Editor,
I was glad to see the article on ‘cervical cancer: A preventable tragedy that requires attention’, in the ST, Dec 11,2018 and I’m glad that the writer is raising awareness on the second most common cancer among Indian women. However, on going through the article, I was troubled to see that it has tried to twist the facts, making me wonder who the author would be. Cervical cancer is a disease which can be effectively controlled by using a strategy called ‘screening’, wherein the disease is detected before it manifests itself, thereby making the treatment easy. For several years the world was trying to screen cervical cancer using Pap smear, which, owing to the expertise involved, was impractical to be implemented in India.
In 2014, Indian researchers published their results of a study involving over 70000 Indian women, wherein the examination of the uterine cervix (VIA) by a trained Healthcare worker was effective in reducing the death due to this cancer by 30%. Thanks to this study, the government of India has implemented this screening in 100 districts on a pilot basis.
Cervical cancer is caused by human papilloma virus(HPV) in majority of the cases and preventing the infection by better sexual hygiene is the most effective way of preventing this cancer. While a vaccine may prevent infection, whether that is the best strategy for the country as a whole is questionable. There have been several debates among academics on the role of vaccines in the prevention of cervical cancer. The following are the most important points against use of vaccines.
- The incidence of cervical cancer is on the decline.
- Use of vaccine does not obviate the need to continue screening for cervical cancer.
- Vaccine can protect only against certain strains of virus, whereas many other strains can cause cancer.
- Though costs can be reduced by bulk purchase, we need to first implement screening before we even talk about vaccination on a public scale.
It’s unfortunate that this article deplores pelvic examination (screening with acetic acid-VIA) which is necessary even if the lady has been vaccinated. Besides, HPV DNA testing, which this article glorifies, also currently needs a pelvic examination for the specimen to be collected. While the author incorrectly says that trained clinicians are needed for the VIA screening, only a few weeks of training imparted to general health workers(matriculates) enabled them to perform this effectively in the study quoted earlier.
Screening for cervical cancer is recommended for all women over 30 years of age. An ideal preventive strategy is to improve sexual hygiene, which involves, among others, reduction in the number of partners. While individuals may choose to vaccinate their children before the initiation of sexual activity, whether the government should spend on vaccines for the entire population is for public health experts to decide.
I request Shillong Times to publish articles from credible sources only and mention the author and affiliations too.
Yours etc.,
Dr Caleb Harris,
Associate Professor, Surgical Oncology,
NEIGRIHMS
Illegal Coal Mining in Jaintia Hills:
Editor,
Apropos to the letter to the editor by Manuel Carey Lymba (ST Nov 28, 2018) captioned, ‘Ban Coal Mining Indefinitely,’ I fully agree with the views expressed on this subject. This has become a hot topic in Meghalaya after the assault and the attempted murder of Agnes Kharshiing and her colleague A. Sangma at Sohshrieh village East Jaintia Hills District by the coal mafia. While agreeing with Manuel’s views that the coal mafia comprises politicians, bureaucrats, police and mine owners, I must add that some prominent NGOs are also involved in this illegal mining and transportation of coal to Silchar, Karimganj, Guwahati, Bangladesh (smuggling) and in supplying to cement factories situated in East Jaintia Hills. As a punishment for the illegal coal mining and the attack on Agnes Kharshiing and A Sangma, coal mining should be banned by the NGT for the next ten years or until a new mining policy is framed by the Government of Meghalava.
It is surprising that some cabinet ministers are quick to certify that there is no illegal coal mining in Jaintia Hills District whereas the recent visit to those mining areas by Justice BP Kataki of the NGT Judicial Committee and his team proved otherwise as he found some fresh extracted coal on the road and fresh lubricants applied on the cranes to bring to the surface the extracted coal. Everyone knows that NGT is a toothless lion otherwise why could it not take the help of central forces like CRPF, CISF, Rapid Action Force etc to enforce the ban. Coal trucks are not the size of ants which police cannot see with the naked eye. Anyone can make out while travelling on the GS Road or NH. 44 that the trucks plying with tarpaulin are carrying coal.
As per information collected by me and my colleagues not less than 500 trucks are carrying illegal coal (smuggling) to Bangladesh, Silchar, Karimganj, Guwahati and supplying to cement factories located at East Jaintia Hills. Each truck pays Rs 80,000 to the people concerned comprising ministers, politicians, mafia, NGO’s, police, bureaucrats etc., and this money is shared among them, percentage wise. Government and District Councils don’t earn a single paisa by way of tax, royalty, challan etc. The volume of trade and loss to the Government exchequer is to the tune of Rs 80,000 x 500 trucks or Rs 4 crore daily and Rs 120 crore a month. This has been continuing for the last two years or so. How come the State Government and all the authorities under it are sitting idle and pretending not to know of this illegal mining?
I met some coal mafia involved in illegal coal transportation and they say they rake in more profit now than before as they don’t need to buy coal challans or pay royalty to the District Council and State Government. Otherwise how can they justify buying costly new cars, houses etc. It is a known fact that the DC’s and SP’s of East and West Jaintia Hills and Ri Bhoi District are handpicked by politicians and cabinet ministers to facilitate easy transportation of coal. If the Chief Minister, Conrad K Sangma wants to maintain a clean image and gain the confidence of the people he should act responsibly by transferring all the DCs, bureaucrats, SPs of East and West Jaintia Hills and Ri Bhoi District including the OC’s of various police stations situated on the National Highway right from East and West Jaintia Hills to Ri Bhoi District up to Khanapara P.S. as all are involved directly or indirectly in illegal transportation of coal and are the ministers’ cohorts. If the Chief Minister does not believe this he should ask for their posting reports and I am sure he will be astonished to know that most of them have been transferred just few months ago due to their proximity with the present ministers by replacing the officers who are not yet due for transfer.
Last but not the least the Government of Meghalaya should agree with the Opposition demand that CBI should probe this illegal coal mining and transportation. Only then will the skeletons come out of the cupboards. No probe less than the CBI should be done as the people know that almost all the bureaucrats, politicians, police and NGO’s have their own trucks for transportation of coal mined illegally.
Yours etc.,
Name withheld on request