Thread by @ProfSomashekhar

@FoolzWizdom I believe that this is because medical leadership has been poor at various levels.
One saw it first hand in the #Covid_19 crises with no medical leader of repute speaking about underreporting of deaths! I have approached faculty and they have simply 1/n

https://twitter.com/foolzwizdom/status/1336469155264909312

wimped out of participating in collection of data. One should remember that #Covid_19 affects leaders personally and yet they have been reluctant. The brazen way with vaccine release on Aug 15 was announced or the how drugs like favipiravir or tolicizumab were allowed 2/n

To be used despite there being barely any evidence shows that academic and professional leadership isn’t upto scratch either in publishing these issue or taking it up with the regulators. Consider the uproar in US when HCQ and Plasma approval was met with uproar by academia 3/n

It is one think to be politically correct and another to stand up for the truth and integrity. In India most crawl when asked to bend. Servility is a treasured trait and audacity is frowned upon. US treasures audacity and innovation and hence it goes places. About 2 decades 4/n

Two decades ago, a retired HOD of OBG who was in the chair for more than a decade filed a PIL against the govt for such poor facilities. One of my friends quipped that what was she doing when she was in office. But people like @DrYogeshparikh have faced transfers when 5/n

When they tried to improve facilities for children and didn’t try to ‘accommodate’ others.
This plays out at all levels whether it is governments or districts; private or public. One needs stringent advocacy. In my area, I have been able to push my institutions 6/n

From having a six bedded NICU with warmers and 1 ventilator to a unit with 26 and more beds with capacity to Ventilate 10. USG, Nitric and High frequency ventilation for more than a decade. It is leadership and conviction which ensures progress as I have seen 7/n

This play out in government too where those with intent have brought about change. What can one do? If one is in academics one should highlight this regularly rather than do another RCT which may no implication. I have worked in the field in tribal areas and it is 8/n

Tough to bring about change especially when data is not shared. BW of neonates are digit specific. They are either 1.5, 2 or 2.5 or 3. Salaries of doctors are very poor & conditions of stay, etc are bad. How many publications or papers address this? Few journalists work here 9/n

Since i work in rural area my perspective and sensibilities have changed quite a bit. They are going to be different from babus or experts who come for a few days and advise - most of which does not help the patients but just feel good for the experts. Do check my DAMA paper 10/n

About 5-6 years back we wrote on research policies of MCI and later on abortion laws and periviability too. While this was a big issue, not many academic leaders wanted to discuss and take a position. In 2013, at a talk in Boston University I actually dismissed the 11/n

Rather criticized the PNDT act in the presence of the Ambassador of India to the US. My point was it has made no difference. This year apparently in a village in Haryana no girls were born. One needs integrity to say the correct things and follow them up. I find it missing. 12/n

It is one thing to be academic and successful and another thing to have brutal honesty and faith in one’s conviction. For things to improve these qualities need to be there in many and not a few.
The public is not going to be interested as we are a population which 13/n

Has faced scarcity and oppression for more than a 1000 years and self preservation is high on everyone’s list. Also many don’t understand health quite well. If this has to improve it is important that healthcare professionals talk about it and be scathing in their opinions. 14/n

As I see it the people who have changed the world or are respected throughout history are not the ones with the most money or the most degrees but those who believed in something and fought for it. People who are afraid can’t be leaders and can’t change anything. 15/n and finish