I am happy to see that "no-go-tell" training program (nobadtouch.com) is now in textbooks.

I must warn about a serious error in govt version.
Please read on. This is vital.
#Thread
For whatever reasons, "good touch-bad touch" has become buzzword with NGOs and Govt agencies.

They feel compelled to include "Good Touch" in every discussion about Childhood Sexual Abuse (CSA).

This is highly dangerous and may make children MORE vulnerable.
Reasons -
1. 85-95% CSA happens at home. From people depicted as "good touch" in various programs.
2. Abusers groom children for a considerable time before moving on with sexual assault. Grooming involves various techniques INCLUDING so called "good touch".
3. Asking a child to differentiate touches in environment of fear, shame, discomfort is like asking Virat Kohli to sing dhrupad while facing Anderson on a green top. - impossible task.
4. Training about touch in NO-TOUCH areas no matter who does that touch, is essential.
I may know where this compulsion to include "good touch" comes from.
My guess -
1. Typical indian discomfort of talking about bad things without sugarcoating it. (Most benign cause)
2. Need to protect tradition of touching child anywhere without thinking, especially by "uncles"
3. My most paranoid and angry thought - abusers have actually infiltrated this training and want to normalize bad-touch under disguise of good touch.

I leave it to you to decide what you want for your children.
Most important components of this safety training are -
1. Establishing no-touch areas.
2. NO-GO-TELL sequence of action
3. Establishing close loop of specific understanding with a SAFE ADULT.

Any change in this leads to dilution of message rendering it ineffective.
Any person with experience of childhood sexual abuse or experience of working with abused children will tell you that my serious objections to include anything like "Good Touch" in safety training are correct.

I hope @smritiirani ji takes this on her agenda and help protect kids
Details of correct safety training - nobadtouch.com
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More from @docbhooshan

10 Jul
#Thread

This picture shows one of the most poignant moments in doctor's/nurse's working life. The moment when patient passes away.
(I don't know name of the painter)
Now a days, most of us choose hospital as our place of transition. It is very rare for people to breathe their last at home in their own bed with dear ones standing by.
Most people have no experience of being witness of this moment of passing away. And for us medical professionals, unfortunately, it is a frequent experience.
Read 10 tweets
22 Jun
#Thread
#RealMedicine
#GroundReality

A batchmate of mine settled in remote area of Maharashtra 25 years ago.
Financially well off family and intelligent chap. He had every opportunity to choose a more lucrative branch and city to settle down for practice.
He chose to go back to his family village. It was a Taluka place but really a largish village. His training as pediatrician in Mumbai was grossly inadequate to work in realities of rural Maharashtra.

He persisted. Became a successful practitioner.
In a recent phone chat he told me that he shut down his pediatric ICU and gave away all the equipment to whoever was willing.

I was surprised and pulled his leg about third wave and child patients of covid. And also about him abandoning the iminent battleground.
Read 7 tweets
30 May
#Thread
#Schizophrenia

A series of 7 short posts about schizophrenia. Written for Schizophrenia awareness week.
1
Is it one single well defined, well understood illness?
2
Some common types of schizophrenia described in #Marathi by fellow psychiatrist Dr Atul Dhage
Read 9 tweets
29 May
Is India listening?
We have started our love affair with insurance driven healthcare in earnest.

We WILL suffer.
Japanese System of healthcare

en.m.wikipedia.org/wiki/Health_ca…
Singapore model of healthcare.

commonwealthfund.org/international-…
Read 5 tweets
22 May
#Thread

Amphotericin B and Mucormycosis bring up uncomfortable memory.

Memory of a family that was ruined because of cost of treatment

Jan1996.
I started my first house job in Nashik after finishing internship.
My very first patient was a middle aged man on ICU bed no 1.
He was operated for removal of mucormycosis balls from his maxillary sinus. He lost one eye to that fungus.
Uncontrolled diabetes caused by misconceptions about illness, insulin and faith in "alternative" ultimately led to this fungal infection.

I met him 4 days after operation.
Amphotericin B was not avaialble in Nashik then. It has to be brought from Mumbai.
Read 11 tweets
19 May
One family or a few families together can not change curriculum or "system".

It is possible to neutralize toxicity of school system by clever use of time and choice.

It needs a deaf year for friends and family.

How to go about it?

A thread -
1. Choose a school that is closest to your home. Preferably walking distance. Commute is a killer.
2. Time is most important tool. Choose a school that engages kids for minimum time. State board schools are best in this area. Esp schools that run in 2 shifts.
3. Getting marks in school exams should not be a priority. Only 12th std matters to an extent.
4. Self learning + help from parents, internet should be preferred way. No tuition classes at all.
5. Understanding questions and trying to get into examiners mind is essential skill in
Read 12 tweets

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