Health Care in India the concepts of health and disease are variable in different socio-cultural context.

The WHO defines health as "a state of complete physical, mental and social well being". Health behaviour should be adopted to prevent disease and promote general welfare. The constitution of India envisages the establishment of a new social order based on equality, freedom, justice and dignity of the individual. It aims at elimination of poverty, ignorance and ill-health and directs the state to regard the raising of nutrition and standard of living, improvement of public health as among its primary duties for men, women and children. Successive 5 year plans have been providing the framework within which states may develop their health services, infrastructure, facilities for medical education and research etc. There is a ntional health policy which states that disease should be prevented and general welfare should be promoted. In the last three decades, considerable progress has been achieved in the promotion of the health status of the people. Mortality rates have decreased and diseases like small pox, plague, malaria have been controlled to a large extent. A network of hospitals and dispensaries have been built where specialised curative care, a large stock of medical personnel and a significant indigenous capacity to produce drugs, hospital equipment, vaccines etc. Universal immunisation programmes have been undertaken.. Inspite of all this progress, the demographic and health picture of the country is a matter of serious concern. The high rate of population growth has an adverse effect of the quality of life. Mortality rates among women and children remain high. Malnutrition is severe and diseases like TB and blindness have a high incidence. Only 30% of the rural population has access to portable water and thus incidence of water borne diseases is very high. 0.5% of the rural population enjoys basic sanitation facilities. Poverty, ignorance and infectious diseases are responsible for not only the high rate of mortality but people are also deprived of basic health facilities. A sociological knowledge of people's needs and desires can help in enlisting the people's support in health programmes and the evaluation of these programmes. The behaviour patterns and the lifestyle of the people affect health, such as food habits, beliefs and therefore every region needs a different program. Lack of education and a stressful environment are some of the causal factors affecting mental health. In 2000 AD in India, one in every 40 adults was infected with HIV and the figure is projected to be above 5 million in the next few years. The WHO is sphere-heading a campaign against AIDS. The HIV virus enters the blood stream and leads to a collapse of the defense mechanisms of the body. All the body fluids contain this virus and when it enters the immune system, it is helped by the T-cells and therefore has multiple effects. High risk groups include truck drivers. prostitutes, CSWs and migrant workers and every infected person is a career. In modern times, mobility, social isolation, conditions of work are conducive to the spread of this problem and in the long run it disrupts people's family and social life. The existing health situation in the country is largely endangered by the development policies based on western models which are inappropriate to the real needs of the

people and the socio-economic conditions of the country. Most medical services and a hospital based approach benefits the upper-crust in urban areas. The doctor-patient relationship in a hospital setting is impersonal. Another problem is securing the public's and individual acceptance in participating in preventive health programmes. People usually demand curative services to treat their illness. What is needed is a comprehensive primary healthcare service for the entire population in the rural and urban areas. Policy makers must learn to think like the people of the community. The continuous emphasis on the curative approach has led to a neglect of the preventive and rehabilitative aspects of healthcare. Various health programs have failed to involve individuals and families in establishing a self reliant community and identifying its health needs and priorities. In India, there are certain traditional indeginous health systems such as Ayurveda, Homeopathy, etc which must be treated as alternatives. The readily available resources must be used and a harmonious social environment must be created so that a comprehensive health policy is evolved. Primary healthcare services must be decentralised and public health education programmes for adults and families must be started. Individual responsibilty on prevention, promotion and rehabilitation must be emphasised. This is a dynamic process of change and innovation through a timebound phased program. Research for eradicating diseases must be funded. The slogan should be 'Health For All' and the right to healthcare must emerge as a movement. The national health policy must be developed as an important issue of survival.

Education in India: Historically, India has many learning centres but education was confined to the males of the higher castes and was mainly religious in content. The western type of education came to India with the British Raj. The Indian constitution made the right to education as a directive principle and the responsibility for it was to be shared by the Centre and the State. All the 5 year plans have emphasised that education must be an intergral part of economic planning. Inspite of the growing investment in education, 40% of our population is illiterate and the dropout rate is very high. among girls as compared to boys at primary level. Many private institutions have emerged in recent years and education has become a marketable commodity. But hte quality of education remains low. The education policy in India defines the essence and role of education. It states that education should be for all and should lead to the all round development of the individual. Education has a enculturing role, in that it promotes a scientific temper, independent thinking, refines the sensitivities and perceptions that contribute to national cohesion and further the goals of socialism, secualarism and democracy. Education develops man power for different levels of the economy. It is also the substrata on which the research perishes and it leads to both spiritual and material development and self-reliance. In brief, educaiton is a unique instrument to bring about social change in the present and future and this is the cardinal principle of the national policy in education.

In 1966, the Kothari commission was appointed to look into the relationship between education and productivity. A year earlier Kendriya Vidyalayas were started in different parts of the country so as to have a uniform system of education for transferrable employees of the govt. The constitution has guaranteed free and compulsary primary education for children under 14. To facilitate this, chid labour has been banned. The attendence rate at the primary level has been increasing but due to economic and social conditions, the dropout rate is high. Moreover, education is not really free at the primary level. 80% of the elementary level schools are run by govt or supported by it. There is a shortage of resources, a high teacher-pupil ratio, poor level of teachers and a lack of political will. Though primary education is supposed to be available in every habilitation, it is not enforced. The stress of education is mostly on rote learning. It is essential that the teachers at the priomary level be well trained and education integrated with the life of the people. In 1968 the National Policy on Education aimed at promoting a rational, progressive sense of common citizenship and culture so as to strengthen integration. Attention was drawn to science and technology, the cultivation of moral values and a closer relationship between education and the life of the people. This led to the establishment of schools at all levels in the country, specially in the rural areas. It also introduced the 10+2+3 system in which work experience was an essential component. There was a restructuring of the undergraduate courses and an attempt to improve the quality of education. Unfortunately all this did not translate itself into a strategy of implementation and the problems of finances and access to quality education remained. In 1976, education was brought into the concurrent list. The National Policy on Education in 1986 provided for an environment to create awareness of science and technology, stressed women's education and the education of the disadvantaged sections of society. The Sarva Shikshan Abhiyaan Scheme was launched to enhance enrolement. Traditional subjects like yoga were brought into the perview of secondary education and vocational training was emphasised. The goal was to bring about social change in the country. New texts were published, funds were increased for secondary education, there was an expansion of new schools and syllabus was restructured in tune with the social framework of each state. There was networking amongst different insitutions for research and development. Education was to be equally accessible for all and hence there was an emphasis on adult literacy and distance education. Technical institutions of a very high standard came up. However university education still remains in a state of despair. There are cases of fake degress been granted and commercialisation of education at a higher level. However this education is confined to only 10% of the student population. The NCERT is the apex body to frame the curriculums and provide technical support to educational institutions. There is also the UGC (Universal Grants Commission) which has an important role to give shape to the national system of education and it works with bodies like the Indian Medical Council and the IITs. India has the 3rd highest number of higher education institutions, but sadly most universities are politicised. Literacy of women still remains very low inspite of numerous campaigns. Rural educaiton remains poorly funded and under starved. An

attempt has been made for increasing the expenditure for the development of education. Education which was a Directive Principle ahs now become a fundamental right under Articles 45 and 46 in 2002. However, the priority given to education in govt policy remains low while in fact the ultimate aim of the education policy should be to transform education into a powerful instrument of qualitative and quantitative social change and national development. TERI (The Enery Reseach Insitute) It is an advisory body where Mr.Pachauri works. It is a govt initiative taken to look at the enviroment. The private initiatives have been the CSE working in the area of air pollution, pesticides, water, and colas. It is also working on the green rating for industries such as automobiles, papers, cement. A recent environmental impact has been the cancellation of coal mining by the Adani Group. Q. What does Pachauri call his iron mine field? A. TERI Ore. PROJECT TIGER: It is a wildlife conservation movement initiated in India in 1972 to protect the Bengal Tiger. The project aims at conserving tigers in specially constituted tiger reserves representative of various biogeagraphical regions throughout India. There are more than 40 Project Tiger reserves in India and according to the 2008 census, the tiger population has dropped to 1411. At the turn of the 19th century, the figure was 45,000. The project was launched in 1973 in the Corbett National Park. Global organisations like the WWF (World Wildlife Fund) have contributed to the funding of this project. But sadly, many of the field doctors use the fund and manipulated the tigers census numbers. Activists and environmentalists like Valmiki Thapar and Velinda Wright have demanded that the Prime Minister establish an independent census to determine the actual number of tigers in India. When Indira Gandhi was the PM this project achieved a recovery of the habitat for the tiger population and a consequent increase in the tiger population. Since tigers are an important indicator of the entire ecosystem, all other wild animals have increased their population. It is unfortunate that poachers are killing these endangered animals. Today wildlife protection requires a state of the art information network and communication technology. There is also a need for awareness among the people and the modification of the land use policy through regional planning. VAN PANCHAYATS: Communal forests in India are typically administered by a locally elected body which is known as the Van Panchayat. Legislation pertaining to such panchayats varies from state to state but the state govt retains the right over matters such as staff appointments and penalisation of offenders. After independence, the govt of India instituted the National Forest Policy which classified forested areas into protected, national, village and common. A direct outcome of this was the empowering and involvement of local communities in the protection and development of forests. Pilot projects were started as early as 1971 in West Bengal. As of September 2003, all 28

state govts had initiated the Joint Forest Management Programme and many past appropriate legislations. Van Panchayats have maintained and guarded Uttarakhand's forests efficiently and continued to play a crucial role in protecting the state's natural resources. They prevent encroachement, forest fires, illicit cutting, smuggling of forest produce, poaching of wild animals and regulate grazing. The importance of this program is evident in that they had raised about 1..58 million hectors of plantations in the country and are also able to meet the needs of the villagers for fodder and fuel. Most of these Panchayats however have failed to ensure the participation of women in their committees. Most of the women are satisfied in growing trees in their homestead to meet the families' immediate needs. However it is necessary that women who are regualr visitors to the forests should have more say in the village committees and play a more positive role so that the participatory development process can be implemented. Intorudction to Maharashtra Economy: Chief Agrucultural Relations: MH as compared to other states is one of the top economic performers with respect to per capita incomee. However this fact conceals the enormous urban-rural contrast and regional disparities. Agriculture emerges as the key sector in the state specially with reference to the workforce (55% are engaged in agriculture). Over the years, agriculture's contribution to income has rapidly declined but the workforce continues to perpetuate indicating limited employment opportunities in other sectors. In other words, MH's economy is predominantly agrarian and barring a few districts (Mumbai, Pune, Thane and Nagpur) a major portion of the workforce is predominantly dependent on agriculture for a livelihood and the incidence of poverty is highest among the agricultural labourers. Agriculture in MH is heavily dependent on the monsoons and hardly 15% of the gross crop area is irrigated and 24% is drought-prone. MH introduced some land reforms after 1947 and Tenancy Acts were ammended from time to time. Consequently, some tenants became owners of the land. The small and marginal farmers however had very small land holdings. Agriculture in MH is dominated by food grains, mainly Jawar. This crop is characterised by a low yield and almost entirely unirrigated. There has been a decline in the growth of cereals while the area under pulses has increased. Most notably, there has been a shift towards commercial crops such as oil seeds, cotton and sugarcane. This has been mainly due to the government policy which assures prices for sugarcane and cotton. For this reason, MH contributes only 5.8% of foodgrain production in the country. With respect to the non-foodgrains with the exception of sugarcane, MH has lower yields than the national average. This is mainly due to lack of irrigation facilities and other inputs like improved seeds, fertilisers, machinery and so on. So far as the growth rate of sugarcane is concerned, it is negative because this crop is entirely irrigated and requires a lot of water. Major institutional finance is being given to farming through commercial banks and credit cooperatives. But due to the adverse environment and unfavourable

government policy, loan advances have shown bad debts. Besides no value crops, land degradation is a major problem and the excessive withdrawal of ground water for wells has led to water scarcity. Attempts have been made by the government to reformulate policies and create a suitable environment through land reforms. The private sector is being encouraged to participate and invest in agriculture. It is necessary to generate supplementary employment for farmers since agriculture is a seasonal occupation. MH is diversifying into horticulture, animal husbandry, fishery and sericulture. These are expected to give the farmers other options to make a living. In MH, most agriculture commodities are traded in regulated markets. But selected crops like cotton and sugarcane are marketed through state intervention. The government of MH has been a strong advocate of cooperative marketing of agricultural produce. COOPERATIVES: India is a land of cooperatives mainly as a result of trying to solve problems at the grassroot level and aiming to eliminate the ills of the public and private sector business enterprises. The ILO defines cooperation as an "association of persons, usually of limited means who have voluntarily joined together to achieve a common end through the formation of democratically controlled business organisation making equitable contribution to the capital required and accepting a fair share of the risks and benefits of the undertaking." The objectives are to arrest monopolistic control through self help and mutual help and transform people's lives. In every nation cooperatives have played an active role in empoweing the people in rural areas. In India, the government has emphasised the cooperative sector right from the first five year plan. The modern day cooperative movement is built on voluntary cooperation where individuals make a deliberate choice. Even the British rulers promoted the cooperatives but it really developed in stages in the latter half of the 20th century. The cooperative movement in MH has a long history and from 1960 to 1995, there was a rapid increase in cooperatives and their membership. Sugar: MH has been a poineering state with respect to setting up cooperative sugar factories. The sugar factory was setup in 1951 called the Pravarana Cooperative Society in Ahmednagar district by Padmashree Vikhe Patil. It was very successful and he was helped by some of the leading economists of that time. Thereafter, the state government has been giving direct loans to enable the CSFs (Cooperative Sugar Factories) to complete their projects. They are located mainly in western MH where irrigation facilities and other complimentary inputs are available. These sugar cooperatives have helped to transform the rural areas but sugarcane being a high water consuming crop is pressurising the scarce resources of the government and affecting water supply for other crops. Unfortunately the sugar cooperative movement has put a fiscal burden on the government as there are many outstanding loans. There is also political interference, corruption and mismanagement. Sugarcane factories also result in a lot of pollution. Cotton cooperatives: 36% of the area in the country is under cotton and MH's contribution is 20%. All private trading in cotton is prohibited and the farmer is forced to sell to a government agency which gives a guaranteed price. However the losses of

such cooperatives have been increasing over the years for various reasons such as seasonal harvesting, transport, labour problems and many of the cotton cooperatives are now 'sick'. Dairy: The Indian Dairy industry has been marked by seasonal fluctuations and the dairy farmers were over the years exploited by middlemen who gave them unremunerated prices. Initially dairy development meant setting up modest sized processing plants in cities and small towns. Incidently, MH is the second largest producer of cow's milk in India and in 1958 the Dairy Development Department was setup to encourage formation of milk cooperatives. Earlier in 1951, under the enlightened tutilage of Dr.Verghese Kurian the farmers of Kaira district had formed a cooperative with the right to collect and sell milk directly to the govt and they were paid according to the quality of milk. This was the beginning of Amul, which is the first recorded cooperative in the dairy sector in the world. Amul today has registered a manifold integrated growth with a large range of products and services. It was very well managed with the direct access to the Mumbai market. When Lal Bahadur Shastri visited Anand in 1964, he wanted to replicate the Amul model all over the country. The govt setup a body called the National Dairy Development Board in 1965 under Dr.Kurian. It was meant to be a techinal consultancy body. However, many states did not show an interest including MH because the dairy industry was already set up. Sadly, most of the dairy cooperatives in MH are highly politicised and a suggestion has been made to privatise the industry.. Ex: Mahanand Milk. MH is the only state where the govt fixes the procurement price of the milk. OPERATION FLOOD: Phase I: By 1968, the NDDB had formulated a program to use funds from the state govt to redevelop the dairy industry according to the Anand model. The first phase lasted for 11 years in the 1970s when funds were obtained from the sale of the World Food Program Commodities (WFP). The aim was to capture the market for public dairies in the four metros. The investment would be Rs.2,000 crores and the ruralurban linkage would be established and modernisation of the dairy industry would be started. By March 1978, there was 75,000 dairy cooperative societies helping in marketing and branding. This has been the most successful movement and has often been referred to as the While Revolution. It is seen as an instrument of social justice as the entire supply chain was in the hands of the cooperatives. Phase II: This was financed by the World Bank in 1979 and covered all the major sheds in the country. Phase III: In 1986 to extend and consolidate the share of the dairy market. Some of its ovjectives were: 1. to provide wholesome milk at reasonable prices to city consumers specially vulnerable groups like children. 2. to improve productivity of dairy farming in the rural areas and make them self sufficient. 3. to remove dairy cattle from the cities and take them to the villages. 4. to set up a self sustaining dairy industry to improve the life of the small farmers.

Operation Flood involves an integrated approach towards milk production at the village and primary level. The milk supply is processed at the district level and marketed at the state level. Attention is given to various aspects such as animal husbandry and health of the cattle. Operation Flood has invited international attention as well as controversy. Some feel it has not touched the poorest farmers altough it has benefitted in terms of economic rationality. Today India has become the largest producer of milk and dairy products in the world. In this era of liberalisation, there is a vast potential for export and new challenges in tune with international standards need to be met in the near future. Industrial Development in MH: MH maybe divided into 4 major reasons: Western MH, Konkan, Vidarbha and Marathwada. Each of these regions is divided into districts and talukas for administrative convenience. MH has resources of agriculture, minerals, forests, fisherieexploer and animals. Infrastructure facilities are available in the form of transport, technical education, state corporations, financial institutions and enterprenuers. MH has the largest number of industrial clusters. Although MH has been one of the leading industrial states, there are intra-state disparities. Vidarbha and Marathwada are comparitively backward and hence during the second five year plan, efforts were made for a balanced regional development. However, since all the regions are not equally endowed, this has not been possible. The potential of each region needs to be exploited and for this further concentration of industries must be stopped in Mumbai, Thane and Pune. At the state level, various institutions have been set up to induce industrial development in the less developed areas MIDC, SIDCO, MDIDC, MTDC, SICOM, MSKVIB. Financial institutions like the LIC are also helping industries and the new industrial policy of the govt is to help the industries to help located away from Mumbai city. For this purpose, licences are given freely to attract more investments in the industrial sector so that MH can enter the competitive market. In recent years, there has been remarkable industrial development in Nasik district and there are industrial estates in Sholapur and Kolhapur. Pune has 10.2% of the industries and the unique, first of its kind feature Mumbai Pune Knowledge Corridoor. Nagpur has a diversified industrial structure but the rest of Vidarbha is backward. Likewise, except for Aurangabad in Marathwada, all other districts are backward. The progress of small scale industries has increased everywhere except in Mumbai between 1961 and 1987 because of the favorable policy of the govt to correct the imbalances. A number of initiatives have been taken up to encourage small and medium enterprenuers and IT parks. There are 33 IT parks in MH and many more private parks have been approved and MH has a world class IT industry. Biotechnology parks have been established in Jalna and Hingewadi. The pharmaceutical sector and research facilities are being promoted by the govt and exports have shown a steady growth with readymade garments, metal products, gems, plastic products and so on. SEBI has been established to protect and regulate industrial activities and there are mutual funds who attract investors. On the negative

side, a major hurdle to industrial development in MH has been sick industries and pollution. SEZ : A SEZ is a specially demarkated area of land owned and operated by a private developer for the purpose of trade, duties and tarrifs with the intent of increasing exports. A SEZ is a geographical area deemed to be foreign territory that has economic laws that are more liberal than the countries typical economic laws. Usually, the goal is to increase foreign investment and therefore the nation's trade policies like lobour laws, taxes etc are relaxed to enable the countries settle there, to compete with low cost producers worldwide. One of the earliest SEZ was in China in 1980 and then other countries like Iran, Russia, Pakistan and India followed. SEZs are artificial small pockets that are linked more witht he global economy than the national economy. They are free market economies and help the govt to make economic gains and postpone economic collapse. The slogan is Liberalised, Privatised and Globalised. The policy of SEZ in India was introduced on 1st April 2000 with a view to provide an internationally competitive hassle-free environment for exports and make the domestic enterprises globally competitive. In 2005 June, the Indian govt passed an act to legalise the creation of numerous SEZs which had access to advantages like the workforce, supply base, simplified export procedures and more domestic duties. Even companies that supplied their material to the SEZ units enjoyed all the benefits. However, the SEZ units could not supply their goods in the local market as this would attract duties. The sole purpose of SEZ is to earn foreign exchange through export and with the winds of globalisation, India is a popular destination for multinational companies to economically invest in the SEZ areas. SEZ means displacement of people and land acquisition. Ex: Nanigram. The first Land Acquisition Act was passed in 1894 when the British justified land for 'public purpose'. Compensation was restricted to ownership of documents and paid in cash. This resulted in landless and displaced owners. In 1986, the Land Acquisition Act tried to address the concerns by precisely defining the term public purpose. The forest dwellers had to claim compensation within 60 days. Hence this amendement was only a cosmetic change and undemocratic. The right of the tribals to common property was ignored and the land was seiged from them. The vast majority of rural and tribal dwellers are not eligible for rehabilitation or compensation and there is no alternative regarding employment or land. The govt usually does not return the unutilised acquired land. SEZ has been opposed on socio-economic grounds by various citizen's groups. A resettlement and rehabilitation bill was passed in Parliament in 2007 to take care of the affected families who have been involuntarily displaced. Most of them are SC and ST. Unfortunately, this bill has made it possible for the govt to have absolute power to acquire land without the consent of the people who occupy it. This struggle against SEZ is turning into a bigger struggle against state oppression through dispossession and marginalisation. TEXTILE INDUSTRY IN MH: The textile industry has gone through various phases each one characterised by the social, cultural, economic and political conditions in the country. The history of cotton

and textile production goes back to the East India Company days. The first textile mills came up in Mumbai between 1859 and 1864 and used modern techonology. They were planned with care and were a profit making venture as they were labour intensive and paid the workers low wages. The Bombay Mill Owner's Association was set up in 1875 and was meant to be an instrument of self protection. After 1947, the govt of India undertook a massive industrialisation program and textiles were comparitively neglected. With the advent of mechanisation, the govt decentralised the powerloom sector and gave preference to cooperatives and textiles. Some of the mills adopted new technology and provided branded cloth for the upper classes. The old mills did not modernise and had a low level of productivity. Their mill owners preferred to transfer much of their capital to other activities. Consequently, their textile mills became sick and declared themselves bankrupt. They were taken over by the NTC (National Textile Corporation). Much of the technology which was imported for manufacture of textiles was adopted by those mills who came up with a superior product. In the 1960s, when foreign resources fell and import licences were cut, cotton prices rose and this affected developments in the textile industry. Infact, the overall trends in Indian industry are reflected in Bombay's textile mills. Modernisation increased the workload and the accent was on increased productivity. Thia laid open the ground retrenchment and had a direct bearing on the nature of labour consciousness and organisation. JOHANNESBERGE SUMMIT: The world summit on sustainable development was held in Johannesberge, South Africa from 26th August to 4th September 2002. It was popularly known as the Earth Summit and was convened to discuss sustainable development by the US. The Johannesberge declaration on the sustainable development builds on earlier declarations made at the UN Conference on Human Environment and the first Earth Summit in Rio 1992. It is an agreement to focus on the world wide conditions that pose severe threats to sustainable development such as chronic hunger, malnutrition, armed conflict, organised crime, corruption, natural disasters, illicit drug problems, arms trafficking, trafficking in persons, terrorism, intolerance, xenophobia, chronic diseases like HIV AIDS, Malaria, Tuberculosis etc. An agreement was made to resotre the world's depleted fisheries by 2015. Instead of agreements between govts, the summit was organised mainly around 300 'partnership initiatives'. One of the important features was the absence of the US. George Bush boycotted the summit. The Earth Summit was criticised for excluding a variety of organisations and individuals who are instrumental in conservation and green history. The real people were excluded.