Friday, November 19, 2010

Has Manmohan missed the boat

Six years ago, a momentous event took place in the history of our nation. We are still struggling to understand the reason why Sonia Gandhi plucked one Mr. Manmohan Singh out of relative obscurity to make him the leader of the largest democracy in the world. Agreed he had a red-lettered history. Losing his mother at an early age had not deterred him from academic excellence which had brought him honours from the Mecca of world education - Oxbridge. A steady rise up the ranks of Indian bureaucracy had seen him ascend to the Governorship of the Reserve Bank in the early 1980s and from there to be Deputy Chairman of the Planning Commission. But it was the masterstroke of P.V. Narasimha Rao in 1991 to buck the tradition of political Finance minister appointments and hand him the reins of an economy that was plunging into bankruptcy. His ambitious and unprecedented reforms paved the way for India's emergence as an economic powerhouse and cemented Manmohan's place in Indian history.

But all this had certainly not prepared the country for its first apolitical Prime Minister. So when Sonia Gandhi silenced all her detractors in one fell swoop by entrusting the government to Mr. Singh, the whole country was bemused. The opposition parties, whose main election plank was Sonia's origins were thrown into a disarray that they never fully recovered from throughout Manmohan's first term in office. Of course, there were questions on everyone's mind. Could this fine, upstanding man, who only fault was that he had never won an election, lead this great nation with all its potential and yet, all its contradictions. Many a great man and woman had been felled by this giant. But amidst the consternation, there was general rejoicing. The appointment of a technocrat as the head of the country with the fourth largest purchasing power in the world was hailed by the media and the common man alike. And the icing on the cake was, as the BBC put it, that he 'enjoyed massive popular support, not least because he was seen by many as a clean politician untouched by the taint of corruption that has run through many Indian administrations'.

In the light of the unfolding events of the last few months, Mr. Singh can no longer hide behind his reputation. In the past, through every scam and every scandal, not even his most vitriolic foes would even think of pointing a finger at him. But today, it is the Supreme Court that has passed judgement. And the people and their representatives in the opposition are at last asking for an explanation. As possibly the greatest thefts in the history of mankind were being played out under his nose, why did he remain silent? How could he allow the perpetrators to get away with the wanton rape of our country's exchequer? How could do nothing as Mr. Kalmadi and Mr. Raja committed these crimes with impunity? How could he allow a host of government spokespersons to yell shallow defenses for these crimes till they were hoarse, while knowing all the time that there was some truth to the accusations? How could he allow a reputation built over a lifetime of selfless service be washed away by colleagues with no scruples or integrity? And worst of all, how could he betray the trust of the Indian people who looked to him and his government to clean out the Augean stables of corruption, not fill them?

Mr. Manmohan Singh had everything going for him. With good governance, he could have cemented the position of his party at the helm of Indian affairs for some time to come. But it seems that our great country of contradictions has taken another victim. The opposition has something to shout about. And the people may not find it easy to forgive. And just like that, our dreams of an India where governance and integrity go hand in hand may have to be put off by a few generations.

India needs you Mr. Singh. Where else can we turn to find someone of your calibre and stature. But your silence has confused even your most ardent supporters. And we need to know the truth. So, will you come clean, Mr. Singh? Will you spell out the details of all that has taken place? Will you explain to us, your people, how these audacious crimes escaped your notice? And if they did not, will you apologise for having been silent for the sake of party and power? Will you ask forgiveness of the people you have betrayed? For therein may lie your salvation.

Thursday, November 18, 2010

Tributes to Santosh Benjamin

Throughout the world, family and friends mourn the passing of Santosh. One of his church members alerted me to some tributes to Santosh printed in the local paper (here and here). The secretary of his church paid him a moving tribute - We can never replace him but only learn from his example as a devoted husband; a proud father; a loving son; a respected Elder; an inspiring worship leader; a talented musician; a gifted preacher; a conscientious worker; an unassuming servant; a willing helper; a faithful follower of Jesus; a much loved and sorely missed Christian friend and brother. Let us continue to uphold Jennifer, the children and the extended family in prayer.

Wednesday, November 17, 2010

What is my response - Lessons from Sunitha Krishnan

I had a long chat today with a friend on some of the stuff I have been writing about recently. The question we were discussing was whether in today's world, it was possible to practically apply idealistic principles. From the time we are born most of us undergo a subtle indoctrination by the world that surrounds us that teaches us that money, possessions, power and comfort are the principal avenues for happiness. And since the pursuit of these virtues requires us to be motivated, driven and often selfish, caring for others, especially those on the margins, is called 'idealistic' and is deemed to difficult for 'normal' human beings. This is a question that I have wrestled with a lot recently - is it foolhardy to make risky decisions that benefit others but do not seem to have any personal benefit? My friend suggested a similar thought. Altruism and service are for the Mother Teresas of this world. Not for you and me.....

As I was thinking about this, I watched again an old TED video of Dr. Sunitha Krishnan, which is doing the rounds on facebook. I have been following her blog, so hearing her speak about what she does was a moving experience. And it gave me an answer to my question. Here was an ordinary woman, whose simplicity and passion are obvious, who is at the heart of an 'idealistic' crusade that any normal person would steer clear of. And her call to the technological and business bigwigs seated in the room was simple - don't just sit in the comfort of the air-conditioned hall and discuss these issues. Don't look for excuses to justify why you cannot respond to these issues. You don't need to be a Mother Teresa or a Mahatma Gandhi. In your limited circle, find at least one way you can respond.

The cry rings out loud and clear. In every place on earth, there is injustice. In every corner, there is someone who needs a helping hand. And in our country, the needs are so obvious that they do not need to be repeated. Do I have a response to that cry? It is a sobering thought. Time and tide wait for no man. And here I am, struggling to understand what my response can be.... I need Your wisdom and guidance, Oh Lord....

Sad news

Santosh Benjamin went to be with Jesus on Sunday. With sorrow we remember the family and uphold them. Please continue to pray for Jennifer who is being gradually weaned off the ventilator.

Tuesday, November 16, 2010

Please continue to pray

Please continue to remember Jennifer and Santosh Benjamin in your prayers. Jennifer is stable now though still in the ICU. Santosh is critically ill.

Monday, November 15, 2010

Daydreaming on Children's Day

Yesterday, India celebrated Children's day and the papers this morning were filled with pictures and articles of competitions and activities organised for children by various groups. It was a good way to remember our first Prime Minister and also to celebrate the joy that children bring to our lives and community. I remember at school, Childrens Day was the day of the fancy dress competition followed by the rest of the day off (which was the best part!). So this morning as I read through the newspapers, my mind took off on a train of thought starting from the fun days of my own childhood and then moving on to the uplifting joy some of the dear children I had interacted with recently had brought to me. How wonderful childhood is. And how special for children to be brought up in a home where God is given the central place.....

And that would have been the end of my remembrance of Childrens Day, but for 2 gentle reminders that came during the day. The first was when I watched the movie August Rush. Having set for myself a strict schedule during this time (which I am often unable to follow!), I had not watched a movie for a long time and was complaining as such to my mother. So she in her kindness, rustled up this movie from a friend and by coincidence I watched it today. It is the moving story of a young boy who is separated from his parents at birth and grows up in an orphanage. Running away from there at around 12, he settles into a life on the street with a group of other children who play music in parks to enrich the pockets of the 'Wizard'. As all good movies should, this one has a fairytale ending, but for me, it was a clear reminder of the one-sidedness of my morning's daydream. The childhood I had and that most of the children I know have is by no means a universal reality. For some, childhood is a story of abandonment, loneliness and despair....

And when I began my computer time for the day, the first article that caught my eye was this one, a story of the children who do not have the luxury of a holiday on Children's Day. The ones who will not take part in any fancy dress or painting competition. The ones who spend Children's Day working for their daily bread, just like every other day of the year. Doing menial labour, often in conditions unfit even for an adult.

I did not do too much more reading today. I had a darker daydream to match the thunder and rain outside. As my mind saw the children to whom life has dealt a different hand than mine. The boy in the dhabha who clears away the plates. The girl on the road selling jasmine flowers. The boy at the traffic signal who wants to wipe your windscreen. The girl at the railway station begging for alms. The boy in the cracker factory slaving away in inhuman conditions. The girl sold to a madam at the age of 12.... Sold to a life of unimaginable trauma.

We live in a country where these little ones are everywhere. And yet, I find it so easy to forget them. To push them to the back of my mind, from where they will find it difficult to trouble me with their memory. Rather, I rationalise. I say that I, with so little time and resources, can do nothing. And so I assuage my guilt.

Dear Lord, I am guilty. Forgive me. And show me how I can show Your love in some small way to these dear little ones. Whom You love as much as You love me

Saturday, November 13, 2010

A prayer for friends

I received some terrible news today. Of an accident that has left 2 of my friends in a serious condition in the UK. They have suffered severe internal injuries due to smoke inhalation in a fire at their home. Please remember Jennifer and Santosh Benjamin in your prayers. They are both in ICU and Santosh especially is very ill. The news report of the incident is here. Another of my younger friends has been diagnosed with metastatic cancer. We specially remember our dear ones and ask God for His favour.....

Thursday, November 11, 2010

Quo Vadis, Doctor, Quo Vadis?

The young lady was brought to the small hospital in Jharkhand gasping for breath 2 hours after she had been bitten by a snake. She was quickly intubated and given the life-saving Anti-snake venom antitoxin. For the next 2 days, the junior doctor manually ventilated her round the clock as she slowly recovered. Her hand that had received the bite developed fasciitis and required a debridement. But after a week, she was ready to go home. Her bill, after heavy discounting came to Rs. 1500, mainly for the medicines that needed to be replaced. After a day, the husband brought in the money to pay the bill. Out of interest, the doctor asked him how he found the money. He said he had taken a loan from the moneylender. And the interest – Rs.10 for every Rs.100, every month. 120% annual interest. The young doctor was horrified – that was a life sentence. With the enthusiasm and altruism of youth, he offered to pay the money which could be returned to him if and when possible. But the farmer was resolute. He said it was actually a good bargain. He would never be able to repay the loan, but he would be able to work on the moneylender’s farm for the rest of his life and be sure of at least a meal a day. And when his young son was little older, he too could work and this way, his family would be secure…… For the sake of a medical bill he signed away his family into a lifetime of bonded labour.

This is a true story. It is no one-off event. It is repeated nearly every day in the villages of our country, where decades of suppression and government apathy have created a feudal system that would be unthinkable in a modern, educated society. A system that has bled the poor to feed the rich. A system that has sparked the rise of a violent movement that, according to our home minister, is the greatest threat to our national integrity. A system that is due, at least in some degree, to the corruption and avarice of those whose vocation it is to serve – our doctors.

A survey by Transparency International found that after the police, healthcare was the most corrupt service sector in India with a quarter of the respondents having paid bribes to access health services. The key culprits were, not surprisingly, the doctors (77%). We have all read in great detail of the unbelievable corruption that has claimed (for the time being, at least), the head of the chief regulatory body of Indian doctors. But then, he was arrested for corruption in 2001 and came back, winning the MCI election again. The astronomical amounts that buy undergraduate and post-graduate seats in the medical colleges of our country only rise every year. India is the world’s biggest bazaar for human organs. And every new government initiative in health care is quickly and confidently hijacked by our doctors to work for their monetary benefit. In short, our health system has fine-tuned itself to greatly benefit one group of people – the doctors.

And this is no secret. Every patient who goes to a doctor goes with mixed emotions. There is always hope – that the doctor will find the cause of the problem and treat it. But there is also fear – of the possibly unnecessary investigations, procedures and medicines that the doctor will order, knowing that every stroke of his or her pen is directly translated to some personal perk or benefit. The rich have no problem with this system. As with every form of corruption, it is the poor who suffer. Official statistics indicate that about 20,000 farmers have committed suicide since 1997 with poverty being the root cause in most cases. And the World Bank has estimated that one-fourth of all patients admitted to a hospital in India are pushed into poverty by this ‘catastrophic’ medical event. Studies done in random villages of Rajasthan, Gujarat and Andhra Pradesh found health-care expenditure being the cause for falling into poverty in 55%, 85% and 77% of respondents respectively. Health care for the poor in India has become a double-edged sword. Not having it is a denial of one’s rights, but having it is detrimental to the well-being of the household – the ‘medical poverty trap’. And often, health costs are driven steadily upwards by the constant search of health care professionals for higher profits and a better life, a situation that is easily exploited by health care companies and pharmaceuticals. The Hippocratic Oath often becomes a big hypocrisy.

Hippocrates refusing gifts of Artaxerxes the king

In today’s world, there are 2 forces that drive our doctors. The more common one is the monetary drive, where decisions of health practice are driven by the higher salary, cut or perk. The more acceptable one is the drive for excellence, be it professional or academic. But there is a third drive – that is often forgotten. In our dedication to either monetary gain or professional advancement (or both), we often subdue the drive that should be given primary importance by anyone who has sworn the Hippocratic Oath – the drive of service. But service is often pushed to the back of our mind during our medical education and practice. The number of doctors even from Christian medical colleges who serve in ‘areas of need’ are so few and far between.

When Nero was burning the Jews at stake in full view of the whole population, including the distinguished leaders of all the conquered kingdoms, when Hitler was exterminating the Jews with implicit knowledge of the Christian church and the educated population of Germany, it was the silence of those who knew better that allowed them to perpetuate these abominations against humanity. And today, many of us doctors participate in a system that is designed to make us richer and the poor, poorer. When Peter was running away from probable crucifixion in Rome at the height of Nero’s persecution, an apocryphal story tells that just outside the city, he met Jesus walking back to Rome to take Peter’s place. And the question he was asked is the one we are asked today – Quo Vadis, Petros, Quo Vadis? Whither goest thou, Peter?

Quo Vadis, doctor? Our country desperately needs more health professionals who will respond to the need and heed the cry of the millions of Indians who suffer under the yoke that the medical system places on them. Men and women of character, who have the courage of conviction to stand against the tide and make a difference like Dr. AK Tharien, Drs. Raj and Mabel Arole, Drs. Abhay and Rani Bang and so many others. The issues are not always so simplistic, but we need to make a start somewhere. Individual decisions need to be made until, over time, we reach the ‘tipping point’ when the flow of health care service will turn from being doctor-centric to patient-centric. It sounds impossible given the present situation, but that day will surely come. And it could start with you and me.

A young doctor stood at the bedside of a patient. This man had survived a major emergency operation in spite of a host of complications. He and his young daughter were extremely grateful to the doctor, but were pleading for a reduction in his bill. The young man took the plea to his boss, but was refused. The next day, the patient was gone, bill paid. Nine months later, the doctor saw his patient again. He had come for the birth of his daughter’s first child. The doctor was confused, remembering the beautiful young girl who had begged for a bill reduction. ‘But I thought she was unmarried,’ he said. ‘She is,’ replied the man, with a bowed head. ‘I sold her virginity to pay my bill.’

This is a true story. Quo Vadis, doctor? Quo Vadis?

References

[1] Sanjay Kumar. ‘Healthcare is among the most corrupt services in India.’ BMJ 2003; 326 : 10 doi: 10.1136/bmj.326.7379.10/c (Published 4 January 2003)
[2] Peters , DH, Yazbeck , AS , Sharma, RR, Ramana, GNV, Pritchett, LH and Wagstaff, A (2002), 'Better Health Systems for India 's Poor. Findings, Analysis and Options', Washington DC, The World Bank
[3] Krishna , A (2003a), 'Falling into Poverty: Other Side of Poverty Reduction', Economic and Political Weekly , February
[4] Krishna, A, Kapila, M, Porwal, M, and Singh, V (2003b), 'Falling into Poverty in a High-Growth State: Escaping Poverty and Becoming Poor in Gujarat Villages',Economic and Political Weekly , December 6, pp 5171-5179
[5] Krishna , A, Kapila, M, Pathak, S, Porwal, M, Singh, K, and Singh, V (2004), 'Falling into Poverty in Villages of Andhra Pradesh: Why Poverty Avoidance Policies are Needed', Economic and Political Weekly , July 17, pp 3249-3256
[6] Whitehead , M, Dahlgren, G, and Evans T (2001), 'Equity and Health Sector Reforms: Can Low-income Countries Escape the Medical Poverty Trap?', The Lancet , Vol 358, September, 833-36
[7] Malcolm Gladwell. ‘The Tipping Point’. Abacus, 2000.

(The edited version of this article was published in Current Medical Issues (hence the references!), the journal of the Continuing Medical Education department at CME, Vellore this month - my mother's farewell issue. She has done a wonderful job of revamping and editing the journal since 2003 and has begun the process to get it indexed)

Saturday, November 6, 2010

Is India rich or poor?

UN HUMAN DEVELOPMENT REPORT 2010: The UNHDR 2010 was released on the 4th of November. Where does India stand? On the Human Development Index, we occupy the 119th spot (out of 169). There has been an improvement of one solitary position (!!) over the last 5 years. We rank below our neighbours, Pakistan and Bangladesh in education (average time spent in school is 4.4 years compared to Pakistan - 4.9) and health (life expectancy 64 versus 67 in Pakistan and Bangladesh). But India has secured the 10th position in the area of improvement of the income index!! In a nation where there are 421 poor people in just eight states, more than the 26 poorest African nations combined - 410 million. We also score 122nd among 138 countries in gender inequality. Generally not a good report card......

2 HINDUSTANS: So how can our income, GDP and economy be going up when there are so many poor people? The mystery man of Indian politics, Rahul Gandhi (or as Lalloo and Sharad Yadav call him - baccha/babua!!), made an interesting observation in an impromptu speech to the AICC meet. 'There are two Hindustans -- one is growing very fast and the other is for the poor (which is in crisis).... We have to connect and unite the two.' He has been doing some interesting things over the last few years, like riding a local train in Mumbai, regularly breaking his security cordon to meet poor people, secretly riding a second-class compartment from Gorakhpur to Maharashtra (with a visit to the unreserved compartment on the way) and meeting students in colleges over the country encouraging them to join politics. It seems he has done some research before making this observation.

WHERE THE MONEY IS GOING: The 2008 Swiss Bank Association report had an interesting finding. The country which has 1/3rd of the global poor also has the maximum amount of money stashed in Swiss bank accounts!! Nearly 2 trillion dollars of it! A large percentage of which must be black...The top 5 stashers are
India ---- $1891 billion
Russia----- $610 billion
China ----- $213 billion
UK ----- $210 billion
Ukraine---- $140 billion
Rest of the world ----$300 billion

AND WHAT'S LEFT GOES TO...: Certainly not the poor!! It seems that a lot of money goes to the world's superpower - Obamaland!! India is now the second fastest growing investor in the United States after the United Arab Emirates!! As for the 42% of Indians below the international poverty line, let's just forget about them for the moment, shall we......

Wednesday, November 3, 2010

Adarsh Society Scam - So what's new?

At the risk of sounding cynical, I really think this latest ruckus is just much ado about nothing new. So some politicians and bureaucrats decided they needed new houses in the heart of our financial capital. So they went about doing it in the same way that most politicians and bureaucrats get anything that they want. Blatantly use the government machinery. Just like our brothers in the CWG Organising Committee. Who made enough money to feed the next three generations through this one event!! But corruption is a character which has run through our veins since Independence and before. Every Indian who needs something done in any area of life is likely to have been exposed to it in some form or the other. So what makes the crimes of the CWGOC and Mumbai's finest worse than the usual steady corruption that goes on throughout our country? What makes the press and the public rise up in protest at something that is a way of life in this great nation of ours? What Lakshman Rekha has been crossed that has given strength to the protests and will allow (hopefully) the culprits to be brought to book?

The tentacles of corruption insinuate themselves into every aspect of life in this land but the Adarsh Society Scam has insulted the basic decency of the nation by touching a raw nerve of our country. The culprits have swindled the families of the Kargil martyrs. The heroes who have given their lives to protect our nation's integrity have been bespoiled. And so blatantly! Imagine the reckless dishonesty that can subvert justice in such a public matter with such impunity. So there is public outcry and the chance that the culprits will be brought to book. And in the case of the CWGOC, it was the dignity of our country that was affronted. When the astronomical scale of organised corruption shocked the world and shamed the nation.

But the root of the problem still remains. These branches that have become so obvious because of their blatant scale and because they have struck at the sensibilities of our nation are but the tip of the iceberg. Corruption has grown deep into our nation's soul and uprooting it will mean a loss of even some of the good things. And what is worse, it will cause great pain to the ones who make it their mission to strike at the root of the tree. Nearly every major corruption scandal in the past has ended with the prime culprits either escaping scot-free or serving small jail terms and often returning to their public offices as powerful as ever. And more often than not, the whistle-blowers and the honest men and women who agreed to testify to the truth have been traumatised by the proceedings and their aftermath and in some cases even killed.

And the huge scandals which break every now and then are but the periferal branches. The trunk and root lies with you and me. The corruption that starts with every small bribe we pay to the ticket collector on the train, the clerk in the transport office, the passport officer, the land bureaucrat, the policeman and every small-time government servant on whom we depend for so many of our activities. I remember the story of my friend in a mission hospital in Uttar Pradesh. The hospital refused to pay the officer in the Electricity Board a bribe. He promptly cut the electricity and for about 3 months in the peak of summer, the hospital managed with a few hours of electricity from the generator every day. After 3 months of daily prayer for respite, the officer was transferred and electricity restored. That is the price we will have to pay for taking a stand. It will not be easy and will certainly cost us something. But in the long run, there will be a 'tipping point' reached - when corruption will at last be seen by the majority for the evil that it is. But until that point it is for the individuals with courage to stand against the tide. Scams like the Adarsh Society will keep popping up. Thousands more will remain unheard of. But the root of corruption can be weeded out only by individuals. Like you and me.

Monday, November 1, 2010

Linkorama 1/11/10

THE DRIVERLESS CAR: Google is progressing rapidly from being just your favourite search engine. It's latest innovation that has been buzzing round the blogosphere is an automatic car - that's automatically driven! It has already been tested with good results over 140,000 miles on busy roads. Click on the pic to enlarge. (HT: SMMJ)


WHAT HAPPENS AT AN ATHEISTS CONFERENCE:
We have a new religion folks - if the main criterion for a religion is that there be a difference of opinion!! When 370 aethist leaders got together, they could not decide whether they should be 'fundamental' or 'liberal'! Sounds familiar?! To Christians?! (HT:IM)

FOR THE MATHEMATICALLY INCLINED: An interesting problem I came across - any takers with the solution? For the least math inclined, 8x8=64 and 13x5=65
picture of math puzzle

COMPETETIVE ADVERTISING: An interesting sequence of ads that reminds me of the Cola Wars of the 90s. Their order of appearance was from below upwards when Jet changed their uniforms! (HT: Freakonomics)