Essay Class – 03 Notes (Brijendra Singh)

Pre-Writing Brainstorming (SIDCOR)

1. SELECT the topic. 2 minutes

2. INTERPRET the topic.
3. DEVELOP your views on topic (BP1). 7 minutes
4. CHOOSE content for Intro. + Conclusion. 2 minutes
5. ORGANIZE Content for Body paragraphs. 7 minutes
6. REVIEW before writing. 2 minutes

Ø Total time: 20 minutes.

1. Select the easiest topic.

- reject the topics you are unsure about.
2. Interpret the topic correctly:
- Rephrase topic as a question.
- Agree/Disagree/Partially agree/Info.
3. Develop your views on the topic – Body Para 1.
- frame + answer 3 questions (5 W’s + H).
- understand broad structure/flow of essay.

GUIDELINES for BODY PARAGRAPHS

Body Para 1
• Don’t use theory/data/examples.
• Framing Ques: use key terms of topic.
• Framing Ans: don’t use key terms of topic.
• Start with relevant Quote.

Other Body Paras

• 6 elements.
• Start by selecting Evidence.
• Work backwards from there.

Choose Content for Intro + Conclusion

1. PURPOSE (Intro): Catch the reader’s attention & interest.

PURPOSE (Concl): Provide final reinforcement of topic.

2. TOOLS: - small anecdote; suitable quote; statistics.

- element of Surprise, Sorrow, Pride etc.

3. Examples/data are interchangeable – select the BEST.

4. Use the topic as the last line of the Intro & Conclusion.
- has a very powerful impact.

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Writing the Intro + Conclusion

Ø Anecdote: discuss one suitable anecdote.

Ø Data: - data points are small/brief.
- use a combination of 2-3 data points to create emphasis.

Writing the Other Body Paragraphs

1. Select relevant & appropriate Evidence.

- should help prove/disprove the topic.
2. Identify the remaining 5 elements.
3. Don’t be in a hurry – mentally scan the entire content.
4. TIP:
- when the evidence is positive, use it at the end of the para.
- when the evidence is negative, use it after mentioning the concern and conclude the para
with the recommendation.

OF ALL THE FORMS OF INEQUALITY, INJUSTICE IN HEALTHCARE

IS THE MOST SHOCKING AND INHUMANE.
Question: Is injustice in healthcare the most shocking and inhumane form of inequality?
Answer: Yes.
Response: Agree.

FRAMING 3 Questions for Body Para 1

WHY do we need equality & justice in healthcare?

- Health is a necessity, not a luxury; affects everyone.
- Without E&J, basic right to life is denied & violated.
WHERE does such inequality exist?
- Rich/Poor; Rural/Urban; Men/Women; Young/Old; Abled/PwD; Medical practices.
- Accessibility, Affordability; Preventive care; Research.
- Lack of qualified medical professionals; financial constraints; malnutrition; social stigmas
and discrimination.
WHY is it shocking and inhumane?
- Has a cascading effect; inequalities become worse across generations.

BODY PARA 1
Nelson Mandela said that health is not a question of income or gender, but a fundamental human
right. This emphasizes the fact that health is not a luxury but an inalienable necessity. Its presence
or absence affects everyone, regardless of age, gender or race. Without just and equitable healthcare,
the basic human right to live itself is violated. However, inequalities exist in the ability of different
sections to be able to access and afford health care. Such inequalities create a divide between the
rich and the poor, between men and women, even between the young and the old. The deprived
sections suffer due to a lack of qualified medical professionals, financial constraints, malnutrition and
even social stigmas and discrimination. These deprivations create a cascading effect, whereby
diseases, anemia, stunting and mortality are significantly higher within these sections and become
worse across successive generations. Thus proving that injustice in healthcare is the most inhumane
form of inequality.

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CONTENT FOR INTRO. & CONCLUSION
i. Reach in rural areas
ii. Birth attendants
iii. Nutrition & stunting
iv. High OOP expenditure
v. Oxfam (vaccination)
vi. ActionAid survey
vii. PwD during lockdown
viii. Savita Halappanavar
ix. Aruna Shanbaug
x. Musahar community

Introduction/Conclusion 1: Anecdote about PwD during Lockdown

When the COVID-induced lockdown was enforced in March 2020, the country came to a grinding
halt. As markets, educational institutions and transport shut down, people faced unprecedented
problems and inconveniences. But perhaps the worst affected were People with Disabilities (PwD).
Policy makers forgot that PwD’s often need caregivers to assist them in accessing medicines,
treatment and in performing everyday tasks. Thus, people with vision impairment could not reach
hospitals, people with cognitive disability could not access government grants from their bank
accounts, people with impaired movement could not even move without assistance. These “Missing
Millions”, invisible in government policies and budgets, became silent and innocent victims of the
inequalities embedded in our health policies. Proving that injustice in healthcare is the most
shocking and inhumane form of inequality.

Introduction/Conclusion 2: Combining data points to create emphasis

India is a country where injustice in healthcare is so common that countless people become fatalities
of its inherent inequalities. The rural-urban divide is visible in the facts that only 37% of rural
Indians have access to In-Patient Department (IPD) facilities within a 5 km distance, only 25% of
dispensaries and 20% of doctors are operational in rural areas. The difference between haves and
have-nots is visible in the fact that 95.5% of births occurring in the richest 20% of households in
India are attended to by skilled birth attendants, while the figure is just 64% for the poorest 20%.
These disparities cause irreversible and generational damages to millions of helpless innocents.
Such damage is visible in the facts that India is home to around 4 crore stunted children and 53% of
women between 15-49 years are anemic. Proving without doubt that injustice in healthcare is the
most shocking and inhumane form of inequality.

Introduction/Conclusion 3: Anecdote about Savita Halappanavar

Savita Halappanavar was a happy and successful 31-year-old Indian woman living in Ireland. In
2012, she was 17 weeks pregnant when she experienced a miscarriage. Despite repeated requests for
an abortion, the medical staff refused to terminate the pregnancy because they believed that the
foetus had a heartbeat. She developed sepsis and her condition deteriorated rapidly, yet the abortion
was denied because Irish laws prohibited abortion. In this tussle between law and life, the law won
and Savita lost her life in October 2012. Her case highlights the issue of women's rights in cases
where the mother's life is at risk. And serves as an undying reminder of the fact that injustice in
healthcare is the most shocking and inhumane form of inequality.

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 Of all the forms of inequality, injustice in healthcare
is the most shocking and inhumane – 5 Body Paras
Evidence Principle Dimension Concern/Recommendation
ASHA workers/HWC Accessibility Geog. Lack of access/ Physical reach
PMJAY Economic Health exp./ Health Insurance
E-Sanjeevani Tech. Remote location/Telemedicine
POSHAN/ F. Rice H. Promotion Social Poor diet/ Improve nutrition
Suicides/ TeleManas Psycho. Stigma/ Raise awareness
PMBJP H. Equity Economic Cost of medicines/Affordable meds
Musahar Social Discrimination/Reduce caste elitism
Cancer (65+) Seniors Discrimination/Targeted campaigns
PwD-lockdown PwD Limited knowledge/Sensitization
Baby Manji Medical Ethics Women Exploitation/ Safeguards
Aruna S Life Die with dignity/Legal framework
Kidney transplant Procedural Organ trade/Organ donation

1. Principle, Dimension: Accessibility; Geographical.

2. Ideal Condition: Universal coverage.
3. Concern: Lack of access in rural areas.
4. Recommendation: Increase presence of frontline workers.
5. Example: ASHA workers.

The first inequality in healthcare arises with regard to accessibility to medical facilities. Ideally,
healthcare systems should have universal coverage. However, many people lack access to medical
services, especially those residing in remote areas- in rural India, only 37% of the people have access
to In-Patient Department facilities. This can be addressed by increasing the presence of frontline
health workers, who belong to the local community and directly provide health services to that
community. For instance, governments in India utilize the services of ASHA workers to provide
community health services in rural areas. ASHA workers are trained female community health
activists who are selected from the village itself and work as an interface between the community and
the formal public health system.

1. Principle, Dimension: Equity; Senior Citizens.

2. Ideal Condition: Customized healthcare.
3. Concern: Disparities in healthcare services.
4. Recommendation: Robust geriatric health infrastructure.
5. Example: NBCCEDP.
One section of people who face gross injustice in healthcare systems are Senior Citizens. Given their
life-long contributions to society and the nation, they deserve customized healthcare solutions. Yet,
they often face ageism and discrimination in healthcare settings, which leads to inadequate
attention to their specific health needs. For instance, the National Breast and Cervical Cancer Early
Detection Program (NBCCEDP) in India provides free screenings for women between the ages of 30-
65 years, but excludes senior women above the age of 65 from accessing these screenings. This
exclusion overlooks the fact that older women are also at risk of developing cancer and denies them
the opportunity for preventive care and early detection. Thus, it becomes vital to develop a robust
geriatric healthcare infrastructure that includes specialized geriatric hospitals and long-term care
facilities.

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 HEALTH IS A RIGHT WHOSE PRESENCE ENABLES OTHER RIGHTS.

Question: Does the presence of health enable other rights?

Answer: Yes.
Response: Agree.

FRAMING 3 Questions for Body Para 1

WHY is health a right?

- Because its presence/absence affects everyone equally.
- Cannot do anything fruitfully without good health.
HOW does the absence of health disable other rights?
- Prevents person from reaching full potential-interpersonal, social, economic-in all spheres of life.
- Cannot living a fulfilling life; dependent on others.
- Resources diverted towards health could be used to enable other rights.
HOW does the presence of health enable other rights?
- Healthy people can be partners in growth; enable and facilitate rights for themselves as well as
others.

CONTENT FOR INTRO. & CONCLUSION

i. Catastrophic Health exp.
ii. Digitization of HR (Golden Hour)
iii. Nutrition & stunting
iv. Hidden Hunger
v. Oxfam (vaccination)
vi. PMBJP
vii. PwD during lockdown
viii. Savita Halappanavar
ix. Gujarat High Court
x. Health
Musahar is a right whose presence enables other rights.
community
5 Body Paras
Evidence Principle Dimension Concern/Recommendation
ASHA workers/HWC Accessibility Geog. Lack of access/ Physical reach
PMJAY Economic Health exp./ Health Insurance
E-Sanjeevani Tech. Remote location/Telemedicine
POSHAN/ F. Rice H. Promotion Social Poor diet/ Improve nutrition
Suicides/ TeleManas Psycho. Stigma/ Raise awareness
PMBJP H. Equity Economic Cost of medicines/Affordable meds
Musahar Social Discrimination/Reduce caste elitism
Cancer (65+) Seniors Discrimination/Targeted campaigns
PwD-lockdown PwD Limited knowledge/Sensitization
Savita H. Medical Ethics Women Right to life/ Clear guidelines
Kidney transplant Procedural Organ trade/Organ donation
HPV vaccine Research Risks/Informed consent

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