WEBVTT
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In this episode, we talk about lung cancer, for which
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screening remains limited in India, even as it becomes the
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leading cause of cancer deaths in the country. We also
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talk about a sharp surge in visitors at the Kenchi
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Dham post the release of Hanuman Anj. But we begin
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today by talking about the ongoing protests against the Election
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Commission and the special intensive revision. Hi, I am Niharika
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Nanda and you are listening to Three Things, the Indian
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Express News Show. Since Friday last week, thousands of people
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in Delhi and Mumbai have joined the protests demanding the
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resignation of Chief Election Commissioner Gyanesh Kumar over alleged irregularities
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in the special intensive revision. In Delhi, more than 600
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people have so far been detained, including All India Students
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Association President Neha Bora, activist Yogendra Yadav and senior advocate
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Prashant Bhushan.
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In fact, in the capital, three women.
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Journalists have also accused Delhi police officers of sexual harassment
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and the crime branch has now been tasked with investigating
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the allegations.
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But the situation in Mumbai has been quite different.
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There, the protests have largely been peaceful and have been
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led by the Cockroach Janta Party.
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The Indian Express's Ishika Gupta has been.
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Covering these protests for the paper and she joined my
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colleague Shashank Bhargav to discuss what has transpired in Mumbai and.
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Why the CJP chose the city as its base this time.
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Ishika, you've been covering these protests for the paper. Tell
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us what have we seen play out over the past
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couple of days in Mumbai?
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All right.
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So this was the first protest organized under the official
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banner of the CJP in Mumbai. So the one that
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took place before this for the education, former education minister
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Dharmendra Pradhan's resignation, that was basically done by a lot
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of political parties and outfits, which had the support of
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the CJP, of course.
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But this was the first one in which the.
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CJP founder, Abhijit Dipke, actually flew down to Mumbai and
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announced that, you know, we will be starting this nationwide
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protest from Mumbai itself. So the site, I think, represented
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the enthusiasm of the people very well. There were about
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4000 people who had gathered outside the Shivaji Park. There
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were about 300 police personnel who were there to sort
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of monitor the situation. And there were people from across
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all generations and ages. There were school going children. I
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met someone as young as the age of 14. And
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there were also people who were personally affected by the
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SIR process, you know, who had their names removed. So
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the crowd included a lot of those people as well. Also,
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in a unique turn of events, there were people who
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were not just residents of Mumbai, but those who had
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travelled from faraway states as well. There was a person
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from Pune who was dressed up. in a Gandhi sort
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of attire with the dhoti and the shawl and everything.
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And because the protest was organized on October 2nd, I
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think that was a very fitting appearance as well. There
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was someone who had traveled from Manipur. He had come,
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you know, to support the CJP in their movement, but
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also to request Deepke and the other CJP functionaries to
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come back home in Manipur and actually speak to the
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warring Kukhi and Mehati communities to sort of foster a
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peace situation there.
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So there were people from all over, they.
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Had different sorts of aspirations, but I think the overwhelming
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sort of motive was the reform of the electoral process,
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which all of them were calling for.
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And you mentioned how the city had very recently seen protests.
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take place regarding the NEET paper leak. And those were
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led by opposition leaders, but supported by the CJP. Because
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that time, all the main CJP leaders were protesting from
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Jantar Mantar in Delhi. And even right now, protests are
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going on in Delhi regarding the EC. But why has
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the CJP chosen Mumbai as their base this time?
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So this choice actually was a very deliberate one to
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start with. Before the October 2nd protest, Dipke had held
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a media interaction where he actually explained that, you know,
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in the 2024 Lok Sabha or general elections, as we
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call them, BJP had won only nine out of 48
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seats from Mumbai. But in the assembly election that happened
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just a few months later, the scenario changed altogether almost
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with the BJP and its allies forming the government at
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the state level. So he sort of questioned the logic
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behind this reversed outcome of sorts. And he said that
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the agitation had ultimately decided to be started from Mumbai.
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And he had also said in Marathi that, you know,
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even the throne in Delhi is guarded by Maharashtra. So
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Mumbai was the perfect place to start this agitation. And
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of course, then it will carry on in states including
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Goa and Kolkata before it's finally with a sit down protest,
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they end it in Delhi.
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And you had covered the need protests as well, right?
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What difference did you see between those protests and the
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one happening right now?
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So that protest, I think a large part of the
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crowd during that protest was, you know, students, people from all.
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Ages, maybe 10 and upwards.
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And then even, you know, their parents, like who were
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essentially demanding for a.
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Reform of the education system overall.
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Right now, what we could see in the crowds who
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were gathered outside Shivaji Park, there were people who were
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personally affected by the SIR process. There were people, very few,
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I would say younger students, but there was a lot
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of Gen Zs as were in the previous protests. There
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were actually famous Bollywood celebrities. There was Shabana Azmi.
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There was.
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Anand Patwardhan who was the documentary filmmaker and the overall
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flavour of the crowd was a little mixed this time
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because while there were people who were seeking for the
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electoral reformation there were also people who had responded personally
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to Dipke's call who wanted to support the CJP in
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their overall mission so that was also a large part
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of the crowd that was present.
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And, you know, in Delhi, for example, we have seen
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a lot of people being detained by the police. We
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have also seen Lathi charge. But have we seen any
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kind of police action in Mumbai against the protesters?
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So there were about 300 police personnel who were stationed
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at Shivaji Park in and around at different locations. But
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there was no sort of crackdown or action against the
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protesters as such. It was appearing only as if the
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police were there to monitor the situation and to do
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crowd control. Now, this was a very deliberate choice, actually,
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and it came from a directive from the top brass.
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So within Maharashtra, the chief minister, Devendra Fadnavis, he holds
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the home portfolio and he had accordingly issued directives against
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the use of excessive force. And to ensure that the
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protests would proceed peacefully. A senior BJP leader had also
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spoken to the Indian Express's Shubhangi Kapriya and he had
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mentioned that, you know, as opposed to 2023, when the
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protests had taken place by the Maratha Kota protesters, where
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Devendra Padnavit, who was the then Deputy Chief Minister, had
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used excessive force against the protesters, which led to him
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later apologising. The situation now has played out a lot
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differently with the police just being there to monitor the situation.
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And this attitude of the police, of course, earned a
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lot of praise from the CJP's core team and the
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protesters alike, who appreciated the differences between the Mumbai and
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the Delhi police.
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And talk about what are the kind of things that
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the CJP is demanding right now and what have been
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the demands of the other protesters? Right.
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So the CJP at the outset of the protest had
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three primary demands. Firstly, the most sort of popular one
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that is heard was the resignation of the incumbent chief
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election commissioner, Gyanesh Kumar, and the initiation of criminal proceedings
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against him and initiating an inquiry of sorts. It also
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called for a freezing of the SIR electoral roll and
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using of the 2025 electoral roll for the upcoming elections
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in whatever states that are set to have elections now.
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And it also called for a more independent and transparent
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process of appointing election commissioners, which included participation from civil
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society members. Currently, election commissioners are appointed by the president directly.
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There's not a lot of civil society involvement. So that
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was the third demand that the CJP had. Of course,
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other than that, the protesters on ground were demanding for
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an overall reformation of the system. Gyanesh Kumar's resignation as
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like in line with what the CJP was demanding as well.
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But they were also demanding for a chance to be
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heard and to have their names actually back on the
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electoral rolls. We met a lot of people who, despite
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the fact that, you know, they had submitted necessary documents,
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and had done all the due actions that needed to
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be taken, they still found their name struck off the
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rolls with a very sort of vague indication as to
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what they should do to reverse the judgment. There were
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people who, again, sought for more transparency in the process
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and a more streamlined process so that, you know, this
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wouldn't take place. There were also people who basically thought that,
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you know, I met a 14 year old who basically
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mentioned that even though I cannot vote right now, I'm
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scared of what will happen when I get to an
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age where I can vote. Because if the process is
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so sort of opaque now, what will happen then? So
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there were also people who wanted for a reform of
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the system in the long run.
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Those were the kind of aspirations as well.
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And next, we turn our attention to the leading cause
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of cancer deaths.
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In the country.
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While breast, oral and cervical cancers have been among the
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most common cancers in India for years, it is lung
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cancer that is now causing the most cancer deaths.
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And while the disease is largely.
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Associated with smoking in the West, here in India, a
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significant proportion of lung cancer cases occur among non-smokers. What
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makes the situation even more concerning is that lung cancer
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is often detected at a later stage, when treatment becomes
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more difficult and chances of survival fall significantly. What is
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also worth noting is that there is very limited screening
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for lung cancer in India, and the government's screening program
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at primary healthcare centres doesn't not currently cover this type
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of cancer. So how big is the burden of the
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disease and why are so many cases being detected late?
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To answer these questions, we speak with the Indian Express's
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Anona Dutt who reports on health for the paper. Anona,
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does India have a larger number of lung cancer cases
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in comparison to other countries?
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So no, India is not at the top if we
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talk about lung cancer. There are countries like the US or... China,
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for example, which have a much higher burden of lung cancer.
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But what we have seen is the incidence of lung
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cancer going up in the recent years. If you look
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at the data for 2022 and 2024 that's released by
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the Global Cancer Observatory, we see a jump in the
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lung cancer cases And we see lung cancer has moved
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from the fourth position in terms of new cases to
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third position.
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And it has also moved.
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Up in terms of the number of deaths it causes
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annually from the fourth position to the first position, which
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means instead of breast cancer being the biggest killer in
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India now, it is lung cancer, according to the latest data,
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which is for the year 2024 released by the Global
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Cancer Observatory. It is also accounting for a higher proportion
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of cases. So what we have seen is now it
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accounts for 10.9% of all cancer deaths and 7.2% of
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all new cancer cases, which is more than what we
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saw previously.
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But why is that?
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Is it mainly to do with smoking or does air
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pollution also make the problem worse?
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So there is a study that is going on to
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see whether it.
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Is the ambient air pollution which sort of leads to
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more lung cancer cases in India or not. There's also
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a study to look at how much contribution air pollution
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plays when it comes to lung cancer because That would
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determine the sort of screening criteria. This is a study
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that is underway right now. But there are also other problems.
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So two things.
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One, in India, a lot of the lung cancer cases,
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nearly half of them are not caused by smoking per se.
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It happens in non-smokers, never smokers. Secondly, there are also
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other risk factors, such as a large proportion of the
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people who do smoke tobacco in India actually use BDs.
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And we do not have any international standard on... you know,
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how many BDs actually lead to increased risk for lung
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cancer like we do have for cigarettes. There is also
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air pollution within the homes from women using chulas, etc.,
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which leads to a lot of smoke within the household.
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That can also be a contributing factor for the increased,
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I mean, for the lung cancer that happens in non-smokers
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in India. But these are all factors that have to
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be determined immediately. through research, whether and how much they
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are contributing towards the increase in the lung cancer cases.
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And you write that people often consult doctors only at
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a later stage of the disease when the chances of
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their survival are much lower.
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So why is that?
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Does lung cancer not have obvious or visible symptoms?
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So you're right. These symptoms are not very pronounced.
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Usually people would have, say, a cough, which can be,
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you know, I mean, you don't think lung cancer when
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you cough. You would think you have flu or maybe
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you have TB. You do not think of lung cancer.
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So that is one of the most commonest symptoms. Then
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you have things such as drastic weight loss, etc. But
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these are not very distinctive lung cancer symptoms per se.
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So people do not realize And a lot of the
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times doctors also are not suspecting lung cancer as the
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first diagnosis.
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So there is a delay in diagnosis.
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Also, if you have, say, a normal cough, you are
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unlikely to go to a doctor, which is why a
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lot of the patients do end up in the clinics
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only when the cancer has spread and they are in
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the advanced stages of the disease. In fact, the group
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that is doing the air pollution study, they have looked
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at some data and they found that approximately 93% of
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the lung cancer patients actually reached the doctors only when
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their cancer was advanced, which drastically reduces survival.
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And now coming to screening, tell us about the screening
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process and how accessible it is for people. And is
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it as accessible as screening for other cancers is?
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So the way to screen for lung cancer is low
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dose CT scan. This is essentially, you know, using any
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CT scan machine at a setting where the radiation levels
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are lower because you do need to do multiple scans
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over the years to keep a track. If you know
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you have found some lumps in your lung, you have
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to over the years check them to see whether it's growing,
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what is happening to ensure that it is not cancer.
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So that is why the CT is used at a
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lower dose of radiation.
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To ensure that patients are not exposed to a very
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high radiation threshold. Now, the problem is there is no
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screening program for low-dose CT in India. When it comes
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to the other common types of cancers, such as cervical cancer,
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breast cancer, oral cancer, there is a government screening program
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00:15:37.929 --> 00:15:41.860
which is implemented across the primary health centers where patients
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The staff at the health centers actually inspect the, they
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do a clinical examination of the breast. They do a
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visual inspection of the oral cavity for oral cancers. So
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these are very simple tests which can be done at
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a primary health center and then if the health worker
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suspects that a person is likely to have cancer, then
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they are referred to higher centers. However, when it comes
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to LDCT, this is not possible. LDCT is more resource intensive.
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You require a CT machine, which is not possible to
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have at the primary health centers, which means patients would
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00:16:19.090 --> 00:16:22.590
have to go to a higher center to get the tests,
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even when they are not experiencing any symptoms. which is
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somewhat unlikely to happen. This is the reason, you know,
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00:16:29.919 --> 00:16:35.980
screening for lung cancer is virtually non-existent. It only happens
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00:16:36.139 --> 00:16:39.059
in case, you know, you have gone for other treatments
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00:16:39.139 --> 00:16:41.779
and the doctor suspects something, then they will ask you
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to get the test.
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00:16:43.789 --> 00:16:47.009
So we need to increase lung cancer screening then. But
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why is there such a lack of screening for it
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in India? How come we are not prioritizing it?
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So there are.
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Several reasons why lung cancer screening is not very commonly, actually,
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it's not really available in the country.
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One is the cost.
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While there are multiple studies that show that it is
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cost effective to do lung cancer screening because that would
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00:17:11.430 --> 00:17:15.339
detect the lung cancer at an early stage and increase
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00:17:15.380 --> 00:17:18.299
the survival a lot. So if you look at lung
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00:17:18.319 --> 00:17:22.339
cancer in the advanced stages, the chances of survival are
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00:17:22.579 --> 00:17:23.880
say 7 to 18%, but that.
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Increases to 80% if it is detected early.
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So while it has been shown to be cost effective
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in many countries and even an ICMR, you know, study
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00:17:35.650 --> 00:17:39.150
looking at the cost of the test versus the benefit
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00:17:39.190 --> 00:17:42.299
that you get from it, they did call the screening
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00:17:42.339 --> 00:17:47.599
program a cost effective way to look at lung cancer screening. However,
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it still is a significant cost and it would add
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00:17:50.660 --> 00:17:54.539
to the government budget to do a CT scan for
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a huge population. The second thing is just availability of
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00:17:58.609 --> 00:18:02.190
the CT scan machines. It's not available at the primary
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00:18:02.230 --> 00:18:04.569
health center near the people. They would have to go
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00:18:04.630 --> 00:18:07.950
to the district hospitals or a higher center to get
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these CT scan. And that makes the screening program more
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00:18:12.029 --> 00:18:15.410
difficult because the access is not there. Thirdly, of course,
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00:18:16.220 --> 00:18:18.539
and which is very important, is that we do not
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00:18:18.640 --> 00:18:23.099
have a great criteria for screening selecting the people who
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should be screened in the first place. So when we
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00:18:26.400 --> 00:18:29.500
look at the Western countries, most of their lung cancer
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cases happen in smokers, which is why the current guideline
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00:18:33.460 --> 00:18:37.839
for screening for lung cancer is basically people between the
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00:18:38.039 --> 00:18:42.039
ages of 50 and 80 years who have smoked a
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00:18:42.099 --> 00:18:44.779
pack of cigarettes a day for at least 20 years.
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This is the current global guideline. But In India, like
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I mentioned earlier, a lot of the people who do
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get lung cancer are not necessarily smokers. So then if
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we follow the global guidelines, a significant proportion of the
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people who are at.
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00:19:00.809 --> 00:19:02.390
Risk will be missed out.
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So India actually needs to develop its own sort of
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risk profile and see who should be screened.
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00:19:11.079 --> 00:19:15.259
And Aruna, you write that India's high tuberculosis burden also
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impacts lung cancer screening.
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00:19:17.430 --> 00:19:19.460
So can you tell us why that is?
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00:19:20.299 --> 00:19:24.849
So because tuberculosis also results in these nodules in the lungs,
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which sometimes may look like lung cancer. But there are
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00:19:29.730 --> 00:19:33.609
several pilot studies that have now happened. One in Mumbai,
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00:19:33.670 --> 00:19:39.809
which was published in 2021, said that even in tuberculosis-endemic country,
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LDCT can actually pick up the malignant nodules. And another
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00:19:45.190 --> 00:19:48.470
study that was done by some Ames doctors and others
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00:19:48.730 --> 00:19:52.400
also said that you know, the proportion of people who
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00:19:52.900 --> 00:19:57.130
are screened positive with the LDCT, the lung cancer detection
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rate and the proportion of false positive cases are comparable
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to Western countries, even in a country like India that
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has a lot of TB cases. So all of these
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are arguments for implementing a lung cancer screening program.
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00:20:12.339 --> 00:20:15.720
However, it would take time and money to do so.
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00:20:16.480 --> 00:20:20.150
So Anuna, according to experts, who are the people more
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00:20:20.210 --> 00:20:24.349
at risk of developing lung cancer and should consider getting screened?
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00:20:25.150 --> 00:20:28.730
So as I mentioned, the current global guideline is anybody
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00:20:28.789 --> 00:20:31.569
who is between the ages of 50 and 80 who
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00:20:31.630 --> 00:20:34.650
has been smoking a pack of cigarettes for at least
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20 years, they should definitely get tested. But now, of course,
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experts are looking at other factors, as I mentioned, at
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air pollution, at pollution within the household, exposure to secondhand smoke.
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00:20:48.900 --> 00:20:51.740
among others, to look at whether a person who's not
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a smoker is also at risk of lung cancer. So
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00:20:56.490 --> 00:21:00.630
those guidelines need to be established still. But the current
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00:21:00.650 --> 00:21:03.890
global standard is anybody between the ages of 50 and
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00:21:03.890 --> 00:21:08.200
80 years with a history of 20 years of smoking.
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00:21:08.960 --> 00:21:12.240
And Anona, could you also talk about some preventative measures
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that people can adopt?
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So, of course, the most important measure is, you know,
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to quit smoking. Smoking cessation is the most effective way
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00:21:21.619 --> 00:21:24.619
to reduce lung cancer cases that we know of right now.
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00:21:24.960 --> 00:21:27.539
Of course, we are looking at the other factors like
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00:21:27.880 --> 00:21:30.750
it is mentioned. But again, even if pollution is linked
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to lung cancer, that is a bigger problem which has
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00:21:34.329 --> 00:21:36.569
to be dealt with the government, the society, etc.
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00:21:36.609 --> 00:21:39.799
But smoking can be stopped by an individual.
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00:21:40.119 --> 00:21:43.509
Also, it has been seen that smoking cessation is much
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00:21:43.630 --> 00:21:47.150
more effective than any drug per se when it comes
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to improving the treatment outcome. So if a lung cancer
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00:21:50.470 --> 00:21:56.079
patient actually stops smoking, their treatment outcomes improve significantly. So
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the best preventative measure and the best way to reduce
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00:22:00.599 --> 00:22:04.279
mortality from lung cancer is to stop smoking.
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00:22:09.250 --> 00:22:12.049
And finally, we talk about the Kanchi Dham, an ashram
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00:22:12.089 --> 00:22:15.680
in Uttarakhand that has been closely associated with the Hindu
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00:22:15.720 --> 00:22:19.380
saint Neem Karoli Baba. Over the long weekend, the ashram
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00:22:19.420 --> 00:22:22.500
has seen a sharp surge in visitors with thousands of
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00:22:22.519 --> 00:22:27.180
vehicles crawling through Kumau hills and traffic jams stretching across Bhimtal,
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00:22:27.460 --> 00:22:31.950
Bhuwali and Kanchi. The Indian Express's Vidhisha Kuntimala writes that
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00:22:31.990 --> 00:22:35.660
the congestion has prompted the Nenital administration to consider opening
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00:22:35.700 --> 00:22:39.839
an alternative route to ease pressure on Kanchidham. Nenital District
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00:22:39.880 --> 00:22:43.960
Magistrate Lalit Mohan told her that the administration is considering
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00:22:44.109 --> 00:22:47.890
a new standard operating procedure under which an existing bypass
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00:22:47.950 --> 00:22:51.750
connecting the Kanchi area towards Almora and Ranikhet could be
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00:22:51.849 --> 00:22:55.859
opened to divert traffic. According to Mohan, two factors contributed
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00:22:55.900 --> 00:22:56.859
to the latest increase.
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00:22:57.180 --> 00:22:59.240
The end of the monsoon season, which.
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00:22:59.119 --> 00:23:01.690
Brings travellers back to the hills after the rains and
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00:23:01.710 --> 00:23:05.000
the landslides, and the release of Hanuman Anj, a film
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00:23:05.059 --> 00:23:07.640
based on the life and teachings of Neem Karoli Baba.
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00:23:08.079 --> 00:23:10.960
Vidisha writes that 24.34 lakh.
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00:23:10.700 --> 00:23:14.559
People visited Kanchidham in the first six months of 2026,
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00:23:14.559 --> 00:23:17.799
compared with around 8 lakh visitors in the whole of
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00:23:17.839 --> 00:23:21.420
the previous year. The surge also prompted Hanuman Anj director
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00:23:21.460 --> 00:23:25.250
Vishal Chaturvedi to ask devotees to check the situation before
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travelling to Kanchidham, and consider other sites associated with Neem
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00:23:29.069 --> 00:23:33.089
Karoli Baba if the shrine remains overcrowded. Vidisha writes that
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00:23:33.190 --> 00:23:36.630
Uttarakhand is already building a Kanchi Dham bypass, while the
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00:23:36.670 --> 00:23:39.289
Public Works Department has identified another.
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Alternative route as well.
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While authorities said the situation at the temple remained manageable
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and the immediate congestion had eased by Monday, Vidisha writes
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00:23:47.470 --> 00:23:49.589
that the problem extends beyond tourists.
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00:23:50.230 --> 00:23:51.490
Residents told the Indian.
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00:23:51.309 --> 00:23:54.710
Express that traffic affects people going to work, bringing supplies,
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00:23:54.859 --> 00:23:57.819
travelling for medical needs and simply trying to get home.
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00:23:58.319 --> 00:24:01.119
As one resident put it, the same infrastructure has to
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00:24:01.160 --> 00:24:04.400
serve both pilgrims and locals, pointing to the need for
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00:24:04.420 --> 00:24:05.299
a permanent.
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Solution rather than additional police.
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Deployment during long weekends. You were listening to Three Things
435
00:24:12.849 --> 00:24:15.809
by the Indian Express. Today's show was edited and mixed
436
00:24:15.890 --> 00:24:19.230
by Suresh Pawar and produced by Shashank Bhargav and me,
437
00:24:19.250 --> 00:24:22.329
Niharika Nanda. If you like the show, then do subscribe
438
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and write to us at podcasts at indianexpress.com.
1
00:00:00.500 --> 00:00:03.359
In this episode, we talk about lung cancer, for which
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00:00:03.399 --> 00:00:06.620
screening remains limited in India, even as it becomes the
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00:00:06.719 --> 00:00:09.960
leading cause of cancer deaths in the country. We also
4
00:00:10.000 --> 00:00:12.859
talk about a sharp surge in visitors at the Kenchi
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00:00:12.900 --> 00:00:16.460
Dham post the release of Hanuman Anj. But we begin
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00:00:16.519 --> 00:00:19.899
today by talking about the ongoing protests against the Election
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Commission and the special intensive revision. Hi, I am Niharika
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00:00:27.379 --> 00:00:30.000
Nanda and you are listening to Three Things, the Indian
9
00:00:30.050 --> 00:00:38.060
Express News Show. Since Friday last week, thousands of people
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00:00:38.200 --> 00:00:41.479
in Delhi and Mumbai have joined the protests demanding the
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00:00:41.520 --> 00:00:46.469
resignation of Chief Election Commissioner Gyanesh Kumar over alleged irregularities
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00:00:46.590 --> 00:00:49.909
in the special intensive revision. In Delhi, more than 600
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00:00:49.909 --> 00:00:53.630
people have so far been detained, including All India Students
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00:00:53.710 --> 00:00:58.659
Association President Neha Bora, activist Yogendra Yadav and senior advocate
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00:00:58.780 --> 00:00:59.579
Prashant Bhushan.
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In fact, in the capital, three women.
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00:01:02.070 --> 00:01:06.290
Journalists have also accused Delhi police officers of sexual harassment
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00:01:06.769 --> 00:01:09.890
and the crime branch has now been tasked with investigating
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00:01:09.930 --> 00:01:10.709
the allegations.
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But the situation in Mumbai has been quite different.
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There, the protests have largely been peaceful and have been
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00:01:17.099 --> 00:01:18.599
led by the Cockroach Janta Party.
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The Indian Express's Ishika Gupta has been.
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Covering these protests for the paper and she joined my
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colleague Shashank Bhargav to discuss what has transpired in Mumbai and.
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00:01:28.209 --> 00:01:31.129
Why the CJP chose the city as its base this time.
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00:01:32.430 --> 00:01:35.640
Ishika, you've been covering these protests for the paper. Tell
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00:01:35.680 --> 00:01:38.319
us what have we seen play out over the past
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00:01:38.379 --> 00:01:39.439
couple of days in Mumbai?
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00:01:40.379 --> 00:01:40.680
All right.
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00:01:40.700 --> 00:01:44.840
So this was the first protest organized under the official
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00:01:44.920 --> 00:01:47.769
banner of the CJP in Mumbai. So the one that
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00:01:47.810 --> 00:01:51.390
took place before this for the education, former education minister
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00:01:51.430 --> 00:01:54.670
Dharmendra Pradhan's resignation, that was basically done by a lot
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00:01:54.709 --> 00:01:57.689
of political parties and outfits, which had the support of
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00:01:57.730 --> 00:01:58.689
the CJP, of course.
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00:01:58.870 --> 00:02:01.269
But this was the first one in which the.
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00:02:01.430 --> 00:02:04.390
CJP founder, Abhijit Dipke, actually flew down to Mumbai and
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00:02:04.430 --> 00:02:07.079
announced that, you know, we will be starting this nationwide
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protest from Mumbai itself. So the site, I think, represented
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00:02:12.060 --> 00:02:14.639
the enthusiasm of the people very well. There were about
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00:02:14.639 --> 00:02:18.599
4000 people who had gathered outside the Shivaji Park. There
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were about 300 police personnel who were there to sort
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of monitor the situation. And there were people from across
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all generations and ages. There were school going children. I
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met someone as young as the age of 14. And
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there were also people who were personally affected by the
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SIR process, you know, who had their names removed. So
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the crowd included a lot of those people as well. Also,
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in a unique turn of events, there were people who
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were not just residents of Mumbai, but those who had
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travelled from faraway states as well. There was a person
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from Pune who was dressed up. in a Gandhi sort
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of attire with the dhoti and the shawl and everything.
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And because the protest was organized on October 2nd, I
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think that was a very fitting appearance as well. There
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was someone who had traveled from Manipur. He had come,
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you know, to support the CJP in their movement, but
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also to request Deepke and the other CJP functionaries to
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come back home in Manipur and actually speak to the
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warring Kukhi and Mehati communities to sort of foster a
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peace situation there.
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So there were people from all over, they.
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Had different sorts of aspirations, but I think the overwhelming
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sort of motive was the reform of the electoral process,
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which all of them were calling for.
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And you mentioned how the city had very recently seen protests.
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take place regarding the NEET paper leak. And those were
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led by opposition leaders, but supported by the CJP. Because
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that time, all the main CJP leaders were protesting from
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Jantar Mantar in Delhi. And even right now, protests are
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going on in Delhi regarding the EC. But why has
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the CJP chosen Mumbai as their base this time?
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So this choice actually was a very deliberate one to
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start with. Before the October 2nd protest, Dipke had held
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a media interaction where he actually explained that, you know,
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in the 2024 Lok Sabha or general elections, as we
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call them, BJP had won only nine out of 48
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seats from Mumbai. But in the assembly election that happened
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just a few months later, the scenario changed altogether almost
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with the BJP and its allies forming the government at
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the state level. So he sort of questioned the logic
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behind this reversed outcome of sorts. And he said that
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the agitation had ultimately decided to be started from Mumbai.
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And he had also said in Marathi that, you know,
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even the throne in Delhi is guarded by Maharashtra. So
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Mumbai was the perfect place to start this agitation. And
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of course, then it will carry on in states including
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Goa and Kolkata before it's finally with a sit down protest,
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they end it in Delhi.
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And you had covered the need protests as well, right?
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What difference did you see between those protests and the
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one happening right now?
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So that protest, I think a large part of the
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crowd during that protest was, you know, students, people from all.
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Ages, maybe 10 and upwards.
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And then even, you know, their parents, like who were
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essentially demanding for a.
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Reform of the education system overall.
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Right now, what we could see in the crowds who
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were gathered outside Shivaji Park, there were people who were
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personally affected by the SIR process. There were people, very few,
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I would say younger students, but there was a lot
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of Gen Zs as were in the previous protests. There
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were actually famous Bollywood celebrities. There was Shabana Azmi.
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There was.
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Anand Patwardhan who was the documentary filmmaker and the overall
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flavour of the crowd was a little mixed this time
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because while there were people who were seeking for the
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electoral reformation there were also people who had responded personally
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to Dipke's call who wanted to support the CJP in
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their overall mission so that was also a large part
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of the crowd that was present.
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And, you know, in Delhi, for example, we have seen
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a lot of people being detained by the police. We
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have also seen Lathi charge. But have we seen any
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kind of police action in Mumbai against the protesters?
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So there were about 300 police personnel who were stationed
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at Shivaji Park in and around at different locations. But
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there was no sort of crackdown or action against the
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protesters as such. It was appearing only as if the
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police were there to monitor the situation and to do
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crowd control. Now, this was a very deliberate choice, actually,
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and it came from a directive from the top brass.
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So within Maharashtra, the chief minister, Devendra Fadnavis, he holds
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the home portfolio and he had accordingly issued directives against
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the use of excessive force. And to ensure that the
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protests would proceed peacefully. A senior BJP leader had also
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spoken to the Indian Express's Shubhangi Kapriya and he had
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mentioned that, you know, as opposed to 2023, when the
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protests had taken place by the Maratha Kota protesters, where
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Devendra Padnavit, who was the then Deputy Chief Minister, had
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used excessive force against the protesters, which led to him
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later apologising. The situation now has played out a lot
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differently with the police just being there to monitor the situation.
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And this attitude of the police, of course, earned a
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lot of praise from the CJP's core team and the
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protesters alike, who appreciated the differences between the Mumbai and
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the Delhi police.
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And talk about what are the kind of things that
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the CJP is demanding right now and what have been
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the demands of the other protesters? Right.
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So the CJP at the outset of the protest had
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three primary demands. Firstly, the most sort of popular one
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that is heard was the resignation of the incumbent chief
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election commissioner, Gyanesh Kumar, and the initiation of criminal proceedings
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against him and initiating an inquiry of sorts. It also
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called for a freezing of the SIR electoral roll and
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using of the 2025 electoral roll for the upcoming elections
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in whatever states that are set to have elections now.
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And it also called for a more independent and transparent
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process of appointing election commissioners, which included participation from civil
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society members. Currently, election commissioners are appointed by the president directly.
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There's not a lot of civil society involvement. So that
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was the third demand that the CJP had. Of course,
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other than that, the protesters on ground were demanding for
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an overall reformation of the system. Gyanesh Kumar's resignation as
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like in line with what the CJP was demanding as well.
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But they were also demanding for a chance to be
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heard and to have their names actually back on the
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electoral rolls. We met a lot of people who, despite
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the fact that, you know, they had submitted necessary documents,
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and had done all the due actions that needed to
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be taken, they still found their name struck off the
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rolls with a very sort of vague indication as to
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what they should do to reverse the judgment. There were
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people who, again, sought for more transparency in the process
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and a more streamlined process so that, you know, this
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wouldn't take place. There were also people who basically thought that,
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you know, I met a 14 year old who basically
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mentioned that even though I cannot vote right now, I'm
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scared of what will happen when I get to an
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age where I can vote. Because if the process is
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so sort of opaque now, what will happen then? So
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there were also people who wanted for a reform of
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the system in the long run.
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Those were the kind of aspirations as well.
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And next, we turn our attention to the leading cause
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of cancer deaths.
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In the country.
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While breast, oral and cervical cancers have been among the
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most common cancers in India for years, it is lung
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cancer that is now causing the most cancer deaths.
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And while the disease is largely.
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Associated with smoking in the West, here in India, a
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significant proportion of lung cancer cases occur among non-smokers. What
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makes the situation even more concerning is that lung cancer
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is often detected at a later stage, when treatment becomes
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more difficult and chances of survival fall significantly. What is
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also worth noting is that there is very limited screening
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for lung cancer in India, and the government's screening program
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at primary healthcare centres doesn't not currently cover this type
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of cancer. So how big is the burden of the
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disease and why are so many cases being detected late?
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To answer these questions, we speak with the Indian Express's
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Anona Dutt who reports on health for the paper. Anona,
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does India have a larger number of lung cancer cases
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in comparison to other countries?
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So no, India is not at the top if we
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talk about lung cancer. There are countries like the US or... China,
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for example, which have a much higher burden of lung cancer.
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But what we have seen is the incidence of lung
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cancer going up in the recent years. If you look
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at the data for 2022 and 2024 that's released by
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the Global Cancer Observatory, we see a jump in the
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lung cancer cases And we see lung cancer has moved
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from the fourth position in terms of new cases to
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third position.
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And it has also moved.
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Up in terms of the number of deaths it causes
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annually from the fourth position to the first position, which
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means instead of breast cancer being the biggest killer in
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India now, it is lung cancer, according to the latest data,
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which is for the year 2024 released by the Global
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Cancer Observatory. It is also accounting for a higher proportion
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of cases. So what we have seen is now it
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accounts for 10.9% of all cancer deaths and 7.2% of
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all new cancer cases, which is more than what we
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saw previously.
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But why is that?
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Is it mainly to do with smoking or does air
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pollution also make the problem worse?
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So there is a study that is going on to
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see whether it.
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Is the ambient air pollution which sort of leads to
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more lung cancer cases in India or not. There's also
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a study to look at how much contribution air pollution
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plays when it comes to lung cancer because That would
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determine the sort of screening criteria. This is a study
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that is underway right now. But there are also other problems.
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So two things.
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One, in India, a lot of the lung cancer cases,
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nearly half of them are not caused by smoking per se.
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It happens in non-smokers, never smokers. Secondly, there are also
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other risk factors, such as a large proportion of the
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people who do smoke tobacco in India actually use BDs.
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And we do not have any international standard on... you know,
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how many BDs actually lead to increased risk for lung
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cancer like we do have for cigarettes. There is also
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air pollution within the homes from women using chulas, etc.,
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which leads to a lot of smoke within the household.
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That can also be a contributing factor for the increased,
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I mean, for the lung cancer that happens in non-smokers
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in India. But these are all factors that have to
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be determined immediately. through research, whether and how much they
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are contributing towards the increase in the lung cancer cases.
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And you write that people often consult doctors only at
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a later stage of the disease when the chances of
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their survival are much lower.
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So why is that?
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Does lung cancer not have obvious or visible symptoms?
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So you're right. These symptoms are not very pronounced.
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Usually people would have, say, a cough, which can be,
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you know, I mean, you don't think lung cancer when
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you cough. You would think you have flu or maybe
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you have TB. You do not think of lung cancer.
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So that is one of the most commonest symptoms. Then
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you have things such as drastic weight loss, etc. But
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these are not very distinctive lung cancer symptoms per se.
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So people do not realize And a lot of the
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times doctors also are not suspecting lung cancer as the
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first diagnosis.
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So there is a delay in diagnosis.
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Also, if you have, say, a normal cough, you are
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unlikely to go to a doctor, which is why a
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lot of the patients do end up in the clinics
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only when the cancer has spread and they are in
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the advanced stages of the disease. In fact, the group
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that is doing the air pollution study, they have looked
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at some data and they found that approximately 93% of
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the lung cancer patients actually reached the doctors only when
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their cancer was advanced, which drastically reduces survival.
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And now coming to screening, tell us about the screening
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process and how accessible it is for people. And is
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it as accessible as screening for other cancers is?
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So the way to screen for lung cancer is low
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dose CT scan. This is essentially, you know, using any
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CT scan machine at a setting where the radiation levels
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are lower because you do need to do multiple scans
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over the years to keep a track. If you know
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you have found some lumps in your lung, you have
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to over the years check them to see whether it's growing,
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what is happening to ensure that it is not cancer.
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So that is why the CT is used at a
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lower dose of radiation.
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To ensure that patients are not exposed to a very
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high radiation threshold. Now, the problem is there is no
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screening program for low-dose CT in India. When it comes
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to the other common types of cancers, such as cervical cancer,
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breast cancer, oral cancer, there is a government screening program
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which is implemented across the primary health centers where patients
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The staff at the health centers actually inspect the, they
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do a clinical examination of the breast. They do a
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visual inspection of the oral cavity for oral cancers. So
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these are very simple tests which can be done at
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a primary health center and then if the health worker
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suspects that a person is likely to have cancer, then
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they are referred to higher centers. However, when it comes
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to LDCT, this is not possible. LDCT is more resource intensive.
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You require a CT machine, which is not possible to
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have at the primary health centers, which means patients would
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have to go to a higher center to get the tests,
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even when they are not experiencing any symptoms. which is
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somewhat unlikely to happen. This is the reason, you know,
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screening for lung cancer is virtually non-existent. It only happens
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in case, you know, you have gone for other treatments
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and the doctor suspects something, then they will ask you
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to get the test.
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00:16:43.789 --> 00:16:47.009
So we need to increase lung cancer screening then. But
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why is there such a lack of screening for it
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in India? How come we are not prioritizing it?
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So there are.
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Several reasons why lung cancer screening is not very commonly, actually,
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it's not really available in the country.
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One is the cost.
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While there are multiple studies that show that it is
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cost effective to do lung cancer screening because that would
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detect the lung cancer at an early stage and increase
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the survival a lot. So if you look at lung
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cancer in the advanced stages, the chances of survival are
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say 7 to 18%, but that.
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Increases to 80% if it is detected early.
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So while it has been shown to be cost effective
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in many countries and even an ICMR, you know, study
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looking at the cost of the test versus the benefit
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that you get from it, they did call the screening
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program a cost effective way to look at lung cancer screening. However,
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it still is a significant cost and it would add
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to the government budget to do a CT scan for
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a huge population. The second thing is just availability of
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the CT scan machines. It's not available at the primary
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health center near the people. They would have to go
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to the district hospitals or a higher center to get
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these CT scan. And that makes the screening program more
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difficult because the access is not there. Thirdly, of course,
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and which is very important, is that we do not
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have a great criteria for screening selecting the people who
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should be screened in the first place. So when we
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look at the Western countries, most of their lung cancer
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cases happen in smokers, which is why the current guideline
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for screening for lung cancer is basically people between the
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ages of 50 and 80 years who have smoked a
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pack of cigarettes a day for at least 20 years.
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This is the current global guideline. But In India, like
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I mentioned earlier, a lot of the people who do
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get lung cancer are not necessarily smokers. So then if
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we follow the global guidelines, a significant proportion of the
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people who are at.
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Risk will be missed out.
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So India actually needs to develop its own sort of
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risk profile and see who should be screened.
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And Aruna, you write that India's high tuberculosis burden also
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impacts lung cancer screening.
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So can you tell us why that is?
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So because tuberculosis also results in these nodules in the lungs,
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which sometimes may look like lung cancer. But there are
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several pilot studies that have now happened. One in Mumbai,
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which was published in 2021, said that even in tuberculosis-endemic country,
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LDCT can actually pick up the malignant nodules. And another
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study that was done by some Ames doctors and others
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also said that you know, the proportion of people who
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are screened positive with the LDCT, the lung cancer detection
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rate and the proportion of false positive cases are comparable
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to Western countries, even in a country like India that
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has a lot of TB cases. So all of these
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are arguments for implementing a lung cancer screening program.
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00:20:12.339 --> 00:20:15.720
However, it would take time and money to do so.
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So Anuna, according to experts, who are the people more
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00:20:20.210 --> 00:20:24.349
at risk of developing lung cancer and should consider getting screened?
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00:20:25.150 --> 00:20:28.730
So as I mentioned, the current global guideline is anybody
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00:20:28.789 --> 00:20:31.569
who is between the ages of 50 and 80 who
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00:20:31.630 --> 00:20:34.650
has been smoking a pack of cigarettes for at least
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20 years, they should definitely get tested. But now, of course,
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experts are looking at other factors, as I mentioned, at
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air pollution, at pollution within the household, exposure to secondhand smoke.
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00:20:48.900 --> 00:20:51.740
among others, to look at whether a person who's not
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a smoker is also at risk of lung cancer. So
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those guidelines need to be established still. But the current
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00:21:00.650 --> 00:21:03.890
global standard is anybody between the ages of 50 and
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00:21:03.890 --> 00:21:08.200
80 years with a history of 20 years of smoking.
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00:21:08.960 --> 00:21:12.240
And Anona, could you also talk about some preventative measures
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that people can adopt?
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So, of course, the most important measure is, you know,
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to quit smoking. Smoking cessation is the most effective way
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00:21:21.619 --> 00:21:24.619
to reduce lung cancer cases that we know of right now.
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00:21:24.960 --> 00:21:27.539
Of course, we are looking at the other factors like
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it is mentioned. But again, even if pollution is linked
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to lung cancer, that is a bigger problem which has
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to be dealt with the government, the society, etc.
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00:21:36.609 --> 00:21:39.799
But smoking can be stopped by an individual.
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00:21:40.119 --> 00:21:43.509
Also, it has been seen that smoking cessation is much
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more effective than any drug per se when it comes
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to improving the treatment outcome. So if a lung cancer
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patient actually stops smoking, their treatment outcomes improve significantly. So
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the best preventative measure and the best way to reduce
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mortality from lung cancer is to stop smoking.
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00:22:09.250 --> 00:22:12.049
And finally, we talk about the Kanchi Dham, an ashram
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in Uttarakhand that has been closely associated with the Hindu
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saint Neem Karoli Baba. Over the long weekend, the ashram
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00:22:19.420 --> 00:22:22.500
has seen a sharp surge in visitors with thousands of
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00:22:22.519 --> 00:22:27.180
vehicles crawling through Kumau hills and traffic jams stretching across Bhimtal,
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00:22:27.460 --> 00:22:31.950
Bhuwali and Kanchi. The Indian Express's Vidhisha Kuntimala writes that
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the congestion has prompted the Nenital administration to consider opening
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00:22:35.700 --> 00:22:39.839
an alternative route to ease pressure on Kanchidham. Nenital District
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Magistrate Lalit Mohan told her that the administration is considering
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a new standard operating procedure under which an existing bypass
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connecting the Kanchi area towards Almora and Ranikhet could be
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00:22:51.849 --> 00:22:55.859
opened to divert traffic. According to Mohan, two factors contributed
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00:22:55.900 --> 00:22:56.859
to the latest increase.
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The end of the monsoon season, which.
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00:22:59.119 --> 00:23:01.690
Brings travellers back to the hills after the rains and
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the landslides, and the release of Hanuman Anj, a film
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based on the life and teachings of Neem Karoli Baba.
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Vidisha writes that 24.34 lakh.
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People visited Kanchidham in the first six months of 2026,
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compared with around 8 lakh visitors in the whole of
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the previous year. The surge also prompted Hanuman Anj director
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Vishal Chaturvedi to ask devotees to check the situation before
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travelling to Kanchidham, and consider other sites associated with Neem
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Karoli Baba if the shrine remains overcrowded. Vidisha writes that
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Uttarakhand is already building a Kanchi Dham bypass, while the
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Public Works Department has identified another.
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Alternative route as well.
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While authorities said the situation at the temple remained manageable
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and the immediate congestion had eased by Monday, Vidisha writes
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that the problem extends beyond tourists.
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Residents told the Indian.
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Express that traffic affects people going to work, bringing supplies,
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travelling for medical needs and simply trying to get home.
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As one resident put it, the same infrastructure has to
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serve both pilgrims and locals, pointing to the need for
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a permanent.
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Solution rather than additional police.
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Deployment during long weekends. You were listening to Three Things
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00:24:12.849 --> 00:24:15.809
by the Indian Express. Today's show was edited and mixed
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00:24:15.890 --> 00:24:19.230
by Suresh Pawar and produced by Shashank Bhargav and me,
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00:24:19.250 --> 00:24:22.329
Niharika Nanda. If you like the show, then do subscribe
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