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In Pakistan, Lady Health Worker (LHWs) Get Their Issues Across #Vaw

Picture caption: Shama Gulani, General Secretary of ASLHWA addresses the public meeting in Karachi

On 30 January, the All Sindh Lady Health Workers and Employees Association, PSI and Workers Education and Research Organisation organised a public meeting in Karachi on “Socio Economic Impacts of Delayed Wages on LHWs and their families” and “Sexual Harassment of Lady Health Workers on the Job and Field” to share the findings of two studies to be published very soon.

Researchers Moniza Inam, senior journalist from daily DAWN and Sohail Javed, from the Applied Economics Research Center of the University of Karachi, presented striking findings of a research that looked at two critical aspects of LHWs lives and work.

Lady Health Workers (LHWs) are part of the National Programme for Family Planning and Primary Healthcare, started in 1994. Under this program, women provide family planning, pre-natal and neonatal care, immunization services and other key child and women health services in the community. It has been shown that maternal and infant mortality rates are lower in areas where LHWs are active.

Findings include that 63%of the respondents are the sole breadwinners of the family. However, they reported an average monthly income of PKR 15,245 (137 euros), whereas their monthly expenditures stood at PKR 29,567 (265 euros). Uncertain job descriptions, long working hours and erratic traveling are other issues faced on a regular basis. Wages are generally not paid on time, and the All Sindh Lady Health Workers and Employees Association (ASLEHWA) has been instrumental in pressurizing the government in releasing salaries.

The programme is a major employer of women in the non-agricultural sector in rural areas. There are 125,000 LHW in Pakistan, out of which 22,576 are in Sindh.

Further due to the fact that their work makes them step over the gender division of public and private space, LHW face humiliation and verbal abuse by members of the communities they serve, domestic violence at home and sexual harassment at work by their colleagues in the health system and in the field by members of the community.

Most of these instances go unreported due to the fear of repercussions. In many instances, LHW reported being worried that their families would ask them to leave the job or even disown them. Cases of extreme violence include orchestrated murders by religious fundamentalist groups, estimated at 22 deaths since 2012.

Recommendations included revising salaries structures commensurate with qualifications, awareness campaigns among LHWs and their colleagues in the health system on laws and mechanisms relative to the protection against sexual harassment. Mechanisms should also be set up in the districts to monitor violence and sexual harassment cases by community members.

For more information, contact Mir Zulfiqar at WERO [[email protected]], or Susana Barria at PSI [[email protected]].

Picture caption: Shama Gulani, General Secretary of ASLHWA addresses the public meeting in Karachi.

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Unwarranted Hysterectomies- Would authorities help if Men’s Genitalia Had Been Removed?

Docs Remove Women’s Uteruses for Profit, Authorities Refuse to Help. Would it be Different if Men’s Genitalia Had Been Removed?

By Ila Ananya


Photo courtesy: Vijayakumar Seethappa.

On 6th February, around 600 Dalit and Lambadi women from different tandas in Aland, Kalaburagi, Chittapur and Chincholi districts in Karnataka gathered outside the office of the Kalaburagi Deputy Commissioner (DC).

Most of these women were victims of unwarranted hysterectomies — the complete removal of the uterus — performed by doctors in private hospitals. The women had been conned by these doctors, who diagnosed a risk of cancer for problems like irregular menstrual cycles, white discharge or pain in the lower abdomen. An urgent hysterectomy, these doctors said, was the only way their lives could be saved. Hysterectomies had become a business, and women’s bodies were the new market.

On Monday the 6th, the protesting women were angry and aggressive. They demanded to meet the DC, and when told that he was ‘out on business’, the women decided to storm the office. “It almost became a law and order situation,” says Akhila Vasan, state convener of the Karnataka Janarogya Chalavali (KJC), a group of public health activists. “But because of the aggressive pressure, the government responded.” The Additional Regional Commissioner assured the women that the doctors would now be booked with criminal cases immediately, and hospitals that had performed such hysterectomies would also be immediately closed. Additionally, the women would also be given compensation after a committee was formed to identify the victims.

Vasan says that the matter had first come to light back in 2015 during KJC’s ‘Health as Human Rights’ workshop in Gulbarga. One of the activists found that women in the villages were talking of a big “bimaari” (illness) in the villages, where their doctors told them they were at the risk of cancer when they went to them with any gynecological problems. “You have had children,” they were told, “so why do you need this organ?”


Photo courtesy: Vijayakumar Seethappa.

6th February was the second time these women came together to protest this injustice and exploitation. Their first protest, also in front of the DC’s office, had been a year-and-a-half earlier, demanding an enquiry into mass unwarranted hysterectomies that had been performed in the area. The KJC had submitted a report while a second report was submitted by a committee set up by the Commissioner of Health and Family Welfare. In both reports, 98 percent of the 707 women spoken to reported undergoing hysterectomies in private hospitals. Thirty eight hospitals were named. What was additionally shocking was how young these women were — 65 percent were less than 35 years old, while 25 percent were less than 30 years old.

In its fact-finding report, the KJC analysed the women’s medical records and whether they had really needed the hysterectomies. They found that, besides the unnecessary and cruel operations, no medical procedure was followed even in cases where women had died of hysterectomies. There was no post-mortem done, the body was cremated in a suspicious manner and families were bribed to stay silent. Between 25th January and 2ndFebruary, 2017, KJC had campaigned in 35 tandas showing women the state’s reports about hysterectomies, asking them what they thought should be done. This was when the women decided to go on an indefinite protest.

Also Read:  Women Out and About in Hyderabad, You Will Have to Cross Your Legs and Wait to Pee

Till date, no FIRs or cases have been filed against these criminal doctors and hospitals. “The reports have been with you for one-and-a-half years, but what have you done,” Vasan describes the women as asking. She sounds furious when she says that private hospitals in India enjoy maximum impunity.

Maitreyi Krishnan, an advocate who has been helping women in Kalaburagi file complaints, says that they had first approached the police to file an FIR a year-and-a-half ago. No FIR was registered and the police didn’t take suo moto cognisance either. The hospitals continued to function and the doctor’s licenses were not revoked. Next, the women had approached the Kalaburagi bench in the Karnataka High Court. On 5thJanuary 2017, the bench had finally issued a notice to the Health Department demanding a response.

Women protesting at Kalaburagi. Photo courtesy Vinay Sreenivasa, ALF.

Photo courtesy: Vijayakumar Seethappa.

Amidst all this, Vasan says, some of the women have been threatened to withdraw their complaints — they speculate that the rich privileged doctors are behind this. According to Narendra Gupta, who filed a PIL on unwarranted hysterectomies in the Supreme Court back in 2013, many such accused doctors have tried to bribe protesting women and used local politicians to exert pressure on them to withdraw their cases.

Hysterectomies have many health impacts. Sapna Desai, Health and Research Coordinator at Sewa Co-Operative, a women’s organisation that operates a community-based health insurance scheme, says that the procedure results not just in early menopause but also causes a decrease in oestrogen production and increases the risk of cardio-vascular disease and osteoporosis. The women in Kalaburagi were never told of these consequences.

Krishnan says that either the Medical Council (a statutory body regulating medical colleges and doctors registration) or the consumer court can be approached in such cases, but neither is a strong option. “In consumer courts, the only possible result is compensation for the victims. The doctors face no other punishment, even if their actions have resulted in death,” says Vasan.

On the other hand, she says that if the police are required to file an FIR for medical negligence under the current law, the complainants first need to get the approval of the Medical Council. The next barrier comes here –Medical Council enquiries are conducted by peers. “If members to the Medical Council are elected by their own fraternity, do you think they are going to act against them?” Vasan asks.

In Kalaburagi, too, the KJC first approached the Karnataka Medical Council (KMC) with a fact-finding report about a case where a young woman had died on the operation theatre table during a hysterectomy. After spending a year on the case, the KJC was dismissed on flimsy grounds two months ago. “The KMC allowed the doctor to go free even though there was proof that the doctor had threatened the victim’s family and bribed her husband with Rs 3 lakh,” Vasan says. According to her, the doctor had got the husband to say that he didn’t want to press charges. The husband said that he believed that the cause of her death was anaphylactic shock. The KMC dismissed the case without even calling for the Karnataka Women’s Commission’s video proof, in which the man supposedly said he had been bribed and made to sign a paper without knowing its contents.

Also Read:  Our Blind Spots on Rural Pregnancy in India Revealed, One Video at a Time

Photo courtesy: Vijayakumar Seethappa.

Such unwarranted hysterectomies have been happening across the country. Jashodhara Dasgupta of SAHAYOG, a voluntary organisation working on women’s health, says that hysterectomies have also been wrongfully carried out in other parts of India as well — and sometimes these scams even deploy government health schemes. The Rashtriya Swasthya Bhima Yojna, a government health scheme for unorganised workers in India, for instance, provides Rs 30,000 for a family of five. But the money can only be used if patients are admitted in hospitals. Between 2010 and 2012, Dasgupta says, many women were diagnosed with great urgency that they absolutely had to have hysterectomies. The doctors then admitted them into hospitals and charged them the full Rs 30,000 available on the scheme.

Similarly, hysterectomies became a scam under the Aarogyasri scheme in 2008. The scheme itself was started in undivided Andhra Pradesh in 2006. SV Kameswari, from Life-HRG, an NGO providing basic healthcare services in Medak, Telangana, found that 163 hysterectomies had been performed by private hospitals (as compared to eight in government hospitals) in Medak alone, between October 2008 and June 2009. In private hospitals, the discharge summary for the women was found to be mostly blank with no information about the procedure done or follow-up instructions.

Vasan argues that we must begin to hold the state responsible for being unable to protect these women against such criminal doctors. She is hopeful that there will finally be some justice after the protest this month. However, given how reluctant the police have been to begin investigations and how slowly the legal appeal has progressed, these women worry if the Additional Regional Commissioner’s promises will hold any meaning after all.

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Meghalaya – uranium mining projects will not get NOCs

 Khasi District Council

After the Centre reiterated its move to open up uranium mining in the state, the highest council of the Khasi community says it will not grant an NOC

                    The Centre, in February 2017, reiterated that the uranium mining activities will be pursued in Meghalaya. Credit: Rikynti Marwein / Flicker
The Centre, in February 2017, reiterated that the uranium mining activities will be pursued in Meghalaya. Credit: Rikynti Marwein / Flicker

With the Central government planning to revive uranium mining in Meghalaya, the Khasi Hills Autonomous District Council (KHADC) has taken the side of the student organisations and NGOs opposing Centre’s plans. According to Chief Executive Member of KHADC, P N Syiem, the council has unanimously approved the decision to not grant No Objection Certificate to uranium mining in Meghalaya.

On February 8, in a written response to a question in the Lok Sabha, Jitendra Singh, Minister of State in the Prime Minister’s Office (PMO), who is also handling the Atomic Energy portfolio, said that it has already planned to develop the mineral resources at Domiasiat, a village in West Khasi Hills, about 130 kilometres from the state capital, under the name of ‘Kylleng- Pdengsohiong-Mawthabah (KPM) Uranium Mining Project’.

Incidentally, in August, 2016, the Meghalaya government revoked its earlier decision that granted permission to the Uranium Corporation of India Limited (UCIL) to conduct uranium exploratory activities in the state. The government had granted the UCIL 422 hectares of land in Mawthabah area of South West Khasi hills in August 2009.

However, the Centre, in February 2017, reiterated that the uranium mining activities will be pursued in the state. “Uranium mineralisation in Meghalaya has been found over a large area around Domiasiat, Wahkyn, Lostoin. The project has the potential to generate substantial nuclear fuel for the atomic power plants of the country,” Singh stated while adding that a detailed project report has been approved by the Atomic Energy Commission. Further, the minister wrote that environmental clearance for KPM project has been obtained from the then Ministry of Environment and Forest in December 2007.

“An agreement has also been signed between the UCIL and the land owners of the project site in May 2007 for acquisition of land on annual lease rent basis,” he stated in the floor of the Parliament. On the other hand, the Atomic Mines Directorate (AMD), which takes up exploration of uranium reserves, has already floated a commercial tender for exploration for drilling in Nongjri Plateau in South West Khasi Hills District, Meghalaya on December 27, 2016.

Rethink on uranium mining

Exploration for uranium in the same region was done by West Bengal-based Maheshwari Mining Limited in Nongjri since 2007. However, the KHADC was not informed about the mineral that company was looking for, according to Syiem. Although the KHADC granted a trade licence to the company, the details of exploration were missing. “We received several complaints from the local organisations and communities living in the areas. Upon perusal, we found that there were massive discrepancies in the documents presented to the council,” said Syiem. In June 2011, the company was asked to surrender the trade licence for felling large number of trees and polluting the local water by disposing drilling waste in the neighbouring water bodies.

The KHADC, which is one of the 14 councils in the six schedule areas in the country, reserves the right to grant permissions to acquire land for different kinds of activities by the government as well private organisations. According to the members of KHADC, as of now, the earlier experience of Uranium mining has forced people, including previous land owners who diverted their land for exploration, to rethink about the mining of the radioactive element.

Rich reserve of sandstone-type uranium

On the other hand, according to the AMD, India’s largest and richest sandstone-type uranium deposits are located in Domiasiat and Wahkyn areas of West Khasi Hills district of Meghalaya. So far, nearly 131 km of drilling by completing about 1,800 boreholes has resulted in procuring 16,000 tonnes of uranium ores, accounting 14 per cent of India’s total uranium reserve.

The KHADC’s decision is backed by two powerful student organisations—the Khasi Students’ Union (KSU) and the North East Students’ Organisation (NESO)— that have been opposed the Centre’s move to develop large deposits of uranium in Meghalaya. “We had made it clear to the government that we would continue to oppose uranium mining until a common understanding of all stakeholders is reached on the issues and all the apprehensions of the people addressed,” the KSU president Daniel Khyriem said while addressing a press conference in Shillong.

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Nuclear Power Is Not “Green Energy” #mustshare

Nuclear lobbyists and some scientists are under the mistaken impression that nuclear power is virtually carbon-free, and thus must be pushed to prevent runaway global warming (if you don’t believe in global warming, please forward this to your friends, family and colleagues who do so).

But this is a complete and total myth …

Former Commissioner for the U.S. Nuclear Regulatory Commission Peter Bradford explains that building nuclear plants to fight global warming is like trying to fight global hunger by serving everyone caviar.

Dr. Mark Jacobson – the head of Stanford University’s Atmosphere and Energy Program, who has written numerous books and hundreds of scientific papers on climate and energy, and testified before Congress numerous times on those issues – notes that nuclear puts out much more pollution (including much more CO2) than windpower, and 1.5% of all the nuclear plants built have melted down.  Jacobson also points out that it takes at least 11 years to permit and build a nuclear plant, whereas it takes less than half that time to fire up a wind or solar farm. Between the application for a nuclear plant and flipping the switch, power is provided by conventional energy sources … 55-65% of which is coal.

Keith Barnham – Emeritus Professor at the Faculty of Natural Sciences, Imperial College London – notes that claims that nuclear power is a ‘low carbon’ energy source fall apart under scrutiny.

Mark Diesendorf – Associate Professor and Deputy Director, Institute of Environmental Studies, UNSW – writes:

Unfortunately, the notion that nuclear energy is a low-emission technology doesn’t really stack up when the whole nuclear fuel life cycle is considered. In reality, the only CO2-free link in the chain is the reactor’s operation. All of the other steps – mining, milling, fuel fabrication, enrichment, reactor construction, decommissioning and waste management – use fossil fuels and hence emit carbon dioxide.

Amory Lovins is perhaps America’s top expert on energy, and a dedicated environmentalist for close to 50 years.  His credentials as an energy expert and environmentalist are sterling.  Lovins is a former Oxford don, who taught at nine universities, most recently Stanford.  He has briefed 19 heads of state, provided expert testimony in eight countries, and published 31 books and several hundred papers.  Lovins’ clients have included the Pentagon,  OECD, United Nations, Resources for the Future, many national governments, and 13 US states, as well as many Fortune 500 companies, major real-estate developers, and utilities.  Lovins served in 1980-81 on the U.S. Department of Energy’s Energy Research Advisory Board, and in 1999-2001 and 2006-2008 on Defense Science Board task forces on military energy efficiency and strategy.

Lovins says nuclear is not the answer:

Nuclear plants are so slow and costly to build that they reduce and retard  climate protection.

Here’s how. Each dollar spent on a new reactor buys about 2-10 times less carbon savings, 20-40 times slower, than spending that dollar on the cheaper, faster, safer solutions that make nuclear power unnecessary and uneconomic: efficient use of electricity, making heat and power together in factories or buildings (“cogeneration”), and renewable energy. The last two made 18% of the world’s 2009 electricity, nuclear 13%, reversing their 2000 shares–and made over 90% of the world’s additional electricity in 2008.

Those smarter choices are sweeping the global energy market. Half the world’s new generating capacity in 2008 and 2009 was renewable. In 2010, renewables except big hydro dams won $151 billion of private investment and added over 50 billion watts (70% the total capacity of all 23 Fukushima-style U.S. reactors) while nuclear got zero private investment and kept losing capacity. Supposedly unreliable windpower made 43-52% of four German states’ total 2010 electricity. Non-nuclear Denmark, 21% wind-powered, plans to get entirely off fossil fuels. Hawai’i plans 70% renewables by 2025.

In contrast, of the 66 nuclear units worldwide officially listed as “under construction” at the end of 2010, 12 had been so listed for over 20 years, 45 had no official startup date, half were late, all 66 were in centrally planned power systems–50 of those in just four (China, India, Russia, South Korea)–and zero were free-market purchases. Since 2007, nuclear growth has added less annual output than just the costliest renewable–solar power –and will probably never catch up. While inherently safe renewable competitors are walloping both nuclear and coal plants in the marketplace and keep getting dramatically cheaper, nuclear costs keep soaring, and with greater safety precautions would go even higher. Tokyo Electric Co., just recovering from $10-20 billion in 2007 earthquake costs at its other big nuclear complex, now faces an even more ruinous Fukushima bill.

Since 2005, new U.S. reactors (if any) have been 100+% subsidized–yet they couldn’t raise a cent of private capital, because they have no business case. They cost 2-3 times as much as new windpower, and by the time you could build a reactor, it couldn’t even beat solar power. Competitive renewables, cogeneration, and efficient use can displace all U.S. coal power more than 23 times over–leaving ample room to replace nuclear power’s half-as-big-as-coal contribution too–but we need to do it just once.

(Read Lovins’ technical papers on the issue here.)

Nuclear engineer and former nuclear industry executive Arnie Gundersen noted last year:

Does the nuclear industry’s latest claim that it is the world’s salvation from increasing levels of CO2 hold up under scrutiny? No! The evidence clearly shows that building new nukes will make global warming worse.


Nuclear power lobbyists and their marketing firms want us to believe that humankind’s current CO2 atmospheric releases would have been much worse were it not for those 438 nukes now operating. How much worse? The World Nuclear Association industry trade group estimates that an additional 1.1 GT of CO2 would have been created in 2015 if natural gas plants supplied the electricity instead of those 438 nukes[17].

Do the math! 1.1 additional GT out of 36 GT emitted is only a 3% difference. This 3% value is not a typographical error. Worldwide, all those nukes made only a 3% dent in yearly CO2 production. Put another way, each of the 438 individual nuclear plants contribute less than seven thousandths of one percent to CO2 reduction[18]. That’s hardly enough to justify claims that keeping your old local nuke running is necessary to prevent the sea from rising.

Let’s fast forward to 2050. Massachusetts Institute of Technology (MIT) estimates that even if the 2015 Paris CO2 accords (COP 21) are implemented and 1,000 new nukes are constructed, global CO2 emissions will still increase to a minimum of 64 GT[19]. While this increase appears counterintuitive given the Paris agreement, it is on target because pent up energy demands from large populations in India, China, Southeast Asia, and Africa who want to achieve the standard of living in western developed countries.[20]

Can new nukes really help cut CO2 by 2050? Unfortunately, what is past is prologue. To do so, the World Nuclear Association claims 1,000 new nukes will be needed by 2050 to combat CO2 buildup and climate change[21]. The MIT estimate also assumes 1,000 nukes must be in operation by 2050. Using the nuclear trade association’s own calculations shows that these new nukes will offset only 3.9 GT of CO2 in 2050. Do the math again! 3.9 GT out of 64 GT is only 6.1% of the total CO2 released to the atmosphere in 2050, hardly enough for the salvation of the polar bears!

If those 1,000 nuclear power plants were cheap and could be built quickly, investing in nukes might still make sense. However, Lazard Financial Advisory and Asset Management[22], with no dog in the fight, has developed a rubric that estimates that the construction cost of those new nukes will be $8,200,000,000,000. Yes, that’s $8.2 TRILLION to reduce CO2 by only 6%![23]

Surely that huge amount of money can be better spent on less expensive alternatives to get more bang for the buck! Lazard also estimates that solar or wind would be 80% less expensive[24] for the equivalent amount of peak electric output.

Atmospheric CO2 releases are not going to go on vacation while waiting for those 1,000 nukes to be built. According to the World Nuclear Industry Status Report 2016[25], the mean [average] construction time for 46 nuclear plants that began operation between 2006 and 2016 was 10.4 years, not including engineering, licensing and site selection. Contrast that with a two year design and construction schedule for a typical industrial scale solar power plant.[26],[27] Atmospheric CO2 levels will increase by almost 70 PPM during the 35 years it will take to construct those 1,000 new nukes, an increase that these new nuclear plants will never eliminate – if they ever operate.


Global climate change is a now problem that requires now solutions[28]. Governments will make the CO2 problem worse by allocating precious resources for alleged atomic power solutions to reduce CO2 when the cost of such proposals is unknown and when implementation only begins in 2030. Fortunately, lower cost renewable solutions are readily available and can be implemented on the necessary time scale needed to reverse the rapidly increasing atmospheric CO2.

Building new nukes applies a 20th century technology to a 21st century problem. Moreover, building nuclear reactors in a tradeoff for CO2 reduction creates a toxic legacy of atomic waste throughout the world. Proponents of nuclear power would have us believe that humankind is smart enough to store nuclear waste for a quarter of a million years, but at the same time humankind is so dumb that we can’t figure out how to store solar electricity overnight. I disagree.

Let’s not recreate the follies of the 20th century by recycling this atomic technology into the 21st century. The evidence proves that new nukes will make global climate change worse due to huge costs and delayed implementation periods. Lift the CO2 Smoke Screen and implement the alternative solutions that are available now – faster to implement and much less expensive.

Alternet points out:

Mark Cooper, senior fellow for economic analysis at the Vermont Law School … found that the states that invested heavily in nuclear power had worse track records on efficiency and developing renewables than those that did not have large nuclear programs. In other words, investing in nuclear technology crowded out developing clean energy.

BBC notes:

Building the [nuclear] power station produces a lot of CO2 ….

Greenpeace points out:

When it comes to nuclear power, the industry wants you to think of electricity generation in isolation …..  And yet the production of nuclear fuel is a hugely intensive process. Uranium must be mined, milled, converted, enriched, converted again and then manufactured into fuel. You’ll notice the [the nuclear industry] doesn’t mention the carbon footprint of all steps in the nuclear chain prior to electricity generation. Fossil fuels have to be used and that means CO2 emissions.

An International Forum on Globalization report – written by environmental luminaries Ernest Callenback, Gar Smith and Jerry Mander – have slammed nuclear power as catastrophic for the environment:

Nuclear energy is not the “clean” energy its backers proclaim. For more than 50 years, nuclear energy has been quietly polluting our air, land, water and bodies—while also contributing to Global Warming through the CO2 emissions from its construction, mining, and manufacturing operations. Every aspect of the nuclear fuel cycle—mining, milling, shipping, processing, power generation, waste disposal and storage—releases greenhouse gases, radioactive particles and toxic materials that poison the air, water and land. Nuclear power plants routinely expel low-level radionuclides into the air in the course of daily operations. While exposure to high levels of radiation can kill within a matter of days or weeks, exposure to low levels on a prolonged basis can damage bones and tissue and result in genetic damage, crippling long-term injuries, disease and death.

See this excellent photographic depiction of the huge amounts of fossil fuel which goes into building and operating a nuclear power plant.

Nature reported in 2008:

You’re better off pursuing renewables like wind and solar if you want to get more bang for your buck.”


Evaluating the total carbon output of the nuclear industry involves calculating those emissions and dividing them by the electricity produced over the entire lifetime of the plant. Benjamin K. Sovacool, a research fellow at the National University of Singapore, recently analyzed more than one hundred lifecycle studies of nuclear plants around the world, his results published in August in Energy Policy. From the 19 most reliable assessments, Sovacool found that estimates of total lifecycle carbon emissions ranged from 1.4 grammes of carbon dioxide equivalent per kilowatt-hour (gCO2e/kWh) of electricity produced up to 288 gCO2e/kWh. Sovacool believes the mean of 66 gCO2e/kWh to be a reasonable approximation.

The large variation in emissions estimated from the collection of studies arises from the different methodologies used – those on the low end, says Sovacool, tended to leave parts of the lifecycle out of their analyses, while those on the high end often made unrealistic assumptions about the amount of energy used in some parts of the lifecycle. The largest source of carbon emissions, accounting for 38 per cent of the average total, is the “frontend” of the fuel cycle, which includes mining and milling uranium ore, and the relatively energy-intensive conversion and enrichment process, which boosts the level of uranium-235 in the fuel to useable levels. Construction (12 per cent), operation (17 per cent largely because of backup generators using fossil fuels during downtime), fuel processing and waste disposal (14 per cent) and decommissioning (18 per cent) make up the total mean emissions.

According to Sovacool’s analysis, nuclear power, at 66 gCO2e/kWh emissions is well below scrubbed coal-fired plants, which emit 960 gCO2e/kWh, and natural gas-fired plants, at 443 gCO2e/kWh. However, nuclear emits twice as much carbon as solar photovoltaic, at 32 gCO2e/kWh, and six times as much as onshore wind farms, at 10 gCO2e/kWh. “A number in the 60s puts it well below natural gas, oil, coal and even clean-coal technologies. On the other hand, things like energy efficiency, and some of the cheaper renewables are a factor of six better. So for every dollar you spend on nuclear, you could have saved five or six times as much carbon with efficiency, or wind farms,” Sovacool says. Add to that the high costs and long lead times for building a nuclear plant about $3 billion for a 1,000 megawatt plant, with planning, licensing and construction times of about 10 years and nuclear power is even less appealing.


Money spent on energy efficiency, however, is equivalent to increasing baseload power, since it reduces the overall power that needs to be generated, says Sovacool. And innovative energy-storage solutions, such as compressed air storage, could provide ways for renewables to provide baseload power.

Thomas Cochran, a nuclear physicist and senior scientist at the Natural Resources Defense Council (NRDC), an environmental group in Washington DC … argues that the expense and risk of building nuclear plants makes them uneconomic without large government subsidies, and that similar investment in wind and solar photovoltaic power would pay off sooner.


Another question has to do with the sustainability of the uranium supply itself. According to researchers in Australia at Monash University, Melbourne, and the University of New South Wales, Sydney, good-quality uranium ore is hard to come by. The deposits of rich ores with the highest uranium content are depleting leaving only lower-quality deposits to be exploited. As ore quality degrades, more energy is required to mine and mill it, and greenhouse gas emissions rise. “It is clear that there is a strong sensitivity of … greenhouse gas emissions to ore grade, and that ore grades are likely to continue to decline gradually in the medium- to long-term,” conclude the researchers.  [And see this.]

Beyond Nuclear notes:

The energy consulting firm Ecofys produced a report detailing how we can meet nearly 100% of global energy needs with renewable sources by 2050. Approximately half of the goal is met through increased energy efficiency to first reduce energy demands, and the other half is achieved by switching to renewable energy sources for electricity production. The Intergovernmental Panel on Climate Change agrees and predicts close to 80% of the world’s energy supply could be met by renewables by mid‐century.


Since nuclear power plants are reliant upon the electrical grid for 100% of their safety systems’ long‐term power, and are shut down during grid failure and perturbations, it is “guaranteed” only as long as the electrical grid is reliable. When the Tsunami and earthquake hit and power was lost in the Fukushima Prefecture, nuclear energy wasn’t so “guaranteed.” Instead, it became a liability, adding to what was now a triple threat to the region and worsening an already catastrophic situation.


[The claim that] Nuclear power is “low‐carbon electricity” … is the propaganda line commonly used by the nuclear industry which conveniently leaves out every phase of the nuclear fuel chain other than electricity generation. It ignores the significant carbon emissions caused by uranium mining, milling, processing and enrichment; the transport of fuel; the construction of nuclear plants; and the still inadequate permanent management of waste. It also ignores the release ‐ by nuclear power plants and reprocessing facilities ‐ of radioactive carbon dioxide, or carbon‐14, to the air, considered to be the most toxic of all radioactive isotopes over the long‐term.

In fact, studies show that extending the operating licenses of old nuclear power plants emits orders of magnitude more carbon and greenhouse gases per kilowatt hour from just the uranium fuel chain compared to building and operating new wind farms.


Nuclear might begin to address global carbon emissions if a reactor is built somewhere in the world every two weeks. But this is an economically unrealistic, in fact impossible, proposition, with the estimated construction tab beginning at $12 billion apiece and current new reactors under construction already falling years behind schedule.

According to a 2003 MIT study, “The Future of Nuclear Power,” such an unprecedented industrial ramping up would also mean opening a new Yucca Mountain‐size nuclear waste dump somewhere in the world “every three to four years,” a task still unaccomplished even once in the 70 years of the industry’s existence. Further, such a massive scale expansion of nuclear energy would fuel proliferation risks and multiply anxieties about nuclear weapons development, exemplified by the current concern over Iran. As Al Gore stated while Vice President: “For eight years in the White House, every weapons-proliferation problem we dealt with was connected to a civilian reactor program.”

Many experts also say that the “energy return on investment” from nuclear power is lower than many other forms of energy. In other words, non-nuclear energy sources produce more energy for a given input.

David Swanson summarizes one of the key findings of the International Forum on Globalization report:

The energy put into mining, processing, and shipping uranium, plant construction, operation, and decommissioning is roughly equal to the energy a nuclear plant can produce in its lifetime. In other words, nuclear energy does not add any net energy.

Not counted in that calculation is the energy needed to store nuclear waste for hundreds of thousands of years.

Also not counted is any mitigation of the relatively routine damage done to the environment, including human health, at each stage of the process.


Nuclear energy is not an alternative to energies that increase global warming, because nuclear increases global warming. When high-grade uranium runs out, nuclear will be worse for CO2 emissions than burning fossil fuels. And as global warming advances, nuclear becomes even less efficient as reactors must shut down to avoid overheating.

Also not counted in most discussions is the fact that nuclear reactors discharge tremendous amounts of heat directly into the environment.  After all – as any nuclear engineer will tell you – a nuclear reactor is really just a fancy way to boil water.

The Bulletin of the Atomic Scientists noted in 1971:

In terms of thermal efficiency, current nuclear reactors are even worse off than the coal plants.  Against the 50 per cent loss of heat in the newest coal plants, as much as 70 per cent of the heat is lost from nuclear plants.  This means that thermal pollution can be even more severe ….

1971 was a long time ago, but some nuclear plants are older.  For example, Oyster Creek was launched in 1969, and many other reactors were built in the early 1970s.   Most American nuclear reactors are old (and they are aging very poorly).

Indeed, the Nuclear Information and Resource Service claims:

It has been estimated that every nuclear reactor daily releases thermal energy –heat– that is in excess of the heat released by the detonation of a 15 kiloton nuclear bomb blast.

It doesn’t make too much sense to dump massive amounts of heat into the environment … in the name of fighting global warming.

The bottom line – as discussed above – is that scientists pushing nuclear to combat global warming are misinformed.  (True, nuclear industry lobbyists may be largely responsible for the claim that nuclear fights climate change. Indeed, Dick Cheney – whose Halliburton company builds nuclear power plants, and which sold nuclear secrets to Iran – falsely claimed that nuclear power is carbon-free in a 2004 appearance on C-Span. But there are also sincere environmental scientists who are pushing nuclear because they have only studied a small part of the picture, and don’t understand that there are better alternatives.)

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Take action against Areva for supplying substandard parts, false quality certificates

EAS Sarma, former secretary of the Government of India, has demanded that action be initiated to blacklist the parts supplier company, Areva, and its subsidiary, Creusot Forge, for doing business in India. Citing various events and reports, Mr Sarma, in a letter to the Secretary of the Department of Atomic Energy (DAE) alleges that the French company have falsified quality certificates and supplied substandard parts. The same company is also expected to supply equipment for the Jaitapur nuclear power plant in Maharashtra.
“While US Nuclear Regulatory Commission (NRC) has had no hesitation whatsoever to divulge these details to the public, India’s DAE seems to be secretive about this for reasons best known to it. There are serious public safety concerns, in addition to the fact that DAE has adopted a highly non-transparent non-competitive procedure for choosing the company and negotiating the price,” he writes to Dr Sekhar Basu, Secretary of the DAE.
He further adds, “Considering that Areva has had not too glorious a track record edging on false certification, I feel that DAE should revoke the agreement, if any, already entered into with Areva, notwithstanding the fact that the Prime Minister of India signed a protocol with his French counterpart. Apparently, the DAE had not apprised the PM of the implications of signing such a protocol.”
In support of his plea, Mr Sarma submitted reports of various nuclear mishaps that took place due to Areva’s substandard supply of parts, including the Nuclear Industry in France Crisis report of 9 November 2016, in which the French nuclear regulator, Autorite de Surete Nucleaire (ASN), had questioned the French nuclear manufacturing companies, namely, EDF and Areva, on the extent to which their plants have such substandard components and their adverse impact on the safety of those plants. Sensitive to the potential danger of operating such plants, France has closed down 20 nuclear plants already.
“These are serious matters on which DAE and Nuclear Power Corp of India Ltd (NPCIL) cannot afford to feign ignorance and pretend that the public here in India would never come to know about these developments. DAE, presided over by the Prime Minister (PM) himself, has the moral obligation to get at the root of this problem and inform the public about the magnitude of the problem and the corrective action taken. This assumes importance against the background of the PM signing an agreement with France earlier and an agreement now with Japan on bilateral cooperation in the area of nuclear power development,” the former Cabinet Secretary said.
In light of the disheartening response from the authorities, Mr Sarma says, “I feel surprised and distressed at the way DAE has chosen to remain totally unresponsive to my numerous cautionary letters on the subject and opted in favour of going ahead with the proposal to negotiate with Areva. This, in my view, is highly objectionable and it raises concerns of propriety, both technical and financial. An independent investigation, I am sure, will highlight the fears I have been expressing. What really distresses me most is that the Indian regulator, AERB too has chosen to remain passive, without opening its eyes and ears to the public disclosures made by both the French and the US regulators. Despite my cautioning the DAE, if any further negotiations are conducted with Areva, the government will be taking a serious risk,” he adds.
Further, ridiculing the DAEs ignorance towards the sudden involvement of China, Mr Sarma says “DAE has not cared even to acknowledge the receipt of my letter. Either DAE is ignorant of this development or it is deliberately keeping the public in the dark about the Chinese entering the picture. Is not DAE concerned about placing the fuel lifeline of the Kovvada project in the hands of China?”
Despite various efforts from Mr Sarma, his plea seems to be falling on deaf ears. There seems to be no effective action that has taken place on the part of the authorities, showing astonishing disregard for the safety of the citizens. This caused Mr Sarma to take the next step and go on to mark a copy of his letter to the Prime Minister’s Office (PMO) requesting that this matter be placed before the PM himself for taking an objective view consistent with the public interest.

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FDA warns hospitals against reusing medical disposables

The Food and Drugs Admi nistration has decided to initiate stringent checks on the use of disposables in hospitals in Maharashtra.The decision follows several complaints from patients and their relatives that disposables such as catheters, guide wires and balloons used in angioplasty were reused in many private hospitals. “We have received several complaints regarding hospitals reusing disposables and billing patients.This is completely unacceptable. We will soon initiate an inspection of state’s private hospitals to check their inventory of disposables and assess if they are reusing the same and billing patients for it. We will not spare anybody if a hospital is found at fault,“ state FDA commissioner Harshadeep Kamble told TOI.

The Union health ministry had on December 21, 2016 issued an office memorandum warning against reuse of disposable surgical items, particularly in cardiology , when they are meant for one-time use. “The disposable items after one procedure are sterilised and reused and (patients) are charged full amount for these items,“ stated the memo.

It said, “Reuse of disposable items, particularly in cardiology and other specialities, is not permitted in healthcare organisations empanelled under CGHS (Central Government Health Scheme).“ It goes on to warn of `suitable action including withdrawal of CGHS empanelment’ against defaulters.The memo, however, did not talk about action against big corporate hospitals that are not empanelled under CGHS.

Activist Sanjeev Dabhade said, “It is good to keep an eye.Alittle strengthening of surveillance makes things fall in place. Nobody can firmly say that there is not a single hospital in Pune that does not reuse disposables.“ All disposable items have instructions on the packaging saying they should be used only once.

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‘Forest cities’: the radical plan to save China from air pollution

Stefano Boeri, the architect famous for his plant-covered skyscrapers, has designs to create entire new green settlements in a nation plagued by dirty air

Artist’s impression of the Liuzhou Forest City which is earmarked for a radical transformation from polluted metropolis to environmental haven.
An artist’s impression of Liuzhou’s plans for a ‘Forest City’

When Stefano Boeri imagines the future of urban China he sees green, and lots of it. Office blocks, homes and hotels decked from top to toe in a verdant blaze of shrubbery and plant life; a breath of fresh air for metropolises that are choking on a toxic diet of fumes and dust.

Last week, the Italian architect, famed for his tree-clad Bosco Verticale (Vertical Forest) skyscraper complex in Milan, unveiled plans for a similar project in the eastern Chinese city of Nanjing.

The Chinese equivalent – Boeri’s first in Asia – will be composed of two neighbouring towers coated with 23 species of tree and more than 2,500 cascading shrubs. The structures will reportedly house offices, a 247-room luxury hotel, a museum and even a green architecture school, and are currently under construction, set for completion next year.

But Boeri now has even bolder plans for China: to create entire “forest cities” in a country that has become synonymous with environmental degradation and smog.

“We have been asked to design an entire city where you don’t only have one tall building but you have 100 or 200 buildings of different sizes, all with trees and plants on the facades,” Boeri told the Guardian. “We are working very seriously on designing all the different buildings. I think they will start to build at the end of this year. By 2020 we could imagine having the first forest city in China.”

Boeri described his “vertical forest” concept as the architectural equivalent of a skin graft, a targeted intervention designed to bring new life to a small corner of China’s polluted urban sprawl. His Milan-based practice claimed the buildings would suck 25 tons of carbon dioxide from Nanjing’s air each year and produce about 60 kg of oxygen every day.

“It is positive because the presence of such a large number of plants, trees and shrubs is contributing to the cleaning of the air, contributing to absorbing CO2 and producing oxygen,’ the architect said. “And what is so important is that this large presence of plants is an amazing contribution in terms of absorbing the dust produced by urban traffic.”

Boeri said, though, that it would take more than a pair of tree-covered skyscrapers to solve China’s notorious pollution crisis.

Nanjing Green Towers, promoted by Nanjing Yang Zi State-owned National Investment Group, will be the first Vertical Forest built in Asia.
Nanjing Green Towers, promoted by Nanjing Yang Zi State-owned National Investment Group, will be the first Vertical Forest built in Asia. Photograph: Stefano Boeri Architetti

“Two towers in a huge urban environment [such as Nanjing] is so, so small a contribution – but it is an example. We hope that this model of green architecture can be repeated and copied and replicated.”

If the Nanjing project is a skin graft, Boeri’s blueprints for “forest cities” are more like an organ transplant. The Milan-born architect said his idea was to create a series of sustainable mini-cities that could provide a green roadmap for the future of urban China.

The first such settlement will be located in Luizhou, a mid-sized Chinese city of about 1.5 million residents in the mountainous southern province of Guangxi. More improbably, a second project is being conceived around Shijiazhuang, an industrial hub in northern China that is consistently among the country’s 10 most polluted cities.

Artist’s impression of the Liuzhou Forest City.
Artist’s impression of the Liuzhou Forest City. Photograph: Stefano Boeri Architetti

Compared with the vertical forests, these blueprints represent “something more serious in terms of a contribution to changing the environmental urban conditions in China,” Boeri said.

Boeri, 60, first came to China in 1979. Five years ago he opened an office in Shanghai, where he leads a research program at the city’s Tongji University.

The architect said believed Chinese officials were finally understanding that they needed to embrace a new, more sustainable model of urban planning that involved not “huge megalopolises” but settlements of 100,000 people or fewer that were entirely constructed of “green architecture”.

“What they have done until now is simply to continue to add new peripheral environments to their cities,” he said. “They have created these nightmares – immense metropolitan environments. They have to imagine a new model of city that is not about extending and expanding but a system of small, green cities.”

Boeri described the idea behind his shrub-shrouded structures as simple, not spectacular: “What is spectacular is the nature, the idea of having a building that changes colour with each season. The plants and trees are growing and they are completely changing.”

“We think – and we hope – that this idea of vertical forests can be replicated everywhere. I absolutely have no problem if there are people who are copying or replicating. I hope that what we have done can be useful for other kinds of experiments.”

Guardian Cities

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PIL filed in Chhattisgarh HC challenging a 38 year-old order restricting permanent family planning among Particularly Vulnerable Tribal Groups (PVTGs)

   Ten members from the Baiga community  have filed a PIL in Chhattisgarh High Court, challenging a 38 year-old order restricting permanent family planning among Particularly Vulnerable Tribal Groups (PVTGs).

Harendra Singh Sijwali, a social worker from Ganiyari and Jan Swasthya Abhiyan (People’s Health Movement) Chhattisgarh are co-petitioners in this PIL.

The order, issued by the Public Health & Family Welfare Department of Madhya Pradesh on 13.12.1979, stated that PVTGs could undergo permanent sterilization only after permission from the block office.

This order was operationalised as a veritable ban on sterilization of PVTGs in Chhattisgarh and those desiring sterilization are forced to travel to Madhya Pradesh or other neighbouring states to get the service. The petitioners, that include eight women and two men from the Baiga community, from Mungeli and Bilaspur districts have been trying to get permission from the government for permanent sterilization, but it was denied.

The 1979 order is being challenged on the grounds that the order is arbitrary and violates the right to life and liberty, which includes the right to health and reproductive rights. It further discriminates against tribal people and hence violates Article 14 of the Constitution of India.


The State of Chhattisgarh through its Chief Secretary, Health Secretaries of Chhattisgarh and Government of India and the Tribal Commissioner of Chhattisgarh have been made respondents in the Writ Petition.

The petition argues that the order has caused tremendous hardship to the tribal people in the state particularly women. In the absence of family planning options tribal couples have been forced to have large families. The High Level Committee on Socio-Economic, Health and Educational Status of Tribal Communities of India constituted by the Government of India noted in its report in 2014 that “such a policy denies members of PVTGs the autonomy to make free and informed reproductive choices, and particularly denies any agency and bodily autonomy to women of these communities, who have to bear the burden of the denial of access to sterilisation facilities. Moreover, it sidesteps the real factors contributing to high mortality rates such as chronic malnutrition, starvation and lack of access to adequate health facilities”.

The PVTG communities in Chhattisgarh are Baiga, Kamar, Birhor, Pahari Korwa and Abujhmaria.

One of the petitioners is presently pregnant with her fifth child, though she had wanted to undergo sterilization after her fourth child, and had asked for permission, but was denied. Another petitioner’s wife had conceived as she had been denied family planning services and subsequently ended her three months pregnancy through self-medication. She is presently facing health complications. A number of media reports and studies have been quoted in the petition that illustrate the hardships being faced by these tribal groups due to denial of family planning services.

Relief requested from the High Court includes directing the respondents to withdraw the government order dated 13.12.1979, provide complete family planning services, including sterilization services, guaranteed under the National Health Mission, to all tribes and in all the areas without any restrictions, as per the guidelines laid down by the Hon’ble Supreme Court in Ramakant Rai (1) & Anr. v. Union of India & Ors. (2009) 16 SCC 565 and the Standard Operating Procedures for Sterilization issued by Ministry of Health & Family Welfare, and to ensure that petitioners from the Baiga community are immediately allowed to access sterilization services at a health facility of their choice authorized to conduct sterilization procedures.

The preliminary hearing was held on 21st February at Bilaspur High Court in the Bench of Justice Pritinker Diwaker and Justice Sanjay K. Agrawal. The petitioners were asked to produce documents to show that the order is not in force in Madhya Pradesh, as sterilization services are being provided to PVTGS there.

Notice has not been sent to the respondents as yet and the next hearing has been listed for 3rd March.

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Snoring a Disease, warrants reimbursement: Consumer Court


Consumer court makes insurance firm pay for treatment to cure snoring

 Related image
Representative image

Kansara, 45, approached a local doctor, Amit Patel, with his snoring problem. Unable to get enough sleep, he was worried about the adverse effect on his health. A sleep study test (polysomnography) was conducted in December 2014 to gauge the sleeping disturbance. The doctor told him that there is no cure to the problem except a C-PAP machine. Kansara bought the device.

To Kansara’s claim for reimbursement for the device cost and doctor’s fee, the insurance company first objected on technical grounds and continued to maintain that snoring is not a disease and money spent on the machine could not be reimbursed. It maintained that snoring is not a disease and its treatment is not covered under the policy.

Kansara’s lawyer argued that snoring is definitely not a disease, but it is a symptom of various health issues like blood pressure, insufficient sleep, breathlessness etc., and their treatment is covered under the policy.

After the hearing, the consumer court said the insurance company could not prove on record that snoring can’t be considered a disease. Moreover, it used an order passed by a Chhattisgarh consumer court as reference, which ordered an insurance company to pay for a client’s C-PAP device.

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UP’s Health Variations: From Worse Than Haiti To Better Than India

Oommen C Kurian,


At a time when India’s sex ratio at birth is low and declining–from 909 (2011) to 887 (2014)–there are, in poor, populous Uttar Pradesh (UP), districts such as Aligarh, Moradabad, Mainpuri, Deoria and Balrampur, with sex ratios at birth exceeding 1000–in other words, better than any state in India.


So, too, with the infant mortality rate (IMR) and maternal mortality ratio (MMR). Kanpur Nagar district in western UP had an IMR of 37 in 2012-13, which was better than the Indian average (42). UP’s maternal mortality ratio (MMR) is 258, but Meerut mandal in western UP (including urban NOIDA and Ghaziabad) had an MMR of 151, better than the Indian average, although Devi Patan mandal, 600 km to the south-east had an MMR of 366, worse than Ethiopia and Haiti.


While UP may appear to be a monolith of Hindi-speaking, overwhelmingly poor people with some of India’s worst health parameters, as the second part of this series told us, a district-level analysis by Observer Research Foundation, using data from the Annual Health Survey (AHS 2012-13)–the latest available–reveals that India’s most-populous state has almost continental style variations in its healthcare system and indicators. The latest data from the National Family Health Survey (NFHS-2015-16) for UP will be released only after the elections, scheduled for February 11 onwards.


The Annual Health Survey (AHS) of 2012-13 covered 21 million people across nine large, low-performing Indian states and close to five million people in Uttar Pradesh alone. The AHS remains the world’s largest household sample survey, with its sample size greater than the population of Sri Lanka.


AHS gives major health indicators at the district level. The wealth of data collected by AHS remains an underutilised resource. The assembly elections may prove to be a good occasion to use it to promote policies that enhance well being in the state. As the Economic Survey 2015-16 observed, investing in health and nutrition are two sure-shot ways of enhancing the productive potential of a state.


Sex ratio at birth: Some districts have more women than men


Within UP, in 70 of 75 districts polled for AHS 2012-13, there are districts with a sex ratio of more than 1000, such as Aligarh, Moradabad, Mainpuri, Deoria and Balrampur, and districts with a sex ratio at birth of under 850, such as Varanasi, Firozabad, Agra, Bijnor and Budaun.


Sex Ratio Across Uttar Pradesh Districts (2012-13)

Source: Annual Health Survey 2012-13. Click on individual districts for data.


Immunisation coverage leaves children at risk of preventable disease and death


Immunisation remains low in UP, leaving many children at risk of preventable morbidity or death. In 2012-13, UP had fully immunised no more than 52.7% of its children, with 7.6% with no immunisation. The all-India average is 65.3% for full immunisation and 6.6% for no immunisation, for the year 2013-14.


Children In Uttar Pradesh Who Did Not Receive Any Vaccination

Source: Annual Health Survey 2012-13. Click on individual districts for data.


Some districts with low proportions of fully immunised children, such as Shrawasti (24.9%), Bahraich (27.5%), Balrampur (36.4%), Budaun (30.7%), Kheri (37.8%), Sitapur (35.4%) and Sonbhadra (32.4%), are potential epidemiological time bombs.


Children Who Received Polio Dose At Birth, By District

Source: Annual Health Survey 2012-13. Click on individual districts for data.


In Shrawasti, Balrampur and Sonbhadra districts, more than half the children do not receive a polio dose at birth. While India celebrates six years of being polio-free, outbreaks are still a risk.


District level infant mortality rates in UP is a picture of regional inequities


The IMR–or the probability of children below one year of age dying, expressed as deaths per 1,000 live births–provides indications about poverty and other socio-economic characteristics of a community, according to this 2012-13 AHS report.


With an IMR of 68 deaths per 1,000 live births in 2012-13, Uttar Pradesh continued to be the last among the states polled for the AHS.


Infant Mortality Rate In Uttar Pradesh, By District

Source: Annual Health Survey 2012-13. Click on individual districts for data.


A district-level analysis throws up wide disparities:  the IMR in the north-eastern Shrawasti district is 96, almost three times the IMR of Kanpur Nagar (37) in western UP.


UP also has the highest neonatal mortality rate (NMR) among the AHS states: 49 neonatal deaths per 1,000 live births, whereas Jharkhand had the lowest at 23 per 1,000 live births. Within UP’s high NMR, again, are wide variations, indicating the precarious state of healthcare in large swathes of the state: Kanpur Nagar district has the lowest NMR of 24 per 1,000 live births, whereas Siddarthanagar to the east has the highest NMR of 70 per 1,000 live births.


As our maps show, a new government will need to address the inter-district disparities revealed in our analysis, particularly regions with high proportions of preventable infant deaths.


UP’s children more stunted than nine low-performing states


UP’s performance in terms of stunting (low height-for-age), wasting (low weight-for-height), underweight (low weight for- age) and undernourished (low Body Mass Index, or BMI) in children under five is among India’s worst.


Stunting among children under five years is highest in UP (62%), as is severe stunting (35.6%), according to the 2014 Clinical, Anthropometric and Biochemical (CAB) survey. None of 70 UP districts surveyed for the AHS figured among 10 best-performing amongst 284 districts across nine states.


However, of the 10 worst-performing districts with stunted children, five were from UP. The worst stunting among 284 AHS districts were found in Rae Bareli in southern UP and the worst underweight outcomes in the western district of Hamirpur.


Surveyors found 77.4% of children in Rae Bareli stunted, and 70.2% children in Hamirpur underweight. Rae Bareli is not an extreme case: 55 of 70 UP districts have a stunting rate of more than 55%, and 50% of children are underweight in 23 districts.


In a sea of undernutrition, overnutrition in some districts


There is a high proportion of overnutrition of children under five in some districts–mostly in western UP–such as Pilibhit (24.6%), Bulandshahr (21.8%), Budaun (21.7%), Auraiya (21.4%) and Aligarh (21.1%). In other words, UP has a dual burden of undernutrition and overnutrition, which will affect its morbidity rates and impact its economic growth.


A comprehensive policy overhaul may be necessary for UP to improve its performance in health and nutrition. The coming state elections provide political parties an opportunity to share with voters their vision for the future of UP’s human development.


There are efforts to improve the situation. UP is one of the six Indian states with a nutrition mission.  It was created in 2013, with the objective of working closely with nodal departments, such as health and women and child development which runs the Integrated Child Development Services (ICDS), the world’s largest child-nutrition scheme, and other contributing departments to reduce undernutrition among children below three years. Its impact on the nutritional status of UP’s children remains unevaluated.

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