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Rapid Responses: Rapid Responses published:
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Doctor's Role during Conflict
- Paras Kumar Pokharel (15 June 2002)
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A Risk factor for Conflict
- Rajnish Joshi (15 June 2002)
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Apathy: Facade for lack of emotional insight.
- Rajesh K Nagpal (16 June 2002)
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Well done docs
- Arun N Patel (17 June 2002)
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BMJ and international politics
- Somnath Mukhopadhyay (18 June 2002)
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Balanced view
- seshubabu gosala, Balanced view required (19 June 2002)
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Responsible medical fraternity
- praveen govind, Dr.varadarajan kumar (21 June 2002)
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Nuclear conflict in South Asia
- Sikander A Arshad (26 June 2002)
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The other side of the story
- S Vinod (29 June 2002)
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A vital subject. Where do we go from here?
- Sunil K. Raheja (30 July 2002)
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Paras Kumar Pokharel, Associate Professor BP Koirala Institute of Health Sciences,Dharan,Nepal
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Dear All Role of Doctors during conflict is ignored or undermined in medical curriculam. Nowhere it is mentioned how social conflict can be a cause of chaotic scenario and damage Public health system. There should be active advocacy against war, riot, terrorism etc in any form. Doctors should come forward as they come to raise the high salary in comparision to other professionals like school teachers, hospital or agriculture workers in the Community. Most of the time it has been mentioned how TRIAGE is important in War. Is it worth to spend sleepless night and day to save a low birth weight baby whose parent was asked to leave the hospital against Medical advice, because she can not afford the charges she has to pay. In the morning Doctor reads in news that 200 maoists, 50 army personnel and a few dozen police officers died in the battle. Reading the article from two eminent Doctors from Pakistan and India we all hope it should go in our professinal ethics to do our best from the place where we are. There are other Countries and people living closely in case of Nuclear Conflict they will be affected for not their cause example Nepal,Bangladesh,Bhutan,Maldives and Srilanka. Time has come to play a wider role of so called Intelligentsia of this region. Unfortunately the role remains static like a Show Case Piece as it appears this time in BMJ. We never heard any active role of both respected Doctors in the Fraternity they are attached too. Wish the best for making concern in time through your journal. It may give food for thought to all of us to think of issues politicians have taken for granted on behalf of us. Paras |
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Rajnish Joshi, Resident, Internal Medicine MGIMS Sevagram, Maharastra, India 442102
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It is indeed ironic, that the bloodiest of all the conflicts in last 20 years, have all taken place in some of the poorest countries, making them poorer still. Let it be 23 year old war in Afganistan, Khmer in Combodia, or the Civil wars in Ethopia, Sierra Leione, or Somalia. Poverty does not seem to be an impediment to conflict. India and Pakistan, have maintained an egoistic posture for many years now, and cost has never seemed to be an consideration either. They have raised one of the largest armies in Asia!! Poverty seemingly is a strong risk factor for conflict,a pathophysiology which would be hard to explain. Is there some overdrive supression or burning out effect towards peace or harmony ? |
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Rajesh K Nagpal, Consultant Psychiatrist Manobal Klinik, A 2, Rajouri Garden,New Delhi 110026
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The medical community in India is an embattled lot. Information overload, Consumer Protection Act, numerous license requirements, growing society's disaffection with doctors, insurance entry into health care and corporatisation of health care has resulted in a confused insecure medical community. With this background,apathy to the disastrous consequences of nuclear warfare can be readily understood. However for the medical community to rise above their narrow concerns and serve as opinion makers and moral watchdogs, we will have to ,through a regular diet of information about nulear warfare and it's devastating consequences, first educate ourselves. National Associations of both countries can spearhead the initiative to educate ourselves. Local data base of the unintended consequences of nuclear warfare will have to be extrapolated from Western literature and documented by a joint team of doctors from India and Pakistan. |
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Arun N Patel, Specialist Regisatrar - PHM North Nottinghamshire HANG21 0ER
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The two doctors who raised this issue must be congratulated. Populations from both countries view each other with suspecion and that includes "Educated and elite" who can have some influence on what goes on in thoes countries. Forging an alliance at population level and removing misunderstandings created by so called "religious dogmas" is the way forward for both India and Pakistan.Their population is caught in a cycle of poverty while they spend millions on arms race. Writing from the west may not be viewed well, but we can certainly support the efforts of doctors in thoes countries. What can we do on this side that can help such bold and visionary initiatives? |
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Somnath Mukhopadhyay, Clinical senior lecturer Dundee
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I was sorry to note that the BMJ editorial column has become politicised, as follows: "To a large extent the numerical superiority of the Indian army and air force translates into a no win situation for Pakistan in the event of a conventional conflict. Faced with the potential of humiliation and dismemberment in such a scenario, a nuclear first strike becomes a frighteningly real possibility." (editorial 15 June 2002) This is Pakistan's point of view, strongly disputed by India. It almost 'justifies' the use of 'first-strike' nuclear weapons. The contrary view is that stopping the export of terrorism in the short term and working towards the long-term goal of a nuclear-free world will substantially reduce risks of both nuclear and anuclear war. The medical issues surrounding nuclear proliferation, threatening to use nuclear weapons and eventual warfare are serious enough. The BMJ can contribute positively to the medical debate. It can also cause much harm by getting involved in the political debate between nations. If the BMJ does wish to take part in political debate, all aspects of an argument should be presented, maintaining strict neutrality. The editors require to take an extremely cautious line in order to protect the international reputation and standing of the BMJ. |
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seshubabu gosala, chief medical officer visakhapatnam 530024, Balanced view required
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The information in the article does not add upto any thing which is not known to the doctor community. What is required is proposals of concrete steps to be taken by the medical community at profesional association and individual levels to educate the general public and medical community about the potential dangers and fall out of nuclear war. It is equally important to encourage the governmental and non-governmental agencies to establish suitable infrastructural facilities in anticipation of possible use. It is onething to wish away the use of nuclear weapons and another thing to be realistic of the situation and establish relevent stuctures. what is required is a balanced view and not reminding the community about oft repeated known dangers. |
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praveen govind, SSHO medicine Heatherwood hospital sl58aa, Dr.varadarajan kumar
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Dear editor, As Indian doctors working in UK we read with interest the above article.we dont feel there is a real threat of war between the countries as its a war no side can win.Politics plays such a dominant role that the rest of the voices tend to get suppressed.we strongly believe the media(including the medical journals) should be more active in getting the message of the educated people to the common man. yours faithfully |
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Sikander A Arshad, Consultant in Rehabilitation Medicine Haywood Hospital, High Lane, Burslem, Stoke-on-Trent ST6 7AG, UK
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Bhuta and Nundy state that the recent crises between India and Pakistan is a direct consequence of a lack of human and social development in the region. It is encouraging that a health professional from both countries contributed jointly to this editorial. One way to prevent escalation would be that the academic institutions in both ccountries act like a "community". This is rooted in the belief that in scholarly communities knowledge is tested and defined by challenge, debate and disputation. Without "community", knowledge becomes idiosyncratic; learning succumbs to narrowness; research and discovery becomes shallow and private. A new "community" based on engagement,openness and interacton should be encouraged. This may be a step towards improving social development. |
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S Vinod, director center for cybermedicine and medical informatics
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The other side of the story Sir, I think Bhutta and Nundy[1] gave us only a one sided story. They have failed to substantiate with adequate importance the prime cause for such a situation. The authors have not considered the lingering figures of lives lost along the border and in Kashmir and other parts of the country as a result of continuous state supported cross border terrorism which still continues unabated. I strongly disagree to the statement that "The current nuclear imbroglio in India and Pakistan is a direct consequence of a lack of human and social development in the region". If that was true, worser situations would have occured in many countries of South east Asia and Africa. I think the authors are trying to shift the focus from the prime cause of the current situation: Terrorism. One should be sure for certain that the conflict is not between the two cultures or the two nations, but a conflict between groups of people with vested interests.But as usual, the sufferers are the innocent lives.Indians and Pakistanis have a common history and a common blood .The common notion of of cultural anymosity is just another myth. Though I agree to the fact that annual defence budgets of both countries are growing steadily, I should firmly assert that no country could keep away from spending more when its neighbour is spending to get military advantage over another and to breed hate, anymosity and promote cross border terrorism .A better understanding and mutual trust would result in a drastic decrease in the defence allocations of both countries.Deterrence should be based on mutual trust and understanding rather than predictability of responses. Another interesting fact is that the countries that are in the forefront of the mission to avert a war are the same as the major arms suppliers in the region. I personally think that the need of the hour is to increase the understanding among Medical professionals in both the countries, which inturn would have a direct positive impact on the political understanding between the two countries. REFERENCES [1]Thinking the unthinkable! Preparing for Armageddon in South Asia BMJ 2002;324:1405-1406 ( 15 June) News p 1412 |
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Sunil K. Raheja, Consultant Psychiatrist Learning disabilites West Middlesex Hospital TW7 6AF
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I very much appreciated Bhutta and Nundy's article on the issue of potential nuclear conflict between India and Pakistan. The media interest has dimmed, but the risks have not. What can we as South Asian doctors in the Diaspora do to encourage greater understanding and collaboration between our two countries? I am struck by the example of Europe that was at war with itself for hundreds of years until 1945. The emergence of the European Union has not been without its problems, but one great achievement has been to make the potential of conflict between nations such as England, France, Germany and Italy practically unimaginable. Not to say that the French and English for example have stopped arguing, but at least they no longer come to physical blows. I would value suggestions as to our own practical response. |
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