Health care leadership summit- Speech by Dr Dr Vinanchiarachi

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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

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