1. What is the Criminal Procedure (Identification) Act, 2022?
How is the recent legislation different from the earlier Identification of Prisoners Act, 1920? What are the main concerns and oppositions against the Act?
The Criminal Procedure (Identification) Act, 2022 provides legal sanction to law enforcement agencies for “taking measurements of convicts and other persons for the purposes of identification and investigation of criminal matters”. It came into effect from August 4.
Over the years, the need to amend/update the Identification of Prisoners Act, 1920 has been voiced several times. In 1980, the 87th Report of the Law Commission of India undertook a review of this legislation and recommended several amendments.
Multiple concerns have been raised about the new law. One of the main concerns is that unlike the Identification of Prisoners Act, 1920, the current law allows for “measurements” to be taken if a person has been convicted/arrested for any offence, including petty offences. The necessity of taking measurements of such persons for investigation of offences is unclear and will probably lead to overburdening of systems used for collection and storage of these “measurements”.
The story so far: The Criminal Procedure (Identification) Act, 2022 provides legal sanction to law enforcement agencies for “taking measurements of convicts and other persons for the purposes of identification and investigation of criminal matters”. While the legislation was enacted earlier this year, the Ministry of Home Affairs notified it to come into effect from August 4, 2022. It also repeals the existing Identification of Prisoners Act, 1920.
What is the use of identification details in criminal trials?
Measurements and photographs for identification have three main purposes. First, to establish the identity of the culprit against the person being arrested, second, to identify suspected repetition of similar offences by the same person and third, to establish a previous conviction.
What was the previous Identification of Prisoners Act, 1920?
Even though the police has powers of arrest, mere arrest does not give them the right to search a person. The police requires legal sanction to search the person and collect evidence. These legal sanctions are designed so as to maintain a balance between the rights of an individual and the interests of society in prosecution and prevention of offences.
The Identification of Prisoners Act, 1920 became a necessity when the recording of newer forms of evidence such as fingerprints, footprints and measurements started becoming more accurate and reliable.
The Statement of Objectives and Reasons of the Identification of Prisoners Act, 1920 states that “the value of the scientific use of finger impressions and photographs as agents in the detection of crime and identification of criminals is well known”. It further goes on to state that although lack of legal sanction has not created problems before, there were increasing instances of prisoners refusing to allow their fingerprints or photographs to be recorded. Therefore, “to prevent such refusals in the future …[and] to place the taking of measurements etc which is a normal incident of police work in India, as elsewhere, on a regular footing” it was considered necessary to enact the Identification of Prisoners Act, 1920.
What was the need to replace this Act?
Over the years, the need to amend/update the Identification of Prisoners Act, 1920 has been voiced several times. In 1980, the 87th Report of the Law Commission of India undertook a review of this legislation and recommended several amendments. This was done in the backdrop of the State of UP vs Ram Babu Misra case, where the Supreme Court had highlighted the need for amending this law. The first set of recommendations laid out the need to amend the Act to expand the scope of measurements to include “palm impressions”, “specimen of signature or writing” and “specimen of voice”. The second set of recommendations raised the need of allowing measurements to be taken for proceedings other than those under the Code of Criminal Procedure (CrPC).
The Law Commission Report also notes that the need for an amendment is reflected by the numerous amendments made to the Act by several States. The Minister of Home Affairs, while laying the Criminal Procedure (Identification) Bill, 2022, in the Lok Sabha, observed that with advancements in forensics, there was a need to recognise more kinds of “measurements” that can be used by law enforcement agencies for investigation.
What are the main highlights and differences in both the legislations?
Like the Identification of Prisoners Act, 1920, the new Criminal Procedure (Identification) Act, 2022 provides for legal sanction to law enforcement agencies for the collection of measurements. The purpose is to create a useable database of these measurements. While at the State level, each State is required to notify an appropriate agency to collect and preserve this database of measurements, at the national level, the National Crime Records Bureau (NCRB) is the designated agency to manage, process, share and disseminate the records collected at the State level.
What are some of the concerns with the present legislation?
Since the Identification of Prisoners Act, 1920 was a colonial legislation, its duplication in the Criminal Procedure (Identification) Act, 2022, a post-independence legislation has raised some concerns related to the protection of fundamental rights.
The legislation comes in the backdrop of the right to privacy being recognised as a fundamental right. A fundamental facet of the right to privacy is protection from the invasion of one’s physical privacy. As per the Puttaswamy judgment, for a privacy intrusive measure to be constitutional, there is a need for the measure to be taken in pursuance of a legitimate aim of the state, be backed by the law and be “necessary and proportionate” to the aim being sought to be achieved. In this case, while the first two tests are satisfied, as “prevention and investigation of crime” is a legitimate aim of the state and “measurements” are being taken under a valid legislation, the satisfaction of the third test of necessity and proportionality has been challenged on multiple counts.
First, while the need for expansion of the “measurements” that can be taken is well justified, the inclusion of derivative data such as “analysis” and “behavioural attributes” have raised concerns that data processing may go beyond recording of core “measurements”. That is some of these measurements could be processed for predictive policing. While this is a legitimate concern, and purposes for which the “measurements” can be processed need to be better defined, merely recording core measurements without conducting the required forensics on them would severely limit the usability of these “measurements”.
Second, unlike the Identification of Prisoners Act, 1920 which provided that “measurements” will be taken for those either convicted or arrested for offences that entail imprisonment of one year or upwards, the current law allows for “measurements” to be taken if a person has been convicted/arrested for any offence, including petty offences. The necessity of taking measurements of such persons for investigation of offences is unclear, and such discretion is likely to result in abuse of the law at lower levels and overburdening of the systems used for collection and storage of these “measurements”. Given that these records will be stored for 75 years from the time of collection, the law has been criticised as being disproportionate.
It needs to be noted here that the new legislation allows that a person who has been arrested for an offence that is punishable by less than seven years of imprisonment, and is not an offence against women and children, “may not be obliged to allow taking of his biological samples”. This is definitely an improvement over the earlier law which did not allow for any such refusal. It also helps allay concerns of disproportionate collection. However, given the option to not submit for “measurements” is limited to biological samples and is available at the discretion of the police officer, this exception provides restricted relief.
Another worry expressed by experts is that such collection can also result in mass surveillance, with the database under this law being combined with other databases such as those of the Crime and Criminal Tracking Network and Systems (CCTNS).
Lastly, concerns are being raised that the present law violates the right against self-incrimination enshrined in Article 20(3) of the Constitution of India. However, this argument is nebulous since the Supreme Court has already settled this point. In the State of Bombay vs Kathi Kalu Oghad, the Supreme Court had conclusively held that “non-communicative” evidence i.e. evidence which does not convey information within the personal knowledge of the accused cannot be understood to be leading to self-incrimination. Therefore, no challenge lies to the law on this ground.
What is the way ahead?
The Opposition has raised objections to a law of such import not being submitted for public consultation or referred to parliamentary standing committees, as was done for the DNA Technology (Use and Application) Regulation Bill, 2019 which has benefited from such scrutiny.
The Central government has responded to the criticisms of the law stating that privacy and data protection related concerns will be addressed in the Rules formulated under the legislation and through model Prison Manuals that States can refer to.
The immediate future of this law is unclear. A writ petition has been filed challenging the constitutionality of the law before the Delhi High Court. The court has issued notice to the Central government for filing a reply.
2. Dozens in China infected with Langya virus found in shrews
There is no evidence of human-to-human transmission
Dozens of people in China have fallen ill with a new virus that is also found in shrews, a report has said, but there is so far no evidence of human-to-human transmission.
The infections were found in China’s eastern Shandong and central Henan provinces, affecting 35 people, according to a report in the New England Journal of Medicine this month.
The virus is called Langya henipavirus or LayV, and patients reported symptoms that include fever, fatigue, cough, nausea and headaches. Some people also developed blood cell abnormalities and impaired liver and kidney functions, the report said.
Research findings suggested shrews may be a natural reservoir for the pathogen. “There was no close contact or common exposure history among the patients, which suggests that the infection in the human population may be sporadic,” according to the report.
But it also cautioned that its sample size “was too small to determine the status of human-to-human transmission for LayV”.
Patients were mostly farmers and cases were found with help from a detection system for people with acute fever and a history of animal exposure, it added.
Further investigation is needed to better understand illnesses associated with the virus, according to the researchers in China, Singapore and Australia who were involved in the paper.
Cases of Langya henipavirus have so far not been fatal or very serious, Linfa Wang of the Duke-NUS Medical School in Singapore, told Chinese state outlet Global Times.
3. Editorial-1: Survey data on poverty and broad policy pointers
There needs to be engagement with survey data, but ground-level realities should shape programmatic interventions
Based on multidimensional poverty measurement, the Poverty Ratio (Head Count Ratio) in Tamil Nadu declined from 4.89% in 2015-16 to 1.57% in 2020-21, based on the fourth and fifth rounds of the National Family Health Survey (NFHS) data. Is this too good to believe? Maybe so. Academics have questioned the quality of NFHS data for various reasons, based on the previous four rounds of NFHS databases. Such questions may be raised against the NFHS 5 database also. But first, let us explore the poverty statistics derived from NFHS 5 data using the multidimensional poverty measurement suggested by NITI Aayog and its pointers for policy intervention. After this, we will raise questions about the quality of NFHS data with the aim of using it with caution and to improve data quality keeping the future in mind.
On the MPI
NITI Aayog, armed with a fairly large sample survey data of NFHS 4 (with more than six lakh households in India), estimated the Multidimensional Poverty Index (MPI) and published the baseline report in 2021. The rationale for the MPI was derived from the concept that poverty is the outcome of simultaneous deprivations in multiple functions such as attainments in health, education, and standard of living. The NITI Aayog identified 12 indicators in these three sectors and calculated the weighted average of deprivations in each of these 12 indicators for all men and women surveyed in NFHS 4. If an individual’s aggregate weighted deprivation score was more than 0.33, they were considered multidimensionally poor.
The non-poor may also be deprived in a few of these indicators, but not as much to be classified as multidimensionally poor. The proportion of the population with a deprivation score greater than 0.33 to the total population is defined as the Poverty Ratio or Head Count Ratio. The authors have estimated the MPI and its components for Tamil Nadu using NFHS 5 and compared it with the estimates based on NFHS 4 given by NITI Aayog.
Another interesting aspect of this approach is the estimation of the Intensity of Poverty. This is the weighted-average deprivation score of the multidimensionally poor. For instance, the Intensity of Poverty in Tamil Nadu declined from 39.97% to 38.78% during this period, indicating that the summary measure of multiple deprivations of the poor has only marginally declined in these five years, and has to be underlined for policy focus.
The MPI is a product of Head Count Ratio and Intensity of Poverty. The MPI for Tamil Nadu declined from 0.020 to 0.006. This sharp decline in MPI is largely due to a greater decline in Head Count Ratio compared to Intensity of Poverty. This gives us a clue that any further decline in MPI in Tamil Nadu should happen only by addressing all the dimensions of poverty and reducing its intensity substantially across the State.
Direction of intervention
The deprivation estimation also indicates that the overall population that has been identified as deprived in most of the indicators individually is higher than the population identified as multidimensionally poor. This once again reiterates the point that people may be deprived severely in a few functions, but may not be multidimensionally poor. This adds another aspect of public policy intervention, i.e., attacking poverty in Tamil Nadu should not only be multidimensional but also universal. Only this approach can address deprivations in all the indicators. This will also surely and squarely reduce the Intensity of Poverty in Tamil Nadu.
Statistically, the Head Count Ratio and Intensity of Poverty can be calculated for each district and segregated by gender, rural and urban, and other dimensions. Therefore, the usefulness of the MPI and its components is enormous in terms of understanding poverty in its totality as well as the granular details that are essential for sectoral and spatial policy and programmatic interventions. The strength of the MPI as an instrument for data-driven public policy depends on the quality of survey data, namely the NFHS data.
Quality of NFHS data
The quality of survey data has been widely debated in academia. The National Sample Survey Organisation’s (NSSO) sample surveys have been debated among economists and statisticians, both in terms of sampling and non-sample errors, right from its initial days in the 1950s. Following several review reports on the NSSO’s methodologies, the NSSO has been attempting to improve sampling design and reduce non-sampling errors, particularly with reference to recall periods for providing consumption expenditure by households. All these are well documented.
Demographers such as K. Srinivasan, S. Irudaya Rajan, and K.S. James have written several articles on the non-sampling errors in different rounds of the NFHS data. They tested, for instance, the arbitrariness in reporting the age of the dead, differences in data quality between educated and uneducated respondents, data quality based on differences in time taken to complete a survey of different household types, etc. All these have serious implications for health data such as fertility and death rates. A market-based approach to decide the data collection process is also critiqued by demographers.
The authors have done a different kind of quality check for NFHS 5 data for Tamil Nadu. For instance, in Tamil Nadu, the NFHS data was collected in two time periods: 8,382 households (30%) in the pre-pandemic period and 19,547 households (70%) in the post-lockdown period, aggregating to 27,929 households for the State. The data collected from 19,547 households in the post-lockdown period should reflect the impact of the first wave of the COVID-19 pandemic. Let us compare pregnant women and their age distribution in the two periods for a glimpse of this. The proportion of pregnant women below the age of 19 years was 18:82; those between 19-21 years was 25:75 compared to the proportion of 32:68 for pregnant women above 21 years. The pandemic has resulted in increasing pregnancy among women below the age of 21 years, more so among teenage girls. Death per 1,000 households surveyed increased from 118.23 to 135.01 — this is clear evidence of the impact of the pandemic.
The authors have estimated the Head Count Ratios for the 12 indicators and found that such ratios were lower in the post-lockdown period than in the pre-pandemic period, leading to the inference that post-lockdown, the deprivation in several functionings was lower, implying a lower poverty ratio as well as Intensity of Poverty. In particular, the deprivation in terms of nutrition and maternal health declined, and schooling and school attendance increased in the post-lockdown period.
Substitution of dry rations for hot meals in the mid-day meal programmes and high pressures in hospitals in handling COVID-19 cases are expected to increase deprivation in nutrition and maternal health in the post-lockdown period, contrary to the decline in deprivation in nutrition and maternal health in the post-pandemic period that we derived from this database. Tamil Nadu is known to have increased enrolment and reduced the dropout rate year after year; hence, the increase in deprivation in terms of schooling should raise questions. As far as school attendance is concerned, we do not know how parents interpreted school attendance during the long period of closure of schools in the lockdown period. Therefore, combined survey data from two different time periods separated by a major pandemic have to be approached with caution while interpreting the statistics derived from the entire database.
Assuming that survey data are from a single time period, it is normal to compare the results of survey data on specific indicators, with the programmatic data derived from official records. There are claims that the deprivation indicators in terms of drinking water and sanitation are on a higher level in Tamil Nadu than the claims made by the respective State government departments. Such issues are common in survey data. For instance, consumption expenditure on foodgrain derived from NSSO data would not be in agreement with the estimation of food consumption, as per the System of National Accounts.
Data use and quality
The quality of survey data has always been a contentious issue in academic and policy debates for various (well-founded) reasons. However, this has not stopped academicians and policymakers from inferring policy directions because such data at a reasonably aggregate level (say at the level of a State), should be useful. As mentioned earlier, in Tamil Nadu, the sharp decline in Head Count Ratio and a marginal decline in Intensity of Poverty in NFHS 5 compared to NFHS 4, cannot be brushed aside.. From this, we can infer that in order to reduce the Intensity of Poverty we need to address deprivations across the entire population, that is there should be a universal approach instead of a targeted approach to addressing it.
The survey data gives us only broad policy pointers whereas programmatic interventions should be curated with ground-level realities. At the same time, continuous engagement with survey data in terms of improving the sample design and response quality has to be sustained. Analysing the data and finding the incongruence of inferences from different databases on an issue would help improve data gathering systems. Let us continue to use survey data both to derive policy conclusions (with caution) and also to help improve data quality.
4. Editorial-2: Signs of a dead end for social justice politics
The success of the OBC alliance in 2015 in Bihar may be difficult to replicate in the Hindi heartland
Bihar Chief Minister Nitish Kumar’s latest ‘partner switch’, from the Bharatiya Janata Party (BJP) to the Congress and the Rashtriya Janata Dal (RJD), has prompted speculation of a new ‘social justice’ front against Hindutva ahead of the 2024 Lok Sabha election. ‘Social justice’ stood for politics that sought better representation and empowerment for lower caste communities. The mobilisation of weaker communities challenged and defeated the Congress first, and slowed down the totalising drive of Hindutva later, in the heartland States of Bihar and Uttar Pradesh.
Success in reaching out
The success of Narendra Modi has been in the remaking of Hindutva, blunting its upper caste image and reaching out to a wider spectrum of Hindu communities. The BJP today is a subaltern party that mixes cultural rhetoric, welfare and empowerment. Still, there is euphoria in the anti-BJP camp following the formation of the new coalition in Bihar because the same coalition had defeated the BJP in the 2015 Bihar Assembly election, on a social justice platform. The question, therefore, is whether a revival of social justice politics is possible, yet again, as a counter to Hindutva.
In 2015, the RJD-Janata Dal (United) alliance worked in Bihar, but it collapsed within two years. The alliance gained buoyancy, less from the promise the two Other Backward Classes parties held than the threat the Rashtriya Swayamsevak Sangh (RSS) posed for backward caste aspirations. RSS chief Mohan Bhagwat had then called for a debate on caste quotas — touching the rawest nerve in Indian politics, though he was only reiterating the long-held Sangh scepticism, encouraged by the Hindutva wave in 2014.
Mr. Modi’s Hindutva overdrive could not salvage the situation once the quota debate caught on. He had been Prime Minister for only one year then, and his promise of social justice within the Hindutva tent was untested then. “From then to now, that promise has been delivered. Now, there is a huge constituency of labharathis — recipients of various welfare schemes launched by the Prime Minister since then — that enthusiastically roots for him. The majority of them are OBCs,” a BJP strategist said.
The BJP, an upper caste dominated party, needed Mr. Kumar to mobilise the OBCs and reassure them that the eviction of the RJD would not mean a change of power from OBCs to an upper caste Chief Minister in 2005. The RJD had lost its original spirit of social justice by then. Numerous members of Lalu Prasad Yadav’s family were in positions of power, and non-Yadav OBCs moved in hordes to the National Democratic Alliance led by another OBC. By 2020, Mr. Kumar’s appeal had diminished, and his party, the JD(U), got fewer seats than the RJD and the BJP.
More space for representation
The BJP had also consolidated its grip over the OBCs, while allowing its upper caste core to flourish through a simple formula — by removing Muslims from its social coalition. Social justice parties had relied on Muslim votes — 17% in Bihar and 19% in Uttar Pradesh, and given them representation in power. By cutting Muslims out, the BJP created space for more representation to OBCs and Dalits. Subaltern representation has gone down overall with the rise of Hindutva, but the BJP managed to rope in communities neglected by the dominant castes of social justice politics, creating a claim that it is truly a platform of Hindu unity. Unlike the Congress that stood stiff and crumbled in the face of social justice storms, the BJP has shown remarkable flexibility in accommodation.
Mr. Modi’s Hindutva 2.0 has addressed upper caste antipathy towards caste quotas by introducing a 10% quota for Economically Weaker Sections (EWS). In practice, this is a quota for the upper castes, turning the whole logic of quotas as a tool to address social backwardness of centuries, on its head. The implementation of quotas itself is patchy under the BJP.
For instance, in Uttar Pradesh, Swami Prasad Maurya, an OBC leader who resigned from the BJP ahead of the Assembly elections earlier this year, had said that 19,000 reserved seats of schoolteachers were filled with candidates from the general category. Hindutva has not merely appropriated social justice within its fold but also reconfigured it. “True social justice is when development reaches villages,” Mr. Modi had said after opening the Bundelkhand expressway in Uttar Pradesh last month. This idea of ‘development as social justice’ is a clever spin to the social justice debate.
It is not that all OBCs and Dalits are sold on Hindutva. Mutinies continue, and will continue. Of particular sensitivity for the OBCs will be the prospects of an upper caste Chief Minister, but that is not a dealbreaker between lower castes and Hindutva, as the U.P. experiment shows. Yogi Adityanath is a Rajput, but managed to remain as a unifying icon for Hindutva voters and won a second consecutive term. In Bihar, the BJP currently does not have an identifiable OBC leader who may not make other communities nervous — it will have to groom one of its existing leaders into that role. The BJP is walking a tightrope of balancing caste equations and it can trip on its original mistrust of lower caste demands. But the parties that flourished as torchbearers of social justice are facing a bigger crisis, and the slogan itself has lost its potency to inspire.
Allegation versus reality
Corruption, nepotism and the shameless promotion of the families of leaders who swear by it have emptied the soul out of the social justice slogan. Mr. Maurya’s rebellion enthused urban secularists but it did little to open a new front of social justice mobilisation against the BJP in Uttar Pradesh. His daughter was already a BJP Member of Parliament and he was demanding a seat for his son too. In the end, he lost his own seat in the Assembly elections. It remains to be seen whether the new JD(U)-RJD alliance will be able to fight back the BJP charge that social justice is merely a facade for aggrandisement by its leaders and their families — or merely prove the charge right. At any rate, social justice politics is at a crossroads. Or perhaps even at a dead end.
5. Editorial-3: A timely gesture
Transferring more tax devolutions to States early in the year is a prudent move
The Centre’s move to transfer a large chunk of tax devolution dues to States in one go on Wednesday is a pragmatic step that will not only lend impetus to fresh capital spending on the ground but also temporarily soothe tempers amid a fresh round of unease between the Centre and States. Higher than anticipated buoyancy in tax receipts has nudged the Finance Ministry into raising the States’ monthly share of the divisible pool of taxes from about ₹48,000 crore in the first quarter of 2022-23, to ₹58,332.86 crore for August. And surplus cash balances with the exchequer have created room to transfer two months’ dues to States in one go, translating into a significant lump sum of nearly ₹1.17 lakh crore. While the Government had done similar transfers to States, dovetailing and remitting two months’ dues together last year as well, the context is dramatically different for States in this fiscal year. For starters, they no longer have the fallback option of assured revenues from GST Compensation in the five years till June 30, 2022. Even for the GST dues that accrued this year, the Centre frontloaded the release of around ₹87,000 crore to States for April and May, although accruals in the GST Compensation Cess account at the time were just ₹25,000 crore, by dipping into its own coffers. With another ₹35,000-odd crore of GST dues outstanding for June, the overall recompense for States from GST will be around ₹1.22 lakh crore, less than half of the ₹2.5 lakh-odd crore in 2021-22.
There is another uncertainty facing States that has led to extremely tentative behaviour from their treasuries in recent auctions of State development loans — changes in their net borrowing norms. While the Centre had pegged States’ borrowing limit at 3.5% of their Gross State Domestic Product for the year, this ceiling is to be pared in accordance with off-budget debt raised by States since 2020-21. Initial signals that all such off-the-books loans will be deducted from this year’s ceiling had a chilling effect too, not in the least because the paucity of clear data on the extent of such borrowings, make it difficult to anticipate the actual ceiling that the Centre would determine for each State. The Finance Ministry has eased up on this front as well, clarifying that only their off-budget debt for 2021-22 will be adjusted against the ceiling and that too, in a staggered manner between this year and 2025-26. The norms for the ₹1 lakh crore interest-free loans offered to States for discretionary projects this year could also be reviewed to help it gain greater traction with State governments. Taken together, these steps should help States, which expressed concerns about dwindling revenues at the recent NITI Aayog governing council meet, back the effort to rev up the economy with a capex spree. Friction points between the Centre and States will persist with fluctuating intensities, but a rising economic tide will ease constraints for both.
6. Editorial-4: Should medicine be taught in the local languages?
English is important as a medium of instruction, but a regional language helps in practising medicine
The demand for medicine to be taught in languages besides English has been made repeatedly over the years, and was reiterated most recently by Union Home Minister Amit Shah when he said instruction in medicine, engineering and law should be made available in Indian languages. Over the years, academicians have considered the advantages, demerits and challenges of such a move. Dr. Sudha Seshayyan and Dr. M. Janakiram explore the various aspects of the issue in a conversation moderated by Serena Josephine M. Edited excerpts:
Do you think it is possible to have a regional language as a medium of instruction in medicine? And is there a need to promote Indian languages in higher learning?
Sudha Seshayyan: First, the question relates to a long-term perspective. In that case, it is possible. I have travelled in countries where medicine is taught in Spanish, German and so on. So, it is possible with certain modifications. We probably cannot be water-tight with our words, especially with technical terms. When we say a regional language, there could be an overlap of words from different languages.
Second, looking at the same question from a slightly different perspective on what is currently possible in India… medical students are guided by regulations from the National Medical Commission (NMC). For these students, the medium of instruction is English. So, teaching in a regional language can only be supplementary in case a student does not understand something in English or has studied in, say, a Telugu-medium institution earlier. As of now, students cannot completely study in the regional language because the NMC declares the medium of instruction as English.
M. Janakiram: I would like to add a few points on standardisation in the field of medicine. Greek and Latin physicians had first set the context as far as language is concerned. The present-day physician should have the zeal for higher learning rather than just treating patients. In the National Education Policy of 2020, there is a proposal to promote regional languages. In medicine, most of our curriculum is based on learning by doing, whereas in most other subjects it is learning as such. Before opting for regional languages as the medium of instruction, we have to keep certain things in mind. We have to develop a standardisation tool for every other curriculum through which we can easily compare and correlate things.
SS: At some point in time, learning Latin was mandatory for a medical student. It is not so now. However, we still use Greek and Latin terms. A stage has come where some Greek and Latin terms have been done away with. Worldwide, there is a shift to Anglicised terms. So, I do not think this is a major problem.
There is a necessity for students to have a zeal for higher learning but that does not hamper the utilisation of a regional language. Yes, there is a need to promote Indian languages in higher education for the simple reason that it would improve the thinking component in an individual and probably communication too. The complaint that we receive from society today is that a doctor seldom communicates. Thinking and communication skills would improve if we learn in the regional language. At the same time, I would like to emphasise that there has to be standardisation in the technical terms in Indian languages.
Engineering courses are being offered in Tamil. Have there been attempts to offer medicine in Tamil? There have been initiatives to find Tamil equivalents for English medical terminologies.
SS: Yes, there have been attempts. Some of the early efforts to translate medical textbooks into Tamil were made in Sri Lanka. In our part of the country, we have had some efforts under Professor Lalitha Kameswaran, who was the first vice chancellor of this university. When she was the Director of Medical Education in the 1980s, she brought in a big team, and we would sit for about three to four hours every day before fixing a word for a particular technical term. About 12,000-13,000 words were formed. The movement dwindled. In the last few years, our university has contributed about 10,000-12,000 technical terms, which were translated, standardised and handed over to the ‘Sorkuvai’ scheme of the Tamil Nadu government, which is a collection of technical terms. Anyone can access and use that word, if it is found suitable. These efforts have been going on. But there have also been some concerted efforts to teach in the regional language in the medical college. This effort is not a complete switchover to Tamil; it is a supplementary one. There are some students who come from other mediums of instruction. We try to give them additional classes.
MJ: As rightly pointed out, there are issues of linguistic dualism as well as abrupt changes in the medium of instruction as soon as a student enters a medical school. We have found that some students find it difficult to understand concepts. The language of the standard textbooks is not easy, and some find it difficult to convert their thoughts into English during examinations. We have alumni associations which come up with materials for students who had studied in Tamil up to Class XII. Translation is done wherever required. The medical terminologies are maintained as such — like when we explain the pathogenesis of a disease, the course of the disease is translated into the regional language. But many such measures have not been documented.
Often, discussions centre around whether language is a barrier to higher learning. Do you think access is an issue for students who have received primary education in their mother tongue or for those from rural areas?
SS: I don’t think language is a barrier for people to learn. The difficulty comes when people find it hard to understand because of the load. Whichever discipline of medicine you take, it’s an ever-expanding area. There is a lot to learn. For that, [students] would have to have access to information immediately. If you don’t have access to information, it deters you, and the motivation to learn is lost. More information is available in English. And that is where it’s necessary to know English so that you can access information. In medicine, I would want to know about newer treating modalities, newer techniques in surgery. If I’m not able to get that information, I have to depend on someone to translate it. There could be errors in translation. For accessing information, we require a language like English, as of now. That is why I’ve been saying information should be available in the regional language for people to understand. You don’t have to necessarily take your exams in Tamil, but at least for you to understand and upgrade your knowledge, it is necessary for the coming generations that we keep all this information in the regional language.
What are the challenges in having medical education in the local languages?
MJ: Medical education is all about research. Going by the U.K. standards, a doctor has to be a social scientist, a scholar, a researcher as well as a practitioner. So, every other aspect has to be covered by a doctor once he/she receives the medical degree. English is required for professional competence; it is the international language of science and medicine. There is also a new concept called English for Medical Purposes. So, taking up medical education in a regional language will always be a challenge.
SS: As of now, it might appear that we will not be in a position to understand things if we move to another part of the country, or if we move to another country. But I don’t think that is a major challenge. Several Indian students have gone to the U.S. and the U.K., not because they were very good in English, but because they were good in their subject and skills. It depends on the individual’s competence to learn. Adapting and surviving under difficult situations is also a skill. Perhaps a doctor will have to learn that as well.
When I was a student at the Madras Medical College, we used to have a very active Tamil Mandram (Tamil Association). But paradoxically, the Tamil Mandram was also trying to teach spoken Telugu. We also brought out publications like Sundara Telugu. It was the 1980s and 1990s. Nearly 50% of our patients in the government hospitals were Telugu-speaking. It would be a challenge to talk to them and get their history, complaints and information, especially during examinations. So, the students learned spoken Telugu. I am saying this because it is necessary for a doctor to communicate with patients.
But again, medicine is an area where we need to have uniform understanding in certain aspects across the globe. Uniform nomenclature is required. We have to know regional languages to deal with the patients. English can be a common factor for some time to break barriers, but after that the regional languages will come into play.
What are the pros and cons?
SS: All our teachers will have to be first equipped. Competency-based medical curriculum has come into the country in the last three years. We are now training our teachers in medical education technology. To train them to teach in regional languages will take more time. But before training them, we also need to have books and materials. I am not sure what will be the future [in the context of] examinations and the medical curriculum with regard to the medium of instruction. The central regulatory agency will take a call. But every language should be equipped with appropriate information, even to help someone study better. They may study in English, but they may also need to study the same thing in Tamil for better understanding and clarity.
MJ:Competency has a number of components — knowledge, skills, values and attitudes. We have to look at what needs to be adapted based on the situation. For instance, interpersonal communication is important when dealing with patients. Here, knowing the regional language will help students. In terms of medical knowledge, to develop our reading skills during undergraduate [studies] and post-graduation and move towards research, English will help us. As far as practice is concerned, it includes both the regional and English language. So, the regional language may be a supplement, whereas English is the essential language.
What is the way ahead?
MJ: As of now, we should stick with English as the medium of education for medical schools. Based on one’s interests, regional language can be taken up as a supplement for better understanding and innovation. If a doctor communicates well in a regional language, it will help them to decrease the gap with the patient.
SS: I would like to add something related. People tend to think that in order to study anything related to science, people don’t have to have a flair for language. But I’ve taught medical students for 34 to 35 years. I have realised the importance of language. Language is required for appropriate communication and understanding. I would request medical educationists to not say that the study of language is not required for someone who is pursuing medical or science studies.