Based onBasedon CBSE OTBA OPEN TEXT BASED ......neighbouring countries, India’s performance in the agricultural sector has been far from satisfactory. The time has come for a Second

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Economics(Class – XI)

1. The Second Green Revolution

2. Medical Tourism in India

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The Second Green Revolution

OPEN TEXT MATERIAL

Abstract:This case study begins by describing the importance of the agricultural sector in India.

It provides a brief background to the rationale for undertaking the Green Revolution andthe various kinds of changes that took place for the Green Revolution to be successful.Despite the successful rise in foodgrain production, agricultural growth rates in the ninthand tenth five year plans have not been up to expectations. Further, when compared to itsneighbouring countries, India’s performance in the agricultural sector has been far fromsatisfactory. The time has come for a Second Green Revolution.There are certain criticalelements that are required for the Green Revolution to take place, both in terms of technologyusage and issues to be considered. Further, India’s Food Processing Industry is at a fairlynascent stage and needs to develop rapidly in order to reduce wastage of food crops, fruitsand vegetables, and help agricultural labour find new employment opportunities throughwhich productivity can improve.

Historically, India has been an agrarian economy. When we mention the word agrarian–it implies agriculture and its allied activities that have dominated not only in the contributionto India’s GDP but have also been the highest employer of the labour force. Over the years,the decline in the population engaged in agriculture has not been as substantial as comparedto its decline in share of India’s GDP. The Economic Survey of India (2012-13), states thatthe contribution of agriculture and its allied activities has been to only about 14.1% ofIndia’s GDP at constant prices (2004-05) in 2011-12 but the sector continues to be importantin the Indian economy as it provides over 58% of India’s employment as per 2001 census.The importance of agriculture is also based in the fact that it produces foodgrain to matchthe population of the country.

Over the years, especially post independence, India’s population has seen a rapid increase.This can be seen from the table 1.

Table-1Year Population (in millions)

1700 1271900 2711947 3451960-61 4391970-71 5481980-81 6831990-91 8461999 1,0002000-01 1,027

Source: Mission India: A Vision for Indian Youth

11111


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Prima facie it would seem to be a herculean task to match foodgrain requirements tothe population needs of the country. This was particularly true in the 1960s when therewere acute food shortages, especially when there was a long drought. This made Indiagreatly dependent on wheat imported from the United States of America. The lateG. Subramaniam, (who catapulted the Green Revolution from the political angle) andDr. M. S. Swaminathan, (the agricultural scientist who handled the technological aspect),described India’s mid 1960 crisis as: ‘During... That critical period of drought [1966-67],President Johnson, because of certain policies he had adopted, was releasing wheat only indriblets. At one point, we reached a stage where there were stocks for only two weeks andnothing else in the pipeline.’ The 1960s crisis made India’s leaders determined to take herout of this situation. They used India’s strengths to remove its dependence on internationalsupplies and become self-sufficient in foodgrains. It was felt that by adopting modernmethods of production and bringing India’s enterprising farmers together, there could besolutions to this problem. This effort became popularly known as the Green Revolution.

The Green Revolution was launched to liberate India from what was called ‘ship tomouth existence’. During the period 1967 to 1978, there were three major changes made tothe traditional agriculture practiced in India. More land was brought under irrigationthrough the use of diesel and electric pumps, double-cropping was introduced on existingfarming land, and most importantly, new, high yielding varieties of seeds were used alongwith fertilizers, herbicides and pesticides. These changes were supplemented by institutionalsupport to the farmers in terms of better transportation facilities and marketing of theirproduce. Certain social innovations were also initiated through land reforms, easier creditfacilities and changes in the distributive system. As a result of this effort, yields increased,weeds and pests were controlled, farmers were able to buy seeds and other inputs. Withmechanization on farms, less labour was needed on farms. India achieved foodgrainsufficiency in the 1970s, with a record 131 million tons of foodgrains produced in 1978-79.

Figure-1: Source: www.pbs.org/thestoryofindia/gallery/photos/7.html

The table below shows that as a result of the Green Revolution, India’s foodgrainproduction has grown dramatically. When two of the worst droughts occurred in 1979 and1987, there was no need to ask any aid giving nation for food. The need to import foodgrainsis now minimal, and there are adequate buffer stocks. In June 2002, buffer stocks stood at64 million tons. India even exports certain quantities of foodgrains. For example, between


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1997 and 2007, agricultural exports have increased 10.9 per cent annually. Milled paddyrice is the major agricultural export followed by cotton lint, soya bean cake, buffalo meat,sugar and maize. During the same time period, agricultural imports have grown at anannual rate of 9.8 per cent. Main agricultural imports include palm oil, soya bean oil, drypeas, wheat, cashew nuts, and dry bean.

Table-2 All figures in million tonnes

1950 1960 1970 1980 1990 2000Foodgrain production 50.8 82.0 108.4 129.6 176.4 201.8Foodgrain import 4.8 10.4 7.5 0.8 0.3 —Buffer stock — 2.0 — 15.5 20.8 40.0

Source: Mission India: A Vision for Indian Youth

Despite a rise in agricultural output, the sector has not shown the growth ratesdemonstrated by other sectors of the economy. In fact, the Eleventh Plan sought to reversethe deceleration of agricultural growth which occurred in the Ninth Plan and continuedinto the Tenth Plan. It has had some success, in that foodgrain production touched a newpeak of 250.42 million tonnes in 2011-12. The Agriculture Secretary mentioned that thecountry was able to achieve a bumper wheat crop in 2011-12 as crop yields rose due tofavourable weather during February and March. This shows that the performance in theagriculture sector is still largely dependent on the vagaries of nature. Despite efforts, theApproach Paper to the Twelfth Plan states that agriculture and allied sectors is expected togrow at 3.3 – 3.5 per cent per year against the target of 4 per cent of the Eleventh Plan.The increasing divergence between the growth trends of the total economy and that ofagriculture allied sectors suggests an under performance by agriculture. It is also importantto note that unlike the overall economic growth pattern, agricultural performance in Indiahas been quite volatile.

Data collected by the Food and Agricultural Organisation of the United Nations showsthat even though India is an agrarian economy, it does not compare well with its neighbourson several agricultural indicators.

Table-3: Comparative study of continuation andgrowth of agriculture with regard to India.

Country Average annual Average annual Wheat yield Rice yieldgrowth rate of growth rate of per hectare per hectare

agriculture food production in 2008 in 2008production 1998-2008 (in tonnes) (in tonnes)

1998-2008

Afghanistan 0.8 0.9 2.06 2.16Bangladesh 3.9 4.0 1.22 3.99Bhutan 5.7 5.8 2.17 2.69India 2.6 2.5 1.29 3.37Nepal 3.1 3.1 — 2.77Pakistan 2.9 2.9 2.22 3.52

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Sri Lanka 1.6 1.7 2.45 3.75China 3.2 3.1 4.76 6.56Asia Pacific 3.0 2.9 2.75 4.38World 2.3 2.3 3.07 4.31

Source: Food and Agricultural Organisation of UN, Report 2008

According to Dr. APJ Abdul Kalam if all Indians have to have good nutrition and plentyof food, then India needs 360 million tons of foodgrains by 2020. This will allow for gooddomestic consumption and still leave a sufficient margin for food exports and aid to othercountries in need. This mission demands a great revolution in research, technologydevelopment, agricultural extension services and, above all, a major network of marketing,storage and distribution. Further the biggest challenge is that India is still heavily dependenton the rains for the success of its agricultural produce. If there is a succession of bad years,output gets affected. To resolve all these remaining problems, we require a Second GreenRevolution.

The Second Green Revolution will enable India to further increase its productivity inthe agricultural sector. This revolution focuses on matching soil to seed, and product tomarket. The key parameters required in this endeavour are high productivity and bettervalue addition by agro-processing.

Some of the important issues that India needs to consider during the Second GreenRevolution are:

Better use of resources: Since productivity of land needs to be increased to feed therising population it is suggested that poorer land be utilized for building roads, agro-processing industries and storage facilities, all of which are needed for processing andselling farming produce. Further a lot of present-day farming techniques result in wastageof water. India needs to adopt waterconserving technologies, as many developed countrieshave done. This will also aid farming in areas with less water, and be environmentallymore sustainable.

Changing mind sets: Farmers typically believe that their role is limited to growing ofcrops. A change in their mindset is required to help them realize that their scope of work canincrease from grain production to food processing and marketing. For this, new technologiesshould be pressed into service. Nearly 60 per cent of India’s population depends on agriculturefor a living. This should be reduced to 40 per cent or less, and the people formerly employed inagriculture should ideally move to agro-processing and services, where earnings arehigher. This will enable both the farmers aswell as the people shifting to the new areasto become prosperous.

Diversifying products: Farmersneed to be encouraged to move toproducing crops where they have anatural advantage, and for which thereis good demand. Animal husbandry andgrowing cash crops are two of the manynew areas which are emerging.



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As mentioned before, there are certain important technologies that are required for theSecond Green Revolution to be successful. These include :1. Soil matching: Using modern sensors, it is now possible to examine the soil and find

out its characteristic deficiencies and excesses. If there are excessive salts, these have tobe neutralized with chemical or biological treatment. Some deficiencies, such as that ofzinc or phosphorus, can be rectified by adding supplements. Another aspect of soilmatching is that it becomes possible to say which crop would grow best on that soil, andfarmers can devote themselves to growing that crop, provided of course that there is ademand in the market for it.

2. Water technologies: The amount of water used should be minimized. Technologieslike drip irrigation, at its most sophisticated, using microelectronic circuits to controlirrigation, should be increased. We should heed the example of Israel, a country withpractically no rain, which is today a leader in many agricultural products and milkproduction.

3. Crop rotation and better seeds: Farmers must more systematically implement age-old ways of increasing production. For example, they must use the multiple croppingtechnique, which gives greater yield from the same land, and judicious crop rotation,which helps in protecting the soil. High-yielding and hybrid seeds are now available,which give new and varied types of genetically improved crops. Simple biotechnologicaltools-like tissue culture-help to improve growth of vegetables like potatoes. Farmerscan also look at new crops, such as herbs, as possible areas of diversification.

4. Fertilizers and pesticides: Whilst fertilizers and pesticides are considered necessaryfor improving crop output, they can be reduced to a minimum if soil tests are conductedproperly and irrigation is controlled. As chemical fertilizers are often expensive andpolluting, farmers could consider using organic fertilizers. Biotechnology can help increating these. Similarly, pesticide usage can be minimized through biological control ofpests.

5. Animal husbandry: India is one of the top milk-producing nations of the world.However, there is difficulty in exporting milk as we do not meet certain internationalstandards in bacterial control. Agencies like the TIFAC (Technology Information,Forecasting and Assessment Council) have worked to establish such standards, especiallyin Punjab, Karnataka and Andhra Pradesh. Such standards need to be adoptednationally.

6. Phytosanitary conditions: In order to reach export markets, it is important that allagricultural produce-whether poultry, animal or plants-meet certain internationalcleanliness levels in chemical, bacterial and other residues. Indian agricultural producedoes not always meet these standards, as a result of which these products cannot reachexport markets. If Indian villages have to prosper, the produce of the farms have toreach the high-value export markets. To achieve such phytosanitary conditions, thetechnologies involved are not complex, but farmers have to be made aware of these andprovided with the tools necessary to achieve these.

7. Cash crops: Crops like tea, cotton and spices have the potential to be high earners. Itis essential that these are given the technological attention they require. New cashcrops also need to be explored. For example, in Uttaranchal, farmers, in collaboration

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with agricultural researchers, have made geranium into an important mass-producedcrop that yields valuable revenue. Aloe vera, which grows in abundance in the wild inIndia, is much in demand internationally. It is only one of many herbs which may sellwell internationally. Vanilla beans and flowers are other cash crops which yield highincomes.There are many specialists at different agricultural universities who have been working

on these areas. For example, TIFAC hasbeen providing information and help to thefarmers in areas of Bihar, UP andUttaranchal where the crop yield was low.In Bihar alone, between 1999 and 2003,the yield in paddy went up from 2 tonsper hectare (1 hectare = 2.54 acre) to5.8 tons per hectare, and the yield in wheatwent up from 2 tons a hectare to almost 5.This caused dramatic changes in theincome of the farmers.

In the past decade or so, Indian shops have increasingly become flooded by processedfoods of various kinds. As a result, there has been a rise in demand for agricultural productswhich are used in the food processing industry.

Structure of the Indian Food Processing Industry

Unorganised42%

Small ScaleIndustries

33%

Organised25%

Source: FAIDA/Ministry of Food Processing Industries

Figure-2

There is a wide variety of processed foods available today that people now eat, whichwas not common, say, thirty years back. For instance, cornflakes, that is a breakfast cereal,needs a special kind of corn, and potato chips required by fast food places need a specialkind of potato. Since there is a demand for these products, it makes sense for farmers togrow these.

Some agricultural produce have very short shelf-lives if they are unprocessed. Processinghelps to preserve and add value to agricultural products such as rice, wheat, vegetables,fruits, potato and fish. As a result of preserving and proper refrigeration, these productscan reach more people without getting spoilt. This ensures less loss for the producers aswell as better food for people. Farmer’s incomes will also increase.

India is the largest producer of fruit in the world (annual production 46 million tons in2002). However, more than 30 per cent of the fruit is wasted as it cannot reach the market



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and there is limited scope for processing it. In the US, 70 per cent of the fruit produced isprocessed, in Malaysia 83 per cent. In India this is a mere 2 per cent. Recently, however,with the increasing popularity of processed fruit juices in the market, this tread is improving.Other major processed items include fruit based ready-to-serve beverages, canned fruitsand vegetables, jams, squashes, pickles and chutneys. The new arrivals in this segmentare vegetable curries in reportable pouches, canned mushrooms, dried fruits and fruit juiceconcentrates.

Processing is especially important for dairy farming. Milk needs to be pasteurized inorder to last for any length of time. It is essential that processing facilities are availablereasonably close at hand for the dairy farms.

India has the highest livestock population in the world. It accounts for 50% of thebuffaloes and 20% of the world’s cattle population, most of which are milch cows and milchbuffaloes. India’s dairy industry is considered as one of the most successful developmentindustries in the post-Independence era.

In 2005-06 total milk productions in the country was over 90 million tonnes with a percapita availability of 229 gms per day. During 1993-2005, the dairy industry recorded anannual growth of 4%, which is almost 3 times the average growth rate of the dairy industryin the world. The total milk processing in India is around 35%, of which the organizeddairy industry accounts for 13% while remaining is either consumed at farm level, or soldas fresh, non-pasteurized milk through unorganized channels.

In an organized dairy industry, dairy cooperatives account for the major share ofprocessed liquid milk marketed in India. Milk is processed and marketed by 170 MilkProducers’ Cooperative Unions, which federate into 15 State Cooperative MilkMarketing Federations. Over the years, several brands have been created by cooperativeslike Amul (GCMMF), Vijaya (AP), Verka (Punjab), Saras (Rajasthan). Nandini (Karnataka),Milma (Kerala) and Gokul (Kolhapur).

The milk surplus states in India are Uttar Pradesh, Punjab, Haryana, Rajasthan,Gujarat, Maharashtra, Andhra Pradesh, Karnataka and Tamil Nadu. The manufacturingof milk products is very much concentrated in these states due to the availability of milk inhuge quantity.

According to the Ministry of Food Processing Industries, exports of dairy products havebeen growing at the rate of 25% per annum in terms of quantity and 28% in terms of valuesince 2001. Significant investment opportunities exist for the manufacturing of value-added milk products like milk powder, packaged milk, butter, ghee, cheese and ready-to-drink milk products.

In the book ‘An Unfinished Dream’ by the milkman of India, Dr. Verghese Kurien,he says, ‘It was by chance I became a dairy man.” He heard a British expert say that “thesewer water of London is superior to the milk of Bombay”. This served as a challenge toyoung Kurien, who started the Anand cooperative in Gujarat in the 1950s. He hastaken dairying from strength to strength over the decades so that today India is theworld’s second largest milk producer.

However, it is not enough merely to grow good crops. In order to reach the marketswhere they will be sold or processed, it is important that a good transportation network isbuilt.


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Management of agricultural waste is another important area which can turn out to bea source for revenue generation. Agricultural waste should be put to use by developingappropriate and cost-effective technologies, such as generation of biogas, and production ofvermin-compost and paper, as well as other products.

This discussion highlights the large potential that exists within the agricultural sectorof India. Whilst India’s growth patterns mirror those around the world–that the contributionof agriculture to GDP decreases, in India’s case what is significant is that agriculturalindustries needs to provide employment opportunities for farmers. This will not only improveproductivity in agriculture but also farm income.

SAMPLE QUESTIONS WITH ANSWERS

1. Why should agricultural processing industries be an integral part of thesecond green revolution ?

Ans. India’s agricultural processing industry is at an infant stage. In the USA about70% of the fruit produced is processed, in Malaysia 83%. Where in India, this is only2%. So, it needs to develop rapidly in order to reduce wastage of food crops fruits andvegetables and help agriculture labour to find new employment opportunities throughwhich productivity can improve.

Many agricultural produce have very short shelf-lives if it is unprocessed. Processinghelps to preserve and add value to agricultural products such as rice, wheat, vegetables,fruits, potato and fish. As a result of preserving and proper refrigeration, these productscan reach more people, without getting spoilt. So, this ensures less loss for the producersas well as better food for people. Now, there are various kinds of processed food in themarket. That is, there has been rise in demand for agricultural products which are usedin the food processing industry. For example, we eat cornflakes as breakfast, Kurkureas snacks, Amul and Mother Dairy milk products, etc. In this way, this will increasefarm productivity and consequently farmer’s income will increase.

Since farm production has too many people employed beyond requirement, this leadsto disguised unemployment. Agricultural processing industries will certainly providealternative employment opportunities. Also, this will reduce division of farm size. Thisis because, less people will be dependent on farms for income. Agricultural processingwill save agricultural output from being spoilt and wasted. For example, India is thelargest producer of fruits in the world. But, more than 30% of the fruit is wasted as itcannot reach the market in time. Recently, with the increasing popularity of processedfruit juices in the market, this trend is improving.

This has also great opportunities in the areas of dairy farming. Milk needs to bepasteurized in order to last for any length of time. So, it is essential that processingfacilities should be available reasonably close to the dairy farms.

Agricultural processing industries can also increase export earnings if it is promotedto foreign markets. According to the Ministry of Food Processing Industries, exports ofdairy products have been growing at the rate of about 25% per annum. So, theseindustries should be an integral part of the second green revolution.


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2. How important is education towards improving the agriculture sector ?Elucidate.

Ans. Undoubtedly, education is critical for improving the agriculture sector. It is animportant part of our life which makes one’s career. In order to increase agriculturalproduction, we will need adopting modern methods of farming. This includes using new,high yielding varieties of seeds, fertilizers, herbicides and pesticides. We have to increaseirrigation facilities and use multiple cropping. We need land reforms, easier credit facilitiesand changes in the distributive system. All these cannot be possible without propereducation. For the second Green Revolution, India would need better use of resources,soil matching, use of water technologies, crop rotation and better seeds, development ofanimal husbandry, to achieve phytosanitary conditions, cultivation of cash crops.Education will be helpful to achieve all these.

Educated farmers can learn new methods of farming easily and increase theirproductivity. They will understand how marketing of their produce can improve. Theycan interact directly with hypermarkets and reduce middle men. They understand theinternational market needs and try to meet those demands. Education helps to matchlocal conditions to global technology. Educated farmers can make informed choicesregarding seeds, technology used. Education improves their ability to understand creditconditions. Educated farmers can take informed decisions regarding bank loans. Theycan prudently compare between bank loans and loans from money lenders. They cancollaborate with agricultural researchers to improve farm output.

In this way, education is very helpful in improving the agriculture sector.

SOME PROBABLE QUESTIONS WITH ANSWERS

1. What are the needs for the Second Green Revolution in India ? Discuss.Ans. The need for the Second Green Revolution has been felt for the following

reasons :1. As a result of the first Green Revolution, India’s foodgrain production has grown

significantly. But, the agriculture sector has not shown the growth rates on demonstratedby other sectors of the economy. The increasing divergence between the growth trendsof the total economy and that of agriculture and allied sectors suggests an underperformance by agriculture sector. Also, unlike the over all economic growth pattern,agricultural performance in India has been quite volatile.

2. Between 1997 and 2007, agriculture exports have increased 10.9% annually.While during the same time period, agricultural imports have also grown at an annualrate of 9.8%. Main agricultural imports include palm oil, soyabean oil, dry peas, wheat,cashew nuts, and dry bean.

3. The Second Green Revolution will enable India to further increase its agriculturalproductivity. According to Dr. A.P.J. Abdul Kalam, if all Indians have to have goodnutrition and plenty of food, then we need 360 million tonnes of foodgrains by 2020.

4. This objective requires a great revolution in research, technology development,agricultural extension services, and a major network of marketing, storage anddistribution.


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5. The Second Green Revolution will focus on matching soil to seed and product tothe market. This requires high productivity and better value addition by agro-processing.

6. India is still heavily dependent on the rains for the success of its agriculturalproduce. If there is a succession of bad years, output gets adversely affected.

In this way, to resolve all these problems, we require a Second Green Revolution.

2. What do you think India should consider on the issues during the SecondGreen Revolution ? Discuss.

Ans. These are the important issues that India should consider during the SecondGreen Revolution :

1. Optimum use of resources : Anything that can be used to satisfy a need is aresource. Land is also a resource that is scarce. It cannot be increased. Similarly, wateris also a resource. In order to feed the rising population of the country, productivity ofscarce land resources needs to be increased. So, we should do optimum use of resources.It would be rational to utilize better land for agriculture purpose and poorer land forbuilding roads, storage facilities and agro-processing industries. They are required forprecessing and selling farming produce.

Similarly, we should adopt water-conserving technologies for farming. This willenable us farming in areas with less water. Also, it would be environmentally moresustainable.

2. Multiple cropping : To grow more than one crop on a piece of land during theyear is known as multiple cropping. For example, during the rainy (Kharif) season,farmers may grow jowar and bajra. It is followed by cultivation of potato betweenOctober and December. In the winter (Rabi) season, fields are sown with wheat. It isthe most common way of increasing production on a given piece of land.

3. Diversification of products : During the Second Green Revolution, farmersshould be encouraged to produce the crops where they have a natural advantage. Also,farmers should cultivate the crops for which there is good demand in that region. Thereis very good prospect for animal husbandry and growing cash crops and herbs.

4. Wide and better prospects for farmers : Farmers need to change his mindset.They believe that their role is limited to growing of crops. While they have wide scopeof work. They should enter into food processing and involve in marketing activities. Forthis, they should adopt new technologies for better services.

Agriculture sector in India is suffering from seasonal and disguised unemployment.Seasonal unemployment happens when people are not able to find jobs during somemonths of the year. People dependent upon agriculture usually face such kind of problem.Similarly, in the case of disguised unemployment, people appear to be employed, butthey are actually unemployed. This usually happens among family members engagedin agricultural activity. For example, the work requires the service of five people butengages eight people.

About 60% of India’s population depends on agriculture for a living. This can easilybe reduced to 40% or less by encouraging them to move to agro-processing and serviceswhere earnings are higher.


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The above issues will certainly increase productivity in the agriculture sector andbring the Second Green Revolution in the country.

3. What do you think certain important technologies that are required forthe Second Green Revolution to be successful ? Explain.

Ans. They are as follows :

1. Multiple cropping technique : To grow more than one crop on a piece of landduring the year is known as multiple cropping. For example, farmers may grow jowarand bajra during the rainy (Kharif) season. It is followed by cultivation of potatoesbetween October and December. Further, in the winter or rabi season, they grow wheat.This gives greater agricultural yield from the same land.

2. Uses of HYV seeds, fertilizers and pesticides : The other way to increaseagricultural production is the use of modern farming methods that include uses of HighYielding Varieties (HYVs) of seeds, irrigation, chemical fertilizers, pesticides, etc.

HYV seeds give new and varied types of genetically improved crops. Simplebiotechnological tools like tissue culture, help to improve growth of vegetables likepotatoes.

Similarly, fertilizers and pesticides are considered necessary for increasing agriculturaloutput. Since they are expensive and polluting, they should be replaced by usingorganic fertilizers and through biological control of pests. Biotechnology can help inthese efforts.

3. Soil matching : The soil of any field can be examined by using modern sensorsto find out its characteristic deficiencies and excesses. On the basis of findings, itscharacteristic deficiencies or excesses can be neutralised by adding supplements or withchemical or biological treatment. Moreover, as a result of soil matching it would bepossible to decide which crop would grow best on that particular soil. Farmers candevote themselves for growing that crop. This would result in greater return.

4. Crop rotation : Farmers can increase agricultural yield by implementing judiciouscrop rotation technique. Also, this helps in protecting the soil.

5. Cash crops : Crops like flower, fruits, tea, cotton, spices and herbs are said tobe cash crops. They have the potential to be high earners. With the technologicalsupport, their production can easily be increased. In addition, new cash crops also needto be explored. For example, the herbs like Aloe Vera, Vanilla beans and flowers havevery good demand internationally. They can yield high incomes. So, farmers should beencouraged to grow these crops.

6. Water technologies : We should use water technologies like drip irrigation. Weshould take example of Israel which has practically no rain. But today, it is a leader inmany agricultural products and milk production.

7. Development of Animal husbandry : India is one of the top milk-producingcountries of the world. But, we do not meet certain International standards in bacterialcontrol. Some agencies like Technology Information, Forecasting and Assessment Council(TIFAC) are working in this area in some states. But, such standards should bemaintained all over the country.


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4. What are the benefits of agricultural processing industries in India ?Discuss.

OrWhy do you think agricultural processing industries may be a boon for

India ? Explain.Ans. Agricultural processing industries may be a boon for India for the following

reasons :1. Many agricultural produce have very short shelf-lives. They, in raw form, begin

to decay just in a week. For example, fruits, vegetables, potato, fish, etc. Processinghelps to preserve and add value to such agricultural products.

2. Foodgrains like rice, wheat, pulses also have short shelf-lives. If these productsare processed and preserved, they can reach more people without getting spoilt.

3. Agricultural processing industries ensure less loss for the producers. That is,farmers incomes will increase. Also, there will be better food available for the people.

4. India is the largest producer of fruit in the world. Its annual fruit production was46 million tonnes in 2002. However, more than 30% of the fruit is wasted. In India only2% of the fruit produced is processed. While in the USA and Malaysia, it is 70% and83% respectively. If they are processed in India, they will not be wasted and farmersincome will increase. Although, recently, popularity of processed fruit juices have increasedsignificantly. So, agricultural processing industries are growing at a fast pace. Themajor agricultural processed items include ready to serve fruit beverages, canned fruitsand vegetables, jams, squashes, pickles, chutneys, vegetable curries in reportable pouches,canned mushrooms, dried fruits and fruit juice concentrates, etc.

5. Processing is very important for dairy farming. India has the highest livestockpopulation in the world. It accounts for half of the buffaloes and one-fifth of the totalcattle population of the world. In 2005-06 total milk production in the country was over90 million tonnes with a per capita availability of 229 grams per day. However, milkneeds to be pasteurized in order to last for any length of time. So, it is essential thatprocessing facilities should be available near dairy farms for better results.

In this way, agricultural processing industry will certainly be beneficial both forproducers or farmers and the general people or consumers.

5. Why do you think processing is especially important for dairy farming ?Discuss.

OrWhat are the main features of dairy industry in India ? Explain.Ans. India is the second largest milk producer in the world. So, processing is certainly

very important for dairy industry in India. It has the following reasons :1. India has the highest livestock population in the world. It has about half of the

total buffaloes and one-fifth of the total cattle population of the world. Most of them aremilch cows and milch buffaloes.

2. India’s dairy industry is considered as one of the most successful industries in thepost independent period. In 2005-06, total milk production in the country was more


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than 90 million tonnes with a per capita availability of 229 grams per day. The dairyindustry in India recorded an annual growth of 4% during 1993-2005. This is almost3 times of the average growth rate of the dairy industry in the world.

3. The total milk processing in India is around 35% of the total milk produced. Ofwhich the organised sector accounts for 13% of the total milk processing which needsto be increased.

In the organised sector, dairy co-operatives play a major role in the processed liquidmilk marketed in India. There are 170 milk producers’ co-operative unions in India thatare engaged in processing and marketing of milk. These unions federate into 15 StateCo-operative Milk Marketing Federations. These federations created several brands ofmilk like Amul from the Gujarat Co-operative Milk Marketing Federation Ltd., Sudha(Bihar), Mother Dairy (Delhi), Vijaya (Andhra Pradesh), Saras (Rajasthan), Nandini(Karnataka), etc.

4. The manufacturing of milk products is mainly concentrated in some states due tothe sufficient availability of milk. The milk surplus states in India are Gujarat, Haryana,Punjab, Uttar Pradesh, Rajasthan, Maharashtra, Andhra Pradesh, Karnataka and TamilNadu.

5. There is wide scope of exports of dairy products for India. The exports of dairyproducts have been growing at the rate of 25% per annum in terms of quality and 28%in terms of value since 2001. There are great opportunities for the manufacturing ofprocessed milk products like packaged milk, milk powder, ready-to-drink milk products,cheese, butter and ghee.

In this way, there is wide scope for processing in dairy farming in India. Milk needsto be pasteurized in order to last for any length of time. There is a great demand formilk products in the market. For better results, processing facilities should be availablenear dairy farms.

6. Why is it said that India has been an agrarian economy ? Justify.Or

What is the importance of agriculture sector in India ? Explain.Ans. An agrarian economy refers to the economy where agriculture and its allied

activities dominate not only in the contribution to the Gross Domestic Product (GDP) ofthe country but have also been the highest employer of the labour force.

Although, the share of agriculture sector in India’s GDP has been significantlydeclined during past years. But, the decline in the population engaged in agriculturehas not been significantly declined as compared to the contribution in the GDP. Accordingto Economic Survey of India, the contribution of agriculture and its allied activities hasbeen to only about 14.1% of India’s GDP in 2011-12 at the constant prices of 2004-05.While this sector continues to be important in the Indian economy in terms of employment.This sector provides more than 58% of India’s employment as per 2001 census.

The agriculture sector produces foodgrain to match the population need of the country.Earlier to 1960s, there were acute food shortages in India, especially when there wasa long drought. The country was greatly dependent on wheat imported from the UnitedStates of America. But now, India has become self-sufficient in foodgrains. The need to


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import foodgrains is now minimal. There are adequate buffer stocks now. In June 2002,India’s buffer stocks stood at 64 million tonnes. India even exports certain quantities offoodgrains. During 1997 to 2007, agricultural exports have increased 10.9% per annum.

The agriculture sector is said to be the primary sector of the economy. In fact, whenwe produce a good by exploiting natural resources, it is an activity of the primary sector.This is because, it forms the base for all other products that we subsequently make.

In this way, it is clear from the above facts that the agriculture sector still dominateson the Indian economy in various ways. That is why, it is said that India has been anagrarian economy.

7. What were the conditions in the 1960s that led to the Green Revolutionin India ?

OrWhy was the Green Revolution launched during the mid-1960s ? What was

the cause behind India’s food crisis during mid 1960s ?Ans. 1. There were acute food shortages in the India in 1960s, especially when

there was a long drought. It was a great challenge for our social and political thinkersto match foodgrain requirements to the population needs of the country.

2. India was greatly dependent on wheat imported from the United States of America.3. It was also a result of then political crisis. Especially due to Indo-Pak war, USA

was looking it from the political angle. That is, due to political reasons, the USA wassupplying foodgrain in very small quantity. At one point, we reached at a stage wherethere were stocks of foodgrains for only two weeks and nothing else in the pipeline.

4. The agricultural and political crisis in the 1960s made our thinkers determinedto take the country out of this situation. They used India’s strengths to remove itsdependence on international supplies and become self-sufficient in foodgrains.

5. Our political thinkers felt that with the help of modern methods of production,multiple cropping bring India’s enterprising farmers together, solutions to this problemcould be found.

All these efforts brought a revolution in the agricultural sector that led to suddenand significant increase in agricultural production. This revolution is popularly knownas the Green Revolution.

8. How did the Green Revolution liberate India from ‘ship to mouthexistence’ ?

Ans. During 1966, more than 10 million tonnes of wheat was imported in India.This labelled India as a nation surviving on a ‘ship-to-mouth’ basis. Prime Minister, LalBahadur Shastri even issued an appeal that every Indian should fast one day a weekin order to enable the government to balance the food budget. But it was the GreenRevolution in the 1960s as a result of which India today is set to commit over 60 milliontonnes of home-grown wheat, rice and nutri-millets to fulfil the legal entitlements underthe Food Security Act.

In the 1960s there were following major changes made to the traditional methodsof production in the agriculture sector in India :


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1. More land was brought under irrigation through the use of diesel and electricpumps. Rainfall in some areas is not adequate as well as it is uncertain. In these areas,artificial irrigation is quite necessary. Also, there are certain food and cash crops suchas rice, wheat, sugarcane, which require adequate and regular supply of water. So,artificial irrigation was essential to increase agricultural production.

2. Multiple cropping was introduced on existing farming land. Under this system,more than one crop are grown on the same piece of land during the year.

3. Modern methods of farming such as new, high yielding varieties of seeds wereused along with fertilizers, herbicides and pesticides.

4. As institutional support to the farmers, better transportation facilities and marketingof their produce was provided.

5. Certain social innovations were also initiated through land reforms, easier creditfacilities and changes in the distributive system.

As a result of all these efforts agricultural production increased significantly. Indianfarmers harvested about 17 million tonnes of wheat in 1968. Whereas the earlier highestharvest was about 12 million tonnes in 1964. In view of such a quantum jump inagricultural production in India, the term, Green Revolution was coined by WilliamGand of the USA in 1968. India achieved foodgrain sufficiency in the 1970s, with arecord 131 million tonnes of foodgrains produced in 1978-79.

9. What do you think in view of massive use of chemical fertilizers, herbicidesand pesticides, the fertility of land will sustain ?

Ans. The Green Revolution is criticised on the ground that the high-yield technologyinvolving the use of mineral fertilizers and chemical pesticides is environmentally harmful.Land is a natural resource. We should be very careful in its us. This has the followingreasons :

1. Scientific reports show that the modern farming methods have overused our landresource.

2. Increased use of chemical fertilizers may result in loss of soil fertility. For instance,farmers of Punjab are now forced to use more and more chemical fertilizers and otherinputs to achieve the same production level.

3. Chemical fertilizers provide minerals which escape from the soil through waterand below the ground. This will adversely affect the fertility of land.

4. Continuous use of ground water for tubewell irrigation has reduced the waterlevel below the ground.

5. Since soil fertility and ground water are built up over many years, so oncedestroyed, it is very difficult to restore them.

Thus, land will sustain only when we are very careful in its use. We should usechemical fertilizers, herbicides, pesticides judiciously. Rather, we should use methods oforganic farming.

10. What do you think the Green Revolution has made India self-sufficientin foodgrains ? If yes, how ?

Ans. I do believe that the Green Revolution has made India self-sufficient in


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foodgrains. In fact, to achieve self-sufficiency in foodgrains, India adopted a new strategyin agriculture which resulted in the Green Revolution in the 1960s. This revolutionhappened especially in the production of wheat and rice. The highest growth rate wasachieved in Punjab and Haryana. In these states, foodgrain production highly increasedfrom 82.0 million tonnes in 1960 to 201.8 million tonnes in 2000.

While the production in Bihar, Orissa, Maharashtra, Madhya Pradesh and thenorth-eastern states increased very slowly. On the other hand, Tamil Nadu and AndhraPradesh recorded sufficient increase especially in the production of rice.

Since the advent of the Green Revolution, India has never faced famine-like situationand has become self-sufficient in foodgrains.

With the increase in production, we do not have to import foodgrains from othercountries. India was labelled as a nation surviving on a ship-to-mouth basis. India hadto import 10.4 million tonnes of foodgrains in 1960 that reduced to 0.3 million tonnesin 1990.

Now, a variety of crops are grown all over the country. The availability of foodgrainsin the country even in adverse weather conditions, is sufficient. In June 2002, the stockof wheat and rice with Food Corporation of India-FCI was 64 million tonnes which wasmuch more than the minimum buffer norms of 24.3 million tonnes.

11. What was the impact of the Green Revolution of 1960s in India ? Discuss.Ans. As a result of the Green Revolution in the 1960s, agricultural yields increased

significantly, weeds and pests were controlled, farmers were able to buy seeds and otherinputs. With the mechanization on farms, less labour was needed on farms.

India’s foodgrain production has grown dramatically. It achieved foodgrain sufficiencyin the 1970s. A record 131 million tonnes of foodgrains was produced in 1978-79.

The country had to suffer from the worst droughts in 1979 and 1987. Even then,there was no need to ask any aid for food.

The need to import foodgrains is now minimal. There are sufficient buffer stocks inthe country. In June 2002, the stock of wheat and rice in FCI godowns was 64 milliontonnes which was much more than the minimum buffer norms of 24.3 million tonnes.

Now, India even exports certain quantities of foodgrains. During 1997 to 2007,agricultural exports have increased 10.9% annually. India mainly exports milled paddyrice, cotton tint, soya bean cake, buffalo meat, sugar and maize.

During the same period, agricultural imports have increased at an annual rate of9.8% per annum. Main agricultural imports of India are : palm oil, soya bean oil, drypeas, wheat, cashew nuts, and dry bean.

12. “Unlike the over all economic growth pattern, agricultural performancein India has been quite volatile.” Justify.

OrHow can you say that the performance in the agriculture sector in India

is still dependent on the vagaries of nature ?Ans. Although, there has been a significant rise in agricultural output in the past

years, but the sector has not shown the growth rates demonstrated by other sectors ofthe economy.


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The average annual growth during the Ninth and Tenth Plans in the agriculturesector were only 2.5% and 2.4% respectively. This grew at the rate of 3.6% per annumduring the Eleventh Plan. The foodgrain production touched a new peak of 250.42million tonnes in 2011-12.

The performance in the agriculture sector is still largely dependent on the vagariesof nature. It is clear from the statement made by the Agriculture Secretary that thecountry was able to achieve a bumper wheat crop in 2011-12 as crop yields rose dueto favourable weather during February and March.

The increasing divergence between the growth trends of the total economy and thatof agriculture and allied sectors makes it clear that the agriculture sector is sufferingfrom under performance. According to the Approach Paper to the Twelfth Plan, agricultureand allied sectors is expected to grow at the rate of 3.3 to 3.5% per annum against thetarget of 4% for the Eleventh Plan.

The performance of the agriculture sector in India has not been satisfactory incomparison to that in the neighbouring countries. The average annual growth rate ofagriculture production in India during 1998-2008 was 2.6% which was 5.7% in Bhutan,3.9% in Bangladesh and 3.2% in China during the same period. So, it is clear from theabove facts that agricultural performance in India has been quite volatile.

13. Various news in these days suggest that a section of people in India arestill without food. Explain.

Ans. Food security is not essential only for the poorest section of the society but forthe persons above the poverty line also. They are also food insecure when the countryfaces a disaster or calamity like earthquake, flood, drought, tsunami, widespread failureof crops causing famine, etc.

The most devastating famine that occurred in India was the famine of Bengal in1942-43 which killed about 3 million people in the province of Bengal. Although, suchdestructive famine has not happened again, but even today there are many places inIndia like Kalahandi and Kashipur in Orissa, Baran district of Rajasthan, Palamudistrict of Jharkhand and many other remote areas where famine-like situations havebeen existing for many years.

A section of people still sleeps without food in the country. Some starvation deathshave also been reported. So, food security is needed in a country to ensure food to allpeople at all times.

14. “A disaster or a calamity situation makes the food security worse.”Justify.

OrHow is food security affected during a calamity ?

OrWhat happens to the supply of food when there is a disaster or a calamity ?Ans. Food security is certainly affected during a calamity or disaster like earthquake,

flood, drought, tsunami, wide-spread failure of crops which causes famine, etc.In the case of a disaster or a calamity, total production and supply of foodgrains

decreases. It creates a shortage of food in the affected areas.


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The shortage of food causes the price rise of foodgrains. At the high prices, somepeople cannot afford to buy food. The condition becomes more serious when such calamityhappens in a very widespread area and for a long time period. It may cause a situationof starvation.

If the starvation is at mass level, it might take a turn to famine. A famine ischaracterised by wide-spread deaths due to starvation.

As a result of all these situations, destructive epidemics also spread over the affectedareas due to forced use of contaminated water, decaying food and loss of body resistancebecause of weakening from starvation.

15. Why do you think a buffer stock is created by the government ? Whathas our government done to provide food security to the poor ?

Ans. Buffer stock is the government stock of foodgrains. It is created by thegovernment to distribute foodgrains from the granaries in the deficit areas of the countryand among the poor sections of our society. The foodgrains are distributed at a lowerprice than the market price. Buffer stock also helps to resolve the problem of shortageof food during adverse weather conditions and during the periods of calamity.

In order to provide food security to the poor, our government has carefully designedour food security system. This system has two aspects—(i) Buffer Stock—a governmentstock of foodgrains; and (ii) Public Distribution System—this is system of distribution ofstocked foodgrains through government regulated ration shops among the poor.

Also, our government has launched special schemes with special target groups. Forexample,

(a) Antyodaya Anna Yojana (AAY) : It was launched in December 2000. Here,poor families are identified and 35 kg foodgrains per month is made available to eacheligible family at a highly subsidized rate.

(b) Anna Purna Scheme (APS) : It was launched targeting the indigent seniorcitizens.

(c) National Food for Work Programme (NFWP) : It is open to all rural poor.This scheme was launched in 2004 in 150 most backward districts of the country withthe objective of intensifying the generation of supplementary wage employment.

In this way, the government has initiated several programmes for food security inIndia. Today, India is set to commit over 60 million tonnes of home-grown wheat, riceand nutri-millets to fulfil the legal entitlements under the Food Security Act. When itbecomes a law, India will operate the largest social protection programme against hungerin human history.

16. Why do you think it is important for India to increase the area underirrigation ?

Ans. In order to raise agricultural production, it is essential to increase the areaunder irrigation. Water is essential for agricultural production. So, the following pointscan be given in favour of it.

There are certain areas where rainfall is adequate but is concentrated in a shortperiod of the year. The rest of the year is dry. So in those areas, irrigation facilities willbe helpful in growing more than one crop in a year.


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Rainfall in some areas is not adequate as well as it is uncertain. This is mainly inDeccan and Central India, Punjab, Haryana, Rajasthan, etc. In these areas, artificialirrigation is quite necessary. Without it, cultivation is almost impossible here. Moreover,there are certain food and cash crops such as rice, wheat, sugarcane which requireadequate and regular supply of water.

In addition, modern methods of water require adequate water. High yielding varieties(HYV) of seeds need plenty of water. So, we need to increase the area under irrigationto cover the more and more areas.

According to an study, even today, of the total cultivated area in the country, lessthan 40% is irrigated. So, irrigation will be an important input to increase agriculturaloutput keeping in view the food requirements of our rapidly growing population.

17. “Modern farming methods require the farmer to start with more cashthan before.” Do you agree with this statement ? If yes, why ?

Ans. Yes, I do believe that modern farming methods require the farmer more cashthan that of traditional methods of farming. This has the following reasons :

Since modern methods of farming require inputs like chemical fertilizers, pesticides,tractors, threshers which are manufactured in industry. So, they require the farmer tostart with more cash than before.

Traditional methods of farming required traditional seeds which required lessirrigation. Whereas modern methods of farming need more irrigation, High YieldingVarieties of seeds, modern agricultural equipments like tractors, threshers etc.

In the traditional method of farming, farmers used cow-dung and other naturalmanure as fertilizers. They also used agricultural wastes for this purpose. They did nothave to buy them. On the other hand, modern methods of farming require more irrigationand also chemical fertilizers, pesticides and use of tractors, threshers to produce bestresults. These all need more money because they are industrial products.

All the above factors justify that modern methods of farming require more cash thanbefore.

18. Why are farm labourers in India the poorest of the poor ? Analyse.Ans. There are various factors responsible for the poor economic condition of farm

labourers in the country. These are as follows :Seasonal employment : The agricultural activities are seasonal in nature. So, the

farm labourers do not have continuous work. On an average, a farm labourer findsemployment for about 200 days in a year and for the rest of the year he is idle. Usually,only large farmers hire agricultural labourers. And that too for a limited number ofdays. While small farmers do agricultural activities with their family members. Theygenerally do not hire farm labourers. Moreover, modern farming methods have snatchedemployment from them.

Low wages : The growth rate of the agriculture sector is always lower than thatof the other two sectors of the economy. It also affects the wages of farm labourers inIndia. The farm labourers often get almost half of the minimum wages set by thegovernment. The government has set minimum wages of ` 115 per day for a farmlabourer. But in reality, they get between ` 50-75 per day.


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Low social status : Most farm labourers belong to the depressed classes. They donot have the courage to evaluate themselves and demand for higher wages.

Unorganised : Farm labourers are generally illiterate, ignorant and unorganised.So, they are not in a position to bargain with the landowners and secure good wages.

Indebtedness : Farm labourers are heavily indebted. They are suffering from thevicious circle of debt. This is because, they earn meagre income.

In this way, farm labourers are the poorest of the poor in the society. It is often saidthat Indian farmers are born in debt, live in debt and die in debt.

19. Why do you think the agriculture sector is called the primary sector oragriculture and related sector ?

Ans. On the basis of economic activities, an economy is classified into three sectors :primary sector, secondary sector and the tertiary sector. The primary sector includesthose activities that are undertaken by directly using natural resources. This sectorinvolves agriculture, dairy, fishing, forestry and mining activities. For example, thecultivation of wheat. The secondary sector covers those activities in which natural orprimary products are changed into other forms through ways of manufacturing. Forexample, from sugarcane, we manufacture sugar. Tertiary sector includes those activitiesthat help in the development of the primary and secondary sectors. For example, Indianpost, railways, shopkeeper, lawyer, etc.

The agriculture sector is called the primary sector because it forms the base for allother products that we subsequently make. For example, the cultivation of wheat is theactivity of the agriculture sector or primary sector. And wheat is used as raw materialin the manufacturing of biscuit that is the activity of the manufacturing or the secondarysector. When we produce a good by exploiting natural resources, it is an activity of theprimary sector. For example, wheat is cultivated within a crop season by directly usingnatural resources. For the growth of the wheat plant, we depend mainly on naturalfactors like soil, rainfall, sunshine and climate. And the product of this activity, wheatis a natural product.

Since most of the natural products we get are from agriculture, dairy, fishing, andforestry, this sector is also called agriculture and related sector.

20. Why is it said that the agriculture sector is the largest employer of theeconomy ? Why do you think a similar shift out of this sector did not happenin case of employment ?

Ans. The most of the working people are still employed in the agricultural sector.It provides more than 58% of India’s employment as per 2001 census. That is why, itis said that the agriculture sector is the largest employer of the country.

Although, there has been a change in the share of the three sectors in GDP, but asimilar shift has not taken place in employment. The agriculture sector continues to bethe largest employer till date.

There has not been a similar shift out of this sector in case of employment. This hasthe following reasons :

The secondary sector has not created enough jobs to absorb people from the primarysector. Though industrial production went up by 8 times during 1973 to 2003,employment in the secondary sector went up by only 2.5 times.


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The tertiary sector also did not create sufficient jobs. The production in the servicesector rose by 11 times during 1973 to 2003, employment in this sector increased by lessthan 3 times.

In this way, more than half of the workers in the country are working in theagriculture sector. But they are producing only about 14.1% of India’s GDP at constantprices of 2004-05 in 2011-12. There are more people in this sector than is necessary.That is, workers in the agriculture sector are underemployed.

21. “Indian agriculture sector is suffering from underemployment”. Comment.Why should we be worried about underemployment ?

Or“Disguised unemployment is generally found in the agriculture sector in

India”. Justify.Ans. Underemployment or disguised unemployment is the situation when the people

are visibly employed but actually unemployed. In this situation, more people are engagedin a work than required. That is, they are made to work less than their potential. Thissituation is also known as disguised or hidden unemployment.

Underemployment is generally found in agriculture sector. For example, a family ofpeople has an agricultural plot where they all find work. The work requires the serviceof 5 people only but all a family members are engaged. Thus, 4 people are extra. So,these 4 people are said to be underemployed or disguisedly employed.

Although, apart from agriculture sector, underemployment also exists in other sectorssuch as casual workers in the service sector in urban areas.

It is a matter of great worry that lakhs of people are underemployed in the agriculturalsector in India. This situation is mainly found in this sector of the economy. If thesepeople work elsewhere, the income earned by them would increase the total familyincome as well as the national income.

22. What is the benefit or importance of organic farming ? Enumerate.Or

Why do you think organic farming should be an integral part of the SecondGreen Revolution ? Explain.

Ans. Organic farming or agriculture is a whole system of farming that restores,maintains and enhances the ecological balance. It is a form of agriculture that relies ontechniques such as crop rotation, green manure, compost and biological pest control.

Benefits of Organic Farming• Organic farming saves us from harmful effects of chemical-based fertilizers and

pesticides on our health and soil. Chemical fertilizers and toxic pesticides enter the foodsupply penetrate the water sources, harm the livestock, deplete the soil and devastatenatural eco-systems.

• Organic farming offers a means to substitute costlier agricultural inputs such asHYV seeds, chemical fertilizers, pesticides, etc. with locally produced organic inputs.These organic inputs are cheaper and thereby generate good returns or agriculturalinvestment.


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• Organic farming generates incomes through international exports as the demandfor organically grown crops is on a rise to enhance food safety throughout the world.

• Organically grown food has more nutritional value than chemical farming. In thisway, they provide us with healthy foods.

• Organic farming requires more labour input than conventional farming that isbeneficial for the Indian context.

• In this way, we can say that organic farming is a boon not for the country butfor the entire world. It is eco-friendly. The produce is pesticide-free and produced in anenvironmentally sustainable way.

23. What do you think organic farming is a boon or a bane for India ?Analyse.

OrWhat are the advantages and disadvantages of organic farming ? what

would you suggest for India ? But, why ?Ans. Organic farming as a boon• Organic farming restores, maintains and enhances the ecological balance.• Organic farming saves us from harmful effect of chemical-based fertilizers and

toxic pesticides, etc.• It offers a means to substitute costlier conventional agricultural inputs with locally

produced organic inputs. These are cheaper and thereby generate good returns.• It generates incomes through exports as the demand for organically grown crops

is on a rise internationally.• It has more nutritional value than chemical farming.Organic farming as a bane• The yields from organic farming are less than modern agricultural farming in the

initial years.• Since the yields from organic farming are less than modern farming, small and

marginal farmers find it difficult to adapt to large scale production.• Organic produce generally has more blemishes and a shorter shelf-life than sprayed

produce.• The choice in production of off-season crops is quite limited in organic farming.On the whole, organic farming helps in sustainable development of agriculture.

Moreover, India has a clear advantage in producing organic products for both domesticand international markets.

24. Suppose you are the Chairman of the International Federation ofOrganic Agricultural Movement. What suggestions would you make India toadopt organic farming ?

Ans. Organic farming is a form of agriculture that relies on techniques such as croprotation, green manure, compost and biological pest control. It restores, maintains andenhances the ecological balance. It saves us from harmful effects of chemical fertilizersand pesticides. Organic inputs are cheaper thereby generates good returns. It has very


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good scope for exports. Moreover, it has more nutritional value. Following suggestionscan be made for popularising organic farming.

• The government should encourage and aware farmers about organic farming.Popularising organic farming requires awareness and willingness on the part of farmersto adapt to new technology.

• Inadequate infrastructure is a major problem. The government should stress onthe development of infrastructure in this context.

• The problem of marketing the agricultural products is a major concern in ourcountry which needs to be addressed.

• The government should make and implement an appropriate agricultural policy topromote farming.

In this way, organic farming is an eco-friendly system of farming and saves us frommany harmful effects of modern farming methods. So, it should be encouraged.

25. What measures do you think should be adopted to remove disguisedunemployment in the agriculture sector ?

OrCan you suggest any five measures to create more employment opportunities

in rural areas ?Ans. Following measures can be suggested to create more employment opportunities

in the rural areas and to remove disguised unemployment in the agriculture sector :• There is urgent need to improve education and health sectors. According to a

Planning Commission estimates, nearly 20 lakh jobs can be created in the educationsector alone. Investment should also be made on transportation. Easy and cheap transportfacilities will certainly encourage farm and non-farm activities and thus employment.

• Irrigation facilities should be improved. Wells and dams should be constructed andcanals should be dug. This could lead to cultivation of more crops, a lot of employmentand income within the agriculture sector.

• Village roads should be constructed so that agricultural labourers could getemployment in the idle season. Better roads should also be helpful for the farmers totransport their produce to a nearby market.

• The villagers should be given loan at low rate of interest so that they could adoptmodern farming methods and start different non-farm production activities.

• The government should encourage for self-employment by providing credit facilities,technical assistance, marketing facilities, etc. Targeted employment generationprogrammes should be implemented with full devotion and honesty. Agro-based industriesparticularly cottage and small-scale industries e.g., pulse mills, rice mills, flour mills, coldstorage should be encouraged.

26. Why do you think the Second Green Revolution is possible in India ?Analyse.

Ans. The Second Green Revolution is a change in agricultural production widelythought necessary to feed and sustain the growing population in the country.


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I think a Second Green Revolution in India is possible. But it must be based onintegrated approaches, considering entire farming systems. The signs for a SecondGreen Revolution are encouraging.

• Gross capital formation in agriculture, as a percentage of agricultural GDP, increasedfrom 12% in 2004-05 to 22% in 2010-11.

• Investment in agriculture has increased by 30% in recent years.• Advances in biotechnology have stimulated private sector interest in varieties of

commodities.• Agricultural co-operatives are becoming larger and more effective.• The contract arrangements have come into existence in the agricultural sector.

Contract arrangements are the arrangements where buyers offer farmers a guaranteedmarket in exchange for quantity and quality commitments. The use of contractarrangements has increased several-fold in recent years.

• Research and extension agencies are now focussing on bridging the yield gaps—the huge differences between actual and potential yields in rainfed areas.

• Food production is expected to increase at 4 to 4.5% per year as a result of hugeinvestments under the 12th Five-year Plan (2012-17).

• The government has launched several nation-wide programmes such as the NationalAgricultural Development Scheme, Food Security Mission, Horticulture Mission, NationalRainfed Area Authority and others. Each of them has a specific mandate.

All the factors support that the Second Green Revolution will happen in near future.


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Medical Tourism in India

OPEN TEXT MATERIALAbstract :

The case study commences by explaining the meaning of health and medical tourism.It brings to notice the fact that whilst medical tourism may be a relatively nascent and newindustry, the concept has existed for centuries. The case highlights the countries that aredestinations for medical tourism and argues that affordability, cost effectiveness and qualityof services provided are the primary reasons why patients from developed countries areusing medial tourism. The study ends by focussing on the medical tourism industry ofIndia in which alternative, non invasive forms of medicine offered by India are discussed.

Travelling is a natural human instinct. People travel across the globe for leisure, work,study and health. The WHO (World Health Organization) defines health as ‘a state ofcomplete physical, mental and social well-being and not merely the absence of disease orinfirmity’. According to the IMTJ (International Medical Travel Journal) - medical tourismis the broadest of all possible categories of travel related to health. Medical tourism is definedas the providing of cost effective medical services in collaboration with the tourism industryfor patients needing surgical and other forms of special treatment. Medical tourism may bea nascent industry but the concept is very old. Florence Nightingale in her letters writtenin1856 explained the dietary and physical conditions of some patients to doctors in Turkey.She wanted these patients to be treated in the spas of Turkey as similar treatment wasexpensive in Switzerland. During the eighteenth century, wealthy Europeans used to visithealth resorts in North Africa. But in the last decade, travelling for health purposes hasincreased tremendously and has led to a plethora of opportunities for countries with medicalinfrastructure, trained manpower and easy connectivity with the world. According to areport by Deloitte,travelling acrossborders for medicalpurposes is a 40billion dollar marketand is growing at15% annually.There has been animmense increase inthe medical tourismindustry worldwideof $ 60 billion in thelast 8 years, asindicated in thesimple bar diagram(Fig. 2). These factsonly point towardsthe increasing popu-larity of medicaltourism in the world.

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Hungary Gulf States

Mexico

Costa Rice

Brazil South Africa Malaysia

Singapore

Thailand

IndiaDefinition: Medical Tourism

Market Drivers forMedical Tourism

Global Market forMedical Tourism

Note: JCI accreditation details atwww.jointcommissioninternational.org/23218/lortiz/Other sources and explanation appear in Appendix II.© 2008 Deloltte Development LLC. All rights reserved.

Source : Deloitte Report on Medical TourismFigure-1 : A World Map showing the 10 most preferred destinations for

medical tourism.

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There are many favourite destinations in the world for medical tourism. Ten suchdestinations have been identified by Deloitte in its report on Medical tourism, as depicted inthe world map.

As you observe the map carefully you will find most of these destinations are developingcountries like India, South Africa, Brazil, Mexico, Thailand, etc. Cost of treatment here ismuch lower than in a developed country. In fact the cost of medical tourism is the lowest inIndia. On an average any treatment in India can be done at only 1/5th of its cost in theUSA, followed by Mexico and Malaysia. It is also clear from above that patients travel for avariety of reasons ranging from cosmetic surgery, to dental treatment. Going back to anotherterm recurring in the map is JCI. What is JCI ? JCI is the Joint Commission Internationalbody launched in 1994 to evaluate the uniformity and safety of patients travelling formedical treatment. The organization reviews the facilities provided by the hospitals andthen issues an accreditation certificate. JCI has so far approved and accredited 120 hospitalsall over the world. There are several other organizations like ISQUA (International Societyfor Quality in Health Care) which do the same task of ensuring uniformity of services inmedical treatment.

Estimated annual number of medical tourists from the U.S.–'000s*

Approximate cost relative to the U.S.– per cent

*Estimates are rough, most patients are not trackedSource : Deloitte, Josef Woodman (consultant and author of Patients Without Borders)

70

60

50

40

30

20

10

0

Medical tourism by countryFive of the countries visited most often for medical treatment

Mexico Thailand Costa Rica India Singapore

Figure-2: A multiple bar diagram showing comparative cost andmedical tourism in select countries-in comparison with the US.

What do you find in common amongst these destinations ? Isn’t the cost of treatmentmuch less ? The multiple bar chart above shows a comparison between the cost and numberof patients visiting five different countries. These are the popular destinations not only forthe US citizens but also for all medical tourists across the world coming from Europe andMiddle East. The diagram clearly brings out the popularity of Mexico because of the distanceand cost, while a developed country like Singapore attracts lesser patients due to highercost. Will it be correct to conclude that maximum no. of out patients from the USA visitMexico and Thailand, while the cost is least in India ?

Do you observe any irony in the concept of medical tourism ? Yes there is an irony. Thecitizens from the developed countries come to the developing countries for treatment. It iswell known that the developed countries have the best, state of art health facilities andinfrastructure, then why do patients from developed countries flock to the developingcountries even though there are flaws in the system ?


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We need to look into the pitfalls of the Medical Tourism industry. Since patients comefor treatment and then go back to their own country, it is difficult to conduct a follow up. Ifany side-effects develop, then it is not always possible to get medical support. Most of theinsurance companies don’t pay upfront and hence the patients have to pay in cash fromtheir own pocket. The laws and implementation in developing countries is weak and henceno recourse can be found in the event of a mishap, by the patient. Yet these patients preferto travel due to the following reasons–✱ The cost of medical treatment is several times more in their native country, about 3 to 4

times more.✱ The employers and patients don’t have to pay for expensive medical insurance as they

avail of medical tourism.✱ There is shortage of medical personnel in the native countries which causes delay in

treatment and a long waiting time.✱ The accreditation of hospitals assures the patients of quality services.✱ The attractive packages offered by the medical travel companies lure them. These include

travelling cost, accommodation, treatment expenses, post-operative care expenses anda holiday to recover.Cost is the most important determinant of medical tourism as far as the flow of patients

from developed to developing countries is concerned.As the medical tourists have a great deal to gain, the incidence of medical tourism is

constantly on the rise. The graphs below explain how the out-patients from the USA areincreasing in leaps and bound, from less than 5 million to 15 million between 2007 to 2012.

2007 08 09 10 11 12 13 14 15 16 17Source: Deloitte Center for Health Solution

OutpatientsForecast number of US patientstravelling abroad for medical care, m

25

20

15

10

5

0

Upper limit

Base case

Lower limit

1 FIGURE I

Worldwide Medical Tourism Industry(billions of U.S. dollars)

$100 billion

$40 billion

2004 2012

It is interesting to note that patients travel from different countries for different reasons.Those who come from USA and other European countries look for life style surgeries likefacelift, dental treatment, and cosmetic surgery. This is primarily because such treatmentsdon’t get covered by their insurance companies. The reason for the European patients totravel for medical treatment is again unique. In Britain, for instance, free health care

Figure-3: Forecast reg. number ofUS patients travelling abroad for medical care

Figure-4: Worldwide medicaltourism industry


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treatment is provided to all the citizens under the National Health Service programme. Itwas setup in 1948 and is struggling today to cope with the shortage of both doctors andhospital beds. Private treatment is limited and expensive. Patients have to wait for 3 monthsor more for getting a surgery like hip replacement or cataract operation. It is difficult towait all the time and hence these patients travel abroad for medical treatment. The patientsflock out of the rich Middle East countries as specialized medical facilities are unavailablein their country. They travel for diverse services-from open heart surgery to problems ofinfertility. Many patients come to India from Nepal, Bangladesh and Pakistan as well forwant of better medical infrastructure in their native countries.

By now we have gathered enough interest in the topic to find out how medical tourismtakes place.

Look at the pictorial flow chart given below, (Fig.5). These are the steps involved in theprocess of medical tourism. At first the patient researches the best possible treatment optionsin the world. He/she then files an application for becoming a medical tourist. The formsubmitted with the moderator or travel agent or travel company will contain the place,time, payment and other preferences. The moderator responds, answers queries aboutpackages and the payment details are finalized. Once the payment is done the treatmentwill commence.

Patientvisits thewebsite

Creates theprofile online

Selectsthe

Hospital Selectsthe

Package

Patient

PaymentDetails

Replies the

Package details

along with the

charges to the

Patient

Sends toModerator

Givesoptionaldetails

Patient isconnected with the

Hospital

Treatmentstarts

MEDICAL TOURISM

Paymentmadeover

PaymentGateway

Figure-5: A pictorial flow chart showing process of how to become a medical tourist.

So you see the process is certainly not complicated. It is just booking an appointmentwith the medical specialist well in advance. The tedious task of booking tickets,accommodation, and paper work is all done by medical travel companies. This industry initself sparks the growth of many other industries like hospital industry, medical equipment,travel industry and pharmaceuticals.

Now let us turn towards the Indian medical tourism industry. Syed Abdul Basir broughthis 10 months old daughter from UAE to India for a heart surgery. John came from USA toget a hip replaced. Lisa flew down from UK to get a liposuction surgery. All these and manymore patients come to India throughout the year to ease their medical problems. They arepopularizing “medical tourism in India”.


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The Indian health sector is developing a new arm to cater to the interest of foreignpatients. These are people of all ages and gender. They mostly come for heart surgery, kneereplacement, cosmetic surgery, bone marrow replacement and dental care. Most patientscome from the neighbouring countries, Middle East, USA and UK. The following is a clippingfrom an article printed in the Financial Express on 4 January, 2009, ‘A Sweet-Bitter Pill’.This data states the current status of medical tourism in India.

SAARC Africa Middle East US Europe

No. of Medical 43,500 16,000 18,000 13,000 13,000

Tourists in India

Exp. Growth Rate 10% 10% 15% 20% 20%

Motive for Travel Lack of Lack of Better Cost Long

facilities facilities quality care waiting period

International Singapore Europe, US Dubai, Europe, Latin Turkey, Dubai

Competition Thailand Singapore US, Thailand America,

Singapore

Pricing Premium 50% 100% 100%

Over all Attractiveness

— —

Mapping the growth path

Source for graphs : Feedbackventures, Healthcare Advisory Practise

Figure-6: The growth of medical tourism

What do you understand from the above table ?The obvious conclusion is that India has many advantages as a medical tourist

destination. Though cost of any medical treatment is a decisive factor, the quality of medicalcare is also important. As can be seen, medical tourists from the USA, UK and Middle Eastenjoy a huge cost benefit. According to a report of IMTJ (International Medical TravelJournal) on medical tourism the medical costs are the lowest in India, about 20% of averageexpenses incurred in the USA. The popular slogan is that India provides ‘first world treatmentat third world prices’. For instance the cost of a heart surgery in India is $8000 while in theUSA the surgery will cost $25000 and in the UK it costs $28000. NABH India (NationalAccreditation Board for Hospitals and Healthcare) classifies and approves select medicalservices and hospitals; it works in co-operation with the JCI. India has world class medicalfacilities, comparable to any western country of the world, 15,000 hospitals and over 8,70,000hospital beds 30,000 doctors and nurses are added each year to the existing pool of 14 lakhdoctors and nurses. State of the art hospitals like AIIMS, Christian Medical College, TataMemorial Hospital, Apollo hospitals, just to name a few are providing various specialitieslike Paediatric, Neurology, Dermatology, Dentistry, Plastic surgery, Gynecology, Pulmonology,ENT and many more . Based on the analysis provided in the research report of RNCOS(Research and Industry Data Analysis Company) ‘Booming Medical Tourism in India’, themedical tourism industry is expected to register a CAGR (Cumulative Annual Growth Rate)of more than 20% during 2013 to 2015. It is anticipated that India’s share in the globalmedical tourism industry will climb to 2.4% by 2012. In an article dated 27th June 2013,the Economic Times stated that as many as 400,000 foreigners travelled to India in 2012for health treatments, making it the fifth most-visited country for medical tourism. Alsohigh-difficulty operations such as coronary artery bypass, graft surgery were successfullyperformed in India. The cost of such operations was 90% less expensive in India than in


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the west. Moreover therecessionary trends inthe west had only addedto India’s popularity.Since foreign currency ismore powerful than therupee, it is cheaper forthem to get thesesurgeries done in India.Many private informationagencies in India areoffering attractivepackages to the medical tourists, which include customised travel, post-operative treatmentitineraries, a holiday destination and accommodation facilities.

Alternative forms of traditional medicines like Ayurveda, aromatherapy, yoga, pranichealing and the like are also becoming popular with the patients. These are non-surgicaltreat-ments for various ailments. For example Kerala Ayurveda centres have beenestablished at multiple locations in various metro cities. The health tourism publicity alsoshowcases the advantages of this traditional form of medicine. There are over 7 lakhregistered practitioners who are catering to the needs of traditional healthcare.

Ayurvedic MedicinesAyurvedic Medicines have also entered the wellness services through spas and

Ayurvedic massages. These give India an edge over other Asian countries. The patients areattracted to the personal care, immediate operative facilities and this is adding to thepopularity of India as a preferred destination for health treatment.

A study by CII (Confederation of Indian Industries) and McKinsey Consultants in2005 estimated that India had the capability to attract one million medical tourists annuallyand could add $ 5 billion to the country’s income. In an article of the Financial Express2012, it was anticipated that India could be hosting 24 lakh medical tourists by 2020,almost four times the number it catered to in 2010. And that’s not all. The figure is projectedto rise to 49 lakh tourists by 2025, according to an estimate by Technopak. However, inorder to achieve any of these targets, the health industry needs to promote its hospitals andallied services abroad and improve upon its transport facilities, especially air connectivity,to the metros.

Indian medical tourism industry’s phenomenal growth is fuelled by quality, availabilityand cost factors. It is surely on its way to making India a Global Health Destination.

SAMPLE QUESTIONS WITH ANSWERS

1. Is it correct to state that development of medical tourism has led to thedevelopment of many other trades ? Justify your stand.

Ans. Yes, it is absolutely correct statement. Undoubtedly, the development of medicaltourism has led to the development of many other industries like hospital industry,medical equipment, pharmaceuticals and alternative forms of traditional medicinesincluding Ayurveda, aromatherapy, yoga and pranic healing, consumables,



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manufacturing, food industry as well as tourism and travel industry. These industrieshave been directly boosted up by the medical tourism in India. Moreover, it has indirectpositive impacts on many other industries also.

As we know, with the growth of medical tourism, hospital industry will flourish. Itsprofit will increase and many more hospitals will come into being.

Similarly, as medical tourism grows, the demand for medical equipments and medicineswill also increase. As a result, pharmaceuticals and medical equipment industries willearn more and flourish.

People who come to India, will consume the goods manufactured in the country. Asa result, consumer goods industries flourish.

Also, with the increase in the number of medical tourists tour and travel industrieswill prosper. People who come to India for medical treatment, will visit to many touristplaces in the country thereby increasing rail, road and aviation industries. Touristsneed hotels and guides to tourist places. So, they will also grow.

Apart from these industries, the other industries like cement industry, iron and steelindustry will also grow in order to develop medical infrastructure. As more and moredoctors will be needed, education industry will also flourish. And, many more industrieswill also notice positive impacts.

2. What additional measures need to be taken to promote the medicaltourism industry in India ?

Ans. Medical tourism is defined as the providing of cost effective medical services incollaboration with the tourism industry for patients needing surgical and other forms ofspecial treatment. The following measures need to be taken to promote the medicaltourism industry in India :

(i) Improvement in Supporting Infrastructures : The supporting infrastructurelike rail and road linkages should be improved so that medical tourists can visit fromairport to hospitals easily and conveniently. Also, these linkages will facilitate them tovisit different tourist places of the country.

(ii) Manufacturing of Medical Equipment and Consummables : There shouldbe improvement in manufacturing of medical equipment and consumables. Medicalequipments should be the state of the art. Consummables like food items, drinks, etc.should be of the world standard.

(iii) Increase in JCI Accredited Hospitals : JCI is the Joint CommissionInternational body launched in 1994 to evaluate the uniformity and safety of patientstravelling worldwide for medical treatment. The organization reviews the facilitiesprovided by the hospitals and then issues an accreditation certificate. This time, thereare only 10 JCI accredited hospitals in India. So, their number should be increased inorder to attract foreign medical tourists in India.

(iv) Alternative Methods of Medication : Alternative methods of medicationsuch as Ayurvedic, Yoga, Yunani, Homeopathy, Aromatherapy and Pranic Healing giveIndia an edge over other Asian countries. So, marketing of these methods of medicationshould be increased. These are non-surgical treatments for various ailments. The patientsare attracted to the personal care, immediate operative facilities. All these factors definitelyadd to the popularity of India as a preferred destination for health treatment.


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(v) High Quality Staff : Although, India has world-class medical facilities with15,000 hospitals and over 8,70,000 hospital beds. More than 30,000 doctors and nursesare added each year to the existing pool of 14 lakh doctors and nurses. Still, there isan urgent need to increase high quality staff to attract foreign medical tourists.

(vi) Customised Packages : The government and private information agencies inIndia should offer attractive packages to the medical tourists including customised travel,post-operative treatment itineraries, a holiday destination and accommodation facilities.

All these measures would certainly promote the medical tourism industry in India.

SOME PROBABLE QUESTIONS WITH ANSWERS

1. What do you think are the pitfalls (demerits) of the Medical TourismIndustry ? Explain.

Ans. In my opinion, the following are the pitfalls of the Medical Tourism Industry inIndia :

(i) Foreign patients come for treatment and after the treatment, they go back totheir own country. So, it is difficult to conduct a follow-up or post-treatment service.After returning to their hometown, if any side-effects develop, then it is not alwayspossible to get medical support.

(ii) During the treatment, most of the insurance companies don’t pay upfront andhence the patients have to pay in cash at that moment from their own pocket.

(iii) The laws and regulations are ineffective and their implementation in developingcountries is weak. Lots of corruption and red-tapism can be seen in these countries. So,in the case of mishap, it is very difficult to find any recourse by the patient.

2. Why do you think patients from developed countries flock to thedeveloping countries even though there are flaws in the system ?

Ans. In spite of many flaws, patients prefer to travel through these countries for thefollowing reasons :

(i) Cheaper cost of Medical Treatment : Since the cost of medical treatment intheir home countries is about 3 to 5 times more than that in the developing countries,they prefer these countries for medical treatment. For example, on an average anytreatment in India can be done at only 1/5th of its cost in the United States of America.

(ii) Uncovered Treatments by Insurance Companies : Patients coming fromthe USA and many European countries generally look for life style surgeries like facelift,dental treatment and cosmetic surgery. This is because, such treatments do not getcovered by their insurance companies. So, they come to the developing countries likeIndia for quality treatment at cheaper rates.

(iii) Benefits of Medical Tourism : Usually in developed countries like USA, UK,the employers and patients do not have to pay for expensive medical insurance as theyavail of medical tourism.

(iv) Shortage of Medical Personnel : The reason for the European patients totravel for medical treatment is unique. There is shortage of medical personnel in mostof these countries which causes delay in treatment and a long waiting time. For example,in Britain, free health care treatment is provided to all the citizens under the National


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Health Service Programme, 1948. But, it is struggling today to cope with the shortageof both doctors and hospital beds. Patients have to wait for 3 months or more for gettinga surgery like hip replacement. On the other hand, private treatment is limited andexpensive.

(v) JCI Accredited Hospitals : The organisations like Joint CommissionInternational–JCI and International Society for Quality in Health care ensure uniformityof services in medical treatment. These organisations review the facilities provided bythe hospitals and then issues accreditation certificate. So, the accreditation of hospitalsfrom these International organisations assures the patients of quality services. Theytravel for diverse services from open heart surgery to problems of infertility.

(vi) Attractive Packages by Medical Travel Companies : The medical travelcompanies of India or other developing countries lure foreign medical tourists by offeringthe attractive packages. They include travelling cost, accommodation, treatment expenses,post-operative care expenses and a holiday to recover.

On the whole, cost is the most important determinant of medical tourism as far asthe flow of patients from developed to developing countries is concerned.

3. Why is it said that India provides ‘first world treatment at third worldprices’ ? Comment.

Ans. India has many advantages as a medical tourist destination. Of them, cost isthe most important determinant of medical tourism. Still, the quality of medical care isalso important. On an average, any treatment in India can be done at only 1/5th of itscosts in the United States of America.

Medical tourists from the USA, UK and the Middle-East countries enjoy a huge costbenefit. According to a report of International Medical Travel Journal on medical tourism,the medical costs are the lowest in India. It is about 20% of average expenses incurredin the USA. For example, the cost of a heart surgery in India is $8,000 while in theUSA, the same surgery will cost $25,000 and in the UK it costs $28,000.

On the quality front, India has world-class medical facilities, comparable to anywestern country of the world. India has 15,000 hospitals and over 8,70,000 hospitalbeds, 30,000 doctors and nurses are being added each year to the existing pool of 14lakh doctors and nurses. National Accreditation Board for Hospitals and Healthcare(NABH), India classifies and approves select medical services and hospitals. It works inco-operation with the Joint Commission International (JCI). More than 60% of doctorsin India’s leading hospitals have international qualifications. They increase the acceptanceand comfort levels among international patients. State of the art hospitals like AIIMS,Medanta hospital, Sir Ganga Ram hospital, Christian Medical College, Tata MemorialHospital, Appolo hospitals are providing various specialities like Paediatric, Neurology,Dermatology, Dentistry, Plastic surgery, Gynaecology, Pulmonology, ENT and manymore. High quality operations such as coronary artery bypass, graft surgery weresuccessfully performed in India. The cost of such operations was 90% less expensive inIndia than in the west. That is why, it is said that India provides ‘first world treatmentat third world prices’.

So, the Indian health sector is growing with a new pace. It is developing a new armto cater to the interest of foreign patients that include people of all ages and gender.


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According to the Economic Times dated 27th June 2013, about 4,00,000 foreignerstravelled to India in 2012 for health treatments. A study suggests that India has thecapability to attract one million medical tourists annually.

4. How does medical tourism take place in India ? Explain.Ans. The process of medical tourism is certainly very easy in India. These are the

steps involved in the process of medical tourism in India :Step-1 : The patient visits the website and researches the best possible treatment

options in the world.Step-2 : He/she creates the profile online.Step-3 : He/she selects the hospitals.Step-4 : He/she selects the package.Step-5 : He/she gives optional details.Step-6 : He/she then files an application for becoming a medical tourist. He sends

it to moderator or travel agent or travel company. The form submitted with the moderatorwill contain the place, time, payment and other preferences.

Step-7 : The moderator replies the package details along with the charges to thepatient.

Step-8 : The moderator responds, answers queries about packages and the paymentdetails are finalized.

Step-9 : The patient makes payment over payment gateway.Step-10 : The patient is connected with the hospital.Step-11 : Treatment starts.In this way, the process is not complicated but simple and easy. It is just booking

an appointment with the medical specialist well in advance. Then, the tedious task ofbooking tickets, accommodation and paper work is all done by medical travel companies.

5. What do you think medical tourism is a boon for India ?Or

What are the advantages (benefits) of medical tourism in India ?Ans. Medical tourism is defined as the providing of cost effective medical services in

collaboration with the tourism industry for patients needing surgical and other forms ofspecial treatment.

The popularity of medical tourism in the world as well as in India is increasing day-by-day. This has the following reasons :

(i) Cheaper rate of Medical Treatment : On an average any treatment in Indiacan be done at only 1/5th of its cost in the United States of America. Medical care is socheap in India because it has lower medical education cost, huge number of medical andparamedical colleges, less infrastructure cost, minimum insurance cost for practisingdoctors, competition within private hospitals, etc. Moreover, Indian government focuseson to keep rules and regulation in costs of healthcare by proper laws. Also, Indiangovernment hospitals offer treatment at free of cost including critical cares. So, privatehospitals have to keep the overall cost affordable. The cost is a decisive factor for thedevelopment of any industry.


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(ii) Increase in Foreign Exchange Reserves : With the advent of foreign medicaltourists, the foreign exchange reserves of the country increases. This is because, theycome with dollars and spend on various consumer goods here.

(iii) Helpful in the Development of Many Other Sectors of the Economy :The development of medical tourism has led to the development of many other industrieslike hospital industry, medical equipment, pharmaceuticals and alternative forms oftraditional medicines including Ayurveda, Aromatherapy, Yoga and Pranic Healing,consumer goods, tour and travels industry, etc. In addition, medical tourism also affectmany other industries positively.

(iv) Increase in Employment : With the development of medical tourism andadvent of medical tourists, the demand for consumer goods increases. This results inincrease in production and employment.

(v) Development of healthcare services : As the medical tourism industryincreases, there is development of healthcare services to attract more tourists. Theindustry earns more profit. So, more and more people are interested to join this industry.

(vi) Medical vacations may be a fun : Most of us need medical treatment fromtime-to-time, and most of us plan vacations every year or so. So, we can combine thetwo into an all-out medical vacation that provides us with everything we need, wantand desire. Recuperating after surgery on a white sand beach while sipping islanddrinks and receiving full body messages will certainly give us a great enjoyment.

Medical tourism is a growing sector in India. It is expected to experience an annualgrowth rate of 30%, making it a $2 billion industry by 2015. In this way, medicaltourism is certainly a boon for India.

6. What do you think hospitals in India are well-equipped and uptointernational standards ? Explain.

Ans. India has several private and government hospitals that are designed to provideworld-class medical care in India. State of the art hospitals like AIIMS, Medanta Hospital,Sir Ganga Ram Hospital, Christian Medical College, Tata Memorial Hospital and Appolohospitals are providing various specialities like Paediatric, Neurology, Dermatology,Dentistry, Plastic surgery, Gynaecology, Pulmonology, ENT and many more. Thesehospitals utilize some of the best medical equipments available in the world. Theorganisations like Joint Commission International—JCI and International Society forQuality in Healthcare ensure uniformity of services in medical treatment. Theseorganisations review the facilities provided by the hospitals and then issues accreditationcertificate. So, the accreditation of hospitals from these international organisations assuresthe patients of quality services. JCI is the international body launched in 1994 toevaluate the uniformity and safety of patients travelling world-wide for medical treatment.The organisation reviews the facilities provided by the hospitals and then issues anaccreditation certificate. A specific example of such a hospital is in Mumbai which hasbeen designed as per guidelines from the Cleveland Clinic Foundation. This ensuresthat they meet rigorous international standards. Such hospitals focus on patient safetyand comfort and has been designed in such a way that will minimize the risk ofinfection. Travel India Company has carefully evaluated and selected only those hospitalsthat meet very high international standards to be a part of the network. In addition,


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high-difficulty operations such as coronary artery bypass, graft surgery were successfullyperformed in India.

All these facts support the statement that hospitals in India are well-equiped andupto international standards.

7. What are the future prospects of medical tourism industry in India ?Discuss.

Ans. Medical tourism industry is a growing sector not only in India but all over theworld. Although, this industry may be a new industry, but the concept has existed forcenturies. The countries that are destinations for medical tourism, provide affordability,cost effectiveness and quality of services. In the last decade, travelling for health purposeshas increased tremendously and provided vast opportunities for the countries withmedical infrastructure, trained manpower and easy connectivity with the world. Accordingto a study, travelling across borders for medical purposes is a 40 billion dollar marketand is growing at a rate of 15% annually. During the last 8 years, there has beenimmense increase (of $60 billion) in the medical tourism industry worldwide. These factsindicate the growing popularity of medical tourism in the world.

India’s medical tourism is also growing with a new pace. According to an estimateby the Confederation of Indian Industries in 2005, India had the capability to attractone million medical tourists annually and could add $5 billion to the country’s income.The Financial Express in 2012 anticipated that India could be hosting 24 lakh medicaltourists by 2020. This is almost four times the number that was in 2010. According toTechnopak, the figure is projected to rise to 49 lakh tourists by 2025.

Advantages for medical treatment in India include reduced costs, the availability oflatest medical technologies and growing to world-class quality standards. Moreover, allmedically trained staff members are fluent in English in our state of the art hospitals.English is widely spoken throughout India, particularly in the metros and large cities.So, the language is not a problem here.

All these positive factors certainly make India a global health destination in future.8. What do you think whether medical tourism is a boon or bane ?Ans. Meaning : Medical tourism is defined as the providing of cost effective medical

services in collaboration with the tourism industry for patients needing surgical andother forms of special treatment.

Medical Tourism as a boon :(i) Medical tourism increases our national income.

(ii) It brings scarce foreign exchange to the home country.(iii) This industry promotes the growth of many other industries like hospital

industry, consummables, medical equipments, tours and travels industry andpharmaceuticals.

(iv) Lower costs of medical treatment, its better quality and its easy availability arethe key factors that are contributing in the phenomenal growth of Indian medicaltourism industry.

(v) Medical tourism package provides various options.(vi) Medical vacations can be a fun by combing medical treatment with vacations.


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Medical tourism as a bane :(i) Most medical tourism facilities like hospitals, dental clinics, etc. are infected

medical malpractices, especially with regard to insurance to cover any unforeseen events.Also seeking damages can sometimes be difficult in cases of negligence, misdiagnoses,or incompetence.

(ii) The type of insurance the patient has and the type of procedure he/she needswhen he/she travels abroad may vary. The insurance may not cover fully.

(iii) Most of the insurance companies do not pay upfront. So, the patients have topay in cash from their own pocket.

(iv) For many medical procedures, it is customary to check in with the physician ordentist from time-to-time as the patient recuperate. Since patients come for treatmentand then go back to their own country, it is difficult to conduct a follow up. The casemay be severe, if any side-effects develop.

(v) The laws and their implementations in developing countries is weak andineffective. So, it is difficult to find any recourse in the case of a mishap.

On the whole, we find that advantages surpass its disadvantages. So, I think medicaltourism is certainly a boon especially for India.

9. Why is it said that Chennai is the health capital of India ? Justify.Ans. Medical tourism is simply the process of travelling abroad to obtain certain

medical procedures. It is defined as the providing of cost effective medical services incollaboration with the tourism industry for patients needing surgical and other forms ofspecial treatment.

Medical tourism is a growing sector in India. And, the city of Chennai is said to bethe health capital of India for the following reasons :

(i) Multi and super-speciality hospitals across the city bring an estimated 55,000international patients every year.

(ii) Chennai attracts about 45% of health tourists from abroad arriving in thecountry and 30% to 40% of domestic health tourists.

(iii) The factors that attract foreign tourists in the city include low costs, availabilityof latest medical technologies, world-class medical facility, little to no waiting period andother facilities offered at the speciality hospitals in the city.

(iv) The city of Chennai has an estimated 12,500 hospital beds of which only halfis used by the city’s population. The rest is being shared by patients from other statesof the country and foreigners.

(v) Also, dental clinics have attracted dental care tourism to the city.10. What are the special features of medical tourism industry in India ?

Discuss.Ans. (i) Medical tourism is a growing sector in India.(ii) Advantages of medical treatment in India include reduced costs, the availability

of latest medical technologies and a world-class medical facility.(iii) On an average, any treatment in India can be done at only 1/5th of its cost in

the USA.


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(iv) Foreigners are less likely to face a language barrier in India. All medicallytrained staff members are fluent in English in our speciality hospitals. English is widelyspoken throughout India.

(v) Most of the foreign medical tourists come to India for heart surgery, kneereplacement, cosmetic surgery, bone marrow replacement and dental care.

(vi) Most patients come from the neighbouring countries, Middle East countries,USA and UK

(vii) According to the Economic Times, about 4,00,000 foreigners travelled to Indiain 2012 for health treatments, making it the fifth most-visited country for medicaltourism.

(viii) High-difficulty operations such as coronary artery bypass, graft surgery havesuccessfully been performed in India.

(ix) Many private information agencies in India are offering attractive packages tothe medical tourists. They include customised travel, post-operative treatment itineraries,a holiday destination and accommodation facilities.

(x) Alternative forms of traditional medicines like Ayurveda, Aromatherapy, Yoga,Pranic Healing and the like are also becoming popular with the patients. These are non-surgical treatments for various ailments. Especially Kerala and Ayurveda have virtuallybecome synonymous with each other.

11. “Kerala and Ayurveda have virtually become synonymous with eachother.” Justify the statement.

Ans. Kerala has pioneered health and medical tourism in India. It has developedhealth tourism as one of the products for the promotion of tourism in Kerala. KeralaAyurveda centres have been established at multiple locations in various metro cities.Most hotels and resorts are coming up with the spas and Ayurveda centres as anintegral part in Kerala. The World Travel and Tourism Council has recognised Keralaas one of the top three medical tourism destinations in the world.

Kerala has strongly focused on Ayurveda and its wide array of treatments andmedications. World-class medical facilities are also available here in other traditionalforms of medicine as well as in modern medical treatment. Speciality hospitals in Keralaare at the forefront of medical tourism. They have opened their doors to patients fromaround the world and have gained a reputation for their quality treatment and medicalcare. Kerala Ayurveda centres highlight the advantages of Ayurveda in healthmanagement. The health tourism of Kerala participate in various trade shows andexpress wherein the advantages of this traditional form of medicine are showcased. Thestate has one of the best qualified professionals in each and every field of medicine. Thisfact has been realised the world over. It has the most competent doctors and world classmedical facilities. There are over 7 lakh registered practitioners who are catering to theneeds of traditional healthcare. Also, it has the most competitive charges for medicaltreatment. Kerala is a very lucrative destination for people willing to undergo treatmentof certain medical problems that do not need immediate emergency treatment. With thebest infrastructure, the best possible medical facilities and the most competitive prices,the patient can get the treatment done in Kerala at the lowest charges.


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In Kerala, Ayurvedic medicines have entered the wellness services through spasand Ayurvedic messages. These are non-surgical treatments for various ailments.

Kerala is ideally suited for medical tourism because of its moderate weatherthroughout the year, world-class medical facilities, renowned doctors, trained para medicalstaff and technicians, international connectivity, high standard of hygiene, competitivecosts for medical packages and ideal locations for a relaxing holiday. That is why, it issaid that Kerala and Ayurveda have virtually become synonymous with each other.

12. What are the 10 most preferred destinations for medical tourism ?Explain the features of each of them.

Ans. Medical tourism refers to the act of travelling to another country to seekspecialised or economical medical care, well being and recuperation of acceptable qualitywith the help of a support system. The most preferred destinations for medical tourismin the world are as follows :

(i) India : On an average, any treatment in India can be done at only 1/5th of itscost in the USA. More than 4 lakh foreign medical tourists visit India every year. Thereare more than 10 Joint Commission International–JCI accredited hospitals in the country.

(ii) Thailand : The average cost of any medical treatment in the country is 30%of the USA. Thailand has 4 JCI accredited hospitals. About 12 lakh foreign medicaltourists visited the country in 2007.

(iii) Singapore : The average cost of each medical treatment is about 35% of theUSA. There are 13 JCI accredited hospitals in the country and more than 4 lakhtourists visited in the country.

(iv) Malaysia : On an average any medical treatment in Malaysia can be done atonly 25% of the USA. About 3 lakh foreign medical tourists visited the country in 2006.Most of them came here for cosmetic surgery and alternative medicines. There is oneJCI accredited hospital.

(v) South Africa : The average cost of medical treatment in the country is 30% to40% of the USA. This is suitable for cosmetic surgery. There is no JCI accreditedhospital in the country.

(vi) Brazil : The average cost of any medical treatment in the country is 40% to50% of the USA. The locational proximity makes it attractive for US patients. Thecountry is especially suitable for cosmetic surgeries. There are 12 JCI accredited hospitalsin this country.

(vii) Costa Rica : The average cost of any medical treatment in the country is 30%to 40% of the USA. Due to its locational proximity, the US patients come here mainlyfor dental and cosmetic surgeries. There is one JCI accredited hospital in the country.

(viii) Mexico : The average cost of any medical treatment in the country is 25% to35% of USA. Due to its locational proximity, a vast number of US tourists come hereevery year mainly for dental and cosmetic surgery. There are 3 JCI accredited hospitalsin the country.

(ix) Gulf States : The country has healthcare city designed to provide advancedhealthcare services. There are 38 JCI accredited hospitals in these countries of which17 are only in Saudi Arabia.

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(x) Hungary : The average cost of any medical treatment in the country is about halfof the cost in the USA. Mostly European medical tourists come to the country especiallyfor dental and cosmetic surgery. There is no JCI accredited hospital in the country.

13. Why do you think the maximum number of out-patients from the USAvisit Mexico and Thailand while the cost is the least in India ?

Ans. More than 5 lakh Americans travelled abroad for medical procedures in 2005.The following table shows that the maximum number of out-patients from the USA visitMexico and Thailand while the cost is the least in India.

Estimated annual number of medical tourists from the U.S.–'000s*

Approximate cost relative to the U.S.– per cent

*Estimates are rough, most patients are not trackedSource : Deloitte, Josef Woodman (consultant and author of Patients Without Borders)

70

60

50

40

30

20

10

0

Medical tourism by countryFive of the countries visited most often for medical treatment

Mexico Thailand Costa Rica India Singapore

Figure : Comparative Cost and medical tourism inselect countries-in comparison with the US.

The above table shows a comparison between the cost and number of patientsvisiting five different countries.

Maxico : The diagram clearly indicates that Mexico is the popular destination forUS out-patients. This is mainly for two reasons :

(i) The country is situated close to the USA.(ii) On an average, any treatment in Mexico costs 25% to 35% of the cost of the USA.

Thailand : This is the second most preferred destination for the US patients. It hasalso two main reasons :

(i) The average cost of any medical treatment in the country is about one-third ofthe USA.

(ii) The country has ideal locations for a relaxing holiday.India : While the cost is the least in India among these countries due to long

distance and pitfalls of the Indian medical tourism industry, the US out-patients preferto visit Mexico and Thailand.

The main market drivers for medical tourism are cost savings, comparable or betterquality care and shorter waiting periods.

The global market for medical tourism is estimated to be around $60 billion currently.In near future, it will touch the score of about $100 billion.


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14. Why do you think medical care is so cheap in India ?Ans. The cost of medical tourism is the lowest in India. On an average any treatment

in India can be done at only one-fifth of its cost in the USA. For example, the cost ofa heart surgery in India is $8,000 while in the USA., the surgery will cost $25,000 andin the UK. it costs $28,000. But, the question is—why is medical care so cheap in India ?This has the following reasons :

(i) Lower medical education cost : Medical education is cheaper in India thanthat in USA. and other developed countries of the world. So, doctors are available atlower salary resulting in cheaper medical care in India.

(ii) Huge number of medical and paramedical colleges : There are a largenumber of medical and paramedical colleges in India which add 30,000 doctors andnurses each year to the existing pool of 14 lakh doctors and nurses. So, doctors andnurses are easily available here.

(iii) Less Infrastructure and Insurance Cost : Infrastructures like education,health, power, buildings, transportation, communication, etc. cost less in India. So,overall cost for medical tourism is less in India.

In addition, the insurance cost for practising doctors is minimum in India. Thedoctors in USA require to pay medical malpractice insurance on an average $1,00,000annually.

(iv) No taxes on health care : Indian government focuses on to keep rules andregulation in costs of health care by proper laws. There is no tax in health care here.This avoids monopolistic approach for drugs.

(v) Free of cost treatment in Government hospitals : Government hospitals inIndia offer medical treatments free of cost. These treatments include even critical cares.These hospitals provide medicines free of costs also. Therefore, private sector hospitalshave to keep the overall cost affordable. Otherwise, only affluent people may prefermedical treatment to these hospitals.

(vi) Competition within private hospitals : In order to attract the patients,private hospitals offer very attractive packages. So, there is competition within privatehospitals. So, in order to sustain in the market, hospitals have to keep competitive pricesfor medical treatment.

All these factors are responsible for lower costs of medical treatment in India.

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