Improve health service to prevent premature deaths

Last year, life expectancy on the planet reached 70, with 66 years in India. This is remarkable progress. In 1900, life expectancy was about 30. Compared to a century ago, each of us has now been granted more than two lifetimes. But there are still many health problems we could tackle better. The question is which we should focus on.

By September, 193 national governments, working through the UN, will be deciding which targets the world should be focusing on until 2030. The world will spend more than $2.5 trillion on these targets over the next 15 years, and in order to help them do as much good as possible for every dollar spent, my think tank, the Copenhagen Consensus Center, has asked 60 teams of economists to assess which targets are best across all areas from health and nutrition to environment and education.

There are lots of excellent proposals to address particular health challenges, such as malaria, vaccinations or infant death. But focusing on these single issues that have lots of media attention and straightforward solutions easily means forgetting about the many other ailments. Our new peer-reviewed reports suggest that we should look at strengthening the entire health system. India only spends $20 per person on public healthcare,and just a little more resources could do a lot of good.

This year, 9 million people in lowincome countries like Bangladesh, Uganda and Haiti will die before their 70th birthday. This will affect another 19 million in lower middleincome countries like India, Nigeria and Guatemala. But as countries get richer by 2030, they will also get healthier. It is estimated that by 2030, the total premature death will have dropped from 28 million to 24 million per year, despite the population having grown by almost a billion. Yet, we can do much better. The Canadian authors of the study find it is possible to achieve a further reduction in mortality, resulting in a two-thirds drop from 2010 child mortality and a one-thirds drop from 2010 deaths from people between 5 and 69 years of age. In total, this would reduce deaths in the poor half of the world by another 7 million annually by 2030.

This would require increasing health spending from the current 2% of GDP to 5% of GDP. In low-income countries, public health spending will have risen to $23 per person by 2030 because countries will be richer. But rising it another $34 will allow us to avoid an extra 2 million deaths each year. For lower middle-income countries, the average public health expenditure will be $85 per person, but increasing this another $128 will save almost 5 million more lives by 2030.

Because we’re talking about helping half the world’s population, this is not cheap. Total extra costs will run to almost half a trillion dollars each year by 2030. Yet, it still compares favourably to the benefits of saving 7 million lives, both as measured in lost productivity and as the intrinsic value ascribed to human beings. The overall estimate shows that for every dollar spent, we will achieve $4 of human benefits. For the poorest 1 billion, because the spending is so much lower that there are many more low-hanging fruits, each dollar spent would do $13 worth of good.

This compares to some of the highprofile diseases like tuberculosis, which will do $43 worth of good for every dollar spent, or malaria, which will produce $36 of benefits for every dollar. These are higher, because it is very effective to save lives of children and young adults afflicted with easily curable diseases. Helping everyone through a more comprehensive health system is more just but also means dealing with less easy diseases and helping

higher age groups, where you can save fewer life-years.

Of course, it’s more complicated than just spending more money on cures; the funds have to be channelled into more trained staff, more clinics and more medicines, to be employed as effectively as possible in each area to reduce overall mortality (and also the wider burden of disease and disability). But the benefits of having better health provision are undeniable. Medical staff can not only provide continuing care and prevent or treat the normal range of illnesses and ensure safer births, but they are in a position to react to emergencies as they arise.

For example, considerable number of people die from injuries each year, and the team of economists reckons that this number could also be reduced by a third. The Ebola outbreak in West Africa is another clear example. The countries which are suffering most have very poor general health provision and large amounts of international assistance are being poured in to halt the epidemic. With a properly functioning local health service, the disease may never have got a hold in the first place.

There are plenty of potentially very good health targets proposed as priorities for the next 15 years focusing on HIV, malaria, TB and infant mortality, in particular. All are worthy of our attention, but a good case has been made for simply strengthening health services to achieve an overall cut in premature death.

The 5 Best Lesser Explored Beaches In India

Get your swim costumes, flip flops, sunnies out and pack your bags to travel to the most beautiful exotic beaches of India which are not fully explored. So, move over the exotic Baga, Calangute, there are plenty more beaches to explore and get a visual treat!

1. Varkala beach, Kerala

God’s own country, Kerela is one of the most un-explored and un-recognized beaches which promises exotic location and is beauty beyond any comparison.

Location: 51 km north of Thiruvananthapurum city

Accommodation: Excellent health and ayurvedic resorts to choose from

Must see: Apart from the picturesque beach, you must check out the mineral water springs, the Sivagiri Mutt and the 2000 year old Vishnu Temple.

2. St Mary’s Island, Udupi

Vasco-da-Gama landed in 1948 and named it as ‘El Padron de Santa Maria’ and that’s how this Island got its present name. Noted for the basalt rocks, this is the only spot in India where you can see such marvel of nature. A treat for geologist and beach lovers.

Location: 7 km from Malpe, Udupi

Accommodation: Not much of accommodation options there, it is advisable to do a one day trip.

Must see: Geological monuments around the beach.

3.Agatti Island, Lakshadweep

Turquoise blue lagoons, pristine sand, plush green palms and stunning coral reefs make Agatti Island a must visit destination. Agatti is one of the untouched beaches and its beauty is yet to be explored. It is the only Island with an airport where you can see a magnificent view of an airstrip.

Location: 459 km off Kochi, Kerela

Accommodation:  There are many around Lakshadweep, but if you had to choose, the Agatti beach resort tops the list.

Must see: The Tuna fishing center, the only airport in Lakshadweep and the only island with 5 satellite uninhabited islands in Lakshadweep.

4.Tarkarli, Malvan

Another unseen paradise is the Tarkarli beach in Maharashtra, which is known for its narrow stretch of beach, clear pristine water and you might be lucky to see the sea bed through a depth of 20 ft on a clear day. Fishitarians, don’t forget to gorge on the local Konkani sea food around.

Location:  406 km from Pune

Accommodation: The government managed MTDC resort

Must see:  Historical forts, famous being the Sindhudurg and Padmagarh fort

5.Radhanagar Beach, Havelock

Voted as ‘Asia’s best beach’ by TIME Magazine, Radhanagar beach is undoubtedly one of the best beaches of Andaman Island. Barely 2 km and a width of 30-40 meters, it’s a small cozy island that is filled with beautiful landmass.

Location: 12 km Havelock’s ferry pier

Accommodation:  Again, there are plenty of resorts to choose from

Must see:  More than seeing, there is so much for all kinds of beach enthusiast to do. Activities like Scube Diving, Snorkelling, Game Fishing, Swimming and much more. And so that you know, Radhanagar is one of the best dive centers of Andaman Islands.

A Ban on Beef in India Is Not the Answer

                                                     

The sacredness of cows in India might be a cliché, but it is deeply felt, rooted in the history of Hinduism. In Mumbai, one often encounters women selling grass to feed the cow they have in tow — for a few rupees, the donation affords not only a blessing, but also a chance to feel connected to the country’s farmland roots. The cow is divinely associated with Krishna, the cowherd, and considered a mother figure because of the milk it gives. One doesn’t go into an Indian branch of McDonald’s expecting to order a Big Mac.

And yet, beef has long been available at various Mumbai restaurants — from the burger at the iconic Leopold Cafe to the marrowbone curry popular at eateries in Muslim neighborhoods. This reflects the accommodation necessary in a city — and country — with such extraordinary diversity of religion, culture and wealth.

Last month, however, this changed. Beef dishes were forced off the menu when Maharashtra, the country’s second most populous state, which incorporates Mumbai, extended a ban on cow slaughter to bulls and oxen, and made the sale of beef punishable by up to five years in prison. A few weeks later, the state of Haryana passed similar legislation. Prime Minister Narendra Modi’s office has suggested that such bills are models for other states to emulate.

The laws have affected more than just restaurants. Thousands of butchers and vendors, their livelihood abruptly suspended, have protested in Mumbai. The leather industry is in turmoil. Beef is consumed not only by Indian Muslims and Christians, but also by many low-caste Hindus, for whom it is an essential source of affordable protein. The poorest waste nothing, from beef innards to coagulated blood, while their religion pragmatically turns a blind eye. Low-caste Dalit Hindu students, and others, have organized beef-eating festivals to protest the infringement on their culture and identity.

With the recent re-criminalization of gay sex, bans on controversial books and films and even an injunction against the use of the colonial-era name “Bombay” instead of “Mumbai” in a Bollywood song, the new laws join a growing list of restrictions on personal freedom in India. Already, the police in the city of Malegaon have arrested three Muslim men accused of calf slaughter, and ordered livestock owners to submit mug shots of cows and bulls to a cattle registry, to create a record in case any of them go missing.

The Maharashtra law had been in limbo, awaiting the Indian president’s signature for 20 years, but was resurrected only after the Hindu nationalist Bharatiya Janata Party came to power last year. This suggests its real purpose is to play to the party’s political base.

Some Hindu hard-liners insist the idea of eating beef was introduced by Muslim invaders, despite references to its consumption in ancient texts like the Vedas, written more than a millennium before the time of Muhammad. By eradicating this “alien” practice, they hope to return the country to values they hold dear as Hindus. “Our dream of ban on cow slaughter becomes a reality now,” Maharashtra’s chief minister tweeted upon passage of the new law.

Another problem with such bans is that aged or unwanted cattle must be looked after at great expense (presumably by the state) if they are not to waste away.

The only practical reason advanced by Maharashtrian officials for their law is that it will help farmers hold on to their cattle in hard times, when they might otherwise be tempted to sell. This motivation actually does have historical standing. In fact, it fits in perfectly with a theory on the origination of the beef taboo that the American anthropologist Marvin Harris proposed almost five decades ago.

Mr. Harris observed that more important than their value as milk producers, cattle in India formed the backbone of small-scale agriculture. They were used to plow fields, provide dung for fuel and fertilizer and produce calves to stock the herd. He noted that a family that consumed its cattle during a time of drought and famine was not able to recover afterward: They had lost the means to work the land. Over the years, farmers who preserved their cattle were the ones who survived, leading to this practice’s being gradually codified into religion.

This drama is still being played out in Maharashtra, which in recent years has experienced persistent and devastating drought. Although religious rules ensured that a farmer would no longer eat his cattle, he could still succumb to the modern equivalent — selling it for slaughter, usually at throwaway prices. The beef ban, then, can be interpreted as an extension of the religious proscription: Thou shalt neither eat nor sell thy cattle.

Unfortunately, the situation in Maharashtra has deteriorated past the point where such a ban will help. Previous governments have squandered billions of dollars on failed irrigation schemes, while encouraging water-intensive crops like sugar cane in drought-prone areas. Farmers are desperate: On average since 2011, there have been four suicides of Maharashtrian farmers every day. Rather than ancient proscriptions, they need a financial safety net and responsible agricultural policies in order to deal with the current situation and probably worse climate change effects to come.

Indian civilization has evolved over the centuries to include multiple diverse communities with competing interests. Despite its secular Constitution, India remains strikingly unequal. The government must make every effort to balance majority sentiments with minority needs. This is what the previous rules that restricted cow, but not bull, slaughter did.

Imposing ideals from a mythic past is not the answer. The true lesson to take away from history is how utilitarian goals can shape religious custom. Hinduism has always been a pragmatic religion; what today’s India needs is accommodation.

Net neutrality: Avoid a collusion course

The plot between Airtel, Reliance and Facebook to steal the Internet from a majority of Indians under the guise of helping them has collapsed. An outpouring of effective truth-telling by media and civil society organisations has doomed this particular scheme, but ‘zero rating’ will recede into the shadows only to return in another form unless we learn the lesson from this fiasco: Any effort to present a ‘walled garden’ of the Internet to India’s less well-off majority on the false ground that this is ‘all they can afford’ is in fundamental conflict with any rational policy of social development through innovation.

What citizens should resent, government should also prohibit as an obstacle to social development. The Internet is not a basket of media websites we ‘consume’ any more than ahighway is a collection of stores along the side of the road we could shop at. The Internet is the possibility of unlimited interconnection, a social condition in which we can all be connected to everyone else everywhere, with rich technical connections that can allow us to produce services for one another.

The integrity of the network — that it provides one indivisible opportunity for everyone connected to it — is its most important feature. As a tool of social development, the Internet allows people with little capital equipment but plenty of ingenuity to build effective businesses from zero. But only if other people can ‘find’ them on the Internet and receive the services they are offering.

Acollusion between one or more local telecommunications oligopolists and a big service platform incumbent to price a small basket of websites at zero, and to deliver network integrity only to those who will pay more for it, destroys this immense value of the Internet in realising human potential. If most people cannot see the ‘real’ Internet, startup businesses will become invisible, and the colluding platform companies will be protected against any developing competition, at the expense of wiping out hundreds of thousands of potential businesses representing India’s economic future. Such collusion is, therefore, directly antithetical to any Digital India worthy of the name.

History reflects the role corruption by telecommunications oligopolists played in the death of the last government. The government now has an opportunity to undo the harms caused by the past. The Telecom Regulatory Authority of India (Trai) should be given a mandate to regulate telecom providers so as to ensure network integrity for everyone, everywhere and cease attempts to find a lopsided ‘middle path’. In doing so, the government will put paid to the patently false argument that ‘this is what we can afford to give them’.

There is no cost savings whatever in providing access only to some addresses on the Internet. The telecom provider is connected to the larger world by the same universal technical protocols — developed and maintained by consensus among all users as equals — through which all computers on the Internet can locate and exchange services with one another.

The provider doesn’t increase its costs by providing the same integrity of universal interconnection to all users further downstream. On the contrary, it incurs costs by artificially restricting the normal interconnection between parties downstream and the Net as a whole. It profits wildly from those investments, by selling at a high additional price what it could, at no additional cost, have provided to everyone in the first place.

Everything in a digital network, whether part of a phone conversation or data moving according to Internet protocols, is broken into ‘packets’, short bursts of data in a standard envelope. Your smartphone sends and receives millions of packets a day. Whether a packet is ‘voice’ or ‘data’ — and if it is data whether it’s being exchanged with a website in California or Mumbai — the cost of moving it on the local telecom network is the same.

Everywhere in India where a device is connected to the telecommunications carriers’ network, it can profitably be served at current rates for ‘phone calls’ or ‘data’. Everything else charged is mere economic rent to the telecom company. This is the sort of pricing behaviour that telecom regulators exist to prevent.

It’s good that the ‘zero rating’ proposal has collapsed. We must remain vigilant. Violating network integrity is as wildly profitable as it is socially destructive. Our real task is helping to change the regulatory culture so that the real Digital India, where ordinary people can make extraordinary businesses from nothing, can flourish, rather than being strangled in the crib.

Eben Moglen and Mishi Choudhary are Founding Director and Legal Director of Software Freedom Law Center, respectively

Give up the ego for spiritual quotient

In today’s world, materialism and stress have become part of our lives. We are constantly looking for answers to how to live a successful and happy life. One way of finding out answers to this question is to explore the spiritual quotient (SQ) related to our ability to understand and comprehend the spiritual aspects of life, which, contrary to popular belief, are not necessarily connected to religion.

Danah Zohar, who teaches at the Oxford Strategic Leadership Programme, Oxford University, and psychiatrist Dr Ian Marshall in their 2001 book, SQ: Connecting With Our Spiritual Intelligence, observe that “while computers have IQ and animals can have EQ, it is essentially an SQ that sets human beings apart”.

So, for the ‘wheel of life’ to roll smoothly, all the spokes of the wheel — IQ, EQ and SQ — have to be equally developed.

The journey from IQ to SQ represents moving from gross to subtle, finite to infinite, tangible to intangible. SQ has several dimensions: compassion, wholeness, self-esteem, gratitude, spirit of surrender and service and the ego. Handling the ego is a critical dimension.

It is very important to understand and handle the ego — both of oneself and others. But is there God in all this?

The Vedanta says he resides within us. By surrendering the ego, we will be able to perpetually experience spiritual actualisation, leading to a higher SQ. For, “we are not human beings having spiritual experience, but spiritual beings having human experience”.

5 Ugly Realities Of Being A Woman Visiting India

The summer before my junior year of college, I volunteered to work for a mental health clinic in a small city in India. I suppose I should say that it was "challenging yet rewarding," or that it was "the hardest summer of my life" but that I really "found myself." But, I'm not about to turn my experience into Eat, Pray, Love. It didn't take long after I arrived for things to turn ugly.

Sure, when people ask me what India was like, I often just placate them with funny stories about shitting my pants on an airplane or watching men practice their Bollywood moves at the gym. While those stories are true, they're not the whole truth. The truth is, almost all of my memories of India are tainted because of one uncontrollable factor: I am female, and, in India, that means ...

#5. There Are Some Pretty Bizarre Rules

All of this talk of "rules" is going to seem cruelly ironic when I tell you what eventually happened to me. But, we'll get to that.

Upon meeting my Indian host family, I was almost immediately given a list of rules that mostly had to do with my gender. Some were common sense, but others were baffling. For example, I was instructed to avoid making eye contact for longer than four seconds with a man. This could be seen as an "invitation" -- specifically, into your vagina. This was one of the most anxiety-inducing aspects of my stay, and, if you read on, you'll see why that's really saying something.

It sure explained all the guys walking around with stopwatches.

So, I would be talking to a male co-worker or friend and think, "How long has it been? Did I fuck it up? Has it been five seconds?" I was darting my eyes around so much that I probably looked like I was on crack.

Also, there was to be no smoking, drinking, or hanging out in bars. No pouting. No spending any time alone with my host brother (exchange students refer to the families they're staying with as "host father," "host mother," etc.). Don't overeat. Don't date. Don't adjust your clothes in public. Don't talk too loudly. Don't talk too softly. Don't stay out past 7 p.m. unless you're with your host father. Basically, try really hard not to be a woman -- that would be great. Thanks.

"In fact, would it be too much to ask for you to wear a fake mustache ?"

#4. There's A Strict Dress Code

Yamini Chao/Digital Vision/Getty Images

This part is something you probably expect from certain parts of the world -- the organization I volunteered for had already advised me to bring conservative, loose-fitting clothing. Still, my host mother took one look at my scandal-packed suitcase and decided we needed to go shopping.

"Ankle socks?! Not in this house, missy."

My wardrobe, under her tutelage, was to consist of long, flowy skirts and shapeless tunics. Keep in mind it was around 110 degrees in the summer, so while I was trying not to be a female, I was also trying not to be a female with swamp ass. Again, if you move to a country like this, obviously you're going to have to be willing to adapt to some major cultural differences. But, if you're a woman in India, there's not a lot of room for fucking up.

There was this one time I was hanging around the house and didn't notice that my baggy shirt came down too low on the sides, revealing a little side-boob action. Well, you would have thought I was running around and grabbing every dick I saw because my host mother went ballistic. She actually threatened to slap me if I didn't immediately go upstairs. I spent the rest of the summer dressed as a nun.

#3. You Have To Have A Man With You, Or Else You'll Constantly Get Harassed

My volunteer organization assigned me a translator, but, in reality, he was more like my security guard. He would accompany me to and from work, and stay with me all day on the job. I made sure he was always around because as soon as he left my side, it was like putting myself out on the sidewalk with a big cardboard "FREE" sign.

Women get treated like objects. In this case, a street sofa.

And here is where the paradox of male attention comes into play: Whether you are invisible or the sole focus of attention depends entirely on what kind of attention you want.

For example, I once had a flight to another part of the country that got delayed. I spent 12 hourstrying to get someone at the airport to help me make a damn reservation for a new flight. Even female employees would just redirect me to someone else, who would then also redirect me to someone else, in a never-ending game of Hot Potato (Hot Samosa?). Eventually, I resorted to asking a random Indian man if he could help me out, but he wouldn't do it. Finally, my male traveling companion walked up and spent five minutes with them -- and poof, we had a flight. I was steaming. That was after 12 hours of trying to get someone to listen to me.

IP

The fake mustache and prosthetic junk were looking more appealing by the minute.

But, when men are walking up to proposition you for sex, well, then it's non-stop. Walking through a market felt like a series of push notifications to my nervous system. It became commonplace for vendors to leave their stands and follow me around, asking dozens of random questions ("Hello? Hello? Hi, are you Indian? English? Are you married? Want to have Chai? How old are you? Where are you going? Hello, lady. Smile, lady."). This could go on for 15 minutes, even if I didn't respond to a single question.

Once, while I was traveling, I came back to my private hostel room to find one of the staff members hiding in my bathroom. He asked me how much I would "cost for the night," to which I responded, "Ask my husband, he'll be here in a minute." When I reported it to the management, I was assured he was "just doing his job."

It's exhausting. And scary. Yes, of course, those types of behaviors can happen in every country around the world, and, yes, not all Indian men, etc. But, it's a full-time job navigating which look is "harmless" and which might turn you into a CNN headline -- I'm talking about a country that has one of the highest rates of sexual violence toward women in the world. And those are just the reportedattacks, not counting the many acts of sexual violence that go unreported each year.

Unfortunately, I'm one of those unrecorded statistics ...

#2. The Rules Do Not Keep You Safe

Arman Zhenikeyev/Hemera/Getty Images

At first, living with my host family was awesome -- I was getting a more local experience and grew to absolutely adore my host mother. But, as time went on, things got weirder and weirder. By "weirder," I mean "creepier." My "host father" would make comments about my body and try to "cuddle" with me on the couch. I would try to laugh it off and say things like, "Hey, I'm your daughter!" but I would just be met with eye rolls or disapproving glares.

Which, in retrospect, I feel like I should've been the one giving.

All of the bedrooms were downstairs, except for mine, which happened to be next to my host father's office. If I had a question or wanted directions to get somewhere, he would ask me to come into his office and close the door. I would refuse, saying I was uncomfortable and that he needed to chill out a little, to which he would reply: "This isn't America, sweetheart. You're living in my house. You live by my rules."

In retrospect, I should have spoken up sooner, but I was 19 years old, naive, and didn't want to come across as difficult. I felt stuck between a rock and a hard place: speak up and have people call me a liar or a drama queen, or stay quiet and feel unsafe. Be accused of being a spoiled American brat, or risk having something really awful happen.

Spoiler: It did.

I had a key to lock my bedroom door, but, unbeknownst to me, my host father had one, too, ironically "for my safety." One night, I awoke to find him masturbating next to me with his hand down my pants. That was the last straw because what would be, if not that?

The next morning, I called a friend and moved in with him. As I mentioned, it was taboo to be alone in the company of a man who isn't your husband, so we told everyone we were married. Note: When I lived with my host family, I was only allowed to be alone with my host father, which is fucked up on at least seven levels. I counted -- it's at least seven.

Moving helped, but this would not be the last time I was sexually assaulted on my trip. There were two other incidents, the details of which I'm honestly not comfortable getting into. And, compared to what other women have gone through, I was actually extremely fortunate.

#1. There Are Great People There, But, Culturally, The Deck Is Stacked Against Women

When I notified my volunteer program of the incident with my host father, they pretty much blew me off. I pray that they didn't place any more young women in that home, but I didn't tell anyone else because I honestly didn't see what difference it would have made.

And that is, of course, part of the problem. I remember thinking, "If I feel this powerless, and this frustrated, what the absolute fuck must it be like to live here?"

You have to remember, in India, up to 90 percent of marriages are arranged, meaning only 10 percent are "love marriages." They actually advertise them right in the newspaper. Looking for a wife? Just head to the "matrimonial" section. Ads include height, weight, job, caste, education, what they're looking for, not looking for, etc. My absolute favorite was one that was specifically requesting a "homely girl." Or, the guy that followed up his long, poetic speech by calling out to his true love with,"I like pets." Swipe right!

"Soul mate wanted! Must love dogs, sunsets, and non-consensual diddling. No smokers."

It really is a lot like Tinder, except it's your dad who's fielding your messages, and it might lead to your death. When I spoke to my host mother about the process of arranged marriages, she explained that when the prospective bride and groom meet for the first time, the woman can play her veto card at that time. If you think that might cause some animosity, though, just be glad you didn't reach dowry negotiations before you decided to be difficult, because you might get killed for that -- that very thing happens 12 times a day there.

In all fairness, I met tons of intelligent, progressive men while I was there, such as my host brother. I met women who were more patronizing than men as well as women who risked their lives fighting for women's rights. I met every type of person because in a country of approximately one billioninhabitants, it's not one size fits all.

Though, as I mentioned, the clothes sure as hell were.

But, there are some traditions and attitudes that have allowed things to get this way, which prevent meaningful change. And, while I can sit here and talk about the trauma of my own experience, my host mother's response summed it up perfectly: "Look, I'm sorry this happened. But, you get to leave. I have to stay here for the rest of my life."