Nurses agitation and "spiritual" hospitals

Last three months, nurses in various hospitals in Kerala have finally found their voices and have started demanding dignified wages. The private medical care business has grown leaps and bounds in the last decade. Many private medical colleges have sprung up in the state too. The relative prosperity of the Kerala population and its health consciousness, although buoyed mostly by Gulf remittances, has provided a fertile environment for the private medical business boom.

That nurses are critical part of a medical team and they need to be accorded required respect is plain commonsense. However, the greedy hospital managements take advantage of easy availability of nurses in the state and have no compunctions in making them work under exploitative conditions.

As per the reports in newspapers many nurses get paid between Rs 2500 and Rs 6500 per month. Assuming, they work only for 8 hrs a day for 25 days in a month, at a salary of Rs 3000/month, the daily wages amount to Rs 120. A domestic worker in Trivandrum city, who works for 5-6 hrs/day, typically takes Rs 120-140 per day. I am sure the hospital managements are aware of the cost of getting domestic help.

Many of the nurses take loans for their studies and in the end get into situation where they are not able to pay back loans leading tragedies.

It is clear as day that the agitation of nurses for humane conditions is fully justified and should be supported by all. I hoped that at least the hospitals run by highly revered spiritual leaders in our society will take a judicious stand on this issue.

But that does not seem to be the case. Amrita Institute of Medical Sciences(AIMS) is a prestigious medical institution run by Mata Amritanandamayi Math. Mata Amritanandamayi is a revered spiritual leader in Kerala and elsewhere. I have read Mata’s teachings about kindness and justice and have always found lot of comfort in them. Recently, I read a report that AIMS had hired goons to intimidate and assault striking nurses. The hospital spokesman has accepted that the assault has taken place but that the hospital had no role in this. He seems to suggest that the nurses hired goons to get themselves beaten up.

The situation is not better in medical institutions run by Catholic Church. As the agitation spreads, many institutions run by spiritual leaders will have to make the choice that we ordinary mortals do almost everyday – to be or not be just. Unfortunately the indications are that these spiritual establishments need some prodding from ordinary people to follow the spiritual path.

Anyway, it seems goons in Kerala and neighbouring states will be in demand to “rein in” nurses demanding dignity and minimum wages.

Have Indian spices become “dangerously” contaminated?

There was a time when the Europeans took tremendous risks and navigated across seas and oceans to come to India in search of spices. Why is that now Indian spices are raising eyebrows in the west? In the last decade there have been many reports of rejections by US and European countries of import shipments of spices from India due to adulteration, filth and presence of micro-organisms. Indian government has reacted by setting up audits, inspections of products exported from India to reduce cases of rejections.

Assuming that the efforts of exporters of spices and Indian government has resulted in better quality spices being exported to US and Europe, are we, residents of India, consuming spices of questionable quality? It is more likely that we are consuming spices that would normally be considered dangerous in US or Europe.

In the March 15,^, 2010 issue of TIMES magazine there was an article highlighting the presence of lead in Indian spices. It said that a research team from Children's Hospital Boston and the Harvard School of Public Health “visited 15 Indian specialty stores in the Boston area and purchased 71 cultural powders and 86 spices and food products”. They found that “about 25% of the food items, including spices such as cardamom, fenugreek and chili powder, contained more than 1 microgram of lead per gram of product”. The article goes on to say that as per E.U. guidelines the acceptable threshold is 2 to 3 micrograms of lead per gram of the product. Some of the tested products exceeded this limit. The important thing to note is that while individually many of these spices have lead levels below permitted levels, these could add to the potential exposure from other sources. for human beings. While the U.S. Food and Drug Administration (FDA) has set the maximum exposure limit for children at 6 micrograms per day (mcg/day) for children and 75 mcg/day for adults, the report in Times says that even as little as 5mcg/dl of blood can be dangerous for children.

CDPH (California Department of Public Health) has reported cases of lead poisoning linked to chilli powder and turmeric from India. What are the possible sources of lead contamination? Lead contaminated soil, manufacturing or drying process or knowingly added to increase weight or lend colour.

The import refusal reports on the US FDA’s website provides details on the rejections of products that do not meet the US food administration standards. The refusal reports can be accessed by country or by product for every month. Many of the venerable names in Indian spices industry figure in the rejections list. A quick perusal of the rejection reports indicate that most of the cases of spices from India, were attributed to suspected presence of salmonella or pesticide residues.

The European Union had conducted an audit of Indian spice exporters in Feb 2011. The report is available online. The following table from the report shows the increase in the number of alerts about food imports from India. There was an alert from EU on aflatoxin contamination of Indian spices. The audit was conducted to assess the quality controls for aflatoxin contamination in India.

	Imports to EU			No of Alerts
	2008	2009	2010	2008	2009	2010
Chilli products (curry)	3156 (UK, BE)	3592 (UK, BE)	2711.6 (UK, FR)	2	1	26

The conclusions of the audit report were not surprising – there were either inadequate or no controls for various spices.