Insights into Editorial: India must recognise the right to a minimally decent life
More than 400 children with acute encephalitis syndrome (AES) have been admitted to various hospitals in Bihar. It has claimed the lives of over 100 children. Most of the deaths have been attributed to low blood sugar level (hypoglycaemia).
Encephalitis results from a viral infection, unless proved otherwise. Specific treatment is scanty for viral encephalitis.
Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. It is eminently treatable.
Deaths of Children are due to systemic failures:
The main reasons for horrific tragedy in Muzaffarpur, Bihar are the systemic failure of health care has killed over a hundred children.
- First, like the constitutional principle of a basic structure, it is time to articulate an equally robust doctrine of basic rights.
- Second, these basic rights must be viewed primarily as positive, rights not against interference from the state (negative rights) but to the provision of something by it.
- Third, just as individuals are punished for legal violations, the government of the day must also be punished for the violation of these basic rights.
This punishment need not await the next round of elections but must be meted out immediately, by the law itself.
Solution: 10% dextrose within four hours:
Hypoglycaemic encephalopathy can be prevented in undernourished children by making sure that they do not eat plenty of litchi fruit and eat some food and not go to bed on an empty stomach.
It can also be easily treated. A full and complete recovery can be achieved if children with hypoglycaemic encephalopathy are infused with 10% dextrose within four hours after the onset of symptoms.
This not only restores blood sugar to a safe level but also stops the production of amino acid that is toxic to brain cells.
Infusing 3% saline solution helps in reducing oedema of the brain cells. If dextrose infusion is not started within four hours after the onset of symptoms, the brain cells may not recover but will die.
As a result, even if they survive, children suffer from various aspects of brain damage speech getting affected, mental retardation and muscle stiffness/weakness.
Reason for systemic failure: The Idea of Basic Needs:
First, a right is something that is owed to us; it is not a favour. So, rights help the recognition of anything that satisfies basic needs as an entitlement.
Basic rights are claims on the state to provide us with goods and services that satisfy our basic needs.
Second, when something is identified as a basic right, it puts the state under a duty to enable its exercise.
The state becomes its guarantor. For example, the right to physical security, the first basic right, is socially guaranteed when the state provides its people a well-trained, professional police force.
When society and its government reneges on its commitment to do so, we hold them accountable.
It follows that basic rights are a shield for the defenceless against the most damaging threats to their life which include starvation, pestilence and disease.
Right to Free Public Expression must be Basic Right:
To these two basic rights, the third one is Right to Free Public Expression of helplessness and frustration, if deprived of other basic rights.
The scope of freedom of expression is large. The right to make one’s vulnerability public, be informed about the acts of commission and omission of the government regarding anything that adversely affects the satisfaction of basic needs, to critically examine them
To hold state officials publicly accountable is a basic right on a par with right to physical security and subsistence and inseparably linked to them.
It follows that governments must make arrangements for people to demand that their basic rights be satisfied, to complain when these demands are not met.
To report lapses and omissions on the part of governments, point fingers at apathetic government officials, criticise the government for its failures and to do so without fear.
Credible threats to these rights can be reduced by the government by establishing institutions and practices that assist the vulnerable; for example, by setting up hospitals with adequate number of doctors, nurses, beds, medical equipment, intensive care units, essential drugs and emergency treatments.
These three basic rights can be summed up in a single phrase, the right to a minimally decent life. This is a threshold right.
Anything short of a minimally decent life is simply not acceptable. It is this precisely that horrifies us about the callousness of the Bihar government in Muzaffarpur and governments in India more generally.
They routinely abdicate responsibility for the suffering they directly or indirectly cause. This is why we must ask why governments are not immediately and severely penalised when they undermine the exercise of these basic rights.
A society may soar, strive for great collective achievement. But the point of having a threshold of minimal decency is that our life must not fall below a certain level of existence.
In short, defaulting governments must be held legally accountable. The systematic violation of basic rights must be treated on a par with the breakdown of constitutional machinery.
When a government fails to provide primary health care to those who can’t afford it, it violates their basic rights.
For this, proper budgetary allocation is required that depends in turn on getting one’s political priority and commitment right.