disability Rights Alliance was involved in this too. We are happy to get opportunity to visit this organisation which is among the few respected by all.

Mr Vijay Dev (Deputy Election Commissioner) and Dr Satendra Singh
After the workshop participants from different states admitted that they were not aware of the barriers their websites had for person with disabilities and now they will try to comply with The web content accessibility guidelines WCAG.

Hope to see improvements in the election commission websites of Gujarat , Manipur, Urrarakhand and Uttar Pradesh soon.

'The Wire' has published a detailed article on our endeavours as how disability activists and EC worked to make assembly polls more accessible. It also highlights the pioneering work down by DM Azamgarh Suhash LY and his wife Additional DM Ritu Suhas in making elections disabled friendly.

Disability Activists and EC Work to Make Assembly Polls More Accessible (The Wire)

Special mobile apps, software, infrastructure, training for personnel and feedback mechanisms have been created to make voting easier for persons with disabilities.

Read the full article at this link.

#A11y #Accessibility #Inclusion #Disability

Workshop on simplification of forms while availing excise rebate

After a lengthy advocacy with Dept of Heavy Industries (DHI), Centre quashed manufacturer's certificate required to avail excise duty concession on the purchase of a new car by a person with disability. This was largely because of my face off with high-headed and insensitive Maruti Suzuki India Limited (MSIL). Still, few problems remained in the medical certificate.

National Centre for Good Governance (NCGG), an autonomous institute under DoPT, along with DHI organised a technical workshop on 'Citizen Centric Governance: Simplification of Forms' today at India International Centre where I was invited too along with stakeholders from auto industries and people who 'faced the music' while availing such concession. Hats off to DHI for revising the 16-question proforma to a single page. Feedback was sough on this revised format.

I suggested removal of medical examination certificate in entirety and replace it with either Disability Certificate OR MSJE's Unique Disability ID (UDID). Director General of NCGG Dr Gyanendra Badgaiyan was very receptive. Few participant raised the issue of multiple format by hospitals to which I highlighted 'Persons with Disabilities Amendment Rules 2009’. Based on stakeholder response from disability sector, RTO certificate was preferred over manufacturer. The affidavit wont be needed as the same info can be used in the online form just above signature. UDID will also make copy of Aadhar card irrelevant.

DG NCGG was especially irked by 'invalid carriage' and I proposed to use the term 'Adapted/Altered Vehicle driven by a person with disability'. He said he will personally take up the issues with Secretaries. Knowing his past contribution in bureaucracy, I am hopeful. Revision of forms will help those PwD also who can use manual transmission. Unlike the PMR deptt of Safdarjug Hospital, now PwDs wont be asked to get mental certificate on 'state of mental health' (Yes, they have actually mentioned this in writing)

Hats off to DHI and Director Praveen Aggarwal and Under Secy Ajai Gaur for hearing me patiently and putting things into action over the past one year. This is not their job still they are doing it. Sadly, I dont have such nice words for nodal Ministry (MSJE or Deptt of Empowerment of PwD)

Saturday, December 17, 2016

RPWD Bill in Lok Sabha: Bill passed but activists term disability bill a 'skeptical Act'

Rights of Persons with Disabilities Bill, 2014

Introduction: 7 Feb, 2014
Com. Ref.: 16 Sept 2014
Com. Rep.: 7 May, 2015

Rajya Sabha: 14 Dec 2016 (Passed)

Lok Sabha: 16 Dec 2016 (Passed)

Activists term disability bill a 'skeptical Act'

TIMES OF INDIA, Delhi, 16 Dec

NEW DELHI: Even as the Rights of Persons with Disabilities Bill 2016 got the approval of Lok Sabha on Friday and Rajya Sabha on Wednesday, disability rights' groups and activists punched holes into the new Act on Friday. While welcoming the passing of the bill, the process which started in 2007, they say that many provisions of the bill will "inculcate exclusion," and that "this Act will be more of obstacles rather than implementation." Activists are also concerned with the bill not specifying any provisions for women and children with disabilities, who are among the most vulnerable groups of the society. 

Concerned over the passing of the bill without any discussion in the Upper House of the Indian Parliament, Sambhavana Organization, a disability rights' NGO said that due to this "the Bill has been passed with many inadequacies and unresolved issues," many of which they claim were part of the previous draft bills "which have been omitted or diluted in the present one." 

"We feel happy with the passing of the Bill, but are concerned over the fact that there has been no discussion on it in the Rajya Sabha. This means the issue of disability is not a priority for the policy makers," said Nikhil Jain, president, Sambhavana. 

While the categories of disabilities have increased threefold, from seven to 21, the amended bill provides only 4% reservation for Persons with Disabilities (PwDs) which has been 3% so far. The rights' groups and activists were demanding retention of at least 5%. "Reservation in jobs, once proposed to be enhanced from 3% (1995 Act) to 5% (2014), has now been restricted to 4%," said disability right's activist, Dr Satendra Singh

Stating that the United Nations Convention on the Rights of Persons with Disabilities, which India is a signatory envisage "no policies without the PwDs in its ambit," Pankaj Sinha, a disability rights activist said that the rights of the disabled have been curtailed by the new Bill. 

"The amendments have been in waiting since 2007 and drafts of many committees rejected. The previous government also tried to pass an ordinance after the Sudha Kaul committee report was not accepted. The present government without putting the draft in public domain passed it," said Sinha. 

Stating that the Bill leaves a lot of lacunas for violators to get scot free, activists said that need of the hour has been more teeth for punitive action. "Another amendment drops imprisonment (two months to six months) for violation. There is only a fine of Rs 10,000 to Rs 5 lakh," added Singh. 

Another major concern has been regarding the rights of women and children with disabilities. "There is a special mention about rights of women and children with disabilities, but nothing specific has been stated. There is no legal provision for women with disabilities in marriage or divorce laws, where we need more clarity because they suffer the most. As far as children with disabilities are concerned there is also a special mention, but we need to clarity on how they are treated in institutions and inclusive education for them. In adoption laws too children with disabilities are left out. We need more specific provisions regarding adoption of children with disabilities," said Abha Khetarpal, president, Cross for Hurdles. 

Subhash Chandra Vashishth, advocate, disability rights, Centre for Accessibility in Built Environment, also highlighted the dilution in the amendments such as how Section 3 (3) allows "discrimination against disabled person if it is 'a proportionate means of achieving a legitimate aim.' This clause leaves 'legitimate aim' open to the subjective interpretation of bureaucracy. 

According to Singh, "Only remarkable part of a skeptical Act is inclusion of autism, dyslexia, deaf-blindness and other impairments." 

The Blind Workers Union too claimed that the main problems faced by the disabled community have not been addressed. The union in a statement said, "The Bill continues to lack any serious engagement on the question of protecting the labour and economic rights of disabled persons employed in the private sector."
Source: Times of India, 16 Dec 2016

RPWD Bill in Rajya Sabha: Bill passed, New conditions, revised quota and a few concerns

Know your Rights of Persons with Disabilities Bill, 2014

Introduction: 7 Feb, 2014
Com. Ref.: 16 Sept 2014
Com. Rep.: 7 May, 2015

Rajya Sabha: 14 Dec 2016

Disabilities Bill passed in Rajya Sabha: New conditions, revised quota and a few concerns

The Rights of Persons with Disabilities Bill 2014, which was introduced in Rajya Sabha in 2014, was cleared Thursday with 119 amendments moved by union Minister for Social Justice and Empowerment Thawar Chand Gehlot. The legislation, drafted to make Indian laws compliant with the UN Convention on Rights of Persons with Disabilities, will replace the Persons with Disabilities Act 1995. The number of disabilities listed rises from seven in the 1995 Act through 19 in the 2014 bill to 21 after the amendments, including acid attack and Parkinson’s disease.

The bill sets the government a two-year deadline to ensure persons with disability get barrier-free access in all kinds of physical infrastructure and transport systems. It recognises the need for reservation for them in promotion and makes special mention of the rights of disabled women and children. It defines many terms vague in previous versions, including what constitutes discrimination.
While disability rights activists have welcomed the amendments, they are upset about section 3(3) allowing discrimination against a disabled person if it is “a proportionate means of achieving a legitimate aim”. Prasanna Kumar Pincha, till date the only disabled person appointed Chief Commissioner for Persons with Disabilities, welcomed the bill but said this clause leaves “legitimate aim” open to the subjective interpretation of the bureaucracy.
Also, reservation in jobs, once proposed to be enhanced from 3 per cent (1995 Act) to 5 per cent (2014), has now been restricted to 4 per cent. CPM MPs Sitaram Yechury, K K Ragesh and C P Narayanan moved amendments to rectify the discrimination and reservation clauses. Gehlot assured clauses will be inserted when rules are framed to ensure the discrimination clause is not misused. “Why is there a hesitation to address this concern regarding discrimination in the parent act itself?” Pincha said.
“The bill is definitely a stride forward from the 2014 bill,” said advocate S K Rungta, convener of the All India Disability Alliance. He felt there was no need for the bill to dilute the fundamental right to equality as the Supreme Court has often recognised “reasonable classification”. “For example, a blind person cannot be employed in the military. It clearly does not constitute discrimination.”
Another sore point with activists is a provision for a Chief Commissioner of Disabilities instead of National Commission proposed in 2014. The chief commissioner has only recommending powers and there is no provision to ensure he or she too is a disabled person. “Every commission — minorities, women, SCs or STs — has a chairperson from the same category,” said disability rights activist Dr Satendra Singh. Another amendment drops imprisonment (two months to six years) for violation. There is only a fine: Rs 10,000 to Rs 5 lakh.
Source: Indian Express 15th Dec 2016

RPWD Bill amendments: what they are, what they will do?

Know your Rights of Persons with Disabilities Bill, 2014

Introduction: 7 Feb, 2014
Com. Ref.: 16 Sept 2014
Com. Rep.: 7 May, 2015

The amendments to Disability Bill: what they are, what they will do?

What is the Disability Bill about?
The government will bring 119 amendments to the Rights of Persons with Disabilities Bill, 2014. The legislation has been pending in Rajya Sabha since February 2014; the term of the UPA government ended soon after it was introduced. The draft legislation is based on the 2010 report of the Ministry of Social Justice and Empowerment’s expert Sudha Kaul Committee, and will replace the Persons with Disabilities Act, 1995. The Bill is being brought to comply with the UN Convention on Rights of Persons with Disabilities, to which India became a signatory in 2007.
The 1995 Act recognised 7 disabilities — blindness, low vision, leprosy-cured, hearing impairment, locomotor disability, mental retardation and mental illness. The 2014 Bill expanded the definition of disability to cover 19 conditions, including cerebral palsy, haemophilia, multiple sclerosis, autism and thalassaemia among others. The Bill also allowed the central government to notify any other condition as a disability.
The 2011 Census put the number of disabled in India at 2.68 crore, or 2.21% of the population. This a gross underestimation, especially in the light of the proposed amendments, which greatly widen the current Census definition of disability. The Bill makes a larger number of people eligible for rights and entitlements by reason of their disability, and for welfare schemes and reservations in government jobs and education.
What changes have been proposed to the 2014 Bill?
The amended version recognises two other disabilities — resulting from acid attacks and Parkinson’s Disease — taking the number of recognised conditions to 21, and defines each one of them. It makes a special mention of the needs of women and children with disabilities, and lays down specific provisions on the guardianship of mentally ill persons. “The amendments include private firms in the definition of ‘establishments’, which previously referred to only government bodies. All such establishments have to ensure that persons with disabilities are provided with barrier-free access in buildings, transport systems and all kinds of public infrastructure, and are not discriminated against in matters of employment,” said an official from the Ministry of Social Justice.
All these are progressive amendments. Are there any obvious negatives?
The amendments, if passed in their present form, will dilute safeguards provided in the originally proposed Bill. The 1995 law had 3% reservation for the disabled in higher education institutions and government jobs — 1% each for physically, hearing and visually impaired persons. The 2014 Bill raised the ceiling to 5%, adding 1% each for mental illnesses and multiple disabilities. The proposed amendments cut the quota to 4%.
“When a greater number of disabilities are being brought under the purview of the Act, the percentage of reservation should go up proportionately, “ said Muralidharan, secretary, National Platform for the Rights of the Disabled.
The proposed amendments do away with the provision in the 2014 Bill for strong National and State Commissions for Persons with Disabilities, with powers on a par with a civil court. They instead continue with the status quo of having only a Chief Commissioner with far fewer powers.
“Several favourable orders given by the Chief Commissioner have been quashed by the courts on the ground that the Commissioner has no powers and is only a quasi-judicial body,” said disability rights activist Dr Satendra Singh. He added that while the proposed amendments rightly recognise a wider range of disabilities, they fail to specify the degree of disability for thalassaemia, learning disabilities or autism. “Moreover, in India there are no suitable tools to quantify autism or learning disabilities,” Dr Singh said.
What if the disability law is violated?
While the existing (1995) Act has no penal provision, the 2014 version made violation of any provision of the Act punishable with a jail term of up to 6 months, and/or a fine of Rs 10,000. Subsequent violations could attract a jail term of up to 2 years and/or a fine of Rs 50,000 to Rs 5 lakh. The amended Bill, however, proposes to remove the jail term entirely, and only keep fines for breaking the law or discriminating against persons with disabilities.
Will the amended law help eliminate discrimination against persons with disabilities?
The proposed amended law defines discrimination as “any distinction, exclusion, restriction on the basis of disability” which impairs or nullifies the exercise on an equal basis of rights in the “political, social, cultural, civil or any other field”. However, it condones such discrimination if “it is shown that the impugned act or omission is a proportionate means of achieving legitimate aim”. Disability rights activists see this rider as paving the way for extreme interpretations.
“The excuse given by the government is that we will cry discrimination if we are denied certain jobs like, say, that of a pilot. However, every job has certain basic requirements, and no person with disability will apply for it unless he or she meets the criteria,” said Muralidharan. CPM MPs K K Ragesh and C P Narayanan are set to move amendments to the Bill asking for this provision to be deleted, and for retaining only the clause, “No person with disability shall be discriminated on the grounds of disability”.

As reported in Indian Express on 13th Dec 2016

Saturday, December 10, 2016

Accessibility is Human Rights issue

3 December 2015: It was my first visit to Vigyan Bhawan, New Delhi to witness the National Award function on International Day of Persons with Disabilities. Govt of India launched the Accessible India Campaign from here but alas the venue was disabled friendly. I along with Abha Khetarpal wrote to the PMO office and Department of Empowerment of Persons with Disabilities about the inaccessible ramp the very next day.

4 December 2015: I was invited at Social Welfare Department of Govt of Delhi on my grievance of web-inaccessibility. When I reached there, I found the premises again disabled-unfriendly. The same day I registered my complaint.

6 December 2015: I was returning to home when I saw the 'masterpiece' steep ramp at IDBI Bank in Vasundhara, Ghaziabad near my house. I tweeted to the officials at the same moment.

A year later!

Today is Human Rights Day (10 December 2016) and the theme is #StandUp4HumanRights

"“Where, after all, do universal human rights begin? In small places, close to home - so close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual person; the neighborhood he lives in; the school or college he attends; the factory, farm, or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere." (Eleanor Roosevelt)

I followed up with all three officials where I get success with IDBI Bank, partial success with Delhi Govt as they released tender for installation of lift and no result with Central Govt as their overhyped Accessible India Campaign failed to produce any results.

Youth Ki Awaaz followed the IDBI story which you can read here. News18's Citizen Journalist program also covered the story:


The end result was creation of an accessible ramp by IDBI Bank.Times of India covered the story on the Diwali Day:
GHAZIABAD: The relentless pursuit for over one year by a differently abled activist has prompted one of the banks in Vasundhara to construct a ramp at its building to enable wheelchair-bound customers to enter premises. The activist had found it difficult to access many banks in the area as he had to climb a fleet of steep stairs.
Bank Manager Sumit Jakhar with Dr Satendra Singh
This year also marks ten years of coming into existence of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) which is the first human rights treaty in the 21st Century. Article 9 of UNCRPD states:
States Parties shall take appropriate measures to ensure to persons with disabilities access, on an equal basis with others, to the physical environment, to transportation, to information and communications, including information and communications technologies and systems, and to other facilities and services open or provided to the public, both in urban and in rural areas.
Since India has ratified the convention, it is obligation of the State to provide us accessibility. As I quote Ms Roosvelt above, no effort is small or insignificant. Accessibility is human rights issue and we should strive to make a difference. Every little effort counts.

#HumanRightsDay #StandUp4HumanRights #envision2030 #CRPD #SDGs #dISABILITY #NothingAboutUsWithoutUs #LeaveNoOneBehind