214. Kerala’s E-Health In Dark Shadows. P S Remesh Chandran

214

Kerala’s E-Health In Dark Shadows

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

Image by Free-Photos. Graphics: Adobe SP.

First published in 2014 at https://sites.google.com/site/trivandrumresearchinstitute/kerala-s-e-health-in-dark-shadows as Kerala’s E-Health In Dark Shadows.

Insurance companies and pharmaceutical companies want people’s medical information which they cannot collect officially. The first need it for screening medical insurance claimants to know about undisclosed medical conditions to deny payments. The second need it to geo-target their products and boost sales and profits. So they pay huge amounts as bribe to political commission agents in government to bring about e-health legislation and policies, set up data banks and collect people’s health information in them for them to steal freely. 

The three major youth organizations in Kerala are on the side of the giant and money-wielding insurance and pharmaceutical companies.

   
01. Original Govt. Order dated 04 05 2013 constituting E-Health Page 01.
 

The government thinks people do not know this but people do know. Because the people are a peace-loving lot they do not revolt. If people do have their vigilant organizations this digital data collection and merchandise would not have been possible. The three major youth organizations of the three political parties in Kerala- of the Indian National Congress, the Communist Party of India (Marxist) and the Bharatiya Janatha Party- are on the side of the giant and money-wielding insurance companies and pharmaceutical companies. These companies also have the Kerala Sasthra Sahithya Parishad (the Kerala Science and Literature Convention), the Indian Medical Association, the Kerala Government Medical Officers’ Association and the Kerala Medical College Students Association in their pockets. The people have none in their pockets including a single parliament member or a state legislative assembly member. So, people’s private medical data and personal data are collected everyday, stored in data banks and sold by politicians and bureaucrats to insurance companies and pharmaceutical companies. This has been going on for a long time and the most lecherous beneficiaries in this nexus are members of the Kerala media from whom never have we heard a word about this clandestine business going on through years. 

We followed Kerala’s e-health project from the beginning till scams publicly broke out.

   
02. Original Govt. Order dated 04 05 2013 constituting E-Health Page 02.
 

E-Health is new to Kerala State in India and, considering the strange avenues into which the massive corruption in this state has penetrated into, we have decided to closely follow the state’s activities in this field from the very beginning to as far as we can follow in time and space such that when something happens good or bad, no one will have to wonder why it happened or how it happened. When corruption occurs in large scale in this field which it surely will and e-health in Kerala reported to be in shambles and disarray in no time, there will certainly be investigations but within that time, millions of rupees will have gone. We wish to report things from the beginning so that we can pinpoint persons who were responsible when considerable amounts money are lost from public funds. We certainly will have to face repercussions, oppositions and even retaliations from those involved, which we do expect to come and will indeed face, which also we hope to report through these pages.

Some said it was 97 crores rupees and some said it was only 92 crores but all wondered where the balance did go.

   
03. Original Govt. Order dated 04 05 2013 constituting E-Health Page 03.
 

The centres of activities in implementing this project in Kerala are the Health Secretary’s office in Government of Kerala in the Secretariate, the Directorate of Health Services, and the Mission Directorate of the National Rural Health Mission, all situated in Trivandrum. The first thing which was got done by those involved in this rigmarole was getting prepared a report on the possibilities and scope of implementing e-health in Kerala which, we believe, was commissioned out to persons not at all with prior experience in this field. This report summarily got approved by government and then what we heard was media news about some funds being brought to Kerala, allocated by the Government of India. (We, in these columns earlier had reported the same in ‘Kerala Health Research Online). Some media reported it to be 97 crores and some reported it was only 92 crores but all wondered in secret where the balance did go, considering the usual rate of commission for getting a project approved and financed in India was ten percent, realized by political agents in government. Government of India usually allots 100 crores. It is inconceivable that the full amount reached Kerala, if it did, in contradiction to the North Indian standards. Or has our country progressed beyond being a puritan state?

Even far advanced countries like England, America, France and Germany fear outsourcing of e-health projects!
  04. DHS Website on 19 03 2014, E-Health Link.
 

If e-health is implemented, all digital health activities in the state will have to be monitored and controlled from a single centre, to minimize misuse or theft of confidential patient medical data which is always at risk and which is always sought by a multitude of commercial organizations ranging from insurance companies to health psychic predictors. We will be startled at the incompetence and lack of imagination with which the Directorate of Health Services is running its own simple website, let alone the massive and complicated encrypted data flow in connection with the e-health governance of an entire state. Theirs is a crude website where people cannot interact; data are scanty, incomplete and unreliable, what shall be there is not there and what shall not be there is there, data never updated since inception and pages will not open and if they do open they will have only a few irrelevant sentences. We enquired and learned that there was no one there to do these things except temporary hands lent from peripheral institutions. No one can believe that such gross neglect and ignorance could be able to be engaged to monitor the digital clinical maneuvers in the whole state, unless the same will have to be outsourced-something even far advanced countries like England, America, France and Germany fear to do. Insurance companies alone will spend millions of dollars to see that a central store of people’s health data is established in the state. 

The DHS’ pilot web site is a laughing stock of all who went there.
 
05. DHS Website on 19 03 2014, E-Health Manager Post Notified.
 

Let us take the example of the E-Health Link in the DHS’ web site. Since the starting of this digital front of the state’s health in 2013, the E-Health link remains skeletally maintained and as a laughing stock of whoever is led there. It has no relevant or important data or information to display. See a snap-shot of this page as on 19 March 2014 which is self-revelatory. There is not even mention of the important things in the field that have happened and have been milestones in the progress of this project if any milestones have been there and also any progress! The importance is laid not in enlightening people on this new subject which even these ‘authorities’ know nothing about and which is going to affect people’s lives every way, but on how the 92 crores could be spent safely without public interference.

Only notification for Expression of Interest for e-health, and no details of bidders or the short-listed.

06. DHS Website on 19 03 2014, Govt. Notification for E-Health Expression of Interest, Page 02 of 30.
 

Notification for an Expression of Interest in May 2013, an inevitable corrigendum six days after, four ridiculous queries in the same month- this was all there was in the e-health link of the DHS’ website. And it was the month of the greatest digital activity in this Directorate! Or that was only what they wished to make public. Five Months later, in October 2013, there was application invited for the post of a Manager but no mention of who applied for and who was selected for this post. 

The Expression of Interest was posted on 03 May 2013 with a deadline on 18 October 2013, with no mention after the deadline of who Expressed Interest and who were approved and short-listed. Note that this was a period in Kerala when the greatest number of fraudulent people and organizations were submitting bids and taking part or collaborating in heavily-funded government projects with Solar Scam in the lead. No wonder the names of people who expressed interest in government’s e-health project could not be publicized!

The internal vigilance wing never caught an officer of authority in the last 25 years.

07. DHS Website on 19 03 2014, Govt. Notification for E-Health Expression of Interest, Page 29-1 of 30.

Things are always dubious in the state where large amounts of public money are involved. Why permit them to steal people’s money in leisure instead of going after them and following their every move from the beginning? We know that there is a Vigilance Wing in the Directorate of Health Services, administered by an Additional Director of Health Services who does nothing but hunt petty lowly employees like Hospital Attendants, Nursing Assistants, Nurses and Clerks. How many doctors and officers of authority did this additional director and his establishment catch, find guilty and charge in the last 25 years? Their main duty is to hand over to the culprits- their loyal subordinates- the names of people who report corruption and misdeeds in the department! Never did this wing detect something on their own initiative without someone from outside reporting or complaining a thing. That is the same situation with the government’s vigilance department also. No one in vigilance detects something on their own account. Everything has to be detected by people or newspaper reporters and details conveyed to them free-of-cost and sweat. Then they will investigate, reluctantly. 

Following the broad, liberal path of the Right To Information.

08. DHS Website on 19 03 2014, Govt. Notification for E-Health Expression of Interest, Page 29-2 of 30.

So it is now people’s duty- our own duty- to detect and report, which we shall do; let us see what they do to charge-sheet and punish if we happen to detect and report something punishable. We decided to follow two routes- the reserved route of private investigation and the liberal route of the Right to Information. What our private investigation revealed shall be reported to you readers in its time but we find it nothing inappropriate in publishing in time to time what we found out via the broad path. 

09. RTI application returned from Govt. Front.

Here is our original Registered Letter to the concerned Public Information Officers on 20 March 2014. We think these questions we asked are pertinent, which everybody may wish to ask:

10. RIA application returned from Govt. Back.

Application for information under the Right to Information Act

To

The Public Information Officer,
Government of Kerala, Secretariate, Trivandrum.
Department of Health and Family Welfare,
Government of Kerala, Secretariate, Trivandrum.
Directorate of Health Services, Trivandrum.
Directorate of National Rural Health Mission, Trivandrum.

Dear Sir,

I request you to kindly make available to me under the Right to Information Act, in writing, the following information which is not classified, within the prescribed time limit. I have affixed Rs.10/ worth of Court Fee Stamps as fees. 

Does Kerala State Government wish to implement E Health in Kerala?

If yes, which are the agencies/offices through which it is to be implemented? Have the Government of Kerala Collaborators/ Nodal Agencies for formulating/implementing this project? 

Did Government of Kerala or any of its departments/offices/collaborators receive any funds from anywhere for formulating, developing or implementing E Health project, and if so, who is the custodian of this fund? Please give name and full official and postal address.

If funds were received or offered, which were the sources of such funds? Please give specific details of communications allowing/releasing/offering of such funds.

Were any amounts from the funds transferred to any individuals/ establishments/ organizations on account of fees, services, salaries, honorarium and/or allowances? If so, please give the mode of payment, their names and full postal addresses and reasons for transfer of money, along with details of cheques, demand drafts and acquittances. 

Were any advertisements given in any media inviting Expression of Interest on this project, and if so, where? What were the dead lines and who were the persons/institutions/organizations who expressed their interest? Please give full postal addresses.

Did the names and addresses of those who expressed interest in the project published in media where the original invitation for EOI was advertised, and if not, why? Where else was it published?

Which are the posts created for implementing this project? Please give full pay scales, incentives and other perks.

Where were advertisements inviting applications to these posts published? Please give specific links and dead lines.

Who were selected for each post? Please give their names, full postal addresses and the last institutions where they served with name of designation and period of service there. Were their names and posts published anywhere?

Which posts are yet/proposed to be created in connection with this project and when and where are they going to be advertised?

Please include names and addresses of Appealing Authorities also in your reply.

Sincerely Yours,

P. S. Remesh Chandran, Padmalayam, Nanniyode,
Pacha Post, Trivandrum-695562, Kerala.
Dated: 20 March 2014.

We sent these requests by registered post, and they have 30 days time to give us their answer, if they ever give answers in time, which is rare. We will wait and post their replies here, along with papers of appeal if it goes to that level. 

The book E-Health Implications And Medical Data Theft announced.

Meanwhile we will see what other things were happening in this field.

 
11. A book- E-Health Implications- being announced in 2014.
 

Here is a book being announced at this time in the course of the investigation, after finding enough worms in the can, and we would have liked to add excerpts from the book here for readers’ knowledge but space here is limited. The image added here of the book was before publishing the book and the published book’s cover can be viewed at the end of this article. 

The address the Public Information Officer, Government of Kerala, Secretariate, Trivandrum is insufficient!
 

The RTI Letter we sent to The Public Information Officer, Government of Kerala, Secretariate, Trivandrum was returned by the Indian Postal Department, with the endorsement, ‘Not Sufficient Address’ and not with ‘There Is No Such Addressee’. We know government functions through its various departments, but why as a single entity the government did not appoint a Public Information Officer for itself? It is dubious. A delivery postman, as per rules, cannot determine in his office whether the designation exists or not or whether the concerned officer would accept the letter or not, provided the name of the government office and the place where it functions is legibly printed in the address. He certainly has to take the letter to that office. So we shall assume the postman did take the letter to the office but the officer-in-charge declined to accept the letter. Note that the government secratariate received and accepted the letter in their office: their office seal is stamped over the stamps on the cover. After receiving it, on second thoughts, they decided to ask the postman to endorse it as they wished and return it to the sender. Think about the lawlessness in a central government employee’s obeying the quite irregular direction of a state government employee! What right has a government officer to reject a letter from a citizen addressed to government, on the basis of whatever technical grounds? Even if a citizen does not mention the Right to Information Act in his letter, is not the government bound by duty to accept the letter and convey the information requested?

 
12. RTI Reply from Govt. on 21 3 2014.

The government does not have any information on a project it has spent 92 crore rupees on!

The Department of Health and Family Welfare sent a reply to us, signed by one Mr. Sudarsanan, Additional Secretary, which stated that ‘the Government of Kerala implemented the e-health through the National Rural Health Mission and details are available with them’. Does not this department have a Public Relation Officer and even a Public Information Officer to reply to RTI letters addressed to the government and why is that designation absent in this reply? He did convey information on point number 1 but omitted point numbers 2 to 10. If government is implementing e-health in Kerala, why are not details of its implementation and its cost sheets available with the Government of Kerala but only with the National Rural Health Mission which is not Kerala government’s but is central government’s? What kind of a government and what kind of an administration is that? Why are details of a project which the Kerala government told press it is implementing in full scale in multi hospitals in different districts not available in the seat of the government which is the Secretariate? Are details of its e-health project available in Secretariate or not is the question and isn’t it dubiousness to hide facts to prevent contradictory information from being released from two sources, i.e. from the Government and the NRHM is the point. These are usual questions which rise in the mind of the common man. We are certainly raising these issues of discrepancy and incompleteness in the reply with this department’s Appellate Authority for record of course, though we understand well in advance from this irrelevant and incomplete reply that these appellate authorities are going to be equally crooked. We are credibly informed that the e-health job assignment bids mentioned in the beginning are in the course of being finalized on the extended date and things are ordered by the political agents in government to be kept secret till then.

Shady recruitment procedures for several e-health posts for selecting favourites and darlings.

 
13. RTI Reply from NRHM on 24 04 2014.
 

Meanwhile dubious advertisements appeared in equally dubious places, inviting applications to various posts in the e-health project of Kerala. In one place, the HOW TO APPLY link led to admissions section of the Manipal University and the CLICK HERE MORE DETAILS FOR THIS JOB link led to http://dhs.kerala.gov.in/index.php/transfer where there was nothing about these posts. The DHS, NRHM and the special and exclusive project of Arogya Keralam had nothing to show on these posts in their websites. It was an old trick- to advertise in places where no one would look and even if someone looked, the links would lead to nowhere. It was clear these posts were reserved for favourites, to be recruited through shadow agencies or appointed at the recommendations of the politicians which they did for a price. And the posts did have handsome salary packages, in Kerala standards.

1. Finance Manager 50,000 rupees per month,
2. Administration Manager 50,000,
3. Technical Manager 50,000,
4. Manager (Change Management) 50,000,
5. Asst. Manager (Finance) 30,000,
6. Asst. Manager (Admn) 30,000, and
7. Office Assistant 15,000.

The following was one of the advertisements (or the only advertisement?) for these posts in e-health. It was online and it appeared in one of the shadiest of places ever known:

‘Directorate of Health Services (DHS Kerala) hiring Managers & Office Assistant (CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree holders). Applications are invited for the following posts in the eHealth Project Management Unit (eHealth PMU) on contract/deputation basis. The contract basis appointment will be for a period of two years. Deputation basis appointments will be based on Government rules. Maximum age limit for posts 1 to 6 is 58 years and for post 7 is 40 years as on 01-01-2014. All the postings will be in Thiruvananthapuram.

Company Name: Directorate of Health Services (DHS Kerala)
Position: Managers & Office Assistant
Education: CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree
Experience: 3-10 yrs
Location: Kerala

Applications may be send to State Mission Director, NRHM, General Hospital Junction, Trivandrum – 35 so as to reach the office on or before 12-03-2014.

http://www.hirelateral.com/directorate-of-health-services-dhs-kerala-hiring-managers-office-assistant/ '

Who make money and who use government projects to do favours and repay those favours received? So, that was why this great reluctance in conveying information under the right to information act was there! If what usually happens in Kerala happens in this project too, we will see that the relatives of the very authorities who were bound to give information out were undergoing this recruitment process. 

 
14. RTI Reply from E-H Project Management on 05 05 2014, Page 1.

(Updated as on 26 April 2014, 02:35 PM, slightly edited since then.)

So, as we feared, government does not know who the custodian of the 92 crores they gave is. The NRHM Directorate also does not know who the custodian of this amount is and how it is spent. See the reply from Smt. Vijayalekshmi P. Nair, Senior Administrative Assistant. We have to wait for months for information which is available under the same roof of her office building.

 
15. RTI Reply from E-H Project Management on 05 05 2014, Page 2.

(Updated as on 30 April 2014, 12:47 AM)
  
 
16. RIA Reply from E-H Project Management on 05 05 2014, Page 3.
 

We received a reply from the E-Health Project Management Unit, directing us to remit by DD an amount of Rs.20/-. Here is their letter (Not published here). 

We obtained a DD and made it for 25 Rupees instead of 20 as we wished to inspect the files also. 

17. Facsimile of Bank DD Dated 13 May 2014 for release of information.

There was no office, no person, not even a name board.
 

We went in search of this E-Health Project Management Unit of Kerala which was entrusted with 92 crore rupees of public money, with the DD to deliver it, receive the details and inspect files. It was 3 P.M., 17th May 2014, Saturday. There was no name board of this supposed institution near the General Hospital Junction. We went and enquired inside the Directorate of Health Services. Many asked us what this e-health project was! Some directed us to a below-ground level warehouse cum go-down where this unit was supposed to be housed. There was no office, no person, not even a name board. And there was also no one to receive the DD. We returned with the decision to enquire further about this ghost institution. 

(Updated as on 17 May 2014, 06:19 PM)

  
18. Expenditure statement of e-health for 2013-14. Page 1.
 

We received some information from E-Health which we doubt to be true. But it proved one thing- Kerala’s Health Director Dr. P. K. Jameela and a few other saints in this department were regularly receiving money from this e-health project. Must be for giving advice though we cannot perceive what expertise they have in this field! This project was serving as yet another of their milking cows. In spite of a government car having been allotted permanently to this project, around 80000 rupees were pocketed every month in the guise of using and paying for a private car owned by a company which in our enquiry never and nowhere existed in Trivandrum. They never would reveal the vouchers for these payments to us as they all were bogus.

  
19. Expenditure statement of e-health for 2013-14. Page 2.
 

The appointments made in the project office contained in the sub-ground floor of the Directorate of Health Services building were all irregular and none were qualified for these posts. They were all recruited under strong recommendations of whoever signed those papers scanned and published here. We needn't mention their names as their names are printed boldly in these communications. The State Health Minister's office also had its quota the enormity of which resulted in feud and many other things and finally nearly reached beating; the Project Manager of E-Health, who was an able administrator, formerly a Superintendent of the Government Mental Health Centre, Trivandrum, and the only person qualified for the post, resigned. We were given details of only minor payments and expenditure from 06/2013 to 06/2014. We are awaiting major payments along with vouchers and payment receipts for the period and those of all payments for all periods. See here the reply forwarded to us: you must search internet for the companies mentioned in the list towards the end. You will see that the majors among them have no experience in implementing, designing and supplying e-health in other states or in other countries. The minor companies never existed; they were just set up as company fronts by politicians in government to loot at will the e-health money allotted by the Government of India. 

Companies enlisted were without previous experience in the field except two.

  
20. Expenditure statement of e-health for 2013-14. Page 3.
 

We were indeed given copies of the various companies which Expressed their Interest in response to the EoE notification. A very few among them were indeed companies with a reputation but it was never revealed which ones among them were short-listed or reached the stage of signing a Memorandum of Understanding. The companies originally bid, in the order of their listing by the e-health authorities were these: Infosys, UST, Bosch, Amritha Technologies, TCS, Madras Security Printers, Tech mahindra, Accenture, Sify, IBM, Equant Tech, Keltron, NSDL Database Management, United Health Group Informatics, Oracle and HCL Infosystems. In our checking only six of them had any kind of credentials and even for of these did not have a policy of disclosure. Most of them had no credentials, and except one or two were previously and practically experienced in the field. It must also be noted that of all these companies listed for the e-health of Kerala with or without credentials but who were actually the first bidders to Kerala’s e-health, none were involved (or were invited to take part?) in the collapsed people’s electronic medical data collection deal 2020 of Kerala.

  
21. Expenditure statement of e-health for 2013-14. Page 6.
 

The official station of this project was one of the front buildings in the compound of the Directorate of Health Services, Trivandrum. This building was originally constructed for housing the Reproduction and Child Health Project (RCH) and a property of the health department and the state government. We believe this building was shown to have been newly constructed or bought for housing the E-Health Project through bogus/fabricated records to convince the central government and steal more crores of rupees from the project on account of a headquarters. 

(Updated as on 27 October 2014, 03:32 PM, slightly edited since then.)

  
22. Expenditure & data statement of e-health for 2013-14. Page 10.

Was it first installment for the pilot project or annual bonanza?
 

By May 2017 the central government had begun to refuse more grants to the Kerala’s E-Health Project. In 2013 they had granted 100 crores for the full implementation of this project in the 14 districts of Kerala but the state did not do that. The state said this amount granted by the centre was not for implementing the project in the 14 districts of Kerala but the first installment towards the pilot project to be spent in Trivandrum district. The state authorities did expect that the central government would grant 94 crores each year for this project to spend extravagantly and foolishly like they did with that ‘first installment’! 

Attempts to secure grants from international agencies fail.
 

So, by 2017, the Government of India’s Department of Electronics and Information Technology went out of the picture. They were already tired of the corruption and mismanagement in the Pilot Project in Trivandrum. So they decided not to fund anymore Kerala’s e-health programme extending to the other 13 districts and taking over the traditional physical medical records libraries in hospitals and setting up digital data banks. The central government’s stand was the state government could do it at its own initiative and at its own expense. So in desperation, the Kerala government tried to secure grants for this purpose from international agencies but they declined. These international agencies were already auditing their previously given grants, asking why the thousands of women’s and children’s deaths in Kerala’s hospitals were not investigated and compensations paid for, and stopping all grant-in-aids to the Kerala health. 

Why break the back window if the front door is open?

In May 2017 in desperation the Kerala government through its health department approached that Shylock, the Kerala Infrastructure Investment Board for a loan. The KIIFB would give loans only based on cost effectiveness and internal rate of return for which a not-for-profit government enterprise will not qualify. So in May 2017 the government was running for setting up an entity of a company for managing the e-health programme of Kerala. The KIIFB’s refusal meant the project had to make money either by realizing exorbitant hospital fees which is safe but which would lead to the immediate fall of the government, or sell the collected data to the interested parties at market rates which is risky but which would extend the life of the government for a few more months till the next elections. The risky path was chosen. The insurance companies, the pharmaceutical companies and a multitude of other types of companies were becoming desperate for this data meanwhile. In 2019 it was reported that there were attempts of hacking and sabotage at the state’s e-health medical data archives and more than one crore people’s data were stolen. In 2020 a foreign company was brought in officially as collaborator. Why break the back window if the archives could be entered through the open front door? 

The politician-bureaucrat nexus with nefarious international connections.

This politician-bureaucrat nexus in Kerala with nefarious international connections knows sometimes things will come out and the bureaucrats in this nexus will have to order enquiries to save their faces. Then they will tell people through press that a few hundred digital devices broke down, the system became down, data were hacked into, and most were tampered with or lost. That was what the government of Kerala through its health secretary Mr. Rajeev Sadanandan told people in 2018- after data of one crore people of Kerala were reported to have been illegally accessed and got hold of by insurance and pharmaceutical companies. So, even from the beginning of this project in Kerala these politicians and bureaucrats and companies were working in cahoots towards the goal of collecting people’s private invaluable medical data officially for the companies. 

Putting these traitors to lie detector tests or applying sodium pentothal on them would just have brought everything out.

Every kind of enquiries is conducted by this nexus when such cryptic data maneuvers occur, except one. The health minister’s and the health secretary’s offices have a multitude of governmental as well as personal private employees including a score of Chief Private Secretaries, Additional Private Secretaries, Assistant Private Secretaries, Chief Personal Assistants, Additional Personal Assistants, Assistant Personal Assistants, and above all Political Secretaries appointed by the ruling party. In addition, there will also be liaisons from the state and district and central committees of the ruling party. Putting these traitors to lie detector tests or applying sodium pentothal on them would just have brought everything out but that is one thing the ‘investigating officers’ take care to never do. 

Saviors of Kerala’s entire electronic health who cannot even manage a couple of social media sites!

E-Health Kerala has a Twitter handle: https://twitter.com/ehealthkerala Joining date March 2015. Tweets Nil. Followers 23, including District Programme Managers and BJP Kollam. Following none. It also has a Face Book Page: https://www.facebook.com/ehealthkeralapage/ . Started on 25 July 2015. Number of posts till June 2018: Five, of which three profile changes! Some windbag will sit in his office and exclaim loudly that social media pages are very important in the modern age to communicate with people. He will order subordinates to open social media pages in Twitter and Face Book and, if they allow, in Linked In immediately and his subordinates will start them immediately as if a great digital revolution was going to begin from their office. The result is there for all to see- no posts for years- abandoned by the master and also his servants! That windbag would have retired and gone or transferred from that post, after getting hold of whatever he or she could from this e-health project. 

E-Health Scheme or E-Health Scam?

We followed this project for six years from 2014 when we predicted this project was going towards heavy corruption, up to May 2020 when we witnessed this project already in shambles and total disgrace, with the government’s massive move to collect people’s electronic medical data in connection with the corona virus epidemic and attempting to sell this enormous data to shady foreign companies rocking the state and creating media headlines, the government standing in court in attention babbling things in explanation and the court ordering to destroy beyond recovery all the data given to the company for crunching. When we read in newspapers ‘E Health Scheme launched by the Chief Minister of Kerala’, shall we not read it correctly as ‘E Health Scam launched by the Chief Minister of Kerala’? So long as there is scope for raising 200 crore rupees yet again for implementing this project in all 14 districts in Kerala, there is still hope for this politician-bureaucrat nexus.

Images Courtesy: Pixabay.
Written and first published in: 24 April 2014


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About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

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Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.

213. Why some cities with fewer mosquitoes have more dengue? P S Remesh Chandran

213

Why some cities with fewer mosquitoes have more dengue?

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

Image by Raman Oza. Graphics: Adobe SP.
 

On the very day the Times Of India selected Trivandrum as the Most Beautiful City in Kerala, it also had to report that of all the cities in Kerala, Trivandrum was the one in the most grip of dengue. Is it not horrible to conceive death and destruction and disease as beauty? The Government of Kerala and the health authorities of this state were asked a simple question by a Times Of India reader: Cochin and Trivandrum are two major cities in Kerala. Trivandrum does not have even a thousandth part of as much mosquitoes as there are in Cochin. But Trivandrum has a thousand times more dengue cases than Cochin. Why is it so? Does not that mean there is another agent spreading this dengue in Trivandrum? The Government of Kerala and the health authorities in this state remained silent on this question. Nor did the Times Of India reporters in Trivandrum ask the state authorities this question. 

Mosquitoes have extra ordinary survival skills. They can survive in heavy rain and fog. They have survived even heavy fires in the Amazon rain forests. A single rain drop is many times heavier than a mosquito’s weight and one drop falling on a mosquito would instantly kill it but it evades by flying always in deviating paths to escape from each single drop. Even if the whole world is set on fire to kill them, they will escape and return to kill the world. History of the planet through calamities of flood and fire proves this. In spite of his efforts through millenniums man has not been able to get the world rid of mosquitoes. In fact, mosquito problem in cities like Trivandrum is not as severe as in other Kerala cities like Cochin except in the coastal areas and Cochin has not shown signs of having as much dengue and chikungunya as in Trivandrum. Therefore the reason for the abundance of dengue cases in Trivandrum is resting with not mosquitoes but some other breeding agent in nature. The reason and the root is not mosquitoes but dogs. The carrier and the injector of the viruses are tried to be eliminated but the breeder is still there roaming freely.

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About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

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Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.

212. Why the British pay a higher price in old age for family relations? P S Remesh Chandran

212

Why the British pay a higher price in old age for family relations?

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

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Everyone knows that the British are great admirers of dogs. Most of them extend their love to their dogs which they deny to their children. Dogs are let to lie with them in their rooms, often in their beds. Their toddlers are left to lie and sleep alone in a separate room- mostly in the family nursery room in crèche, even before they are even one year old. This is what affected their present day social structure- children leaving parents in their old age, abandoning them in old age homes. In India it rarely happens, and in countries like China, Tibet, Japan, Indonesia and Ceylon also. That is the price the British dog lovers pay in their old age for substituting dogs for children. One can say and argue that their children grow up more independently than the children in the Asian countries mentioned and more early too, but within that time the ardence between the parents and their children- the very cementing bond of human relations in man's society- is irredeemably lost. It is not unemotional haughty brutes that we need to build our society but ardent affectionate young men who respect and take care of their elders. An average British man now finds himself marooned in an island of hostility in his old age because he once had no love left to be shared with his sons and daughters after pouring all what he had as parental love on his dogs. The British who ruled India for a very long time were startled at the common sight of children- young and old alike- sleeping in parents’ rooms without leaving any privacy for anyone, but they did not understand that it was the bond which very early cemented and held together parent-child relations in India and other Asian countries and prompted them to never part from each other at any age. 

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About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

Face Book: https://www.facebook.com/psremeshchandra.trivandrum
Twitter: https://twitter.com/PSRemeshChandra
You Tube: http://www.youtube.com/user/bloombooks/videos
Blog: http://sahyadribooks-remesh.blogspot.com/
Site: https://sites.google.com/site/timeuponmywindowsill/
E-Mail: bloombookstvm@gmail.com

Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.

211. Press interviewing a District Medical Officer of Health in Trivandrum (Imaginary of course!) P S Remesh Chandran

211

Press interviewing a District Medical Officer of Health in Trivandrum. (Imaginary of course!)

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

Image by Simaah. Graphics: Adobe SP.
 
“Are you accusing that dengue is entirely due to mosquitoes?”

“Yes, there is no other reason.”

“Do you agree dengue is a Zoonosis disease which is caused by viruses?”

“Yes, that is basic knowledge.”

“Is dengue an Arboviral infection which needs an animal reservoir host for the virus to complete its life cycle?”

“Yes, that also is basic science but there have been disagreements….”

“What disagreements...? I was quoting from W.H.O. article in which it is stated that arthropod vectors such as ticks which are abundant in dog bodies are needed for maturing this virus?.”

“Then it might be true.”

“Is it true that these viruses are spread to man by mosquitoes who themselves get infected from dogs and monkeys?”

“Then it might be the monkeys, not dogs.”

“Do you have dogs?”

“Yes, I have three.”

“Which is the possible source of this disease, considering the number of monkeys and the number of dogs in this district?”

“According to your statement, it has to be the dogs.”

“Then why are authorities hunting mosquitoes and excluding dogs from the hunt; why don’t you tell people about the role of dogs so that they can take precautions and guard against this disease?”

“Because, dogs are protected by the central government; mosquitoes are not.”

“So the government is going after the second accused, leaving the first accused uncharged?”

“Yours is a damned newspaper which does not even have an editor.”

“Who said it?”

“Mr. TJS George recently, perhaps he might have wished to become your editor…why are you asking me these absurd questions?”

“Because I can…why are you not answering my questions scientifically?”

“Because I cannot.”

All of a sudden a newspaper reporter who had been sleeping at the back in a chair sat up straight and asked:

“Have you ever read Dr. A. J. Cronin’s famous novel The Citadel which is a quick look into the ethics of medical profession?”

“No, I do not have much time for reading, except medical books…why are you bringing this up?”

“Because it is relevant, and you should know about an incident described in this novel. The young Dr. Manson found out that a generations-old, rusted sewage line seeping contents into water lines was the cause of colleform-related epidemics and deaths in the coal districts of England which the municipal authorities won’t replace fearing the heavy costs its replacement would incur. The DMO of that English district warned him he was entering the red zone, but for his love of people in his district, helped Dr. Manson to dynamite the sewage line secretly and get it immediately replaced by the municipality. Trace the actual source of an epidemic and do what is needed boldly. It is your people who are dying there in your district due to dengue.” 

So the press meet ended in bedlam. It was accused by the government that the press behaved irreverently towards the DMO. The press charged that the DMO did not rise up to scientific standards. 

(The newspaper mentioned here was the Times of India and this article was written for and first published as comment in the Times of India).   

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FROM THE BOOK:

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English Essays Articles, 

About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

Face Book: https://www.facebook.com/psremeshchandra.trivandrum
Twitter: https://twitter.com/PSRemeshChandra
You Tube: http://www.youtube.com/user/bloombooks/videos
Blog: http://sahyadribooks-remesh.blogspot.com/
Site: https://sites.google.com/site/timeuponmywindowsill/
E-Mail: bloombookstvm@gmail.com

Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.

210. For whatever inhuman purposes are dogs used! P S Remesh Chandran

210

For whatever inhuman purposes are dogs used!

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

Image by Tania Dimas. Graphics: Adobe SP.

We will wonder for whichever inhuman purposes dogs could be used by people. In the northern city limit areas of Trivandrum there is a very quiet place like a rural village situated inside a town. Behind a Goddess Temple there lived a very poor family. One of their girls was a very brilliant student. One day a very rich lady came to live there in a rented house nearby. One morning she asked the poor girl to go to a shop and purchase something for her, as if the child was her errand girl. The child said her father won’t allow it since she had to study hard to pass the entrance examination for securing admission to medical course. We don’t know infuriated whether by the inservitude of the girl or by the jealousy at the girl getting medical admission, the lady took her car, went somewhere and returned with four fierce dogs, parking one each in front of the house, back and sides. She got built perhaps the smallest animal cages in Trivandrum, got the dogs inside with clanking chains and all and got them barking without stop all day and night. Some say there were one in the terrace and another in the bedroom too. Though her house was a two storied modern building, it had no space, no compound, and what space there was around the house was floor tiled. Naturally, she took a morning and an evening walk each day for relieving the dogs in the streets. The people there became furious at the temple surroundings, nearby pathways and the water pond there being soiled and polluted by these dogs. When the poor child complained that she could not learn her lessons due these four dogs continuously barking, this jealous woman went to the market, purchased four heavy tin plates for pretentiously feeding the dogs and put them and kept them all inside the cages. She also air-conditioned the house so that she won’t have to hear the horrible sounds coming from the dog cages night and day, the continuous dog barking, chains dragging and clanking and metal plates grating and tinkling- all a total horrible bedlam. People of that area complained to the district collector of Trivandrum, the mayor of the city, the director of the animal welfare department and the society for the prevention of cruelty to animals, about the soiling of their pathways, the continuous dog barking from the house and the inhuman treatment of dogs. The City Corporation sent their health inspector to inspect and his report said there was no such public nuisance in that area. Some said he reported there was even no such house in the area! He was paid 1000 rupees, the lady told people. The other offices also sent officers who, she said, were all paid 500 rupees each and the problem was solved. We will wonder why these authorities should take action. The collector has three dogs, the mayor has four and the SPCA Trivandrum is a haunt of rich ladies who do not even have any other place to go in the evenings when their husbands are irrigating in their club bars.

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English Essays Articles, 

About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

Face Book: https://www.facebook.com/psremeshchandra.trivandrum
Twitter: https://twitter.com/PSRemeshChandra
You Tube: http://www.youtube.com/user/bloombooks/videos
Blog: http://sahyadribooks-remesh.blogspot.com/
Site: https://sites.google.com/site/timeuponmywindowsill/
E-Mail: bloombookstvm@gmail.com

Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.

209. Those who wish to keep a non-human in their house should also be prepared to do whatever is necessary to safeguard humans. P S Remesh Chandran

209

Those who wish to keep a non-human in their house should also be prepared to do whatever is necessary to safeguard humans

P. S. Remesh Chandran
 
Editor, Sahyadri Books & Bloom Books, Trivandrum

Image by Stock Snap. Graphics: Adobe SP.
 

If we are all set to spend a considerable portion of our fortune for keeping dogs, we must also be prepared to adopt methods to keep them from continuous barking. They can be trained in the houses. If they can be trained extensively to bring the morning paper from the lawn, bring the scotch bottle from the bar, chase the birds and cats that stray into the compound, baby sit children when parents are away, lead blind men on the road, catch thieves by smelling and detect explosives by sensing, they can also be trained not to bark. Several decent dog owners do that. If people in the house are not skilled and patient enough to do that, there are trainers there who do it for a fee. Spend that money. Surgical and chemical innovations have been in every country for preventing dogs from continuously barking with or without reason. Spend money on them darlings. Mechanical devises also are available for purchase in the market. Infra red dog bark arresters can be purchased and fitted inside or outside the house which produces response waves of low frequencies and interferes with the dog’s interest in barking- actually hampering and wetting its zeal to bark. These responsive waves are inaudible to man or most of his other pets. If these gadgets are not produced or available in your country, import them from abroad spending dollars and pounds. There are simple dog collars too to prevent them from barking too often. Those who wish to keep a non-human in their houses with them should also be prepared to do whatever is necessary to safe guard humans.

Images Courtesy: Pixabay.
Written and first published on:


FROM THE BOOK:

 Buy: https://www.amazon.com/dp/B0874WBRQY

Tags:


English Essays Articles, 

About the Author P. S. Remesh Chandran:

Author Profile Of P S Remesh Chandran By Sahyadri Archives.

Editor of Sahyadri Books & Bloom Books, Trivandrum. Author of several books in English and in Malayalam. And also author of Swan: The Intelligent Picture Book. Born and brought up in the beautiful village of Nanniyode in the Sahya Mountain Valley in Trivandrum, in Kerala. Father British Council trained English teacher and Mother University educated. Matriculation with distinction and Pre Degree Studies in Science with National Merit Scholarship. Discontinued Diploma studies in Electronics and entered politics. Unmarried and single.

Face Book: https://www.facebook.com/psremeshchandra.trivandrum
Twitter: https://twitter.com/PSRemeshChandra
You Tube: http://www.youtube.com/user/bloombooks/videos
Blog: http://sahyadribooks-remesh.blogspot.com/
Site: https://sites.google.com/site/timeuponmywindowsill/
E-Mail: bloombookstvm@gmail.com

Post: P. S. Remesh Chandran, Editor, Sahyadri Books, Trivandrum, Padmalayam, Nanniyode, Pacha Post, Trivandrum- 695562, Kerala State, South India.