Doctors with disability: Surgical jobs still denied

Rema Nagarajan,TNN | Jun 29, 2015 

If the health ministry and the Medical Council of India (MCI) had had their way, Dr Suresh H Advani, the haemato-oncologist who performed the first successful bone marrow transplant in India, would never have become a doctor. 

Advani's legs were afflicted by polio and he uses a wheelchair. By the health ministry's classification, he would be certified as being more than 70% disabled and hence not fit to study medicine. For decades, policy makers, mostly 'non-disabled', have decided what persons with disabilities are capable of. That is why, a double amputee or even a mid-thigh amputee, who would be classified as having 85% or more of locomotor disability, would not be allowed to study medicine. "How can some people sitting at the top decide what people are capable of, in a blanket fashion? If people can prove they're able to do a certain job, without asking for too many concessions, they ought to pose no hurdles," said Advani, who was initially denied permission to study medicine. He then obtained a special permit from the then state health minister to study in Grant Medical College, Mumbai, and completed his MBBS in 1969.

Medical colleges have been opened up to people with locomotor disabilities, thanks to the 1995 Disability Act. But until very recently, these doctors were kept out of all central health service (CHS) jobs. It took four years of RTI appeals and legal tussles by Dr Satendra Singh, a doctor with disability, to change this policy. 

Even though the health ministry has changed the policy for CHS jobs, discrimination continues in top institutions such as PGI Chandigarh, Maulana Azad Medical College in Delhi and various ESI hospitals and medical colleges across the country. TOI has scanned copies of advertisements that state jobs under non-surgical disciplines only are reserved for persons with locomotor disabilities. Ironically, several MBBS graduates with disabilities who cleared the PG entrance exam have been allotted surgical disciplines. "Why allot us surgical disciplines and train us when these jobs are not open to us?" asked a student who is currently pursuing PG in orthopaedics. 

In 2003, the MCI stipulated that only those with locomotor disability of the lower limbs between 50% and 70% can be given admissions in medical courses and the courts ensured that these persons could avail the 3% disability quota in medical colleges. Certain disciplines have also been opened for those with one arm affected. In the 12 years since, even if just 1% of those 3% MBBS seats were filled, it would amount to over a thousand doctors with locomotor disability. 

Data on physicians with disability is not readily available internationally. But since 2000, associations of such doctors have been coming up in the US, the UK and Canada. In the UK, the General Medical Council has stated that a disability need not be a bar to becoming a doctor if the student can fulfill the demands of professional fitness to practise as a newly qualified doctor. 

In India, encouraged by their increasing numbers and Dr Singh's victory, these doctors are coming together to fight for their rights. Recently, they formed a Google group called 'Doctors with Disability: Agents of Change'. "I had approached the Indian Medical Association for help; they ignored us. But our numbers are growing and we are confident that we can do this on our own," said Dr Singh.Source: Times of India 29 June 2015     

Why are institutes still using the word “handicapped”?

The Hindu, 24 June 2015, New Delhi

A year after an advisory by the Union Ministry of Social Justices and Empowerment stating that various national institutes for persons with disabilities should discard the use of the word “handicapped” in their institute name and rename them — institutes continue to flout the recommendation and stick to “discriminatory names”.

National institutes such as National Institute for the Visually Handicapped, National Institute for the Hearing Handicapped, National Institute of Mentally Handicapped, National Institute of Visually Handicapped and National Institute for Orthopaedically Handicapped were instructed to remove the word “handicapped”, but to no avail.

“The word is simply not going away despite instructions to do away and replace it,” said disability activist Satendra Singh, Assistant Professor at University College of Medical Sciences and Guru Teg Bahadur hospitals.

“I wrote to the directors of these national institutes asking why the name hasn’t been changed so far. Nobody replied except the National Institute for the Hearing Handicapped. Even when the consultation and change was done last year, no consultation was done with disabled people organisations,” said Dr. Singh.

He filed an RTI application asking about the ban on the expression of the word “handicapped” and renaming national institutes accordingly.

“The response from the Ministry stated that that the file dealing with this issue was not readily traceable in the division. The information will be provided as and when the file is traced in the division,” said Dr. Singh.

He applied again in May and got a response stating that “a committee was set up under the Union Ministry of Social Justice and Empowerment and directors of the national institutes suggested following names in names for the establishments.’’

Boxed image: Name Game

1.      2007: India has ratified UNCRPD which makes it legally binding to harmonise all existing laws and policies in line with UNCRPD. The Convention uses the terminology ‘Persons with Disabilities’.

2012: The Chief Commissioner for Persons with Disabilities  banned the expression “handicapped”. 

1.      2014: Deptt of Disability Affairs was renamed as Department of Empowerment of Persons with Disabilities.

S.No	Name of the Institute	Name suggested by the committee
1.	Pt. Deen Dayal Upadhyaya Institute for the Physically Handicapped	Pt. Deen Dayal Upadhyaya Institute for the Persons with Physical Disabilities
2.	National Institute for Orthopedically Handicapped	National Institute for Persons with Locomotor Disabilities
3.	Ali Yavar Jung National Institute for the Hearing Handicapped	Ali Yavar Jung National Institute for the Persons with Speech & Hearing Disabilities
4.	National Institute for Mentally Handicapped	National Institute for Persons with Intellectual Developmental Disabilities
5.	National Institute for Visually Handicapped	National Institute for Persons with Visual Disabilities

The RTI added that the committee felt that there was no need to change the names of National Institute for Empowerment of Persons with Multiple Disabilities and Swami Vivekanand National Institute for Rehabilitation, Training and Research as they do not involve the expression handicapped.

“Negative terminology fosters attitudinal barriers. What is also shocking is the fact the Ministry of Social Justice and Empowerment doesn’t have the facility to provide information (circulars or RTI responses) in Braille. They told me that this information can be formatted only at the National Institute for Visually Handicapped, Dehradun,” said Dr. Singh.

While the directors of the institute refused to comment on the issue saying they were not authorised to speak to the media, a senior ministry official said the change of name was a long drawn process and takes time.


Source: http://www.thehindu.com/news/cities/Delhi/why-are-institutes-still-using-the-word-handicapped/article7348415.ece

A crusader's lone fight opens up CHS jobs for disabled doctors

After keeping out doctors with disability from over a thousand central health services (CHS) jobs for years, the health ministry has decided to open up teaching, non-teaching and public health specialist cadres of CHS to doctors with disability. The decision was the result of one doctor's relentless fight for justice over four years.

It all began in 2011, when Dr Satendra Singh, who became an assistant professor of Physiology in the University College of Medical Sciences and Guru Tegh Bahadur Hospital in Delhi in 2008, applied for the post of assistant professor (physiology) in the Teaching Specialist sub-cadre of CHS through the Union Public Service Commission (UPSC). He received no interview call.

Dr Singh, whose right leg is affected by polio, is certified as having 70% locomotor disability of the lower limb. The Medical Council of India has extended 3% reservation for persons with disability in medical college admissions, open only to students with locomotor disability of the lower limb between 40% and 70%. However, many such students who completed their MBBS and post-graduation were being kept out of services for which recruitment is done through the UPSC. "They are never told why they are rejected. I have a permanent job. I am in Delhi. How many doctors with disability who were rejected by UPSC can go to court or even approach the UPSC?" said Dr Singh, who is also a member of the Delhi Medical Council.

According to Dr Singh, he mentioned his disability in the application form because it demanded the information and not because he wanted to be selected under the disability quota. "On getting no interview call, I enquired at the UPSC recruitment cell and was told I am not fit to apply as I was disabled. This, despite the fact that I was already working as an assistant professor in a medical college under a central university," said Dr Singh.

He then approached the Central Administrative Tribunal, which asked the UPSC to call him for interview. He was called, but did not get selected. In 2013, seeing an ad for the same post, he applied just to find out if things had changed for disabled candidates. In the online form, when he filled the boxes on disability, type and percentage, the registration flashed, "sorry, you are not eligible for the post." Nothing had changed.

Dr Singh approached the court of the Chief Commissioner for persons with disability and the health ministry and got permission to apply for the posts, but UPSC cancelled all interviews in physiology, for reasons not known. "I was allowed to apply, but what about other candidates like me? I wanted the policy changed for all candidates with disability and not just for me and so I decided to follow up the issue," said Dr Singh.

Through an RTI application, Dr Singh found out that all specialist jobs under CHS, whether teaching, non-teaching or public health, were deemed not suitable for persons with disabilities. "To be granted an MBBS or MD/MS (post-graduation) degree, all disabled medical students attend clinical postings, operation theatres, OPDs and emergency postings during internship. How could they say we are not suitable? It was shocking. So, in December 2014, I wrote to the health minister requesting that all specialist posts under CHS be opened for doctors with disabilities," said Dr Singh.

Though the minister sought action, it was only after repeated reminders and phone calls to ministry officials that Dr Singh was finally told that all CHS posts were open to persons with disabilities. However, they did not give him a copy of the order. It took an RTI application for him to eventually get a copy on June 6.

Thanks to Dr Singh's persistence, 756 posts in the teaching specialist sub-cadre, 770 posts in non-teaching specialist sub-cadre and 78 posts in public health specialist sub-cadre have been thrown open to doctors with disabilities.

"PM Modi tweeted on World Disability Day that we, the people with disabilities, are 'heroes'. Unfortunately, these heroes have to go to courts for their rights and a government doctor has to file an RTI to get a government order," lamented Dr Singh.

Source: Times of India, 14 June 2015

'Hindu' highlights the Color Blind CSE aspirants issue

‘Consider colour-blind CSE aspirants for non-technical posts’

Yesterday, I highlighted the issue on  this blog here. The leading daily 'The Hindu' has picked up the story today. Here is the report:

Disability rights activists have written to the Secretary (Personnel), Department of Personnel and Training, pointing to the apparent oversight that they say is discriminating against candidates with colour blindness when it comes to their right to earn a livelihood.

In his letter, Dr. Satendra Singh, Coordinator of the Enabling Unit (for persons with disabilities), UCMS and GTB Hospital, said: “High-grade colour vision is required for IPS, RPF and other police services. Low-grade colour vision is acceptable for the other services under Civil Services Examination (CSE).”

He said the criteria does not mention candidates with lower grade colour perception, who are unable to identify all colours. “If such candidates are found fit in all other respects, it is unfair to declare them ‘unfit for all posts’ as is being done. They should be declared ‘unfit for technical posts’ on account of low-grade colour perception,’’ said Dr. Singh.

Civil Services Examination Rules notified by the Department of Personnel and Training (DoPT), Government of India, state that a candidate must be in good mental and bodily health and free from any physical defect likely to interfere with discharge of his duties as an officer of the service.

The Central government had constituted Central Standing Medical Boards (CSMB) in seven hospitals across Delhi for conducting medical examinations for candidates appearing for the CSE. Among these are Safdarjung Hospital, Dr. Ram Manohar Lohia Hospital, Lok Nayak Jai Prakash Narayan Hospital, Sucheta Kriplani Hospital, Guru Teg Bahadur Hospital, Deen Dayal Upadhyay Hospital and B.R. Ambedkar Hospital.

Dr. Singh said when total colour blindness is caused due to rod monochromism, the vision is poor. This condition renders a candidate unfit for technical posts. They may, however, be fit for non-technical posts.

He has now demanded that as colour blindness is just an impairment, candidates with this condition, who are fit otherwise, should be considered for non-technical posts.

Also, Dr. Singh has asked for candidates who have been declared “unfit for all posts” to be re-examined and placed under “fit for non- technical” category.

Dr. Satendra Singh has asked for candidates who have been declared “unfit for all posts” to be re-examined and placed under “fit for non- technical” category

#ColorBlindness

Are we rejecting Color Blind Civil Services candidates because of an oversight?

Civil Services Examination is conducted in terms of the provisions of Civil Services Examination (CSE) Rules notified by Department of Personnel and Training (DoPT), Government of India. Rule 21 of these rules provide that a candidate must be in good mental and bodily health and free from any physical defect likely to interfere with the discharge of his duties as an officer of the service. A candidate, who after such medical examination as the Central Government or the Appointing Authority, as the case may be, may prescribe, is found not to satisfy these requirements, will not be appointed.  The Central Government constituted Central Standing Medical Boards (CSMB) in the seven designated hospitals in Delhi for conduct of medical examination of candidates in CSE.

Medical examination of these candidates are being conducted in seven designated hospitals in Delhi viz. Safdarjung Hospital, Dr. Ram Manohar Lohia Hospital, Lok Nayak Jai Prakash Narayan Hospital, Succheta Kriplani Hospital, Guru Teg Bahadur Hospital, Deen Dayal Upadhyay Hospital and BR Ambedkar Hospital.

However, a medical oversight in the medical examination is hampering the careers of civil service candidate with color blindness.  High grade Color Vision is required for 'Technical' posts like IPS, Other Police Services, 1RTS and RPF. Low Grade Colour Vision or in other words Color blindness is acceptable for 'Non-technical' services (rest of the services under CSE).

With respect to color vision, the point number 11(f) on page 18 of the “Appendix III Regulations relating to the physical examination of candidates” (http://persmin.gov.in/ais1/Docs/Appendix-III.pdf ) states:

11(f) Color Vision: Color Vision will be examined with the help of following two techniques:

1. Edrige Green's Lantern technique: Color perception should be graded into higher and lower grade depending upon the size of aperture in the lantern as described in the table below:-

Grade	Higher grade color perception	Lower grade color perception
1	2	3
Distance between the lamp and candidate	16 ft	16 ft
Size of aperture	1.3 mm.	13mm.
Time of exposure	5 seconds	5 seconds

2. Ishihara's Plates.

Earlier, Ishihara's plates were used aloe to test color perception. Now Lantern test is used to grade the color perception. The above table is the cause of controversy. Those who fail 'higher grade color perception' are color blind but subjecting them further to 'lower grade color perception' test further classify candidates into pass/fail which is immaterial as all applicant with color blindness are FIT for Non-Technical posts as per rules.

The table makes no mention of candidates with lower grade of color perception who are unable to identify all the colors when the size of the aperture is 13mm.

If such candidates are found fit in all other respects, it is unfair to declare them “UNFIT FOR ALL POSTS” as is being done at present. Instead they should be declared “UNFIT FOR TECHNICAL” on account of low grade color perception.

As per the medical experts, the table above should be modified as follows so as to remove this injustice to a section of persons with low grade color perception:

1. Edrige Green's Lantern technique: Colour perception should be graded into higher and lower grade as described in the table below:-

Distance between the lamp and candidate	16 ft
Size of aperture	1.3 mm
Time of exposure	5 seconds
Interpretation	Makes no errors: High grade color perception Makes even one error when tested twice after 15 minutes of dark adaptation: Low grade color perception*

*The possibility that persons who fail the lantern test as described above have no color vision is remote since total color blindness is extremely rare:

1. When total color blindness is due to rod monochromism, the vision is poor and there is nystagmus – rendering such a candidate unfit for techical posts. They may, however, be fit for those nontechnical posts where persons with visual disability can be employed.

2. When total color blindness is due to cone monochromism, the vision may be normal and there is no reason to believe that such people cannot hold nontechnical posts.

I wrote to Chief Commissioner for Persons with Disabilities but since 'Color Blindness' is NOT  a disability (less than 40% and otherwise) so they can not do anything. I then wrote to both Ministry of Health and Family Welfare as well as Secretary, DoPT but there has been no response so far.

I have requested them to urgently intervene in the matter and pass appropriate instructions so that:

A)  All those candidates who are found fit in all other aspects but fail to to identify all the colors (in lower grade of perception) when the size of the aperture is 13mm SHOULD NOT be declared "unfit for all posts". 

B). As color blindness is just an impairment and these candidates are fit otherwise, these should be considered for "Non-technical' posts.

C). All such candidates who have been declared "unfit for all posts" in all the 7 hospitals should be reexamined and placed under "fit for Non- technical" category.

D). An urgent notification should be issued since the medical examinations are currently going on.

I hope our Government take urgent steps so that qualified color blind civil services candidates are not unduly rejected because of an medical oversight.


Impact

'The Hindu' carried the news next day. Here is the link:

Consider color-blind CSE aspirants for non-technical posts (Hindu, 7 June 2015)