Documente Academic
Documente Profesional
Documente Cultură
SAMAJAKARYADA
HEJJEGALU
SOCIAL WORK FOOT-PRINTS
Contents
jr
1. Editors Desk
Ramesha M.H.
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- 123
- 149
- 167
- 187
- 201
- 211
8. AzQAi
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Ramesha M.H.
g JA.JZ.
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UAzgd
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Editors Desk
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Ramesha M.H.
Editors Desk
Dr. K. Prabakar
CEO, Apollo Knowledge, Chennai
Abstract
The article traces the evolution of nursing as a globally
recognizedprofession from an intuitive art in the homes. The
historical development of nursing by Egyptians, Greeks, Romans,
Chinese, Hindus, Christians, and Arabs is discussed. Nursing in the
modern era, with its low and high points, and the contribution of
Florence Nightingale as the turning point in the development and
recognition of nursing arealso examined in the article. The
professional characteristics of nursing, the personal qualitiesneeded
for a professional nurse, code of ethics, and professional
accountability are the other key components of the article.
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K. Prabakar
Historical Background
It is extremely difficult to trace how prehistoric society dealt with
their sick. One of the earliest evidences of compassion for the sick
comes from the Neanderthal stage of human evolution (about
1,00,000 years back). From one of the burials of an old man, it is
seen that the old man has suffered a bone deformation crippling
him. Palaeontologists say that the old man lived long after he was
crippled and his death was not due to this deformity. Obviously he
could not have survived without being a good hunter. With the
deformity he could not have hunted. He must have been looked
after by others of his group.
The study of various civilizations provides an insight into the
concept of health and health care practised in different societies.
The civilization of Mesopotamia believed that health care was
religion-oriented. The practitioners were herb doctors, knife doctors
and spell doctors equivalent to the present day intensivists, surgeons
and psychiatrists.
The Egyptians believed that medicine was divine and the person
in-charge was the priest physician. The priest was elevated to the
rank of God, temples were built in his name and the sick people
were taken to the site for healing. The Egyptians developed the art
of embalming the body after the death for preserving the same in
the pyramids.
The Greeks also considered medicine as divine. Apollo, the Sun
God, was considered the God of medicine. The dynasties of curative
medicine and preventive medicine came into existence. Priest
physicians were in-charge of the temples and the sick people were
brought to the temples and kept for relief. The greatest Greek
physician Hypocrites studied and classified diseases based on
observation and reasoning. He challenged the tradition of magic
in medicine and initiated a new approach by applying clinical
methods in medicine. Greeks rejected the supernatural theory of
disease and looked upon disease as a natural process.
The contribution of Romans was mainly in the field of
comparative anatomy and experimental physiology. The greatest
Roman medical teacher Galen felt that health preceded disease and
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to the shelters built for the sick and poor pilgrims, and nosocomia
was the name given to hospitals built by St. Zoticus in
Constantinople during the reign of Emperor Constantine. The
Christian Bishop St. Basil built up a Xenodochiam called Basilias
in Caesarea in Palestine (Dolon, 1973).
The early Christian period (till 500 AD) created a base to nurture
nursing. Charity and love in action based on the teachings of Christ
were apparent in nursing which took root during this period. The
first organized visiting the sick began with the establishment of the
order of Deaconesses and they endeavoured to practise corporal
works of mercy. This work included the basic human needs such as
to feed the hungry, to give water to the thirsty, to clothe the naked,
to visit the imprisoned, to shelter the homeless, to care for the sick,
and to bury the dead. Charity was considered as the greatest social
reform during that period.
After the order of Deaconess, a group of noble Roman matrons
distinguished themselves in the field of nursing. They were women
of wealth, intelligence and social leadership. They founded hospitals,
convents and monasteries and worked for the good of others. These
nurses were not just comforters, but they were also nurturers,
observers, listeners, counsellors, and teachers, and gave care to the
patient and the family. These intellectually and socially skilled leaders
identified the basic ingredients of nursing care through careful
assessment of needs. They realized the dependency of the acutely
ill patients upon their nurse for vital life processes.
The nurses role of healer as well as builder of health was achieved
by cleaning up the filth and squalor, and by rectifying human
indignities and degradation. Nurses, in effect, were early social
reformers. The site of health delivery occurred where the need existed
- in the community, in the hospital, in the home, in the hostel of a
pilgrim, and in a home for the elderly. The nurses during this period
were motivated by a strong spiritual force and were independent
practitioners.
With the fall of the Roman Empire the medical schools established
during that period disappeared. Europe was devastated by various
diseases like plague, smallpox, leprosy, and TB. The practice of
medicine reverted back to the primitive medicine dominated by
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disease. She identified a nurse the sick and not the sickness
philosophy many years before Dr. Osler pronounced his famous
statement: it is better to know the patient who has the disease than
the disease the patient has (Dolon 1973).
After Florence Nightingale, other nursing professionals like Mary
Adelaide Nutting, Isabel Hampton, Lavania L Dock and Fredericka
Fliedner contributed much to the development of nursing.
Certain hospitals for many years accepted men to a short course
in nursing. The men were called attendants but not nurses. In
1888, at Bellevue Hospital in New York, the Mills School was
established with a two year course; its graduates were also called as
attendants, following the custom of the time. In 1943 there were
four schools of nursing for men only; the Mills School, New York,
the Pennsylvania Hospital School of Nursing for Men and the two
Alexian Brothers hospitals in Chicago and St. Louis. Many more
men opted for nursing programmes and by 1948 the number of
male student nurses increased.
The period that followed World War I saw a greater demand for
nurses. It opened up new fields of specialisation, accelerated the
educational process to create public consciousness with regard to
the importance of good nursing. The World War taxed the medical
and nursing resources of the world to the maximum. Two
catastrophic episodes of World War I-the epidemic of pneumonia
in 1917 and the pandemic outbreak of influenzea in 1978emphasized the need for well-prepared nurses.
World War II also had a profound influence on nursing. In the
United States almost revolutionary changes came about as a direct
result of it. Many nurses were needed for the great army camps
established throughout the country, and many responded to the
governments appeal. In 1940, the nursing leaders had comprehended
the potential need and had formed the Nursing Council of National
Defence, composed of representatives from all the national nursing
bodies. In 1942 this body became the National Nursing Council for
War Service.
With the inception of Nursing Section of the World Health
Organisation in 1949, Oliver Baggallay was appointed chief and
she continued in this office until 1954. Miss Baggallay graduated
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from St. Thomas in London and had been secretary of the Florence
Nightingale International Foundation from 1934 to 1949. In July
1954, Lyle Creelmana, graduate of Vancouver General Hospital
School of Nursing, became the chief of the Nursing Section of the
World Health Organisation. She had been public health nursing
administrator in the Nursing Section of WHO since 1949. Her
guidance and counsel had been extended in the area of public health
nursing to all, throughout the world.
Nursing a Profession
Over the years people doubted whether nursing is a profession
or is it a semi-profession. The doubts are not centered whether or
not the nurses have professional attitude or professional
organizations but on whether the nurses meet the criteria of
professionalism. Then what is Nursing? Is Nursing an art or a
science? Is the Nurse a professional? If nursing is to be a profession,
what are the criteria for it to be a profession? To understand these
and related issues there is a need to first study the definitions of
Nursing.
Beginning with the simplest definition, a nurse is a person who
nourishes, fosters and protects - a person who is prepared to care for
the sick, injured and aged. In this sense Nurse is used as a noun
and is derived from the Latin word Nutrix which means nursing
mother. Dictionary meaning of a nurse includes suckles or
nourishes, to take care of. In this way nurse is used as verb,
deriving from the Latin word nutrix meaning to suckle or
nourish. According to Schulman (1972) nursings long historical
orientation has been based on a concept of mother- surrogate, a
role characterised by affection, intimacy and physical proximity
with an orientation for meeting the needs of the dependent ward,
providing for protection and identification.
Florence Nightingales (1859) Notes on Nursing describe the
nurses role as one that would put the patient in the best conditions
for nature to act upon him. Nursing in its broadest sense may be
defined as an art and science which involves the whole patient body, mind and spirit ; promotes his spiritual, mental and physical
health by teaching and by example ; stresses health education and
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K. Prabakar
to the public and dedication, and these must be the motivating force
for the individual to take to the profession of nursing care. The
image of nursing as a profession had a strong religious heritage
supported by the concept of giving of self to the profession.
The heritage of nursing is a rich one. The history of nursing has
given us a complete picture regarding the growth and the
development of the profession and the contributions of various
nursing leaders. The vision of the great nurses of the past has to
develop nursing practice with ethical standards for the good of the
society. Quality nursing care has become a very important factor
for the survival of a health care institution. Todays nurse is required
to possess all round personality, necessary general education,
professional education, and a high degree of commitment and
maturity to work as a nurse.
Nursing Practice
The important personal qualities needed for a professional nurse
are a caring attitude, a willingness to put service before personal
gain, poise, self discipline, honesty, courage, a pleasant and neat
personal appearance, and good health.
A caring attitude usually comes with being able to express a
sense of spiritual love to the fellow human being. Professionally it
includes concern and empathy. Putting service first rather than
personal gain is extremely important in spite of the changes in ethics
and values, which are taking place in the nurses professional work
and relationships with patients. A well balanced and a stable
personality is a requirement for the nursing profession as nurses
will have to take full control of the emotions, mental activities and
actions under pressure. It is important for an individual nurse to be
self disciplined to develop into a good quality professional nurse.
Self discipline supported by being truthful, sincere and fair will not
only make a good nurse but also a good individual. A nurse will
have to be courageous in handling difficult times while treating a
patient. A neat clean pleasant appearance with good health and a
well balanced life will help a nurse to be good and effective in a
profession (Ann, 1996).
The most important goal of a hospital organization is to provide
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K. Prabakar
Professional Ethics
To become a nurse is not just a matter of learning particular
knowledge and skills, or adopting forms of behaviour appropriate
to the context. It is also a matter of assimilating the attitudes and
values of the nursing profession in a way, which can influence the
thinking, the personality and the lifestyle of the individual concerned.
There is a combination of knowledge, skill and acquired moral
responsibility, which is a part of the process of nursing education.
Those entering the nursing profession may fail to realize the difficult
decisions one has to take which can question ones own personal
convictions and values. Doctors are highly specialized and skilled,
and they are often seen to be dealing with the matters of life and
death of a patient. As nursing sometimes is carried out by lay people
in a family apart from professionally qualified nurses it makes it
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K. Prabakar
Professional Accountability
In the health services sector the doctor, the nurse and the
organization become the service provider and the patient is the
purchaser. The introduction of the purchaser and provider concept
has raised the issue of accountability in the health care services.
The concept of accountability impinges on nurses the ways in which
it does not impinge many other non-professional occupations.
Nursing as a profession demands training and registered
qualification in order to practice the profession. The nurses are
accountable to the patients and to the hospitals for their practice
and this accountability is regulated by statutory bodies (Watson,
1981).
The average nurse appears to believe that accountability is
following procedure and making sure one is covered by having
the right kind of note or record and refer back to when something
goes wrong or where for whatever reason the acquisition is made.
Nursing accountability is moral responsibility narrowed down to
the role of a nurse. Nurse is one element of the health care unit. So
the nature of accountability to the patients is moulded by the
particular political, economic and administrative forms which the
institution takes.
There are two ways through which the gap between the patient
and the institutional ends are reconciled. The reconciliation takes
the form of self regulation otherwise called lateral accountability.
The nurses keep a check on each other for the best interests of the
patients. The other takes the form of upward accountability, that is,
the nurses are checked by the authorities for the best interests of the
patients.
The first type depends an notions of honourable, gentlemanly,
lady like behaviour which underlies reputation and justifies public
trust. The second rests on authority, the rule of experts and discipline
(Hunt, 1994).
Nurses may be expected to account for their actions and to explain
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References
Abraham, M.
1996
Ann, M.T.
1996
ANA
1973
Aroskar, M.A.
1998
Bixler,G.,&
Bixler,R.
1945
Corley, M.C.
1995
Dolan, J.A.
1973
Edwards,S.D.
1996
Fagin, C.M.
1978
Fletcher, N. &
Holt, J.
1995
Hart, H.L.A.
1994
Henderson, V.
1966
148
K. Prabakar
Hunt, G. (ed.). Nursing and the Concept of Care. New York: Routledge.
1994
Kath,M.M. &
Nursing Ethics. London: Churchill Livingstone.
Boyd, K.M.
1995
Nightingale,F.
Notes on Nursing : What It Is and What It Is Not. (Fascimile
1859
Edition).Philadelphia: J.B.Lippincott.
Park K.
Parks Textbook of Preventive and SocialMedicine. Jabalpur:
1996
Banarasidas Bhanot.
Pavalko,R.M.
Sociology of Occupations and Professions. Itasca: IL Peacock
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Publishers.
Rao, S.K.
Introduction to Community Health Nursing. Madras: B I
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Publications.
Rushton,C. M., EnvironmentsThat Support Ethical Practice. New
& BrooksHorizon ,5(1) :20-29.
Brunn,J.A.
1997
Schulman,J.
Experience of a Nurse Practitioner in a General
1972
Medical Clinic .JAMA, 279(11) :1453-1461.
Schlotfeldt, R.M. The Professional Doctorate : Rationale &
1978
Characteristics. American Journal of Nursing, 60: 492494.
Torres, G.
Curriculum Implications of the Changing Role of the
1975
Professional Nurse. NLN Publications.
Yura, H.P., &
The Nursing Process. New York:Appleton Century Croft.
Welsh, M.B.
1973
Watson, J.
Nursings Scientific Quest. Nursing Outlook, 29(7):4131981
416.
Zwemer, A.J.
Professional Adjustment Ethics for Nurses in India. Chennai
1996
B I Publications.
Dr.T.K.Nair
Development and CSR Consultant
Abstract
The article has three parts .The environmental crisis facing Mother
Earth is described in the introductory part. The second section
Sustainability and Spirituality is a summary of the meditations on
sustainable cultures and cosmologies in Asia and the associated
writings of Nadarajah in his seminal, visual-textual book Living
Pathways. The final part looks at the expected role of social work
profession in the environmental justice movement and the
disappointing reality.
Mother Earth
Mother Earth is the only planet that supports life .Scientists
estimate that the Earth came into being about 4.6 billion years ago
(Ignacimuthu, 2010) .Three concepts are used interchangeably in
the discussion on the planet Earth: nature, environment and ecology.
Nature refers to the physical world comprising all living and nonliving components. All living forms from microbes to human beings
including plants with diverse shapes, sizes, statures and colours
constitute the living components. Light, air, water, soil, temperature,
150
T.K. Nair
152
T.K. Nair
154
T.K. Nair
156
T.K. Nair
158
T.K. Nair
Economic Sustainability
Dematerialising the economy, market alternatives, appropriate
technologies
Efficient resource allocation, foot print management, use/
waste management
More equitable access to resources for all
Glocalism (that is, the adaptation of a product or service
specifically to each locality in which it is marketed )
Political Sustainability
Human rights
Democratic development, multi stakeholder participation
Good governance, accountability, transparency, trust
Social Sustainability
Improved income distribution with reduced income
differential, both locally and globally
Gender equity and equality, equity and equality for indigenous
peoples and people with disabilities
Social investment in health and education, and in the family
Emphasis on peoples participation and empathy
Cultural Sustainability
General sensitivity to cultural factors, enlightened localism
Cultural diversity and dialogical transaction
Values contributing to non-anthropomor phism /
dematerialisation
Long term time sense and holism
The environmental justice movement in the world for ensuring
the human rights of all people to live in a clean and healthy
environment has a history of over five decades initiated by the United
Nations and its related agencies and divisions. The environmental
human right is the right to live in an environment free from toxic
pollution and to have control over local natural resources (Hancock,
2003 ). The UN Conference on the Human Environment held in
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162
T.K. Nair
164
T.K. Nair
References
Bartlett,H.M.&
Beatrice,N.S.
1970
Besthom, F.
2002
Coates, J.
2003
Dankelman, I.
2002
Dewane, C.J.
2011
Gitterman, A. &
Germain,C.B.
2008
Hancock, J.
2003
Hawkins, C.A.
2010
Abstract
The ageing scenario in India has transformed in the recent decades
due to the observed demographic trends among the older population
and rapid social change that has led to the decline in informal
supports for older persons within the family, which may be adversely
affecting their well-being. In this context, Living Arrangements (LAs)
are identified as a basic determinant and an indicator of the care and
nature of informal supports available to the older persons within the
family, and therefore of their Quality of Life (QoL). In the current
study, while understanding the family relations that are part of LAs
of the older persons, the findings revealed who the hardest and easiest
person to get along with them were, and that respondents perception
about the level of interest shown by their family members towards
their well-being varied according to their current LAs and seemed to
impact their QoL and its related factors such as loneliness and
adaptation to old age. The implications thereby point out to the
necessity for efforts towards making families aware of who the older
persons reported as having difficult relations with in the different
LAs, what are the perceptions of older persons about indifference
shown by their family members, and its possible impact on their
lived realities. Further, planning appropriate interventions to improve
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Smita Bammidi
Introduction
Ageing is a multi-faceted process that is determined not only by
the passage of time, but also by certain physiological, psychological,
social, economic, and cultural factors. Hence, the experience of
ageing by individuals differs across the countries and regions.
Moreover, there are variations in the experience of ageing even
among the elderly within a country or region due to factors such as
age, gender, marital status, health, place of residence, economic
status, attitudes, work and retirement policies, importance given to
social security, living arrangements, level of family support and the
sexual orientation (Calasanti & Sleven, 2001; Virpi, 2008). In
general, old age is seen both as a time of decline and fulfillment,
depending on the individual and generational resources, and
opportunities to which persons have access during their lives.
Older persons are coming to comprise a significant proportion
of a nation/countrys total population. The various demographic
trends among the older population have been observed across the
globe since the 1900s. In 2013, the people aged (60 or over)
comprised almost 841 million i.e. they were 12 % of the then total
world population. It will increase more rapidly in the next four
decades to reach % in 2050. During 2013, in the case of developing
countries, the proportion of older persons ranges from 9% to 22%
of their respective total populations (Global Ageing Watch Index
Website, 2013). In India, the older persons (60 or over) comprised
of about 121 million i.e. 9 % of the nations total population (Census
2011). For example, in India, 1 out of 5 persons will be found to be
60 or over years. Older persons are large in absolute numbers and
this trend of their proportion in the total population will only increase
in coming years. Along with demographic trends, rapid social
change took place during the 1900s due to the occurrence of the
social processes such as industrialization, globalization,
westernization and modernization. Changes in family structure
(joint to nuclear), changes in family values & obligations, social
roles, attitudes of individuals took place, women were going out to
work, adult children migrated in search of better prospects.
Individualization and lifestyle change, economic development,
consumerism and technological advances occured. These sweeping
changes altered the roles of older persons in the family and society,
our attitudes towards them, ideas on obligations for caregiving and
gave rise to social institutions that care for older persons. Hence,
every issue may obviously effect a large number of older persons
and therefore makes it necessary to identify them, understand their
implications and attempt to address the same.
In the Indian context, in keeping with the developments at the
global level, and the Government of India being a signatory to the
initiatives by the UN, a policy for the older persons and several
interventions to enhance the quality of life of older persons were
initiated. The Govt. announced the National Policy for Older
Persons (NPOP) in January 1999. While recognizing the need for
promoting productive ageing, the policy also emphasized the
important role of family in providing vital non-formal social security
for the elderly (Government of India (NPOP), 1999). In view of
the changing trends in demographic, socio-economic, technological
and other relevant spheres in the country, a committee was constituted
for formulating a new draft National Policy for Senior Citizens
(NPSC), 2011 that advocated priority to those needs of the senior
citizens that impact the quality of life of those who are 80 years and
above, elderly women, and the rural poor (Government of India
(8th NCOP), 2010). The focus of the draft NPSC, 2011 would be
to promote the concept of ageing in place or ageing in own home.
From this angle, housing and living arrangements, income
security, home based care services, old age pension, access to
healthcare insurance schemes and other programmes and services
are seen as important to facilitate and sustain dignity in old age.
This draft policy recognizes the need for intergenerational bonding,
so that care of the senior citizens remains vested within the family,
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Smita Bammidi
which may partner with the community, government and the private
sector for provision of informal supports. Hence, it emphasizes
institutional care as the last resort (Government of India (NPSC
Draft), 2011).
Family Relations
One of the most influential factors in peoples lives is the
environment in which they live. For the older persons this is
particularly true as they spend most of the time in their home, as
compared to other groups in the society (Van Solinge & Esveldt,
1991). Their living arrangements emerged as a parameter of great
importance for understanding the actual living conditions of the
older population in the developing countries (and their Quality of
Life) within the contemporary ageing scenario, affected due to the
lack of public institutions and social security nets (Sen & Noon,
2007). In view of this, exploring the above aspects has important
implications for social work practice with the older persons- in
improving their living conditions and quality of life within the
rapidly changing contexts. Hence, in the current study, an attempt
is made also to explore about the family relations within the living
arrangements of the older persons (hardest and easiest person to get
along with, frequency of arguments and tensions caused by hardest
person, perceived level of interest shown by family members towards
their wellbeing in different LAs as effecting their QoL domains and
its related factors such as loneliness and adaptation to old age) that
affect their quality of life.
Method
The data used in the present analyses were collected as part of
an exploratory and descriptive study that was conducted during
the period 2010-2012. A household survey of sample elderly
respondents in the Vadodara (Urban) Municipal Corporation
(VMC) limits was taken up using an interview schedule, as part of
the quantitative approach and for qualitative approach the case study
and observation methods were used. The schedule comprised of
questions covering socio-demographic and family details, work and
economic background, financial security, living arrangements, family
Sampling
Multi-stage probability sampling was used to arrive at a sample
of 243 respondents who are 60 years and over, selected from the 13
wards in the Vadodara City. The map of the Vadodara city with
the 13 wards already outlined was divided into equal sized grids
and then the grids were serially numbered. Thus, it resulted in 26
grids. Out of the 26 grids, only 22 grids covered residential areas.
Further, in the 26 areas which have been identified falling in the 22
grids covering the 13 wards, older persons living in the family context
were enumerated using the preliminary data sheet. In this manner,
a list with a total of 640 elderly was enumerated from all the 26
areas. Next, keeping the constraints of time and human power in
view, it was decided to select randomly around 40 per cent of the
older persons from the list thus generated. Thus, the researcher arrived
at a sample of 250 respondents. While finalizing the filled interview
schedules, 7 schedules were found to be incomplete and therefore
were discarded thus making 243 persons as the final sample for
study. The sample turned out to be purposive in view of the mobility
and non-availability of some of the respondents when approached
during data collection.
Analytical Framework
This article explored the family relations (an important factor of
the living arrangements) such as the hardest and easiest persons to
get along with vis-a-vis LAs, duration of stay and the frequency of
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Smita Bammidi
Results
The data analysis of information pertaining to the family relations
of older persons as part of their living arrangements collected during
the study revealed various findings that are presented in this section.
the type
Percent
64.2
3.7
23.5
7.4
1.2
100
living with them at the time of the study. Of the 121 respondents
who reported a hardest person, about 55 per cent (n=66) said they
were actually staying with that person. Of these, 80 per cent reported
that person as their primary care giver. Now, who figured or were
reported as being the hardest persons for the older persons?
Table 2: Sex-wise distribution of the sample older persons by
the relationship to the hardest person to get along with as
reported by them
Relation with the
Sex of Respondent
Total(n=121)
Hardest Person
Male (n=58) Female (n=63)
Son
24 (41.4)
20 (31.8)
44 (36.4)
Daughter-in-law
8 (13.8)
16 (25.4)
24 (19.7)
Spouse
12 (20.7)
7 (11.1)
19 (15.7)
Sister-in-law
1 (1.72)
6 (9.5)
7 (5.8)
Daughter
2 (3.2)
2 (1.7)
Son-in-law
2 (3.2)
2 (1.7)
Other a
13 (22.4)
10 (15.8)
23 (19)
Note. a Includes siblings, grandchild, nephew, niece, spouses relatives,
and child (ren)s in-laws.
Son emerged as the hardest person in the case of both men (41
per cent) and women (32 per cent). Daughter-in-law (20 per cent)
was the person hardest to live with for women (25 per cent) than
men (14 per cent). The next hardest person reported was the spouse,
mostly by the older men (21 per cent). While in the case of older
men, the daughter or son-in-law did not emerge as the hardest
persons to live with, in the case of a few older women they were
reported as such. The other persons identified as hardest to live
with were sister-in-law, siblings, grandchildren, nephew, niece,
spouses relatives and childrens in-laws (see Table 2).
It was further explored in Table 3 whether the age of the older
persons was associated with who was the hardest person being
reported. If we consider the median age of the elderly respondents,
much older respondents (70 years) reported son and daughter-inlaw as the hardest persons to live with. The respondents who
mentioned spouse and daughter as hardest persons were relatively
younger with their median ages being 68 and 66 years respectively.
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Smita Bammidi
Living Arrangement
Total
with
Parent-child Living
Living Living
Living (n=121)
Hardest
Coresidence with
Alone with
with
Person
(n=77)
(n=4)
Spouse
Relatives Assist-
(n=26)
(n=11) ance
(n=3)
Son
33 (42.8)
5 (19.2)
2 (50) 3 (27.2)
1 (33.3) 44 (36.3)
Daughter
19 (24.6)
3 (11.5)
2 (66.7) 24 (19.8)
-in-law
Spouse
7 (26.9)
2 (18.1)
19 (15.7)
Sister-in-law 1 (1.2)
4 (15.3)
2 (18.1)
7 (5.7)
Daughter
2 (2.5)
2 (1.6)
Son-in-law
1 (25) 1 (9)
2 (1.6)
12 (15.5)
7 (26.9)
1 (25) 3 (27.2)
23 (19)
Others
10 (12.9)
176
Smita Bammidi
178
Smita Bammidi
25 (43.8)
19 (33.3)
5 (8.7)
6 (10.5)
2 (22.2)
2 (22.2)
1 (11.1)
2 (11.1)
1 (5.5)
5 (27.7)
Total
Living (n=239)
with
Assist
ance
(n=3)
72 (30.1)
2 (66.7) 57 (23.8)
1 (33.3) 52 (21.7)
19 (7.9)
1 (1.7)
2 (11.1)
13 (5.4)
1 (11.1)
2 (0.8)
2 (11.1)
6 (2.5)
1 (1.7)
6 (2.5)
3 (33.4)
6 (33.3)
12 (5)
as such by the older person. To look into this aspect, the respondents
were asked to rate their perception regarding the level of interest of
the family members about their well-being and the results are shown
in Table 9.
Table 9: Sex-wise distribution of the sample older persons by
their perception of the level of interest shown by family
members about their well-being
Perceived Level
Sex of Respondent
Total
of Interest
Male(n=120) Female(n=123)
(n=243)
Interested
93 (77.5)
92 (74.8)
185 (76.1)
Somewhat interested 17 (14.2)
14 (11.4)
31 (12.8)
Not interested
7 (5.8)
10 (8.1)
17 (7)
Indifferent
3 (2.5)
7 (5.7)
10 (4.1)
A majority (76 per cent) of the sample perceived that their family
was interested in their well-being while around 13 per cent felt that
they were somewhat interested in their well-being. A slightly more
percent of women compared to men felt that their family was not
interested or indifferent toward them. Data were analyzed to see
the relationship between the type of living arrangement and the
perception of the elderly sample about the level of interest shown
by family members about their wellbeing. The results are shown in
Table 10.
Table 10: Distribution of the sample older persons by their
perception of the level of interest shown by the family
members about their well-being and type of Living
Arrangements
Perceived
Living Arrangement
Level of Parent-child Living
Living
Living
Interest Coresidence with
Alone
with
(n=156)
Spouse
(n=9)
Relatives
(n=57)
(n=18)
Interested 113 (72.4)
Some23 (14.7)
what
interested
50 (87.7)
3 (5.3)
5 (55.6)
2 (22.2)
Total
Living N=243
with
Assist
ance
(n=3)
14 (77.8) 3 (100) 185 (76.1)
3 (16.7) 31 (12.8)
180
Smita Bammidi
Not
11 (7.1)
interested
Indifferent 9 (5.8)
3 (5.3)
2 (22.2)
1 (5.6)
17 (7)
1 (1.8)
10 (4.1)
It seems that a majority of the older persons across the five living
arrangements felt their family was interested about their well-being.
However, around half of the elderly who were living alone reported
that their family members were somewhat or not interested about
their well-being. Similarly 16.7 per cent and 5.5 per cent elderly
living with relatives respectively felt that their families were somewhat
interested and not interested.
Table 11: Distribution of the sample elderly by their
perception of level of interest shown by the family about their
well-being and the means and SDs of scores on the three
measures used
Perceived
Quality of Life
Loneli Adapt -
Level of
Physical
Psychol
Social
Envir-
Interest
Health
ogical
Relatio-
onment
well-
nsh ips
ness
ation
to Old
ag e
bei n g
Interested Mean
14.74
16.14
14.3
16.93
43.19 63.74
(n=185)
2.857
2.23
2.17
8.7
Somewhat Mean
SD
13.64
14.68
11.48
14.33
49.12 55.58
8.94
interested
SD
3.31
2.52
2.89
2.27
7.18
Not
Mean
12.1
12.98
9.96
13.2
53.05 54.41
interested
SD
2.77
2.65
2.98
2.94
7.51
10.3
Indifferent Mean
10.62
11.93
9.73
12.3
58.1
49
(n=10)
SD
3.09
4.48
2.81
3.8
10.81 8.13
Total
Mean
14.24
15.56
13.45
16.15
45.25 61.44
N=243
SD
3.08
2.68
3.35
2.73
9.39
10.58
(n=31)
(n=17)
10.12
182
Smita Bammidi
5. For the 66 elderly who lived with the hardest person, the
overall duration of stay with that person was 33 years.
Further, in terms of the duration of stay of the respondent
with the hardest persons- spouse, son, daughter and sister-inlaw figured in that order.
6. Of the 121 elderly who mentioned they had a hardest person,
71 per cent (n=86) reported that the person had been creating
tensions and arguments, during the preceding year. Of these
86 elderly i.e., 70 per cent revealed that conflicts occurred 10
times a year, while 23 per cent of them said it occurred almost
daily.
7. Out of the total sample, 122 elderly did not report having a
hardest person to get along with. Interestingly, a majority
(52 per cent) of the elderly who belonged to the age range of
75-84 years and more than half of the elderly (56 per cent)
who lived alone did not report a hardest person to get along
with.
Easiest person to get along with
8. Out of the total sample elderly, 98 per cent (n=239) reported
having persons in their life who were easy to get along with.
9. Of the 239 elderly who reported an easiest person to live
with, a majority (30 per cent) reported the spouse as the one,
followed by daughter and son.
10. In terms of living arrangements, 44 per cent of the elderly
living with spouse reported that their spouse was the easiest
person to get along with. Even in parent-child co residence,
spouse was reported as the person easiest to get along with.
Level of Interest shown by family members and the well-being of the older
persons
11. A majority i.e. 76 per cent of the elderly perceived that their
family members were interested in their well-being.
12. A majority of the elderly across all the five living
arrangements felt their family was interested about their wellbeing.
13. Calculation of the means of quality of life scores and the
related variables showed that the elderly who perceived their
family as interested in their well-being reported better on the
184
Smita Bammidi
References:
Calasanti, T. M.,
& Sleven, K. F.,
2001
Efklides, A.,
Kalaitzidou, M.,
& Chankin, G.,
2003
Government of
India,
1999
Government of
India,
2010
Government of
India,
2011
Global Ageing
Watch Index,
2013
Katz, S.,
Down, T.D., &
Cash, H.R.,
1970
Registrar General
of India,
2011
186
Smita Bammidi
Russell, D. W.,
1996
Abstract
Advancement of medical sciences have influenced significantly
on the lives of people, it broadened the scope for well being, improved
the quality and expectancy of life. A large number of health problems
and diseases are under control through the improvement of medical
technology. Emergence of medical technology for human organ
transplantation is one of the crucial steps in the journey of sustaining
health, and life. Even the technology is advanced in regard with the
organ transplantation but the non availability of the organs always
constrained the process. Present paper analysis how the changing
epidemiology and etiology have an impact on the organ shortage crisis
and the various prospect to address these issues. Different types of
organ donation and its sources are discussed in detail. This paper
views the lack of availability of organs as an important health issue
by correlating it with the needs and importance of availing organs
through a voluntary donation perspective. The statistical data on
existing demand and supply has been analyzed in this paper. Possible
attempt were made to rationalize the strategies to meet the existing
needs of human organs by exploring different sources of availability,
188
Introduction
Health care is one of the fields that achieved significant
development in the past century in regard with the advancement in
the technology of care and cure. The innovation in medical care
has reflected as the potential benefits in different dimensions of
human life include physical, psychological and social well being.
Many of the health problems, issues, diseases are under control
through continues research and advanced practices. The
improvement of pharmacology and vaccination methods yields
positive results in preventing number of public health vulnerabilities.
The first organ transplantation in the year 1952 was one of such
milestones in the history of medical care, especially the critical care.
It gave hope to a colossal section of population who are under the
burden of organ failure. Organ failure is a public health issue, thats
having significant implications on the lives of people and the whole
society. The failure of a human organ is disabling him/her in holistic
aspects of life which include familial, economic and psychological
and social dimensions. The possibilities of modern medical science
can be better utilized for overcoming the issues created by organ
failure, but the shortage of organ availability for transplantation is
a constrain. The changing epidemiology of health problems shows
that organ failure is one of the foremost health issues that create
significant socio-demographic, psychological and economic impact.
Every year lakhs of people were dying or severely disabled due to
the failure of organs. Most of the organ failures are threaten to
sustain life and organ failures like corneal blindness lead to extreme
kind of socio- physical disability. Organ transplantation is the most
suitable and last option for many diseases, but the shortage of donors
190
affects the hope and life of people, who are waiting for organ
transplantation with terminal illness. Unofficial statistics from India
indicate that there are nearly 300 deaths every day due to failure of
organ. That is more than one lakh deaths per year (Sudheendran,
2010). There are several issues which related should be highlighted
in relation with the organ failure.
192
Organ Transplantation
Organ transplantation is a surgical method where the failed
organs of human body is removed and replace with a healthier
one. The advancement in medical technology significantly influences
in the quality of the surgery and post surgery care. Today, most
organ transplantations are safe procedures, no longer considered as
experiments, but considered as treatment option for thousands of
patients with medical indication, such as those suffering from renal
failure, heart diseases, respiratory disease and cirrhosis of liver (Otak.
K, 2004). Organ transplantation has been hailed as one of the
194
Brain Death
Brain Death is the irreversible and permanent cessation of all
brain/ nervous system functions. Brain is the centre which controls
the vital body activities includes the basic and necessary functions
like breathing, sensation, obeying commands etc. Most of the brain
deaths are due to the head injuries. Brain death is a complex issue
encompassing overlapping areas of medicine, philosophy, ethics,
and the law (Laureys S, 2005).Conformation on brain death is
medically and legally a sensitive issue, the procedures are different
from countries to country and region to region. In India, organ
transplantation is regulated by the Transplantation of Human Organs
Act, 1994. The act defines brainstem death to mean the stage at
which all functions of the brainstem have permanently and
irreversibly ceased.
This Act calls for a panel of four physicians to make the diagnosis
of brainstem death, composed of the following team.
(i)
Physician treating the patient
(ii) Physician in charge of the hospital treating the patient
(iii) A specialist physician from an unspecified specialty
(iv) A neurologist or a neurosurgeon.
In the context of organ transplantation, brain death is one of
the potential sources of organ. Therefore one cadaveric donor can
possibly save many terminally ill patients by donating both solid
and non solid organs, as indicated in the Table. No. 01. Cadaver
transplantation involves declaring brain death, seeking permission
from the relatives, retrieval of the organs, storage of organs, transport
to the recipients hospital and ultimately transplantation. The first
two stages are the more difficult ones (Illangovan Veerappan, 2012b).
There are number of organs, that can transplant only from the brain
dead individuals, heart, and lungs are the typical examples. Deceased
donor transplantation has the potential to significantly reduce the
mismatch between need and availability of the organs for
transplantation and minimize the burden on living donors for organ
donation (Illangovan Veerappan, 2012c).
Living Donor
Living Donor
A considerable percent of organ donation in India depends up
on the living donor; most probably the potential donors are the
relatives of the patient. A live donor who wishes to donate organs
can do it in two ways.
1. Donate one half of the paired organ set: Kidney is the best
suitable organ that can donate among the paired set of human
organs. Even with among the pair, both recipient and donor
can live healthily.
196
198
Conclusion
Social interventions for sensitizing the issue of organ donation
can make a positive result. An intensive and grassroots level
awareness only can make the things possible. The issue of organ
availability will be manageable only when people are ready to donate
organs voluntarily after death. The typical example of such
improvement through awareness in medical field is blood donation.
Before two-three decades availability of blood in the same group
was a risky task but the meanwhile it has been improved a lot with
millions of potential blood donors. The voluntary organ donation
can also cease the commercialization of organ transplant. According
to Delmonico (2009) the ease of communication technology in 21st
century made organ trafficking and transplantation tourism/
commercialism in to a global issue, accounting 10% of the organ
transplant performed yearly in the world. The potential benefits of
voluntary organ transplant after death can prevent these kinds of
evils practice and shed hopes on the lives of many people.
Reference
Abouna
2008
Alkhawari FS,
Stimson GV,
Warrens AN
Childress JF
2001
Chugh KS.
2009
Delmonico. F.
2009
Linder,
2009
Moosa. M,
2008
200
Ota. K.
2004
Peoples Health
Report
2009
Rito Paul
2011
Sudheendran,
2010
Tom scheve
2008
Vathsala,
2004
Veerappan Illango
2012
WHO
2013
Abstract:
Children constitute 39 percent of the total population and majority
of the children (72% of the total child population) are in rural parts
of the country who are living in an unequal condition compared to
their urban brethren. Due to ignorance, lack of facilities, and omission
by the duty bearers most of the rights of the rural children are violated.
In the best interest of children several meaningful and powerful
statutes and systems are created, but fail to reach the poor and rural
children resulting in their continued exploitation. There is an urgent
need for the concerned statutory body like the District Juvenile Justice
System to take note of the real condition of rural children with facts
and figures and direct the concerned duty bearers to deliver expected
services. If we ignore the rural children today, all the good intended
programmes, projects and statutes fail our young citizens.
Introduction
Till recently, the United Nations Convention on the Rights of
the Child (UNCRC) 1989 was one of the favourite subjects to discuss
at the podiums and seminars. It was also a very good material to
202
204
Sex ratio: While the Sex ratio in all age groups is 943 [Rural
949 and Urban 929]; the child sex ratio [0-18 years age group]
is 907 [Rural 911 and urban 896].
Health: Although India has made several strides in achieving
health targets, large chunk of children are still out of
immunisation cover, routine health checkups, referral services,
ICU care due to inactive PHCs.
Child Marriages: In every 100 marriages, 47 brides were
below 18 years. [56 Rural and 29 Urban]
School Dropouts: In the midst of the much acclaimed RTE
Act and other programmes and having almost 100%
enrolment in schools, 50 to 60% of children dropout much
before they complete their primary schooling. Again rural
dropout rate is higher than the urban areas and added to it
girl child dropout in rural areas is much higher than the
latter. Over and above, the recent studies also have shown
that children in schools have not attained required academic
skills that re expected to be.
School facilities: Most schools and particularly rural schools
[Government, aided and unaided] schools even today report
lack of basic facilities, adequate number of teachers, etc] that
result in poorly equipping the students who fail to compete
with their counterparts from urban areas.
Missing and run away children: On an average one lakh
children go missing in the country and almost 50% of the
missing children go untraced. It is girls from rural areas who
are the most susceptible. As per the reported number of cases,
a child goes missing every 8th minute.
Child labour: As per Census 2011, the child workers [in 5 to
14 years age group] number is around 43 lakhs [2001 it was
1 crores 26 lakhs]. Although this sounds very encouraging,
one may have to question about what do the school dropout
children do and where do the missing children go?
Abuse, violence, crimes against children: The statistical trend
clearly shows that there is increase in the reported number of
206
208
References
GOI
2013
GOI
2011
GOI
2009
GOI
2014
GOI
2000
GOI
2011
GOI
2015
GOI
2014
GOI
2011
210
GOI,
2005
GOI
2012
GOI
2000
GOI
2006
Govt of
Karnataka,
2006
Nayak.CD
2003
Olinda Pereira
Karnatakas Social Work's Finest Icon
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Urban poor development
Microfinance
Other (Specify) ........................
9. Major Activities
Health
Education
Adult education
Vocational training
Residential Care
Old age home
Day care centre for elderly
Counselling
Advocacy/ Campaign
Other (Specify) ...................
10. Have you received grant from any govt agency ? Yes No
11. Kindly suggest other NGOs and their Contact Details to
include in this NGO Directory.....................................................
.........................................................................................................
Niratanka, #244, 3rd Main, Poornachandra Road,
MPM Layout, Mallathahalli, Bangalore-560056.
Contact-080-23213710, 8064521470
http://angokarnataka.blogspot.com/