to good health and thank you so much sir it's my honor to introduce the next speaker of the day dr jaba mali venentia writes me dr zebra malibu nancy richie has several degrees to his credit with the distinctions which include mamfil phd he is a sustainable development expert with over 30 years of experience in the united nations industrial development organization inito vienna austria where he served in various capacities he has authored several books and journal articles on the changing patterns of development focusing on the key determinants of economic efficiency ecological complaints and social inclusion he has won several awards including dynamic indian of the millennium award recently auckland-based indo-new zealand business association gave him a commemorative award for his distinguished contribution to the international community and you received lighting achievement award from barbados in university in the year 2019 and what not the list goes on it's an honor to welcome you to srihasa once again a warm welcome to you may now request you to deliver the special address over to you thank you thank you honorable vice chancellor dr phoebe distinguished speakers and dear participants i am extremely happy to participate and this is for the second time siri ramachandra institute of higher education is inviting me i feel honored i am doubly happy that my very good friend dr mukesh kapila is part of the show now getting up at the early morning four o'clock in london time very kind of user um before i start reflecting on the qualities of health care leadership health care leadership i would like to spend one or two minutes on the great leadership demonstrated by dr mukesh kabila then i was working under him in sudan as united country director and he was the head of human operations and the u.n permanent resident representative to sudan the conflict was on between southern states and northern states and all the interventions by all international organizations in sudan were humanitarian centric and i felt enormously incompetent to make interventions refitting my mandate that is the united nations industrial development organizations mandate which aimed at enhancing economic ecological and socially desirable pattern of industrial development 2 million killed and 4 million stranded and in a country like that one could not talk about development at raleigh everything was humanitarian if you don't use the word humanitarian you're out of context so my team you need a team and myself b came out with a program called humanitarian plus and we managed to get 1.4 million from the japanese contribution to united nations trust fund for human security and to make the long story short making intervention we eradicated extreme poverty in 147 villages in the nuba mountain region of sudan i got full support and blame is the implicable support from i want to take this opportunity to thank him because everybody ignored our organization and he supported he even participated in the program the humanitarian plus program was launched and even world bank appreciated it in a document called community-based development projects in sudan lessons learned in that report they say what unito does is the best model for post-conflict recovery and development in terms of sensitization target beneficiaries tangible impact local empowerment and sustainability it's all due to the great support i got from you sir i want to take this opportunity to thank you profusely for the timely and adequate support rendered to me and by doing that you made unido more humanitarian than humanitarians no exaggeration let me now turn to the so-called good qualities of health care leadership kobit 19 exposed developed countries and developing countries to a very very bad center that means it exposed the total and under preparation under preparation to address the vagaries and the ramifications of forbid 19. except one country taiwan the leadership failed everywhere across countries and continents first they said and nothing to fear the only fear we have to fear is fear itself within one week they said come on this is something very dangerous everything should be locked down something like that try one handled it very well they got an email in december look at the quality of the qualities of the great leadership demonstrated by taiwan they got an email from unknown source about something dangerous happening in china which turned the entire world upside down then that was in december 2019 in january announced the first kobe case health minister of taiwan announced the first covet case and while announcing his roll down his face and then in february schools and colleges were closed down only for two weeks but manufacturing was allowed to function they did not ask the factories to be closed down all these schools and got this only two weeks and efficient trading professional tracing using technological marvels and administering a social distancing and imposing total isolation they managed it very well and what is the result when the seven patients died can you imagine only seven patients died and only 441 infected in a country where 23.48 million people live and they are living just 80 kilometers away from the
mainland china when who appreciated giving growing tributes to the day china handled the kobe crisis it was not for uh actually it was not for the mainland it was definitely for taiwan because in the u.n taiwan is called taiwan province of china i very strongly believe the appreciation was more for taiwan than for uh china and so the vice premier vice premier was recently interviewed i listened to the very interesting one he said this was the outcome of 17 years of preparation they learned very bad lessons from stars which occurred in 2003 17 years they were preparing for this pandemic that is why there was a timely and apt response wrapped attention timely act and wrapped attention to address the issues and extremely successful in doing because many countries refuse to learn lessons from lessons the only lesson they refuse to learn is lesson itself the taiwan learned very bad lessons from sas 2003 and then realized the importance of creating the required capacity to withstand the crisis and they did it very well the second best performer was new zealand their approach was totally different if you look at it in taiwan everything is back to normal business as usual within the framework professional tracing uh using technological markers through yi through the use of e-card they are able to trace what is going on with the patient they know more about the patient than the patient himself knows about him so their name social distancing and also isolation very strict isolation within the framework of all these things everything is back to normal there is no new normal the world normally is normal there it is it's going on we have to accept that it's all going on very well now this is some that they want to interview the vice premier asked by premiere okay it is the outcome of 17 years of preparation and maybe it is also due to the fact that taiwanese are very obedient people immediately he said no no they are not obedient they are not obedient that they are obedient politely obedient when it's a matter of saving their life if it's a matter of saving their life they are obedient they are paid by the norms that's why new zealand is the second one totally different about lockdown second first blocked on second law from third block and the australia after i i would say a third best performer in demonstrating the great leadership in handling this now germany and austria are going for the third lockdown based i am not able to fly back to vienna because of this flights are not allowed there so um a good leader a good leader unisphere of life is known for his ability to conceptualize formulate implement monitor and audit the impact of interventions policy interventions institutional direction and policy interventions are very important and taiwan very systematically demonstrated it and let me just take you to west african countries which were affected by ebola initially they created one unit attached to each hospital my very good friend dr feiter based in vienna told me if you have any influence with any prime minister or president please give this advice it is ridiculous to attach a unit with each hospital to handle ebola this is very dangerous ebola victim should be immediately isolated in the whole country there should be only one isolation center of course the african countries are smart so one isolation center the moment they identify a victim immediately the support staff with the self personal protection press should airlift this guy and take him to the remote isolated area total isolation far away from the crowded places maybe in rebound corners and that was one of the main intervention made by them so based on that when the problem surfaced in india i contacted a minister i will not name the name of the minister i mean not i said sir this is how africa handled ebola total isolation is a must why can't you create one isolation center in each district so many engineering colleges are remaining high because of single digit admission they are not able to attract students now in the environmentally nice places i even told him the name of the place in kamehameha district between tactile and military and near the mountains and valley and everything there's a nice engineering quality for sake either you hire it or buy it and create only one isolation center in each district that means anybody suffering from covet can be transported to that particular spot within one another maximum one and a half and in that isolation and the isolation center you create excellent ambience a collectible environment for everybody to work and stay nurses should be enjoying foster style and doctors should enjoy five star style ambience and patients should not the one who goes there for treatment should come back and tell everybody that it's worth going he would like to go again something like that this is the one he said it's a wonderful idea he would talk to the top people at the secretary and but it was not translated in the teams because i am not an economist maybe i was not taken serious i i i'm an economist i'm not a medical doctor right i'm an economist so it should be very economical a technical perception of medical treatment okay and now and then another experience i saw leadership demonstrated by a hospital he said young british people islam medicine there ten years ago they started a separate department called natural body they were teaching siddha ayurveda and the homeopathy everything in fact this they could not make optimal use of the staff at the and the facilities for nearly ten years when the kovit crisis surpassed what they did they converted the latest hospitals into an isolation center administered all this indian medicine traditional knowledge traditional knowledge applied traditional knowledge and traditional medical practices to be honest with you not even a single patient diet and no patient transmitted the disease to anybody even to the support staff or anybody running very well this is a very good lesson we learned so in the new education policy and we say we should offer holistic and multi-disciplinary education these two words are factored in i would say 26 times in a 56 page document on the new education policy holistic means even in a medical college students should learn drama theater movement and acting and this and that this is called holistic education i hope they will definitely include the teaching of sita ayurvedic and community medicine indian medical treatment and traditional material knowledge as part of the holistic this one a famous the latin american doctor once said that claudia bernard in latin america they call him bernardo i think this lady's name is claudia she said if a physician knows his subject and does not know anything about the related subjects he does not know his own subject what a fantastic statement i tend to agree with that a physician knows only allah and he does not know anything about siddha ayahu i hope again the new education policy will reports really in incorporate these things as ancillary subjects or supplementary subjects this is possible and let me let me go from upstream activities i said few case studies about the the the policy from the policy perspective and that means the initial the policy initiatives and the interventions needed to take decisions and implement the projects related to this now i go from upstream to downstream in a medical hospital i am happy that vice chancellor uh dr vijay rahman made a reference to the role of the teacher in the medical college role of the teacher is to facilitate facilitate the students this is very important i will give you one case study you must have heard about the famous dr jay seguran in another video his the name is by word in kanye the best surgeon the district ever heard he told me that in the medical college he was an ordinary student he was scoring only just 40 percent of 45 percent in theory itself one of his professors one day told him that your strength is in cutting and stitching and he said you make capital out of that that statement made by the professor was very well registered in the mind of the doctor he said i say this famous doctor discovered this talent in me and he makes this dead man it boosted his spirit he started concentrating and he emerged as the best surgeon when you have a district ever had so this is this is the role of the teacher tuition and again in the hospitals there are three mistakes very often happen what is expected of the hospital leader system failure technical error and human error according to research findings these errors are bound to occur you have no control on technical snack if like an error access because of technical failure you you cannot control that then human earth takes place like an accident accident is accessed that's why it's called accident you cannot prevent that and then system failure if you have a very bad system to monitor things then it will fail so these things will always happen but there should be a mechanism to monitor the frequency of these failures if there is no mechanism if the leader of the hospital does not establish a mechanism to monitor it's i would say it's a leadership failure then another thing i noticed when i was a patient in many hospitals i'm happy that the vice chancellor made a reference to the need for shifting from consultancy based treatment consultants basic treatment tool he said the patient-centric participatory approach i like it i quote you mr seldom please tell the vice chancellor i think he left the meeting please tell him there is lot of meaning in what he says most of the hospitals invite consultants they are all coming from mostly government hospitals they go to the patient they have the lung expert prescribes some tablets related to lung disease and the heart expert comes and he prescribes something the kidney expert comes and he prescribes something eventually the nurse is carrying a tray of 23 course dinner something like the tablets and is there any system to coordinate this i asked one of the doctors once sir they are all coming and prescribing i know it's a heavy dose i cannot consume it is someone looking at reviewing these prescriptions or just you collect the nurses yes they collected it and they just buy whatever is being prescribed by the these experts and the patient has to take everything there should be at least one person in charge of charge of reviewing this and to just to coordinate this and then decide whether this might establish this many number of tablets could be given i see the absence of this everywhere and about whatever i saw maybe in other hospitals it's there if there's nobody to coordinate this to review the prescriptions and prescriptions by the consultants i think again i would say there is a leadership failure now i turn to this last point that is vaccination last but one point there are two points i will take only five more minutes vaccine production i am really at a loss to know what is going on in vaccine production as far as i know in order to get a track commercialized different stages will have to be passed through one laboratory research it takes a long time eventually through laboratory research they discover something then it's called pre-clinical process or something like that which i cannot explain then in the pre-clinical test animal test human test then review process and then getting the patterns registered then commercialization on an average it takes 10 to 15 years in order not to expose my ignorance i googled many many discoveries on an average it takes 10 to 15 years and when i was in sudan working under dr mukhi scapula i visited the center called center for aromatic and aromatic and the medicinal plants something like they discovered that they extract from a very wide plant which grows in the desert you don't plant you don't water you you don't take care of that it grows inside of you they extract from the rain and this information they collected from the villages of the remote village inhabitants of remote villages remote villages in africa the towns are okay but when you travel 100 kilometers away from town you see people in in stone age totally isolated villages from those villages they got this knowledge about the traditional knowledge they discovered that this extract from the wild plant could he open wound up diabetic patients for 20 years it is not being patented they are not able to get the patterns registered for want of technical assistance and the finance so i organized a meeting because at that time because of the financial crisis in the us petrodollar did not want to invest the petrol dollar in american stock exchange they were looking for opportunities in neighboring regions i invited some investors i invited some indian scientist and i also invited the the researchers working for this institute organized the seminar how to pave the way for patents being registered and to commercialize and they also said it will take long time and you test and this and that okay that's okay so now to uh to comprehend the fact that within eight months eight companies discovered vaccine i am really at your last to know what is going on i am now reminded of the content of a very interesting article that appeared in the analysis of internal medicine a journal produced by the institute for scientific information in that journal they systematically proved that industry funding of laboratory research eventually leading to the production of drugs and commercialization of that resulted in biased prescription killing thousands if you want you can google that industry funding of labor laboratories eventually now i am not against vaccine i am not against people who are funding it you know and someone said they are discovering because of over finding surplus findings and i don't know i really don't know i don't want to expose my ignorance here i am i i am not able to understand how within within eight months eight companies could come out of the vaccine and it is being administered i think they started russia started china started i think yesterday trump had one who's back i don't know i think it's it is good to and organize a series of meetings like this to reflect on this it's very important because collective response to address the issues the calls for discussion dissemination of knowledge and i used to wonder whether there is a database on undiagnosed disease i always tell my doctor friends at the district level it's quite possible many people died because you are not diagnosed why can't we create the data based on undiagnosed um the diseases and undiagnosed disease network and every month you people meet and discuss maybe someone will come out with a solution if that is absent again it's a reflection on leadership failure then the last point is the technological marvels everything is triggered by um technological marvels markers particularly disruptive technologies they even talk about bio 3d printer in the future in the not in the near future maybe in the future you can go to the pharmacy and buy heart lung and the kidney everything bio 3 printer will be able to do that and then they also talk about so many things and the artificial intelligence based diagnosis 100 normally in medical science nothing is hundred percent you all know that nothing is hundred percent but now artificial intelligence based uh diagnosis is hundred percent correct so it is thought they are not taking deep into so the doctor is the so-called health care leaders and the stakeholders of healthcare cannot be bystanders at this current technological feast i would put it like that you have to keep pace with the rapidly changing facets of a medical treatment as you saw as you see that you know the treatment changes every time and once i attended a conference the way minister criticized the conference you need a country saying that oh you organized this meeting every year and discussed the same question again and again and again then i said i in my response yes we discuss the same question because the answer changes the answer is changing every year that's why we continue to discuss the same thing so you cannot so you have to keep pace with the rapidly changing dimensions of medical treatment and reach the frontiers of best practice triggered by technological models frontiers of the minimum is to know your distance and then try to identify viable avenues of reaching the frontiers of best practice and your best do your best to do that your best may not be good enough as long as you realize that your best is not good enough that is good enough thank you thank you very much for the great opportunity
2021-01-04