The Edge

I I L M I N S T I T U T E F O R H I G H E R E D U C AT I O N

Vol-IV, No. 4, October 2007

INTERVIEW of Mr. RAJEEV TALWAR Group Executive Director, DLF Limited

FROM THE DIRECTOR’S DESK Brand, logo trade marks are related concepts and tools which are building blocks of marketing, as well as corporate identity.

However, brands in generic sense of the term, are not singular domain of business. One of the most famous logo in the world is Red cross which belongs to a not -for-profit organization.

Logo, if appropriately designed, is a visualization of the organization's vision and mission. This is an extremely difficult task and there are not many instances which can be considered as classic. Moreover, companies go through, at periodic intervals, the process of revisiting their visions and missions, as market conditions, perceptions and preference profiles of the stake holders as well as intra-corporate dynamics undergo paradigm shifts. Any redefining of the corporate identity due to such massive changes will need creating new visions and missions as well as their visualization. A recent Indian example is that of Hindustan Unilever Limited.

The best visualization that I have ever seen of the institutional vision and mission comes not from the corporate sector but from an NGO. Ramakrishna Mission, and it has remained true to its core more than 150 years. The logo was designed by Swami Vivekananda and in his own words, it stands for : "The wavy waters in the picture are symbolic of Karma, the lotus of Bhakti and the rising sun of Jnana.

The encircling serpent is indicative of Yoga and the awakened Kundalini Shakti, while the swan in the picture stands for the Paramatman. Therefore, the idea of the picture is that by the union of the Karma, Jnana, Bhakti and Yoga, the vision of the Paramatman is obtained."

Corporate sector has a lot to learn from the world of religion.

B. Bhattacharyya

05

INTERVIEW OF Mr. RAJEEV TALWAR Group Executive Director, DLF Limited

09

RISE & RISE OF THE RUPEE

19

HOSPITAL MANAGEMENT: A QUANTITATIVE APPROACH

The

Edge

CONTENTS INHOUSE MAGAZINE FOR LIMITED CIRCULATION Vol-IV No. 4 October 2007

04

12 15 22 25

IILM GURGAON RATED A++ BY BUSINESS INDIA

26 30 33 35

THE MONEY SPINNER THE POWER OF EI INSURING A HEALTHY FUTURE NEEDED DEDICATED HEALTHCARE HR

HOW IMMUNIZED WE ARE FLEXIBILITY IN HEALTHCARE PITFALLS OF MEDICO-ACTIVE WASTE DIET PATTERNS FOR YOUNG EXECUTIVES

EDITORIAL BOARD Mrs Malvika Rai Prof. B. Bhattacharyya

EDITORIAL TEAM Sonam Phogat

Ms. Disha Dubey

MEDICAL PRODUCTS A LONG SHELFLIFE THE CUTTING EDGE HEALTH SERVICES GROWING FAST BEING HEALTHY, WEALTHY & WISE DELETE STRESS WITH NATURE'S BIG FIVE BOOK REVIEW STUDENTS’ CORNER CAMPUS NEWS

Published by IILM Institute for Higher Education 69, Sector 53, Gurgaon-122003 Phone:: 0124 4559300

Pulak Tandon

Shree Dina Nath Mishra Prof. Kailash Tuli

37 40 42 44 47 50 54 58

Kanika Arora Kanika Batra

Design: SUNIL KUMAR

Printed by Avantika Printers Pvt. Limited, 194/2, Ramesh Market, Garhi East of Kailash,New Delhi-110065

The

Edge

CONTENTS INHOUSE MAGAZINE FOR LIMITED CIRCULATION Vol-IV No. 4 October 2007

04

12 15 22 25

IILM GURGAON RATED A++ BY BUSINESS INDIA

26 30 33 35

THE MONEY SPINNER THE POWER OF EI INSURING A HEALTHY FUTURE NEEDED DEDICATED HEALTHCARE HR

HOW IMMUNIZED WE ARE FLEXIBILITY IN HEALTHCARE PITFALLS OF MEDICO-ACTIVE WASTE DIET PATTERNS FOR YOUNG EXECUTIVES

EDITORIAL BOARD Mrs Malvika Rai Prof. B. Bhattacharyya

EDITORIAL TEAM Sonam Phogat

Ms. Disha Dubey

MEDICAL PRODUCTS A LONG SHELFLIFE THE CUTTING EDGE HEALTH SERVICES GROWING FAST BEING HEALTHY, WEALTHY & WISE DELETE STRESS WITH NATURE'S BIG FIVE BOOK REVIEW STUDENTS’ CORNER CAMPUS NEWS

Published by IILM Institute for Higher Education 69, Sector 53, Gurgaon-122003 Phone:: 0124 4559300

Pulak Tandon

Shree Dina Nath Mishra Prof. Kailash Tuli

37 40 42 44 47 50 54 58

Kanika Arora Kanika Batra

Design: SUNIL KUMAR

Printed by Avantika Printers Pvt. Limited, 194/2, Ramesh Market, Garhi East of Kailash,New Delhi-110065

W

RANKING LIST IN ALPHABETICAL ORDER RANK A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ A++ The

NAME OF THE INSTITUTE

CITY

DIRECTOR

Alliance Business Academy Bharathidsan Institute of Management Great Lakes Institute of Management IIM Kozhikode IIM Indore Indian Institute of Modern Management Indraprastha Uni. School of Management Institute for Financial Management IILM Institute for Technology & Management K. J. Somaiya Inst of Management Loyola Institute of Business Administration Met Institute of Management New Delhi Institute of Management Nirma University PSG Institute of Management SCMS Cochin Shailesh J Mehta School of Mgmt, IIT Mumbai Siescoms St. Joseph's College of Business Administration Xavier Institute of Mgmt & Enterpreneurship

Bangalore Tirochirappalli Chennai Kozhikode Indore Pune Delhi Chennai Gurgaon Navi Mumbai Mumbai Chennai Mumbai New Delhi Ahmedabad Coimbatore Cochin Mumbai Navi Mumbai Bangalore Bangalore

B.V. Krishnamurthy M. Sankaran S. Sriram Krishnakumar Parashar S. Krishnamurthy R. K. Mittal R. Kannan B. Bhattacharya C.S. Adhikari Suresh Ghai P. Christie Vijay Page R. M. Singh Upinder Dhar R. Nandagopal V. Raman Nair Karuna Jain A. K. Sen Gupta Aveline R D'Souza J. Philip

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AVERAGE SALARY (Rs. lakh)

Mark 50 150 180 130 100 150 55 50 15 70 50 1,000

STUDENT ADMISSIONS

PARAMETER Methodology Background information Academic programmes Faculty details Student profile Infrastructure Placements Curriculum and pedagogy Income & expenditure Alumni Intellectual interface MDP activity Total

ith the rapid proliferation of B-schools in the country, aspiring management students have a very difficult task in distinguishing the Best from the Rest. B-School rankings are recognized world over, as data driven and unbiased indicators of the overall academic and infrastructural standards of the schools participating in the exercise.

In the 8th Annual Business India - B-school survey, out of 1400 B-Schools across the

country, there are 21 B-Schools including IILM who have received an A++ rank. The participating institutes have been divided into two groups i.e. the top twenty B-Schools followed by nine broad categories (A++, A+, A, B++, B+, B, C++, C+& C) The ranking of BSchools is based on specific parameters like academic programmes, intellectual capital, learning ambience, curriculum and pedagogy, admissions and placements, faculty student ratio, corporate networking and MDPs to name a few.

Specific weightage has been assigned to each parameter.

IILM has been striving constantly in all the parameters that have been set and the results show in a quantum jump in the ranking.

120 112 164 240 240 300 165 45 598 120 240 127 121 240 240 150 240 79 720 60 240

8.25 7.02 9.3 8.4 8.4 5 5 5.6 3.24 3.5 6.7 5.97 4.5 5.2 6.5 4.52 4 9.71 3.85 2.75 5.05

WEBSITE www.alliancebschool.org www.bim.edu www.greatlakes.edu.in www.iimk.ernet.in www.iimidr.ernet.in www.iimmpune.com www.ipu.ac.in www.ifmr.ac.in www.iilm.edu www.itm.edu www./simsr.somaiya.edu www.liba.edu www.met.edu www.ndimdelhi.org www.nim.ac.in/ www.psgim.ac.in www.scmsgroup.org www.som.iitb.ac.in www.siescoms.edu www.sjcba.ac.in www.xime.org

INTERVIEW

Building up a robust future INTERVIEW OF Mr. RAJEEV TALWAR Group Executive Director, DLF Limited October 3, 2007

Construction is a booming sector and with the right policies and Governmental approach, India can do wonders to its global image. We have the potential to rub shoulders with the best in business across the world. With such a bright future ahead and professional corporate giants like the DLF, the future is India’s to the fullest

I

ndia is witnessing an unprecedented boom in realty which is not only restricted to metropolitan cities but in all nooks and corners of India. DLF Limited is the prime mover company in India, who started its operations in Delhi 60 years back just after independence in New Delhi. Today DLF is synonymous with urban skyline not only in NCR region but all over the country. It is because of the innovative and visionary leadership of Mr. K P S Singh. Though DLF is steered by Mr. Singh but it is also supported by the excellent team which he is heading. With New Bangalore project of worth 60,000 crores awarded to DLF and its foreign partner, DLF is reaching towards new height in its

amazing growth story.

Mr. Rajeev Talwar is the Group Executive Director who plays very crucial and dynamic role in fulfilling the big thinking and dream plans of DLF. Students of IILM had the opportunity of interviewing him at DLF's corporate head quarter in New Delhi. He warmly welcomed the students and faculty and gave ample time from his busy schedule.

Below are given some excerpts from his interview. The interview was conducted by students namely Sonam Phogat, Pulak Tandon, Kanika Arora and Praleen Chopra of PGP and Kanika Batra of UBS. Students were accompanied by Prof.

Kailash Tuli, Prof. Akhil Swami and Mr Rahul Mishra.

Q1. Which sector do you think, is contributing to the gaping demand for quality infrastructure? Is it the commercial The

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real estate / housing or retail?

Ans. There is an economy of shortages prevailing in India. So, it runs across whether it is housing or commercial real estate or retail. GDP is increasing at a growth rate of 9 to 10%.

So, the demand for offices space will also grow. We need more hotels as businesses are growing for business travelers and tourists. Even for the existing markets, they are in pathetic condition. New constructions must take place in order to run effective and modern markets. The demand is far more up-surging than the supply. With 50% population below 25 years of age , next 20 years , you are our prime market.

Right now, the prevailing interest on housing loan is higher to lower the inflation and the flow of money. It is best to curb the demand in shortterm. But in the long run, it is better to increase to supply of real estate. There is warped thinking going on that puts emphasis on urban sprawl and expansion rather than high -rise buildings which help commercial activities to concentrate and free up land for greenery and the environment at the same time increasing the supply of office and residential space.

Q2. Government policies in terms of 100% FDI approval through the automatic route and tax incentives, are promoting this sector. What more are you looking for in terms of government support in policy measures?

Ans. We are looking for the support of Government in terms of more measure to increase the supply of land and to sort out regulations in built-up area and also to allow high rise buildings, allowing private participation and giving same stature as infrastructure. We will be able to grow more if there is less intervention of Govt. policies & laws.

Since DLF has spread in 31 Cities and 18 States. So, Government can help the sector grow more even.

Q3. The National Housing Bank pegs the housing shortage at 45 million units during the eleventh five year plan.

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During the British period, our architecture was contemporary to the then South Africa and England. But then, we slowed down on technology and, thus, started lagging behind mainly due to the adoption of socialist policies

What will be DLF's strategy for market access?

Ans. The DLF strategy for market access will be planning for middle income group housing. As we have land banking as major asset with us, 25,000 acres of land in different parts of the country. We are building new housing complexes. Builders will go where the markets and demand exist.

Housing shortage spans across all categories, from economically weaker section to lower middle class to to middle class to premium category. DLF will concentrate on middle income category with quality and affordable housing in its 90% activities at the same time generates profits from premium category in 10% of activities.

Q4. "If the country's largest real

estate developer DLF had been listed on the bourses over the past four years, it would have delivered a return unparalleled in the history of Indian stock markets". DLF opted to de-list the company from Delhi Stock Exchange in September 2003 at the time when global investors were queuing up to get a share in the booming real estate sector and after annualized appreciation of over 500% going by the valuation.

What was the reason behind this decision?

Ans. This is a complement for DLF but if we compare the situation of past 4 years with today, the investors is still queuing up to get our shares. We opted to de-list our company in 2003 because we were told by SEBI, to withdraw our Company at that time because of promoters share holding was above the permissible limit at that time. So, it was a strategic decision taken by our company, and we are running into great profits by recent IPO's with total of 175 million shares.

Q5. Do you feel that IPO will regulate DLF more?

Ans. We have opted for this. When you go for IPO, you declare all your companies, assets, strategies and financial assets. It becomes easier to govern, earn more profits, pay more taxes and create more vale for shareholders.

Q5. A report by Jones LaSalle (property consultants) estimates that US $ 10 billion foreign investment will be injected into the Indian real estate sector in the next 12-18 months. International companies like Ayala of the Philippines, Signature from Dubai, Och-Ziff Capital, EurIndia and Old Lane have indicated their interest in entering the Indian real estate market soon. How do you plan to combat this foreign competition?

Ans. Foreign players need partners who are strong in Indian market. We have strength, so we can do well in India. We don't need to go abroad.

There is no foreign competition existing. We are planning to set up a Japanese city of 500 Acres in India

only. There is a lot of money to make in India. Will we get better returns abroad? We will instead make them come to India and invest here based on contract management & market management. D E Shaw and Lehman Brothers have invested roughly 400 million dollars in DLF. Q6. Describe DLF's corporate statement and philosophy?

Ans. DLF's Corporate philosophy 1.

Value Code Transparency in finance.

Use of best technology Walk to work philosophy 2.

To establish a totally professional firm which is involved in the benefit of Each employee Stake holders Company The vision of DLF is to contribute significantly to building the new India and become the world's most valuable real estate company.

Q7. How long would you think it will take for the construction processes in our country to match up to international standards?

Ans. To tell you the truth, yes of course thanks to the Government and practice of lowest tender we tended to go slow on technology, the best example of that is Government buildings because you possibly before independence you were contemporary when the British were here with the south block & the north block, the Rashtrapati Bhawan, if you see the buildings in England at that time or of South Africa which is a very close example. But after that we lag behind as we followed the socialist model.

Coming to catching up with technology, yes, we have done our own bit as a company. DLF building in CP is the first zero maintenance building which was ever built, its now about 16 to 17 yrs old. Now we require intense technology, so you need mixtures, you need pouring machines to that extent which can used in laying down large floor

We feel we can become the largest real estate company in the world by our work and the opportunity we have in this and the next two decades. We can do wonders by driving our share value and giving our shareholders a better return

plates of 70,000 sq ft to 100,000 sq ft in one go ; we have also gone and done our own innovations like connectors.

We have done that by using steel rods which saves 4% of existing steel consumption. So, there may be there is a re-thinking going on in the world technology-wise after 9/11 about steel core of the building, the world may be moving towards with more usage of concrete as we use in India as they can with stand more heat. In any case we abide the best, its easier in the private sector than in Government The Government needs to change in terms of its mindset a lot.

Q8. According to the latest AT Kearney study, for the third year in a row, India leads the annual list of most attractive emerging markets for retail

investment followed by Russia and China. The retail sector is contributing to a great extent to this upsurge in the real estate sector. Do you see this as a long run phenomenon?

Ans. We do, there are no markets, whether you take Land's in rural markets or whether you take up market destination malls in India, across the entire spectrum we have failed to develop. I mean which better example than that of Delhi, where do you find markets here, right now there only one Connaught Place (CP) has been turned into Chandni Chowk with the keep up of Metro, Because there are 10 Lac people dropping here everyday, coming in and coming out. So, 1 lac people diverging through a place, it can't be CP anymore, I mean no place to hang around. Destination malls do tend to give you a place that is more exclusive. Therefore, huge demand for retail will continue as soon as the society gets more organized. All these DDA's, HUDA's are doomed to failure not because they don't have good people working but because they back organizational structure & no management. We have 24 hours McKinsey team working inhouse for last 2 years we are the largest engagement of McKinsey in India today and there's a total restructuring and rejigging going on as we are expanding in 31 cities in India in pan-continental way and becoming more professionally managed company.

Q9. How much effort does the tedious government policy have on the real estate sector particularly when you go for any reform you as director would recommend?

Ans. We neither would nor recommend. We are trying it as a sector that this thinking must change. Just as globalization and reforms have brought in automatic approvals, all these must come in. Why is FSI regulated if we would have total regulation of FSI, do you think we would have a Manhattan in New York, no Tokyo, no Canary warf, no place which has high rise buildings would have been allowed to The

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have them, who sets that 1.5 should be allowed here and no more than that. It takes me more cost to go and develop something in NOIDA, so, why not allow it here (CP) itself. I mean Govt. has huge reserves of Land FSI's need to look at again, your town development policies need to be looked at again why can't people acquire Land. Why can't you provide what is known as housing for economically weaker section the service provider. There are power plants in this country which were established some sixty years ago, depreciation would have taken place & also reduction in cost. Why can't economies of scale, bringing prices of goods down and transferring that benefit to the poor. Every Rich person and politician would say he would like to stay in Lutyen's Zone or just outside it, but why would you pay same price for power even if you can command a price of Land disproportionately compared to residents in Mangolpuri whose real estate price is much lower?.

Q10. In this modern era of globalization, Could you describe DLF's growth strategies in terms of acquiring assets outside India?

Ans. There is so much opportunity within India you do not have to go outside for your growth. We have no intentions of going outside right now. Let's see what the future holds but we feel that yes we can become the largest Real Estate Company in the world by our work & the opportunity which we have for this decade & the next 2 decades and by driving our share value & giving our shareholders a better return. In future, may be if you go there you can acquire assets outside merely by financial power play, we will have enough financial surplus perhaps to invest wherever you feel like otherwise there's so much to do in India.

Q11. DLF is venturing into telecom sector but why not into more infrastructural developments like bridges, roads?

Ans. It is not an either or situation. It The

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is and, and situation. You go into infrastructure huge amounts is required as ministry of finance says 320 billion dollars are required for that, they don't know from where to get the money. But it's also here that very many people are not used to paying for infrastructure in this country, as yet Telecom services fortunately people are used to paying and there's a 950 million corpus of subscriber remaining to be captured. If you have 750 million subscriber corpus, if you two or three new player picking up 8% market share, they will acquire 60 million consumers which is going to be larger than the biggest player now.

With DLF in 31 cities, covering Hotels, malls and residential complexes and

Our strategy for market access will be planning for middle income group housing. We have land banking as major asset with us — 25,000 acres of land in different parts of the country. We are building new housing complexes with robust momentum in many SEzs, if I am a telecom player I can supply connectivity and bandwidth immediately on plug and play basis and they will pay so it's totally in synchronization with our development.

Q12. Where do you see Gurgaon 10 years from now which has been your main hub of development?

Ans. We see Gurgoan as a global city, we are getting two designer Golf Courses, one is the Arnold Palmer one which is already there, one encircling it a Gary Player. You are getting Arallia which would be selling between 6 Crores to 10 Crores a flat, the highest price for residential flat. You are getting 'Four Seasons Hotels', 40 of the world's

best 100 hotels are Four Seasons, is that high a brand. The only new hotel which they have in India is in Gurgaon which they have signed up with us.

Across that you are getting Robert Stern whose one of the major architects in US to design a commercial center, which will have hotels, service department, commercial center, retail mall, social and cultural Center, huge development, so which will be a focus center of that place. So, that entire area, you will get a global level city.

Q13. How do you take care of ecology and greenery?

Ans. In each of our buildings we do rain water harvesting, water recycling, our AC systems and toilets are run by recycled water. Greenery, in fact, that's the reason to go high-rise, when we talked of FAR and FSI, why we have height restrictions, we have planes landing in New York City with so many high-rises also same with Hong Kong.

If you put restrictions on the high rise buildings in Gurgoan because of Palam Airport, so it makes no sense to say that we are eating up green cover. You allow only 1.5 FAR, allow 20% ground coverage but allow 100 storey building.

Why can't we make one, again it is all in the mindset, the mindset has to be changed.

CONCLUSION This life is almost lived we stand to deliver for next 20 years. But next 2030 years young generation has to work for it and actually create it. So, you got to have a vision for what you are going to leave behind and one is of course plenty of money. Everyone will be making more money in India and hopefully the poorest man also. So it's a part of our responsibility collectively to see that he makes more money, because if he has more money, we all get a better salary too.

Mr. K.P Singh, CEO, DLF is of the view that the kind of opportunities which are emerging in India, it will provide market space for 100 DLF to emerge.

FIRMING UP

E S I R & E RIS OF UPEE R THE

R

APPRECIATION OF RUPEE: POLICY AND CORPORATE RESPONSE

T

he external value of the Indian Rupee is on an upward swing.

The Indian corporate sector, especially the export segment, is not familiar with such behavior of the Rupee. Most part of Independent India has seen the Rupee depreciating, both in nominal and real terms, though there have been phases of short volatility. Viewed in this context, the current phase is rather unusual.

During the whole of 2007, the Rupee has been appreciating, as Figure 1 shows, — from Rs 44.25 to $1 on 2nd January 2007, the rate has steadily climbed up to Rs 40.29 by end July.

There are reasons behind appreciation, or for that matter deprecia-

tion, of any currency. The Rupee is no exception, and it is not easy to identify one major factor which might have caused the change.

In India's current context, it is more or less certain that there are two important proximate factors.

First, a fairly high and sustained level of FII in-flows. And second, the weakening of the US dollar in the global market against almost all major foreign currencies.

To some extent, the impact of the first factor — FII inflows — was being moderated, off and on, by RBI intervention in the forex market.

Whenever RBI decided to stay away, the rate of Rupee appreciation was high, as in April 2007. The market expectation is that if RBI stays away

40 40.29

41 42 43 44 44.25 45 Jan 02

2007

July 23

B. Bhattacharyya Principal & Director General

from the market, the Rupee may cross the threshold of Rs 40 to $1.

However, the market reversed itself in the first two weeks of August.

Taking cue from the problem of the sub-prime market in the US, all major Asian currencies, including India, have started rising against the US dollar. The Rupee has lost more than 1.5 percent, reaching by Rs. 41.36 on 17th August, 2007. Again, the main factor has been FII flows.

The FIIs have bought more in the first seven months of 2007 than in the whole of 2006. But in August, they turned into net sellers.

Impact on Trade The most immediate impact of a change in the external value of a currency is on exports and imports.

Rupee appreciation makes exports costlier and imports cheaper.

Consequently, exports are expected to fall or experience reduced rate of growth, while imports will behave in the opposite manner. As a result, the balance of trade is expected to deteriorate.

Some relevant data are presented in Table 1. Latest data for April - June 2007 as compared to those for the corresponding period in 2006 confirms the theoretical deductions. The export growth rate has declined, that of imports increased and balance of The

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trade has deteriorated substantially.

In Rupee terms, export growth has slumped to 7 percent during the first quarter of 2007 - 2008 and only 0.9 percent in June 2007.

The Governmental view is that given India's massive forex reserves of more than $200 billion, the trade deficits are not alarming. Moreover, the composition of increased imports, comprising essentially raw materials, intermediates and capital goods, broadly reflect the spurt in India's industrial growth.

Impact on Corporates Companies which will get more impacted by Rupee appreciation are those which are more trade-dependent. Exporters who invoice their receivables in USD will find that there has been a proportionate reduction in their Rupee export earnings to the extent of Rupee appreciation. Firms which have import payments in terms of USD or other payments, such as repayment of debt obligations, will have their savings in terms of Rupee costs.

The invoicing pattern in India

TABLE-1

EXPORTS & IMPORTS (US $ Million)

(Provisional)

April - June EXPORTS (including re-exports) 2006 - 2007 29044.58 2007-2008 34303.50 % Growth 2007-2008 /2007-2007 18.11 IMPORTS 2006-2007 40885.73 2007-2008 54908.83 % Growth 2007-2008 /2006-2007 34.30 TRADE BALANCE 2006-2007 2007-2008

-11841.15 -20605.33

broadly reflects the global composition. About 70 percent of India's trade is invoiced in USD. Therefore, the impact of Rupee appreciation, especially against USD, is expected to have widespread impact on India's

TABLE-2

HOW THE STOCK MARKET PERFORMED - % Returns (29 December 2006 and 27 June 2007) Country (Index) In Local Currency Brazil (BVSP) 21.7 India (BSE) 4.7 Thailand (SET) 13.4 China (SSEA) 52.1 Malaysia (KLSE) 23.8 Pakistan (KSE) 36.1 Egypt (Hermes) 13.2 South Korea (KOSPI) 20.8 Singapore (STI) 17.4 Taiwan (TWI) 13.0 Argentina 6.5 Israel 19.4 Indonesia 17.7 South Africa 13.5 Russia -4.2

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In $ terms 33.0 13.0 18.6 55.8 25.4 37.0 13.6 21.1 17.1 12.3 5.0 17.9 15.9 11.4 -24.0

Difference 11.8 8.3 5.2 3.7 1.6 0.9 0.4 0.3 - 0.3 - 0.7 - 1.5 - 1.5 - 1.8 - 2.1 - 19.8

trade and industry, though the extent of impact, adverse or beneficial, will vary from sector to sector, depending on their trade intensity.

India's software industry, which is highly export oriented with USD denominated receivables, is badly affected, with hardly any offsetting impact on the import side.

For example, Infosys which had originally used Rs. 43.1 for one USD for computing estimates, is faced with an almost 5.5 percent downward adjustment. Tata Consultancy Services (TCS), India's largest software exporter, has estimated that the near 9 percent Rupee appreciation during the year might impact its quarterly margin by 2.5 percent . It has calculated that for every percentage drop in the Rupee-Dollar rate, there is an impact of 40 basis point in terms of margin.

On the other side of the spectrum, Tata Motors has gained appreciably from the Rupee's gains. It has gained almost Rs.205 crore during the quarter. The foreign exchange gain is large attributed to the dollar-denominated convertible bonds the company issued a few years back.

One of the major beneficiaries of the Rupee appreciation is the FII's as a group. While the BSE Sensex has recorded a return of only 4.7 percent during the first six months of 2007 in Rupee terms, this gain gets translated in a return of 13.0 percent in terms of USD. The Rupee -denominated return is the second lowest among the emerging economy countries. However, India is second only to Brazil in terms of returns to equities on account of appreciation of the local currency (Table - 2). Since the index returns have been very poor, the currency movements have helped cover the risk premium of capital allocation to India.

Policy Response Reacting to the continued rise in the Rupee value which could affect India's export growth which has been rising at more than 20 percent on a trend basis, the Government

decided to announce some measures in July 2007 with specific sunset provisions. In a market driven exchange rate determination scenario, there is very little that a government can do to help exporters. The WTO regime which severely restricts the degree of freedom that a Government has in terms of granting export incentives is also a factor to be considered.

Further, a strong Rupee may be bad for exporters but not necessarily so for other stake-holders such as importers or consumers who may get benefits due to lower priced imported goods. The package of incentives announced were quite unambitious possibly due to these reasons.

The aggregate cost of the relief package is estimated at Rs 1400 crores for 2007-2008. The Sunset clause makes 31 December as the cut off date.

The relief package includes as subsidy of upto two percent on pre and post shipment credit (costing Rs 600 crore to the government) and an increase in DEPB rates by 3 percent for 9 sectors and 2 percent others ( cost to the government being Rs 800 crores).

Most export organizations have termed the package to be inadequate as well as questioned the validity of differentiation among sectors, as the Rupee appreciation affects all sectors. They have also pointed out several procedural difficulties in availing of the benefits. The Ministry of Commerce, the modal agency for external trade, has reacted with the possibility of announcing a further set of measures.

Corporate Response Indian trade and industry has not

The overall scenario is positive. The main reason is that trade and industry have not panicked, even when they found their profit margin getting eroded by 5-7 percent within a span of just six months experienced a sustained phase of Rupee appreciation in the past. In fact, most of them had gained appreciably most of the time from Rupee depreciation. Therefore, a large proportion of the firms have only now started working out strategies for survival and growth in the changed context.

Some highly export dependent firms in the textiles sector have started looking at the domestic market to hedge too large foreign exposures.

Gokuldas Exports, one of India's largest garment exporters and supplier to global brands such as Nike, Gap and United Colours of Benetton has, over the last three months, added domestic clients such as Shopper’s Stop and John Players.

The current contribution of domestic to total sales is 4 percent which is targeted to be raised to 15 percent by the end of the fiscal year.

Players with a strong brand equity are trying to renegotiate contracts.

Welspun, India's one of the major textiles players, is confident that while pricing pres-

sures exist in the export markets, it is possible to convince importers to pay a higher price for quality, especially when the higher price is due to an exogenous factors such as, currency appreciation. There are several examples of Indian firms who are renegotiating for better prices to lesson the impact of Rupee appreciation.

Conclusion The overall scenario appears to be fairly positive. The main reason is that the trade and industry have not panicked, even when they found their profit margin getting eroded by 5-7 percent within a span of six months. They have taken steps to cut down costs, raise productivity and leverage their brand equity. These reveal maturity to face risks and uncertainties which are integral elements of global trading.

The Government has also come out with a well-calibrated and measured response, which treats currency adjustments as essentially short term phenomena.

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INDIA TIME

HOW

IMMUNIZED

WE ARE T

wenty five million infants are states as mentioned above.

Drop in Immunization Coverage born in India every year. A large number among them Rates over time add to an already existing infant The Rapid Household Survey population of 49.8 % who remain RCH Project makes data available for un-immunized/not fully 244 districts surveyed immunized and hence which can be compared 5 susceptible to common years apart that is year vaccine preventable dis1998-99 and 2002-03. eases. Out of these the not The data indicate that fully immunized 64% chil72 % districts surveyed, dren live in five states showed a decrease in full namely Bihar, Uttar immunization rates over Pradesh, Rajasthan, the five years with averAndhra Pradesh and West age decrease of 15.4% Bengal. (ranging from 0.1% to R. K. Pal On an average, 14 64.2%). As many as % infants in each state 27% surveyed districts Dean, PGP in Hospital Administration who come to receive showed an increase in the BCG as first vacfull immunization rates cine after birth, do not continue com- with average increase of 9.4% (ranging to immunization facilities to ing from 0.1% to 41.1%). The statereceive the Measles vaccine. Of these wise distribution of districts included dropouts, 57 % are in the same five in the Survey indicates that the states with lowest percentage of districts achieving more than 80% coverage in year 2002-03, for DPT vaccine are: Assam, Bihar, Jharkhand, MP, Rajasthan, Uttar Pradesh and West Bengal.

Identifying the Constraints The Micro-view: In spite of increasing resources being

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invested by the government and development agencies to provide more immunisation centres, the routine coverage is decreasing in a number of states in northern India, along with a rise in the drop-out rate between successive doses of the vaccines. Evaluation studies attribute this gradual erosion of the programme to a number of reasons.

One of the main reasons is the shortage of Auxiliary Nurse Midwives (ANMs) or female health workers in the urban areas of most states. Responsible for immunisation drives, much of their time is spent in travelling, collecting and returning vaccines, and maintaining records that are seldom utilized.

Their presence in many areas at outreach immunization sessions has been found to be irregular, demotivating mothers who frequently receive no services. Also, all the service providers are not consumer friendly and have too many records to maintain, with no analysis or guidance on their usage. A consistent lack of monitoring and accountability compounds the situation.

The Macroview: Central government provides the major portion of the funds for the immunization programme, while implementation falls within the purview of the state authorities.

Resources and approaches for programme implementation remain mostly similar in all states, howsoever remote or difficult the geographical terrain.

Programme management capacity is vested in the office of the Programme Manager Immunisation, at both the state and central levels, comprising only one state EPI officer and the nodal officer UIP. The staff assisting for procurement planning, monitoring and management of vaccine distribution and related logistics are either missing or burdened with many other activities. In most states, there is neither a functional system nor adequate support to compile and analyse the immunisation figures

In most states, there is neither a functional system nor adequate support to compile and analyse the immunisation figures and vaccine utilisation reports from districts, leading to poor monitoring and vaccine utilisation reports from the districts. This leads to poor monitoring and lack of coordination between vaccine utilisation and vaccine procurement and distribution.

The Need for Innovative Remedial Practices The encouraging observation is that the Government has been the initiator and active participant in most of the above stated reviews and surveys. The issues of improving support to ANMs to facilitate more time for immunization, improving systems for logistics management and monitoring have been addressed in documents related with strategy of the Government in coming years in the area of Maternal and Child welfare. In spite of the above mentioned observations, there seems the need for major shift in programme strategy. Innovative approaches to the inherent problems are, therefore, required.

Professional Management Approach: Planning needs to be decentralized when deciding on targets and vaccine requirement.

Stronger political will regarding public health issues and a generation of demand for National Health Programmes from the communities also needs attention.

Accountability for services and effective utilisation of available resources are not fixed at different levels. Help of the media, celebrities and relevant public and community organisations is more often sought to popularise slogans for crash immunization campaigns and not as part of a well-conceived communication strategy to mobilise demand from the communities for regular routine immunization.

The high-powered committees periodically appointed to review programme performance have more programme managers from the system rather than professionals from relevant disciplines. This prevents fresh thinking and a paradigm shift on proven examples from different development or business sectors, which is crucial to bring about significant change.

Build Capacities at Multiple Levels: The government is burdened with multiple programmes, with not enough professionally trained and accountable support staff to run them. The tendency to allocate work targets to healthcare staff without involving them in planning, administrative and management leads to breakdown in collaborative efforts.

Delegating responsibility with authority and resources to stakeholders would work in achieving desired results.

Instead of trying to control the system, the government can consider encouraging participation of NGOs and the private sector in management of immunisation programmes.

In the states where, in spite of reasonable resources being provided by the government the quality and covThe

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erage of immunisation is less than desired, outsourcing of vaccination services can be explored, at least as a pilot project.

The responsibility to track and analyse performance and vaccine utilisation reports can also be outsourced to professional agencies under the supervision of development agencies. This will ensure efficient resource utilisation and transparency.

The challenge, therefore, is to improve the performance of the immunization programme. What may be worth trying is, to place resources in the hands of state governments which demonstrate better performance and limit the role of central funds to extending help in planning, monitoring and fixing accountability. In case of poorer performing states, the role of Central Government in planning and monitoring the immunization programme needs to be increased substantially.

Quality is Crucial: Finally, the faith of the people in the healthcare system needs to be restored.

Apart from injection safety being of immediate concern, there must be accountability and provision for compensation in proven cases of adverse impact of immunization. A system to track possible outbreaks of vaccine-preventable diseases and follow-up measures to prevent recurrence should be in place, as also special strategies for difficult areas. Last, the programme must be customerfriendly.

Assessing New Vaccines feasibility: Management Issues: Planning and implementing a pilot project to test the feasibility of a new vaccine is a wise investment prior to expansion. Introduction of a new vaccine in areas with high coverage by vacThe

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cines already available will help to assess the impact and enhance chances of reducing disease transmission due to better herd immunity.

Where the coverage by existing vaccines is low, impact assessment becomes difficult as the low coverage of target children by the new vaccine results in lower herd immunity.

Integration with relevant areas: The impact of any new vaccine depends on the status of the existing programme. Important parameters include coverage and quality of

Routine Immunisation, Cold Chain, Logistics Management and Injection Safety.

Hand-holding States: Proactive preparation for the following activities has been found crucial - advance micro planning; training of trainers; timely mobilisation of funds and logistics from the central government to the states; regular monitoring and feedback; involvement of senior healthcare authorities and political leadership. The states where these activities were undertaken during introduction of

Hepatitis B vaccination pilot project of the government in 2002-03, showed better implementation.

Assessment of the Burden of Diseases: The existing surveillance system is unable to reflect reliable data for assessment of the disease burden. Hence, encouraging competent institutes to take up studies and funding may be considered to assess the need for new, cost-effective vaccines.

Lessons from Polio Eradication Efforts: Polio eradication efforts have thrown up effective models for improving vigil and mobilising resources. The strategy should be to supplement polio eradication efforts by strengthening routine immunisation and utilising the same resources to the best extent possible.

A fresh look on Cost sharing for healthcare: In India, basic healthcare services have been provided free of cost. In the case of higher costing new vaccines, systems of recovering the cost price will have to be developed from those who can afford to pay. Only then the use of new vaccines can be sustainable. Moreover, government-run institutions can learn from private sector how to market services, be more patient-friendly and provide quality services with empathy so that patients do not mind paying.

The most important cost consideration is that we have the support of organisations such as Global Vaccine Fund and competing manufacturers, combined with significant bargaining power due to one of the largest birth cohort of beneficiary infants in the world. Are we then going to move forward or wait till a significant number of children die or are rendered disabled due to the lack of new vaccines which are justified by the data available on disease burden?

GENERAL WARD

Flexibility in Healthcare Management

H

ealthcare is a state of complete physical, mental and social wellbeing and not merely the absence of a particular disease or ailment (WHO).

Healthcare in India has traditionally been a state responsibility which has provided enough flexibility to different states of India to act in a manner they consider appropriate to suit their individual needs. This provides states flexibility to pursue a particular healthcare policy of mix of public versus private hospitals, completely targeted versus modular expansion, and centralized versus decentralized monitoring of healthcare programmes.

Flexibility is usually defined as the ability to change or react with little penalty in time, effort, cost or performance. A flexible

K. M. Mital Professor, Strategic Management

organization is in a better position to change its product profile and add capacities in a shorter time period in keeping with the rapidly changing customer needs.

Flexibility is not a one time change but a process of continuous change in accordance with the changing priorities. Thus, flexibility should be seen as a higher order of stability that involves a combination of both stability and flexibility. A flexible hospital can abandon one market and embrace another at a short notice.

Patient needs are drivers of efficient hospital services which. in many cases. can be better served with a flexible approach. Flexibility is relevant in some way for any hospital service, be it, outpatient, in-patient, emergency or hospital The

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administration. Flexibility as a decision criterion is relevant for planning any hospital resource such as medical or para-medical staff, beds, ambulances, medicines, various medical scopes, or any other hospital equipment.

Flexibility imparts resilience to hospital administration which can better take care of patients and his relatives. Flexible budget is more appropriate for hospital services as it facilitates adjustments to rapid fluctuations in healthcare needs. A flexible budget provides estimates for a variable scenario.

Zero-base budgeting is one such flexible budgeting technique which provides stage-wise funding and next stage is funded only when it is established that going further will be beneficial otherwise the project is stopped at that stage.

In Chinese culture, bamboo is a popular symbol of flexibility and long life. According to Tao Te Ching, a Chinese philosopher, "when alive the body is supple and yielding. Following death the body becomes hard and unyielding. Whereas living plants are flexible but dead ones become dry and brittle. Thus, whereas stubborn people are disciples of death, flexible people are disciples of life. In the same way, inflexible people cannot win a victory. The hardest trees are readiest for an axe to chop them down.

While tough guys sink to the bottom, flexible people rise to the top."

Flexible hospital policies Flexibility in hospital administration means that it should pursue a policy of best mix — of owned versus hired equipment.

Hospitals should have the flexibility to make a choice between owned versus hired/rented equipment. They should have flexibility of hiring their equipment in any fashion they like based on economic and other considerations. Several hospitals prefer renting hospital equipment during peak periods while some prefer to have entire range on rent.

Hospitals can also exercise flexibility to The

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A flexible policy can be made to admit selectivesurgery cases in ICUs when normal load is less up to a limit based on past hospital data

buy pre-owned versus new equipment. A flexible approach in such matters may lead to higher equipment utilization and divert hospital administration's engagement from equipment management to its primary responsibility of patient care.

Outsourcing means focusing more on areas of key specialties by minimizing risks involved in performing activities for which the hospital may not have requisite expertise to carry out internally Outsourcing is as important in hospital management as in other economic sectors.

In hospital context outsourcing means retaining patient-centric vital services for which it has core competence and outsourcing some services, be it, clinical or non-clinical to 'Private Service Providers' (PSPs) who may provide them more efficiently at low costs and in greater volumes.

Outsourcing non-core specialties or hiring equipment on selective basis may encourage more fruitful sharing of facilities across hospitals, clinics, and PSPs. Application of priority queuing concepts in emergency services such as ambulance service can provide flexible policy for reserving some ambulances out of the total fleet for high priority calls. Low priority calls shall be served only when ambulances more than the pre-decided cut-off reserve are available. Otherwise the low priority caller shall be asked to wait till the number of available ambulances available in the hospital is more than the cut-off reserve for high priority calls. Thus, high priority calls are served faster, at the expense of little extra waiting for low priority calls while keeping overall system cost low.

Similarly, in intensive care units (ICUs) if beds are reserved only for treating emergency cases and none for performing elective-surgeries, it may not be sensible to do so when ICU cases are not reporting and elective-surgeries may turn away to other hospitals due to non-availability of

beds. A flexible policy can be made to admit selective-surgery cases in ICU units when normal ICU load is less up to a limit based on past hospital data. Flexible policies of this nature can be evolved by carrying out simulation and queuing analysis on the hospital data.

In private hospitals where patients spend huge sums on treatment, patient choice for attending nurses with whom patients may have better rapport may be entertained whenever such choices exist and does not disturb other patient schedule.

In cases of terminally sick patients when recovery is ruled out hospitals should concede (although it is a debatable issue) that the patients have a right to die or shift to home. Nurses should be duly trained in counseling family and friends to help pass through the grieving process.

A hospital is normally supposed to provide test reports and other sickness details at the time of discharge. Accordingly, hospitals maintain in-patient registers giving patient treatment details which are needed while issuing 'discharge report' or 'care sheet' to patients, which they may require afterwards at the time of future healthcare check-ups.

While it is mandatory to provide 'discharge report' situations may arise, especially when the patient insists for discharge against medical advice, when hospitals should have flexibility to deny issuance of discharge report. This is necessary as issuance may create problems for hospital administration later by snowballing into medico-legal complications for which doctors were opposed and cannot be blamed for consequences.

Flexible customer relationship management in hospitals Personalized contacts, relationships and flexibilities are important issues in healthcare environment. Cordial patient care and flexibility are important issues in hospital customer relationship management.

Hospital staff is always supposed to main-

Personalized contacts, relationships and flexibilities are important issues. Cordial patient care is an important customer relations requisite

tain caring and sympathetic attitude towards patients and their relatives. While patient care is most sacrosanct for any hospital and flexibility within limits i.e. as long as it does not lead to 'free for all' kind of situation is generally beneficial in hospital business, in a hospital there may be enormous instances when flexibility and patient care may go ill together. While 'flexible visiting hours' may not harm in many situations but it may be undesirable in several situations when visitors come too many in number affecting recovery process and bringing infections to the patient.

When patient condition is not critical and it does not interfere with the treatment being provided, hospital security standards may permit 'flexible visiting hours' for some patient relatives who may be in distress. The hospital security should not create impression of 'unsympathetic and uncaring' attitude and when it is rule bound not to relax, it can at least be kind and polite towards visitors many of whom often wail in hospitals. While security has to be firm in most situations, at the same time it can be flexible when visitors in distressed state pose no problem to the patient or hospital. Hospital security has to be firm or flexible on case-to-case basis and in general hospital security needs to adopt softer attitude than traditional security rules in business. After all, security provides first interface to visiting relatives and are an important component of hospital CRM policy.

Flexible supply chain management On the inventory side, a flexible hospital supply chain management (HSCM) may help keep hospital stocks low with reduced safety margins. A flexible HSCM policy in terms of stock locations, inventory levels and material supplies can keep inventory costs low and enable quick flow of material in cost-effective manner.

Information technology and webenabled services are at the heart of flexiThe

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ble HSCM. IT and web-enabled services are key in view of unparalleled access to timely information. Flexible HSCM involves integrating various hospital services, data and systems of different hospital service providers with a system architecture.

Built-in flexibility, robust network infrastructure, tight integration and uninterrupted communication are hallmarks of flexible HSCM. With flexible HSCM it is possible to make supplies right at the dispensing counter at a place and time when they are actually needed with minimum of delays within shelf life.

Flexibility in hospital design Flexibility and innovation should be hallmarks of hospital design in view of rapid developments in hospital engineering and information technology.

Hospitals should continuously innovate to deliver easily accessible, affordable and highest quality health care services. Post-operative care with built-in flexibility to ward off any emergent and critical situation should be the hallmark of a modern hospital.

Hospital automation and built-in-flexibility in systems helps to reduce the cost and improve the quality of healthcare. A microscope used for neurosurgery earlier was 'fixed on floor' type but later versions make it 'hanging' type. A hospital design should have built-in flexibility to accommodate 'hanging' type microscope as well.

A CT-scan room should be designed with provision for all important lines that are available in Operation Theatres (OTs) so that if suddenly a need arises to perform operation it can be done without shifting patient; similarly, OTs should have the facility to carry out CT scans in the midst of operations in operation theaters. In the same manner a hospital 'brain suite' where brain surgeries are performed should also be fitted with CT scan facilities to be used should such a need arises during the course of operation and vice versa.

'Delivery theatres' for women should have The

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Built-in flexibility, robust network infrastructure, tight integration and uninterrupted communication are hallmarks of flexible HSCM

essential lines for performing 'cesarean' operations.

Conclusion Hospitals should have the flexibility to engage volunteers who take time out from their work, their leisure and home life to volunteer their talents and energies for hospital services. Whether working directly with patients or working behind the scenes, volunteers can go a long way in enhancing the standards of hospital services. There should be flexibility of engaging volunteers on weekdays, evenings and weekends. When hospitalization is not absolutely necessary, hospitals should provide flexibility of extending home health care services as a substitute of inpatient services for sub-critical cases.

A hospital philosophy should be patient-centric, quality-driven and flexibilityoriented that should be based on the shared values of teamwork, trust, integrity, compassion and respect for individuals. Hospital staff should deliver services with empathy and flexibility and try to meet patients' medical, personal and social needs. When patient condition is source of concern to family members and relatives presence does not interfere with the treatment being provided, security standards for entry can be relaxed and 'flexible visiting hours' permitted. All hospital staff should maintain a combination of firm and flexible attitude in the best interests of individuals and hospitals.

References Kim, S.C., et al. (2000) Flexible Bed Allocation and Performance in the Intensive Care Unit, Journal of Operations Management, 18, 427-443.

Mital, K.M. (2000). Analysis of Ambulance Service. In "Raghavachari, M. and Ramani, K.Y. (ed.), Delivering Service Quality: Managerial Challenges for the 21st Century, IIM, Ahmedabad, (December 28-29, 1999). New Delhi: Macmillan India Ltd., p. 322-329".

FROM THE TABLE

HOSPITAL MANAGEMENT

A Quantitative Approach

H

ealthcare is a rapidly changing industry, and facilities are struggling to find tools to enhance their ability to keep up with the change. Quantitative techniques offer an analytical method for solving problems in practice design, planning and operations. It can be used, for instance, when designing a facility, planning for renovations, planning for changes in patient demand or evaluating practice system operations.

Quantitative skills focus on quantitative measurements to better describe the situation or to make decisions. Quantitative methods involve topics in both applied optimization and applied statistics. Applied optimization explores resource allocation issues that frequently arise in managerial decision making. In an era of dwindling resources and increasing competition, optimization questions have assumed a new and urgent importance. Applied statistics address managerial problems in which randomness or uncertainty complicate the decision environment.

Overall, managers are paid to manage resources, including people, systems, facilities, equipment and finances. These resources must be managed toward the goals of the organization. In the case of a hospital or medical center, the goals include providing high quality care to patients in a cost effective man-

ner. In this article, with a quantitative approach, some of the performance criteria, their measurements and goals are explained to illustrate how quantitative techniques are important in hospital management.

Types of Performance Criteria: Measuring only one type of criteria often leads to decreased attention to other important characteristics. Types of performance criteria include: Workload. Measurement of workload is W key to performance monitoring and planning.

Productivity. This is the ratio of workload P and the number of labor hours to complete the workload. Depending on the amount of time required to complete a unit of work, the ratio may be stated in terms of number of hours per workload unit, or the number of workload units per person hour.

Examples in a hospital would be the number of radiology procedures per hour, or the number of staff hours per surgical procedure.

Quality or Service Level. The quality of the Q service or product is very important, and should be measured on a regular basis.

Typically quality is measured on a sampling basis, wherein a percentage of the workload is judged in terms of quality. Examples in a hospital would be the percentage of randomly observed areas

Bhawna Agarwal Lecturer, QT & OR

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Although often not included in the criteria for management, measures of human resources of your organization provide an important assessment of the strength of one of, if not the, greatest asset of your organization

The

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judged to be acceptably cleaned by housekeeping, or the percentage of errors in patient's bills prepared by the finance department.

Utilization. This is a measure of the per U centage of the potential "capacity" or "capability" being utilized to perform the workload. For example, only 50% of the available time of a set of examination rooms might be utilized. Monitoring utilization of facility and equipment resources is necessary to judge when more resources are required, or resources should be reassigned to more productive uses. Monitoring utilization of personnel resources is virtually the same as monitoring productivity.

Budget. The performance of a B department in relation to its budget is often considered to be the major criteria for judging acceptable performance. With the increased need for hospitals to become more cost effective, it is likely that they will move toward variable budgeting. In this case the variable staff costs, non-staff costs, and revenues are budgeted on the workload predictions, and change to meet the workload experiences to date. The fixed staff and non-staff costs do not vary with the workload.

Human Resources. Although often not H included in the criteria for management, measures of human resources of your organization provide an important assessment of the strength of one of, if not the, greatest

asset of your organization. There are a number of possible measures, including turnover rate, average tenure with the organization, average education level and amount of training hours per year per employee.

When and Where Measured Performance can be measured at different times and stages of a system.

IInputs. Measurements can be taken before or as something enters the system being monitored. Examples for productivity in a hospital might be to weigh dirty linen as it enters the laundry. Dirty linen typically weighs approximately 10% more than the same linen weighs after it is cleaned.

Process. Measurements can be taken P while something is in process. For example, process measurements for workload are the number of instrument trays prepared by the Central Service Department. An example process measure of quality is the known samples included with laboratory specimens to test the accuracy of the test process.

Outputs. These measures are taken as the O product or service is completed. Output measures are important because they measure what your clients receive, and how satisfied they are with the service or product.

Example, output measures of productivity would be the number of patient bills sent to insurance companies per staff hour, or the number of patients discharged per day.

Goal of Productivity and Staffing The performance goals should be established consistent with the goals of the organization. For healthcare managers, there

has been or soon will be a change in their goals related to productivity. Traditionally most managers have aimed at keeping staff constant, equivalent to budgeted positions, independent of the workload experienced.

Consequently, productivity varies directly with workload. As workload increases, productivity increases too (graph 1).

However, it is more appropriate to staff for a constant productivity level and to vary the staff to meet the workload (graph 2).

PERFORMANCE MONITORING SYSTEMS Performance monitoring systems have several different characteristics that will be explained in this section.

Components Of Performance Monitoring There are three primary components of most performance monitoring systems: Criteria. These are the variables used to C measure workload, staff time, productivity, quality, timeliness, budget, etc. For most departments, there may be several criteria each for productivity, quality, timeliness and budget. These criteria can be regularly measured and reported with or without a comparison standard.

Standard.. These are the values against which the department's or person's performance will be compared. There are many different types of "standards", such as: Estimates.

Negotiated performance levels.

"Norms" from other institutions, which frequently have inconsistent sources.

Medians from other institutions,

which report their current performance.

A time standard based on several important characteristics that are commonly ignored when people refer to the term "standard".

Time Standard: The time determined to be necessary for a qualified person, working at a pace ordinarily used, under capable supervision and experiencing normal fatigue and delays, to do a defined amount of work. Each term in this definition must be operationally defined and measured to arrive at a time standard. The "standard" should represent reasonable expectation of performance and may change over time. The standard gives a specific numeric goal for comparison. Often standards are interpreted rigidly as the correct value. This, however, is counterproductive to future change in systems and improvements in productivity.

Monitoring System: This sys M tem calculates, summarizes and reports performance.

The topics covered above are tip of the iceberg. To understand applications of quantitative Methods in Healthcare Management one needs to get into quantitative methods, detailing problems and their solutions. It contains numerous helpful exhibits and graphics that explain the methods presented. It also provides a readable narrative for the manager.

Managers are paid to manage resources and people. In the case of hospitals or medical centers, the goals include providing high quality care to patients in a cost effective manner

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BIO DUMPYARD Hospital waste management is a crucial part of hygiene not just for patients but doctors and public too.

Wastes generated from healthcare facilities can be highly hazardous and an environmental disaster

WASTE

PITFALLS OF MEDICO-ACTIVE

H

ospital waste management is non-infectious but hazardous (chempart of hospital hygiene and ical, pharmaceutical and radioacmaintenance activities. tive).

Wastes generated from healthcare Proper waste management is facilities are varied in nature, rang- essential to minimize the adverse ing from ordinary organic effects of environmental waste to highly hazardous pollutants, including bioliquids and solid waste. logical pollutants. There Hospital waste can be a is hardly any focused potential health and enviattention on the growing ronmental hazard, which, menace of waste which is if not properly managed, directly proportionate to can pose a serious health the growing population. risk to healthcare The working group on providers, patients and Hospital Waste P. Malarvizhi the public.

Management constiWe seldom considtuted by WHO in 1983 Associate Professor, Finance er the harmful impact unanimously agreed of environmental pollutants on that healthcare establishments human health as a preventive should be held legally accountable healthcare. We strongly believe that for their waste management pracenvironmental pollution is more of tices, based on the universal princian environmental issue rather than ple that the "generator is a health issue. responsible".

Studies in India show that hospi- This "poltals generate 1-2 kgs./day/bed of luter pays" waste. A part of the hospital western waste is hazardous and may m o d e l cause a threat to the health and life not only of patients and staff but also of the community at large. According to a WHO report, around 85% of the hospital wastes are actually non hazardous, 10% are infective (hence, hazardous) and the remaining 5% are The

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should not have been adopted in its entirety in India as it has produced more fragmented and confused results. It has become an accepted practice in India, polluters pollute, and get away with it by paying. Poor waste management practices pose a huge risk to the health of general public, patients, professionals and contribute to environmental degradation. This issue of indiscriminate Bio-Medical Waste management in India has attracted the attention of the Government. The Biomedical Waste Management and Handling rules have been notified in 1998, promulgated by GOI, to control and reduce various type of environmental pollution. It regulated the disposal of biomedical wastes and lays down the procedures for collection, treatment and disposal standards to be complied with. These rules apply to all persons who generate, collect, receive store, transport, and treat or handle biomedical wastes in any form. Accordingly all hospitals in the public and private sector are now bound to follow these rules.

Biomedical waste Bio-medical waste is the waste that is generated during the diagnosis, treatment or immunization of human beings or animals, or in research activities. Delhi is generating approximately 6500 metric tons of waste

out of which 65 tons is Biomedical Waste. It is a subject of considerable concern to public health. Scientific disposal of hospital waste is of paramount importance because of its infectious and hazardous characteristics.

Bio-Medical Waste Management programme cannot successfully be implemented without the willingness and participation of all sections of employees of healthcare establishments.

Appropriate handling, treatment and disposal of waste by type reduces costs and does much to protect public health. There are various types of bio-medical waste.

Infectious waste includes all those medical wastes which have the potential to transmit viral, bacterial or parasitic diseases. It includes both human and animal infectious wastes and waste generated in laboratories and veterinary practice. Infectious waste is hazardous in nature.

Pathological waste includes human tissues, organs and body parts and body fluids that are removed during surgery or autopsy or other medical procedures and specimen of body fluids and their containers. They are part of infectious waste.

Hazardous waste is that which has a potential to threaten human health and life. In hospitals, chemicals, cytotoxic drugs, incinerator ash and radioactive elements constitute hazardous waste.

Each type of these wastes is to be disposed of according to its characteristics. To name few disposal methods, there is incineration, microwaving, autoclaving, disinfecting and deep burial. Biomedical waste treatment is different from other type of pollutions, as each establishment requires different expertise and resources to handle the waste generated.

Segregation of Waste Segregation is the key to any waste management scheme.

Creating systems for segregation of waste is the first step in hospital

Segregation is the key to any waste management scheme. Creating systems for segregation of waste is the first step in hospital waste management. The key to minimization and effective management of healthcare waste is identification of the waste waste management. The key to minimization and effective management of healthcare waste is identification of the waste. Bio-medical waste is to be segregated into containers/bags at the point of generation.

Segregation of waste into infected or contaminated waste and non-infected waste is mandatory and is a prerequisite for safe and hygienic waste management. The segregated waste should be treated on site (if the hospital has the provisions) or it has to be given to a common biomedical waste treatment facility provider.

No bio-medical waste shall be mixed with other wastes. There is an urgent need to keep the infectious waste separate from noninfectious waste stream. Infectious wastes are human tissues, anatomical waste, organs, body parts, animal waste (tissues/cell cultures), any pathologi-

cal/surgical waste, microbiology and biotechnology waste (cultures, stocks, specimens of microorganisms, live or attenuated vaccines, etc), pathological wastes and soiled wastes too (swabs, bandages, mops, any item contaminated with blood or body fluids). Clinical and general wastes should be segregated at source and placed in color coded plastic bags and containers of definite specifications prior to collection and disposal.

Treatment/Disposal of Bio-Medical Waste Bio-Medical waste is to be treated and disposed of in accordance with Bio-Medical Waste (Management & Handling) Rules, 1998. Treatment may be defined as the process that changes the character of hazardous waste to render them less hazardous or non-hazardous. Treatment renders waste unrecognizable.

Treatment of bio-medical waste should depend on the nature of the waste, its volume and technology.

The treatment process must be technically and economically viable and environmentally safe. It must meet regulatory standards and public acceptance. At times pre-treatment of waste may be required before storage/ transportation of bio-medical waste. Following are few methods of treatment and disposal of waste that are widely practiced by hospitals.

Incineration Incineration is a high temperature dry oxidation process that reduces organic and combustible waste to inorganic, incombustible matter and results in a very significant reduction of waste volume and weight. This process is usually selected to treat wastes that cannot be recycled, reused, or disposed of in a landfill site. Wherever common facilities for treatment and disposal of bio-medical waste are available, installation of incinerators by individual hospitals may not be encouraged and such waste should be transported to be common facility for The

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proper treatment.

Microwaving Microwaving utilizes electromagnetic, microwaves that enter into or penetrate materials. In microwaving the waste is evenly heated to a temperature of 97°C-100°C. Microwaving makes it possible for treatment of waste at site (point of generation) and waste does not require shredding. Microwaving is suitable for the treatment of most infectious waste and is done in special microwaving waste treatment facility.

Autoclaving The principle of autoclaving is the destruction of micro-organisms by steam under pressure. Autoclaves are used in healthcare facilities for sterilization of heat-resistant patientcare items. Autoclaving is an effective method for treating infectious waste before disposal.

Shredding Shredding will reduce the volume of waste and will also effectively prevent its re-use. It should be ensured that waste is disinfected by chemicals/microwav-ing/autoclaving before shredding.

Needle and syringe destroyer These can be used for needles and syringes at the point of use.

They burn up used needles ashes and cut the syringe effectively preventing the re-use.

Transportation of waste Bio-Medical Waste (Management & Handling) Rules, 1998 say waste must be transported away from the areas of generation at regular interThe

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Treatment of bio-medical waste should depend on the nature of the waste, its volume and technology. The treatment process must be technically and economically viable and environmentally safe. It must meet regulatory standards and public acceptance vals or every morning. Transport of waste, within the hospital, from areas of generation, must be done in dedicated wheeled containers, to the site of storage/treatment. The wheeled container should be designed so that waste can be easily loaded, remain secure during transportation, does not have sharp edges

and is easy to clean and disinfect.

Untreated bio-medical waste shall be transported only in specially designed vehicles. No untreated biomedical waste shall be stored beyond a period of 48 hours.

Conclusion Over the years, there has been tremendous advancement in the healtcare system. Increasingly, hospitals are responsible and accountable to a broad network of stakeholders who benefit from hospital services. However, it is ironical that the healthcare settings, which restore and maintain community health, are also threatening their well-being. Poor waste management practices pose a huge risk to health of public, patients and professionals and degrade the environment. To promote and protect our environment and health of community at large, hospitals should develop clear environmental management strategies and communicate them to all stakeholders.

The development and implementation of effective waste management system requires co-operation and interaction between the many stakeholders, which include hospital management, municipal bodies, pollution control board, manufacturers of equipment and pharmaceuticals, environmentalists, NGOs, media, medical and nursing schools, biomedical technologists, and the general public.

EAT RIGHT

I

n our so called Modern Diet, there is a mismatch between need and supply. In modern living, there is limited physical activity which does not require high calorie count or fat foods but this is the kind of diet we normally eat. The pattern is worse in the executives/ corporate employees diet. As there is a lot of work stress, a healthy and balanced diet takes a backseat, the end result being our so called Modern Diseases: ❚❘❘ Obesity ❚❘❘ Diabetes ❚❘❘ High Blood Pressure ❚❘❘ Heart Problems ❚❘❘ Osteoporosis ❚❘❘ Deficiencies People who are overworked mostly skip their most important meal i.e breakfast, which is the fuel for your body. They, thus, encounter weight related problems.

There is no time for a proper meal as they are very busy with meetings and planning and their own health plan gets neglected.

There is no time to have fruit and water and so it is substituted with tea / coffee at their work stations or during meetings. The caffeine in them further prevents absorption of nutrients which they consume, worsening their condition.

Mostly people who are stressed, eat at wrong times, consuming major portions at one time, which damages their health.

But a well-planded, balanced and nutiritious diet is stress fighting tool during regular and nonregular working hours.

The best way is to include food from all food groups.

It should be a balance of all essential com ponents: ◆ Cabohydrates ◆ Proteins ◆ Fats ◆ Vitamins & Minerals ◆ Fibre and Water The intake of simple carbs can be substituted by complex carbs like one should prefer wheat flour

Sedentary lifestyle leaves little scope for high calorie, high fat diets. Make sure you eat the right things at the right time and in right proportion Honey Khanna Dietician, Max Medcentre

DIET

PATTERNS FOR YOUNG EXECUTIVES Prefer Wheat flour Chappati Brown Bread Oat meal Parboiled Rice Fruits

In place of Maida Puri, Parantha's,Naans White Bread Cornflakes Polished rice Tinned juices

in place of maida, chappati instead of puri, parantha and naans; brown bread instead of white bread; oatmeal over cornflakes, parboiled rice over polished rice and fruit instead of fruit juices.

Fiber should be an important part of the diet and the good sources are: Whole wheat products, brown bread, fenugreek, whole pulses, oatmeal, vegetables, sprouts, fruit with peel intact, bran, beans, peas, etc.

FORMULA OF HEALTHY LIVING Keep a water bottle at your workstation so that you are reminded of having it, so that the

good intake of water is made up.

Always keep fruits as an option in corporate meetings rather having just plain cookies.

The lunch served in the cafeteria of corporates should have good portions of salad, have less oil, or else there’s also an option of low diet calorie food.

There should be proper meal timings Have a good, healthy breakfast and carry fruit with you for office binging.

Carry lunch/other meals with you rather than just being dependent on office cafeteria.

Keep healthy snacks like roasted nuts, chirwa, channas with you Try not to skip any meals Excessive tea / coffee can be substituted for drinks like panna, lemon water, lassi etc and should be a part of lunches you carry from your home.

The

Edge 25

THE WANDERER

THE

I

MONEYSPINNER

ndia has always been the cradle for medical innovation — from the time the Charak Samhita was composed in ancient India, to the present trend of medical tourism and export.

India is known all over the world for Yoga and Ayurveda, which enjoy an esteemed place in perceiving India as a health recapitulating destination.

Medical Tourism is basically visiting another country for getting treatment. The reasons may be different for residents of different countries.

Americans may get treatment in other countries for one fourth of domestic cost, Canadians may visit other countries because of the long wait in their country, Britons may prefer Medical Tourism because they can not wait for treatment under the National Health Services and can not afford private treatment and Bangladeshis and Pakistanis may come calling because they do not have the facilities. In ancient times, patients came to India from all over the Mediterranean in search of the Health God. In modern times, countries like Cuba, Costa Rica, Hungary, India, The

26 Edge

Israel, Jordan, Lithuania, According to CBC Malaysia, Thailand, News, Canada: "India is Belgium, Poland and considered the leading Singapore have taken the country promoting medlead in Medical Tourism. ical tourism and now it is India has proven its moving into a new area of worth by producing best of "medical outsourcing," the talent in healthcare as where subcontractors prothey have done in informavide services to overburtion technology. India's dened medical sysAkhil Swami top-rated education tems in western counsystem is churning out tries."

Associate Professor, Finance an estimated 20,000 to India's National 30,000 doctors and nurses each year. Health Policy declares that treatment The result is, India has been the of foreign patients is legally an most sought after destination for "export" and deemed "eligible for all medical tourism. fiscal incentives extended to export

300 250

USA

200

INDIA

150 100 50 0 Bine Marow Transplant

Heart Surgery

Cataract Surgery

TABLE: 1

COST COMPARISON OF VARIOUS TREATMENTS IN USA AND INDIA

earnings."

There are many privately owned institutes who are aggressively catering to the medical tourism and export business in which, Apollo Hospital Enterprises is leading the way.

During 2001 and the spring of 2004, they treated 60,000 patients.

Apollo already provides overnight computer services for US insurance companies and hospitals as well as working with big pharmaceutical corporations with drug trials.

Dr. Prathap C. Reddy, chairman of the company, began negotiations in 2004 with Britain's National Health Service to work as a subcontractor, to do operations and medical tests for patients at a fraction of the cost in Britain for either government or private care.

There are other institutes like Max Speciality Hospitals and Escorts Hospitals which are aggressively pursuing the Apollo lead.

The Government and private sector studies in India estimate that medical tourism could bring between $1 billion and $2 billion into the country by 2012. Medical tourism to India is growing by 30

Procedure

United States (USD) Approx

India (USD) Approx

Bone Marrow Transplant

USD 2,50,000

USD 69,200

Liver Transplant

USD 3,00,000

USD 69,350

Heart Surgery

USD 30,000

USD 8,700

Orthopedic Surgery

USD 20,000

USD 6,300

Cataract Surgery

USD 2,000

USD 1,350

Smile Designing

USD 8,000

USD 1,100

Metal Free Bridge

USD 5,500

USD 600

Dental Implants

USD 3,500

USD 900

Porcelain Metal Bridge

USD 3,000

USD 600

Porcelain Metal Crown

USD 1,000

USD 100

Tooth Impactions

USD 2,000

USD 125

Root Canal Treatment

USD 1,000

USD 110

Tooth Whitening

USD 800

USD 125

Tooth Colored Composite

USD 500

USD 30

Fillings / Tooth Cleaning

USD 300

USD 90

Procedure

United states (USD) Approx

India (USD) Approx

Breast : -Mastopexy -Reduction Mammoplasty -Mammoplasty Augmentation -Replacement Of Implants

USD 7,500 USD 8,000 USD 8,000 USD 6,500

USD 2,800 USD 3,300 USD 2,750 USD 3,000

Face : -Blepheroplasty (Upper & Lower) -Facelift Dermabrasion (Total face) Canthopexy w/Orbicularis suspension -Hair Transplant Endoscopic Brow lift -Neck lift -Otoplasty(For prominent Ears)

USD 6,000 USD 6,500 USD 5,500 USD 6,000 USD 50 Per graft USD 5,800 USD 6,100 USD 4,700

USD 2,000 USD 2,800 USD 2,150 USD 2,200 USD 3 Per graft USD 2,300 USD 2,400 USD 1,500

Nose : -Primary Rhinoplasty Tip Rhynoplasty

USD 7,300 USD 6,300

USD 2,900 USD 1,300

Body Contouring : Abdominoplasty -Thigh Lift (Bilateral) -Total Lower Body Lift(Belt Lumpectomy) Liposuction (One Region)

USD 7,700 USD 7,200 USD 9,500 USD 6,100

USD 3,200 USD 3,150 USD 6,000 USD 1,750

Non - Surgical Procedures : Laser Hair Removal -Laser Resurfacing/ Wrinkle Reduction -Laser Acne Treatment -Laser Scar Treatment -Botox

USD 550 USD 550 USD 225 USD USD 575 USD 500 225 USD 230 USD 210 USD 8 USD 70 Per Unit Per Unit

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TABLE: 2

COST COMPARISON OF VARIOUS TREATMENTS IN UNITED KINGDOM AND INDIA PROCEDURE

UNITED KINGDOM (USD) Approx

INDIA (USD) Approx

Open Heart Surgery

USD 18,000

USD 4,800

Cranio-Facial surgery and skull base

USD 13,000

USD 4,500

Neuro- surgery with Hypothermia

USD 21,000

USD 6,800

Complex spine surgery with implants

USD 13,000

USD 4,600

Simple Spine Surgery

USD 6,500

USD 2,300

Simple Brain Tumour -Biopsy -Surgery

USD 4,300 USD 10,000

USD1,200 USD 4,600

Parkinson's - Lesion, - DBS

USD 6,500 USD 26,000

USD 2,300 USD 17,800

Hip Replacement

USD 13,000

USD 4,500

* These costs are an average and may not be the actual cost to be incurred per cent a year.

The main cause for the substantial growth in this sector is the high cost of medical care in western countries like the UK and US. Indian institutes offer excellent medical care along with the famous Indian hospitality to customers at a fraction of the price they would spend in their own countries. The following comparison charts will make this point more clear: Cost comparisons: India vs UK Significant cost differences exist between the UK and India when it comes to medical treatment.

Accompanied with the cost are waiting times which exist in UK for patients which range from 3 months to over months.

India is not only cheaper but the waiting time is almost nil. This is due to the outburst of the private sector which comprises of hospitals and clinics with the latest technology and best practitioners.

These countries are the one which have been targeted by most of the institutes for their clientele and The

28 Edge

possibilities. There is one more market which has not been exploited — Canada.

Canada enjoys free medicare system which is envied by its neighbours; providing its citizens free medical benefits, it has given a model structure for developed nations to follow.

But the fall out is that there is an increase in demand for medical care in its aging population which even the Canadian infrastructure is unable to cope with. In recent studies it was revealed that patients have to go through six months to two years to undergo a hip replacement surgery.

Waiting for this long is torturous for the old aged people who have surplus money to spend. As a result people tend to rely on US. Medical care system is very expensive there and that is also inhospitable as the rudeness of the staff is notorious.

Therefore, the states in Canada are considering medical tourism as a legitimate option for supporting their infrastructure. Following news extracts taken from CBC news will explain it further: "Foreign Governments (CANADA) promoting Medical Tourism for Citizen Canadian Government: In Canada Ontario Health Insurance Plan (OHIP) will pay in full for health services outside Canada if the patient gets written authorization from the Ministry of Health and Long-Term Care before the treatment is given, and the treatment is generally accepted in Ontario, and the treatment or an equivalent procedure is not performed in Ontario or the treatment is performed in Ontario but it is necessary that the person travel outside Canada to avoid a delay that would result in death or medically significant irreversible tissue damage. In order to obtain consideration for full funding of treatment outside Canada your Ontario physician must apply to the ministry for prior approval while

you are in Ontario, before you receive out-of-country treatment Alberta would consider paying for "medical tourism," a controversial way around long queues for medical procedures that sees patients go to other countries for surgeries, says a provincial spokesman" Global destinations of medical tourism India is an attractive destination for heart, hip resurfacing and other areas of advanced medicine.

Cuba: The reputation of Cuban doctors is excellent. Low prices along with nearby beaches enable patients to recuperate.

Colombia is famous for eye/cosmetic surgery, Cardio vascular surgery and transplantation of organs. The country has excellent system of organ donor laws and organ banking system. Proximity to US/Canada helps it to be a good destination.

Singapore is famous for separating conjoined twins and toothin-eye surgery.

Thailand has modern infrastructure, clean and safe roads but high incidence of AIDS acts as a distraction.

South Africa is famous for Plastic Surgery.

Medical tourism risk It is important to see that the host country is not exposed to medico-legal hassles. Special attention should be paid to following factors.

If complications arise and the patient is not covered under medical insurance.

Legal hassles and different laws in different countries.

Different countries have different patterns of infectious diseases so the patient may not have immunity to diseases prevalent in host country.

Traveling soon after treatment may increase the risk to patient.

When the patient goes back to his country, doctors there may not conversant with the infections that he brings with him from the visited country.

Steps requiered to make India a medical tourism In times of globalization, India must catch its share of medical

While India is known for hip replacement surgeries, Cuba boasts of excellent doctors, South Africa excels in plastic surgery and Singapore is the leader in separating conjoined twins

tourism and that requires lot of proactive approach Make organ donation easier and make organ banks.

Club medical tourism with other type of Tourism activities so that whole family can visit India Promote indigenous systems of health like Yoga and Ayurveda Promote alternative medicine Develop SEZs for this Open more institutes for education/medical tourism/ hospitality Make a coordination committee for developing synergy between Ministry of Health/Tourism.

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MENTAL HEALTH

EI

THE POWER OF E

versince the publication of There is an impressive and Daniel Goldman's first book growing body of research suggeston the topic in 1995, emo- ing that these abilities are importional intelligence (EI) has become tant for success not only in works the hottest buzzword in corporate but also in many life world. Goldman claimed that EI is d o m a i n s . twice as important as IQ for success E m o t i o n a l in life and made the concept a intelligence household name. It has been found is the ability to be associated with greater hap- to deal with peopiness in life and better psycholog- ple, manage oneself, ical functioning, positive mood and understand his/her feelhigh self-esteem besides greater ings, motivate others and optimism and increased ability to respond appropriately to the repair mood. environment successThe study of emofully. It is an array of tional intelligence is curcapabilities, competenrently a topic of considcies and skills that influerable interest and activence one’s ability to sucity within industrial and ceed in coping with enviorganizational behavior ronmental demands and researches. It has gained pressures. EI affects our immense importance academic, occupation, and attracted subpersonal and mental Khurshid Alam stantial attention of health functioning. scholars from differJust like there are Professor, OB & HRM ent disciplines individual differences because of the existing volatile and in happiness and self-esteem so too fast changing business environ- do individual differ with regard to ment. As the face of change their levels of emotional intelliincreases due to globalization, lib- gence; some person may possess eralization, and intense competi- high levels of EI, other may have tion and the world of work makes difficulties in certain area of EI. ever greater demands on a per- Despite being an important deterson's cognitive, emotional and miner of performance and success physical resources, this particular in life, there are several others reaset of ability will become even more sons to understand EI and mental important in coming years. health together. Some of the very The

30 Edge

important considerations are as follows

EI is a significant trait of personality and this may provide the context in which EI may operates for greater satisfaction in life and better mental health functioning.

Facilitate understanding 'where' and 'what' about EI, for example, EI as mental ability inside or as a part of personality or both as predictor of psychological functioning.

Placing EI in its psychological context allows one to compare and contrast it with different other determinants of mental health. This will help in understanding mental health functioning as a whole as it is related with EI. Helping in establishing a cause and effect relationship that can alert researchers and practicing managers as to which psychological factor influences EI more and increases it's effect or lowers it.

Developing Emotional Awareness Training programs for employees that can help them to cope with the fast changing corporate world and adapt appropriately to any new

environmental situations.

EI is a learned phenomenon so emotional competencies can be taught and any organization can significantly benefit by incorporating it in their management training programs.

High Levels of EI & Mental Health The relationship between EI and mental health has been examined in a very few studies.

These studies have investigated variables that describe the intellectemotion connection with different aspects of well-being. Emotional intelligence has been conceptualized both as an enduring personality trait and as mental ability [Mayer et al., 2000; Pet rids and Furnham, 2003]. It has been observed that EI is positively related with eight distinct parts of personality such as empathy, interest, curiosity, arousal, need for achievement, need for affiliation, need for power and sensation seeking. So emotional intelligence not only includes mental ability related to intelligence and emotion but also other personality traits like motives, sociability, and warmth.

Generally, EI improves an individual social effectiveness, the higher the EI better the social relations.

It has been observed that EI is positively related with eight distinct parts of personality such as empathy, interest, curiosity, arousal, need for achievement, need for affiliation, need for power and sensation seeking

The higher EI persons can better perceive emotion, use them in thoughts, understand their meaning and manage emotion much better than others. The person also tends to be higher in verbal, social and intelligences and more open and agreeable than others. They are good at psychologically healthy living and avoiding conflicts, fights and other social altercations. So it is associated with greater satisfaction in life and better psychological functioning. When feeling good, individuals with high EI find it easy to categorize, organize and use and remember aspects of a problem and new information. It is individual awareness, recognition, thoughts and the capacity to appreciate emotional complexity in self and others.

The high EI individuals are likely to have possession of sentimental attachment around the home and have more positive social relationships. Such individuals may also be more adept at describing motivational goals, aims and missions.

They are also less apt to engage problem behavior and avoid selfThe

Edge 31

destructive activities such as smoking, excessive drinking, drug abuse or violent episode with others. It is now established that high EI leads to improved social relationships, greater creativity, reduced stress level and improved responsiveness.

Studies indicate that high EI is linked with increased well-being such as greater satisfaction with life and increased happiness.

Low Level of EI & Mental Health Researches on EI have moved on in recent years. There are now a whole host of researches on this topic pointing to the negative influence of low EI on person's mental health. Low EI has been found to be associated with depression, anxiety, loneliness, low self-esteem, suicidal feeling, aggressive behavior, poor impulse control, maladjustment, poor inter-personal relationships, increased alcohol and drug use and even personality disorders.

Although there are now many studies showing detrimental impact of low EI on psychological well being of the person, there is still a great deal of research that needs to be done on this important area.

Only a handful of studies have actually examined each of the mental health difficulties described above, with many studies suffering from serious methodological inadequacy.

The relationship between low EI and borderline personality disorders [BPD] has only been investigated in one or two studies. BPD, according to the DSM-1V-TR, is a disorder characterized by clear profound deficits in the ability to understand and regulate one's emotions and moods. It is surprising that E-based programs and therapies have yet not been developed to assist those with BPD. Researches should be undertaken on the development of such programs if we are to really discover exactly what components of EI plays key roles in which aspects of BPD. Those with low EI might display behavior and characteristics The

32 Edge

High EI leads to improved social relationships, greater creativity, reduced stress and improved responsiveness. Low EI has been found to be associated with depression, anxiety, loneliness, low selfesteem, suicidal feeling, aggressive behavior, poor impulse control, maladjustment, poor inter-personal relationships, increased alcohol and drug use and even personality disorders

due to insufficient ability to manage emotions.

Moreover, personality disorders may also developed as a result of complex interacting factors including physical abuse, certain life events and neurochemical imbalances.

We urgently need to develop emotional training and treatment programs for low EI individuals.

These people can be taught the following skills during the training session to enhance their emotional ability and improve their emotional competencies.

Recognize and identify one's own emotions. This is an ability to understand one's own emotions.

More specifically the participants are required to name their emotions.

Learn to take full responsibility for your emotion.

Feel your emotion and learn to bless them.

Develop the ability to recognize and understand the emotions of people around you. This is the ability to comprehend other's emotional feeling which will surely help to predict others emotional responses.

Express your emotion appropriately and in most adaptive ways.

This skill will help in coping with environmental demands and pressures.

Reflective regulation of emotion to promote emotional and intellectual growth. It is the capacity to monitor emotions and ability to stay open to pleasant and unpleasant features of emotions.

Learn to regulate emotion in self and others. This controls impulse and delay gratification.

The above skills help to manage EI in well-developed Emotional Management Training programs. EI may serve as a valuable tool for HR professionals and managers intending to bringing about radical changes in their organizations.

INSURANCE AGENTS

INSURING A HEALTHY FUTURE M

edical science has Mediclaim Insurance which caters advanced at a tremendous to the needs of individuals, families pace in the past three and can be customized for groups. decades. There is an increasing Mediclaim policy provides cover awareness among people about the for hospitalization and domiciliary importance of diet, fitness and hospitalization due to disease (other lifestyle for healthy livthan exclusions) and acciing. There is an increase dents. Whereas hospitalin longevity and 60 is ization deals with innow the new "middlepatient admission in age." approved nursing homes The state of the art and hospitals, domiciliary operation theatres, modhospitalization comes to ern diagnostic equipthe rescue of those who ment, advanced medical can not be shifted there procedures assisted due to the medical Shama Behl

by GenX machines, condition of the medical research and patient or non-availAssistant Professor, Insurance the elaborate infraability of the same in structure to provide these services the vicinity. Under such circumhas caused a revolution. Above all, stances, a patient can be the dedication, skills and specializa- temporarily supertions of the physicians and surgeons vised by a doctor has caused the surge in life-span. at home by The original cut-open surgery providing has given way to minimum invasive, him with life stitch less techniques with very little s u p p o r t i n g loss of blood. Patients are recover- fluids and ing much faster, thereby saving the drugs adminisproductive manhours. tered intraBut all these and allied services v e n o u s l y , are available at a cost. Highly spe- observed and cialized medical treatment is not assisted by a affordable for all. Even those who trained nurse. have to undergo treatments on Hospitali-zation account of unforeseen ailments will involve several have to draw heavily from their expenses such as hard earned savings. d i a g n o s t i c Since hospitalization expenses charges, specialare rising due to an increase in costs ists fee, surgical of drugs, materials and services, it and procedurhas become essential to have a con- al expenses, tingency fund. nursing General insurance provides c h a r g e s , The

Edge 33

room rent etc.

These are reimbursed to the insured subject to limits, terms and conditions of the policy opted for.

Once diagnosed and found necessary to admit the patient for further treatment, mediclaim covers the pre-and post-hospitalization expenses also for a limited period.

There are eight private and four public sector general insurers besides a single health insurance company which offers this policy.

The insurance covers provided by them are linked to several factors such as age, medical fitness, sum insured, claims experience etc.

The insurance can be granted from the age of three months to sixty years. The upper age limit has now been relaxed by some insurers and can be extended till seventy years.

The premium is primarily charged on the basis of the age band in which an insured falls. Interval in a particular age band tends to get shorter beyond age 35. In other words, premium is revised more freThe

34 Edge

Mediclaim is an excellent measure to mitigate the financial crunch which people may face owing to unforeseen illness and hospitalization quently with advancing age. Age bands are broader between 10 to 30 years. The insured can opt for the sum insured which ranges from Rs. 50,000 to Rs.10,00,000.

It is mandatory for an insured to disclose his medical fitness status at the time of taking the policy.

Pre-existing diseases which were excluded from mediclaim policies until recently can now be covered after four* continuous claim free years. (*Limitation as to number of years is decided by the individual insurers themselves.)

Insurers can suitably load premium rates in case of an adverse claims experience faced by them. There is a

very high claims ratio in mediclaim insurance which is a cause of concern to all general insurers.

To expedite the speedier settlement of claims and provide cashless service to the insured, third party administrators (TPAs) are appointed by the insurance companies. They maintain a registry of the approved hospitals and nursing homes.

The insured can get their prior approval for getting a cashless treatment (subject to policy limits) in these hospitals. Else he can always get the claim reimbursed from the insurers if the same is admitted by them.

Mediclaim is an excellent measure to mitigate the financial crunch which people may face owing to unforeseen illness and hospitalization. There is an increase in the tax deduction limit under section 80D for health insurance premium.

From the financial year 2007-08, the limit has been revised to Rs. 15000 for regular and Rs 20000 for senior citizens.

JOB PROFILE

T

he Indian healthcare industry, currently positioned at USD 23 billion, is growing at a phenomenal rate of 13% annually and is estimated to grow by 170% by 2012.

New players, both in private and public sector are increasing manifold in response to the heavy emphasis placed by the government on improving the quality of healthcare in the country.

At the same time though, contemporary healthcare organizations are struggling with critical human resource issues, including employee alignment, agility, retention, utilization and crystallizing the nature of hospital HR. Hospitals face the twin dilemma of providing quality patient care in an intensely competitive environment and catering to the unique demands and pressures of the internal customer i.e. the employees.

Escalating labor costs, high attrition and fluctuating volumes emerge as major concerns for the HR managers of hospitals. Given the above backdrop, rolling out innovative HR initiatives to woo employees becomes a prime function of the HR manager.

Understanding and Addressing the Problem Areas Maintaining quality of service for superlative patient care by inculcating best organizational practices.

Inculcating the right organizational philosophy and principles

NEEDED

DEDICATED HEALTHCARE

HR

becomes a key function of HR in driven culture. "Performers are order to ensure the delivery of qual- motivated with ample opportunities ity patient care. Apt organizational to take up challenging assignments. practices must be adopted not only We empower employees to take by consultant doctors, nurses and decisions and thus instill self-confiassociated staff but by Grade III and dence and sense of pride in working IV employees as well. for us," says R Basil, CEO Training programmes of Manipal Hospital. The assume tremendous sighospital also conducts nificance under such cirsports and cultural activicumstances. ties for a span of three According to Dr. months in parallel with Bidhan Das, Director, regular work every year, Administration, Rockland which culminates in the Hospital, "It is the role of annual Manipal festival HR to analyze behavioral called Manifest. "All these patterns whether it is go a long way to instill Shweta Khanna a high-skilled surgeon a sense of loyalty not Lecturer, HR/OB or a low-skilled secuonly among our rity guard, chart their behavior for employees but also among the conmonths together and then use tar- sultants, who are not on our direct geted intervention, which is accom- payroll," says Basil. The importance plished through behavioral and of well-defined HR is slowly taking motivational training." roots. With a spate of new hospitals, Manipal Hospital, Bangalore, like there is renewed emphasis on trainsome of its counterparts, is con- ing and development. sciously creating a working environ- Controlling attrition and retaining ment that facilitates a performance- talent in an improving economy The

Edge 35

Many hospitals allocate between 55 percent and 60 percent of their budgets to costs related to human resources. High attrition rates of 15-30% become important variable adversely impacting bottom-line profits. Analyzing turnover trends, identifying root causes of turnover and initiating measures to retain key employees becomes a major responsibility of the HR department.

Turnover cost has to be calculated not only in terms of the employee leaving but also associated costs of recruitment and advertising for replacement staff, non-productive staff time of newly hired employees during orientation, training, and assimilation, cost of human resource and in-service staff to recruit, train, and orient new employees. Costs related to turnover can thus be significant to a hospital's budget and bottom line.

The solution to managing turnover and its costs need not involve additional expenses — that The

36 Edge

Hospital administration is much more complex than administration of other business organizations.

Hence, there is need for sound and patient friendly employee management is 'throwing money' at the problem through more benefits, higher wages and recruiting bonuses.

In fact, most management studies suggest that employees value the content of their jobs, the quality of management and the culture of an organization over financial incentives.

Turnover can often be reduced without any cost or cost reallocation through organizational improvements, such as: Enhanced communications, accessible leadership, increased employee participation in decision making, empowerment,

and flexible job structures.

That the functioning of a hospital is not plagued by somebody's sudden exit, it is important to keep a databank of apt substitutes ready.

"I always chat with my employees trying to understand who is not happy and may leave the organization. I try to address their problems and grievances and always keep the replacements ready," says Gupta.

Anupam Verma, Director, Administration, PD Hinduja Hospital agrees, "We always keep a second line of people ready so as to avert a sudden crisis."

Multi-tasking also comes handy in crisis. "It is HR’s job to identify talent, encourage and train them for multi-tasking," says Dr. Biswas.

Different hospitals are beset with different HR problems. Mumbaibased Jaslok Hospital has to cope with high degree of absenteeism and indebtedness in class III and class IV employees. Every year, around 30 people are suspended because of absenteeism. This, after innumerable notices. To avoid problems, most hospitals have started outsourcing Class IV staff.

Ensuring adequate supply of skilled personnel: All institutions need good administration. Hospital administration is more complex than any other organization. Hospitals deal with human beings rather than products; it involves 24X7 work; is emergent; involves high risk and legal issues; work is stressful since it is a question of life and death and the atmosphere is a blend of hope and grief.

Redefining nature of Hospital HR In order to fuel and maintain the frenetic growth of healthcare, focus has to shift from not only keeping the cost advantage ticking, but also focusing on people issues, ensuring decentralization in health sector reforms and fostering development of trained and specialized personnel.

MARKETPLACE

MEDICAL PRODUCTS

A long shelflife T

he healthcare sector in the global economy is changing. There is unprecedented growth and competitive forces play a prominent role in the final outcome of the service product. In addition, consumers have become more informed and more empowered. Patients are no exception to this trend. As patients become more informed, it is imperative for healthcare providers to become more effective at marketing their services.

In general, physicians have received little training in the field of marketing, which results in potentially limited understanding of the key marketing issues being faced in today's healthcare environment There is widespread support for the premise that healthcare managers and executives need continuing education and skill development to cope with the increasing challenges in the healthcare industry. The dynamic nature of the healthcare industry is particularly challenging and requires advanced executive expertise to survive. Complicating matters is the prospect that the management approaches used by many healthcare organizations continue to lag other businesses in similar competitive industries.

Although it took the conveniently provided with cept of marketing decades quality care at a reasonable to take hold in the healthcost and risk of adverse outcare industry, it has become comes has been minimized, an integral part of a healthhealthcare organizations care organizations' success run the risk of going out of in recent years. Public relabusiness sooner than later. tions, advertising and marThe demise of the individual keting departments have organization can come staff, budgets and the about from the lack of Sujata Khandai responsibility of conwilling customers in a tributing to the bottomcompetitive marketAssistant Professor, Marketing line, just like any other place, and/or from department.

Healthcare service increased exposure to liability arising providers are as concerned about the from human, technological and procereturn on marketing investment as any dural failures that may occur in the other industry. course of delivery of healthcare serThe market for delivery of health- vices. care services has been steadily moving In most industries, marketing planinto the private sector as part of a glob- ning is a well established function. In al phenomenon. Even the markets the health care industry, it is a relativewhere socialized healthcare services ly new function. Till about a couple of are predominant are beginning to real- decades ago, healthcare providers typize the potential for increasing the pro- ically did not engage in formal marketductivity of systems as well as the qual- ing activities, thereby obviating the ity of services provided. In almost every need for marketing plans. While some corner of the globe, realization has sectors of the industry such as insurdawned that healthcare organizations, ance, pharmaceuticals and medical like any other, have to make a con- supplies have a long history of market scious effort to competitively meet cus- strategizing and planning, organizatomer requirements. Unless the cus- tions primarily involved in patient care tomer is satisfied that he has been con- have become involved involved in marThe

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keting planning only very recently driven by the forces of competition.

Today, the contemporary healthcare environment demands that virtually all organizations have a well designed marketing plan.

STRATEGIC MARKETING OF HEALTHCARE OFFERINGS To many healthcare executives, emphasis on marketing strategy has become a means of survival in the threatening environment of intense competition and cost containment. The difference between the winners and losers in the marketing arena is in their ability to develop and implement plans to position themselves to take advantage of the rapidly changing social, economic and technological environment compared with their competitors. For effective positioning of the healthcare product, there is a need to first and foremost understand the intricacies on the entire service offering.

The Healthcare Product The term health is defined by WHO as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1986, p.1). The emphasis on complete physical, mental and social well-being suggests that one is unhealthy without complete well-being.

Today, health offerings are designed to bring about complete physical, mental or social well-being for a person to maintain complete health.

For the marketer, it is imperative to understand the complexity of the healthcare offering as a product. To understand the totality of a healthcare offering, there is a need to distinguish between medical care and

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healthcare.

Medical care is a generic term that describes the organization, financing and delivery of health services that focus on individual or personal needs.

It encompasses the services and skills of a variety of health providers, including physicians, nurses and therapists.

A major concern of medical care is the diagnosis and treatment of the disease process which means that medical care is actually a subset of the broader concept of healthcare. The healthcare offering includes not only the medical treatment of the illness but also constitutes social, cognitive and emotional factors.

Healthcare is composed of a mixture of products, services and information. The health care offering is the content in the exchange that a health care provider and a patient engage in jointly to create value.

Complexity of the healthcare offering Being a complex product, there is a need to understand the dimensions of the healthcare offering and its related activities and resource allocations. The dimensions include the following: The medical component The social component The cognitive component and The emotional component These four components are inextricably combined, developed or exchanged to create value. For example, surgery will require a large dosage

of medical input and very little social or cognitive input. On the other hand, the diagnosis and treatment of some inherited illness may require more social, cognitive and emotional inputs than medical input.

The medical component: This dimension deals with the problem that made the patient seek the health care provider's help or advice. It deals with the symptoms and feelings of "something is wrong with me" that alert most people to seek the advice of the health care provider. Thus, the medical dimension includes all known diseases, physical or psychological.

The social component: This includes health related information received from the social interaction with families, friends and work environment and also the collective attitude of society toward health services. For example, a family member may have had the same health problems a year ago. This family member is then able to provide information about the health problem, correct or incorrect information that will influence the way the patient sees their illness.

The cognitive component: The cognitive dimension includes the knowledge that the individual patient has about his/her health problem before seeking the help from the health care provider. This knowledge is usually attained through experiences with the same or similar health problem. The internet today provides another resource to obtain cognitive knowledge.

The emotional component: The emotional dimension includes the rights of the consumer, for example, to be treated with respect and dignity and to be treated as a functional, intellectual and passionate human being. The emotional dimension also includes a static measure of the consumer's emotional status at the time of the offering.

Thus, this dimension should be both strategically managed prior to the healthcare encounter and also at the time of exchange. It is also important to understand that the emotional level and treatment of the patient will affect the flow of information between the

healthcare provider and patients.

Positioning the Healthcare Offering It is imperative for the healthcare service provider to occupy a distinct position in the minds of the consumer.

This will earn the service provider a superior competitive advantage relative to its competitors.

For individual healthcare organizations, the positioning would primarily occur at two levels: (i) Some healthcare organizations compete with each other in areas such as prestige, capital, innovativeness and human resources. In this case, the overall healthcare organization, including all its offerings, is positioned relative to its competitors. This position is based on the "image" of the entire hospital rather than the strategic positioning of a specific healthcare offering that is provided by the hospital: (ii) On the other hand, organizations also compete with each other based on specific healthcare offerings.

In this case, the organizations prefers to position itself taking a core service offering in which it has developed a certain level of competence which probably cannot be easily replicated by its competitors.

Both organization level and offering level competition demand the formulation of marketing strategies to gain and sustain competitive advantage.

RETAINING CUSTOMERS An oft quoted statement and which rings true is that it costs five times more to recruit a new customer than to retain an old one. Retaining customers is an absolute imperative today which holds very true even in the healthcare industry taking into consideration the high level of competition that exists in the said industry today.

Gone are the days when the patient looked upon the doctor as God and did not deem it fit to ask questions beyond what he told him. Today, consumers are demanding, very aware and have a relatively good knowledge about the services they are procuring. Whether they are sick or just trying to stay healthy, today's healthcare consumers

Gone are the days when the patient looked upon the doctor as God and did not deem it fit to ask questions beyond what he told him. Today, consumers are demanding, very aware and have a relatively good knowledge about the services they are procuring

are involved more than ever in decisions about their care. And they are learning more about their options and asking more questions. To meet this challenge, providers must provide information, proactive communication, follow-through and sophisticated relationship marketing and personalized service.

As far as healthcare services are concerned, quality care and competitive pricing are a must but the real differentiator is customer service. Customers need quality care along the entire pathway - from acquisition to delivery to retention. They want readily accessible and easy-to-understand information on subjects ranging from consumer-directed health plans to disease management.

Customer service is only as effective as the people who deliver it. Along with quality care, competitive pricing and abundant information, consumers want compassion and kindness. They want to feel important and the providers to

remember them and take their concerns seriously. By and large, consumers expect co-ordination of care, clear directions and personalized communication which can lead to more positive health outcomes and greater satisfaction with providers for customers.

THE FUTURE Globally, certain trends are evident.

Trends such as improved access to health care via the Internet, the growth of self-groups and expenditure on alternative medicine signals consumers are taking an active role in their own health management.

Chronic illnesses, such as diabetes and asthma, require a significant amount of self-management and, thus, call for a collaborative patient-physician relationship.

Another evident emerging trend is customer/patient empowerment.

Advances in information technology are enabling customers to specify product/service features and prices choose service delivery methods control exposure to product information and learn from other customers.

Patient empowerment may end up delivering the following benefits to healthcare service providers: (i) It will potentially force patients to make choices and take risks. (ii) It will make them spend more time and money on treating themselves and their family members. (iii) It will also have the desired effect of increased patient participation which may substantially reduce health care costs and diminish negative health care outcomes.

Significant interest in patient empowerment has been shown by academics, government health professionals and consumers in general. In the healthcare industry, it will assume significant proportions taking into consideration the fact that there is a perceptible shift away from cure towards preventive health and patient self-care that emphasizes contributions patients make to medical consultations. All these emerging trends distinctly suggest that this industry has finally entered an era of consumerism.

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COMPETITION MASTER

The cutting Himani Avasthi Lecturer, OB & HRM

edge T

he demand for healthcare services has expanded so much that the industry at Rs. 70,000 crore, is among the fastest growing sectors in the country.

While central and state government health services provide essential hospital services in the rural and urban areas, the basic infrastructure and the quality of services are inadequate to meet the growing requirements of an increasing population.

Health services in India require not only an infusion of more doctors and specialists, but professional services of trained manpower to manage hospitals and medical facilities.

While health administration focuses on community health, public health legislations, urban health, policy formation and financing of services, hospital management aims at social services in

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hospitals, financial management, organization and administration of clinical/ support services, hospital planning, quality assurance, marketing management, and information management.

The last decade has seen a huge development in this sector with private organizations and MNCs setting up multi-specialty hospitals. This has, in turn, stimulated the need for trained professionals. Fierce competition and customer demand for better service delivery standards in the healthcare industry are compelling hospitals to improve their services.

The goal of hospital management is to develop HR in manner that they can confidently assume responsibilities of a hospital administrator. A formal training can develop expertise in planning and managing different types of hospitals. Also, there is need to rationalize resource utilization and maximize output.

The hospital administrator of the future needs to be armed with the psyche of a manager, who can meet the challenges arising out of rising

healthcare cost, procurement, utilization and maintenance and cost effective analysis of technology import.

Hospital Management System is designed for multispeciality hospitals, to cover a wide range of hospital administration and management processes. It is an integrated end-toend Hospital Management System that provides relevant information across the hospital to support effective decision making for patient care, administration and critical financial accounting, in a seamless flow.

HMS aids hospital administrators by improving operational control and streamlining operations. It also enables improved response to demands of patient care as it automates the process of collecting, collating and retrieving information.

By enabling an automated and intelligent flow of patient information, HMS enables hospitals and doctors to better serve their patients. Additionally, HMS provides a host of direct benefits such as easier patient record management, reduced length of stay, reduced test requests, lower staff turnover, greater organizational flexibility, reliable and timely infor-

The hospital administrator of the future needs to be armed with the psyche of a manager and meet challenges arising out of rising healthcare costs, procurement, maintenance and cost effective analysis of technology import mation, easier resource management, minimal inventory levels, reduced wastage, reduced waiting time at the counters for patients and reduced registration time for patients.

The indirect benefit would be an improved image of the hospital and increased competitive advantage.

Management Information System (MIS) optimizes the resources to be deployed and helps in prioritizing the developmental activities of the hospital.

Corporate players wanting to target the medical tourism segment must look at HMS solutions that

comply with international standards. This would open up a market for high-end HMS solution that complies with international standards such as Health Level Seven and Health Insurance Portability and Accountability Act. It is being proved more and more by hospitals worldwide, that investing in a good HMS is worthwhile and can transform their business. Even a study done at a reputed Hospital in Bangalore after implementing TATA HMS has shown that there was a substantial overall improvement in health care delivery for increased patient numbers and operations. There was also a quick ROI, strengthening the argument for investing in HMS. HMS not only provides an opportunity to the hospital to enhance their patient care but also can increase the profitability of the organization. The Return on Investment (ROI) coupled with an enhanced image of the hospital act as drivers for health care providers to invest in good systems that will keep their patients satisfied.

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HEALTHCARE BOOM

HEALTH SERVICES

growing fast

T

he healthcare industry in India has come a long way from the days when those who could afford it had to travel abroad to get highly specialized services such as cardiac surgery, while others had to do without it.

Today, patients from neighboring countries in Asia are coming to India to get specialized medical treatment.

Not only is India meeting international standards, but at prices that compare very favorably with developed countries. The demand for healthcare services in India has grown from $ 4.8 billion in 1991 to $ 22.8 billion in 2001-02, indicating a compounded annual growth rate of 15 per cent.

The healthcare industry accounted for 5.2 per cent of India's GDP in 2002, and is expected to reach $ 47 billion or 6-7% of GDP by 2012. On the one hand, the Indian middle class, with its increasing purchasing power, is willing to pay more for

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Madhur Varma Head, Service Quality & Business Support, Max

quality healthcare. On the other, the supply of healthcare services has grown steadily, as the private sector becomes more involved in owning and running hospitals.

With increasing awareness of the urban population, the health insurance sector is also expected to cover 15% of the total population by 2012 which currently stands at 3%.

Setting up new facilities and improving the health services involves management and requires focus on inter-related dimensions which are: Number and distribution of managers Appropriate competencies Management support system Working environment

To attain the above, we need to have an effective leadership and management in the organization.

Leaders set the strategic vision and mobilize the efforts towards its realization; good mangers ensure effective organization and utilization of resources to achieve best results.

In order to ensure better services to patients a growing number of hospitals is recognizing the need for professionals to manage their facilities.

In practice, these functions are performed simultaneously but they are discussed separately for the sake of clarity.

PLANNING: Health service planning is a process that appraises the overall health need of a geographic area or population and determines how these needs can be met in the most effective manner through allocation of existing and anticipated future resources. Healthcare is characterized by a wide variety of customers

and their nature varies from industry to industry. Patients represent only one group of customers and an entity like a large hospital may have a dozen different customer groups to contend with.

Hospital planning has the following three stages: Facilities Planning: The major emphasis was regarding replacement or expansion of physical facilities. The focus on expansion of physical facilities was dictated by the growth of hospitals in every direction coupled with technological and medical advances.

Architects and engineers were the major players in facilities planning.

Institutional Planning: In this stage, focus shifted to the planning of departments of the hospital. This shift was characterized by the expansion of existing programmes and exploring new types of healthcare services.

Strategic Planning: This is characterized by the ongoing and systematic use of planning as a top management tool to set short and long-term goals of the hospital and to attain them in order to best position the hospital.

FINANCE: The role of the finance department in any healthcare enterprise has assumed greater importance over the years.

Hospitals can use one of these budgeting approaches for better management — appropriation budget (used often for government healthcare service units and based on previous year expenditure), fixed forecast budget (is most common among the hospitals as it provides the greater flexibility by allowing yearly forecast of activity levels and adjustment to expenditures based on services provided) and flexible budget (requires a highly sophisticated cost accounting function. As each month concludes, the budget esti-

mate of variable cost is replaced with a new estimate and it occurs essentially on monthly basis).

HUMAN RESOURCE Human resources when pertaining to healthcare can be defined as the different kinds of clinical and non-clinical staff responsible for public and individual health intervention.

The most important of the health sys-

For India to become an effective healthcare provider, Government policy has to ensure that services at all levels are qualitative tem inputs, the performance and benefits the system can deliver largely depend upon the knowledge, skills and motivation of those individuals responsible for delivering health services.

HR ISSUES IN HEALTHCARE: Size, distribution and composition within a country's healthcare workforce are of great concern. For example, the number of health workers

available in a country is a key indicator of that country's capacity to provide delivery.

Workforce training: New options for education and in-service training of healthcare workers are required to ensure that the workforce is aware of and prepared to meet a company's present and future needs.

Economic development: There is a significant positive correlation between the level of economic development in a country and its number of human resource for health.

Countries with higher GDP per capita spend more on health care than countries with low GDP. This is an important factor to consider when examining and attempting implementing solutions to problems in health car e systems in developing countries.

Socio-demographic elements: Such as age distribution of the population also play a key role in a country's healthcare system. An ageing population leads to an increase in demand for health services and health personnel. An ageing population has important implications: Additional training of younger workers will be required to fill the positions f the large number of heath care workers that will be retiring.

Cultural and demographic factors: Such as climate or topology influence the ability to deliver health services, the cultural and the political values of a particular nation can also affect the demand and supply of human resources for health.

CONCLUSION: In order to bring effectiveness and efficiency, one has to take care of all the levels of health services in the hospitals. As the health care industry in India is booming, the top players in like Apollo, Ranbaxy, Max, and the upcoming hospital of Dr. Trehan's (Medicity) have to ensure better services towards its patients.

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CONCERN CELL

, Y H T L A E H Y H T L A E W E S I &W I

ndia is the second most populous monia and reproductive tract infeccountry of the world and has tions dominate the morbidity patchanging socio-political-demo- tern, especially in rural areas. graphic and morbidity patterns that However, non-communicable dishave been drawing global attention eases like cancer, blindness, mental in recent years. illness and hypertension, Despite several growthare also on the rise. The orientated policies adopted health status of Indians is by the United Progressive still a cause for concern Alliance (UPA)-led governespecially that of ruralites ment, under the stewardbecause trained medical ship of Prime Minister Dr. professionals are not Manmohan Singh, many interested in serving rural facets like widening ecoareas. This piquant situanomic, regional and gention is reflected in the life der disparities are posexpectancy (63 years), Nagaraj Murthy ing challenges for the infant mortality rate Lecturer health sector.

(80/1000 live births), About 75% of health maternal mortality rate infrastructure, medical manpower (438/100 000 live births). However, and other health resources are con- some progress has been made. centrated in urban areas where only To improve the prevailing situa27% of the population lives. In all its tion, the problem of rural health is to buzz and hype, contagious, infectious be addressed both at macro (nationand waterborne diseases such as al and state) and micro (district and diarrhoea, typhoid, infectious hepati- regional) levels. This is to be done in tis, worm infestations, measles, holistic way, with a genuine effort to malaria, tuberculosis, whooping bring the poorest of the poor to the cough, respiratory infections, pneu- ambit of the fiscal policies.

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A paradigm shift from the current 'biomedical model' to a 'sociocultural model', is indispensable which should bridge the gaps and improve quality of rural life, which is the current need of the day. A revised National Health Policy addressing the prevailing inequalities, and working towards promoting a long-term perspective plan, mainly for rural health, is imperative.

Earlier, public perception was to attain a state of 'no-illness' but today it is defined holistically and as a function of lifestyle, diet and fitness, physical, emotional and spiritual wellbeing. Now, consumers are more health conscious and looking for the wellness quotient in all aspects.

Healthcare is important not only for reaping demographic dividend, but also for attaining population stability. This aim is to be achieved by addressing issues like child survival, safe motherhood and contraception.

There has been steady improvement in the quality of health care over the years but wide inter-state, male-female and rural-urban dispar-

ities in outcomes and impacts posed wider ramifications and grave concerns. In fact, population stabilization is in the concurrent list but health is a state related subject. The reproductive and child health services reach community and household levels through the primary healthcare units. This sector consists of inadequacies in the existing health infrastructure and gaps in coverage and outreach services in rural areas.

In order to boost the health sector centre (both the previous NDA government and the present UPA government) have initiated various programs all over the country. Some of these initiatives have been enumerated in Economic Survey 200607. Following are the few excerpts: Among the many initiatives one is the National Rural Health Mission (NHRM) which focus on weaker infrastructure and status of the health sector. Necessary steps have been taken for provision of accessible, affordable, effective and reliable primary healthcare facilities to the poor, downtrodden and vulnerable sections of society, thus bridging gaps in rural healthcare services through creation of Accredited Social Health Activists (ASHA) and improved hospital care with decentralized planning.

This mission envisaged selection of trained female community health workers - ASHA - in each village in the ratio of one per 1000 population in all 18 high focus states and in tribal and under served areas of other states. The NHRM seeks to strengthen service by ensuring community ownership of the health facilities and success of decentralized planning process under NRHM hinges on the capacity of the districts and states with the constitution of Program Management Units (PMUs) with professionals, including MBAs, CAs, and IT experts. These professionals have been assigned specific roles and a training component has been built in to make management more effective.

A UNICEF evaluation conducted

in 2006 indicated that the coverage of immunization has improved from 52.8% in 2000-01 to 54.5% during 2004-05. The Janani Suraksha Yojana (JSY) has been launched all over the country to promote safe delivery and incentives are being provided to Below Poverty Line (BPL) families for institutional delivery. Till December, 12 lakh beneficiaries were listed under JSY by all states.

Reproductive and Child Health Program (RCH), launched on April 1, 2005 for a 5-year period, intended to improve performance of family welfare in reducing maternal and infant morbidity and mortality together with unwanted pregnancies and,

Healthcare is important not only for reaping demographic dividend but also for attaining population stability thus, led to population stabilization.

Funds approved for RCH went from Rs. 1,52,375 crore to Rs 1,871,67 crore between 2005-07.

Under the Universal Immunization Program, vaccines are given to infants and pregnant women for controlling vaccine preventable diseases like childhood tuberculosis (BCG), Diphtheria, Perfusis and Tetanus (DPT), Measles, Poliomyelitis (OPV) and Neonatal Tetanus (NNT). The program was first launched in urban areas in 1985 and covered the entire county by 1990.

The Pulse Polio Program aimed at eradicating pulse polio cases with supplementary immunization activities was intensified in high risk areas. Now, once in a month all over the country, this program is being carried out to eradicate this bane once for all.

Similarl,y the National Vector

Borne Diseases Control Program (NVBDCP) which is an umbrella program for prevention and control of vector borne diseases is in tandem with the goals set out in the National health Policy (NHP) 2001 and Millennium Development Goals (MDGs). Due to this, the instance of Malaria came down from 1.82 million cases with 963 deaths in 2005 to 1.2 million cases with 961 deaths in 2006. In some pockets, where the parasite has developed resistance to widely used anti-malaria drug Chloroquine, the GOI introduced new drug combination of Aretemisinin plus Sulfadoxine Pyremethamine.

Dengue, which is a viral disease, recorded focal outbreaks mainly from urban areas. So emphasis was laid on avoidance of mosquito breeding conditions in homes and workplaces and minimize man-mosquito contract through community awareness and participation.

Similarly, Chikungunya is a debilitating non fatal viral illness which re-surfaced after long pause in 2006 but a prompt and timely initiative by the government at the centre finally put this menace under control.

The National AIDS Control Program launched in 1992 got active encouragement all over the country as this program aimed at reducing the spread of HIV infection in India and strengthen India's capacity to respond to HIV AIDS on long-term basis. It is estimated that about 5.2 million HIV infections was reported in the country during 2005 with infected syringes and needles as the major mode of transmission besides sexual transmission.

So far, the total outlay for the National AIDS Control Program (NACP) is Rs. 1,064.65 crore with five-point targets. They are priority targeted intervention for populations at high risk, preventive intervention for the general population, low cost care for people living with HIV/AIDS, institutional strengthening and inter sectoral collaboration.

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The National Leprosy Eradication Program launched to eliminate leprosy was scheduled in December 2005 with 26 States and UTs. The program was decentralized and the prevalence came down drastically.

Now, leprosy services have been integrated with general healthcare.

Control of Non-communicable Diseases continues to be an important public health problem in India as they are responsible for sizeable mortality and morbidity. Ageing population allows manifestation of cardiovascular diseases, cancer and mental disorders which also result in high prevalence of chronic disability.

Research by the Indian Council of Medical Research (ICMR) focusing on identifying risk factors, their prevention, health service requirements and control strategies is in progress.

The National Control of Blindness has addressed cataract very effectively, a condition which continues to be the major cause of blindness. As many as 15 lakh cataract surgeries were registered in 1992-93 which increased to 49.05 lakh in 2005-06.

The main cause identified was diabetic retinopathy and glaucoma and this needs to be addressed.

Under the National Mental Health Program assistance has been provided to 58 medical colleges for up-gradation of their psychiatric wings.

The Integrated Disease Surveillance Project (IDSP) initiated in November 2004 with World Bank support, aims at the establishment of and co-operation of a central level disease surveillance unit, with World Bank support. It aims at establishment and operation of central level disease surveillance unit, integration and strengthening of disease surveillance at all states. The diseases covered under this project include waterborne diseases and emerging diseases.

Introduction of user charges in government health facilities in India have improved accountability of the health system reliably. This is so as in a developing country like India, priThe

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vate healthcare tends to be too expensive for the common man, especially the poor and the downtrodden.

The public health scenario is in a sad state as inadequate resource and poor service delivery and reforms often require huge funds to remove inefficiency. To augment resource, user charges have been introduced to improve accountability, to meet the cost of operation and for the maintenance of health service delivery. BPL users are exempted from payment. Apart from allopathic services, government also encouraged Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy medicines (AYUSH). So far, there are 7.25 lakh registered practitioners under this category, 3,194 hospitals

Non-communicable Diseases are a public health problem as they result in sizeable mortality and morbidity and 21,290 AYUSH dispensaries all over the country. Mainstreaming of AYUSH in the healthcare delivery network is envisaged in NHRM with focus on improvement and upgradation of standards of education.

India's health system is at crossroads. Post Independence, the country's health conditions have undergone a sea change. A high proportion of people continues to suffer and die through preventable infections, pregnancy, child birth related complications and under-nutrition or malnutrition. At the same time, more than 3.5 million people are living with HIV AIDS and this virus has spread beyond highly susceptible groups to the general population in some states, threatening to erase much of the social, economic, and health gains since independence.

Also besetting the nation are non-

communicable diseases like heart disease and mental illnesses and health problems associated with higher income groups in India.

Building robust a healthcare system requires building the capacity to do better on the 'unfinished agenda of health problems as well as meet emerging health realities and challenges. The large disparities across India place the burden of these conditions mostly on the poor, women and scheduled tribes and castes. The poorest 20% of Indians have more than double the mortality rates and fertility of the richest quintile.

Despite all these problems, the public remains uninformed about much of the health system. It knows little whether health services are appropriate and who is benefiting from them, whether the quality of health service is sufficient, or whether people are getting good value from public and private spending on health. Equity, quality and accountability are badly in need for both public and private health sectors. The time has come to revisit and reassess how the Indian health system should function and re-tool it for the new millennium.

The public should raise a hue and cry in four directions: One is to compel the government to take responsibility for the needs of the entire population by making the health system pro-poor, gender sensitive, client friendly and by responding to the high burden of preventable diseases borne by the poor. Second, look forward to the health transition by preparing for the shift in disease burden, increase in health costs, by developing health financing systems.

Third, remove blind spots in the private sector by harnessing its energy and countering its failures.

Fourth, focus efforts by putting emphasis on quality, efficiency and accountability, of health services in both private and public sectors.

THE NATURAL WAY

DELETE STRESS WITH NATURE'S

BIG FIVE

W

ith the advent of modern hits, punches, frustrates, attacks technology and resultant and does all sorts of nasty things to changes, the present human beings. As a reaction to world has reached an interesting stress, people suffer, cry, get hurt, and crucial juncture, where stress feel sick, sad and dejected, and is a way of life. There is not much often feel mowed down. Stress is solution in making a hue often cruel and more to and cry about it. Stress is those who fail to combat there to stay and we as it. This dilly-dallying human beings need game between stressors more modified interacand victims goes on. tion levels in managing Stress is much of a mega stress. phenomenon and in the In fact, victory over long run stress because of stress is an indicator of its basic character wins. the achievements Men, women, chilKailash Tuli made by human race dren and old ones do over many millennia. succumb to stress in Professor, OB/HR Articles on stress the long run. Yes, it are common in the media. Such even kills people when it is vehearticles help readers only as small ment and unabated. therapeutic doses. Writings of this Stress induced damages nature provide some tips about Stress, especially when it is prostress resulting in some benefit. longed, is bad for both body and Creating awareness about stress mind. When stress comes without and various coping mechanisms warning, and often that is what helps in facing stress in a healthy happens, it causes acute pressure manner. Knowledge about stress both on mind and body. We are so and its causes is basically the strat- familiar with feelings like being egy for stress coping. wrenched up, squeezed, drained Stress squeezes, pressurizes, out, sucked up and crushed. Stress

can break the body and mind of people by jeopardizing the harmony between them. Stress snatches the glow from the face, power from the muscle and conductivity from the nerves.

Fatalities which are caused by stress are innumerable. When the tussle of fighting stress between person and stressor is lost to stressor then stress is cursing and fatal.

Stress is lovely too!

Hans Selye, known as the father of a new discipline called Stresslogy, considers stress as the "spice of life".

According to Selye, stress should not be feared. That creates more complexities. You can enjoy the stress, provided you know how to go through it. If you can keep a date with stress in a funny manner, perhaps you can enjoy stress. So hold it, play with it and stress is there to make your life interesting and stimulating, provided you heed to the following advice of Selye for living in a style what he aptly calls, 'Stress without Distress'. He summarizes three basic approaches to resolve stress, to live conjointly with stress.

These are: The

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Find your own natural stress level and work towards what you accept as your own goal Practice altruistic egoism, which refers to the selfish hoarding of goodwill, respect, esteem, support and love of our neighbor. This is the most efficient way to give vent to our pent-up energy while creating enjoyable, beautiful or useful things around us Earn Thy neighbor's love: This motto, unlike the command to love, is compatible with man's natural structure, and although it is based on altruism egoism, it could hardly be attacked as unethical.

Stress can be tamed Stress is a phenomenon, with which we need to coexist.

Scientists, physiologists and psychologists have now studied in detail all aspects of stress and know numerous ways of coping with it.

Needless to say, those positive strategies of coping with stress will be far better than negative approaches like smoking, drugs, alcoholism or other hazardous methods of coping stress.

Ellen White, a visionary and positive health psychology writer, recommends eight practices for good health primarily aimed at reducing stress. These eight habits are: Sunlight, Air, Water, Exercise, Temperance, Nutrition, Rest and Trust in God. She tops these up with six mental steps to perfect health, which are: Clear conscience, happier heart, gratitude and praise, power of prayers, love and help for others and sweet words.

Tune in to Nature We, as human beings, need to know what engulfs us all the time.

It is interesting to realize that every moment three environments sur-

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roundus. These are: Natural environment Social Environment Man-made environment.

Most stressors emerge from these components. Natural environment is what Nature has in abundance. Look at these great super structures of Nature, to which men have done so much damage. Infinity is the paramount characteristic of Nature and this is filled with abundance of five tatvas or basic elements.

Tatvas: Nature's Big Five The infiniteness of the nature is evident by its five core components.

These are: Prithvi (Earth), Jal (Water), Vayu (Air), Agni (Fire) and Aakash (Space).

An analysis will reveal that all these existed much before arrival of man on this planet. They are the representations of true Nature.

Everything living on this planet has evolved out of these tatvas.

One thing very unique about these five things is that they are in abundance, but the artificialities of modern civilization have dimin-

ished their power. Here, we need a re-searching of the soul. A connection which is somehow lost in this march of progress, has to be recaptured. We have a natural inbuilt affinity for natural things. The mask has to be removed. This deviation from Nature has created too much stress. In order to cope with stress this reversal is crucial.

Connecting with Nature is very beneficial in resolving stress. It gives lot of peace and tranquility to the soul. It is a holistic experience.

It leads to creation of Gestalt in the human mind and body and thus becomes therapeutic. Only, connectivity is needed to get it. We can achieve this by getting a real taste of Nature's tatvas. Each element is enriched with so much power that it will resolve stress of anybody.

Earth element: Connecting with Earth is easy. One should walk barefoot on grass, clean soil, sand and beaches and even stones.

There are many such natural and safe places where one can feel the communion with Mother Earth. In Greek, Earth is called Gaia and is considered as a living organism.

One can have an entire body contact with Earth at places like beaches, clean soil, trees, by mud baths and in grassy pastures. Earth elements bestow power and strength to the body and are, thus, super stress busters.

Water element: Water is not only meant for bathing the body but gives great solace too. Swimming is one of the best exercises. Water is a great stress-dissolver and one should frequently avail this contact through rivers, lakes, seashores and beaches. One can take the destressing benefits of water by enjoying or being in rain. Splashing water on each other as enjoyment

is another do-gooder. Even a cool shower resolves stress. Drinking plenty of water helps in removing toxins from the body and is thus indirectly beneficial in resolving stress. water is life.

Fire element: This comes basically in the form of energy by the sun. The entire natural energy and life on Earth is by the grace of the Sun. So get connected to this natural source. Sun-bathing is one very relaxing activity which replenishes the body with Vitamin D and is also good for the skin. Do not stare directly at the sun but face it with closed eyes. Getting connected with Sun is a very warming and energetic experience. The fire element creates energy and well-being in any individual and enhances the stress coping mechanisms.

Air element: Air is all around us and it is regular breathing which nourishes us at every moment. All life is basically continuous breathing. We must understand correct breathing and get life out of this. In the Indian yogic system of Pranayam, there is a lot of focus on breathing, especially inhaling, retaining and exhaling of breath.

Air can be enjoyed in various ways, especially in contact with the body.

Whenever the opportunity comes, one should expose the body to the soothing touch of air. Breeze is very soothing for body, mind and spirit.

The feeling of being engulfed in air is quite blissful.

Space element: Space is both inside and outside the body. The cavities like lungs, stomach, intestines, chambers of heart, oral cavity and uterus are spaces within the human body. These are enclosed spaces and there is abundance of them in our environment around us. Peeping deep into the

sky, gives a unique feeling of infinity. Imagining the distances between Earth and various other planets in space gives a very spiritual kind of experience. Thinking of vast spans of emptiness creates a very cool feeling in the mind. In fact, living in crowded spaces often numbs us and is a major contributing factor in stress causation.

You can destress yourself by being in open spaces like big fields, seashores, desserts, forests and other typically natural places which

The elixir of happiness, comfort and a stress-free world lies in some sort of a prudential concoction of the five tatvas and boons of technology, provided the latter is used with intelligence

show spaces in abundance. It is very expanding experience to visualize infinity and space.

It is evident that human body is made up of these five tatvas and it is also all around us, so there is a natural harmony if we are enjoying connectivity with these five tatvas which we are made of.

Technology: Mankind's child A perfect human life is not just about the five tatvas, but also of correct usage of technology. There is a unique bondage between Nature and Technology. We exist because of the five tatvas and also because of technology.

Technologies, over the years, have produced millions of objects derived and manufactured from the surrounding environment with the genius of human mind.

The basic spirit in this developmental activity has primarily aimed at making human life comfortable.

Indeed, Technology did that great job in comforting human beings and more so when it took the shape of mass production. Modern technology has brought many boons for mankind, though with many adverse things like pollution and global warming. We need to be prudent in selecting those facets of technology which are useful in individual and global contexts.

So the elixir of happiness, comfort and a stress-free world perhaps lies in some sort of a prudential concoction of the five tatvas and boons of technology, provided the latter is used with intelligence.

The intelligence of human race has made it feasible for more than six billion people to live in this gigantic home which Greeks call Gaia and Indians call Mother Earth. Let us live stress-free life in the lap of Mother Earth.

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BOOKMARK

A gripping, moving mount “I can still see Hassan up on that tree, sunlight flickering through the leaves on his almost perfectly round face, a face like a Chinese doll chiseled from hardwood: His flat, broad nose and slanting, narrow eyes like bamboo leaves, eyes that looked, depending on the light, gold, green, even sapphire. I can still see his tiny low-set ears and that pointed stub of a chin, a meaty appendage that looked like it was added as a mere afterthought. And the cleft lip just left of midline, where the Chinese doll maker's instrument may have slipped, or perhaps he had simply grown tired and careless."

There are many first to "the kite runner". It is the first novel to be published in English by an author from Afghanistan. It is also the author Khaled Hosseini’s debut novel.

It is the story of two boys of the same age, one is the son of a wealthy man and the other son of a hazara, traditional servant of the household. They grow up

BOOK REVIEW Rohini Rode Lecturer

Title: THE KITE RUNNER Author: Khaled Husseini Publisher: Riverhead Books Hard Bound/Pages 336. Price: $ 15.00

ment, Hasan gets the last kite for his master. That is when the story takes a turn to haunt Amir through his life. And he repents his sins later.

While as a child he vies for his father's attention, as an adult they are on an equal footing as they form their lives in America. He takes care of his father towards the end. Baba, as Amir calls his father, is much at peace when he passes way. This part has been penned down quite beautifully - Baba dies but is rest assured about the life of his own son.

The book gives a picture of what Afghanistan was like before Russia invaded the country. The darker side of life in Afghanistan comes to the fore when Hosseini describes the suffering of his country under the tyranny of the Taliban, whom Amir encounters when he finally returns home, hoping to help Hasan and his family.

Afghanistan's culture and ethnic

The book gives a picture of what Afghanistan was like before Russia invaded the country. The darker side of life in Afghanistan comes to the fore when Hosseini describes the suffering of his country under the tyranny of the Taliban, whom Amir encounters when he finally returns home, hoping to help Hasan and his family.

Afghanistan's culture and ethnic differences come through in the Kite Runner together and live through many forms of relationships with each other. Man and servant, brothers and friends. Neither of them has a mother, but they grow up together. It is about one being subservient, the other the one in control yet challenging subservience.

It is also about the past. How Amir's past haunts him — comes up again and again — lives on him and makes him feel guilty, over and over again — of things The

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he had done or rather not done.

His deeds, misdeeds gnaw at him.

Trying to deal with his own guilt, Amir's father keeps him at an arm's length. The father's remorse is brought to light only later in the book while Amir longs for his attention.

This makes him want to win Kabul's largest kite running tournament. Retrieving fallen kites is part of the tournament. While Amir wins the kite flying tourna-

differences come through in the Kite Runner.

Hosseini draws the reader into the book by giving vivid descriptions of the country, the place where Amir lives and catches subtle nuances of relationships. It is a powerful book and difficult to put down.

Towards the end, the book drags a bit, especially when Amir goes back to Afghanistan to get Hasan's child back.

Ditties from Wal-Mart

W

ritten by a former WalMart strategist William H. Marquard, this book is an insight into the world that we live in heavily influenced by Wal-Mart, not only in the countries where the World's No. 1 retailer and Fortune # 1 company with $312 bn in sales is present but also in countries where it is not.

Some interesting statistics compiled by the author — Wal-Mart has 61,000 suppliers across seventy countries; it contributes to 2.5% of GDP of the US; it saves an average American $2,329 per year on account of the efficiency and bringing down the costs of consumables. For new product launches, Wal-Mart captures 100% of sales for the first two weeks and 70 percent of the sales for the first four weeks, that is selling tons before other retailers get to sell any at all — such is the level of efficiency of its supply chain.

He starts with his experiences during his three-and-a-half year stint in the advisory role to the strategic planning team. The focus Wal-Mart executives maintained during the planning meetings, and clarity of purpose made things happen. The cost plus negotiation approach and continuous improvements in the supply chain made things possible for Wal-Mart and brought it to the position it is in. Not to forget the research dollars spent by WalMart on figuring out what the customer is looking for - 'Barbie dolls and candies have lot in common'is one such example of their extensive research.

Applying the research data into practice has yielded phenomenal results for Wal-Mart, displaying the 20% toys on its shelfs that comprise 80% sales, helped it

BOOK REVIEW Sangeeta Yadav Assistant Professor

Title: WAL-SMART Author: William H Marquard Publisher: Tata McGraw-Hill Hard Bound

push to the position of No 1 toy seller. The research data that WalMart has surpasses the entire number of static pages on the Internet. No wonder Federal Reserve consults Wal-Mart data to gauge the impact of tax policies!

However, not all has been rosy for this retailer form Bentonville, Arkansas, also known as 'Godzilla-Mart' in rival camps. It has faced protests form local communities for space, protests from child labour activists, environmentalists and unions — the list is long.

But it has overcome the challenges to stay ahead of competition. An example found in the book is — people who hate shopping at Wal-Mart for various reasons, still end up buying at Wal-

Mart on account of its sheer geographic coverage and stock of products. A testimony to its efficient supply chain is the fact that it can replenish its entire inventory nine times over in a year, which means every 40 days each single item on its shelf is replenished.

The author, on account of his experience as industry consultant and being in the hot seat for managing operations for a large supplier, has taken a structured approach to writing the book. On one hand, he talks about the right things Wal-Mart has been doing and how influential it has become to change market dynamics. On the other, he talks about the competition and how it needs to hold on to itself to survive in a world dominated by Wal-Mart.

This is not a book about WalMart but for leaders in any industry — public or private, manufacturing or services, large and small, international and local — who want to survive from the stiff challenges posed by large dominant players in their respective industries and who want to become a dominant player themselves.

This book is a must read for everyone, from management students, economists, retailers to business managers. For, it has something for everyone to look at — how it impacts them and where they stand in the 'sphere of influence' created by Wal-Mart.

It also assumes significance on account of recent announcement

by Wal-Mart to enter in the Indian market through a joint venture with Bharti. Although initially it will operate only in the wholesale business, it still has potential to eliminate the middlemen from the markets it chooses to operate in.

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Lessons from Latin America E very nation aspires that the human resources it possesses should be healthy and productive. Though in India, a lot of research work has been done but this book is an eye opener for various health related problems facing India.

This excellent research based book is brought out under the aegis of the Pan American Health Organization (PAHO), which is an affiliate of World Health Organization (WHO) and mostly addresses health related issues of North and South America.

It is an elaborate reflection on the health perspective at the global level with major focus on Latin American countries. Nonetheless, it has great implications and learning possibilities in the Indian context.

Major issues pertaining to health like Iodine deficiency, disseminating dosage of Vitamin A, folic acid fortification, breast-feeding practices, promoting lifestyle in urban areas and many other topics of broader interest have been discussed by eminent researchers and policy makers.

Such kind of Action Research is a necessity in the health management of the masses.

Editor Wilma B. Freire has brought out an academically rich content which is the part of a series on scientific and technical publications. This work is numbered 612 in the series. She has 13 articles from distinguished academicians and researchers resulting in a volume of 247 pages of knowledge rich work.

All articles address very crucial issues which can be quite beneficial from global health perspective.

For review purposes each chapter is discussed below.

Reynaldo Martorell has disThe

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BOOK REVIEW Kailash Tuli Professor

Title: NUTRITION AND AN ACTIVE LIFE FROM KNOWLEDGE TO ACTION Editor: Wilma B. Freire Publisher: Pan American Health Organization Year of Publication: 2005,Washington Paperback/Pages 247. Price: $ 29.95

cussed the serious issue of childhood nutritional deficiency. He has connected childhood nutritional deficiency with poor formation of human capital and low economic productivity. The paper emphasize role of nutrition and interestingly quotes studies about school food program from Tamilnadu done on children.

Another study is about infant feeding practices in Latin America in which it has been examined that breast feeding reduces morbidity rate. Victora, Albernaz and Lutter found that optimal duration of exclusive breast feeding helps promoting the child's health and wellbeing. Based on their research, it is recommended that breast feeding

should be the exclusive source nutrition for children under six months.

There are four chapters on research related to micronutrients.

Notably, these are about Iodine deficiency, Vitamin A and Folic acid fortification. The studies done in context of Ecuador by Freire, Vanormelingen and Vanderheyden reveal multi-pronged strategy to combat with Iodine deficiency disorders (IDD). They found that most effective progressive intervention strategy is the sequence of i) salt iodization, ii) radio announcements, iii) teacher education and iv) intensive education.

Another serious area in public health is about Vitamin A deficiency. Studies by Dary, Martinez and Guamuch in the context of Guatemala looked into this problem of Vitamin A deficiency. There were rich dividends through the program of The Law of Food Fortification of Guatemala of 1992 created the National Commission on the Fortification, Enrichment and Comparison of Foods (CONAFOR).

The Virtual Control of Vitamin A Deficiency (VAD) program in Nicaragua is a major topic not only for Nicaragua but for countries too. Vitamin A deficiency was tackled in the second poorest country in Latin America through an integrated strategy encompassing mass supplementations of children and postpartum women, fortification of sugar, IEC (Information, Education and Communication), periodic deworming, training and program monitoring and evaluation. Such public health measures are very useful and hit the core of the problem thus delivering quality and healthy life to millions of children.

Eva Hertrampf has discussed

the serious problem of Neural Tube feasible to reach the grassroots tion of human psyche and studying Defects (NTDs) in context of Chile. strata of people to effectively implethe paradigm of changing individFolate is a generic term for comment positive health practices and ual behavior. This is aided by the pounds that have a common vitaa tirade against sedentary lifestyles. concept of "Walking for utilitarian min activity. Natural folates are "Agita Sao Paulo's physical activand recreational purposes". Road common in green leafy vegetables, ity" recommendation included at safety is the vital concept in any big citric fruits, juices, whole grain least 30 minutes of physical activity, city and these Latin American bread, and legumes. The approach at least five days in a week had far experiences offer a lot for us in adopted in Chile was through Folic reaching impact in reversing the rapidly changing cities like Delhi. acid Flour Fortification of bread. bad and sedentary lifestyle habits of The concluding write-up by The positive effects were even seen people.

Wilma B. Freire is concise and gets in the elderly population.

Rivera's study on "Improving you to the crux of crucial issues The dictum of, "Think globally, Nutrition in Mexico: The use of pertaining to mass health. There act locally" is reflected in the article research for decision-making in are many similarities between India entitled, "Implementation of Breast nutrition policies and programs" is and Latin American countries and feeding practices in Brazil: From about tackling the problems of aneas such this reading offers rich conInternational recommendations to mia, micronutrients deficiencies, tent for health policy makers and Local Policy'. Rea and Araujo point medical and social health profesout the success of the program by sionals.

Developing the fact that currently in Brazil Some unique findings of these Breast feeding for an average research studies are as follows: countries like India child is 10 months in contrast to Impact of malnutrition on can learn a lot from the what one in two Brazilian individual health requires effecwomen did in 1975 and that tive and low cost programs health research done in Latin too by feeding a child only Sedentary lifestyles are a American countries. one or two months and then major risk factor contributing discontinuing the healthy to global burden of non-comKnowledge derived from this practice. municable disease book has potential of transforming One interesting study is Mass urbanization in

by Benavides, entitled "The recent years has lead to serilives of vast spectrum of popula- ous health problems which Best Buy project in Peru: tion, especially children, Nutrition recommendations need to be addressed. Research within the context of local on health issues needs to be women, the poor and Urban Market Realities". The proimplemented in action and not the aged ject had an innovation in dissemimerely left as an academic exercise nating information to low-middle Major behavioral and environincome people about the cost effecmental risk factors are amenable to tive ways of purchasing food, so overweight and obesity. Results modification through implication of that as a consumer they get maxiwere encouraging because of cutconcerted action mum benefit in terms of food nutriting-edge methodology of applying Commitment of health for peotion, protein, caloric value and thus an educational communication ple by state, national and internahealth benefit. component, including formative tional agencies, if properly impleA study entitled, "Agita Sao research and social marketing. mented, can show better quality of Paulo: Encouraging Physical activity The final chapter touches a very human resources as a Way of life in Brazil" by crucial area of 'road safety' which Developing countries like India Matsudo and Matsudo tells you in many countries is the major with a mammoth population how a nation can be made health cause of road accident-related require this kind of input inforconscious. The program was targetinjuries and deaths. mation. We can learn a lot and ed for nationwide population, with Five eminent authors bring out buy the experiences of these emphasis on the positive effects in an interesting read on, "Transport, Latin American countries. terms of biological, psychological, Urban Development, and Public Knowledge derived from this cognitive, and better schooling and Safety in Latin America: Their book has potential of transformemployability. With suitable organiimportance to Public Health and an ing lives of vast spectrum of popzational structure of scientific and active Life style". ulation, especially children, executive-level partnerships, it was This chapter is a fantastic revelawomen, the poor and the aged.

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STUDENTs’ CORNER Feasibility of Capital Punishment

C

apital Punishment is the execution of a conAbolition of death penalty is often adopted due victed criminal by the state as punishment to political change, mostly when countries shift for capital offence such as pre-meditated from authoritarianism to democracy. In the US, murder, espionage, treason, rape and so on. In some states have had a ban for decades the earMuslim countries, sexual crime warliest being Michigan which abolished PULAK TANDON, PG-1 rants capital punishment and in Chicapital punishment in 1846. In south na serious cases of corruption and huAsia, Nepal is the only country to man trafficking are punishable by death. In India, abolish it. capital punishment is legal but it is used in the Ban advocates contend that since we do not 'rarest of rare case'. In our country, the defendant have the power to create we should not have a can appeal right up to the Supreme Court and a corresponding power to extinguish human life. further appeal can be made to the President of In- They believe in the rehabilitation of the criminal dia for clemency under Section 72(1) of the Indi- rather then his execution. With the emergence of an Constitution. modern world, civil organizations have opposed Support for death penalty varies from country the death sentence. Amnesty and UNHRC are to country. Several countries which had previous- known opposers of capital punishment regimes. ly abolished capital punishment have had to re- Most international treaties exempt capital punstore it in the face of violent crimes like terrorism. ishment and several organizations have made aboExamples in this category are Sri Lanka and Jamaica. lition a pre- condition for membership, most noIn the US, the ABC news survey in March 2007 tably the European Union. found 65% of the population favoring capital punHuman rights are universal, indivisible and inishment. terdependent. Almost all nations follow the right Death penalty serves as a major deterrent. No to life which implies the right to not be extermiwonder in the Middle East countries the annual nated and it, thus, follows that capital punishment crime rate is merely 3%. is a gross violation of this right.

The Colour of Money

L

et's talk money — Mammon's earthly incar- we don't carry/own. nation, Satan's weapon of temptation, CapiMoney is the material shape of the principle that talism rightful expression. Are we really talk- man who wishes to deal with one another must deal ing about a piece of paper? A scrape by trade and give value for value.

DEVENDRA GAUR, PG-1 created from wooden good that The use of money provides an easwould not even fetch a glass of waier alternative to barter, which is conter if used for trade on the basis of its actual worth. sidered in a modern complex economy to be inIn prehistoric times, people exchanged goods efficient because it requires a coincidence of wants to satisfy their wants. But, as soon as any one com- between traders and agreement that these needs modity begins to be acquired not merely for its own are of equal value before a transaction can occur. sake but as a store of recognized, general value Money makes possible the integration of inin exchange, it becomes an equivalent of money. dustry, the security and leisure of old age, the esIts features had been decided long bak — that it tablishments of the government, the intercourse should be long lasting, durable, and not be per- of nations. ishable. Thus came metallic money, made of gold If the chain is broken anywhere, the money and silver and baser alloys, stamped with the of- mechanism fails to function, the whole vast sysficial emblem or portrait heads of kings or tribal tem breaks down and men in all continents may gods. be thrown into hunger.

Money has seen many makeovers — from clinkThis can only be controlled by an effective moning coins to rustling paper notes and now the squeak- etary policy, by which a Government, central bank ing plastic cards embedded with a tiny chip, which or monetary authority manages the money supcan literally excess crores of rupees, quite a bit of which ply to achieve specific goals.

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Banking on Ombudsman

T

he concepts of Ombudsman has gained im- non-payment/ inordinate delay in the payment or colportance as an expeditious and cost effective lection of cheques, drafts, bills, non-issue of drafts customer grievance redress mechanism. The Re- to customers, non-adherence to prescribed working serve Bank of India formulated the Banking Om- hours by branches etc. budsman Scheme in 1995 which was The Banking Ombudsman (BO) funcKARAN BIST, PG-1 amended in 2002. tions as an arbitrator in respect of any It covers commercial banks, regiondispute with mutual consent of both the al rural banks and scheduled primary co-operative parties provided that the value of the claim in such banks. The objects of the scheme are to resolve and dispute does not exceed Rupees ten lakh. settle complaints relating to banking services and to Under the new scheme, the complainants will be resolve disputes between a bank and its constituent able to file their complaints in any form, including as well as between one bank and another bank online. The complainant can appeal against the through the process of conciliation, mediation and awards given by the Banking Ombudsmen. arbitration.

A quick review of the complaints received at the The Indian banking systems dates back to 1870 various offices of the Ombudsman since the revised when the Bank of Hindustan was set up. Following scheme came into force reveals that the number of British colonisation, three banks were set up under complaints received by the BO's offices has more than the Presidency's act of 1876, and these later amal- doubled to 13,483 during the quarter ended gamated in 1921 to form the Imperial Bank of In- March 31, 2006. dia.

This increase could be attributed to the comIn the past decade, the banking sector has un- plainants tending to approach the Ombudsman's ofdergone tremendous change with private and in- fice or RBI directly instead of first approaching the ternational banks with deep pockets daring to give concerned bank's internal machinery for redressal. huge credits.

There is an urgent need for banks to strengthen their The latest addition to banking has come with rigid own internal grievance redressal machinery and set controls giving way to deregulation and banks gear- up nodal officials at various centres. ing up their communications infrastructure to obBanks should give wide publicity to the names/contain a competitive edge from eBanking, which is fast tact addresses etc. of such nodal officers so that membecoming a reality in India. eBanking is a strategic bers of public can forward their grievances to these necessity for most commercial banks, as competi- officials. tion increases from private banks and NBFIs. If no response is received within a month's time or Though de-regulation may have had an impact if the customer is dissatisfied with the response he can on the banking industry in general, the Indian in- approach the concerned Banking Ombudsman. Curfrastructure itself is plagued by a lack of PC pene- rently BO offices are functioning at 15 centres. tration and low telephone penetration. Due to this The banking industry is now a very mature one a large part of the potential clients have been left and banks are being forced to change rapidly as a out of the loop of ebanking which is, thus, in a fledg- result of open-market forces such as the threat of ling state still. competition, customer demand, and technological However, with such sea changes have come a innovations such as the growth of the Internet. litany of complaints not just from the clients but alIf banks are to retain their competitiveness, they so from the banking sector which has expanded so must focus on customer retention and relationship fast that it is fighting to keep pace with its own management, upgrade, and offer integration and valgrowth. ue added services, especially in the consumer-bankKeeping in view the large number of complaints ing sector. continuously being received against banks, the BankIn addition, if they are to remain cost-effective, ing Ombudsman Scheme was revamped this year to forming strong alliances and joint ventures with othenlarge its extent and scope of the authority and func- er non-banking entities must become a major stratetions to specifically cover redressal of grievances gic weapon in a volatile, and rapidly-evolving maragainst deficiency in banking services, including a va- ketplace. With increasing consumer demands, riety of banking products/services. banks have to constantly think of innovative cusThese include loans and advances, credit cards, tomised services to remain competitive.

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STUDENTs’ CORNER Implications of Rupee Appreciation The rupee's strong run against dollar seems unstoppable.

In March 1991, the dollar was Rs. 26.40. The rupee had been steadily coming down since then and reached the bottom at Rs. 49.08 to a dollar in May 2002. But in the last three months, it is appreciating with no limits.

Re.per unit of currency End March 2005 End March 2006 Mid-May 2006 Early August-2006 Early March-2007

Us $ 43.62 44.48 45.30 46.51 40.75

British pound 82.4 77.36 85.27 88.70 80.72

Euro 56.57 53.99 58.08 59.76 55.18

Japanese yen 0.407 0.379 0.411 0.404 0.339

Reasonsaggressively to cut the rupee appreciation.

Demand and supply: RBI has two options. It can allow market forces Indian economic performance has attracted the of demand and supply to determine the rupee attention of global investors. Improving eco- dollar rate. We have excess supply so dollar nomical fundamentals and stronger should fall or otherwise RBI shall growth prospects have led to a PARAG BHARDWAJ, PG-1 buy the excess dollars from the global interest in the Indian econmarket. The result would be that its omy. reserve will rise. This option is costly for the RBI Foreign money is pouring in to ride the eco- because it earns a low rate of return when innomic boom and take advantage of the rising vested in US government securities where as interest rates and stock and real estate prices. it pays to people who have invested in India NRIs remitted home a considerable amount in at a much higher rate. dollar. So the supply of dollar has exceeded the US economy is not performing well: The doldemand and the rupee has appreciated. lar's fall is primarily due to a big and rising curHigher interest rate in India has encouraged rent account deficit of the US. companies to borrow from abroad.

Foreigners, even the Americans, are not willRBI did not intervene: Another reason for the ing to invest in US because interest rate is low rise in rupee value is that RBI did not intervene and stock market is not doing well.

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Consequencesnow we have to pay lesser amount.

The sudden sharp appreciation of Indian rupee Employment: Due to fall in profitability of the over the last three months has unleashed con- export firms it is expected that employment is siderable uncertainties about the business en- going to be hit, mainly in IT and Textile sectors. vironment in India.

Expand the balance of trade gap: The failure Exports- A bulk of India's trade is invoiced in to achieve export targets and rising attracdollars. Hence, an appreciating rupee against tiveness of imports would lead to widening the dollar means that Indian export will trade gap in the Balance of become expensive. It is going to Payments account from an esbe challenging time for the timated $70 bn in 2006-07 Indian industry and busito as much as $100 bn in It is going to be ness. The challenges are 2007-08. challenging time for the in term of improving ExpectationsIndian industry and business. productivity and comThe current phase of petitiveness. Though rupee appreciation is The challenges are in terms of the Indian economy is unprecedented and improving productivity and comnot much export dehad not been anticipetitiveness. Though our econopendent as export conpated even as recentstitutes less than 20% ly as six months ago. It my is not too export depenof India's GDP, yet they is both inevitable and dent, they are crucial part are important part of desirable. It is inevitable of the economy economy. Sectors like IT, because increasing inflow textile, garments, gems and of dollars represents the jewellery are facing the heat. trust that people have in IndiImports: Appreciating rupee is helpan economy. It is desirable because ful in bringing down the inflation rate. Cheap we have cheaper imports. The Indian basket of import facilitates better supply. Prices of vari- crude oil is moving up and has already ous essential commodities as petroleum prod- touched its highest level of $ 67.40 a barrel on ucts, edible oil, and industrial goods are bound 18 may 2007. to come down.

There is a view that rupee appreciation might Owings: India owes money in term of dollars be corrected over the next few months and it to various countries and institutions. So, as the will come back to a level ranging from 42.50 rupee appreciates it is good for India because to 43.50 per dollar.

New Urban Governance Culture

I

nitially, our economy wasn't excelling in any sec- frastructure and urban governance structures in ortor, be it rural or urban. According to the UN, der to manage such a staggering population. Many during 2000, 47% population of the world lived more fast growing cities with a million-plus popin urban areas. In fact, 76% people live in cities in ulation are likely to emerge as big urban centers. developed nations while the percentFinancing for such centers is a big task.

VARUN HANDA, UG 2 age of urbanities in developing counIt will need currency in billion in order tries (like India) is barely 39.9%. to manage urban transport, water supply, and sewAs per a report released by Goldman Sachs, In- erage and drainage requirements. dia is surging ahead in urbanization. The pace is An attempt is being made to develop a municso fast that 140 million people (approx.) are likely ipal bond market. Financial institutions are coming to become city dwellers by 2020. together to create a pool of money to fund muBy 2050, the population will swell to a whop- nicipal bonds. One of the issue mandatory for whole ping 700 million. As for urban growth, there is go- economy is funding. ing to be as many as 120 cities in India having a However, the bigger question is whether India population beyond 5 million by 2021. Evidently, the is prepared to invest in a new urban governance real challenge for our decision makers and devel- culture. If this is resolved than other things will auopment planners will be to evolve broad-based in- tomatically fall in pace.

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Faculty Development Programme on Classroom Management

A one-day workshop for faculty members of IILM both from Lodhi Road and Gurgaon campus was held on Tuesday, 31 July 2007 at the Lodhi Road campus.

The workshop was conducted by Professor Namita Ranganathan (Professor at Central Institute of Education, Delhi University).

The workshop was well attended by more than 50 faculty members. Prof. Ranganathan explained various dimensions of classroom teaching. Her focus

Prof. Namita Ranganathan explaning various dimension of class room teaching

was on interactive, participative and workshop teaching approach. Students in a B school are more mature and are focused for their career growth, so they seek more of practical tips and techniques of learning rather than only academic and bookish,

Talent hunt by Kala students The Talent Hunt called Pratibha was organized by the cultural club, Kala, on 19th September, 2007.

The event had the students competing in four categories — instrumental, solo singing, solo dancing and monoacting.

It was a huge success with a massive participation by stu-

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dents. The final participants were chosen on the basis of auditions held earlier.

The auditorium was packed to capacity with an electrifying audience. It was heartening to see the participation of students both as audience and on stage.

The events were ably judged

she pointed out.

The workshop concluded with questions/answers and a debate.

Every teacher actively participated in these deliberations. On the whole, it was a great experience for the faculty of both the IILM campuses to be a participant in this activity. Teachers looked forward for more such programs.

by Mr. Shashwat Pandey, a trained classical singer from the Banaras gharana, Ms. Shama Behl and Ms. Shuchi Aggarwal.

Arman won the instrumental round; solo singing was won by Surabhi and Gunjan Srivastav was the first runners up.

Solo dancing was won by Sakshi with Shikha as runner up. Consolation prize went to Dharmendra for monoacting.

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COUNSELLORS MEET

Prof. Colin Neville addressing the UBS faculty and school counselors

IILM hosted a talk on "Effective Learning" by Prof Colin Neville on Friday, the 31st of August, 2007 at 3.30pm. at the New Delhi campus for Education Counselors of prominent schools of Delhi. The session began with a brief introduction about IILM by Ms Shweta Khanna, followed by an address by Prof Keith Hanning- Director of Studies, Undergraduate Collaborative Programmes-India. The talk was followed by a very interesting & rewarding session on Learning Techniques by Prof Colin Neville. Who has been associated with the University of Bradford since 1990. The session was well received by the school counselors and faculty. It was followed by a small farewell to Prof Colin Neville as it was his last day at the University of Bradford.

UG Orientation Day Orientation Day on 3rd August 2007 marked a new beginning in the lives of IILM Undergraduate Business School first year, first semester students, as they formally joined the IILM Undergraduate Business School.

The Orientation Day program commenced with the registration of the students. As the registration formalities got over, the program formally began with lighting of the ceremonial lamp by the chairperson Ms. Malvika Rai. The lighting of the lamp was aptly followed by invoking blessings from Goddess Saraswati. The IILM Dean Undergraduate Business School Ms. Neeti Sanan welcomed students and talked about the importance of attending classes; working hard for their career and making most of their stay at IILM Undergraduate Business School.

Post her address, Ms Meena Bhatia Associate Dean IILM Undergraduate Business School, introduced the faculty members to the students. It was then time to share the functioning of the IILM Undergraduate Business School Program Office. Ms. Merlin Mythili,

Ms. Neeti Sanan, Dean, UBS addressing the students

the Program Office In charge, familiarized the students to various issues such as courses offered, attendance requirements, intranet and so on, also reiterating the importance of attending classes and working hard.

The students were also addressed by eminent speakers such as Ms. Pria Warrick of Warrick Finishing School and Mr. Dhruv Chak of Success Point, who would be sharing a few courses with them.

Who could be better brand ambassadors than the Alumni.

IILM Undergraduate Business School Alumni spoke to the students and shared their experiences and concluded the program.

A brief and an insightful orienta-

tion program addressed parents as well. The Director-General of the Institute, Professor B. B. Bhattacharya, addressed the parents where he emphasized the role of both the faculties and parents in educating a child. The Dean IILM Undergraduate Business School, Ms. Neeti Sanan also addressed the parents and familiarized them with the Institute. Ms. Meena Bhatia, Associate Dean of the IILM Undergraduate Business School, introduced the faculty members to the parents who discussed the various modules and pedagogy.

The program ended with an informal interaction between the faculty and parents over tea.

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PGP Orientation Day

Dr. S.R. Mohnot, President Emeritus-ISTD Mrs. Malvika Rai, Chairperson, IILM Institute and Prof. B. Bhattacharyya, Director General & Principal lighting the cermonial lamp

Education is the soul of the society as it passes from one generation to another G K Chesterton Joining an MBA program is a powerful and formative transition in a person's life. Appreciating the above, IILM organized orientation day on 21st and 23rd August, 2007 for PGP batch (2007-09), to provide the students with information they would require before the commencement of classes and to begin the process of relationship building. Students from both New Delhi and Gurgaon campus attended the program.

The program began with the lighting of the lamp by the Chief Guest Dr. S.R. Mohnot, President Emeritus-ISTD and Chairperson Mrs. Malvika Rai. Prof. Bhattacharyya, Director General, IILM Institute for Higher Education, in his inaugural address, drew attention to the importance of future managers in shaping the country's economic growth. He The

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emphasized the fact that even though the two campuses were separated by distance they were one.

Ms. Sapna Popli, Dean, welcomed the students and apprised them of the new academic environment and life in IILM. She introduced the Area heads who further introduced the PGP faculty to the audience. Dr. Surabhi Goyal, Associate Dean, spoke about the courses offered and pedagogy, followed in the twoyear learning program.

Examination system is the backbone of any educational institute.

Mr. Naushad Mullick , controller of examination, briefed the students about the examination and grading system followed at IILM. IILM provides a conducive environment for the students which is supported by a well endowed library and well equipped state of the Art IT labs. An overview of the library and IT resources was provided by Mr. Basab Ranjan Shee and Mr. Yavar Hasan, respectively.

The highlight of the orientation

program was a panel discussion ably moderated by Prof. Akhil Swamy. Eminent personnel from the corporate world discussed about the expectations of the corporate world from students. The speakers were Mr. Rajiv Sharma, GM, Flex Group, Mr. Vineet Bajpai, Chief Executive Officer, Magnon Solutions Pvt. Ltd. and Mr. V Maheshwari, Vice president, HT Media Limited.

This was followed by an interactive session where students had a first hand chance to interact with the business world and satisfy their queries.

Emphasizing the need for courses on personal grooming and development Ms. Pria Warrick, Executive Director, Warrick Finishing School gave an enthralling presentation on etiquette, manners and body language required in today's business world.

The placement office acts as a hub for all placements related activities. Ms Sumati Channa

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briefed the students about the role of the placement office in not only the final placement but also in building a strong industry interface and enhancing industry interaction.

Highlighting the need for international exposure for future managers, Dr. Shuchi Agrawal gave a brief overview of the various collaborations, strategic alliances and exchange agreements which IILM has developed with business schools all over the world and the role of international office in gaining these exposures.

Mr Anil Vashisht and Ms. Anu Sharma introduced the students to the various clubs which IILM has to broaden the student's horizon.

The function ended with a presentation by the representatives of Dell computers and the distribution of text books and Time Table to the students.

Students Societies UBS, IILM A key feature of good college life is active participation in student societies where 'real education starts' once the formal teaching is over. A student society comprises a group of 10 or more students who wish to participate in an activity with a social or cultural focus. Student societies offer a platform to develop and demonstrate basic managerial capabilities in an area of interest.

IILM UBS witnessed an enthusiastic response to various student societies with the new batch com-

ing in on 6th August.

The Sports Society elicited an overwhelming response from first year students who went on to organize an Inter-Section Basketball and Football match in the Institute premises on the 16th and 20th of August, respectively.

The Sports Society has further proposed inter program and inter collegiate events in the coming months to be organized by the Club President, Ribhav and Secretary, Shikhar. Coaching sessions are also being detailed and will be made available students.

The Music and Theatre Society proposed a 'Talent Show' in the 2nd week of October. The Debating Society identified two teams from the Undergraduate course for participation in LSR Entrepreneuria, an inter-collegiate festival.

CLUBS AND SOCIETIES Extra curricular activities are the elixir of education process. The PG programme at the IILM Institute for Higher Education provides a common platform to all its students to hone both academic and non-academic skills. At the same time, to cultivate a feeling of belonging to the alma mater, the institute has a host of societies from which students can choose and obtain membership. The clubs and societies operational at IILM are: a) "Prometheans" This is a functional club which includes Finance, Marketing, HR & OB clubs and is responsible for activities like seminars, industry interactions, business quizzes and others.

This is the students' first brush with the industry. b) "Kala"

This is a cultural club that takes care of the activities such as, dances, dramas, songs, candle-making, admad shows, slogan writing contests, and much more which help the students develop more holistic personality. c) "The Word Power" This is a debating club which entails activities such as debates, declamations, management talks etc. d) "Werk Statt" This is a workshop club which takes care of the various workshops that are organised on topics such as stress management, time management, power of positive thinking and many more.

The workshops are designed to meet the specific need of the students and help them inculcate not

only managerial skills but also soft human skills. e) "Warriors" The sports club is responsible for all sports activities that will be organized in the institution.

The clubs organizes cricket, table tennis, basket ball matches regularly.

The clubs till date have performed the following activities for the benefit of the students: operational "Prometheans", under the guidance of Prof Akhil Swami, with the students getting their first brush of industry interaction at the close quarters, with COO of Mind Tree addressing them.

This was followed by talk by Dr Ibrahim Principal Consultant ABIA Consultancy, on "Importance of Human resources Management for a Business Corporation".

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Blood donation camp at IILM The gift of blood ranks highest among all human gifts. No volunteer wishes for a reward. To the giver, the gift is quickly replaced by the body. There is no permanent loss. To the receiver, it may mean anything, life itself, there is no substitute for blood and the human body remains the only source. Man must, therefore, help man by giving blood. In a well organized community, blood donation by able-bodied individuals becomes a social obligation.

In our constant endeavour to be socially responsible, we at IILM Lodhi Road, in association with the Indian Red Cross Society, organizised a blood donation camp on 12th

September, 2007.

Our students from the undergraduate and the postgraduate programs volunteered to make the camp a success. The volunteers worked hard towards creating awareness regarding the many myths associated with the donation of blood. The posters were displayed on the campus motivating the young donors of our college. There was an overwhelming response from the students, faculty and staff. A special acknowledgement to those who wanted to donate but couldn't do so on account of certain medical grounds.

Remember, Blood is replaceable, life is certainly not.

NEW ENTRENTS MONICA DUTTA Assistant Professor, Economics ❘❘❙❙ She has done her Masters in Economics from the Delhi School of Economics. Prior to IILM, she was associated with the external study programme of London School of Economics teaching the undergraduate students.

She has also been associated with a couple of research organizations wherein she has had the exposure to various research fields including market research. Her total work experience in this arena has been over 2 years. Her research interests include microeconomics, industrial organization, development economics & econometrics

SHAMA BEHL Assistant Professor, Insurance ❘❘❙❙ She has served United India Insurance Company for 22 years where she was posted after direct recruitment by General Insurance

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Corporation of India, She has specialized in key areas of underwriting, claims and loss minimization. She is a M.Sc. in Zoology from Delhi University. She also holds Fellowship of Insurance Institute of India. Marine, Engineering, Liability, Motor and Mediclaim insurances are her areas of interest.

SANDEEP KAPOOR Lecturer, Finance and Accounts ❘❘❙❙ He is Chartered Accountant from The Institute of Chartered Accountant, New Delhi and has done B Com (Hons.) from Delhi University. After completing his CA, he worked as a finance executive in a MNC dealing in the development and export of Software handling. His academic experience is 6 years and has taught in a number of reputed institutes including ICAI, ICFAI University and IIMT. His area of interest covers Taxation, Finance and Accounting.

FELICITATION Mr PHIROZ VANDREVALA Executive Vice-President, Tata Consultancy Services & Member of the Governing Body of IILM Institute for Higher Education, has been appointed as the cochair of the Indo-British Partnership (IBP), a core body formalized to boost bilateral trade between India and Britain.

Its special focus would be medium and small enterprises. In the backdrop of current surge in Indo-British trade, entrusting this significant responsibility to him is a big achievement.

IILM congratulates him on his new assignment.

ACADEMIC ACHIEVEMENTS Prof. Dr. TRIPTI P. DESAI Dr. Tripti P. Desai was a visiting professor at the University of Luneburg, Germany for one semester where she taught 4 papers. She was given this assignment under the aegis of Deutschen Akademischen Auslandsdienst (DAAD).

She is also trained in the Gestalt Associates Therapists Los Angles (GATLA) summer Residential Workshop in Vevey Switzerland for two weeks. She is now a reporter for Sloan Work and Family Research Network as a roving reporter on work-family developments representing India The Alfred P. Sloan Work and Family Research Network serves a global community of individuals interested in work and family research by providing resources, building knowledge, and sharing information. It has eminent researchers representing their country as reporters.

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Abbreviated form

A TO Z OF MANAGEMENT

A

AM

Asset management

B C

BM CM

Business Management Cash Management

D

DM

Disaster management

E

EM

Emotional Management

F

FM

Financial management

Good to manage properties and assets Guy, You are already in it!

To make optimal use of funds even if these are for few hours with you Very humane and noble aspect of management Area of OB and emotional intelligence Very sought after area

G

GM

Genius management

Creative area of HRM

H

HM

Hospital Management

You find in PGP-HA course

I

IM

Information Management

J

JM

We are living in Century of information.

Media related management

K

KM

L

LM

M N

MM NM

Material Management Number management

O

OM

Operation management

P

PM

Q

QM

R

RM

S

SM

Strategic management

T

TM

Time Management

U

UM

Underwriting management

V

VM

Vanity management

W

WM

Wealth Management

X

XM

X-management

Y

YM

Yacht management

Owning Yacht is symbol of richness and wealth

Z

ZM

Zigzag management

Many erratic processes require that kind of management

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Existing

Humorous Comment (Non-serious)

Take a care of others (honestly) Good for career growth Art of handling money in bags You help most, when really needed most You can surf successfully over own and others emotions You feel elated in managing 7-8 digits funds of others.

Just chill!!!

Once you get a patent like Edison, you can zoom in that product Making everybody healthy and robust Never be a laggard.

It's a Serious Study Business power of modern times are media driven Never be a frog in your own well Lawyers know the art of twisting. Beware!

Improves your logistics Art of polishing rotten and unacceptable facts What sounds so orderly is often done by disorderly persons. Creative are crazy too You get a sigh of relief if it reaches its destination You feel great that you are not cheater

AZ Journalist management

Knowledge Management Law management

Project Management

of

Very much part of knowledge, innovation and creativity Law is very essential field in modern corporate Professional discipline Statistics can often be big lies

to

Very logistical studies which enhance your operational methods Your skills become reality after some period Brands are always ego inflators and brands do not exist without quality The super most experience of shopping without tears Managing things and activities with keen insight and analysis Real high profile managers have that lifestyle It is big activity in new equity market Vanity is for personal enhancement of self image and more common to women Very absorbing discipline. You play with others golden dice All researches start with X.

MANAGEMENT

Quality management

Retail management

When consumers flock to your store, you smile like Buddha Your management genius is at test Makes you professional manager, even if not employed You assure them though you may be fully unsure If anyone is enterprising manager, there is great scope in this. Grab it!

Makes you moneybag

Managing uncharted paths.

An inquiry in to the unknown So obviously Yacht manage ment is managing wealth of super wealthy clients It is real super management skill to manage zigzagging persons on Delhi roads The

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Complied by Prof. KAILASH TULI and Prof. AKHIL SWAMI, while strolling in the ground of IILM Lodhi road for post lunch walks.

Institute for Higher Education