Desicritics Category: Culture: Health

The Opium Eaters - The Roads Between

Harold Bergsma — Wed, 16 Jul 2008 00:07:59 EDT

We are the opium eaters; we are the consumers of the 6,500 tons of opium produced in Afghanistan and Pakistan with an export value, according to the United Nations, of about $3.1 billion. While we fought the war against terror and weapons of mass destruction in Iraq, against the Taliban, the war against opium growing and trafficking was neglected, went soft. A virulent opium trade has flourished in Afghanistan and Pakistan since 2004, a time when the Taliban had all but eradicated poppy growing. Now, ninety percent of the world’s opium is produced in the region of southern Afghanistan and border areas of northern Pakistan. But the world continues to have a tremendous need for opium products to be used for legitimate medical purposes. India is a producer of licit opium for the pharmaceutical market, however, the farmers are paid so little to grow approved amounts of opium that they have also learned how to subvert the system and receive ten times the amount for their crops on the illegal market. There is a shortage of raw opium for medical uses, while the illegal trafficking of opium continues. Efforts to eradicate opium in the fields as it is grown have been ineffective. Graft, bribery and corrupt political forces have protected the growers; only a tiny proportion of the entire opium 2007 crop grown was destroyed. The fields that were destroyed with weed cutters were frequently those of the poor peasant who did not have the support of a landlord or a war lord. Aerial spraying of poppy fields has been prevented by those in high authority in Afghanistan. Supply and demand, that is, the need we, a drug culture, express for opium, is what moves the trade of this narcotic, and move it does, by the hundreds of metric tons annually.

Amazingly, America through its international clout exerts controls in many other sovereign territories it avoided many years ago. Remember The Monroe Doctrine? What is that? What we may remember is President T. Roosevelt’s statement, “Speak softly and carry a big stick.” Now we speak loudly, explosively, and carry huge economic sticks and massive military ones but the opium trade goes on, seemingly ignoring the international sanctions, the military presence of the United States, and in the past of England, in Afghanistan, and their tanks rumbling on paths right through the middle of the bright and beautiful fields of poppies growing in Kandahar or in Nangahar along the Baluchistan border where the greatest increases in opium production have occurred.

De Quincey’s famous book, Confessions of an English Opium Eater, 1822, is a classic rendition of one who used opium and who experienced the “...extreme euphoria initially,” as well as the hellish results of addiction in the later stages, “...the darkness and nightmares.” In the late eighteen hundreds, at the time of the Monroe Doctrine which spoke of American autonomy and non-involvement in European wars, and in the early nineteen hundreds, opium was consumed widely and openly in Europe, England and the United States. It could be purchased in the local chemist shops or drug stores as we call them; women took laudanum drops in a glass of water for the ‘vapors’ or other ailments. We were a nation of opium ‘eaters’, however, in terms of actual volume, more opium is now consumed in various forms illegally in the United States than during that early period.

“The State Department’s bureau of International Narcotics and Law Enforcement Affairs (INL) plays a key role in carrying out the President’s National Drug Control Strategy by leading the development and implementation of U.S. International drug control efforts. INL manages a diverse range of counter-narcotics programs in 150 countries throughout Latin America and the Caribbean, Asia, Africa and Europe. These bilateral, regional and global initiatives aim to fight the cultivation of drug crops at their source, disrupt the trafficking of drugs and precursor chemicals, and help build host-nation law enforcement capacity.”

(Nancy J. Powell, Acting Assistant Secretary for International Narcotics and Law Enforcement Affairs, July 12, 2005, Washington D.C.)

The efforts of the US government to get a handle on the drug and opium problem, continues world-wide. Since more than ninety percent of the opium of the world is grown in Afghanistan and Pakistan, special efforts are made there to slow down opium growing, because its sale, transport and processing, provide the very ones we are fighting in our world against terror with the financial means to carry out their activities. Taliban and Al Qaeda receive some of their financial backing from such drug trafficking. Corrupt officials at every level have their hands out for bribes to allow the growth of the opium poppy, the transport of opium and processing of it, and this trade is growing.

A blind eye. It seems there are many along the way when it comes to opium. Such blindness pays off very well. So well in fact, that the small business man has learned that huge profits can be made by becoming part of the purchase and sale of opium; much like we buy stocks, they buy shares in its purchase, transport and sale. Many of these actors are not huge investors by international standards. Sixty thousand rupees may seem a vast sum to many Pakistanis, however, $6000 may not be a huge investment in other parts of the world. But it is small investors like this who make it all happen, make the opium flow freely across international borders to Iran and on to Europe and the States. We in the western world are the eventual buyers which make it all possible. We are the consumers, the infidel opium eaters.

I talked with a few opium growers in NWFP, the small-fry types, and asked if this was not an activity proscribed by their religion. They were surprised at my question, “Of course not, the growing, sale and dealing with opium is business, a way for a man to make a living by growing a crop.” They were amazed at my placing an immoral connotation on the activity. But when it comes to talking about foreigners in their country who are trying to manipulate them, to destroy them if they do their business, then the strong ‘moral and immoral’ words fly, shaitan, words of condemnation and frustration, oaths calling on Allah to destroy the infidel invaders. Americans, by Nancy Powell’s own words, are involved in 150 countries carrying out anti-narcotic activities; involved in an equal number of military programs, carrying out our nation’s efforts to control and fight against our enemies, terrorism and anti-democratic activity. “While undermining the narcotics industry through successful eradication and interdiction, we are also helping extend democracy and strengthen security...by building democratic institutions that provide security and justice.” (Counter-narcotics Programs, 5/23/2007)

The small man in Pakistan, Afghanistan, Iraq, Egypt or Iran looks at this monster and sees the big infidel bully that is pushing around, getting its way in the world through the power of money and the might of armed force. Hatred! Why? Hatred is focused against this force that is such a powerful agent for change; hatred is the strong emotional undercurrent to undermine it. Drugs, opium and the power of it on the international market has provided the little man, the student of truth, the Taliban, with tools to undermine our world-wide efforts of domination, albeit extending democracy. The more we buy opium, the stronger their cause. Our appetite for opium means the Taliban will prosper. Their strength is surprising. President Karzai was their target for assassination in April of 2008. He did not die, but others around him did. Puppets are hated as vehemently as the one who holds the strings. Puppets, whether they be leaders ‘nominated’ by America in Iraq, leaders who are supported in Israel, or even those wearing the green robes of aristocracy in Afghanistan are looked at in distaste; but it is really the string pullers who are the target of hatred, the demon puppet master.

Our threats in Jan. 2008 to go after ‘them’ in Pakistan from our already compromised ‘puppet’ base in Afghanistan drew surprisingly strong words from President Musharraf during his hay day. If I may paraphrase it, “Don’t mess with your troops and anti-terrorist programs on Pakistani soil. The terrain is terribly rough out there, you won’t like it.” (Italics mine) We are not used to having ‘sovereign nations’ react like this, particularly Islamic nations who accept our foreign aid to the tune of a billion dollars of American taxpayer money in AID, a great deal of which is used for their military purposes.

The little guys, thousands of them, support the ‘opium eaters’ through their moving opium on the back roads from Afghanistan, through Pakistan and to the markets beyond. Opium is the livelihood of thousands of farmers, thousands of merchants and truck drivers, thousands of shippers. These actors on a small stage in Pakistan say their lines in the play on drugs with halting voices, but keep the play alive.

I have walked on small paths in the opium fields on the Pakistan/Afghanistan border and talked to the farmers. They make so little from their sales of raw opium; it is those who buy it and move it that reap the huge financial benefits. I have talked to the farmers about trying alternative crops; they smile and say, yes, yes, sahib. Stretching out in front of me were vast acres of white and red blossoms, another harvest of opium getting ready for the opium eaters. I have on my computer screen a wonderful picture of Afghani men harvesting opium, standing in their fields as British and American tanks rumble by on the dirt roads, oblivious to the harvesting activity around them, and carefully staying on the roads between the poppy fields. That picture is the metaphor for opium eaters.

HIV+ By Marriage - High Court Denies Rights

Sakshi Juneja — Thu, 10 Jul 2008 04:10:06 EDT

The question of pre-marital HIV testing has been debated in media and on blogs. We are still searching for a balance between:

A) A nation’s effort in curbing a dreaded disease

B) Freeing the society of its prejudices/taboos

C) An individual’s right to protect what is ultimately a private and confidential matter regarding his/her health

While we are fighting this battle, there are causalities like this 29-year-old woman from Satara.

The woman said she was infected with the HIV virus from her husband, who had been suffering from the disease before their marriage which took place in 1997. Their child who was born in 2000, she said, was also diagnosed as HIV positive.

Her only hope was of course the judiciary, but just yesterday, that door too has been shut. The Bombay High Court rejected her plea stating that her applications under sections 498 (a) (dowry harassment) and 420 (willful cheating) of IPC does not hold, because these laws are only meant for property-related matters.

These offences (dowry harassment under section 498A) relate to property of a person. The body of a woman can, by no stretch of imagination, be treated as property, and therefore sections of cheating and willfully cheating (Section 420) would not attract in this case," ruled Justice Nishita Mhatre. […]

Though the court agreed that the woman's husband and her in-laws were fully aware that he was HIV positive at the time of their marriage, it disagreed to try the accused for willfully cheating.

As a bystander this is what I understand or more suitably can’t get a grip of…

Doesn’t withholding such vital information constitute the vilest form of cheating – that of snatching her entitlement to a healthy life – something we all regard as an unquestioned given?

In reaction to the court’s verdict, the victim’s lawyer Uday Warunjikar said

This is a case of cheating and should be treated as one of the 'rarest of rare' cases, where a HIV positive woman has come to the court saying she was cheated by her husband. The authorities should treat such cases sensitively, but here they failed miserably. The local police did not even bother to record her statement, hence she was forced to approach the court.

As someone who is very particular about her individual freedom, I cannot even begin to imagine what this woman would have gone through – to be duped twice; her marital family and the Indian judiciary.

Uttar Pradesh Police on Cleanliness Drive for Gomti River

DeeptiA — Sun, 6 Jul 2008 10:54:45 EDT

Indian rivers are extremely polluted, and have been so for a long time now. It is all the more horrible since we consider many of these rivers as holy and worship them; the waters of the river Ganga find a very holy spot in Hindu culture. And yet, the waters of most of these rivers look hideous (unable to support aquatic life, unfit for human consumption, and so on). Various Governments claim to spend a lot of time and effort to clean up these rivers and have drawn up plans over the past two decades with big sounding names (all ending with the words of 'Action Plan') and the rivers remain dirty.

Over a period of time, even the courts of India have been unable to push the Governments to prepare an effective plan that is also executed well. All you get in the end is a lot of discussion about which method is the best for river cleaning (for those familiar with the discussions, the endless discussion in Delhi around where the sewage treatment plants should be, and how to stop the big drains from throwing their filth directly into the river would be funny if it was not so critical to public health). Otherwise, you would not get cases whereby drinking water to a city became critical when the filth content of the water available for drinking became too high.

What is required is for Governments to set up dedicated action plans that will ensure proper treatment of sewage (whether industrial or residential) so that no untreated sewage flows into the various water bodies that we have. Industries that violate this dictum need to be severely fined and punished (and that means that corruption levels in the environmental inspection area need to come down). Else we will end up with more cases such as the one in Punjab where millions of fish in a canal suddenly died due to release of untreated industrial waste. What we don't really need is for this kind of publicity generating measures such as this one:

With the state police coming to the fore to free the Gomti of pollution, now those caught red handed throwing garbage in the river will be severely dealt with. This announcement was made on Saturday by the director general of police (DGP) Vikram Singh, even as along with other senior officials of the department he took it upon himself to clean the city's lifeline.

In the morning the officials arrived at the banks of the Gomti for the cleanliness drive that is on to clean the river for the past few days. During the drive, the DGP made an official announcement that one company of river police will be deployed on all the banks of the river.

How will they prevent people from throwing trash into the river? Will it stop if they patrol a few kilometers? Would it not be more effective to have a proper education drive along with ensuring that people get a proper garbage collection facility? Or am I hoping for an ideal world?

Mercy Killing in India

DeeptiA — Sun, 29 Jun 2008 10:00:13 EDT

A very sensitive subject indeed. Mercy killing, or allowing a person to take his own life (or a team of doctors to do so) is a dilemma that raises ethical questions all over the world. For a world that has derived many of its laws and regulations from religious backgrounds (Ten Commandments / The Gita / The Koran / etc..), mercy killing is something that raises the hackles of a large section of the world's population. It is only permissible in some countries, and that too under strict control. In many other countries (even one such as the United States), mercy killing has run against a moral hard rock and many physicians have been sentenced for helping in carrying it out. In the recent case of Terri Schiavo (Wikipedia), the case went through major conflict, with people at all levels (politicians, religious figures, family rights groups, etc) getting involved.

The basic premise for mercy killing is simple: There are many medical conditions that are terminal, and there is no established medical treatments that can cure the disease or prevent death. And unlike movies, people don't dance or sing till almost just before death, they go through horrible phases of steadily declining abilities - losing control of vital motor abilities, losing control of their mental faculties, unable to fend for themselves and being dependent on others, and a steadily increasing pain. In such cases, there has been the logic that given that their condition is terminal (that is, they have reached a condition where death is confirmed and they no longer have a life that seems meaningful in any way), they should be allowed an option to end their life when they still can command control of their life.

Taking the first step towards legalizing euthanasia or mercy killing, the Law Commission has decided to recommend to the government to allow terminally ill to end their lives to relieve them of long suffering. It allows those whose death is virtually certain to avoid their painful journey to the end.

The core of the recommendation to make euthanasia legal stems from several SC judgments which ruled that 'life does not mean animal existence’. "If a person is unable to take normal care of his body or has lost all the senses and if his real desire is to quit the world, he cannot be compelled to continue with torture and painful life. In such cases, it will indeed be cruel not to permit him to die," says the report, receiving final touches from Commission chairman Justice A R Lakshmanan.

However, aside from the moral and ethical problems that this issue comes up with, there are many other problems that arise when such a discussion comes up:

- There are a host of new treatments that are arising as we experiment more with genes and new areas such as stem cell technology, so is it right to assume that a condition that is treated as terminal now could not become one where a treatment is possible in a few years

- Who decides whether the condition is terminal ? If it is a team of doctors, who do you trust ? How do you prevent misuse, especially when we have seen so many new cases whereby elderly people are dumped because of the effort of taking care of them.

- Will this become a poor vs. rich thing? Suppose that a very expensive treatment is available abroad, and a poor person cannot afford to get this done for the terminal condition?

- How will the actual logistics of carrying out the termination of a medically terminally affected patient be carried out ?

- In a country where there are many more needy people than hospital beds, would this become a misused thing ?

Is India ready for something like mercy killing?

I feel that we need to make this a possibility, subject to some stringent checks and balances.

The Vagina Dialogues

IdeaSmith — Fri, 27 Jun 2008 11:20:44 EDT

Eight years after hearing about it for the first time, I finally watched The Vagina Monologues. Wish me a happy birthday since I'm being reborn. On second thoughts, don't say a word. Just listen as we speak - my vagina and I.

I hated being a woman. The restrictions, the rules, the fears of my mother, it made me angry.

I hated being a woman. Being smaller built than the boys, slower than them at games, lagging behind them on my bicycle, my scrawny legs pedalling furiously to keep up. I never could.

I hated being a woman. It took me a long time to get used to my curves. I walked like my flat-chested 12-year-old self till I was 17. Till a classmate told that it wasn't the done thing for a girl to walk with such a straight back. Till, a boy said, "You walk with your boobs thrust right out at the world." And when I did get used to them, I took them on with a vengeance and used them as lethal weapons. Bait? Hah! Call them Venus fly-traps! I loved their power and I hated them for the compromise they were.

I hated being a woman. Bleeding every month, feeling pukey and giddy-headed and sticky and smelly.

I hated being a woman. 10 years old and being told, "Boys can do whatever they like. But a girl's reputation is like glass." Twelve and my tuition teacher's voice, "What a horrible laugh, so loud and monstrous! Look at Sonya, how prettily she covers her mouth when she laughs. And she doesn't make a sound." Thirteen and being admonished, "Sit with your legs together. Only a slut sits with her legs apart." Yes, I really and truly hated being a woman.

But I didn't always. I didn't know I was a woman for some time. And then suddenly I did. Or more accurately, I suddenly knew he was a man. As he introduced me to his manhood and asked me to pat it, hold it, feel it.

Oh stop! I wanted to scream. But I didn't. I held myself back. And I held myself in. Realizing suddenly that if I didn't, everything inside me would fall out of the hole. And in that moment, I separated my vagina from me.

Sometime later, I summoned up the courage to tell my parents. I said he had tried to kiss me once. 'Tried to', not did. 'Once', not many times. 'Kiss me', not....

My classes were stopped and we didn't speak about it again. I gave up trust that day as well as faith in men. I even stopped hugging my father. I assumed a genderless identity. And later, sexuality was paraded as an accessory, not experienced from within.

As the years passed, I built armour upon armour. The strongest of them was the decision that when I was uncomfortable or hurt or unsure or unwell, no one would know, least of all the person who caused me pain. I banished the fears. I suppressed the blushing and giggles. I stifled innocence and wonder. I held back pain. I shut down tears. I sent them all to the dungeon to keep my shameful prisoner company.

~o~o~o~o~o~o~o~o~o~
I didn't speak of it for ten years. One day a neighbor asked my mother about the guitar lessons I'd taken, since she wanted to send 8-year-old daughter for them too. When my mother told me, I asked her to tell our neighbor what had happened. She admitted that she was too embarrassed to. I said, "If someone had told us the truth a decade ago..." and I left the room. There was nothing more to say.

Four years later, I was playing a silly game with my boyfriend, slapping and giggling. Then in a dramatic flourish, he pinned me down and held my wrists. That's the last thing I remembered. The next thing I knew, he was shaking me very gently and asking, "What happened? I was only playing." I didn't say a word. Apparently I'd gone all stiff and began whimpering.

My vagina was locked away into a dungeon when I was nine and went into silence after that.

~o~o~o~o~o~o~o~o~o~
As I watched the monologues and the vaginas of women around me sing and squeal and laugh and moan, I asked myself,

If my vagina could speak, what would she say?

And I heard her stammering, painfully shy reply so clear it made me cry.

She said,

I AM SORRY.

I'm sorry I disappointed you.
I'm sorry I hurt you.
I'm sorry you are in pain.
I'm sorry that I remind you of my existance.
I'm sorry I exist.
I'm so very sorry that I didn't make you happy.
I'm really sorry that I don't make you proud.
I'm sorry that you're ashamed of me.
I'm so, so very sorry.

And as she spoke, her fellow prisoners stepped free from two decades of confinement. I had scratched off the worst I'd seen in my life and sent them down to my vagina, keeping the best bits for the part of me on show to the world.

My poor vagina, surrounded by my shame,
my guilt,
my pain,
my bad memories,
my nightmares,
my anguish,
my betrayal,
my agony,
my frustration,
my sorrow
...and my tears.

She cried, my vagina cried. And for the first time in years, I did too, with her.

~o~o~o~o~o~o~o~o~o~Small wonder then that my relationships failed. Such a hellish place it had turned into that I'd only send those I wanted to banish down there. No wonder the very worst of men appealed to me and the very worst in them turned me on. And even they were petrified by what they found there.

I hated doing it in the dark.
I hated doing it on my back.
I hated doing it in bed. Or a couch. Or a car. Or in the open.
In fact I hated doing it so much that I never did.

Those who came to visit were offered a gracious cup of tea and then lulled into a battery of tests - a moat, a dragon, an army of defenses. And those that got past, walked up to the gates to find them locked. No entry into this love-lane, we're shut, you're unwelcome, go home. They did.

~o~o~o~o~o~o~o~o~o~My new friend calls me a child and tells me that there's a little girl he sees when he looks at me. Now I understand. At long last, I'm in the throes of an emotion nearly long-forgotten - TRUST. I banished it to my basement along with the other more tender emotions. If other people trust with their hearts, mine has gone made its home in the hovel downstairs. I trust from deep down there, like a slender creeper growing out of the ground. And what do you know? He's right after all. My vagina thinks she's only nine years old. That's the last time she breathed free. Sweet child of mine indeed.

I used to be a sweet child. Warm, affectionate, trusting and open and always getting into scrapes. All of that went away with the confinement, right down into my vagina which is everything I am not. Sweet, pure, soft and warm. And it stayed that way for twenty years despite the confinement.

~o~o~o~o~o~o~o~o~o~The book was wonderful. But the play brought it to life. It made me laugh (not smirk) and cry (not scowl). It gave my vagina her freedom and her voice too.

This is for Mahabanoo, Dolly Thakore, Avantika, Jayati (the moaner!) and Sonal Sachdev, the wonderful, spirited ladies who made last night come alive at Prithvi theatre. You made me whole again. You brought me back to life.

~o~o~o~o~o~o~o~o~o~

If my vagina were to dress up, what would it wear?

Well, it's worn iron shackles for two decades. Now, if she could, she'd like something light and airy - preferably nothing at all. :grin:

~o~o~o~o~o~o~o~o~o~I read Lolita when I was eighteen. It was a revelation. One more step in what turns out to be a long journey. A journey of healing. A lot of people I've discussed the book with say that it is a sick book, making excuses for paedophilic behaviour. But I think, they just don't know. Of all the people, I can hardly be an advocate for child abuse.

But reading Lolita gave me some perspective on what happened to me. I suddenly saw my abuser as a human being - a very bad and flawed human being, a sick human being but a human being nevertheless. Not a monster, but human. And human beings can be overcome, overpowered and even forgotten. Almost.

~o~o~o~o~o~o~o~o~o~About 5 years ago I was at a doctor's clinic when I suddenly realized that the man sitting across me was my former guitar teacher. I was shocked that it had taken me that long to recognize him. Even more shocked at what I felt - nothing at all. In my memories he was a big-built man. But in person, after all these years he just looked so tired, so small, so weak, so obscure and so old. I can't change what happened and it would a lie to say that I've forgiven. This is a wound that cut me so deep, it bled me right out of the right to be angry and seek revenge. Seeing him again was like someone smoothing over the scars of the wound.

~o~o~o~o~o~o~o~o~o~I didn't have the courage to put this up online immediately. I had to ask a few friends about it. Two of them told me that it was deeply moving and should be shared. One cautioned me that I should remember to ignore any weird-ass reactions. Finally two others, told me about their own personal accounts of horror. And in the end, that's really what gave me the courage to share this.

Happy birthday to my vagina. And welcome to the world of the living again.

Snoring in Peace

Suresh Naig — Tue, 17 Jun 2008 02:42:46 EDT

Of late my wife keeps complaining that her sleep is insufficient. Not that she is getting older, or she has any pressing problems. As always, pinning me for all her inadequacies, when she accused me for her lack of sleep, I was perplexed. Don’t get me wrong. She attributed her lack of sleep, to my sound sleep.

No. She is neither envious. When she described minute details of my ‘snoring’, I couldn’t help but laugh. When she mimicked my snoring – she is popular in our house for mimicks and she has given several repeat performances on request – I admired not only her mimicking prowess, but also the rhythm of my snoring.

The facts pertaining to snoring, is as weird as snoring. I started collecting details on snoring, corroborating with my personal snoring pattern, and some of them are very interesting, a few very disturbing.

The first fact would make men, rallying behind “harassed hubbies”, very happy.

Because it is mostly men, who snore with advancing age. The “harassed hubbies” in wakeful hours, can take a sweet revenge, during sleep. It may be because their voice is silenced, when awake after marriage, their sub-conscious mind helps them to raise their voice during sleep.

Snoring intensifies with consumption of alcohol or sedatives. I also found out that, my snoring decibel increases, when I am physically drained. As per the medical literatures, during sleep all the muscles are relaxed, the relaxed muscles of the air-way, causing obstruction to the air movement in the wind –pipe, resulting in the resonant snoring.

Initially I did not consider it serious. One night, I was startled and woke up as I felt breathless. Further research of mine, lead me to believe that I survived what is known as “sleep apnea”, mostly associated with snoring men. Suddenly breathing stops for more than ten seconds, due to the blocking of the wind-pipe, by the relaxed muscles.

Instead of resorting to hi-tech investigations and medicine, which my physician warned is not fool-proof, I started looking for other avenues, of course not the off-course ‘Quacks’.

My regimen consisted of brisk walk, towards reducing my weight especially my bulging tummy, few Hatha Yogas, which I learned it long back, regular “Pranayama”, total abstinence from the magic elixir in exotic names & packings, and the white stick with fire at one end and the fool at the other. The results were dramatic. Within a month my wife was looking fresh in the mornings, having slept peacefully, since she never had the necessity to shift to another bedroom, in the night. I wished to end this, like the bed time stories we heard, usually ending with “they lived happily ever after”. But it was not to be.

A fortnight ago, I was urgently summoned by MD, who was in Colombo, for finalising a business deal. I was to catch the early morning flight of Srilankan Airlines, scheduled to depart from Bengaluru at 0140. I left my house at 10PM and the flight was delayed, which left only at 0340 hrs. When I reached the Hotel at Colombo it was 6AM, and my day started immediately, with the briefing by my MD.

The day was very busy with several rounds of meetings, we eventually concluded the deal at 5pm. It was so lucrative, my boss wanted to celebrate. I had few swigs of finest wine, on the house, a courtesy extended by the Casino and my boss. After few hours, my stomach and his pockets were full, we retired to bed at 11 PM to catch the morning flight at 0740hrs.

Since we had a lot to savor, I shared his luxury room. In the morning when I wanted to make some coffee, I was surprised to see that, no coffe sachets were available in the tray, which I saw the previous night. My MD was looking haggard, when asked, he replied with usual sarcasm- You lived up to your designation of GM-Operations, you were operating that Bull-Dozer of yours in full throttle, throughout the night. I never felt like waking you up, I spent the whole night drinking coffee after coffee. Both of us skipped the luxurious break-fast, the finest accompaniment in business class, for an hour’s sleep.

And I thought we accomplished it. On touch down at Bengaluru, my MD pronounced two vital points he learned in that trip. First one was not to share a room with me and the second, not to have me as his co-passenger.

Book Review: Mountains Beyond Mountains

Shantanu Dutta — Fri, 13 Jun 2008 13:12:30 EDT

The story of Dr Paul Farmer, an unconventional American doctor, medical anthropologist and ethnographer as recorded in Mountains beyond Mountains by Tracy Kidder is a riveting piece of work; considering it is after all classified as a biography and describes the life and work of an infectious disease specialist dabbling in TB, HIV & AIDS, human rights, international health and a myriad other things.

Twenty years ago, Paul Farmer, then a young doctor met Ophelia Dahl, the daughter of the renowned British author, Roald Dahl, then on a volunteering trip to Haiti. He was 23 and she was 18. Their initial romance did not last but their friendship did and together they founded a rather unconventional charity called Partners in Health.(PIH) Mountains beyond Mountains is as much the story of this charity as much as that of Paul Farmer, Ophelia Dahl and Jim Yong Kim and their large hearted benefactor Tom White, a unique millionaire with the determination to die practically penniless, giving away his entire fortune way along the way. Now in his eighties, he has largely succeeded in doing this.

A man of Paul Farmer’s eminence as a clinician and an infectious disease specialist with a particular affinity initially for tuberculosis and then for HIV & AIDS would be expected to confine himself to the technicalities of disease control and international public health. But Farmer’s vocabulary includes terms like redistributive justice, preferential options for the poor and published works like Infections and Inequities : The Modern Plague(University of California Press, 2001) and Pathologies of Power : Health, Human Rights and the New War on the Poor ( University of California Press, 2002). Continuing in the same vein, Paul Farmer could then go on to write erudite articles in the Lancet, International Journal of TB and Lung Disease or the Medical Anthropology Quarterly

The PIH vision says it all “At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When a person in Peru, or Siberia, or rural Haiti falls ill, PIH uses all of the means at our disposal to make them well—from pressuring drug manufacturers, to lobbying policy makers, to providing medical care and social services. Whatever it takes. Just as we would do if a member of our own family—or we ourselves—were ill”

This is best illustrated by the story of John, a little boy from Haiti, who was discovered to be suffering from naso pharyngeal cancer and could not be treated in the country. Incurring a cost of close to 20,000 $, the boy was airlifted to the Massachusetts General Hospital for treatment under the world’s best pediatric oncologists. When the boy eventually died, one of his younger staff members brought up the classic cost effectiveness question- the money spent on that one boy who any way died could have saved many other lives. But for Partners in Health, Paul Farmer and his friends, conventional number crunching was not important – saving every life and treating every one who crossed their path was the driver… as Paul Farmer would explain to Tracy Kidder…. People were not numbers and every life was important.

Perhaps the most disturbing element of the book is where Paul Farmer’s philosophy of life – and it is profoundly provoking. As Farmer puts it …… “What we are really trying to do is to make common cause with the losers. We want to be on the winning team, but t the risk of turning our backs on the losers, no, it is not worth it…… I am not going to stop because we stop losing…..”

The question stares at us … in a culture, society and time where success is every thing and winning every battle counts and tabs are kept of every loss, how many of us can stand up and say that we want to be on the winning team…… but not by selling our souls. Paul Farmer, Ophelia Dahl and Jim Kim, Tom White and their bunch come through as incredible people who will be an inspiration in any generation. Unlike many charities of this nature, which grow cash rich over the years’ Partners’ in Health hasn’t. Ophelia Dahl, the long time Director reports in her web site that for the first time in twenty years, Partners in Health was not able to raise enough funds to cover the budget for the twelve months ending December 2006. for those looking for a charity to donate, here is a worthy cause.

On Mercy Killings and Euthanasia

Pingu — Wed, 11 Jun 2008 14:45:09 EDT

A teenage girl in Siliguri has been demanding mercy killing. The issue of mercy killing has been discussed several times and yet there is no provision in the constitution about it. The legal hassles involved are just too much.

In the case of the girl, Ms Fulbari Das, she is requesting mercy killing because she has been suffering from tremendous abdominal pain. After her surgery (to remove the kidney stones), her condition only worsened and for the past year, she has been living under a lot of pain.

I have lost all faith in doctors as I don’t know if my disease or wrong treatment is responsible for my condition

-Ms Fulbari Das

She is currently admitted in the North Bengal Medical College & Hospital.

Now there are a lot of factors that one needs to take into consideration. Now this is a rather complicated case (as most euthanasia cases are). The first and foremost is regarding terminal illness.

Based on the information in the newspaper, she is suffering from tremendous pain. I am assuming that’s the only reason why she wants to end her life.

What I mean to say is that I don’t think Fulbari’s case can be proved as terminal illness merely because the cause of her condition isn’t fully known. Another issue which might stop the doctors from taking this extreme step (apart from their inhibitions that they’re breaking the law) might be her young age. It’s quite convenient to think that a young girl like Fulbari might be making a hasty decision and this might just be a solution to end the short term discomfort. One way of looking at it is that it’s her life and now that she is legally an adult she should be responsible for it. Another way at looking at it might be that she is still quite young and has her whole life ahead of her and what if there’s a slightest chance of the pain going away. The question here is, as long as the doctors take their time to find a solution, this woman is experiencing pain beyond everything. Should that or shouldn’t that entitle her to end her life.

The Indian constitution hasn’t really helped matters either. Verdicts in the past have shifted either ways, merely because of the complexity of the circumstances. The Indian Constitution says that the ''Right to Die'' is not a fundamental right under Article 21. However for the first time in 1987, during the The State of Maharashtra v. Maruti Shripathi Dubal case the judges at the Bombay High Court felt that the desire to die is merely abnormal/uncommon but not unnatural. They listed several circumstances in which people may wish to end their lives, including disease, cruel or unbearable condition of life, and a sense of shame or disenchantment with life. And finally held that everyone should have the freedom to dispose of his life as and when he desires. That being said there have been many more instances where panels of judges have simply overruled the plea.

I think the authorities should really work on the finer aspects and various circumstances. The reason I say this is because we’re really progressing as far as science is concerned. In the future years the technology might achieve so much progress so much so that we might have support systems which can keep a person alive, just saving him from claws of death but not really giving him a life. What if the person doesn’t want treatment? I think along side the research that’s going on in medicine (or any other branch), we must also keep updating our constitution regarding matters which might be affected due to this advancement in technology.

Tobacco: Gift From the Great Spirit or Global Epidemic?

Harold Bergsma — Mon, 2 Jun 2008 12:40:06 EDT

Blame it all on the Indians, the American Indians, that is. They were smoking when the pilgrims arrived. Histories about tobacco state that the weed grew and was used in the Americas as early as 600 B.C. It is well documented through artifacts that the ancient Mayans smoked tobacco as far back as 470 A.D. In 1492, Christopher Columbus sailed the ocean blue and ‘discovered’ tobacco. Americus Vespucci, for whom the Americas are named, wrote about the natives use of tobacco and that it was a very “curious habit” of inhaling smoke from a pipe and blowing it out again. They are still at it! Tobacco was considered a rare and special gift and was used medicinally and ritually by the native people of the Americas. It was considered a gift from the Great Spirit.

The American Lung Association report of 2007, “Smoking and American Indians/Alaska Natives Fact Sheet” presents some current, interesting facts about the use of tobacco. “Among racial and ethnic groups, the prevalence of current smoking is highest among American Indians/Alaska Natives (32%). Also, ”American Indian lands are sovereign nations and are not subject to state taxes or laws prohibiting the sale and promotion of tobacco products to minors. As a result, American Indian youth have access to cheap tobacco products at a young age. Tobacco is also considered a sacred gift and it is used during religious ceremonies and as a traditional medicine.” Then, “Chronic cigarette smoking and spit tobacco use increases their risk of developing tobacco-related health problems. Tobacco use is a risk factor for heart disease, cancer and stroke, all leading causes of death among American Indians and Alaska Natives. And… “In 2004 American Indian women had the highest rate of smoking during pregnancy (18.2%). This 2007 report indicated that as smoking declined among white populations, “…tobacco companies targeted American Indians… by funding cultural events such as powwows and rodeos to build its image and credibility in the community.”

In the early colonial days of the new world, the explorers and settlers took up the pipe, perhaps what the movies love to call the peace pipe, and got hookah-ed. They became addicted with the cursed weed. Its use created such a high that the colonialists decided to bring tobacco to Europe in 1558. It became a smoking disaster, a kind of ‘ashes to ashes’ thing. But back then lighting up was a sign of high fashion, sophistication. Even the women began to puff. Smoking tobacco was done openly. Somehow a smoke filled room brought on a feeling of authority, mystery, and it was here that business deals were spawned. Early European governments decided to make money on tobacco import and taxed it heavily. King James I, well known for his version of the Bible (1611), is well known for imposing staggering taxes on tobacco imports, some historians say, 4000%, and not to curtail its use, per se, but to benefit from the cash flow into the government’s kingly coffers.

Leap forward in time. In 2008, millions of Asian Indians are smoking themselves to death. They can thank sailors who took the weed to various ports of the world; colonial settlers carried with them the seeds for change, to places like Goa and Sri Lanka which became hot-houses for growing tobacco. Within a century the Indian continent was enjoying the pleasures of the weed. For some reason, smoking, whether you were a rajah or a coolie, went well with a cup of chai, smoking relieved the sweating laborer pulling a rickshaw, it gave endurance to the koila wallahs staggering up the steep Landour hills carrying elongated baskets of charcoal larger than themselves, wheezing and grunting at each awful, laborious and trembling step while smoking; smoking enhanced social gatherings of the wealthy, the drinking of alcohol, smoking began to replace a desert after a good meal; smoking was Kool with a brandy held in one hand as the sahib log met alone on the verandah or in the drawing room while the women gossiped, (is that what they do?) and supervised the bearers who cleaned up the dishes. Smoking was for everyone including our chowkidar who sneaked around quietly on the compound with bare feet; but we always knew where he was because he smoked bidis.

Opium was a world problem, but soon was eclipsed by the tobacco epidemic which became the biggest killer by far. Imagine a silent war that would kill eight million people, annually! Tobacco, as we read this, is doing just that. “…tobacco is the only legally available consumer product which kills people if it is used as intended.” (The Oxford Medical Companion, 1994.) Tobacco, and its ability to create addiction rapidly, (some say after two cigarettes) is presently a global epidemic, and China and India have the highest addiction rates, together representing almost forty one percent of the world’s total use of tobacco. If only just the rich and influential smoked in India, it would not be such a huge problem. Those people have good medical care and when they get cancer, they have the funds to pay the medical costs and to provide care for survivors through savings accounts, life insurance and stock portfolios. But those already in poverty are doubly damned by their use of tobacco. The net economic effect to them when they use tobacco deepens their poverty. The costs are staggering in lost lives, lost labor and lost income. The poor are disproportionately hurt by tobacco because the lowest income group has the highest tobacco use rate. Bangladesh’s poorest households spend ten times as much on tobacco as they do on education. Pakistan is not far behind. Bidis are cheap poison.

The 2008 WHO “Report on Global Tobacco Epidemic” is clearly written with wonderful charts and graphs which reveal a tragedy of immense proportions globally. Time Magazine, Vol. 171, No. 10/ 2008 also presents the problem graphically with the use of a huge cigarette which shows which countries use the most tobacco. The above-mentioned report states, “If global trends continue, by 2030 more than 8 million people will die each year from tobacco related causes—80% of them in the developing world. Among other things, a new study finds that in India, where 120 million smoke, and 5 cents buys 10 small cigarettes called bidis, 1 in 5 men will die from smoking.”

How they got that statistic, that only 120 million Indians smoke is unclear, the number seems larger than that to me, but let that be. I can unscientifically state that during my various visits and residencies to India, Pakistan, Nepal and Sri Lanka, I was amazed at how many people smoked. I was amazed at how many public establishments allowed the use of tobacco, considering what we know from research about second-hand tobacco’s effects on people. Can you see the shop keepers, squatting and smoking their hookahs? Or the subzi wallahs (vegetable sellers) in Mumbai, smoking bidis? ( If I smelled that odor today I would turn my head to track it down. )

Bidis! There is nothing like a reformed, old sinner to get on the case of those who are still sinning. ‘One can always find dirt if one digs deep enough,’ one of my critics wrote recently. Confession is good for the soul. I was once addicted to bidis. What a wonderful invention they are. Pure, strong tobacco, no paper wrappings, nicely shaped and so very cheap and perhaps lethal. As a high school student residing in Mussoorie I would sneak off with my buddies to indulge in a smoke, sitting in a quiet corner in utter contentment as the nicotine raised the levels of our already raging life urges and hormones. That was a beginning for me, and yes, the fault this time, goes to a real, pukka Indian, our cook, Caseru, who smoked bidis and was happy to share his habit with me. That introduction to strong tobacco lasted another twenty years before I was finally, happily and permanently was able to shake the ‘dirty habit’ as my wife and my mother would say.

Global Epidemic! Yes, and the problem is that about 70 % of those addicted and who are going to die from tobacco related causes, reside in ‘developing’ countries. Worldwide, tobacco companies now target developing countries with their effective sales pitches; and what disturbs me greatly is that the new target population group that is being influenced is young women. This trend is something new. Usually women had enough sense not to smoke, culturally it was considered to be unsuitable for women to do so. Now? Now it is the new rage, girls are learning to smoke and join their men, puffing away. In America girls are the taking up this habit with a passion. This tragedy will change the statistics in the next ten years. Rates of cancer deaths from tobacco use, cancer, will increase tremendously as a whole new group becomes addicted. Tobacco is the only legally available consumer product, that is if used properly, as intended, will kill millions of people in India, with an increasing percentage of them being girls.

What is the answer? What is the solution? How can this epidemic be stemmed? Or, as one snide cynic asked, is there even a need for a solution? Is this an evolutionary mechanism at play in the global ‘survival of the fittest’ game? People who have addictive personalities will die off. (Bad logic, they reproduce at a young age and pass it on.) Perhaps they meant, oh well, there are too many of the poor addicted blighters anyway.

India is not alone. China has an even greater problem. America is experiencing a disturbing trend. Young women and girls are taking up smoking at an alarming rate, while the American population at large, is actually reducing its use of tobacco.

Unfortunately, the poor, the illiterate, the unsophisticated, the unschooled are the hardest people to influence; quoting statistics at them won’t help. National legislation? Heavy taxation on tobacco products or their producers? Prohibition of advertising on television, bill boards and the radio? Education may be the answer. Wherever there are schools where young people meet, the facts about the tobacco epidemic can be taught. But the curriculum will have to be presented by teachers who are not smoking ‘secretly’ on their break in the staff room. Perhaps that is a good starting point; the teachers.

The WHO report I mentioned above is a very fine document. Unfortunately few people will ever read it. Answers about how to solve the problem of Asia’s increasing tobacco use are being sought by responsible people in the world community. It may take a generation to create changes among those already addicted. Young people need to be informed. We worry about the deaths that would occur if atomic bombs were used in the Indian sub-continent. We already have a slow-fused devastation occurring of gigantic proportions that needs to be addressed by all, the politicians, scientists, religious leaders and journalists. This is an area of ‘development’ that must be addressed, now.

The American Indians really started something that was lethal, strange and dreadful that Indians have adopted; a killer in their streets, a rampant mad dog that can only be dealt with in one way, dispatch.

Book Review: The Global Food Economy by Tony Weis

C R Sridhar — Mon, 19 May 2008 08:28:57 EDT

The corporate images of the food economy are full of deceptive advertisements of a mythical cornucopia of contented animals waiting for their disposal as someone else’s meal. The other images, which reinforce the intrinsic ‘fun and plenty’ of the food economy, are of supermarkets catering to the affluent sections of society, with food products stacked in shelves procured from far off places.

Beneath the illusion of plenty, there are other contradictory images of starved babies with distended bellies in famine stricken Africa, coexisting obscenely with obese people from the developed world. Starved farmers in agriculturally dependent economies who eke out a miserable living out of cash crop economy offer a harsh contrast to the bon vivant life style of CEOs of Transnational Corporations.

Tony Weis, an Assistant Professor of Geography teaching at the University of Western Ontario- Canada, has written a book called The Global Food Economy, which is a searing indictment of Big Agri-businesses destroying small farmers and the delicate eco-systems devastated by modern capital-intensive modes of production. Going beyond the platitudes of corporate PR, the author ‘examines the human and the ecological cost of what we eat.’

At the heart of the problem, the author argues, lies the role of TNC agribusiness, especially the grain-livestock complex, in adopting industrial methods, which are inimical to the eco-systems and the condition of human beings in general.

Ecological footprint

The ecological footprint left by Industrial Agriculture is a negative one and exacts a mounting toxic burden. In the past the long-term viability of farms depended on a sensitive relationship with respect to the ecological limits of growing food. It was recognized that there must be functional diversity in crops, soil species, trees, animals and insects to maintain ecological balance and nutrient cycles. This was maintained in traditional farming methods by multi-cropping, rotational patterns, green manure, fallowing land, careful seed selection and the integration of small animal populations.

In contrast modern farming transformed by capitalism and industralisation represented ‘a movement toward the radical simplification of the natural ecological order in the number of species found in an area and the intricacy of their interconnections’. This was made possible by the development and rising use of synthetic fertilizers, agro-chemicals, enhanced seed varieties/genetically modified seeds, farm machinery, concentrated feedstuffs, animal antibiotics and hormones, and the expansion of irrigation systems, which allowed industrial techniques to override previous ecological constraints. Moreover, embedded in industrialized farming is the new dependence upon fossil fuel consumption in the twentieth century, not only on transportation costs involved in bringing the food from the place where it is grown to the plate of the consumer and the demands of the machinery used for agriculture instead of animals, but with the petroleum demands of proliferating synthetic fertilizers and agro-chemicals. With the price of oil reaching $120 per barrel (expecting to touch $200 per barrel) it is certain that food prices would shoot upwards.

Rejecting simplistic notions that the industrial transformation in agriculture has resulted in high yielding crops, which are also yield stable, the author points out the inconvenient truth that it leads to chronic toxicity. This is evident as crops grown in industrial monocultures are prone to pest infections- a threat that is suppressed by the use of pesticides leading to greater pest resistance to the pesticides and involving greater use of pesticides in a never-ending cycle. The excessive use of pesticides results in pesticide poisoning which afflicts nearly three million suffering every year leading to 2,50,000 deaths. The other problems that arise with mechanized tillage are that the soil is drained off its nutritive power. The quick fix in the form of technology is a mere illusion as more and more use of inputs serves to mask the problems while creating fresh ones, one of which is the increasing use of fresh water for agricultural purposes, which is becoming scarce and a flash point of conflict.

Hoof prints left by livestock

The increased meatification of diet offers fresh challenges to the eco-systems as the increased demand for consumption of meat products leads to large-scale supply from feedlots. There are also health problems associated with increased meat intake as it increases the risk of strokes and cardio-vascular diseases.

In the factory, the dense livestock population is the major consumer and polluter of water. It is calculated that in excess of 3000 litres of water go into producing a single kilogram of US beef while a factory farmed pig requires about 132 litres of water for drinking and flushing of its wastes. A typical slaughterhouse in US uses in a day the water used by 25000 people.

The faecal matter of the cattle and pigs creates problems of waste disposal, as it is a gigantic task to get rid of 1.4 billon tons of animal manure (US) without polluting the rivers and streams. Added to the problems of sink function, there are health hazards arising out of over crowding of poultry birds in production factories which exposes the public to the dangers of a virulent strain of H5N1 which is capable of mutating and jumping the species barrier to human beings. The WHO warning led to hundreds of millions of birds getting culled in China, Thailand, Vietnam and Indonesia. The feeding of neural tissues, bone meal and blood from cattle carcass to essentially herbivorous cattle created the mad cow disease (BSE), which could transmit to humans when they eat the infected meat. Thus the hoof prints left by livestock production leaves an intolerable burden on eco-systems and public health.

An Uneven Playing field

The human cost of the food economy is a heavy burden disproportionately resting on developing countries- where overwhelmingly large sections of the rural people depend on agriculture for livelihood. TNC Agri-businesses, which are subsidised by rich developed countries (especially US) flood the world market with cheap grains/ cereals, driving the poor farmers of the developing world out of the market leading to destitution and poverty. They are driven to cities in search of jobs in Urban areas, where they constitute the under class found in Urban ghettos living in abject poverty and filth. Most of the poorer countries are still trapped in neo-colonial relationship with centers of Metropolitan capital as they increasingly depend on cash crops grown for export to the affluent people of the world and face the daunting prospect of not able to feed themselves out of their dwindling export earnings. The producing countries simply do not control the international price for their commodities- they take what they get. The export earnings are insufficient to buy finished goods from the developed countries and they face the dreary prospect of increasing the volume of export of cash crops without increasing the value, which is just not enough to pay for the imports.

The author’s book is a sane and compassionate plea to reorder the global food economy to serve human needs and not the diktat of corporate agriculture with its obsession of profit maximization. In the last chapter of his book called the future of farming, he passionately calls for moving agricultural systems off the chemical and fossil energy treadmill and towards lower-input, labour-centered intensification and more bio-diverse agriculture. That this vision is not that of a Luddite who wants to turn the clock back to a romantic past, is borne out by the fact that there is an urgent need for agro-science to be shaped by more scientific research for more humane ends like empowering the small farmer and not for mindlessly enriching the corporate coffers of the few.

For people of India, especially the middle class, who are enthralled by the IT service economy, it may be a wake up call to know that even today two-thirds of its one billion plus population still depend on agriculture as source of income. The author’s book, which pleads for a socially just, ecologically rational and humane food economy, should find a place in our bookshelf.