QUESTION : During the pandemic which has led to lockdown and other social-distancing norms, has exacerbated the sex-worker crises to almost a human-crisis. Comment. 

Covid-19 and Sex Workers in India
Adults who earn by providing sexual services should be granted basic labour rights.
• One community that got hit hard by the pandemic is the sex workers.
• Owing to the non-recognition of sex work as “legitimate work”, sex workers have mostly been kept at arm’s length from the government’s relief programmes.
• COVID-19 has thus provided more reason to consider a long-pending demand of sex workers in India by;
o Decriminalisation of sex work and 
o A guaranteed set of labour rights.
• The legislation governing sex work in India is the Immoral Traffic (Prevention) Act.
• The Suppression of Immoral Traffic in Women and Children Act was enacted in 1956.
• Subsequent amendments were made to the law and the name of the Act was changed to the Immoral Traffic (Prevention) Act. 
• The legislation penalises acts such as 
o Keeping a brothel, 
o Soliciting in a public place, 
o Living off the earnings of sex work and 
o Living with or habitually being in the company of a sex worker.
o The Act has not only criminalised sex work but also further stigmatised and pushed it underground thus leaving sex workers more prone to violence, discrimination and harassment.
o The Act denies an individual their right over their bodies. 
o It imposes the will of the state over adults articulating their life choices.
o It gives no agency to the sex workers to fight against the traffickers and in fact, has made them more susceptible to be harassed by the state officials.
o The Act fails to recognise that many women willingly enter into agreements with traffickers, sometimes just to seek a better life as chosen by them.
• This Act represents the archaic and regressive view that sex work is morally wrong and that the people involved in it, especially women, never consent to it voluntarily.
o In the popular depiction, entry into sex work is involuntary, forced, and through deception.
• This view is based on the belief that sex work is “easy” work and no one will or should choose to practise it.
• It is believed that these women need to be “rescued” and “rehabilitated”, sometimes even without their consent. 
• It led to the classification of ‘‘respectable women” and “non-respectable women”. 
• The Justice Verma Commission had also acknowledged that; 
o There is a distinction between women who are trafficked for commercial sexual exploitation and adult, consenting women who are in sex work of their own volition.
• Adult men, women and transgender persons in sex work have the right to: 
o Earn by providing sexual services;  
o Live with dignity; and  
o Remain free from violence, exploitation, stigma and discrimination.
Other Legislative Provisions related to trafficking and sexual abuse in India:
• Immoral Traffic (Prevention) Act 1986:
o It penalizes trafficking for commercial sexual exploitation.
• Protection of Children from Sexual Offences (POCSO) Act, 2012, which has come into effect from 14th November 2012 is a special law to protect children from sexual abuse and exploitation.
• Prohibition of Child Marriage Act, 2006, 
• Bonded Labour System (Abolition) Act, 1976, 
• Child Labour (Prohibition and Regulation) Act, 1986, 
• Transplantation of Human Organs Act, 1994, 
• IPC sections
o Sections 372 and 373 dealing with the selling and buying of girls for the purpose of prostitution. 
• Formal education should be made available to those victims who are still within the school going age, while non-formal education should be made accessible to adults.
• The Central and State Governments in partnership with non-governmental organizations should provide gender sensitive market driven vocational training to all those rescued victims who are not interested in education.
• Rehabilitation and reintegration of rescued victims being a long-term Recruitment of adequate number of trained counsellors and social workers in institutions/homes run by the government independently or in collaboration with non-governmental organizations.
• Awareness generation and legal literacy on economic rights, particularly for women and adolescent girls should be taken up.
• Adequate publicity, through print and electronic media including child lines and women help lines about the problem of those who have been forced into prostitution.
• Culturally sanctioned practices like the system of devadasis, jogins, bhavins, etc. which provides a pretext for prostitution should be addressed suitably.
• The Supreme Court, in Budhadev Karmaskar v. State of West Bengal (2011), opined that sex workers have a right to dignity.
• We must recognise sex work as work and stop ourselves from assigning morality to their work.
• Recognition of their work can guarantee them basic labour rights.
• During the time of crisis, Parliament must also take a re-look at the existing legislation and do away with the ‘victim-rescue-rehabilitation’ narrative. 
• Utmost need of reforms in labour laws with respect to sex workers.
• Adult men, women and transgender persons in sex work have the right to earn by providing sexual services.
• They must be allowed to live with dignity; and remain free from violence, exploitation, stigma and discrimination.
• The government must take a re-look at the existing legislation and do away with the ‘victim-rescue-rehabilitation’ narrative.
Achieving healthier communities and controlling COVID-19 requires a collective and inclusive response. Resources and support for sex workers need to be prioritised. Involvement of communities in social protection schemes, health services, and information will enable sex workers to protect their health during this pandemic as equal citizens, in line with principles of social justice.

QUESTION : Define the term ‘telemedicine’ and  how the recent COVID19 pandemic proved to be a boon for the telemedicine sector. Discuss  

Telemedicine Practice Guidelines
As India entered its first lockdown in March 2020, the board of governors, Medical Council of India, published the Telemedicine Practice Guidelines, 2020 (‘Telemedicine Guidelines’) that lay down the basic framework for practising telemedicine in India. 
• India faces a difficult challenge in rapidly bringing up the level of healthcare infrastructure, especially in rural areas. The difficulty is augmented by the fact that about 75 per cent doctors stay in cities and towns, whereas about 65 per cent of India’s population resides in rural areas.
• In order to bridge this gap, the Centre has recognised telemedicine as the solution in the short to medium term. The recent expansion of the National Digital Health Mission with the rollout of unified health interface (UHI) in the future gives clear hints about the intention of the government to place substantial reliance on telemedicine in the fight against Covid-19.
• Telemedicine a term framed in the 1970s, which means “healing at a distance”.
• According to WHO telemedicine is defined as “the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”.
• It signifies the use of Information Communication Technology (ICT) to improve patient outcomes by increasing access to care and medical information to rural and remote areas.
• MoHFW has adopted citizen centric approach while framing Telemedicine guidelines.
• In India, guidelines regarding Telemedicine are published under the Indian Medical Council Act, 1956 and are for.
 privileged access only.
• These guidelines are designed to serve as an aid and tool to enable Registered Medical Practitioners (RMP) to effectively leverage telemedicine to enhance healthcare service and access to all.
• Telemedicine would include the delivery of whole range of healthcare services by health care professional using information and communication technologies including research and education. 
• Fail to address the issues relating to the data generated in the process of telemedicine.
• Fail to lay down any standards relating to technology required to ensure safety of the patient’s electronic records or the explicit liability in case of leak of data from communication mediums chosen by the RMP.
• Fail to lay down the minimum technical requirements required for the purpose of a successful telemedicine programme.
• Fail to deal with the liability of technology providers or institutions in case of breach of data or in case of presence of unauthorized RMPs on such platforms.
• The guidelines only provide for blacklisting of such technology providers who fail to verify the persons providing telemedicine services on their platform.
• The absence of a clear grievance redressal mechanism with respect to telemedicine service providers is another significant omission in the guidelines.
• Significant challenges such as medico-legal liability of doctors in case of negligent consultations or surgeries are likely to arise, which also have not been addressed by the guidelines.
• Due to nationwide lockdown, people are seeking new solutions to routine tasks, be it food-delivery, medical consultations or education.
• The World Health Organization mentioned telemedicine among essential services in “strengthening the Health Systems Response to COVID-19” policy.
• Tele health can directly influence flattening the curve of demand on health systems worldwide, slowing transmission and spreading incidence over a longer time period.
• Startups like Practo, Portea, and Lybate, are facilitating remote medical checkups keeping in mind the practice of ‘Social Distancing’.
• Diabetes care and management app BeatO is trying to emulate the real-life experience by giving patients the option of adding their regular doctor to the platform.
• Meddo Health, which lists over 200 doctors across 16 specialties, has opened up its platform to doctors free-of-cost to cover other chronic ailments as well apart from Corona virus.
• Maker’s Asylum, a community hacker space in Mumbai and New Delhi, has designed face shields for healthcare workers. The M-19 shield can be made in just about three minutes by anyone following the guidelines of the prototype.
• The Indian government, on April 6, launched the Aarogya Setu app for contact-tracing. It is similar to Singapore’s Trace Together.
• Aerial surveillance or drones helps track large gatherings, minimizing physical contact, and monitoring narrow by lanes where police vehicles cannot enter. They can also be used to spray disinfectants in public spaces and residential colonies.
• Tamil Nadu has hired Garuda, a Chennai-based start-up, for sanitization of hospitals etc through drones. 
• There is an urgent need to address the issues relating to data safety, privacy as well as for demarcating liability of technology providers and healthcare workers in order to address the trust gap between patients and telemedicine providers.
• Look for guidance at the telemedicine guidelines of various provinces in Canada and the United States, which have a well-established regime for telemedicine.
• Telemedicine saves time and cost. Further, these platforms are in line with the government’s vision of ‘Digital India’ and necessary to tackle situations created by a pandemic like Covid-19. 
• Awareness programme can be initiated about the benefits of telemedicine
• The strengthening of digital health services will also be in line with WHO’s Global strategy on Digital health. It would help in realizing the dream of ‘Health for All”.
A timely intervention in updating the regulations is the need of the hour for increase in acceptance as well safety of the stakeholders involved in telemedicine.

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