India and its neighborhood relations, International relations.
Bilateral, regional and global groupings and agreements involving India and/or affecting India’s interests.
Effect of policies and politics of developed and developing countries on India’s interests, Indian diaspora.
Important International institutions, agencies and fora- their structure, mandate.
India and Shanghai Cooperation Organisation (SCO)
About Shanghai Cooperation Organisation (SCO)
The Shanghai Cooperation Organisation (SCO) is a Eurasian political, economic, and military organisation.
It was founded in 2001 in Shanghai by the leaders of China, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, and Uzbekistan.
*On July 10, 2015, the SCO decided to admit India and Pakistan as full members, and they are expected to join by 2016.
Since its formation in 2001, the SCO has slowly begun to establish itself as an important forum for the Eurasian region.
With China and Russia and most Central Asian states as members, there is an obvious strategic dimension to the SCO.
This organization has been evolving as an important forum to discuss and address the common security challenges of terrorism and extremism faced by the region.
India has been an observer member of the group for a decade and it will become a full member by 2016. (Along with India, Pakistan will also become a member of the forum.)
India and Pakistan’s entry will expand the membership of the SCO from the current six — China, Russia, Tajikistan, Uzbekistan, Kazakhstan and Kyrgyzstan — to eight.
It will also draw South Asia into the SCO geography, which, till now, has been confined to Central and East Asia.
Benefits for India:
India’s inclusion and full membership with the SCO accrues the following benefits:
will increase the country’s engagement and energy interests in the region
will improve connectivity, fight terrorism, increase energy cooperation and take measures to check drug trafficking
SCO also brings big energy producers, like Russia and Kazakhstan, and big energy consumers, like India and China, on one platform
SCO has the potential to play a strategically important role in Asia given its geographical significance
India sees role of the SCO in the reconstruction and development of Afghanistan.
Importance of India’s membership to SCO:
India’s inclusion in the SCO makes it more balanced regional organization as the Central Asian republics perceive India as a ‘soft balancer’.
In other words, one of the key reasons behind the SCO’s stunted growth in regional economic and strategic matters is the complicated dynamics between China and Russia. Neither has been willing to concede each other greater turf. India’s entry in the forum at this point in time would be visualised as a balancing factor for both.
If SCO is able to draw in India and also some countries from the Middle East, particularly those bordering Iran, it would cover a huge land mass in the world and would be among regional associations with the largest populations and energy and mineral resources.
The presence of Pakistan and India in the SCO provide its members the much-desired access to the Arabian Sea that leads to the Indian Ocean.
India and Central Asia security cooperation may increase with New Delhi’s full membership to the SCO.
Challenges faced by the SCO:
SCO being a forum of the world’s noted non-Anglo-Saxon Asian powers and a reservoir of abundant energy resources, the SCO has not been able to develop a constructive economic agenda.
This lack of an economic agenda has limited the scope of Shanghai Cooperation Organisation.
Energy cooperation, which Russian President Vladimir Putin had flagged in 2006 as one of the key goals of the SCO, has remained dormant.
Rather, most energy cooperation between the SCO members has been happening bilaterally.
Beyond energy, China had proposed a SCO development bank in 2010, which has also remained a non-starter.
Meanwhile, China’s interests have shifted to other regional initiatives like the New Development Bank of the BRICS and the Asian Infrastructure Development Bank.
One of the key reasons behind the SCO’s stunted growth in regional economic and strategic matters is the complicated dynamics between China and Russia. Neither has been willing to concede each other greater turf.
In 2013, the SCO members signed an MoU on the creation of SCO Energy Club. The idea of forming an energy club was first proposed in 2004, although SCO members had different views on it. It is still struggling to start this ‘common energy space’.
The long-term economic prospects of the SCO would, however, depend on its connection to the One-Belt-One-Road (OBOR) infrastructure connectivity plan proposed by China for connecting Asia and Europe through land and sea.
India’s concerns:
Case I: India-Pakistan Cold War
India has some concerns over how the forum might react to its delicate relations with Pakistan. But this is unlikely to grow into a major concern as the rest of the members, particularly the Central Asian countries, are likely to maintain considerable distance from the Indo-Pak bilateral domain.
Case II: China’s growing interests (OBOR)
China would be aiming to utilise the SCO as an important organisation for drumming up regional support for the OBOR. In this respect, India, which till now has refrained from committing to the OBOR, might find itself on relatively weak ground.
China is already working on connecting its western region to Central Asia through projects that are exclusive of the SCO. Its long-term objective would be to dovetail these projects into the OBOR network. (similar to the plans it has for the China-Pakistan Economic Corridor (CPEC) and the Bangladesh-China-India-Myanmar (BCIM) projects)
The way ahead:
An important prerogative for India at the SCO would be to fix a strategy for the OBOR.
Having a totally non-committal attitude to the OBOR is not the right way to approach an initiative that is slowing spreading deep and wide across Asia and is becoming bigger than all other ongoing regional connectivity plans.
Much of what India might gain from the SCO will depend on its own calculations of the OBOR.
It is crucial, that New Delhi takes a constructive and long-sighted view of the opportunities the SCO provides for integration of South and Central Asia.
Connecting the dots:
Addition of India and Pakistan into SCO “would not only change the political map, but would change the balance of power”. Substantiate.
What are the benefits that India accrues upon its full membership to SCO? Also discuss the challenges faced by the country upon such membership.
SCO as an economic, political, and military organisation has remained dormant and stunted. Do you agree? Discuss the challenges faced by it.
NATIONAL
TOPIC:
General Studies 1:
Women related issues
General Studies 2:
Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources
General Studies 3:
Science and Technology – developments and their applications and effects in everyday life Achievements of Indians in science & technology; indigenization of technology and developing new technology
Districts without Uteruses—The malpractice named Hysterectomies
What is ‘Hysterectomy’ —
A hysterectomy is an operation to remove a woman’s uterus for different reasons, including:
Uterine fibroids that cause pain, bleeding, or other problems
Uterine prolapse (sliding of the uterus from its normal position into the vaginal canal)
Cancer of the uterus, cervix, or ovaries
Endometriosis (a disease in which tissue that normally grows inside the uterus grows outside it)
Abnormal vaginal bleeding
Chronic pelvic pain
Adenomyosis (thickening of the uterus)
UK
A hysterectomy is rarely performed in the UK to save life—other treatment options are usually explored first
In order to confirm a diagnosis of cancer, doctors first perform a biopsy and other lab tests. In some cases, they would treat with radiotherapy and/or chemotherapy before recourse to a hysterectomy.
The vast majority of hysterectomy cases in the UK involve women between the age of 40 and 50. It is rare for a woman in her 20s or 30s to have one.
After a hysterectomy—
Menopause, irritable bowel syndrome, and depression, loss of sexual pleasure, thrombosis and vaginal prolapse
Increases chances of Breast Cancer & Brain strokes
Increases risk of bloating and water retention by body
Increases risk of heart attack and other diseases as female hormone oestrogen protects women from it. Ovaries should preferably be retained by every woman at least till 65 years of age
Hysterectomy along with removal of ovaries can cause calcium deficiency which results in early osteoporosis, leading to fractures, joint pains and back pain
If hysterectomy is done, it requires hormonal replacement therapy which is not advisable
Trend of performing hysterectomies for women in India—
Frequently performed to economically exploit poor women or government-run insurance schemes
Reported from rural pockets of about half a dozen States — Gujarat, Rajasthan, Bihar, Chhattisgarh, Karnataka, Maharashtra, especially in the last six years—
Poor illiterate women are prescribed the procedure for white discharge, irregular menstrual cycles, and even abdominal pain
Their willingness to undergo the procedure stems from the fear of cancer (which doctors convince them of) to the belief that their uteruses are of no use once they have had children.
Loss of daily wages during menstruation only makes the prospect more appealing
(Over 18,000 insurance-funded hysterectomies are conducted in Bihar and Chhattisgarh alone)
The practice a “human rights violation”—not just as a clear violation of reproductive health rights but also as a heinous crime and a form of violence on women
Comparison with the West: The total number of hysterectomies in India is lower than in the West. But it is alarming that 30-32 is the average age group of women undergoing the procedure here, while in the West post-menopausal hysterectomy is common
Fuelling Schemes—RSBY
In 2010, the Andhra Pradesh government dropped hysterectomies from Aarogyasri, the State insurance scheme
Self Employed Women’s Association (SEWA) in Gujarat also noticed a high number of hysterectomy claims under its community health insurance scheme in Ahmedabad district
In the water-starved Sangola taluka of Solapur in Maharashtra, for instance, women for years have been made to believe that hysterectomy protects them from cancer.
Hysterectomies done in Bihar involved women in the 30-40 age group and were covered under the Rashtriya Swasthya Bima Yojana (RSBY)
Action taken by the Government—
Rajasthan
An inquiry committee was set up and licences of doctors cancelled
But a second committee was set up that gave the doctors a clean chit—Private hospitals were hand in glove with diagnostic centres that would do a sonography, give the report in an hour, and conclude that the uterus is about to become cancerous
Chhattisgarh—Two inquiry committees were formed and the second one let the doctors go scot-free.
Karnataka—Three inquiry committees have been formed (reports are still awaited)
IASbaba’s Views:
Factors that must be addressed:
Extremely limited primary gynaecological care for women in most of rural (Time and cost of travel, unskilled doctors)—There is a need for regulation like in the case of the PNDT (Pre-Conception and Pre-Natal Diagnostic Techniques Act) that doesn’t allow an ultrasound without proper documentation
Attitudes towards women’s bodies and health—drive unnecessary intervention; a uterus is not ‘necessary’ once reproductive functions are fulfilled and this same attitude fuels menstrual taboos, violence against women and sex-selective abortion
Low investment in the public health sector over the years leaving India with a fractured and weak health system—
The gap left by the public health system combined with a government policy of proactively promoting the private sector has led to the proliferation of private health providers which are unregulated, unaccountable, and out of control
When the private sector provides health services on behalf of the state it can make it more difficult for citizens to hold their governments to account and to seek justice
Absence of composite national data:
Makes regulation difficult
Difficulty in determining the population prevalence, if these procedures were
necessary, and drivers of hysterectomy amongst young women in India
Sol: For the first time, the National Family Health Survey-4 has included a question on hysterectomies (first comprehensive data)
Setting up guidelines for private hospitals (attitude of business mechanism and profit-making needs to be dealt with) while tightening norms of insurance schemes
The doctors must be properly monitored and regulated to ensure they provide a decent level of care— Ethical medical practice needs to be re-affirmed
Women should be informed about its long-term consequences, and the alternative medical treatments available; Complications post-hysterectomies need to be recorded and followed up
Private health care providers need to be regulated and controlled and public health care provision needs to be scaled up and improved— must be properly standardised to improve rationality of care, regulation of fees, and to uphold patient’s rights
Prioritise strengthening and scaling up of government health care which is available to all citizens.
Medical Practices:
Ovaries should be preserved in every woman till the age of 65 to maintain hormonal balance as the oestrogen hormone also helps protect women from heart attacks.
Even in extreme cases, preservation of at least one ovary should be done, so that oestrogen hormone is released into the body.
In case of cervical cancer, it is possible to remove the cancerous tissue surgically and prevent uterus removal.
Other available non-surgical methods like endometrial ablation; balloon therapy etc. should be utilized.
‘Save the Uterus and Ovaries’ Campaign: Government should recognize and support the campaign—promoting preservation of uterus as part of the FOGSI (Federation of Obstetrics and Gynaecological Societies of India) initiative
Note:
Uterine Balloon Therapy:
A new development and technique, called Uterine Balloon Therapy (UBT), is invented solely to prevent hysterectomies in women who suffer from unmanageable periods and who no longer desire fertility
A simple procedure by which the inner lining of the uterus is compressed and thinned out with a special balloon inserted inside the uterus for a period of eight minutes.
The balloon is connected to special equipment which helps to raise the pressure and temperature of the water in the balloon. With this heat and pressure, the inner lining (endometrium) is partially destroyed which leads to reduced bleeding later.
Advantages—
No blood loss and no pain
Gets over in 10-15 minutes and therefore, does not involve hospital stay
Helps to save the uterus of about 95 per cent women in whom the uterus is otherwise normal
Connecting the Dots:
Enumerate the possible reasons for the high incidence of hysterectomies. Highlight the challenges and action plans required to deal with it.
Has asymmetry of information been the driving force behind the increased rate of ‘medically perpetuated women violence’ in India? Discuss.
