Head of institutes or associations should avoid chairing routine meetings

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Dr KK Aggarwal

Some days back I attended a function, where Prof NK Ganguly, Former Director General (ICMR) also spoke.

He said something very interesting. He said that he tried to avoid chairing committee meetings as the head of the organization unless absolutely required to do so.

“I preferred constituting expert committees instead as I can’t be an expert in all fields.” The reasoning behind this approach is clear. If the head of the institution is chairing an expert committee meeting, all those attending the meeting hesitate to speak up and they tend to defer to the views of the institute head. “I want their views, not just my views,” he said.

It was a lesson for me. At IMA we have different committees, each with different assigned functions such as family welfare, medical education, medical ethics, anti-quackery, rural health and national plans, to name a few and each with a designated Chair.

As National President, I have been chairing many meetings and now I personally feel that this may not always be the right way to look for ways to solve a problem or any issue.

The more junior staff tend to defer to the Chair or more senior colleagues. The right way to do it is to involve experts. This is what we routinely follow in standing committees for finance and building.

Diversity of ideas, even if dissenting views, can change the way we think.

Brainstorming or ideas and viewpoints gathered from a group of people give different perspectives, different interpretations of any given situation and different ways of solving that particular situation. Diversity leads to creative and innovative thinking as ideas that come up are often original in thought.

In the remaining term of my tenure, this is what I will try to do i.e. chair fewer meetings and attempt to gather more wide ranging ideas by letting experts take the chair and tap into their knowledge for the benefit of the Association and in turn the fraternity as well as the community.

Disclaimer: The views expressed in this write up are entirely my own and do not represent in any way the official stand of the IMA.

Celebrate the centenary year of IMA’s All India Medical Conference: Wear Khadi

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In September this year, the Indian Medical Association (IMA) will hold the 218th meeting of its Central Working Committee (CWC) in New Delhi.

This year also marks the 100 years of IMA’s All India Medical Conference, the first of which was held at Calcutta in 1917.

The concept of IMA was born out of these conferences in response to a need of a national organization of doctors. A resolution adopted at the 5th All India Medical conference held at Calcutta in the year1928 led to the formation of an All India Medical Association. The objectives were to improve medical education, promote medical and allied sciences in their different branches and safeguard interests of the medical profession. The All Indian Medical Association and the body were duly registered in the year 1930 under the Societies Registration Act, XXI of 1860.

At its inception, the Association had only 222 members. But since then it has only grown from strength to strength.

Today, IMA has more than 2.5 lakh doctors as its members through more than 1765 active local branches spread across the country. It is the only national voluntary organization representing the collective consciousness of doctors of modern scientific system of medicine in the country, with its Headquarters in New Delhi.

This is also a time to remember the struggles and sacrifices of the founding members, both before and post-independence, not only in the formation of the Association, but also for the independence of our country as many of the stalwarts of the medical profession in those days had also served time in jail for their participation in India’s freedom movement.

In this centenary year of the All India Medical Conference, we can pay our tribute to our founding fathers by promoting our national heritage.

Khadi is one way by which we can do this. It is not merely a piece of fabric, khadi is a powerful symbol of “self-rule” and “self-reliance” of the freedom movement propagated by Mahatma Gandhi as a means to boycott the British textiles.

Khadi is made of natural fiber and is non-allergenic; it keeps the body cool as it allows better air circulation with less sweating. Being hand woven and hand spun makes it environment-friendly. By virtue of these properties, does khadi prevent skin infections? This can be a subject of research.

All of us should consider wearing Khadi voluntarily, and include it in our daily wear, as much as possible. And, I request all members to wear a ‘Khadi apron’, particularly during the centenary celebrations. And, also on 2nd October, when all doctors of modern medicine in the country will undertake a dawn to dusk fast in continuation of our Dilli Chalo movement.

This initiative will be a good way to not only honor our cultural heritage, but also preserve this invaluable legacy and carry it forward. Also, by wearing khadi, doctors can make their contribution in empowering khadi weavers.

Wear Khadi with flair, wear khadi with pride…

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

IMA White Paper on Indian Medical Service

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The Indian Medical Service owes its origin to the East India Company formed by the British. It was on December 31, 1600 that Queen Elizabeth granted a charter to the Association of Merchant Adventures of London to trade with the East, which gave birth to the East India Company. As a matter of fact the establishment of the company was a result of a huge struggle amongst the nation for the control of lucrative spice trade, in which to begin with the Venetians, then the Portuguese, the Spaniards, the Dutch, the French and finally the British came to be drawn into the treasure hunt.

For the said trade, the First Fleet of the East India Company under the command of Captain James Lancaster, in December, 1600 sailed out. Each of the four ships in the fleet carried ‘Surgeons’ and a ‘barber’. They came to be designated as ‘Ship Surgeons’. This was also the voyage, which resulted in experiment on lemon juice as a cure for scurvy.

With the establishment of trading posts around India, more surgeons and physicians found employment not only with Europeans but also in the service of wealthy natives. These men of medicine included Nicholas Manucci, a Venetian, born in 1639, who served Dara Shikoh before studying medicine in Lahore where he served Shah Alam from 1678 to 1682. An Armenian named Sikandar Baigh served as Surgeon to Suleman Shikoh, son of Dara Shikoh and there are records of several Dutch and French physicians in courts across India.

Surgeons were also availed for diplomatic missions to various courts and they were found to be very effective. Operationally speaking, the Indian Medical Service (IMS) was a military medical service in British India, which also was attributed some civilian functions. It has served during the two world wars and remained in existence until the independence of India in 1947. Many of its officers who were both British and Indian served in civilian hospitals as well.

The East India Company in 1614 introduced a hierarchy in their establishment with the appointment of a Surgeon General. The first to be appointed to the said post was John Woodall. However, he was accused of financial embezzlement in respect of pay from apprentices as a result of which he was retrenched in 1642.

There are many anecdotes of which one of the important depiction is of Gabriel Boughton who is reported to have saved Shahjahan’s daughter Princes Jahanara from injuries due to burns. In reward he was given Duty Free Trading Rights and it is said that it was the very document, which was availed by the East India Company to procure Rights for itself from the ruler in Surat.

Historically speaking the First sign of organization came into being with the establishment of the Bengal Medical Service on 20th October, 1763, with fixed grades, rules for promotion and services. On the similar lines Madras Medical Services and Bombay Medical Services came to be established in 1764. It was due to increased military actions that compelled the separation of ‘Military Surgeons’ from the ‘Civil Surgeons’.

As a matter of rule each nonnative military regiment had a surgeon and as a result of which the strength of the medical service grew. A census record of 1854 reveals that the Bengal Medical Service had a strength of 382, while Madras Medical Service had 217 people and Bombay Medical Service had a strength of 181. The medical services of these three Presidencies were united into a single Indian Medical Service after 1857, which was in vogue till 1947.

The personnel under the medical services contributed to the foundation of other departments as well under the organization of the Govt. Dr William O’Shaughnessy, while serving as Professor of Chemistry at Calcutta conducted the first experiment for the introduction of electric telegraph in India and was designated as Director General of Telegraphs in 1852. In 1861, Dr James Rankin was appointed as Director General of Post Offices in India. Dr John Royale represented the East India Company as a Reporter on their economic products as the great exhibition of 1851 and the first four appointments of Conservator of Forest were also filled by the Medical Officers under the medical services of the presidencies.

In 1858, when the Crown took over the Government of India, and in the context of several epoch making developments that were occurring in the art of medicine the Indian medical service entered upon a new phase of the history. The General Hospitals were built in the presidency towns and several smaller hospitals and the dispensaries came to be established in the Districts. In 1835, a medical college was founded at Calcutta and another one at Madras. A decade later another medical college was instituted at Bombay. From 1853 onwards, several medical schools were laid out, which mandated the services of the medical officers working under the presidential medical services to be availed for teaching at the initiated medical schools till they had trained graduates to succeed them.

The Indian Medical Service always primarily remained a military service so as to provide medical officers for duty with the Indian Army in the time of War. During the 1914-1918 First World War, the service was represented in France, Palestine, Asia Minor, Persia, China, East and West Africa. Ninety-two Retired officers rejoined for duty and well over 1000 temporary commissions came to be granted. Likewise during the Second World War, more than 1000 filled medical units were mobilized over and above, the hospital accommodation for 11000 officers and 1.50 lakh other ranks arranged for in India. In the course of all these, members of the Indian Medical Service earned ‘Victoria Cross’ for five times. And one of the recipient of the same Dr John Alexander Sinton was later conferred the fellowship of Royal Society in his researches for the problems of Malaria.

It is a matter of record that in the legislative council in Delhi in 1918 a motion was brought forward by an Indian Member of the council to disband the Indian Medical Services primarily on the ground that India was a poor country and could not afford to maintain such a service.

The defense that was put forth by the then Surgeon General Dr Edwards gives a significant insight into the utility of the Indian Medical Service at that point of time. The text of the defense put across by him is as under:

“I need not dwell, on the fact that this resolution is tantamount to the abolition of the distinguished service to which I have the honour to belong, but before proceedings with my reply I wish to say few words concerning the work which has been done by this service in recent year and which is still being done, for I do not think that this council is fully aware of the extraordinary value of the Indian Medical Service not only to India but to the world at large. This service has worked out the life history of the malarial parasite, a discovery which has revolutionized our ideas concerning malaria and which, among other things, has enabled the Panama Canal to be successfully built. It has reduced the mortality of cholera by 2/3rd and Shorn amoebic dysentery of most of its terrors. It has worked out the method of transmission of bubonic plague, work which points the way to the ultimate eradication of that disease. Enlarge prostate, that terrible and fatal concomitant of old age, can now be overcome, thanks to the member of Indian Medical Service, while in the domain of eye surgery more specifically with regard to cataract and glaucoma the work of the service is recognized throughout the scientific world.”

The resolution so moved did not succeed and the Indian Medical Service continued for nearly three decades thereafter with significant work and contribution in research and the unending problems of public health resulting in several achievements as a result of which it stands the scrutiny at the bar of history. Great names attached with it are Ronald Ross, Leonard Rogers, Rickard Christophers, Robert McCarrison, Henry Shortt and many others.

In the year 1943, the Government of India, decided for a review of the whole medical position and also to seek suggestions for future improvements. In fact it was aimed that evolving a model like that of National Health Service, however, the disease burden that was observed was too huge. It was stated in the report that in India that nearly 10 crore suffer every year from malaria. Five lakh deaths from tuberculosis every year and a further 25 lakh active cases required treatment, cholera, small pox and plague add to the said disease burden. The other diseases of topic namely leprosy, filaria, hookworm, guinea-worm saddle the country with innumerable chronic sufferers. To combat adequately, this magnitude of disease burden and many other problems involved and to provide a comprehensive health service for whole of the population would require a staff of 2.5 lakh doctors, 7.50 lakh nurses along with a great army of associate medical workers. The Indian Medical Service which served India, so well almost for last 300 years definitely had prepared a way for the same, but when power was transferred in 1947, the Indian Medical Services stood abolished.

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