Human Rights in India and the Case of Binayak Sen
David Barsamian Interviews Satya Sivaraman
Satya Sivaraman is an independent journalist, filmmaker and human rights activist based in
In your article "The Mistrial of Dr. Binayak Sen" you write, "Anyone trying to figure out, after the recent Mumbai attacks, whether
Dr. Binayak Sen is a medical doctor who has been working in the
So he went there and he helped set up the Shaheed (Martyrs) Hospital, which became the first hospital run by a trade union in this country. It was low-cost health care for the first time affordable to a lot of people, not just workers but the whole area around the hospital. Shankar Guha Niyogi, the leader of the trade union movement was the visionary behind this whole idea of integrating health care into trade union activities. Health care as in direct intervention in health care; not just demanding that the government give them medical facilities but also actually doing somebody about it hands on. Niyogi was assassinated in 1991 by goons allegedly hired by the owners of the Simplex Group of companies.
So sometime after that Binayak and his wife, Ilina Sen, who is a sociologist, decided to set up their own organization to do work among rural poor, particularly the indigenous tribal communities. Chhattisgarh province was carved out of Madhya Pradesh in the year 2000, largely because it has a significant indigenous community as part of the population. The idea was that it should be sort of a state where special attention is paid to them. The reality is that the politics of Chhattisgarh is dominated by non-tribals who are migrants from other parts of
And these indigenous people are called Adivasi.
Yes. To complete what I was saying, Binayak Sen spent maybe over a decade or more running this clinic in a place called Bagrumnala in Raipur district in Chhattisgarh, which is largely a forested area with a large tribal population, and where there is hardly any kind of health care available to the people. He and his colleagues have been running this clinic there and doing some outstanding public health work, because in a country like
It was in the course of this work that he got involved with a variety of other issues, which may or may not seem to be directly related to public health, but in a developing-country situation, or for that matter anywhere, health is not just about human bodies, not just about doctors and hospitals and medicine; it's ultimately about what kind of society you are. It's about the politics of your society. It's about the distribution of resources. It's about the environmental conditions in which you live. And so many other socioeconomic factors. Dr. Sen obviously figured that out very early.
Bastar district in particular of Chhattisgarh also became the hotbed of rebellion what is called Naxalite or Maoist. The Communist Party of India-Maoist is a far-left organization which believes in armed struggle. It had a bit of strength in that area, which grew in the early part of this decade. They stepped up their activities and immediately came into conflict with a huge range of state and non-state vested interests in that region.
The forest areas of Bastar, like forest areas elsewhere in
That's when some of the politicians in the province came up with this idea, which is an old American idea from
The Chhattisgarh government cleared 640 villages and armed many of the youth from those who had been put in refugee camps and appointed them as special police officers, which has no particular meaning. They were basically state-armed civilian militia, vigilante groups of some kind. They were encouraged to go back into the forests on raids and attack other villagers who seemed to be supportive of the Maoists or were seen as being supportive.
It's led in the past six years or so to a tremendous amount of bloodshed. There has been rape of women, there have been entire villages burned down. The Maoists have also used a lot of violence against members of the Salwa Judum. In a sense what the state did was, instead of dealing with the issues that the Maoists were raising in terms of the oppression of tribal populations, they decided to pit one section of the tribals against the others. In fact, the whole Salwa Judum campaign has been adversely commented upon by the Indian Supreme Court, which has called it virtually tantamount to encouraging murder, and that law and order is the responsibility of the state, and the state cannot outsource it to any other group under any pretext.
Dr. Sen's case is linked to Salwa Judum because he got involved in human rights work. He became the national vice president of the People's Union for Civil Liberties, one of the oldest civil liberties groups in
That's the Bharatiya Janata Party.
Which is the largest opposition group right now in
The case, more specifically, is about Narayan Sanyal, a senior Maoist leader who is in jail. He's an aging person, close to 70, and he had a medical problem. Dr. Sen was approached by Sanyal's brother to look after him, provide medical care for him. So as somebody who is a doctor and also a human rights activist, he visited Sanyal many times in jail. What the police accused Dr. Sen of doing is acting as a courier for letters passed on from inside the prison to so-called Maoist supporters outside. This is the crux of the case that has been going on.
Dr. Sen was arrested on the 14th of May 2007. The hearings started only in April 2008. Typically what the police do in places like Chhattisgarh or many parts of India is, if they want to fix you, they put false charges on you and then they produce a long list of witnesses—many of them have nothing to do with the case at all—and just delay. So the court process itself takes months and years sometimes. And then on top of it, if you are refused bail for whatever reason—and in the case of Dr. Sen, he was refused bail, largely because was arrested under very draconian anti-terrorist legislation which Chhattisgarh passed several years ago. Under that law, anybody can be arrested, for having seditious thoughts even. It's that draconian. So he's been arrested under that. And the bail provisions under that act are very, very stringent, so he didn't get bail.
What is worse is that during the course of the trial one has seen the prosecution trying to feed false documents before the court, which were caught in court. They've been trying to tutor witnesses to say things that they did not originally say at the time the charges were filed. Six of the witnesses have been actually termed hostile by the prosecution itself. The case against Dr. Binayak Sen is a complete mess. Despite what is happening, there is so much political pressure onthe judicial system and on the police that, on one hand, Dr. Sen's bail has been refused; on the other hand, new charges have been slapped on him, supplementary charges, which is a whole litany, tissue of lies, one can call it.
This is a phenomenon which I would call punishment by trial—that you don't need to be convicted, none of the charges need to be proved against you. The trial itself is the punishment. Here is a public health doctor who has spent three decades working among the rural poor. He's got a sterling record as a humanitarian worker, as a peaceful, nonviolent person, and who is admired worldwide. One of the letters calling for his release, which came at the time of the first anniversary of his arrest, was signed by nothing less than 22 Nobel Prize-winners from such fields as medicine, chemistry, physics, and economics. There have been appeals like that from all over the world, despite which the government is not budging because they see Dr. Binayak Sen as somebody who is a threat to what they are trying to achieve.
I would argue that what the Maoists are doing, which is armed struggle, is something that the state can handle. It's obvious, if somebody is fighting the state to overthrow it, you send in your troops, you repress people. Warfare is something that the state is meant for and excels in. But somebody like Binayak Sen, who is doing hands-on public health work and hands-on human rights work and in many, many ways is exposing the fact that the state has failed in all these areas, is far more dangerous in the long run. He robs the state of all its legitimacy and its credibility. It's also a sort of lesson that they want to teach all these so-called human rights activists who dare to question what the state is doing. It's sent a chilling message across Chhattisgarh, certainly. A lot of people have been frightened into dropping out of doing such work.
Actually, the real terror there is of the state and the police, in many ways. The reason why I said that you have to look at Dr. Binayak Sen's case very closely to understand what's happening with terrorism in
When he was arrested on the 14th of May 2007, it was in rather unusual circumstances. He actually went to the police station.
Dr. Sen was away in
He went back to Chhattisgarh. While in
But the remarkable thing about Dr. Sen, and why it's important to focus on this case, is that he's an exceptional human being, beyond anything else. It is a very rare breed of people with that kind of integrity, somebody who is truly moved by his conscience. First of all, he could have been anywhere in the world. He could have been a top doctor in the
To put people away like him in prison under false charges and subvert not just procedures of law and the spirit of the Indian Constitution but every sense of human decency, causes despair of enormous proportions. This is where anger comes from, this is where extremism comes from. It's very easy for somebody who has never done anything close to what Dr. Binayak Sen has done to use this case and say, "If this can happen to a man like Binayak Sen, why should I not take a gun and blow up some of these guys who are behind all this?" So it breeds a cynicism, it breeds extremism.
Dr. Binayak Sen in a large country like
The basic problem in
I would call it a genocide by default. Any government in this day and age which allows, say, something like 2 to 3 million children to die every year of malnutrition-related diseases, which is what happens in India, should be hauled up before the International Court of Justice. I don't know what category you would use, but there is some category as drastic as crimes against humanity. And the elites that run this country pretend that they are some kind of a superpower and they want to become an ally of NATO and they want to be part of the big boys' club. Do your homework first. I have no problems. You want to become a superpower? Fine. But where is the homework? Half your people are dying of hunger.
It is still being run by the Chhattisgarh Mukti Morcha. It's a big hospital. The clinic he was running in Bagrumnala in
So dissent is being criminalized.
Yes. Human rights never had a very great tradition in
And where do the Adivasis, the indigenous people, fall in that structure?
What the mainstream Hindu upper caste society has not been able to do in all these years is to incorporate all the Adivasis into the Indian caste structure. If they had been incorporated, they would have occupied the bottom-most rungs, like the Dalits do, the untouchables do. So the Adivasis still have a degree of independence from Hindu culture, and they actually have their own religion and spiritual traditions. The Hindu ideologues like to pretend that all these people can be subsumed under this magic category called Hindu, which is a hugely abstract category which very few people understand what it really means.
But the Adivasis have been exploited in so many other ways. They are treated worse than animals in many parts of the country by government officials, by the police, by forest officials, particularly who have authority over the forests in which the Adivasis have lived for centuries. And suddenly there is something called the government of
What it means in practice is that a handful of forest officials and police officials, in collusion with local politicians and businessmen, do whatever they want in these areas. And that's where the Maoists come in. The Maoists have found a ready base among the tribal populations in different parts of
And as you referred to earlier, there is a huge amount—actually, the figure is 80% of
The Adivasis constitute around 8% of the overall population. But figures show that all these so-called big development projects that have been undertaken in the country since independence in 1947, 70% of the displaced people are from the indigenous groups. So they are 8% of the population, but they pay a disproportionately high price for the so-called development of
Actually, what the government of
One of the great things about the forest people or indigenous people all over the world is they don't need urbanization to survive, by and large. The forest provides them enough: from food to medicine to the best possible environment. In many parts of
So in a country of religion and faith where there is a lot of noise made, particularly by the BJP, about Hindu faith in crisis and under threat, when it comes to the traditions and faiths of tribal groups and indigenous people, they don't give a damn. Anybody can steamroll over their traditions and their faiths. Their gods don't matter. So the Adivasis have paid a very high price for the development of
In April of 2008, Dr. Binayak Sen received the Jonathan Mann Award from the Global Health Council. He was invited to
The state of Chhattisgarh and the police made a lot of noise about Dr. Binayak Sen being some kind of a dreaded terrorist. Whenever he was being brought to the trial hearings in the court, his arrival would be preceded by armed commandoes, sniffer dogs. They created this whole atmosphere that al-Qaeda is coming, something like that. Really drastic stuff.
So when he was awarded the prestigious Jonathan Mann Award for 2008, there were a lot of requests, including a letter from 22 Nobel laureates, calling upon the Indian government and the Chhattisgarh government to allow him to go to
You had an opportunity to talk to him.
This was in late November. I went from
Another thing that is an indicator of the kind of person he is, he doesn't speak about his own imprisonment. He doesn't say, "I have been in here too long. Somebody should do something about it." Nothing of the kind. He spoke to me about how vaccine production in India has been stopped in the past year or so, the state-run companies that were producing vaccines have been closed down, and saying how this is going to make India more dependent on imported vaccines, going to increase the cost of vaccines. He talked about the need for a national campaign for a new law to ensure access to health care. He talked about issues that he is passionate about, and continues to be so, even in prison.
The man is locked up but he's not defeated. He's still in high spirits. He looks a bit tired and I was sad to see that. I think it's a complete shame that a country that dares to call itself the world's largest democracy does something as gross as what it has done to Dr. Sen. It robs Indian democracy of any credibility that it has. And the longer he stays in prison, I would argue, the worse off all of India and all Indians are.
Dr. Sen was able to write, even though he is in prison, an essay about health issues in India. I'm interested that he is also a harsh critic of the World Bank and its policies. He says that the bank "rammed the structural adjustment program down our throats. In the health sector this took the shape of health sector reforms. This heralded an emphasis on using the private sector to deliver health-care services while reducing or removing the public sector. This has resulted in the situation in which more than 80% of all expenditure in this poverty-stricken country is out-of-pocket expenditure, the biggest cause of private indebtedness today."
He's absolutely right. I would add that public spending on health in India has always been very poor. It's one of the lowest in the world, something like $14 per capita.
How does that compare to the country India is always being compared to, China?
China is much, much higher, because health expenditures are calculated largely on the basis of just looking at infrastructure set up for health or training of doctors and medical staff and provision of medicines. I would say that if you factor in things like better nutrition, access to drinking water, China scores much better historically. Things are declining in China also in recent decades. That's a different story. They have their own problems. But compared to India, China is way, way ahead in these matters.
State expenditure, as I mentioned, was always very low. The kind of World Bank-inspired policies that took hold in India in the late 1980s and early 1990s, removed even the fig leaf of pretensions of the Indian state that they were actually doing something for the poor. And it became an unabashed orgy of celebrating and worshipping wealth and basically doing everything possible to cater to rich people.
If you take the big cities in India, some of the hospitals are seven-star hospitals. There are people flying in from all over the world. This is part of the medical tourism Dr. Sen also talks about in his paper. The Indian government now is promoting medical tourism that is attracting patients from developed countries who find Indian health care fairly good quality but cheaper, so they come here to get operated, get all kind of work done. But this is in a country where the Indian state has not been able to provide health care for 80% of its people, who, as Dr. Sen says, pay for their health expenditure from their own pockets.
He calls medical tourism "a moral obscenity."
It is a moral obscenity. I personally am convinced that one more reason Dr. Sen is so important a figure is because of his work on public health. To me, there is no other agenda I can think of in this country that is simply more important than public health and health—and health in the holistic way, with all its links to socioeconomic determinants of health. Because the solution to health care in this country is not just about making more fancy hospitals and sending more doctors and stuff like that. It's really about empowering people, right on the bottom, to get what is due to them as human beings, as citizens of India, what is enshrined in the Constitution, and ensuring democracy in the true sense of the term, so deepening democracy.
What you have typically is you can have a rural health clinic set up by the government, but where the poorest people who come to those clinics are shooed away by state employees or local guys who want to control that. There is a huge democracy deficit in India. India is a democracy by default, because we have many, many, many thousands of little dictatorships cobbled together into one large entity called India. If you zoom into any local context, it's totally authoritarian. You have domination by the upper class, by the landed gentry, by the rich, by the police. The state and the elites merge very easily with each other; they're part of each other.
So the little man in this country is seriously oppressed. Unless they're liberated, health also cannot change, because there is no concern. Health is ultimately about concern. A good doctor is not even somebody, necessarily, very skilled in his profession. A good doctor is somebody who's concerned about the health of the patient. It's only then he begins to think, he begins to do things, takes the time to actually make sure things go right. That concern is not there. The Indian state is not bothered about what's happening to a majority of its population. As far as they're concerned, they can just disappear from the face of the earth. It wouldn't matter to them.
And in that sense, it mirrors the global realities also, how the global elites—essentially today, if you look at the idea of what the globe is, it depends on who you speak to. For some people it's all the big metropolitan capitals of the world: Paris, London, New York, Tokyo, Seoul. This is the world for them. Nothing else exists beyond that. And if the rest of the world in between these metropolises disappears altogether, 70% of the world's population disappears, it won't make a damned difference to them.
That is why I get this uneasy feeling that there is a sort of genocide in the offing somewhere. There is going to be this huge massacre at some stage, which is happening in the form of poverty and conflict and disease anyway. But that is exacerbated by other political trends that we see globally. India has the same attitude. The Indian elites are one with the global elites when it comes to the way they look at the poor. We have people who claim to be nationalists and patriotic, and "We stand for India." But what do they mean by India? They mean themselves and their families. Nobody else exists. India is an abstraction. India is a property to be defended. The people don't exist. The whole idea of the nation as property. Do you defend dead property over living human beings? This is what is going on in India.
That's why I say that health is so important in a country like India. It's more important than every other issue. The kind of work that Dr. Sen is doing, hands-on work in some of the most difficult areas to operate in, is a model for every other activist in this country, every other citizen in this country.
He writes, continuing on the health issue here in India, that "poor sanitation and unhygienic water supply remain major causes of disease and death."
Sanitation and hygiene are a big issue in India. In rural areas sanitation and hygiene is not a big issue. It's a big issue in semi-urban and urban areas. In rural areas what happens is that, unless there are toxic chemicals spewing out of factories located there, a large amount of the so-called waste is biological, biodegradable. There is enough space, there are enough ecological and natural systems around to absorb all this. In semi-urban and urban areas, where people are crowded together, and particularly in the slums, the state doesn't exist. The state doesn't provide water, roads, shelter, and sanitation. So these become cesspools of dirt and filth and breed diseases of different kinds.
In a sense, it's also indicative of the flawed policies we have adopted over a period of 60 years of Indian independence of promoting more and more reckless kinds of urbanization. The urbanization issue I'm raising only because it's got a big implication for health. People in general know how to look after themselves, except if they're displaced, forced to migrate from a context where they are comfortable and have the skills to survive in and thrust into areas where they have no way to survive, they don't know what to do, they're completely at the mercy of their surroundings, and the state doesn't do anything for them.
So you have in the Indian cities a vast variety of problems, primarily related to nutrition, I would say, because of poverty. But it's a vicious cycle. Once you are malnourished, you are more susceptible to tuberculosis, for example, which is rampant in India, and children are vulnerable to pneumonia, which is a major killer in India of children under the age of 5. Women are anemic. There is chronic anemia among most Indian women, which results in children being born with low birth weight and stunts their growth, stunts their ability to do a lot of things. So it's a vicious cycle. Poverty breeds ill health. Ill health furthers poverty. That's the vicious cycle we are sort of living with.
Sanitation and hygiene are very important issues, which are simply not dealt with. In Europe, for example, there was a very interesting survey that was done not long ago by the BBC, which wanted people to choose what they considered the single biggest step forward for public health in the past 200 years. And they listed a whole range of new technologies, new medicines, like antibiotics, for example, the magic pill that came up in the 1940s. Of all the things, what won the number one ranking as the most effective intervention was the cleaning up of Europe after the Great Plague. The cleaning up of European cities, improvement of sanitation systems wiped out more disease, more infection than all the medicines and doctors put together. So India is in the same situation as Europe was three centuries ago in some ways.
Dr. Sen writes about chronic hunger and its persistence in India despite all the call centers and malls and high-rise buildings that are sprouting up all over the country. He says, "Our people are eating far less than they did some years ago and are going deeper into the grip of a chronic, ongoing famine." It's interesting, that with all of this so-called economic development and growth, people are actually eating less.
People are eating less for a wide range of reasons. One is that agriculture in India has not been growing anywhere near as fast as industrial growth and growth in the services sector have been happening. This is because of long years of neglect of agriculture. So there are fewer and fewer employment possibilities, opportunities to make money in the rural areas for people who don't own land or even for small farmers, many of whom have committed suicide because they're neck-deep in debt. So there is a lot of migration into the cities. The moment a rural person migrates, as I was saying earlier, he loses his ability to survive without money. And in the city money is always short. No amount of money you earn is enough, and the poor don't earn very much. Everything is much more expensive. So what people do is cut back on their nutrition, because they don't have money. And they can't forage. In the city where do you forage? So that is one part of the story.
The second part of the story is that in tribal areas, where large companies are eyeing mineral resources or where large projects are being built, people have been displaced in large numbers. Again, the same problem. They have been displaced, forced by the state, in many ways, or by companies and corporations. The displaced people, again, the first thing that happens to them is they lose their ability to nourish themselves. Then, of course, you have the issue of rising prices of essential food items. That's been going on for years together. So it puts things out of their reach.
Yet another point I want to make is that the kind of agriculture that has been promoted in the past 40, 50 years, the whole Green Revolution technology, is capital-intensive and has also resulted in loss of crop diversity. Many crops that are highly nutritious, high-protein. were always, for centuries, part of the diet of different peoples in India. Those crops you don't get anymore. Or if you get them, you get in them health food shops, packed by Nestlé. There is one millet, for example, called ragi. Ragi, in the south and parts of southwest India, is a staple diet of the poor. It's a black kind of millet, which you boil in water, make into a paste, and drink it, or you can roll it into a ball. I've seen villagers who have not had money to even put salt in it. They just eat ragi.
Ragi now is marketed in supermarkets around cities in India by Nestlé as a health drink. And it is extremely good for your health, no doubt about that. But what little ragi is being grown is being sucked out of the countryside by these large multinationals. People who suffer from obesity or cardiac problems or diabetes need to do more hard work, manual work. They don't need health drinks; they just need to go out there and do the work that ordinary people are doing.
You're involved in a poster campaign called "Another India Is Possible."
The slogan "Another India Is Possible" is a rip-off from the well-known slogan of the World Social Forum, which is "Another World Is Possible." There are a couple of reasons why we are doing this poster campaign. One is that there is a feeling of hopelessness, with all the problems of the world around us, economic gloom and doom, and the terrorist attack in Mumbai, which was extremely depressing, that people can do something like that at all, that kind of really heartless, merciless killing of innocent people. There is a lot of despair everywhere.
So we thought that we should break the cycle of despair and just allow people to dream. What kind of world do they want to see and what kind of India do they want to see. That is the first point. The second is that we want it to be in the form of posters because it's easy—we want to involve people, young people, particularly from arts colleges. You don't have to be an artist, really. But you can make a poster, scan it, and send it to us. We put it up on our Web site. The idea is that the best 50 posters will be made into what we call a visual election manifesto, which we want to present to all the Indian political parties before the next general election. We want to give this to these politicians and say that "This is what the people of India want the future of India to be like. And it's in pictures, because we know you don't know how to read."
And one of them features Binayak Sen.
The invitation for this poster campaign shows Dr. Binayak Sen looking out of this prison van, with a beautiful smile on his face, of course. And at the top of the poster it says, "Yes, we can. Yes, we can. Yes, we can. Dr. Binayak Sen for prime minister of India. Another India is possible." It lets us dream. I want Dr. Binayak Sen to be the prime minister of India, not Manmohan Singh, who went to Washington last September and tells George Bush that the "People of India deeply love you." I wish we had a few more journalists like Muntadar al-Zaidi going to the press conferences of the Indian prime minister.
And throwing a shoe at him.
How can people get involved in the campaign to secure Dr. Sen's release?
Some of us run a Web site called www.binayaksen.net, where we've been trying to provide regular updates on what's happening with the campaign and the debate, discussions going on around his imprisonment and the issues involved there. Internationally a lot of support has come in already for Dr. Binayak Sen's release. In May 2008, the first anniversary of his arrest, there were protests organized in nine North American cities, eight in the United States, one in Canada, besides which there were protests in London, Stockholm, Paris, apart from many cities in India. Internationally there has been a lot of goodwill and support.
More is required. There needs to be pressure put on the Indian government not just on the issue of Dr. Binayak Sen. What is very important here is to understand that he doesn't talk about his own release. He talks about the issues he has been working on for 35 years. He talks about public health and human rights. He talks about issues that matter to ordinary people. I think internationally there needs to be more pressure put on India on those issues, on public health. How can you have a country which has a nuclear bomb, which sends rockets into space, which claims to have a very large pool of scientific manpower and much of Microsoft is teeming with Indian software engineers, and you allow people to die in very large numbers avoidable deaths due to malnutrition, lack of simple medical care, where people go into debt, commit suicide because they can't pay for their health bills? Long sentence There has to be pressure put on India on this primarily, together with the call for Dr. Binayak Sen's release. But I think that both go together. One is not independent of the other.
Thanks very much for your time.
Thank you very much for having me on. I hope people join our campaign. They can visit the Web site and get in touch with us through that.
(Due to time constraints some portions of the interview were not included in the national broadcast. Those portions are included in this transcript.)
For more info - www.binayaksen.net