Hospitals have stopped unnecessary elective surgeries – and shouldn’t restart them after the pandemic

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Adam Elshaug, University of Sydney and Stephen Duckett, Grattan Institute

Part of Australia’s response to the coronavirus pandemic was a severe reduction in elective surgery, and so private hospitals have stood almost empty for a month now.

People who might otherwise have had a procedure are experiencing “watchful waiting”, where their condition is monitored to assess how it develops rather than having a surgical procedure.

The big question is whether all those procedures which didn’t happen were even necessary. There has now been a steady stream of work which suggests many procedures don’t provide any benefits to patients at all – so called low- or no-value care.

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Read more:
Dodgy treatment: it’s not us, it’s the other lot, say the experts. So who do we believe?

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Bringing about change in health policy is usually difficult (or slow, at best) because it’s like turning a big ship around. But in the past six weeks that ship has made a sudden about-turn.

Australia’s elective procedure system after the pandemic should be different from before the pandemic. We should dramatically reduce the number of low- or no-value procedures.

What is low- or no-value health care?

Low- or no-value health care mean the intervention provides no or very little benefit to patients, or where the risk of harm exceeds the likely benefit.

Reducing such “care” will improve both health outcomes for patients and the efficiency of the health system.

Research in New South Wales public hospitals showed up to 9,000 low-value operations were performed in just one year, and these consumed almost 30,000 hospital bed days that could have been used for high-value care.

One example of low-value care is spinal fusion surgery for low back pain. This is a procedure on the small bones in the spine, essentially welding them together. The alternative is pain management, physiotherapy and exercise.

Spinal fusion for low back pain is an example of low-value care.
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The NSW analysis revealed up to 31% of all spinal fusions were inappropriate. But even this figure is likely an underestimate.

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Read more:
Needless treatments: spinal fusion surgery for lower back pain is costly and there’s little evidence it’ll work

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Other examples include:

• vertebroplasty for osteoporotic spinal fractures: surgery to fill a backbone (vertebrae) with cement

• knee arthroscopy for osteoarthritis: inserting a tube to remove tissue

• laparoscopic uterine nerve ablation for chronic pelvic pain: surgery to destroy a ligament that contains nerve fibres

• removing healthy ovaries during a hysterectomy

• hyperbaric oxygen therapy (breathing pure oxygen in a pressurised room) for a range of conditions including osteomyelitis (inflammation of the bone), cancer, and non-diabetic wounds and ulcers.

Low-value care can harm patients because of the risks inherent in any procedure. If a patient having a low-value procedure gets even one complication, the time they spend in hospital doubles, on average.

For some patients, the hospital stay can be much longer. For example, a low-value knee arthroscopy with no complications consumes one bed day. If a complication occurs, that length of stay increases to 11 days, on average.

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Read more:
Needless procedures: knee arthroscopy is one of the most common but least effective surgeries

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For most low-value procedures, the most common complication is infection.

The situation is even worse in private hospitals, where a much greater proportion of elective procedures are low value.

Prioritise treatments that work

Most state health departments and private insurers now know the size of the low-value care problem and which hospitals are providing that “care”.

Due to the COVID-19 response, the tap for these procedures has been turned down for some and off for others. This is a risk for some patients, but others will benefit from not having the surgery. We must grasp the opportunity to learn from this enforced break.

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Read more:
The coronavirus ban on elective surgeries might show us many people can avoid going under the knife

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One of the challenges for policymakers in the past in controlling low-value care has been difficulty in ratcheting down supply by reducing or redirecting a hospital’s surgical capacity and staff.

In many ways, the COVID-19 response has done this for them. After the pandemic, we can reassess and reorient to high-value care.

Some people will need catch-up surgeries after the pandemic, but some won’t.
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This does not necessarily mean reducing capacity. Some people aren’t currently getting the care they need. When the tap comes back on, this unmet backlog of care must be performed.

But this needn’t detract from a focused effort to keep the low-value care from re-emerging. The last thing we need is for low-value care to take the place of high-value care that has been delayed because of the COVID-19 response.

So how do you do it?

Australia should take three immediate steps to ensure we don’t return to the bad old days of open slather.

First, states should start reporting the rates of low-value care, using established measures. This reporting should identify every relevant hospital – public and private – and it should be retrospective, showing rates for the past few years.

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Read more:
Australians are undergoing unnecessary surgery – here’s what we can do about it

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Second, states should require all public hospitals to take steps to limit low-value care – and hospitals that don’t comply should be called to account.

States have the insights and data necessary to do this.

Hospital strategies might include requiring a second opinion from another specialist before a procedure identified as low-value care is scheduled for surgery, or a retrospective review of decisions to perform such surgery.

Hospitals could require second opinions before scheduling low-value procedures.
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In the post-pandemic world, states should also consolidate elective surgery, so the number of centres performing elective procedures in metropolitan areas is reduced, with decision-making tools to highlight downsides of low-value care and the alternatives.

Third, private insurers know low-value care is provided in private hospitals, but currently have fewer levers at their disposal to reduce such care. The Commonwealth government should legislate to empower funds to address this issue. Given the Commonwealth government is providing financial support to the private hospitals during their downturn, perhaps a requirement should be that they work with the insurers and Medicare to police the re-emergence of low-value care.

It would be a dreadful shame to waste this unprecedented opportunity, and revert to the old status quo of low- and no-value care.

Adam Elshaug, HCF Research Foundation Professorial Fellow, Professor in Health Policy and Co-Director, Menzies Centre for Health Policy, University of Sydney and Stephen Duckett, Director, Health Program, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Article: Music – Do We Buy It Any More?

I don’t often buy music any more. On the odd occasion I may, if I believe the price is reasonable, grab a CD or these days something of the iTunes site. Generally though I stopped buy music a long time ago. Why? Well, in my opinion it was far too overpriced. A CD with just 8 songs on it or perhaps even less than 8, for the price they were charging – no way!

Now I have a subscription to Spotify and I can stream (and save playlists to my lap top) music for a very reasonable price. Not everything is on Spotify, but I will still buy something from iTunes should I wish to – such as a couple of The Voice Australia songs.

For me, buying music or not buying music was never about could I get a pirated version. I stopped buying music because it was too costly to do so. I think the music industry got too greedy.

I think a similar thing with books. Traditional printed books cost too much to buy generally speaking and besides that I’m now a digital geek so ebooks are my thing.

For more on the music debate visit:
http://www.neatorama.com/2012/06/20/the-eternal-debate-of-nobody-buys-music-anymore/

India Briefs

Recent Incidents of Persecution

Karnataka, India, April 15 (CDN) — Police on April 10 arrested a pastor and other Christians of the New India Church in Mysore after some 25 Hindu extremists from the Sreeram Sena attacked their Sunday service, accusing them of forcible conversions, reported the Mathrubhumi daily. Pastor Vinod Chacko was leading the service when the Hindu nationalists barged into the church, stopped the prayer service and complained to police of alleged forcible conversions. The Global Council of Indian Christians reported that the extremists along with police detained the worshippers inside the church building, including 20 women and 10 children, taking down personal details about them and asking them whether they were paid money or otherwise lured to attend. Police also seized vehicles belonging to the church and those attending the service. Police charged Pastor Chacko, his wife Asha and others identified only as Sabu, Simon and Sayazu under section 295A of the Indian Penal Code with “deliberate and malicious acts intended to outrage religious feelings.”

New Delhi – A mob of about 150 Hindu extremists on April 9 attacked a Christian worship meeting in Bhajanpura, East Delhi, beating Christians with clubs and stones, including women and children. Pastor Solomon King told Compass that the Assembly of God church organized an open-air “Festival of Deliverance” meeting at which he was speaking; there were about 150 people in the arena when he arrived with 40 choir members. After the meeting began at about 6 p.m., some present suddenly shouted “Jai Shri Ram [Praise Lord Ram]” and started beating the Christians. Two Christians identified only as Prabhu and Abhisek sustained head injuries and received hospital treatment. Pastor King, his wife and other Christians also suffered bruises. The intolerant Hindus also destroyed furniture, a sound system, a generator and some Christians’ vehicle. The Christians had received permission from government officials to conduct the worship meeting, and five police officers were on duty to protect it; the Hindu extremists also severely beat them. The attack lasted for about an hour before police reinforcements arrived, and the extremists fled. Police were able to arrest two of the assailants.

Madhya Pradesh – An enraged mob of Hindu extremists on April 7 stormed into the prayer meeting of a Christian Assembly house church shouting anti-Christian slogans and filed a police complaint of forceful conversion against those present in Sagar. The Hindu extremists accused Pastor Joy Thomas Philip of forceful conversion, Pastor C.P. Mathew of Bhopal told Compass. Police arrived and took Pastor Philip and three other Christians into custody for questioning but claimed it was a protective measure. After area Christian leaders’ intervention, the Christians were released on bail on April 9.

Karnataka – Mulki Circle police officials on April 4 forcibly took church documents from Hebron Assembly Church in Mulki and told the pastor not to allow any Hindus to enter. The Global Council of Indian Christians reported that officials identified only as Inspector Shivaprakash and Sub-Inspector Neelakanta, along with five police officers, verbally abused Pastor I.D. Prasanna and harshly denigrated church activities. Police officials questioned Pastor Prasanna for three hours, telling him what church activities he can and cannot undertake, and threatening to close the church if he disobeyed. They also ordered the pastor to give detailed information about the families that attended the church service.

Karnataka – Police in Shimago on April 3 detained Pastor Abraham K.G. and a Christian identified only as Eerappa for their faith in Christ. The Global Council of Indian Christians (GCIC) reported that Hindu extremists led by area Bajrang Dal member Subbraya Shetty interrupted the worship meeting of the Jehovah Nizzi church and warned them to stop meeting. The extremists had been harassing the pastor since March 27, reported the GCIC. As the April 3 service started at about 10:30 a.m., a sub-inspector from the Hosanagara police station arrived in a Jeep with three other police officers to make the arrests. When the Christians asked about the reasons, the officials said without basis that the Christians were using abusive language. Later that evening, police released the Christians without charges after taking a statement from them pledging that they would conduct no future worship meetings – and that they should leave the area.

Report from Compass Direct News
http://www.compassdirect.org

Christian Woman Freed from Muslim Kidnappers in Pakistan

Captors tried to force mother of seven to convert to Islam.

LAHORE, Pakistan, March 11 (CDN) — A Christian mother of seven here who last August was kidnapped, raped, sold into marriage and threatened with death if she did not convert to Islam was freed this week.

After she refused to convert and accept the marriage, human traffickers had threatened to kill Shaheen Bibi, 40, and throw her body into the Sindh River if her father, Manna Masih, did not pay a ransom of 100,000 rupees (US$1,170) by Saturday (March 5), the released woman told Compass.   

Drugged into unconsciousness, Shaheen Bibi said that when she awoke in Sadiqabad, her captors told her she had been sold and given in marriage.

“I asked them who they were,” she said. “They said that they were Muslims, to which I told them that I was a married Christian woman with seven children, so it was impossible for me to marry someone, especially a Muslim.”

Giving her a prayer rug (musalla), her captors – Ahmed Baksh, Muhammad Amin and Jaam Ijaz – tried to force her to convert to Islam and told her to recite a Muslim prayer, she said.

“I took the musalla but prayed to Jesus Christ for help,” she said. “They realized that I should be returned to my family.”

A member of St. Joseph Catholic Church in Lahore, Shaheen Bibi said she was kidnapped in August 2010 after she met a woman named Parveen on a bus on her way to work. She said Parveen learned where she worked and later showed up there in a car with two men identified as Muhammad Zulfiqar and Shah. They offered her a job at double her salary and took her to nearby Thokar Niaz Baig.

There she was given tea with some drug in it, and she began to fall unconscious as the two men raped her, she said. Shaheen Bibi was unconscious when they put her in a vehicle, and they gave her sedation injections whenever she regained her senses, she said.

When she awoke in Sadiqabad, Baksh, Amin and Ijaz informed her that she had been sold into marriage with Baksh. They showed her legal documents in which she was given a Muslim name, Sughran Bibi daughter of Siddiq Ali. After Baksh had twice raped her, she said, his mother interjected that she was a “persistent Christian” and that therefore he should stay away from her.

Shaheen Bibi, separated from an abusive husband who had left her for another woman, said that after Baksh’s mother intervened, her captors stopped hurting her but kept her in chains.

 

Release

Her father, Masih, asked police to take action, but they did nothing as her captors had taken her to a remote area between the cities of Rahim Yar Khan and Sadiqabad, considered a “no-go” area ruled by dangerous criminals.

Masih then sought legal assistance from the Community Development Initiative (CDI), a human rights affiliate of the European Center for Law & Justice. With the kidnappers giving Saturday (March 5) as a deadline for payment of the ransom, CDI attorneys brought the issue to the notice of high police officials in Lahore and on March 4 obtained urgent legal orders from Model Town Superintendent of Police Haidar Ashraf to recover Shaheen, according to a CDI source.

The order ultimately went to Assistant Sub-Inspector (ASI) Asghar Jutt of the Nashtar police station. Police accompanied by a CDI field officer raided the home of a contact person for the captors in Lahore, Naheed Bibi, the CDI source said, and officers arrested her in Awami Colony, Lahore.

With Naheed Bibi along, CDI Field Officer Haroon Tazeem and Masih accompanied five policemen, including ASI Jutt, on March 5 to Khan Baila, near Rahim Yar Khan – a journey of 370 miles, arriving that evening. Area police were not willing to cooperate and accompany them, telling them that Khan Baila was a “no-go area” they did not enter even during daytime, much less at night.

Jutt told area police that he had orders from high officials to recover Shaheen Bib, and that he and Tazeem would lead the raid, the CDI source said. With Nashtar police also daring them to help, five local policemen decided to go with them for the operation, he said.

At midnight on Sunday (March 6), after some encounters and raids in a jungle area where houses are miles apart, the rescue team managed to get hold of Shaheen Bibi, the CDI source said. The captors handed over Shaheen Bibi on the condition that they would not be the targets of further legal action, the CDI source said.

Sensing that their foray into the danger zone had gone on long enough, Tazeem and Jutt decided to leave but told them that those who had sold Shaheen Bib in Lahore would be brought to justice.

Fatigued and fragile when she arrived in Lahore on Monday (March 7), Shaheen Bibi told CDN through her attorneys that she would pursue legal action against those who sold her fraudulently into slavery and humiliation.

She said that she had been chained to a tree outside a house, where she prayed continually that God would help her out of the seemingly impossible situation. After the kidnappers gave her father the March 5 deadline last week, Shaheen Bibi said, at one point she lifted her eyes in prayer, saw a cross in the sky and was comforted that God’s mighty hand would release her even though her father had no money to pay ransom.

On four previous occasions, she said, her captors had decided to kill her and had changed their mind.

Shaheen Bibi said there were about 10 other women in captivity with her, some whose hands or legs were broken because they had refused to be forcibly given in marriage. Among the women was one from Bangladesh who had abandoned hope of ever returning home as she had reached her 60s in captivity.

Masih told CDN that he had prayed that God would send help, as he had no money to pay the ransom. The day before the deadline for paying the ransom, he said, he had 100 rupees (less than US$2) in his pocket.

Report from Compass Direct News

Christian Family in Bangladesh Attacked, Charged with Crime

Muslim neighbors fabricate attempted murder charge after beating them for their faith.

LOS ANGELES, October 27 (CDN) — Muslim neighbors of a Christian family in Bangladesh scheduled to be baptized last month beat them and filed a false charge of attempted murder against them and other Christians, the head of the family said.

Foyez Uddin, 62, told Compass that his neighbor Nazrul Islam and Islam’s relatives told him, his wife and his two adult children that as Christians they were “polluting” society and beat them on Sept. 17 in Joysen village in Rangpur district, some 300 kilometers (186 miles) north of Dhaka. Islam is a policeman.

Islam’s uncle, Abdul Mannan Miah, then filed false charges against Uddin, his family and three others, accusing them of trying to kill Miah’s niece, Uddin said by telephone after his release on bail on Oct. 8. The village is under Pirgacha police jurisdiction.

Uddin said his family was fishing at his pond on Sept. 17 when eight to 10 Muslim neighbors led by Islam appeared and began speaking abusively about their Christian faith.

“Nazrul told us, ‘You are polluting society by deviating from Islam. Come back to Islam, otherwise we will not allow any Christian to live here in this village,’” Uddin said.

He told them that his family would not return to Islam, Uddin said.

“I replied, ‘Invite Islamic scholars, and if they can satisfy us in light of the Quran, then we will go back to Islam. Otherwise nothing can affect our unshakeable faith in Christ,’” Uddin said. “They beat me, my wife and two sons for objecting to their proposal to come back to Islam.”

The angry neighbors then broke into his home and burned two Bibles, tore two others and ripped four hymnals, he said, and they also damaged some furniture and chairs. Their home serves as a worship venue, and Uddin said the villagers also hacked with a machete the sign board of their house church, Faith Bible Church of God.

The pastor of the church, Lavlu Sadik Lebio, told Compass that he went to a nearby police station to complain about the attack, but officers did not respond to him. He said he only went to inform police, not file a case, but even so officers were unresponsive.

“Intentionally burning Bibles was the most sacrilegious attack on our faith – how can a member of the police department do that?” Pastor Lebio said. “Those people should have kept in mind how an announcement of burning a copy of the Quran in the U.S. stirred up the anger, discontent and hatred of Muslims all over the world.”

Taken into police custody on Sept. 18, Uddin said he and his family were unable to be baptized as planned.

“We were planning to be baptized in the last week of September,” he said. “Somehow our neighbors came to know about the baptismal ceremony, and they became very rude to us. We have been living in faith in Christ, the mainspring of our life, but we were not baptized.”

 

Murder Charge

As part of the attack on Sept. 17, Miah, the uncle of police officer Islam, filed the charge of attempted murder against Uddin, his family and three others that day, the Christian said.

When handing Uddin over to court, police filed a report stating that he had collaborated with people within the Christian community and that he had made defamatory remarks about Islam, Uddin said.

“In the police report while handing me over to court, I was mentioned as a troublesome Christian, but in the case copy filed by my neighbor, nothing was mentioned about me as a Christian,” Uddin said. “I was hurt by the police role.”

The police report to the court said that area residents did not approve of his Christian activities, and that there was the possibility of a communal clash. On this basis police requested he remain in custody while the investigation was underway.

According to the case file obtained by Compass, Uddin and his companions allegedly attempted to kill Islam’s sister (Miah’s niece), Jahanara Begum, sexually harassed her, severely beat her and stole her gold jewelry worth 41,000 taka (US$570).

Uddin said that Begum – sister of police officer Islam and niece of Miah – had a boil on her head that her father lanced the day of the attack. When blood continued rushing out from the procedure, her father, Azizul Muhury, took her to a nearby clinic called Pirgacha Medical and admitted her there. Later her brother Islam filed the false case, saying one of the eight accused had hit her on the head in an attempt to kill her, Uddin said.

According to the case file, Uddin was fishing on Begum’s inundated land, though he says he was at his own pond. Furthermore, the case file states Uddin was on Begum’s land at 9:30 a.m. on Sept. 17, when according to Uddin he was worshipping at his house church. The service did not end until 10 a.m.

According to the police file, Begum objected to him catching fish on her flooded land, and after paying no attention to her he eventually became furious and allegedly beat her “in a pre-planned manner.”

Uddin’s companions were said to be hiding nearby with bamboo, knives and machetes to attack her, and at some point in a quarrel, they supposedly emerged and surrounded Begum. Nural Islam, 52 – known in the area as a recent convert to Christianity – allegedly struck her in the head with a machete on Foyez’s order, according to the case file. Uddin said Islam is a rickshaw driver who was working all day and was not present.

Uddin was then alleged to have hit her on the hand with bamboo, and when she supposedly fell down, according to the case file, his brother Iman Ali, 45, hit her with an iron rod on her back. Uddin said Ali could not have been present either, as he was suffering from tuberculosis and could not walk properly due to the debilitating illness.

Uddin’s son, Shahjahan Miah, 25, then allegedly snatched the 27,000-taka (US$375) gold chain from her neck, according to the case file, and 25-year-old Mohammad Sirajul Islam took her 14,000-taka (US$195) gold earring. Uddin said Mohammad Sirajul Islam – also known in the area as a recent convert to Christianity – had lost work due to his new faith and had been forced to relocate to Chittagong district, some 500 kilometers (310 miles) away from Rangpur district, and he was in Chittagong on that day.

His father, Mohammad Farid, 42, had also converted to Christianity, and the case file accuses him of trying to strangle Begum. Uddin said Farid also lives in Chittagong district and was there at the time. In the case file, Uddin’s wife, 47-year-old Mosammat Shahar Banu, is then accused of removing Begum’s clothes. Uddin’s other son, 28-year-old Shahdul Islam, then allegedly seriously wounded her by striking her with bamboo, according to the case file.

Thus the case file charges all members of Uddin’s family, as well as three people who were not present – two other recent converts to Christianity and Uddin’s brother, he said. Uddin said he has sent letters stating the falseness of the charges to the Rangpur district administrative chief, district police chief, sub-district administrative chief, home minister of Bangladesh, home secretary of Bangladesh, inspector general of police (Bangladesh police chief), president of the Rangpur district press club, member of parliament of that area, Rangpur divisional commissioner and commander of Bangladesh’s elite force (RAB-5), as well as to the Faith Bible Church of God chairman.

The case file mistakenly identifies Uddin as Foyez Ali, and also errs in listing his age as 50 rather than 62.

Since Uddin became a Christian in 2007, some of his neighbors have threatened to kill him or expel him from the village, he said.

“In threatening us, they have also said that the government will reward them if we Christians are beaten,” Uddin said.

The main weapon of Muslim villagers opposed to Christians is to withhold work from them, he said.

“Once I used to cultivate other people’s land for my livelihood,” he said. “When the local people came to know that we lead our life in Christ, then they stopped giving us their land for cultivation. Nobody talks with us, and we are outcasts here.”

Last Christmas, around 100 to 150 people went to Uddin’s house to protest their celebration of the birth of Christ.

“Police are deployed in all churches at Christmas,” he said. “Two police were deployed at our house to avoid any kind of unwanted situation. Those two police stopped the angry villagers.”

Report from Compass Direct News

Turkmenistan: Protestant pastor’s trial set for Oct. 21, 2010

Protestant pastor Ilmurad Nurliev is due to begin trial in Turkmenistan on the morning of Thursday 21 October, nearly two months after his arrest, Forum 18 News Service has learned.

“The criminal trial in Mary [a south-eastern town in Turkmenistan) is on charges of large-scale swindling, with a penalty of up to five years’ jail. His wife and church members vigorously deny the charges, and insist that the five people named as making accusations are not as the indictment claims church members,” said Felix Corley of Forum 18 News Service.

“Three of them only attended the church a few times, and the remaining two are unknown. Other accusations vigorously denied are that Pastor Nurliev is a drug addict in need of treatment; he is a diabetic and – as she has not been allowed to see him – his wife is very concerned about his health. They also refute an allegation that he is unemployed and lives off the earnings of others, as he worked – until his arrest – as a barber.”

Maya Nurlieva, wife of the accused, told Forum 18, “Up to 20 church members will try to attend – all are ready to speak up to defend my husband.”

She has asked the Organisation for Security and Co-operation in Europe (OSCE) Centre in Ashgabad to send independent monitors to the trial. The Church has stopped meeting for worship after the arrest.

Report from the Christian Telegraph

Christian in India Suffers Miscarriage in Hindu Extremist Attack

Four pastors also injured in Karnataka, hub of anti-Christian persecution.

NEW DELHI, October 13 (CDN) — Police in a south Indian state known for turning hostile to minority Christians in recent years have arrested two suspected Hindu nationalists for beating four pastors and striking the wife of one of them in the stomach, killing her unborn child.

The attack took place at a Christian gathering in a private Christian school to celebrate the birth of Mahatma Gandhi on Oct. 2 in Chintamani, in Karnataka state’s Kolar district, reported the Global Council of Indian Christians (GCIC).

About 40 people barged into New Public School during the concluding prayer that morning and began selectively beating the pastors and Kejiya Fernandes, wife of one identified only as Pastor Fernandes. Chintamani police arrived but the attack went on, and when it ended at noon officers took the Christians to the station instead of arresting the attackers.

Denied medical attention, the injured Christians were released at 7:30 p.m. only after Kejiya Fernandes began to bleed profusely, GCIC reported. She and her husband later received hospital treatment, where she lost the baby she had been carrying for four months, according to GCIC.

Pastor Fernandes received an injury to his ear. The three other victims, identified only as pastors Robert, Muthu and Kenny, all ministered in a local independent church.

Of the 12 suspects named in the police complaint, two were arrested the same day, and the rest are absconding, said attorney Jeeva Prakash, who is associated with the Evangelical Fellowship of India’s (EFI) advocacy department.

The police complaint against the 12 includes “causing death of quick unborn child by act amounting to culpable homicide” (Section 316 of the Indian Penal Code), and “intentional insult with intent to provoke breach of the peace” (Section 504). No charges related to defiling a religious place or gathering or creating communal conflict were included.

All the accused are residents of Chintamani city and suspected to be associated with Hindu nationalist groups.

The attack was reportedly carried out to avenge an alleged insult to Hindu gods during the Christian gathering, with the accused also having filed a police complaint, added Prakash, who visited the area and the Christian victims this week.

The complaint against the Christians was for “deliberate and malicious acts intended to outrage religious feelings or any class by insulting its religion or religious beliefs” (Section 295-a), and, strangely, Section 324 for “voluntarily causing hurt by dangerous weapons or means,” among other charges.

The Christians were not arrested, as a court granted them anticipatory bail.

Mohandas Karamchand Gandhi, whose birthday the Christians were celebrating, was friends with Christian missionaries during British rule and taught religious tolerance. The acclaimed Hindu, India’s greatest political and spiritual leader, was killed in 1948 by Nathuram Godse, who was allegedly influenced by the ideology of the Hindu extremist conglomerate Rashtriya Swayamsevak Sangh.

For the last three years, Karnataka has been seen as the hub of Christian persecution in India. Of the more than 152 attacks on Christians in 2009, 86 were reported in Karnataka, according to the EFI.

This year, too, Karnataka is likely to top anti-Christian attacks. According to the GCIC, at least 47 attacks on Christians in the state had been reported as of Sept. 26. Persecution of Christians in Karnataka increased particularly after the August 2008 anti-Christian mayhem in eastern Orissa state, where Maoists killed a Vishwa Hindu Parishad leader but Hindu extremists wrongly blamed it on local Christians.

The attacks in Orissa’s Kandhamal district killed more than 100 people and burned 4,640 houses, 252 churches and 13 educational institutions.

While Hindu nationalists had targeted and were working in Karnataka for close to two decades, the Hindu nationalist Bharatiya Janata Party (BJP) came to sole power in the state for the first time in the history of independent India in May 2008. Prior to that, the BJP ruled in coalition with a local party, the Janata Dal-Secular, for 20 months.

It is believed that the victory of the BJP – and later the violence in Orissa, which was also ruled by a coalition that included the BJP – emboldened Hindu extremists, who now enjoy greater impunity due to the party’s incumbency.

Despite the high incidence of persecution of minorities in Karnataka, BJP leaders deny it, alleging complaint are the result of a political conspiracy of opposition parties.

There are a little more than 1 million Christians in Karnataka, where the total population is more than 52 million, mostly Hindus.

 

SIDEBAR

India Briefs: Recent Incidents of Persecution

Karnataka, India, October 13 (Compass Direct News) – Hindu extremists belonging to the Bajrang Dal on Oct. 3 stormed into a Christian worship service, beat those attending and confiscated Bibles in Emarakuntte village, Kolar district. The Global Council of Indian Christians (GCIC) reported that nearly 25 extremists barged into the house of a Christian identified only as Manjunath, where Pastor Daniel Shankar was leading Sunday worship. Verbally abusing those present and falsely accusing them of forcible conversion, the extremists dragged them out and photographed them. Pastor Shankar managed to escape. Police arrived – after the extremists called them – and confiscated the Bibles and a vehicle belonging to the pastor. A GCIC coordinator told Compass that Shankar, accompanied by area pastors, went to the police station the next day, and officers made him give a written statement that he would stop Christian activities in the village. Only then were the Bibles and vehicle returned. No worship was held on Sunday (Oct. 10).

Karnataka – Police on Sept. 5 detained a pastor after Hindu nationalist extremists registered a false complaint of forcible conversion in Doni village, Gadag district. The Global Council of Indian Christians (GCIC) reported that at 8:30 p.m. nearly 100 extremists belonging to the Hindu extremist Rashtriya Swayamsevak Sangh stormed the worship of an Indian Pentecostal Church at the home of a Christian identified only as Nagaraj. A GCIC coordinator told Compass that the extremists repeatedly slapped Pastor Mallikarjuna Sangalad, dragged him outside and tore his shirt. They also tore up a few Bibles of those in the congregation. The extremists called Mundargi police, who arrived at the spot and took Pastor Sangalad to the police station as the slogan-shouting extremists followed. Police questioned the pastor for over two hours and warned him against leading services. With GCIC intervention Sangalad was released at around 11 p.m. without being charged, but he was forced to sign a statement that he would not conduct services at Nagaraj’s home.

Karnataka – Police on Sept. 3 stopped worship and falsely accused a pastor of forcible conversion, threatening to jail Christians if they continued religious activities in Ganeshgudi village. A Global Council of Indian Christians coordinator told Compass that Ramnagar police Sub-Inspector Babu Madhar, acting on an anonymous accusation of forcible conversion, disrupted worship and threatened Calvary Fellowship Prayer Centre Pastor P.R. Jose as nearly 40 congregants of the house church looked on. The sub-inspector warned the Christians against worshipping there and told Pastor Jose to shut down the church or be arrested. On Sept. 4, however, Madhar returned to the house and informed Pastor Jose that they could continue worship services.

Report from Compass Direct News

Recent Incidents of Persecution

Tamil Nadu, India, September 30 (CDN) — Police detained evangelist V.K. Williams and seven other Christians after Hindu extremists disrupted their evangelistic meeting on Sept. 29 in Theni, according to the Global Council of Indian Christians. The extremists filed a complaint against the Christians of “forceful conversion” and pressured police to arrest them, and officers took the eight Christians to the station for questioning. At press time, area Christian leaders were trying to free them.

West Bengal – On Sept. 26 in Purulia, Hindu extremists stopped a worship service and dragged Christians out, saying no more prayer or worship should take place in the village. A source in Kolkata reported that the extremists were threatening to kill the Christians if they did not convert to Hinduism. The Christians reported the matter to the Kenda Police Station. Officers summoned both parties to the police station, but the extremists threatened to kill the Christians if they went.

Karnataka – Hindu extremists belonging to the Bharatiya Janata Party and the Bajrang Dal attacked Gnanodya Church at Yellapura, Karwar district, on Sept. 26. The All India Christian Council reported that the assailants broke into a church worship service after having filed a complaint against Pastor Shiva Ram of “forcible conversions.” In the presence of the police, the attackers started to vandalize the church, pulling down calendars and breaking furniture. Church members said their pastor was targeted because of his social service works. Police took the pastor into custody and jailed him.

Karnataka – Karnataka police on Sept. 26 arrested a Pentecostal pastor, Shivanda Siddi, on false charges of “forceful conversions” in Mundgod. The Global Council of Indian Christians (GCIC) reported that at about 11 a.m. five Hindu extremists from the Bajrang Dal stormed the church building while Christians were praying and began arguing with the pastor. They beat him, stripped him of his clothes and took Bibles from those present. The extremists later telephoned police in Yellapur, about three kilometers away (less than two miles), and an inspector arrived and took the pastor, seven women and two young children to the police station. The extremists continued to threaten the Christians in front of police, who watched in silence. With GCIC intervention, police released the women and children without charges, but Pastor Siddi was charged with “defiling a place of worship with intent to insult the religion of any class.” He was put in Uttar Kananda’s Sirsi prison.

Karnataka – On Sept. 19 in Santhemarnalli, police led by Inspector Madhava Swamy threatened a pastor with harm if he did not stop alleged “forceful conversion” activities. The All India Christian Council reported that police threatened Pastor Mhades of Good Shepherd Community Church after Hindu extremists filed the complaint against him. Police barged into his church, questioned him and told him that they would take action against him if he did not stop trying to convert people. Area Christian leaders claimed that there was no case of forceful conversion, and that Christians were only conducting their regular worship services.

Andhra Pradesh – Police on Sept. 17 arrested a Christian convert from Islam, Sheik Magbool, after Muslim extremists filed a complaint against him of uttering derogatory remarks against the prophet of Islam, Muhammad, in Kurnool. A source reported that Maqbool organized a three-day, open air Christian meeting and distributed some tracts that allegedly contained comparisons between the teachings of Jesus Christ and those of Muhammad. The Muslim extremists accused Maqbool of making derogatory remarks against Muhammad, threatened to kill him and filed a police complaint against him. Area Christian leaders maintained that the tracts did not contain any hateful remarks against Muhammad; they asserted that the Muslim extremists reprinted the tracts after adding some lines insulting to Muhammad in order to fabricate a case against the Christians. Maqbool was put in a jail cell, with the Down Court rejecting his petition for bail on Sept. 21.

Chhattisgarh – On Sept. 15 in Raipur, Hindu extremists misrepresenting themselves as journalists barged into a prayer meeting led by Pastor Kamlakarrao Bokada and accused him of “forceful conversion,” verbally abused him and falsely accused him of dishonoring their idols. They ordered the pastor to video-record the prayer meeting, but he refused. The pastor, who visits Christian homes in the Khorpi area, was ordered not to do so again. Police refused to register a complaint by Christians.

Andhra Pradesh – Hindu extremists in Vizianagaram on Sept. 13 attacked a pastor’s wife, injuring her head, and told the church leader to leave the area, according to the All India Christian Council. The attack came after Pastor Y. Caleb Raj of Good Shepherd Community Church requested that youths playing loud music before the idol of Ganesh near his church not disturb the Sept. 12 worship service. As the pastor was speaking to organizers of the Ganesh event, Hindu extremists gathered and some tried to manhandle him. They told him to close down the church and leave the village. When Pastor Raj was out on ministry work the next day, the same group of Hindu extremists came and struck his wife with a wooden club. Pastor Raj filed a police complaint, but no arrests had been made at press time.

Chhattisgarh – Hindu extremists in Raigarh on Sept. 12 beat evangelist Robinson Roat and ordered him to stop all Christian activities. The Global Council of Indian Christians reported that about 25 extremists barged into the worship meeting in Roat’s home. They told him he would face further harm if he left his house. The Christian did not venture out for two days.

Madhya Pradesh – Hindu extremists in Satna on Sept. 12 accused Pastor V.A. Anthony of “forceful conversion” and of carrying out the funeral of a non-Christian in a local Christian cemetery. Based on the complaint of the Hindu extremists, the inspector general of police summoned Pastor Anthony and a high-level inquiry is pending, reported the Global Council of Indian Christians (GCIC). The son of a local church member had died under mysterious circumstances earlier this year, and the pastor and church members had buried him in the Christian cemetery according to the wishes of his parents and other relatives, according to the GCIC.

Uttar Pradesh – Hindu nationalists from the extremist Rashtriya Swayamsevak Sangh on Sept. 5 beat a pastor in Sarva village in Babina, Jhansi district. The Global Council of Indian Christians (GCIC) reported that three Hindu extremists led by Surendra Yadav and armed with wooden clubs barged into the church building after Sunday classes and beat Pastor Anil Masih on his back and legs, kicked him and verbally abused him. The assault went on for about 30 minutes. The next day, Masih’s father informed Babina police. Masih received hospital treatment for a broken left leg. GCIC sources told Compass that after Masih’s discharge from the hospital on Sept. 10, he filed a complaint against the extremists at the Babina police station on Sept. 13. At press time, no arrests had been made.

Karnataka – Police on Sept. 1 stopped a pastors’ meeting in Mysore, claiming that they were being trained to “convert people,” though conversion and persuading to convert is legal in India. The Global Council of Indian Christians (GCIC) reported that the Mysore Pastors Association organized a two-week pastoral training program with about 50 local church leaders and evangelists in attendance. Police arrived and ordered the organizers to vacate the premises by the next day. Even though such trainings are legally permitted in India, the Christians called off the meeting.

Rajasthan – Hindu extremists attacked two Christian workers, damaged their vehicles and seized evangelistic literature from them on Aug. 26 in Udaipur. The All India Christian Council reported that evangelists Charlie John and V.M. George were distributing gospel tracts when a group of Hindu extremists suddenly came and began objecting. The extremists blocked their vehicle and beat the two Christians, leaving them with serious injuries. Police came to their rescue and suggested they file a complaint against the extremists, but the Christians said they chose to forgive their attackers.

Report from Compass Direct News

Muslim Extremists Murder Christian Family in Pakistan

Lawyer, wife, five children shot to death after he tried to defend Christian.

ISLAMABAD, Pakistan, September 30 (CDN) — Islamic extremists killed a Christian lawyer, his wife and their five children in northwestern Pakistan this week for mounting a legal challenge against a Muslim who was charging a Christian exorbitant interest, local sources said.

Police found the bodies of attorney and evangelist Edwin Paul and his family on Tuesday morning (Sept. 28) at their home in Haripur, a small town near Abbotabad in Khyber Pakhtunkhwa Province (previously known as the North-West Frontier Province, or NWFP), according to Haripur Station House Officer (SHO) Maqbool Khan.

The victim and his wife Ruby Paul, along with their five children ages 6 to 17, had been shot to death.

“On Sept. 28 at around 8 a.m., we received a call from Sher Khan colony that people heard gunshots, and there was a group of people who ran from a house and drove away,” Khan said. “We went and found seven bodies in a house.”

Paul’s Muslim neighbor, Mushtaq Khan, told Compass that the previous day a group of armed men had threatened the lawyer.

“On Monday a group of armed men stopped Paul and took him by the collar and said, ‘Leave the town in 24 hours – we know how to throw out Christians, we will not allow even a single Christian to live here. We will hang them all in the streets, so that no Christian would ever dare to enter the Hazara land.”

The Hazara are settlers from northern Pakistan who are an ethnic mixture of Punjabi Jats and Pashtuns (also called Pathans). Drawing attention for demanding a separate province for themselves when the NWFP became Khyber Pakhtunkhwa, the Hazara community financially supports area Islamic extremist groups and is known for charging up to 400 percent interest to Christians. Paul had moved with his family to the area in February.

He had taken up the case of Robin Mehboob, a Christian taxi driver in Haripur who had received a loan of 150,000 rupees (US$1,725) from Noor Khan, an influential Muslim whose lending network extends to some parts of Punjab Province, to buy a taxi. Originally Noor Khan agreed that Mehboob would pay back 224,000 rupees (US$2,580) after one year, Mehboob said.

“I gave my property papers as a guarantee,” Mehboob told Compass, “but then the amount of the interest was raised to 500 percent because I am a Christian – he was demanding back 1.12 million rupees [US$12,893]. They have forcefully taken over my property and have confiscated my taxi as well. I am a poor man, the taxi is the only source of income.”

Paul took Mehboob and the documents of the original loan agreement to the Haripur police station, Mehboob said.

“We talked to the SHO, who said, ‘You can file a complaint, but I can assure you that no one will testify against Noor Khan, as he is supported by extremist groups,’” Mehboob said. “We filed the complaint, and one of the police officers informed [Noor] Khan that we went to the police station.”

On their way back from the police station, three cars filled with Noor Khan’s associates stopped near his house, Mehboob said.

“They came out and said, ‘How dare you Christians go to the police, don’t you know we own the law here?’ They assaulted us, beating us with fists and clubs, and warned that if we try to seek any assistance, they will kill us.”

Mehboob left Haripur that night and went to his brother in Sialkot.

Paul wrote to the Khyber Pakhtunkhwa government, Christian organizations and churches for help, explaining how Noor Khan and the extremist groups were driving Christians out of the area by taking over their property or threatening to kill them unless they sold their homes.

The Muslim extremist groups most active in the area are the banned Jamat ul Dawa, the Sunni Tahreek, and some groups linked with the Pakistani Taliban. The extremist groups were making fake documents to occupy properties owned by Christians, and Hazara investors were supporting the campaign, area Christians said.

The Muslim extremists have also threatened many Christians with death if they do not convert, they said.

Pastor Rehmat Naeem of St. Paul Church in Haripur told Compass that he had also received threats.

“Some extremists sent us threats through phone calls and letters, asking us to leave Haripur,” Pastor Naeem said. “Many Christians were forced to sell their property at very low rates and leave the area. Edwin Paul tried to help the Christians – he even talked to the higher authorities, but no one was ready to testify against the extremists.”

Pastor Naeem added that two months ago area extremists kidnapped eight missionaries; six have been released, and the two others are presumed dead.

A First Information Report has been filed in the murder of Paul and his family, and the District Coordination Officer and District Police Officer (DPO) have strongly condemned the crime and instructed the SHO to find those responsible, authorities said.

Chief Secretary of Hazara Division Ali Ahmed has released a statement ordering a police operation “under the Terrorist Act against the extremists and the Hazaras for forcefully driving away the Christians and killing seven innocent people. We will not allow anyone to threaten the religious minorities. It is the duty of the state to protect the life and property of its people. The DPO has been instructed to arrest the culprits in 72 hours and submit a report or he will be suspended.”

Report from Compass Direct News

Government wants church to stop contruction in Malaysia

Christians in a small village in Malaysia have been told they can’t build a church. Reports coming out of Malaysia say Christians in the Temiar village of Pos Pasik, about 70 km northeast of Gua Musang Kelantan, have been told by the Department of Orang Asli Affairs (JHEOA) that they have no permission to build a church on their land, reports MNN.

On 20 May 2010, the village head wrote to the Director-General of the JHEOA to inform him of their plan to build the church in their village, half of whom have converted to Christianity in recent years.

In response, the Deputy Director-General writing on behalf of the D-G replied that their "application" to build the church had been rejected and the community was asked to stop work on the building immediately.

This is contrary to what Malaysian Prime Minister Najib Razak said this week. He praised the work and mission of the Inter-faith Relations Working Committee. It’s a group of Malaysia’s religious leaders representing Christians, Hindus, Buddhists, Sikhs, and Muslims. In a 45-minute session he praised Malaysia’s pluralism, saying, "It’s the foundation of national unity, rather than a front of division."

Todd Nettleton with Voice of the Martyrs says, "While the prime minister is saying we celebrate religious diversity and we celebrate the freedom to worship, the reality on the ground for some of the Christians in Malaysia is a little different."

Nettleton says it appears that religious tolerance depends on your ethnicity. "It is not uncommon for an ethnic Chinese person to be a Christian. So that is thought to be acceptable. It is much less common for an ethnic Malay person to be a Christian. They are thought culturally to be Muslims. Typically you see a harsh response from that."

Nettleton says, "There is some type of revival movement that is going on there. The ethnic villagers are becoming Christians. They want to have a church building. What I’m not clear about–and I think it deserves a little bit more study–is why this government agency said you can’t build this church building."

If the church is demolished or stopped, it will be the second Orang Asli church in the state of Kelantan (and no less than 5 in the peninsular altogether) that has been demolished by the authorities on the basis of various excuses, including that the Orang Asli do not have rights to the land concerned. But it is evident that the issue is religion-related as other structures, including suraus, have been built on such lands without any issue.

Report from the Christian Telegraph