Monday, 29 October 2018



I am here to narrate a tale, a tale of victory overshadowed by an assassination.
The Maharashtra Andhashraddha Nirmoolan Samiti, committee for eradication of superstitions, fought for 18 years a battle to bring in an act against superstitions. The committee is better known as ‘ANIS’, acronym of its colloquial name.

But before I begin let me put into perspective where we are from. We are from Maharashtra, a state in India with Mumbai as its capital.
It was in 1989 that Dr. Narendra Dabholkar, gave up medical practice and formed the Maharashtra Andhashraddha Nirmoolan Samiti, committee for eradication of superstitions. The committee is well known as ANIS, its acronym in vernacular. The aim was obvious in the name. From thereon began a war with many battles won and a few lost.
ANIS has been fighting and exposing god men and charlatans, challenging their miracles. The prize money of 30,000$ to whoever proves a supernatural claim remains intact for past 29 years.
We have fought astrologers, soothsayers and people selling ‘lucky’ gems, ‘Feng Shui’, ‘Vastushastra’ etc: It’s a long list and the challenges are unending.
We have picked up and pecked at irrationalities in festivities. India is a land of festivals. We just through the ten day long festival dedicated to the elephant headed god Ganesh. At the culmination of the festival, Ganesha idols are immersed in water. ANIS has been successfully molding public opinion urging people to use mud idols rather than plaster of Paris ones. The mud idols dissolve in the water bodies. While the plaster of Paris ones are an environmental hazard often clogging springs at the bottom of the water bodies. ANIS has also worked hard to make Diwali celebrations free of noise pollution.
ANIS has been at work trying to inculcate scientific temper in school kids through a competitive examination. These questions are not directly based on the texts but rather test the student’s ability to apply these ideas.
We work for casteless matrimony. In India cast forms the very basis of finding a suitable match. ANIS believes that caste is the biggest of superstitions! 
We have a monthly publication, the ‘ANIS Vartapatra’. I must tell you that my translation of Richard Dawkins’, ‘Magic of Reality’ has commanded the largest readership in recent years.

As we challenged superstitions and miracles and god men and god women; as we tried to bring them to book; we garnered large experience and became well conversant with the lacuna in the system. Fighting exploitation, sexploitation, inhuman rites and rituals, fighting powerful self professed men of religion with brainwashed followers aplenty, is no easy go. The keepers of the law and public order themselves were genuflecting in front of these miracle men. They often had a soft comer for these so called ‘sadhus’ and helped them with loopholes in the law; sought to weaken the evidence or tampered with it to suit the culprits.
 Democracy also means that public figures will usually toe the popular line. For the fear of alienating potential voters ANIS rarely received strong political backing. More often than not, community leaders are hand in glove with these charlatans. We also realized that the judiciary too had a limited insight into the problem and often went by the letter, rather than the spirit of the law. Few understood that superstitions formed the very core of many crimes.
Under such circumstances we demanded an anti superstition act. Many hardly saw any role for legal succor. Most believed that literacy, education and affluence will usher in the awakening necessary and the evil, inhuman, ghastly practices will vanish… miraculously.
However in our experience the existing laws were woefully inadequate to deal with certain peculiar situations. We did try. In certain situations we invoked the Drugs & Magic Remedies Act, but we found that it was limited to objectionable advertisements. The punishment is almost notional and conviction was really very difficult.
The Indian Penal Code also provides for punishment against ‘cheating’. But ‘cheating’ was mostly understood to be financial losses in a ponzee scheme and investigating agencies, courts and the executive rarely If ever interpreted it more broadly than this and simply refused to apply it to religious practices.
Often when persons claimed miracle cure we lodged a complaint under the Medical Practitioners Act. But the act deals mainly with the misdemeanor of the ‘registered’, ‘qualified’ Medical practitioners. While the act reined in qualified persons from making outlandish claims it had no powers to stop others from claiming anything, right from cure for AIDS or Cancers. I must mention that Maharashtra now has an act against bogus doctors.

It was on 8th August 1989; almost thirty years ago that The Committee for Eradication of Superstitions was formed. Soon thereafter ANIS put forward the demand for an act. There thus began a long, treacherous, arduous, painfully slow journey to get this act passed through the legislature. The demand for this Act was signed by noted litterateur P. L. Deshpande, as the first signatory.
In 1991 the first draft was presented to the government.
Nothing happened even after eight long years of demand and protests. In 1999, government promised enactment within two years. Nothing materialized. A day long sit in protest at Mumbai was held. A fresh assurance was all that the government had to offer.  
In 2003 things appeared to be moving. The then Chief Minister Mr. Sushilkumar Shinde suggested that the name of the act be changed to ‘Eradication of Evil Practices and Black Magic Act’; rather than ‘Anti-Superstition Act’. This was to stem long, fruitless, philosophical debates about what is ‘belief’ and what is ‘superstition’.
The cabinet approved that on 4th of August 2003. On 15th of August, the Indian Independence Day, the same year, government flashed advertisements claiming to be the first state in India to pass a progressive act such as this. However the necessary next step of tabling the act in the legislature and getting it passed by majority never happened. The act was never tabled in the house.
The next year (30th November 2004) the Chief Minister assured enactment in the upcoming winter session of the assembly. The state news channels carried this news prominently.
Two years later on 13th of April in 2005 when the concerned Minister tried to table the resolution, rowdy members of the opposition as well as the ruling party, forced an adjournment and forced the government to postpone the enactment.
In July the government readied a watered down version of the Act after prolong committee meetings with right wing reps and leaders.
In December the same year the Legislative Assembly passed the act but it was never taken up and never tabled in the Legislative Council which is The Upper House
Agitation continued many luminaries from various fields in the state wrote to the Chief Minister and his Deputy both replied and assured action.
In 2007 the upper house demanded a whetting by a joint legislative review committee. This was nothing but procrastination.  
The act was all the time on the agenda of the house but only just, it was never officially tabled. Certain religious groups kept protesting and over 20 changes were made to pacify them.  Come April 2013, the cabinet approved the act for the sixth time. In July the same year the committee published a ‘black paper’ as opposed to a white paper exposing the tactics and doublespeak of the rulers.
ANIS and its volunteers boldly faced a backlash throughout the agitation. ANIS was deliberately misquoted, a misinformation campaign was unleashed, propaganda drummed up, mass hysteria was whipped up with overt and covert support of the ruling as well as opposition representatives. ANIS was accused of being an agent of the West, funded by western powers. We run exclusively on voluntary donations and our accounts are transparent.  Spurious complaints in hundreds generated a litany of court cases wrecking the organization’s finances. Threats, attacks, disruptions of rationalist meetings continued to foul the atmosphere. But we pressed on, through democratic, nonviolent, constitutional, yet novel means of protests.
Volunteers slapped themselves to highlight the insensitivity of the government. Letters signed in our own blood were sent and volunteers fasted for days together. There were sit-in protests, marches, signature campaigns and street plays.
Things came to such a head that on 20th August 2013, the Founder president of the organization Dr. Narendra Dabholkar was assassinated while on a morning stroll. Two young assailants came riding a bike and shot three bullets at close range killing him instantly. They are yet to be traced…!
The assassination shocked everyone, proponents and opponents alike. It led to something unprecedented. All of a sudden, there was a groundswell of support for the ideas and ideals of Dr. Narendra Dabholkar.  Less than a week from this fateful incidence the government issued an ordinance declaring its firm intent to bring in the law.
On 19th of December 2013 the Legislative Council finally passed the resolution by voice vote and the ordinance became a law. An 18 years long struggle finally came to fruition but with the loss of the person who toiled most.

 This act has a schedule listing twelve specific deeds, the practice, propagation or promotion of which is a cognizable and non bailable offence. It provides for an appointment of Vigilance Officer at police Stations to look into contraventions of the act. These officers are expected to be proactive. The act provides for imprisonment for up to 7 years for the first offence.
It also lists practices clearly out of the ambit  of the act, deeds that are not deemed to be black magic, inhuman or ‘Aghori’ practices, to prevent any misinterpretation of the law that might restrict religious freedom.  This list was whetted by former justice of the Supreme Court Mr. P. B. Sawant.
ANIS had provided a longer list and what we have is just 12 items as against more than fifty that were proposed.  This was to ensure that religious rites and practices that cause no mental physical and financial harm to the individuals do not come under the purview of this act.
Let’s go through the list of offences.
1.     According to the act to whiplash, to suffocate with fumes, to otherwise cause pain or harm, to force exhibitionist sexual act, to make one consume excreta; so as to exorcise the person; is a crime.
2.     It denounces display of so called miracles to earn money, deceive or defraud or terrorize people as a crime.
3.     Following any inhuman or ‘Aghori’ practice to receive blessings of a ‘supernatural power’ is a crime.
4.     Performing acts, including human sacrifice, to divine water, to seek hidden treasure, etc: is a violation of the act.
5.     Claims of, having been possessed by a power inapprehensible by the senses, thereby threatening evil consequences if the wishes of such a person are declined, is a crime.
6.     Canvassing powers of witchcraft, black magic; claiming to diminish milk yield in cattle by such powers; declaring someone a witch or ‘Satan’ incarnate, claiming that the person brings misfortune, illness or such other troubles is an offence.
7.     Ostracizing, boycotting, parading a person naked in public is a crime.
8.     Invoking ghosts, souls through chants of Mantra; claiming wrath of powers inapprehensible by the senses; preventing a person from seeking medical treatment under such guise  causing physical or financial harm; is a crime.
9.     Preventing a person with a dog/ snake or Scorpion bite, from seeking medical aid, by offering cure through chants, amulets etc  is a crime.
10. Claiming to perform surgery with bare hands, claiming to change the sex of the fetus in utero is a crime as well.
11. Claiming to be a couple or paramour in an earlier incarnation or offering to treat infertility and thereby sexually exploiting a person, is a crime.
12. To claim Supernatural powers on behalf of a mentally challenged person and thus exploiting others is a crime.
Some crucial changes were agreed upon and the current version of the act allows only the affected person or family to complain.

It's been 5 years that we have the act. In the last 5 years more than five hundred complaints have been registered. Ten cases have completed the due process of law and all the accused have been pronounced guilty, which is 100% conviction rate.
Cases have been filed across all religions and castes. The act is thus not anti Hindu, it is just anti-exploitation.
More than half the victims are women. Indicating how women remain at the lowest rung of the social ladder and are easy prey. The act helps women's emancipation.

ANIS and likeminded organizations have demanded similar law in ten other states and a central act as well.
It is already in place in neighboring Karnataka.  
ANIS next plans to challenge pseudoscience, especially pseudo medicine.
 The charlatans have changed their stance as well. Hardly does anybody claim miracles in Maharashtra. But claims of afterlife and the pleasures in heaven, of Moksh and Mukti remain to be tackled.
Irrational medicine is now disguised as ‘Ayurveda’ the ancient Indian practice of medicine.
Less than a year from today, in August 2019, the committee, ANIS, turns 30! We are planning a grand celebration and an international conference and I extend my invitation to all of you. The conference is scheduled in Mumbai, on Friday, Saturday and Sunday; 9th 10th and 11th of August 2019. The session on Friday will be for the international faculty. So welcome one and all. Thank you so much.

Tuesday, 2 October 2018

तपासा, तपासा आणि तपासाच!

तपासा तपासा आणि तपासाच
डॉ. शंतनू अभ्यंकर, वाई.

आपलं मूल नाकीडोळी नीटस असावं, बुद्धीने चलाख असावं, वागण्यात चुणचुणीत असावं असं कोणत्या आई बापांना वाटत नाही? पण हे होण्यासाठी सहजी शक्य आणि  तुलनेने स्वस्त अशा कित्येक तपासण्या आजही वापराविना पडून आहेत. याला पालक जितके जबाबदार आहेत तितकेच डॉक्टरही जबाबदार आहेत. याबाबत जनजागृती आणि ‘जनक’जागृती करण्याची जबाबदारी डॉक्टरांवर आहे आणि कोणतेही किल्मिष मनात न ठेवता स्वतःला जागृत करून घ्यायची जबाबदारी पालकांची, कुटुंबियांची आहे.

लोकसंख्येच्या  प्रश्नाला  आपण बऱ्यापैकी  वेसण घातली आहे. आता प्रश्न लोकांच्या संख्येचा नसून त्यांच्या गुणवत्तेचा आहे. जी काय एक-दोन लेकरे  निपजतील ती अधिकाधिक निर्दोष, निर्मळ, आणि सकस कशी निपजतील हे पहाणे महत्वाचे झाले आहे. मुले ही भविष्यातील गुंतवणूक तेंव्हा ही गुंतवणूक अत्यंत किफायतशीर व्हावी असा विचार असणं योग्यच आहे.

मुलांची संख्या समाजानी अत्यंत मर्यादित केली आहे. ‘हम दो हमारे दो’ हा सरकारी सल्ला कित्येकांनी अगदी मनाला लावून घेतलाय. कित्येक तर एकावरच थांबणारे आहेत. जे पदरात पडले त्याचेच उत्तम लालन, पालन, पोषण, शिक्षण, करून त्याच्या पंखांना बळ देऊ असा अगदी व्यावहारिक विचार त्यामागे असतो. भारत मातेच्या भल्यासाठी कोणी मूल टाळत  नाही. एखादच जरी झालं तरी ते आपल्याला आधार लागेल तोपर्यंत जगेल, अशी जबर शक्यता असते म्हणून लोकं कुटुंब मर्यादित राखतात. सुधारलेल्या आरोग्यव्यवस्थेमुळे सुधारलेले आयुर्मान आणि सुधारलेल्या अर्थव्यवस्थेमुळे सुधारलेले जीवनमान कुटुंब नियोजनाच्या यशामागची मुख्य कारणे आहेत.

मुळात मुलं कमी त्यामुळे झालेल्या बाळाचं कौतुक काय वर्णावं? कुणी तळहाताचा पाळणा केलेला तर कुणी सोन्याचा, मग त्याला रेशमाची दोरी, मखमली गादी, जरीची गिरदी, वेलबुट्टी कुंची, सोन्याची साखळी, रुप्याचा वाळा, तीट लावले तान्ह्या बाळा! पण ह्या सगळ्या वर्णनात केंद्रस्थानी जे सुदृढ, गुटगुटीत बाळ ते मात्र सगळ्यांनाच लाभते असं नाही.
पण आजही भारतात दरवर्षी आठ लाख सव्यंग मुले जन्मतात त्यात  ‘जीसिक्सपीडी’नी ग्रस्त अशी साडेतीन लाख बाळे, चयापचयाच्या व्याधींनी ग्रस्त (Inborn Errors of Metabolism) अशी पंचवीस हजार बाळे, ‘डाउन्स सिंड्रोम’वाली वीस हजार मंदबुद्धी बाळे, जन्मत: थायरॉईडची कमतरता असल्याने मतीमंद झालेली पंधरा हजार, ‘थॅलेसेमिया’वाली चौदा हजार आणि ‘सिकल सेल’वाली पाच हजार बाळे जन्माला येतात.
पण हे असंच व्हायला पाहिजे असं अजीबात नाही. ह्यातले काही आजार पूर्णतः  टाळता येतात, काही अंशतः, तर काहींचे दुष्परिणाम टाळता येतात. पण कधी? जर तपासण्या करून तसे वेळेत निदान केले तर. पण आपल्याकडे एकुणात तपासण्या न करण्याकडे कल. जाऊ दे नशिबात असेल ते होईल, ही वृत्ती. गरिबीला, अज्ञानाला, अशिक्षितांना लघुदृष्टीचा शाप असतोच. आला दिवस ढकलायचा असे त्यांचे धोरण बनत जातं. आपोआपच. दीर्घकालीन फायद्या-तोट्याचा विचार त्यांना शिवतच नाही आणि शिवला तर परवडतही नाही. पण आश्चर्य म्हणजे शिकले सवरलेले, खात्यापित्या घरचे लोकही असं वागतात. सांगून सुचवूनही जाम तपासण्या करत नाहीत.
आज इथे यातल्या काही महत्वाच्या आजारांबद्दल बोलणार आहोत. (थॅलेसेमिया आणि सिकल सेल अॅनिमिया या दोन आजारांच्या तपासण्याबाबत मी याच सदरात, ‘चुकवू नये असे काही’ असा लेख लिहीला होता.)
तपासता तर काय बरेच काही येतं. म्हणून तपासता येईल तो हरएक आजार तपासायचा हे धोरण योग्य नाही. यात वारेमाप खर्च होईल आणि हाताशी क्वचितच काही लागेल. त्यामुळे काय तपासायचं हे नीट ठरवावं लागतं. त्यासाठी काही निकष आहेत, हेच ते प्रसिद्ध विंडसर–युग्नर निकष.

·       त्या त्या ठिकाणी तो तो आजार बऱ्यापैकी प्रमाणात आढळायला हवा.
·       निदान झाले तर त्यावर उपचार उपलब्ध आहेत असेच आजार तपासणीसाठी निवडायला हवेत. नुसतंच निदान करून उपयोग काय?
·       जन्मतः उपचार करून विलक्षण फायदा होत असेल तर असे निदान करण्यात अर्थ आहे.
·       शिवाय निदान, उपचार आणि या साऱ्याचा खर्च याचं गुणोत्तर फायदेशीर हवं.

या निकषात बसणाऱ्या आणि म्हणून सर्वांनी आपल्या तान्हुल्यासाठी आवर्जून कराव्यात अशा किमान तीन तपासण्या आहेत.

·       थायरॉईड स्त्रावाची तपासणी (TSH),
·       ‘जीसिक्सपीडी’साठीची तपासणी आणि
·       ‘कन्जेनयटल अॅड्रीनल हायपरप्लासिया’साठीची
तपासणी ह्या सर्वांनी करून घ्याव्यात अशा आहेत, नव्हे तसा मुळी भारतीय बालरोगतज्ञ संघटनेचा (National Neonatology Forum) सांगावाच आहे. हे आजार बऱ्याच प्रमाणात आढळतात. जन्मतः मुळीच लक्षात येत नाहीत. यावर झटपट तपासणीही उपलब्ध आहे आणि उपचारही. तपासणी स्वस्त आहे. तीन्हींना मिळून सुमारे १०००/- रुपये फक्त.  शिवाय आहेत ते उपचारही स्वस्त आहेत, कुणालाही परवडण्यासारखे आहेत. मुख्य म्हणजे वेळेत निदान झालं नाही तर कधीही भरून येणार नाही असं नुकसान होतं. हे मी अलंकारिक भाषेत म्हणून लिहित नाहीये. हे शब्दशः  खरं आहे.

जन्मतः जर थायरॉईडचा स्त्राव कमी असेल तर त्या बाळाची वाढ खुंटते. ते कायमचं मतीमंद होतं (Cretinism). पण जन्मतः जर निदान झालं आणि उपचार सुरु केले, तर ते छान टवटवीत होतं. अगदी नॉर्मल होतं.

जन्मतः जर ‘कन्जेनायटल अॅड्रीनल हायपरप्लासिया’चे (CAH) निदान नाही केले तर आफतच. यातील काहीं बाळांना लवकरच शरीरातील क्षारसंतुलन बिघडल्यामुळे  जीवघेणे आजार उद्भवतात. काहींत मोठेपणी उंचीच वाढत नाही, काही मुलींत पाळी अनियमित येऊ लागते. काहीवेळा हा आजार गर्भावस्थेपासून आपले प्रताप दाखवायला सुरवात करतो. मग मुलीचा गर्भ असूनही कधी पुरुष सदृष बाह्यांग निर्माण होतं. ते मूल मुलगा की मुलगी हे ठरवणं मुश्कील होतं! ही तर वैद्यकीयच नाही तर कौटुंबिक आणि सामाजिक आपत्ती. डिलिव्हरी झाली असं कळताच पहिला प्रश्न येतो, ‘अरे वा, काय झालं, मुलगा की मुलगी?’ आता सांगणार काय?

जीसिक्सपीडी (Glucose 6 phospohate dehyadrogenase deficiency) यात मुळात या रसायनाची कमतरता असल्याने नेहमीच्या वापरातील काही औषधे (उदाः मलेरीयारोधक, अथवा सल्फा गटातील औषधे) रक्तनाशक आणि म्हणून कधीकधी  प्राणघातकही ठरतात. हे आधी माहीत असणं म्हणूनच आवश्यक आहे. हा आजारही जन्मतः ओळखता येतो पण तपासणी केली तर.

पण हे डॉक्टर सांगतच नाहीत. त्यांनाच माहित नसतं हा एक भाग आणि सांगितलं तर हा ‘अव्वाच्यासव्वा’ खर्च लोकांना अनाठायी वाटतो! मुदलात विषयच माहीत नसतो त्यामुळे, ‘हे काय नवीन खूळ’ असा खुळचट विचार मनात रुंजी घालू लागतो!! याच्या बिलात डॉक्टरांचा वाटा किती अशी शंका मनाला चाटून जाते!!! ‘हाय रे दैवा, ह्यापेक्षा दुसऱ्या दवाखान्यात सत्यात झालं असतं’, असा विषाद दाटून येतो!!!! हे सगळं ‘मन-निस्सारण’ निस्तरण्यापेक्षा डॉक्टर काही सांगतच नाहीत.
पण माझा सल्ला, त्यांनी सांगायची वाट पाहूच नका. तुम्हीच आग्रह धरा. एकवेळ कुंडली मांडू नका, बाळलेणी सावकाश एक एक करून घ्या पण जन्मतः हे तपासा, तपासा आणि तपासाच.