Know Your India

Mahendra · Post by **Mahendra** » 02 Jan 2010 01:25

RamaY Ji

500 students in a medical college with a attached 200 bed hospital

No-No!

I doubt there are more than a handful of Medical Colleges in India with an intake of >200

Continue in Education thread?

Virupaksha · Post by **Virupaksha** » 02 Jan 2010 01:43

Ramay,

Your cost calculations are very very much on the lower side. I know of a private engineering university which has decent infrastructure in around 50 acre campus---> approximately the same number of buildings for another medical college I saw and the initial project cost of the engg was around 200 crore.

For example, take the cost of setting up of IITs. Its said to be around 3000 crores. Heck the running costs which govt gives each iit every year is around 90-130 crore.

shiv · Post by **shiv** » 02 Jan 2010 07:12

It's not just about building more and more expensive medical colleges to train doctors who are fit for working in the west.

The system of medicine we teach in our medical colleges is unsuitable for India. Indian doctors and that includes me are only good for manning Western hospitals. We are not taught the most fundamental things about the Indian ethos and the way Indians see health and disease. Part of the problem is that allopathic medicine is very effective - but does not teach things that are appropriate for India.

No matter how competent they may be Indian doctors are Macaulay number one because they were taught by teachers and from books that were not written taking into consideration 3000 years of Indian medical knowledge (and the consequent Indian societal beliefs) the etchers of our teachers were Brits who knew little of local beliefs that play a massive role in health and disease.

Of course the real learning about India comes long after graduation, but that does not translate into changing the system of learning to include Indian beliefs. India has taken the easy route of claiming to maintain heritage by keeping a separate parallel system of Ayurvedic medicine alive. Ayurvedic doctors and Allopathic doctors are often able to understand each others strengths perfectly well but each is thoroughly ignorant of the other and one tends to make a lot more money from Allopathy. Allopathy is of course supremely effective over areas where Ayurveda does not appear to work, but nobody is doing any research to find a meeting point. India is showing profound stupidity because the powers that be of medicine are doing nothing about this and individual doctors who spend the first ten years of their professional lives earning a pittance then spend the rest of their lives raking it in and earning deep respect. Who would then rock the boat? And who can rock the boat when the entire boat consists of people like yourself? Any layman who tries to rock the medical boat is putting himself in deep trouble. He only has to see a bit of blood with his crap after which his boat rocking will stop pronto. The medical profession in India has to see the light from within.

Karna_A · Post by **Karna_A** » 02 Jan 2010 08:55

The system of medicine practiced in US is also unsuitable for US. Its just too expensive as its 99.99% allopathy.
Its only now that alternate medicine is being investigated by Top US Medical colleges.
http://www.hopkinsmedicine.org/cam/

My proposal is to have create joint Allopathic/Alternate medicine clinics in US as well as India.
If a patient enters and is found to be more suitable for acupuncture, he should be directed to the suitable doctor in clinic. Same with ayurvedic, homeopathic and allopathy medicines.
Some pains are better handled by acupuncture at very reduced costs and after effects.
Some other diseases are better handled in allopathy.

This will create a healthy sustainable system and hence a healthy country.

shiv wrote:
The system of medicine we teach in our medical colleges is unsuitable for India. Indian doctors and that includes me are only good for manning Western hospitals. We are not taught the most fundamental things about the Indian ethos and the way Indians see health and disease. Part of the problem is that allopathic medicine is very effective - but does not teach things that are appropriate for India.

.

ShauryaT · Post by **ShauryaT** » 02 Jan 2010 09:03

Just a question, was not the Indian system designed to fast breed just "good enough" Doctors for the seriously deprived health care system for the India of the 1950's?

vera_k · Post by **vera_k** » 02 Jan 2010 10:55

So my solution is premised on 3 assumptions.

A. It has to start showing results within 10 years. MBBS doctors take too long to train to meet this goal.

B. Has to work for the rural areas. Urban students can not be made to work in rural areas as the economics does not work out.

C. Should accomodate existing interests to minimise backlash. Therefore borrows from the existing American model.

1. Introduce Physician Assistant courses of 2 years duration. Course can be taken up by anyone who studied Physics, Chemistry, Biology in 12th std following an initial college degree. Those who did not study PCB in 12th should be allowed to take 1 year of preparatory courses after college prior to studying for Physician's Assistant course.

2. PAs who have not worked in healthcare prior to enrollment should practise for 1 year with an existing doctor. Allow Physician's Assistants to prescribe medicines and practise by themselves in locations where a MBBS doctor is not available. For cases where the PA needs supervision of a doctor, allow such supervision using remote conferencing and call center technologies (VSAT terminals, video conferencing, telephone). The government should create call centers employing doctors for remote consults.

3. Possibly allow PAs to study towards a MBBS degree after working for 5 years in their field. There may be capacity issues here if teachers are not available.

4. This can also work for Physical Therapy Assistants with the Assistant implementing treatments specified by a Therapist who visits the clinic once a week.

5. Colleges for these courses should be in rural areas to make the economics work. It is nearly impossible to satisfy an urban student's wage demands when he or she first takes up his job (if ever).

6. The government should either provide these assistants with a full clinic (EKG, Ultrasound, XRay, etc) or should give 0% loans for equipment purchases in case these people are not employed by the government.

shiv · Post by **shiv** » 02 Jan 2010 16:07

I think one needs to understand Indian society before talking of "doctors". The title "doctor" is so respected in Indian society that people like actor Vishnuvardhan who died 3 days ago in Mysore have been conferred with the honorary title "Dr" and is referred to as Dr. Vishnuvardhan.

It is my firm belief that it would be a wrong move to create a "second lower tier" of "Doctors". The plan will fail - Indians will instantly recognise the trick and start shunning the lower tier and soon even students will not join the second tier training courses.

What should be done is to create a second tier of "Nurse practitioners" who are qualified to see and treat a specific range of conditions while being able to recognise what needs to be seen by a specialist doctor. Already, nursing colleges are a dime a dozen. Upgrade them, increase the course length by a year and churn out qualified practitioners.

On the other side - the MBBS degree should be done away with and any student entering medical college should come out with some sort of speciality degree from a 6 or 7 year training program in which he actually earns while he works and trains after 4 years or so,

Giving a rural posting is the most idioticest crappiest idea a netababu peabrain can come up with. It has never worked an will never work simply because it is like making airline pilots man bullock carts for 2 years. You train a guy (or a chick) to work with sophisticated machines and high tech biochem investigations and medicines and then throw him in a dusty shack with desperately poor patients, no facilities and no medicines - you are creating the formula for GIGO. But we are a nation that has some highly aware and educated people mixed up with 99% blind and unaware people whose intentions may be noble but whose ability to see what is what in this world is limited.

shiv · Post by **shiv** » 02 Jan 2010 16:11

ShauryaT wrote:Just a question, was not the Indian system designed to fast breed just "good enough" Doctors for the seriously deprived health care system for the India of the 1950's?

Perhaps this is true I don't know. But medicine has moved on since the 50s, not the system.

niran · Post by **niran** » 02 Jan 2010 17:37

Karna_A wrote:
My proposal is to have create joint Allopathic/Alternate medicine clinics in US as well as India.
If a patient enters and is found to be more suitable for acupuncture, he should be directed to the suitable doctor in clinic. Same with ayurvedic, homeopathic and allopathy medicines.
Some pains are better handled by acupuncture at very reduced costs and after effects.
Some other diseases are better handled in allopathy.

This will create a healthy sustainable system and hence a healthy country.

Saarji. one elementary question
-Who will decide, who goes where, in your system ?
Answer, some one at the front desk screening, right?
then this person will have to be knowledgeable in Acupuncture(which is Yunani)
Ayurvedic medicine, and Allopathic medicine, correct?
i think you should be able to deduce yourself, it is a no go.

i have experience working with 3.5 year Dakter(from PRC and Vietnam)
and regular Daktors (Thai, American, British and Germans)

the 3.5 year- just this, i will not trust a House fly in their hands let alone a Human.

shiv · Post by **shiv** » 02 Jan 2010 18:05

600 million in India lack toilets (and yet this paper printed some Paki crap - OT see Paki thread)
http://timesofindia.indiatimes.com/indi ... 246171.cms

Embarrassment means women and girls often wait all day until it is dark to go to the toilet, increasing their chances of infections and exposing them to violence or even snake bites as they seek out remote places.

In this connection, here is an excellent article by Bindeshwar Pathak, founder of Sulabh Shouchalaya

History of Public Toilets
http://www.plumbingworld.com/toilethistoryindia.html

In 1970, realizing that sewerage facilities will remain out of the reach of the society at large, Sulabh International introduced a pioneer technology twin pourflush latrines and human excreta based Biogas plants. We have constructed in the last 25 years over 650,000 toilet cum bath complexes and 62 human excreta based biogas plants and are maintaining them. I believe this gives an appropriate solution to dispose of and recycle human waste into fertilizer, electricity and working gas.

shiv · Post by **shiv** » 02 Jan 2010 18:18

For those who may not know, bacteria, viruses and other agents causing infections are often spread by what is called in medical circles as the "fecal-oral" route, that is, the bacteria, virus or eggs of worms are excreted in the feces, and that feces ends up contaminating the food - usually the water supply leading to infections and deaths. Most diseases that cause diarrhea are spread this way and diarrhea is a big killer.

Among the diseases that you get from a fecal oral route are Cholera, Typhoid, jaundice and worm infestations and a host of other less well recognized, more exotic, but nevertheless killer diseases.

Here is a related article:

http://www.who.int/mediacentre/multimed ... index.html

The World Bank estimates 21% of communicable diseases in India are water related. Of these diseases, diarrhoea alone killed over 700,000 Indians in 1999 (estimated) – over 1,600 deaths each day. The highest mortality from diarrhoea is in children under the age of five, highlighting an urgent need for focused interventions to prevent diarrhoeal disease in this age group.

Despite investments in water and sanitation infrastructure, many low-income communities in India and other developing countries continue to lack access to safe drinking water. Regardless of the initial water quality, widespread unhygienic practices during water collection and storage, poor hand washing and limited access to sanitation facilities perpetuate the transmission of diarrhoea-causing germs through the faecal-oral route.

brihaspati · Post by **brihaspati** » 02 Jan 2010 19:28

Reforming the medical sector in India is going to be a very tricky business, and there are areas Shiv ji has not even touched which can be serious spanners in the wheel of any reform.

We can divide up the system into three essential components from the service side :
(1) the medical professional
(2) the infrastructure for providing service
(3) material input, production and supply

We have typically looked at (1) either from the purely economic angle, or from political angle, and sometimes from so-called ethical angles. But my personal impression has been that we may need to change that view towards a "social investment" one, and see it in the context of developing "sustainable and self-sufficient communities".

I would coin the abbreviation MP for this post only - meaning "Medical Professional". A MP can lie at various points on a spectrum of skill and specialization, and includes those usually called "nurse", "paramedics", "medical technician", and "doctors". The problem of creating MP's appropriate for the population is micro-reflection of the overall vision problems for the society. In spite of various policy declarations, the basic task of creation of MP's has been left in the hands of market forces, and has not been looked at from the "national and social investment" angle. MP's should be treated as a national and social investment for national and social future. This does mean a degree of intervention in the market forces.

If all of this is left to the market, MP production will be geared towards pure monetary profit. People with money would buy seats for training. Medical schools will auction training slots. Investments will pour in where there is proven record of profits, and therefore already having huge investments. This automatically leads to concentration of production facilities at well known urban centres, and is intricately linked to similar high-investment and capital-intensive infrastructure. This will in turn lead to intensive profit seeking from the MP's once they graduate.

One way of trying to change this is to think of a National Health Service of India. The NHSI will have a "social contract" and have preferential and legal rights to intervene in (2) and (3). It should have a charter of service to be given to citizens, and in return a guarantee of a minimal proportion of the GNP. It should be subject to supervision and audit by an independent autonomous body of a mixture of experts and professionals as well as with direct or indirect electoral representation (e.g. Parliamentarians+Scientists+retired MP's+economists+non-national experts).

NHSI should
(1) formulate policies for producing MP's, project future needs and set quotas accordingly (it should not be that difficult to estimate needs at the beginning of training programme as to what the demand for MPS's will be at the end of the programme).
(2) Students should be selected strictly by an aptitude test and all tarining costs to be maintained by the NHSI. They should also be paid a maintenance stipend and any residential support needed. In return, students will be under contract to NHSI to take up service with NHSI. There can be povisions for future changes in contract and compensation as and when qualifications or circumstances change.
(3) training should be adequate with a minimal foundational training that qualifies all in the programme to be able to perform a minimal agreed set of services (say at the level of a fully qualified nurse under current practice), and with exit routes at a small number of various levels after that foundational qualification.
(4) the minimal training must take into account public health perspectives, a national "health vision", and indigenous techniques and medical knowledge with a systematic and non-hostile exposure to alternatives to allopathy. (Shiv ji must be aware of the deep seated bias against the alternatives within the training system, as well as inherent difficulties in aligning the basic attitudes/theories in the alternative forms with those of modern physiological and biochemical research).
(5) Part of the training should be distributed away from established urban centres to newly developed or developing centres on a rotational basis. This is linked to another aspect of NHSI that has to be discussed under infrastructure.

Infrastructure

(6) The whole country should be divided up into medical districts where, NHSI must provide a minimal number of MP's per unit chunk of population, with corresponding infrastructure.
(7) Infrastructure has to be based on distance and accessibility from individual to service provider. This would necessarily concentrate the upper levels of specialization pyramid at smaller number of centres with the lower tier distributed in larger numbers in awide dispersal method. The centres of increasing specialization should not necessarily c)oincide with existing large urban sprawls - but more on coverage. Each centre should be able to digitally connect to larger centres immediately and have image or live audio-visual transfer capabilities - so that the "triage" system can work up from the remotest "outpost".
(8) NHSI will have its own labour laws that recognizes right to negotiate on the part of employees through organized or individual channels, but will not recognize industrial action as a right. Health should be declared a special category service exempt from ordinary labour laws. Administration must have the right to take action on spot for dereliction of duty or insubordination which can only be challenged in special tribunals and not through the regular legal system (at least until RM's proposed reforms seem to work!)
(9) NHSI should have its own security service, and MP's should be able to avail of such security services (tempted to consider RM's proposal for right to carry firearms for MP's

)
(10) MP's should be prepared to be posted anywhere within the system, commensurate with their qualifications and experience. In return, NHSI will provide all supporting infrastructure for the MP and dependents.
(11) The guaranteed support of portion of GNP should be balanced by a NHSI run national health insurance, compulsory for all citizens. This must contain incentives towards smaller families, and adoption of proven health enhancing practices.
(12) NHSI should have rights to set and intervene in public health programmes and infrastructure development.

The trickiest part is the "material input" bit and the greatest source of corruption and market greed. My experience says that one of the greatest obstacles to reform will come from this sector. NHSI should have its own pharmaceuticals and medical supplies production facilities as well as unified supervised medical waste disposal. The GOI should also setup multiple competing independent public limited pharmaceuticals who will have binding contracts to provide preferential supplies to NHSI and NHSI should hold a significant interest in their stocks. These production facilities hsould be distribued around the country and allowed to compete with each over marketing their surplus (after satisfying NHSI demands).

shiv · Post by **shiv** » 02 Jan 2010 19:41

Just a little comment as this thread fills up.

I have been "studying" some of these parameters for over 3 decades now and looking at the figures I am finding actually makes me happy.

I would be lying if I did not say that India has done a remarkably good job of improving a raped and discarded country. One day I want to sit and arrive at actual figures but even at a glance India has, in that last 50 years provided education and development to more people than anyone else in the world.

But that is not necessarily a cause for rejoicing. We have a long lo-oong way to go. We must all be aware of how far we need to go and be acutely conscious of our duty to the nation. Most people don't even know what problems we face because the country is too vast. The fact that other countries are bigger does not make India less vast and its human burden is far higher than anyone else. As wrote in my Pak book, Pakistan could have raced ahead of us in human development parameters. But it has goes the other way India is ahead - esentailly meaning that India has done a ten times bigger job than Pakistan on a 7 times bigger population

But still awareness of our problems is essential. The terrible conditions that our 70% rural Indians have to face goes unnoticed by most.

http://www.allacademic.com//meta/p_mla_ ... 7182-1.php

The Cost of Cooking The Impact of Bio-fuel use on women’s lives in rural India Mitali Sen and Douglas F. Barnes
All over the developing world, the free availability of biofuels from nature makes themthe primary fuel source for domestic purposes. The increasing use of biofuels in regionswith local shortages of trees has a detrimental impact not only on the local environment,but also on women and children’s health and life. Women tend to be the managers ofthese fuels since they are primarily responsible for collecting and using it for cooking andheating water in the household.
...
For India, one of the first studies to recognize the impact of the fuel wood crisis on women was reported by Bina Agarwal (1986), who documents the hours women spend on collecting fuel on a daily basis. She implicates various developmental projects that lead to severe deforestation. As forests were cleared for the expansion of railways,pastures, mining, industries and agriculture, access to wood became scarce. She report sthat in the severely depleted forest areas of Gujarat, women and children spend as much as five hours a day collecting fuel. Reviewing various studies on collection of firewood in India, she found that the distance traveled averaged between 4 to 10 kilometers in search of firewood, depending on the ecological environment.

In forested areas, the collection may have been done once in 4 days, while in depleted areas it was a daily activity. Since wood is the predominant fuel used for cooking and fuel collection is a woman’s responsibility in most of the developing world, the implications for their well being are serious. Apart from the drudgery, the time and effort spent collecting fuel limits their opportunity to spend time on income generating activities or educational and leisure pursuits. More recently studies on traditional stoves using biomass fuels have examined the health impact on women exposed to continuous smoke whilst cooking. The prolonged exposure to respirable suspended particles and carbon monoxide has been found to have severe detrimental effects on the lungs and eyes of anybody in the proximity to such stoves.

vera_k · Post by **vera_k** » 02 Jan 2010 23:05

shiv wrote:I think one needs to understand Indian society before talking of "doctors". The title "doctor" is so respected in Indian society that people like actor Vishnuvardhan who died 3 days ago in Mysore have been conferred with the honorary title "Dr" and is referred to as Dr. Vishnuvardhan.

It is my firm belief that it would be a wrong move to create a "second lower tier" of "Doctors". The plan will fail - Indians will instantly recognise the trick and start shunning the lower tier and soon even students will not join the second tier training courses.

What should be done is to create a second tier of "Nurse practitioners" who are qualified to see and treat a specific range of conditions while being able to recognise what needs to be seen by a specialist doctor. Already, nursing colleges are a dime a dozen. Upgrade them, increase the course length by a year and churn out qualified practitioners.

Both would be necessary because a nurse practitioner takes more time to train than a PA. If it helps, they don't have to have the Dr. title. Looking at the situation here in the US, people really don't care if their physician is a ARNP or a PA since a typical doctor's office will have all types of practitioners.

Even if it is a lower tier of doctor, it will be an improvement because in any case you have all types of unqualified and tangentially qualified (non-Allopathic) people working as allopathic doctors in India.

vera_k · Post by **vera_k** » 03 Jan 2010 04:49

Better communication of availability of help can avoid cases like this.

Maternal mortality in Gujarat

India's maternal mortality figures are among the highest in the world. The reasons for this are not hard to find.

When a pregnant woman, Vaishali (not her real name), died in a village in Gujarat, we decided to examine the circumstances that led to her death. We asked healthcare professionals and the sarpanch in the village if they could identify the events that caused her death. Not only were they clueless about the cause of Vaishali's death, they also showed no interest in discussing how such deaths could be prevented. Worse, it took them a month to report the death. It was only when we wrote to the district health officer that he ordered an autopsy. But this was two months after Vaishali died. We realised that if we wanted to know the circumstances that led to her death, we would have to speak directly to members of her family.

Vaishali, age 23, was poor, barely literate, and belonged to a tribal community. She was detected to be pregnant during the third month of her pregnancy and came to live with her parents. A month later, an auxiliary nurse midwife prepared an antenatal card to record her physical signs and immunisation status. According to the card, Vaishali had received three antenatal examinations, had her blood group checked and was vaccinated against tetanus. In the last trimester of her pregnancy, she was detected to have mild anaemia for which she was prescribed iron and folic acid.

Her pregnancy had reached full term in November 2007, when she began to have labour pains at 8 pm. Her mother sought help from a local dai trained by a non-government organisation working to reduce maternal mortality in the district. The dai explained the complications associated with a first pregnancy and urged a hospital-based delivery.

The nearest healthcare facility, a cottage hospital, was 15 km from the village. Vaishali's family took her there around 9 pm. The medical officer at the hospital, trained in basic gynaecology, found that the foetus had no heartbeat. Vaishali said that she had felt no foetal movements either. The medical officer thought that she might need a caesarean section and blood transfusions, which could be provided at a bigger hospital, so Vaishali was moved to the district hospital an hour later, only to find that the district hospital had no gynaecologist. The nurse at the hospital directed that Vaishali return to the community health centre (CHC). She was therefore re-admitted to the CHC in the early hours of the morning.

Six hours later, a blood test revealed that she had an uncommon blood group. The blood bank officer suggested that Vaishali be sent to the big city of Surat where she could get the required blood group should transfusions be required. However, she delivered a still-born baby before she could be transferred to the Surat hospital, began to bleed heavily and her blood pressure dropped. Critically ill and in shock, she arrived at the Surat civil hospital at 6 pm and died a few hours later.

Vaishali had sought healthcare from five public hospitals, rural and urban, in a single day but failed to get the medical care that could have saved her life.

Vansada block in which the village is situated has a population 1,50,000, but lacks a blood bank. During an emergency, people have to travel long distances to get blood. We don't think that pregnant women who could bleed heavily during or after childbirth will ever survive in this village.

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 05:28

Terrorism will rise in India, but the economy
will still keep growing. How so? Well, 3000 people die every year falling off Mumbai's suburban trains, and that does not stop Mumbai's growth.

http://timesofindia.indiatimes.com/indi ... 401981.cms

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 05:28

Virupaksha · Post by **Virupaksha** » 03 Jan 2010 05:44

sanjaykumar wrote:Well, 3000 people die every year falling off Mumbai's suburban trains,

is this true or did I need sarcasm 101?

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 06:09

Actually I do not know. The remarkable thing is that I do not know- and that this number could very well be true and within the realm of fatalistic India's everyday experience.

In which case terrorism is a cause Indians choose to value, unlike malnutrition, low literacy, gender inequality, open defecation ( are you reading and getting ideas Arundhoti?)

shiv · Post by **shiv** » 03 Jan 2010 06:34

ravi_ku wrote:
sanjaykumar wrote:Well, 3000 people die every year falling off Mumbai's suburban trains,
is this true or did I need sarcasm 101?

This subject has come up on BRF before. My take on this is as follows.

It is a no brainer for anyone to accept that we should neither have 300 terrorist deaths nor 300 deaths falling off trains. It is only when one is weighed against the other and a statement made to say that one is "less important" that leads to a self goal. Unfortunately rhetoric often results in exactly such a self goal that causes irritation and anger.

But one of the comments that have heard made about Indians is that they are callous and disregard the loss of human life I believe that what actually happens in India is as follows. There is always an underclass of people whose lives are so full of misery and drudgery that they cannot realistically be expected to retain the emotional drive to "empathize and light candles" when yet another person dies. It is easy to see such people around you if you keep your eyes open in India.

A couple of months ago I had started yet another controversy on BRF when I spoke of begging as business in India. There is plenty of circumstantial evidence and some real proof of begging cartels. The "proof" comes occasionally, while the circumstantial evidence is, well. more "evident"

I can't recall where I read it, but in begging circles, the most valuable asset is mother with child. After that are people with lost arms, legs whatever. A news item (clicky here) that appeared two months ago in Bangalore was interesting in this regard. A Bangalore couple have a two year old child. Both mother and father were working (mother in WIPRO I think) and they would leave the child in the care of a young ayah. It turned out that the young ayah would actually drug the baby with some cough syrup or similar medication (Benadryl is fine and delicious) and hand the sleeping child to a begging cartel for Rs 100 per day. It is absolutely amazing that a sleeping baby on rent can fetch Rs 3000 a month, which is more than what most domestics earn. If the woman was being paid Rs 100 a day, the baby must have been fetching much more.

I have observed how beggars at Bangalore traffic intersections can earn about Rs 5 in every 3 minute traffic light cycle. I have this tendency to hide behind closed car windows and look mean so that beggars don't spend too much time with me and I get to observe them through tinted windows. Beggars generally get some coins after every 5-7 tries. People are always pulling out coins and handing them to beggars - for whatever reason. I am still trying to figure out what factors are in play that make people hand money to beggars. I am sure it is not always sympathy or searching for better karma. It is sometimes to get rid of an irritant by throwing money (like the US does to Pakistan!

)

Since my job involves seeing people with illnesses in a hospital and I have been at it for over 3 decades now I have a fairly good idea of what percentage of children come to hospital to have an arm or a leg taken off (for any problem - accident or illness). Not only is this extremely uncommon, surgical removal is very easily recognizable because of the type and length of stump that is left after amputation. So it is fascinating (actually horrifying) to see young children minus an arm or a leg that has been removed at a very unusual spot and with deformities that would be unusual for a hospital treated child. A traffic intersection near where I live has two young men in their twenties - strapping and well fed young fellows - both begging. One has a missing leg cut off at the thigh and the other has a stump of an arm.

I am sure there are some doctors involved in this amputation scam and there is a least one news item to support that.
http://locitv01.indiantelevision.co.in/ ... yrel67.htm
http://www.telegraph.co.uk/news/1525399 ... -legs.html

Even otherwise it is easy to induce gangrene in an infants arm or leg and then get a doctor to legally amputate a limb that cannot be saved. A simple technique would be to tie a very tight bandage on a leg or arm of an infant - tight enough to obstruct the blood supply. In 2-3 days the arm or leg will be dead enough to require amputation, or the child will die.

Begging is a thriving business in India. Why is begging a thriving business in India? Mere poverty is not the cause. But the flaunting of vulgar poverty is lucrative. Lots of people. Lots of people thrive on the business of poverty. One won a Nobel too. But why do Indians allow this? Is there something in our culture that sees poverty in a way that is exploitable? Poverty is exploited everywhere - but only in India has someone got a Nobel out of that.

shiv · Post by **shiv** » 03 Jan 2010 06:40

sanjaykumar wrote: In which case terrorism is a cause Indians choose to value, unlike malnutrition, low literacy, gender inequality, open defecation ( are you reading and getting ideas Arundhoti?)

Add begging to that sir.

"Are you getting ideas Arundhoti" sounds to me like the anger of cognitive dissonance on being exposed to facts that one does not desire to hear and hurt one's personal and comfy sense of reality and truth.

To me the anger of cognitive dissonance is funny when Pakistanis show it. When Indians show it worries me because denial is not a river. It is an indicator of how we help hold our country back by refusing to look at realities that exist.

The only people who have really helped India are the people who were willing to face facts and address them head on rather than sink into denial.

shiv · Post by **shiv** » 03 Jan 2010 07:06

About 4 days ago the popular film actor Vishnuvardhan died. That morning I was in an area of town that was later badly damaged by mob violence by Vishnuvardhan's "fans" who went berserk. One MacDonald's franchise was damaged

This time my car escaped the wrath of a mob - unlike the last time - when Rajkumar was kidnapped.

http://www.deccanherald.com/content/441 ... blore.html

Fortunately Vishnuvardhan's death did not spark the scale of rioting that actor Rajkumar's death provoked a few years ago. Isn't it strange that nobody damages shops and buses in anger when people are killed in terrorist violence, but it happens after film actors die?

Why do some Indians riot when a popular figure dies of natural causes? Why were there no similar protests after Nov 26th 2008? The fact is that violence after someone dies (in terrorism) in Kashmir is common. However in Karnataka terrorism does not provoke such violence, but an actor's death (or kidnapping) does.

Clearly the behavior that Indians display in response to events is different from what one learns to expect from our Macaulayite education and what we observe in developed nations. But is such behavior wrong? Or if it wrong what causes it? Can it be prevented?

The thoughts that went through my mind when I was sitting and waiting for my car to be either burned or spared last week echoed the thoughts I have expressed in my post about begging above. There are some people right here is "Silicon Valley/Garden City/IT capital" Bangalore whose lives are so miserable that they see the loss of a person such as Vishnuvardhan or Rajkumar as the loss of one of the few things that gave them pleasure. Some Indians lead such fcued up lives that the only escape they get is from Bollywood (or Sandalwood, as the Karnataka movie industry has come to be called). Movie "heroes" become larger than life, and the death of such a person, a seemingly invincible and immortal figure who has always "rooted for the poor and downtrodden" sparks off exactly the denial and anger of cognitive dissonance as people are asked to accept the permanent loss of a figure that was "theirs" and gave them hours of joy.

Indians are not especially stupid or violent. But I believe such violence is an indicator of how bad life is for a segment of the population. That segment is hidden from many who live in India, leave alone those who live outside of India. But it comes to the fore as paroxysms of odd behavior. We notice it only when there is violence. We deny it and get angry when some newspaper or "Arundhoti" ally reports the state of life of too many Indians.

pgbhat · Post by **pgbhat** » 03 Jan 2010 07:29

From chindu
The unsettled debate on Indian poverty

In India, poverty is presently estimated by fixing a poverty line based on a differentiated calorie-norm. A task force of the Planning Commission in 1979 defined the poverty line as that per capita expenditure at which the average per capita per day calorie intake was 2400 calories in rural areas and 2100 calories in urban areas. Average per capita expenditures incurred by that population group in each State which consumed these quantities of calories, as per the 1973-74 survey of NSSO, were used as the poverty lines.

Based on the observed consumer behaviour in 1973-74, the poverty lines arrived at were Rs. 49.09 per capita per month in rural areas and Rs. 56.64 per capita per month in urban areas. These poverty lines were updated for the following years by simply accounting for changes in consumer price indices. Thus, the all-India poverty lines updated for 2004-05 were Rs. 356.30 in rural areas and Rs. 538.60 in urban areas, per capita per month. The shares of population below these poverty lines (the head count ratios; HCR) were estimated to be 28.7 per cent in rural areas and 25.9 per cent in urban areas.

These estimates of poverty threw up a number of controversies. First, it was argued that the poverty lines were extremely low in levels. An amount of Rs. 356.30 per month per person amounted to just Rs. 11.90 per day in rural areas, which was at best a destitute income. The fact that about one-fourth of India’s population did not incur even this level of expenditure was in itself instructive.

The Tendulkar Committee has reviewed the present methodology for measuring poverty and suggested drastic changes for the future. It has recommended the abandoning of the calorie-norm for estimating the poverty line. Instead, the committee has recommended a new method where the present all-India urban poverty line is taken as the basis for estimating every other poverty line in the country. With the urban poverty line as the basis, the parity levels at the State-level for rural and urban areas are to be separately estimated using a typical purchasing power parity (PPP) method. Thus, the new State-level rural and urban poverty lines are to be at those levels at which the average national urban consumption levels can be attained.

shiv · Post by **shiv** » 03 Jan 2010 09:10

Crop losses from inefficient and outdated methods of harvesting, transport and processing and the shifting of industries to faraway cities.

http://www.tnagmark.tn.nic.in/phtechnology.htm

Post-harvest technology has potential to create rural industries. In India, where 80 percent of people live in the villages and 70 percent depend on agriculture have experienced that the process of industrialization has shifted the food, feed and fibre industries to urban areas. This process has resulted in capital drain from rural to urban areas, decreased employment opportunities in the rural areas, balance of trade in favour of urban sector and mismatched growth in economy and standard of living including the gap between rural and urban people.
<snip>
Due to old and outdated method of paddy milling, improper and inefficient methods of storage of paddy, rice, transport and handling we lose about nine percent of production. It is estimated that ten percent of food grains produced in India are lost in processing and storage. The traditional methods of storage are responsible for about six percent losses. If better methods of processing and storage are adopted, the losses could be reduced to 2 to 3 percent and more food grains could be available to the people. It is estimated that 10-15 percent of horticultural crop such as vegetables and fruits perish due to lack of proper methods of processing and storing.

From the Tribune
http://www.tribuneindia.com/2001/20010226/agro.htm#3

Packaging: In our country mostly gunny bags, bamboo baskets and wooden crates lined with newspaper sheets are used for packing which imparts a little easiness of transportation and handling. Sometimes inedible plant parts are also transported like pods, stem etc. which could be used as fodder for animals. In foreign countries, the vegetables are cleaned, trimmed, pre-treated, pre-cooled and packed in bags of transparent film, trays or cartons overwrapped with transparent film, etc. Before despatch it is quite important to improve packaging material and it should be less expensive also.
Transportation: The system mainly adapted in India is road transportation to supply vegetable produce resulting in a lot of damage. The poor road conditions coupled with speedy driving also cause much harm to the produce. The Railways plays a great role in long-distance transportation of vegetables and are more efficient in the use of energy than road transport. The use of railway wagons will continue to be difficult unless there is a comprehensive redesigning of the wagons to carry more perishable produce across the country. Air transport has been adopted with success, especially in the hill regions of India and for exports. Overall, it is necessary to modify the long-distance transport vehicles by introducing more ventilation, reducing temperature, increasing relative humidity , improving loading and unloading systems.

Floriculture
http://www.tribuneindia.com/2001/20010226/agro.htm#1

According to 1995 world statistics, India has 34,000 hectares under flowers and ranks second to China (60,000 hectares) with more than 15 per cent of the total world area of 2.23 lakh hectares. In India, Karnataka has the highest area (14,253 ha) followed by Tamil Nadu 8,384 ha), Maharashtra (4,500 ha) and West Bengal (3,200 ha).
Despite the plus points, India’s performance in the global floriculture market is miserable because of the following bottlenecks:
— Inadequate infrastructure.
— Lack of appropriate plant material.
— Lack of good production technology.
— Non-availability of basic inputs.
— Lack of suitable market surveys and relative information.
— Lack of sale promotion activities.
— Absence of quality control mechanism.
— Lack of coordination between government and floricultural industry.
— Absence of cold chain.
— Exorbitant air freight
— Unorganised domestic market and lack of established marketing channels.
— High import duty on imported inputs.
— Unstreamlined export-import policy.
— Variety patenting.
— Lack of adequate trained personnel.
— Strict lending norms by banks and other financial institutes.

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 09:32

"Are you getting ideas Arundhoti" sounds to me like the anger of cognitive dissonance on being exposed to facts that one does not desire to hear and hurt one's personal and comfy sense of reality and truth.

It is helpful when posters only speak for themselves.

I was one of the first to ('eloquently') point out the penchant for Indians (street Indians as opposed to the 'better' kind) to stick their fingers in their noses and crotches.

If you wish I can make explicit comparisons to the Japanese and how their sidewalks may be cleaner to eat from than many dhabas.

A brief mention marks the record, if Indians in India continue to pee over the wall into the neighbour's yard there is little point in wailing.

Arundhoti's admirable sense of outrage may be better employed in the service of latrines than Kashmir.

shiv · Post by **shiv** » 03 Jan 2010 09:50

sanjaykumar wrote:
If you wish I can make explicit comparisons to the Japanese and how their sidewalks may be cleaner to eat from than many dhabas.

Sir. You make it sound as if my wish is your command. Suit yourself and please tell me about your in depth knowledge of how you can eat off Japanese sidewalks. I have no idea whether the Japanese eat off their sidewalks and while I wait with bated breath for you to describe that to me I want to point out that some Indians (usually infants and children) actually do eat stuff from the sidewalk and it is not a healthy pastime.

The point is not about awareness and gyan about Japanese sidewalks, but of Indian sidewalks. You seem to know a lot about the former. I know about the latter. Not the same thing by a long shot Sir. Do people fall off trains in Japan? Or are there more terrorist deaths? Neither are pertinent to this forum or thread.

Arundhoti's admirable sense of outrage may be better employed in the service of latrines than Kashmir.

In fact if more Indians serviced latrines it would be a great idea. Arundohti alone is not enough. Her snooty pretentiousness is mirrored by others who might talk of servicing latrines and yet act like Arundhoti in not lifting a finger to service latrines themselves - or even acknowledge that the activity is as important for Indians to do as perhaps the Japanese know it to be. But I know little of Japan other than what I am told by the experts.

shiv · Post by **shiv** » 03 Jan 2010 10:07

Airavat wrote: 60 years of reservation have kept the SC/ST population at the same level of poverty. And in those 60 years the GOI was run mostly by the INC and it's latter day offshoot, the Congress(I). One reason why the SC are increasingly voting for the BSP.
.

There is remarkably little data that I could find about this. Reservation of course is not poverty based. It is "caste based" and recent statements by the Supreme Court have been asking that reservation be based on poverty and not on caste.

There is one often quoted paper about reservation and poverty. It is here:
http://www.uh.edu/~achin/research/chin_ ... eb2009.pdf

We examine the impact of political reservation for disadvantaged minority groups on poverty.

To address the concern that political reservation is endogenous in the relationship between poverty
and reservation, we take advantage of the state-time variation in reservation in state legislative
assemblies in India that arises from national policies that cause reservations to be revised and the
time lags with which the revised reservations are implemented due to the timing of state elections.
Using data on sixteen major Indian states for the period 1960-1992, we ﬁnd that increasing the
share of seats reserved for Scheduled Tribes signiﬁcantly reduces poverty while increasing the share
of seats reserved for Scheduled Castes has no impact on poverty. Political reservation for Scheduled
Tribes has a greater eﬀect on rural poverty than urban poverty, and appears to beneﬁt people near
the poverty line as well as those far below it.

I found another paper with the following information:
http://www.esocialsciences.com/data/art ... 91E-02.pdf

The majority of the Scheduled Castes and Scheduled Tribes are
agricultural labourers. Because of economic compulsions, their children
have to go to work when they should be in schools. Children who
labour, lose education and therefore employment opportunities when
they are adults. Without the means of income for want of education,
they in turn may continue to send their children to work. It strengthens
the vicious circle of poverty and this has not been addressed by ‘job
reservation’.
<snip>
In short, the impact of reservation policies is visible in the political
culture where the SCs the STs and the OBCs have emerged as new
corporate identities with constitutional protection for representation
and empowerment. But it has not contributed towards any qualitative
shift in the lives of the poorer sections of these communities, where
poverty is getting perpetuated in overwhelming numbers despite
decades of freedom and democracy, planning and reservations.

Both papers say that the poorest stay poor, but the results are better among the more wealthy .

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 10:16

I am sorry I do not do petulance and I would only be reiterating the obvious.

asgkhan · Post by **asgkhan** » 03 Jan 2010 10:17

sanjaykumar wrote:
I was one of the first to ('eloquently') point out the penchant for Indians (street Indians as opposed to the 'better' kind) to stick their fingers in their noses and crotches.

Sir, i drive taxi in London for a living, and i can assure you, Men, regardless of Nationality
scratch their crotches and clean their Noses publicly. It is not just an Indian trait, as you so
('eloquently') point out. I have had Inebriated proper Englishmen peeing and leaving behind Semen
in my Taxi, but never have had the opportunity to observe the same from Indian Gentlemen.

shiv · Post by **shiv** » 03 Jan 2010 10:53

One more paper on what effect, if any, reservation has
http://www.econ.yale.edu/~rp269/website ... ad_024.pdf

This paper provides evidence that increased political representation for disadvantaged mi-
norities can allow them greater inﬂuence on policy-making. I show that political reservation for
scheduled castes and scheduled tribes in India has, in part, been responsible for the observed rise
in targeted redistribution towards these groups over the last half-century.

But the paper clearly states that its aim was not to asses the outcome on wealth/poverty

Very little research seems to have been done on the actual outcome of a reservation policy. But all that I have read so far is that political empowerment occurs, but the poorest of any group remain poor.

sanjaykumar · Post by **sanjaykumar** » 03 Jan 2010 12:03

Asgkhan those are interesting and relevant observations. But not anything new. A person I work with is from the Philippines-she once stated that the mainstream people 'have so much water here but they are not clean'. This is a very common non western criticism of westerners.

It is just that decorum is largely maintained in the streets. I don't really care if they don't wipe thei......, as long as I can avoid shaking their hands.

EDIT.

Avinash R · Post by **Avinash R** » 03 Jan 2010 12:35

shiv wrote:One more paper on what effect, if any, reservation has
http://www.econ.yale.edu/~rp269/website ... ad_024.pdf
This paper provides evidence that increased political representation for disadvantaged mi-
norities can allow them greater inﬂuence on policy-making. I show that political reservation for
scheduled castes and scheduled tribes in India has, in part, been responsible for the observed rise
in targeted redistribution towards these groups over the last half-century.
But the paper clearly states that its aim was not to asses the outcome on wealth/poverty

Very little research seems to have been done on the actual outcome of a reservation policy. But all that I have read so far is that political empowerment occurs, but the poorest of any group remain poor.

Linking to poisoned research conducted by foreign universities who are adept at social engineering (dividing people and making them fight based on perceived differences or historical slights) and then trying to understand indian social conditions is waste of time.

If this policy is so successful then why are there no reservations of seats --political, educational n employment-- for minorities on the basis of race and religion in their own country(america). Let the latinos, blacks, native indians be given reservations similar to that prevalent in india. Throw in some seats for the irish, italians and the polish as well. And as the somalians are streaming back to their country of origin to fight the american supported govt throw in some goodies for them too, obama should make a statement that somalians have the first right to resources. Well that should solve all the world's problems.

shiv · Post by **shiv** » 03 Jan 2010 12:48

Avinash R wrote:Linking to poisoned research conducted by foreign universities

This inevitably leads back to the question - are Indians so stupid that they don't do their own research? I have asked this question before and it leads to increasingly angry answers that talk of colonized minds and anti-Indian foreigners.

But hey the minds of researchers abroad are not colonized no? The minds of people abroad are free. They do not miss the big picture about India because they live outside? So they should writing the truth. But no! inconvenient things about India must be ignored because
1) Indians who write that have colonized minds from social engineering
2) Foreign sources come up with poisoned research.

The only other thread in which there is so much foreign propaganda identified against an innocent and pure nation is the Pakistan thread.

Does this sound like an equal equal? Let's not have any more denial.

JwalaMukhi · Post by **JwalaMukhi** » 03 Jan 2010 12:51

One way to understand India is to see that it is full of minorities (not just narrowly defined religious lines). But the powers that be; would like to delude that defining minorities along religious lines in India is correct; and it pays handsomely.
Alternately, since everyone belongs to minority based on various criteria; the usage of term 'minority' is complete hogwash in Indian context. Well, till most Indians realize this fast one being pulled on them, there is hay to be made while the sun shines by peddling 'minority' based on religious lines.

shiv · Post by **shiv** » 03 Jan 2010 13:27

JwalaMukhi wrote:One way to understand India is to see that it is full of minorities (not just narrowly defined religious lines). But the powers that be; would like to delude that defining minorities along religious lines in India, pays and pays handsomely.
Alternately, since everyone belongs to minority based on various criteria; the usage of term 'minority' is complete hogwash in Indian context. Well, till most Indians realize this fast one being pulled on them, there is hay to be made while the sun shines by peddling 'minority' based on religious lines.

This is correct. India is a nation full of minorities. It pays to be a minority and that is why uniting to form a single bloc is always tripped up by the temptation to play a minority card. The least trouble arises in India when the maximum number of minority groups is happy. The route to success and happiness in India is to belong to a special interest group. If you try to unite two or three groups it will be advantageous for some special interest sub group from all the groups to split away and blackmail the larger group so they get more attention.

In an eerie way India too operates on the principle o "Me against my brother. Me and my brother against my neighbor. All of us against the people in the next street"

I have to shine over everyone else in my XYZ Brahmin group. But when I have trouble my group will go against ABC Brahmins. XYZ and ABC Brahmins will unite as Brahmins against the dominance of PQR caste group. The South Indian Brahmin and other caste group will all unite against the North Indian caucus. The whole gang will come together against Muslims. But at any stage any single group can split away if it is not to their total advantage.

Avinash R · Post by **Avinash R** » 03 Jan 2010 14:27

shiv wrote:This inevitably leads back to the question - are Indians so stupid that they don't do their own research? I have asked this question before and it leads to increasingly angry answers that talk of colonized minds and anti-Indian foreigners.

Well the poisoned data suggests the cat they are trying to help is actually a camel and the super brainy macaultiyes rush to feed it grass and then whine why wont the damn camel eat it. Then they blame the indian genes of the camel for being responsible in their failure to feed and 'uplift' it.

The question should be why are macaultiyes so stupid that inspite of knowing the research data is poisoned they make attempts to use it to solve india's problems instead of collecting their own data.

shiv wrote:But hey the minds of researchers abroad are not colonized no? The minds of people abroad are free. They do not miss the big picture about India because they live outside?

So true harvard's nazi professor micheal witzel and his buddy steve farmer will support you on this.

And dont forget to contact truth ki pujarin wendy doniger for additional research data. She will teach how to properly read kamasutra and then write a book on hinduism. I hear that wendy is currently reading playboy and researching tiger woods's life and writing a book titled "The Xtians: An Alternative History". I hope you will volunteer to help her and lend an helping hand. We can expect another book "The Jews: An Alternative History" after she completes researching david beckham's football skills but that will have to wait, these playboy books are just too many for her to complete her research.

shiv wrote:The only other thread in which there is so much foreign propaganda identified against an innocent and pure nation is the Pakistan thread. Does this sound like an equal equal? Let's not have any more denial.

Well speaking in your language, yes pakistan is innocent terrorist nation. It does best what the brahmins and banias have taught them. It's foreign propaganda that india is an equal to pakistan, how can that be so when pakistan is 100% sharia compliant state while india remains a kafir state. I think it's your brahmin genes which makes you relate to pakistan. Dont ask me what these genes are, ask the foreign researchers who call hinduism as brahminism, they will teach you all that is needed to be learnt.

Paul · Post by **Paul** » 03 Jan 2010 14:38

In an eerie way India too operates on the principle o "Me against my brother. Me and my brother against my neighbor. All of us against the people in the next street"

Perhaps this is what makes the world go round....Leon Uris had made the same comment about Arab society in his novel "the Haj"

Abhibhushan · Post by **Abhibhushan** » 03 Jan 2010 14:40

This thread is about knowing India, but regretfully, it is taking on the hue of a whine thread. I would like to post a personal incident that looks at present day India from a different angle.

This is very personal story. The entire situation of this story was random, accidental, unpremeditated and unique. It took place many years ago and it touched no one else but me. It did not leave any physical emotional financial or social imprint on me and yet I have never been able to forget this incident. Let me now narrate it without further ado.

On 26th January 1968 I was in a holiday mood. I had just been ordered to report to the Institute of Aviation Medicine for a high performance medical test on 29 Jan 68. Implication of this order was clear: I was being considered for active flying in a high performance aircraft. Since I had just put on the rank of a wing commander, it also meant that I was being considered for the command of a squadron equipped with either MiG 21 or Su 7. The feel-good feeling that came over me was therefore justified. 26th January fell on a Friday in 1968. That gave me a long weekend before the medical test. My ticket from Delhi to Bangalore was booked. Every thing was fine and dandy. My three kids at that time were at their 8, 6 and 4 year stage. They wanted to go and see the R Day Parade from the stands on Rajpath. I had no reason to say no. Passes were obtained and at first light we drove from our Subroto Park residence to the earmarked parking lot near Akbar Road. Distance from the parking lot to the allocated stand was long, and the queue that we were forced into was serpentine and slow. By the time the family reached the allocated stand, we could garner only three seats for us five. The little ones of course did not mind the cuddly squeeze on the bitterly cold morning.

The parade was spectacular as usual. Helicopters showered rose petals from the sky. Troops and military bands marched with heads held high. The Camel Corps made an appearance. Tanks and Guns rolled by. Antiaircraft missiles registered their presence. School children marched by. Some other school children danced and performed acrobatics. Folk dancers in shiny and colourful costumes presented themselves. Tableaux depicting themes from various states and central government departments rolled by on wheeled trailers. My eldest daughter Sutapa, all of eight years of age, enjoyed the show sitting primly between her parents. Her younger siblings had to make do with parental knees as their seats. Sukanya, the second girl, sat on her mother’s lap while Mishti, the little one sat on my knee. She was a tiny little thing a month over her fourth birthday. All of a sudden there was a commotion. Some one spotted the first of the jet aircraft approaching the saluting base and pointed to his left. Within seconds, every one stood up on their feet shutting out the view for the little children on our laps. Sukanya, for ever the claustrophobic, turned around and grasped her mother. Mishti wailed – Baba pick me up! I stood up on my seat grasping Mishti under her armpits. In the process my elbows went out poking a gent on my left and blocking the view of a young boy standing behind me on my right. Their reactions were predictable; they just pushed my elbows down. Unfortunately for me, with the weight of the child slung from my arms and with an unsure footing for my own balance on my perch, my back bent without my control. There was a nasty crrrrick sound from my spine. I just collapsed on the stand with the child still resting on my chest. Pain shot through my body. I discovered that I just could not move any further.

As the first formation of aircraft went by and the spectators switched their attention to the next block approaching us, one person in front of me saw me and understood my problem; perhaps the agitated gesticulation by my wife Leena drew his attention. He picked the child up and tried to help me to my feet. I am a bit fuzzy even now about what exactly happened to me at that time. I could not stand up. I remained slumped on my seat till the flypast ended and the crowd started going home. I could not walk on my own and I certainly could not drive the car back. Some one must have brought us home and had the car retrieved. I went straight to bed and stayed there groaning with pain. Friday the 26th rolled by and then the Saturday. I started becoming increasingly concerned about my impending trip to Bangalore.

On the evening of the Saturday Savitri, the house maid, made an appearance at my door. She was aware of my condition and was keen to offer some help. ‘My Mard is a very good remover of pain’, she informed us. Would we be interested in his ministration? I was in two minds. On the one hand I was suffering from excruciating pain and was almost immobile. I needed to go to Bangalore on the following day and I did not know how I could perform the journey. On the other hand I was reluctant to let a village bumpkin, perhaps a quack, play around with my painful body without a proper doctors say so. Leena was in a dilemma as well. She wanted me to get well soon and any help would be welcome. However, we had never even set our eyes on this Mard of Saviti. Could we trust this village lad loose on my body with no certification other than from his wife? Neither of us knew really what to do. ‘He is very good at this job saheb’, Savitri persisted. ‘My mother in law was a very good masseur too. Every one in the village used to praise her. She has taught her son very carefully and now he is very good too’. Savitri seemed very confident of her Mard. I was without any clear cut medical plan for my aching body. The need to get back to my feet and pass the high performance medical test just two day away was too great. I gave in. OK, I said, send him in. But Savitri’s Mard was not at hand. ‘I will go home and bring him tomorrow morning’, said Savitri. I passed another very painful night, unable even to toss and turn.

Early on Sunday morning Savitri came with a young man in tow. Clad in a clean shirt and a pair of trousers, he looked barely over twenty two or twenty three years of age. His name, he said, was Pishtumlal. He was from Garhwal. His village was close to the Indo Tibetan border town of Kalpa. In Garhwali language Pishtumlal meant a mischievous and naughty child, but this young man with a bright smile looked dependable and trustworthy. His eyes were bright and he moved with a deliberate confidence. ‘OK’ I said. ‘Go ahead and start.

Pishtumlal closed the doors and windows and drew the curtains. He then made me strip down to my underclothes and lie face down on the bed. For me this was sheer torture. Even though an electric heater was on, I felt cold without clothes and even shivering caused intense pain. Slowly Pishtumlal got to work on my back. Every touch brought in waves of pain. Dipping his fingers into a small bowl of warm oil he continued to work on my arms and legs. While his fingers were busy on my body, he set up an incessant chatter that needed no response from my side. Slowly my muscles became warm and I grew drowsy, but the pain down my spine showed no signs of abating. I pride myself for my patience and forbearance. That morning however I began to be wary of the proceedings. One hour went by and then a second but my pain along the spine was as severe as ever.

At long last he stopped. I tried to decide whether my pain had decreased even marginally and was unable feel happy with the result. While I was feeling miserable and sorry for myself, Pishtumlal got hold of a straw mat and spread it on the ground. He then asked me to get up from the bed and lie down on the mat facing the floor. I found it difficult to get up. He came close to me and lifted me gently. The effort took my breath away. He then put me down on the mat and started rearranging the position of my arms and legs as I lay breathless. I could take it no longer. ‘Bus karo Pishtumlal; bahut ho gaya. Our sahaa nahi jaataa!’ I cried out. Pishtumlal paid no attention to my cries. He stood astride my prone body, put his arms below my arm pits, pulled me up and shook me like a piece of rag. Pain shot through my whole body and I almost passed out. The loud cry that rent the air must have been frightening because Leena came running from outside and pushed the door open. Savitri followed close behind her. Pishtumlal put me back on the mat gently and stood away. I lay limply on the floor wondering what I should do next. Slowly I realized that Pishtumlal was asking me to sit up. ‘It is alright saab, you have become bilkul theek’. Had the guy gone mad? I had no strength left to take any more pain. Leena crouched beside me, put her hand gently on my shoulder and said ‘he is asking you to sit up’. Very reluctantly I moved my arms to a new position to push myself up.

All of a sudden the world around me changed! There was no pain! I pushed myself up and sat up. A sense of wellbeing enveloped me. The room was warm and my body felt relaxed. I jumped up on my feet and pulled my clothed on. I wanted to hug that fellow tight. I wondered how I could express the gratitude that welled inside me. I pulled my purse out of my pocket and pulled out all the money I had in there. It was about forty rupees and it could be called quite a lot of money in those days. I smiled at Pishtumlal, thanked him, said that I felt wonderful and extended my arm with the notes in my palm. Pishtumlal stepped back, folded his hands and said ‘No Saab. I cannot accept any money. This is my mother’s order. She has given me her guru given vidya. This vidya is to be used only to remove pain from the world and to bring happiness to people. If I use it to earn money and fill my stomach then that will be a paap karma.’ I was stunned. I could only hold his folded hands and thank him over and over again. That evening I flew to Bangalore and returned a few days later with an A1G1* - fit for high performance aircraft rating.

As I write this tale to day, some forty odd years after the event, I wonder as to how much skill knowledge and ability lies buried in our society, passed on by our culture, running in deep subterranean streams, unrecognized and unsung. I lost touch with Pishtumlal soon after this incident; I was given the command of 47 Squadron with MiG 21aircraft and I moved away. I however wonder if the ever changing values of our society have allowed Pishtumlal to nurture his talents and skills and pass it on to a successor. This is a part of our heritage. Are we protecting it? Or are we carelessly letting it wither away?

shiv · Post by **shiv** » 03 Jan 2010 17:05

Avinash R wrote:I think it's your brahmin genes which makes you..

Thanks. That says it all. You are a true Indic Nationalist Patriot. Timeless Bharatiya wisdom courses though you and flows out from your words.

shiv · Post by **shiv** » 03 Jan 2010 17:33

Nice story Abhibhushan. If it was today you would have had an MRI scan and been advised surgery on your spine or bed rest.

Indian knowledge is being lost partly because it does not pay to be like Pishtumlal. A lot is made about ancient Indian values, but most Indians have come to believe that the more money one spends on something the more valuable that item is, or that dedication can be bought with higher salaries.

Most modern Indian allopathic doctors would not be as honorable as Pishtumlal, but even if they were your bill would not get smaller because the system (MRI scans, pharma company manufactured drugs) is inherently expensive.

On the other hand most Indian patients are still like you - willing to pay the doctor a handsome fee. Indian attitudes towards life and death, health and disease make it a joy for dedicated doctors to work in India. The dirty American invented vicious circle of suing at the drop of a hat and keeping insurance high, and fees higher as a result are not yet in India. It's arrival has been predicted for most of my working life and it is only because Indian attitudes have remained philosophical that it has not happened. This has been documented in a book - but that book also says things which will attract angry reactions like "poisoned research". The old Indian philosophy that good comes along with bad in an equal mix is forgotten too. And a hybrid mindset of Indian and American influence is now thought to represent the real India. Now that is funny.

The real American value that has come in to medicine is a mixed blessing/curse. It is called "Evidence Based Medicine". I am sure that in the US a man such as Pishtumlal would have his pants sued off for not practising "Evidence Based Medicine" and violating every guideline in the book and the excuse that he did not charge fees would not work in court. But Evidence Based Medicine can go only so far and no further. That will be believed when some poisoned foreign researcher says it. Not when a brainwashed Indian says it. Ironic