Desicritics Category: Culture: Health

Photography Times: Celebration

Vidhya — Sun, 18 Jul 2010 16:27:05 EDT

A few weeks back we headed out to Olive Garden for dinner. “We have some of the finest wines for you to start”, the maître d’ had said as he seated us at a comfortable table. That was when I first tasted Castello del Poggio Moscato – a fine sweet sparkling wine that is sure to make one surrender to its taste. It indeed was a perfect start for the dinner!

Wines have a distinct charm of their own, not to mention the health benefits generally associated with Red Wines. Wines have a special place in the field of photography as well. The color, the sparkle, the wineglass with its unique curve has been a subject of many a creative photograph.

This photograph of a rim-lighted wine glass with Red Wine is something I had been conceptualizing for a while. This area of photography is generally called the Concept Photography. Shooting a Concept photograph involves a significant analysis of the message one wants to convey. The idea was to portray the Red Wine glass as a sign of Cheer and Celebration; the reflection of the glass on the table denoting a level of sophistication and the dispersed red tinge towards the right arc of the glass symbolizing a sparkle.

The logic behind the lighting effects of this Wine glass was the fact that – when a beam of light is placed directly behind the glass, the rim of the glass reflects the light, while the wine in the glass blocks the light – thereby forming a rim-lighting effect. It required a few trials to get the positioning of the backlight to be at the best possible angle so that the rim is sufficiently lighted and at the same time there is no unwanted light falling on any other sides of the glass. Placing the glass on a shiny dark-wood table helped with the reflection on the floor.

In addition to the lighting and its angle, the photograph was shot with the aperture and shutter adjusted such that the exposure is controlled sufficiently to make the surroundings dark and to let only the light-reflected areas to show up. So after a few attempts to get the combination closest to what I had visualized – here's to all good times – Cheers!

Indian Railways: The World's Largest Loo Network

Being Cynical — Fri, 9 Jul 2010 13:27:24 EDT

Why can't we be little sophisticated, if not sober is all what I think whenever I travel by Indian Railways. When we are capable of sending an unmanned toy to the moon, calling it as the Chandrayaan and tout ourselves on the verge of manufacturing our indigenous Cryogenic engine, can't we think of a better way to give our loos a modernised look in our Railways? If not for comfort at least shouldn't we develop a better disposal mechanism, rather than making all our Railway tracks along with the platforms perhaps the largest and longest toilet network of the world?

Anyone who had travelled via our Railways would have some reservation in calling those obnoxious looking small cabins at the end of the boogies as toilets. A steel base with a hole down which would help you see the moving tracks below when the train is in motion is far from termed as a toilet. All what the patrons left to do is to spread out above that hole and drop down whatever they can. The quantity is never a concern, so does the location. Thanks to this legendary loo engineering even a blind man can spot the Railway station in any city as the aroma of fresh drops on the platform would hit your nose the moment you are anywhere near 200 meters of the station. The beauty that this natural artwork adds to our already filthy Railway stations is for anyone one to see and worth appreciating. But to amuse all our Railway authorities think we Indians are sober enough (even when we are travelling) to read the scribes written on the door advising individuals to refrain from the dirty work when the train is in stations. That's too much of an expectation when we are not even considerate to our constitution and flaunt it in every level that too openly to agree to some idiot's suggestion written on the door panel. I have seen entities give their bladders and bowels a lock and eagerly wait for the stations to come, so that they can do away with their dropping exercise without bothering for the unwanted jerk that a moving train provides. In fact the toilets are found mostly occupied on stations with few more in line in the wait list to contribute generously to the beauty of the platform.

Other than the platforms this loo mechanism works as a mayhem for the general populace of the city who might have got nothing to do with the moving train or the entity inside the loo. Every time the train passes over a bridge in the city area the bikers apply their brakes as hard as they can and stop few yards before the bridge - A part out of respect and another part out of self respect. Our trains might be painfully slow but the stuffs flying out of it are oppositely faster. Even our over bridges have adequate size strategically placed openings to let the drops go through them with ease ornamenting the unfortunate individual on the road who might not be aware of this trick. Just wondering why to have bridges ? Let there be the old fashioned level crossings as the traffic comes to a grinding halt whenever a train passes over the bridge on both side, much like the level crossings.

Our stride towards having the world's largest loo network was cut short when Mamta Didi suggested something called green (I always thought them to be yellow though. My mistake) loo. I am not sure how far green we became but the whole idea failed miserably. After the green thing was announced I happened to travel in one of the trains which was marked to have a green loo on experimental basis. More than my journey I was excited to have that honour of having a glance at that green loo. No sooner I entered the loo, I was disappointed to see the same steel base with a slightly bigger (chances of toddlers going down to the track below) hole. Is this the green thing (a bigger hole) Mamta Didi was talking about, I asked the attendant. I don't know what I got as a reply but for sure I was more confused than I were to begin with and had that sudden urge of relieving myself down that hole to the track below.

Keep this in mind, the elaboration is for the AC boogie toilets. How devastating our sleeper coach toilets are is any one's guess. Can't we think of someway of storing the unwanted stuff somehow and getting them disposed on stations in some civic way? Perhaps we are capable of finding water on moon surface but not brilliant enough to contain this water and last nights rotten Railway food extract from flying out from all directions of our Railway boogies. Till we get to that green loo thing it's better to have a deodorant bottle handy while on stations or if at all you see a train going over a bridge stay away from it and pray to God that the things flying out are not fast enough to splash your face from that distance and you look more civilized when you are back at your home.

Bhopal : A Gas Tragedy

Being Cynical — Wed, 23 Jun 2010 18:40:25 EDT

I was confused then and I am worried now. And still it has got nothing to do with Terrorism, Maoists or Himesh Reshamiya. Being a kid when the damn thing happened, I had little or no idea on this whole gas issue. Or I should say I had an overtly embarrassing confusion on the very word called Gas. I still remember when our small classroom filled with more than required number of pupils thrown into some unbearable smell of last night's Paratha and Dahi Wada, our class teacher pointed at the culprit with her ever so shrinking nose and advised him to maintain some civic sense and refrain himself from producing unwanted gas in public places. So when it came to the Bhopal catastrophe of some uncontrolled gas leak my knowledge was limited to the Dahi Wada aspect of it and not beyond. So when this gas did manage to kill some 20000 odd people it took me by surprise, as I never had an idea that a gas other than make you vomit does have some killer instincts too.

Now the worry for me after 26 years of the said gas leak is the way we handled it. When I say we, it constitutes all citizens, our then able government and the governments to follow, our judiciary, Arjun Singh with that cap, the peon at the investigation agency, et all. If this farce of 26 years is to be termed as an effort to give justice to all those who suffered, then let me assure you, it failed more miserably and quickly than Jugal Hansraj's bollywood career. I would say my class teacher handled the gas leak situation better and made sure the culprit beg an apology for his unwanted behaviour and advised all others not to repeat this mistake of our friend ever. But in case of the Bhopal leak we as a country failed decisively on all aspects - starting from rehabilitating the sufferers to bringing the culprits to book.

We never value the lives of our countrymen is a well known fact, but never been displayed so openly before Bhopal. The Anderson chap, who was touted to be the culprit in chief very ceremoniously being taken out of the country by government chartered flight was nothing less than some Priyadarsan's comedy movie. Now when asked what made the government take so much pain in transporting perhaps the biggest offender of Indian law, we hear some idiotic version of law and order going haywire if he remained stationed in Bhopal. If even this argument is taken on face value, it still baffles me and million others on why this chap was allowed to fly out almost giving him a state honour? He could have easily been dumped in some jail in Delhi, if not Tihar and the law should have been allowed to take it from there.

The sharp contrast of British Petroleum paying 20 billion to USA for killing few Turtles and Octopuses in Gulf Of Mexico to the $450 compensation for each dead corpus in Bhopal is nothing short of projecting ourselves as a bunch of jokers. If this comedy was not enough the apprehended smaller fishes were handed a paltry 2 years jail term and bailed out in 58 minutes is rubbing salt in the wounds. Two years jail term for 20000 deaths? doesn't it look like something has gone horribly wrong somewhere? Looking at these statistics I don't think we have any authority to hang Afzal Guru or Kasab, if we judge all these cases on the same yard stick. Well Hang on - I don't think these two jokers would ever be hanged though.

Now what have we achieved after 26 years? A sour mouth and red ass, 450 dollars each which I guess the average outgoing US spoiled brat might be spending in strip clubs over the weekend, a new avatar of Arjun Singh plus the white cap, Manish Tiwari becoming a definition of idiocy and as usual Bharat Ratna Rajiv Gandhi (then Prime Minister) projected as the sole person in the face of the planet who seriously wanted justice to be delivered to the gas victims. So many achievements, I must say.

Thanks to the media, the case was revisited by the present government and some useless committee did finally advised the prime minister on how the whole thing has gone wrong. But justice seems to be far from being delivered. The Anderson fellow is enjoying his golf and National Football League and cheering from Chicago Bears, while we as a nation are deep in blame game and some funny looking jingoism. None seems to stand accountable. Arjun Singh (Minus the white cap) washed off his hands by pointing the blame to the dead Narashima Rao, who in turn might be pointing to Rajiv Gandhi somewhere up in the heaven and we lesser mortals are searching for credible answers down below on planet earth.

National disgust is a milder word. I always thought for 2010 the biggest national shame would be the Commonwealth Games, but was proven wrong as the biggest shame for this financial year came at least 4 months early. I as well as all know, nothing is going to come out of this in future. We are licking our Bhopal wounds and would continue to do so. Only prayer is that no more national shame be brought in prior to the last national shame for this year - The commonwealth games. Till then move on and plan your next holiday somewhere in Andaman & Nicobar. Good Night!

Book Launch: Angel of Death - The Story of Smallpox

Dr Bhaskar Dasgupta — Tue, 22 Jun 2010 16:36:47 EDT

Smallpox was one of the deadliest diseases known to man. The reason I said “was” is that this disease has been conquered. Perhaps uniquely, this is the only infectious disease which actually has been conquered and killed totally. There are no smallpox germs anywhere in the world, except for in some laboratories. This disease has killed billions of humans down history, half a billion in just the last century itself. I like this story, the idea that a global problem has been resolved by human ingenuity, technology, global coordination, use of education, vaccination, and so on and so forth. Whenever I find that there is a global problem of poverty, climate change, lack of clean water or what have you, I just think about smallpox and how humankind overcame it and my enthusiasm and motivation come flooding back.

So when I read that a book on the history of smallpox, The Angel of Death, based upon primary original research is going to be released, I picked up my camera and took off to the Wellcome Trust to hear the man himself. Not going to give much away other than to say that the book is pretty good for a non-fiction book, it provides a great view on the various doctors who checked out the disease. It reviews diaries, it talks about the rich and poor who died a gruesome death, it talks about how the anti vaccininists worked (there are still men who do not believe in vaccines in this day and age!), etc. Strongly recommended.

But as I said, I took the liberty to take some photographs of the book launch. So this is not a book review as such (although I have talked about it above), but is more a photo essay on the book launch at the Wellcome Trust. It was also a charity event as all proceeds of the book go to a charity.

When you come to the Wellcome Trust building, what you see outside is this torch with two snakes entwined. You might wonder where this is coming from. Well, the Wellcome Trust is a medical charity and snakes form part of the staff of Asclepius, the Greek God of Medicine. Although the fact that it has two snakes means that its a bit confusing as that is a staff of Caduceus.

A view of Euston Road from inside the building.

Lovely hanging lamps in the vestibule.

And a great little quote on a poster. Anyway, be that as it may, this building holds a library, offices of the charity, archives and other bits and bobs.

It also contains a small exhibition in the ground floor, a cafe and a bookstore.

The Book Store

First you have a set of photographs of pretty much standard gift stuff you find in a bookstore, notebooks, cups, skeletons (ha!) etc.

The Books

Then you have the books. Its a scientist oriented / non fiction library, dont come looking around for mills and boon here.

Brilliant bag, eh? sounds about right to me :)

Books on London

Book summaries. Horrible.

There is an exhibition on skin and these displays related to skin, tattooing, etc. But we weren't here for these books, we were here for the book launch of the book on smallpox.

The Book Launch

Here’s the book, nicely arranged.

They had small tables with olives and crisps discreetly arranged, I therefore discreetly arranged myself next to a convenient refreshment table and gobbled up some of these lovely little nibbles.

The great and good of British medical intelligentsia were here.

This gentleman is somebody great and good at the Wellcome Trust.

Then the publisher came on.

And then the author spoke for about 10 minutes, explained the amazing journey behind the eradication of smallpox, how luddites were against the vaccination campaign and thanked a very large number of people who had helped to make the book a reality.

Then he was going around signing the books and at one time, he was kneeling down to sign more. Lovely chap. So I turned around and decided to take off back home but took some photographs of two exhibits that were in the reception.

The exhibition.

This was an extraordinary sculpture and positioning. And peek as I might, I could not see what it related to or who the artist was or what have you. Very interesting placement, eh? But the second sculpture by Silvia Petretti, which was made in wax mixed with one day’s dose of the chemicals in an Anti HIV medication.

This sculpture spoke to me, the tension in the body, the way the woman is lying, the stark glass box and floor. All makes it into a very poignant sculpture. Much more resources are being poured into the Anti AIDS fight compared to the smallpox fight, but mankind is slowly but surely winning the fight against AIDS as well. Gives me hope for the future. And here is the slideshow with more photographs.

Do Gadgets Obscure Observation?

Suresh Naig — Wed, 19 May 2010 02:57:54 EDT

A school girl from France vacationing at Phuket, Thailand observed certain tell-tale changes on the surface of the sea and warned her parents to move away from the shore line. Her observation skills learnt from her teacher, had saved her parents from the perils of tsunami on 26 December 2004. As a Boy Scout I was trained to hone my observation skills which had averted many gas, electricity and automobile related accidents in my life. Before the onset of complicated computerised gadgets, medical practitioners were supposed to have sharp observation skills and the test results would be confirmatory for them.

I have come across certain legendary stories involving observation faculties of doctors whose diagnosis used to be flawless. One doctor was in Madras before the name was changed to Chennai. A lady reached this doctor having exhausted all other avenues in finding a cure for her perennial head ache. After keenly observing her face and her diamond nose stud dazzling, he had requested the lady to lend it to him, so that he can replicate it for his wife. He had also prescribed some medicine of no consequence to her. When the lady came to collect her nose stud the next week, she had no complaint of head ache. The dazzling diamond caused the head ache by its direct reflection to the left eye. The doctor advised her not to wear the diamond nose stud. Another legendary observer - again a medical practitioner was from a remote village in north Kerala. By changing the yellow cloth which the child sucked along with her fingers he had stopped the yellow urine of the kid, saving further expenses and ordeal for the poor parents.

Recently one of my colleagues had visited an ophthalmologist for an eye condition described in medical literature as self limiting and benign. (I wonder what is benign about a malady. Perhaps it was used as an antonym to express non malignant. I would prefer innocuous instead). Instead of prescribing palliatives for a self limiting and "innocuous" condition, the doctor embarked on a series of tests to rule out the possibility of tuberculosis. The test results arrived after a week; expectedly negative for tuberculosis and the eye condition also improved being self limiting. Usually doctors resort to lab tests to confirm tuberculosis, when they observe drastic loss of weight, recurrent cough, blood stains in sputum, loss of appetite and most importantly evening raise in temperature. In my colleague's case in spite of none of the clinical parameters present, the tests were performed. What was confirmatory for the observant doctors is perfunctory for non-observant medical practitioners.

Foot Pain, An English 'Infection'

Amitabh Mitra — Tue, 30 Mar 2010 21:35:24 EDT

Picture yourself in eighteenth century England. I would rather be in Liverpool, walking on cobbled streets late in the evening, drunk like a skunk, heaving out of a tavern called 'The Turtle's Tale', slightly distracted by the cat calls and hoarse laughter of the hookers clamouring in the shadows, high heeled, their pelvis swaying and then suddenly the clippity-clop clippity-clop, is it that beautiful hooker stalking me or is it a carriage horse from a nearby lane? I remain blurred.

The ballrooms of Victorian England are full to the brim, the velvet, silk, artificial mannerisms and obviously the awful clippity-clop of the heels striking a rhythm louder than the piano music cannot keep pace with the swish of the clothes or hushed conversations in the corners.

The rooms of Mr. James Steiner, Osteopath and Podiatrist to her Royal Highness on the second floor of St. Georges Street, West End London are full of woman of all class, the rich and the famous, high class hookers and con women with their surnames ending in St. Claire, all having a common ailment, the burning feet syndrome or more specifically heel pain.

They have been treated albeit unsuccessfully by the streetside quacks with magical balms, dipping the foot in warm horse's urine sometimes hitting the plantar aspect with wooden hammers and sometimes tickling the nerves with a peacock feather, but to no avail.

The osteopaths used massage, sometimes corkscrewing the foot in directions as the muse dictated and sometimes dipping them in hot and cold water simultaneously keeping the banter of irrelevant conversations at the same time.

The Harley Street physicians looked at them with disdain, 'It's the foot that is meant to cause pain and the mind that must tolerate this pain' they said

Russian criminals posing as magic charlatans, having escaped from Tsarist Russia found refuge in London. They advertised their exotic titles, wares and equally exotic powers. Many beautiful well heeled women with heel pain fell to their charms. Their long beards and moustaches took the attention of these women from their foot sometimes even permanently.

Robert Wentworth an anatomist and a barber surgeon went to the extent of exhuming a dead body and dissecting the foot. He found nothing significant but went on to explain in his treatise the fascia, nerves and the calcaneal bone which individually or in combination may cause such a pain.

Eighteenth Century India, still under the various Maharajas, it's beautiful women always indoors showed diseases common to a tropical climate but rarely a heel pain or a painful foot that refuses to be cured.

Beautiful nautch girls danced in havelis and even on the bare back of Maharajas while holding on to a tree trunk. The right amount of pressure with their heels on their spine would relieve off the back ache. Unani Medicine flourished and people were healed off their aches and pains.

Modern Orthopaedics talks about a bony projection called calcaneal spur which might irritate a nerve or create a bursa that would cause pain. It is also referred as Plantar Fascitis or inflammation of the fascia underneath the foot.

I have operated on these spurs but unfortunately pain was never relieved. In fact the patient was left with an ugly scar and a chronic pain from the healing tissues.

The various treatments that may be followed are -

Decreasing activity
Stretching in bed the calf muscles
Taping in standing position
Application of Ice
Injection with Hydrocortisone
Massage
Losing weight
Arch Support
Extracoporeal shock wave therapy
A Below Knee Plaster cast for six weeks
Non Stroidal Anti-Inflammatory Drugs

So what might be the cause of foot pain, is it footwear that was prevalent in Western countries, can there be a genetic component or is it a symptom of a wider systemic disease like the rheumatoid disease? I won't be able to tell. My friend Glory Sasikala, a well known poet from Chennai suffers from this ailment. The physicians suspected that she might be having a thyroid or a diabetic disorder trying to connect the foot pain to a metabolic disease. Her blood sugar and thyroxin levels are found to be normal.

Meanwhile I think of the clippity-clop, the beautiful high heeled damsels wishing if only I could have been there during that period.

Pastel Drawing by Amitabh Mitra

Fear and Lust

KG — Tue, 9 Mar 2010 19:17:36 EST

A look of disgust invariably crosses my face when I stand in front of the entrance. What with a glass door, subtly lit veneer walls, the depressingly dull blue stripes on the seat covers and frosted glass in the distance-all signs that scream SUCCESS- the first thought that crosses my mind is 'Dude this guy must be rich!' And not you-and-me rich. More of the fancy car driving, spoiling-the-child kind of rich achiever that makes me sick with the way people have commercialized their talents. No- that isn't right, there's a simpler, altogether more descriptive word for it- sick with ENVY.

Well, I snobbishly think to myself- At least I'm an intellectual. I have Nobel Laureate Orhan Pamuk's celebrated novel My Name is Red in my hand- holding it casually with my finger inside making sure everyone can see the title printed in big red letters. To hell with the air conditioning, the pretty-(actually radiant)- secretary biting her pencil trying to figure out the supremely difficult task of who goes in next, all the time blissfully unaware of the fact that her blouse is too tight and things are playing peek-a-boo. It's then - in the midst of this hide and seek that I wonder why she's playing these devious sexual games with me here of all the places. And it's then that I hear a disapproving cough coming from the toady mouth of an overdressed, overweight high society type who gives me the head to toe look. Cool, I think- maybe she's a cougar checking me out- and then her upper lip curls in disdain when she sees that I'm wearing fading, ancient jeans, a dirty grey T shirt and Woodland footwear so discoloured that it's original colour is unrecognizable.

I sit down between my would be cougar lover and the secretary who's obviously so into me that she knows her top button's open and the- well- twins seem to be much bigger than when I last saw them. She's had a boob job done just for me! If that isn't true love, if that isn't the sweet, innocent love that Keats- (or was it Playboy? Damn Literature can get confusing..) wrote about, then I don't know what is.

Well I think- maybe this visit isn't going to be so bad. I've found someone who's ready to enhance herself for me- that can never be a bad thing.

Absolute power is terrible. There are places where you are so completely under someone's control- and this I don't mean in a wink-wink way- that you just can't do a fucking thing. All you can do is to lie down and take it. Even the Queen of England has to submit body and soul to this man once a year. He enjoys men, women, children, virgins- there's no end to his escapades. And what's worse, even in these days of laws and civilization, this ancient profession exists. And thrives.

And then the moment of truth arrives. It's time for me to get mine. The frosted door opens and there he stands- a balding, short paunchy man- the same man who just had a session with my sister the previous day- and he points to me and beckons. The secretary gets up. My eyes travel down to discover to my horror that she's pregnant. And that I'd been ogling a pregnant much married woman.

Fear. That's what it is. Fear of the unthinkable. Fear- that makes you think all kinds of stuff.

And I go in. And the door closes.

And then the dentist hands me a glass of water and says 'Rinse'.

Casual Racism in Advertising

Dr Bhaskar Dasgupta — Wed, 13 Jan 2010 07:22:33 EST

While walking back from work, at my local chemist, I spotted this advertisement which I photographed for posterity.

This totally blew me away and I blogged it at face book saying this:

“This is WTF on so many levels. Not least because of massive confusion between dermatology, geography, language and racism. What the hell is Arabic or Asian skin?”

I got some really interesting comments and the heartfelt fulminations such as:

I think they mean if your skin is darker - I guess they could have said mediterranean or south american too :)
are they trying to whiten it? What the fuck for?
this is presumably people with dark skin wanting to whiten or lighten their skins. MORONS!, I have a better idea, how about DULUX? they do a great line in white paint. in Matt, Satin or Smooth finish even.
I'm in india and cant find a facewash without a whitener in it...its all about being fair here...
I know that a TV commercial got banned in India for this product. In the commercial, a dark skinned lady went for a job interview and got rejected. She used the cream, got lighter, went back to the interview and got the job. Absolutely horrific that (a) companies make this product (b) people buy them! This whole inferiority about being dark skinned... See More has been externally imposed upon dark skinned people for centuries, now we seen to be sustaining the complex internally. It MUST be challenged, first and foremost by ourselves - people are beautiful no matter what color skin they have, have we not learned that yet?
Wow!! Some deep shit right here Bhaskar.
it's horrid!! In India this is rampant for fairness, yeah?
In Cambodia, I found Paula's Pinky Nipple cream so dark skinned people could ... you know, be like white people ... even there! horrid.
WTF indeed. us dark skins aren't safe here too now eh? good grief!

My brother in law, Sameer Bhargava, sent me this link to a You Tube Video:

This is horrible, to see these morons all gallivanting around trying to get fair. I knew about this phenomena in India but Arabic? So it proves from this story about how Palestinian women are also busy slathering this gunk on their faces to become whiter. I quote:

“I admit it. I want to change my complexion,” Ms. Suleiman, a sociology student at Al-Quds Open University, explains with a sheepish smile. She and a classmate sport Islamic head scarves and a significant coat of makeup, also aimed at a lighter-skinned appearance. “Palestinian men like brunettes,” she says, “but they want light skin.”

The article also quotes another writer:

“Lebanese standards of beauty and complexion have taken the Arab world by storm since the resurgence of the Lebanese in media ... further limiting the accepted definition of beauty as light-skinned, catty-eyed and slim-nosed. Fair & Lovely, a popular whitening cream, advertises itself on Arabic TV when a model is rejected for being too dark, only to be ecstatically accepted after a few weeks of applying the magic cream.”

This seems to be a pretty normal problem with Arab teenagers. Here’s a very good article on how an Arab American Lebanese teenager felt while growing up and the impact on skin colour. Strongly suggest readers read these 4-5 pages. While I can understand the background to this, this wanting to fit in with the white Americans does not apply to people in say Palestine. For them, it must be because of attainment hero’s and heroines such as Ms. Wehebe which they see on TV and want to become like that. How about sending Ms. Naomi Cambell to the TV studios?

And while researching this topic, found that Wikipedia had a full fledged entry on skin whitening. Reading the variety of crud that goes into these cosmetics is simply horrifying. And to think that people slop mercury and acids on their skin, these film stars push these products and the stupid girls get taken in by this. Plus there are 1.6 million hits on “skin whitening” not counting the hits for other terms that Google helpfully suggests:

skin lightening pills
skin lightening tips
natural skin lightening
skin lightening cream

proactiv skin lightening lotion
skin bleaching
hydroquinone
meladerm

So nice. When women use this crud, this photograph shows what can happen as written in a Tanzanian site:

Talking about Africa, my friend, Vikram Doctor (who btw has a planet sized brain with the most amazing stories), told me about the Aparthied Museum in Jo’burg. This museum was made by this family who made millions by selling creams to South Africans who would want to pass as whites for obvious reasons. I have not seen this museum, but the next time I am out there, i will definitely go check it out.

This syndrome seems to be all over the damn world. Here’s an article on the skin lightening market in Japan, use in Senegal, Nigeria, South Africa, China / Hong Kong, etc.. The same kind of feeling was in China as well, where women would prefer to be foot bounded and very pale skin to show that they are rich enough not to work in the fields and presumably get tanned.

But while there have been tons of medical articles, I was simply unable to find solid well researched academic articles from the sociology, anthropology, history, psychology or other areas which could shed more light on this issue. Why would this be the case? I immediately jumped to the conspiracy theory that its the cosmetic and pharmacy industry which stops this research from happening. But surely this isn't the case. While, for example, the NHS does state clearly that this kind of skin lightening stuff should not be used, why isn't there more research on this?

There are also tons of legal judgements. In other words, people are buying this stuff enough to make economic sense out of counterfeiting them. If there was not enough demand, then you counterfeit this stuff, would you? So this also goes to show that the creams and potions are sold at an absurdly high price.

And all this while, we have this crap showing on TV, in our films, in our songs and even casually walking up and down the high streets. Disgusting.

What Ails Healthcare Delivery In India? Part 1- The Infrastructure

Arundhati Thapar — Sat, 26 Dec 2009 21:51:21 EST

Aaditya has shot off another angry email to the health minister…knowing fully well that just like the last time, this one would most likely be ignored too. Both times he actually put in an enormous amount of research, expertise and perspective - formulating clear plans and suggesting ways and means to remedy the particular problems he’s been perturbed about.

These weren’t a means to rant at the establishment. I suspect the powers that be lost no time in brushing his emails off to the trash bin in one clean sweep without so much as a curious glance.

At least that seems the most likely scenario as he has never heard back.

It’s true that the Indian healthcare system inspires dread and frustration in a by and large susceptible population struggling with every bend and curve of the system, unable to find any alternative. Some of the obscene statistics that have now become the hallmark of Indian healthcare system around the globe include the 900,000 Indians that die every year from drinking contaminated water and the more gruesome “5.6 million child deaths” in India every year, making up more than half of the world’s total.

In the age of ‘India shining’ and words such as ‘corporate superpower’ being bandied about, this almost seems like an anachronism. I won’t harp on about more of these ‘numbers’ as generations have sat on these statistics with nothing changing except the hospital walls which now look more beige than red, with successive generations of patients, their relatives and ward boys having spat that ubiquitous ‘paan ki peek’ that is as much a part of the hospital as the flies that buzz above.

As with everything else, Indians of a few thousand years ago seem to have been a lot more proficient and systematic at managing health care problems as well. We all cram lessons in school about Charaka, the ancient physician and Sushruta, the ancient surgeon who were both pioneers in their respective fields. Even before their time, there is some evidence that Agnivesh wrote an encyclopedic treatise under the guidance of the ancient physician Atreya in the eighth century BC. There is some evidence that Emperor Ashoka Maurya (third century BC) was the first leader in world history to attempt to give health care to all of his citizens. Thus it was the India of antiquity which was the first state to give its citizens national health care.

What seems to have gone wrong? The modern Indian system of health care is loosely based on the tiered British system, the National Health Service or NHS. We have Primary health care centres at village/small town levels and district hospitals/referral centres at the district or city level to manage the greater numbers in the city and more complicated problems referred from the PHC’s. But here the similarity ends. The PHC’s, though ideally suited to the needs of a country like India, are hardly functional. In actual effect, the system works with major input from the private sector through corporate hospitals and what are called ‘polyclinics’ where money making takes precedence over all else. The ‘sarkari haspatal’ experience is nothing short of purgatory for most of its users.

The system as it works in the UK (and yes, they have had their own share of problems with a fully state funded system of health care recently) caters to ALL citizens irrespective of their paying capacity. From the most basic level of preventative care to highest level of surgical /interventional care, everything is offered free of cost. This is what the planners in India envisaged. Except that they forgot to make provision for the basic needs of such a system.

In India, health care comes under the remit of state Governments with central government providing overall direction and recognizing areas of impetus through the five year plans. The Seventh Five-Year Plan (FY 1985-89) budgeted Rs 33.9 billion for health, an amount roughly double the outlay of the sixth plan. However, the catch is that health spending as a portion of total plan outlays, had declined over the years since the first plan in 1951, from a high of 3.3% of the total plan spending in FY 1951-55 to 1.9% of the total for the seventh plan.

But financial resourcing is only part of the problem. Health care professionals – their attitudes, ethics and respect for self and profession seem to be the major players in what ails this system.

In 2005 the World Bank conducted a study and reported that "a detailed survey of the knowledge of medical practitioners for treating five common conditions in Delhi found that the average doctor in a public primary health center has around a 50-50 chance of recommending a harmful treatment". This is the more shameful aspect of how a country of over one billion and a so called emerging economic superpower manages the health of the nation. Note the setting here- the public primary health center. Something about that rankles.

It’s as if the country’s polity has decided that the poor/lower middle class Indian can make do with second grade health care. How else do you explain the fetid, non-resourced environs of a primary health care center? A rickety chair and desk, plaster falling off walls, no medical equipment to speak of and no support system in place should a difficulty arise. So by logical extension, the only people you find populating these centres are ones who would rather be elsewhere but find themselves unable to.

The disparity between how core services such as health and education are delivered by the public sector and how things work in the economic/commercial hubs of the nation couldn’t be any wider. There has been a complete failure to integrate health with wider social and economic development. While money flows in certain sectors, health and education end up being the ‘poorer cousin.’ The attitude at the top is that of indifference and apathy. Obviously, people have been dying of poor health for decades and no political party has ever lost an election on this issue. So why bother? And here is where the story of downfall begins for a medical professional.

A healthy and motivated workforce only exists where adequate support is available at the top. As with people in the financial sector, give these people proper working conditions, make resources available to them and they would work.

The lowest rung of health care in the UK starts with the GP’s or General Practitioners, who also happen to be some of the best paid health professionals. They have a planned system of referral to the secondary level and a thoroughly self sufficient setup to cater to all health problems that can be managed at primary level. They work with immense pride in what they do and society recognizes them as the key player in improving community health. There is never any question of their being treated as inferior to a doctor in a tertiary hospital.

The GP’s have support from well trained nursing and paramedical staff and work with a team rather than in isolation. They have an electronic medical records system and access to national guidelines and protocols for management of the plethora of non-serious conditions that they manage in the community. Above all, they are trained from an early stage to be ‘family physicians’ and are not therefore people who could not be specialists settling in for the compromise of general practice.

And that is precisely what we lack. An adequately paid ‘primary’ workforce that has access to at least basic infrastructure. No one is asking for an interventional radiologist at every PHC but basic medicines, syringes, gloves, antiseptics, wound dressing, local anesthetic in adequate quantities is elementary. Nobody can ever know all about all aspects of medicine and its futile to expect this from our overworked and underpaid band of community medics. In a country like India where roughly 700 million people have no access to specialist care, it is astonishing that there is no recognized training programme in community medicine!

So what the world bank report failed to highlight perhaps was that these people who they found lacking in knowledge, were functioning not only without guidelines/protocols, knowledge resources and infrastructure to upgrade their learning but also without any semblance of training for the job they were expected to do. They carry out a job that no one else seems to want to do and morale, motivation, job satisfaction and pride in what they do is nonexistent. They need to be appreciated and recognized, not treated like second rate citizens in the medical fraternity.

Just about a quarter of a million trained doctors come out annually in our country and yet there is a perpetual shortage of medical staff in rural areas. The Government tried a policy of enforcing rural postings but why not invest in rural healthcare instead? If these doctors had a viable career option in the form of rural practice, why would they struggle in the cut throat competition in surplus areas?

While no one would dispute the fact that India has its own set of unique problems and no foreign model can be superimposed on it, the obvious lack of interest in improving grass root level healthcare is a disgrace. While we brag about an ever expanding ‘medical tourism’ industry and healthcare is set to become a $150 billion industry by 2017, this seems like a hollow victory in the absence of any sign of improvement in the health of those that need it most. It’s a slap in the faces of policymakers that less than 40% births in the country are attended by trained birth attendants and maternal mortality still sits at the same level as 60yrs ago.

To get a sense of just how far behind we are from the rest of the world , maternal mortality rate i.e. a mother dying in childbirth, which is arguably the most sensitive index of the health of a nation, was still sitting at about 450/100,000 live births compared to about 14/100,000 in the UK. That is a staggering difference. What’s more poignant is that about 800,000 women each year die of the most easily preventable causes possible- anemia, infection and hemorrhage. If Mumtaz Mahal died of hemorrhage after childbirth in the 1600’s, more than three hundred years later, one of our most prominent and promising actresses of recent times, Smita Patil, dies of the same in 1986 telling us that nothing had changed in the interim.

It requires the simplest measures to prevent so many unnecessary deaths each year- deaths that leave fragmented families and the spectre of infants without their mothers. We’re perpetually in a race to be as advanced as the developed countries of the west. Why then has no initiative been shown to be at par with these countries in terms of the most basic human necessity- efficient healthcare? The answer lies perhaps in freeing healthcare from corrupt political influence and putting people who really know, in charge of the system. Maybe then we’d be able to make a start towards becoming a healthy nation, which I presume comes before ‘superpower’ nation.

Gems of the Planet: Infinite Vision

Somik Raha — Mon, 21 Dec 2009 07:25:36 EST

In the fourth installment of the Gems of the Planet series for Desicritics (others were on Krishnammal, Sandhya and Dr. Bindeshwar Pathak), we embark on the incredible and inspiring story of Dr. Govindappa Venkataswamy, or Dr. V as many called him.

Dr. V grew up in a village in Tamil Nadu, and was inspired to become an obstetrician, after being deeply saddened as a child to see a lady next door pass away during childbirth. He joined the army as a medical officer, but was discharged after contracting rheumatoid arthritis, that left his fingers permanently crippled. That is when he came into the field of eye surgery, and then went on to perform more than 100,000 successful surgeries.

After working as a government eye doctor for all his professional life, he retired at the mandatory age of 58. Unlike so many others who feel they are done with life, for Dr. V, life was just beginning. He decided to tackle the problem of needless blindness, or cataracts. A simple sight-restoring surgery can fix the problem. Yet, due to lack of access to healthcare, millions in India live blind, and are unable to feed themselves. Dr. V started an 11-bed clinic to tackle this, and called it Aravind, after Rishi Aurobindo, whose philosophy deeply inspired him.

He also encouraged, trained and coached his family members to get into the field of eye care with him, and several members of his family served at Aravind when it first began (and are still with it). In the beginning, as he went around doing fundraising, people were unkind and suspicious, and thought he wanted the money to lead an easy retired life. Dr. V was deeply offended by that, and determined not to ask for donations, and instead serve people with whatever he had. His belief was that if value was created, money would automatically come for expanding their work.

As part of their operation, Aravind does not charge those who cannot afford surgery. Paying patients cover the cost of two patients who cannot pay. Both paying and non-paying patients would get the same level of eye care from the doctors. However, after the surgery, paying patients would get their own AC rooms with TVs, while non-paying patients would be put up in dorms. This unique mix happened right from the beginning, and their entire system was optimized to handle large volumes of patients. This is a unique factor that distinguishes Aravind from other philanthropic eye-care ventures - Aravind does not take any donations and is entirely sustainable from their service to paying patients.

Not only did this model work extremely well, Aravind also made enough money to invest in R&D, through which, they were able to reduce the cost of an intra-ocular lens from $200 to $5. Today, these lenses are exported to various countries around the world to help others bring down their eyecare costs.

One of Aravind's big strengths is their paramedic team, which comprises of women who are recruited from villages and trained. One of the criteria for hiring is that the women should have had someone to serve at home (like parents), thus implying that they knew what service was about. The paramedics absorb the time needed for many tasks that don't require a surgeon's attention.

Today, Aravind Eye Hospitals are known for the largest volume of eye surgeries anywhere in the world. Their care is considered world-class, and foreign interns often come to get experience and learn. Its headquarters are in Madurai, but they have additional hospitals at Theni, Thirunelveli, Coimbatore and Pondicherry.

All of this success, I feel, is not because of their external strategy, which is open-source and known to all. They don't consider the other eye-hospitals as competitors. Instead, their goal is to remove the problem of needless blindness, and they see all other eye hospitals as partners in this goal. They help these hospitals make their operations more efficient. Recently, they have moved to managing hospitals in the north and bringing their famous efficiency with them.

The big factor that underlies this tremendous success is their focus on service as their spiritual mission, which in India, many people would know as karma yoga. By understanding that the patient's suffering is their own suffering, they take medical care to spiritual heights. And the universe responds as it is bound to, for what goes around comes around. Paying patients are attracted to this hospital not because of their philanthropy (Dr. V forbade using this to attract patients, so it was not mentioned), but because the doctors had tremendous experience and gave great value. When the volition of service is pure and non-violent, the mind becomes calm and joyful and is able to recognize the way forward with great clarity. All strategies necessary for success become evident.

Today, Aravind's management style is the subject of case studies in the leading business schools of the west (see Harvard Case Study). Not a single member of the original founding team has left the organization. What's more, three generations of this family have helped this work in some way or the other.

Dr. V passed away in the year 2006. His life has been immortalized on film by his granddaughter, Pavi Mehta, in her award-winning film, "Infinite Vision." George Bernard Shaw famously stated, "The reasonable man adapts himself to the conditions that surround him. The unreasonable man adapts surrounding conditions to himself. Therefore all progress depends on the unreasonable man." In a sense, Dr. V fit this description really well as one of his colleagues stated in the film, "His vision of what was possible was way beyond what was anything reasonable." Watch Infinite Vision below:

One tip - watch till the end after the credits - there is more footage and a lovely quote from Dr. V. (While the entire film can be watched for free above, you can also get a high-quality Infinite VisionDVD on Amazon.)

Since the film, Aravind has grown in leaps and bounds, and here is a recent TED-talk by Aravind's current Managing Director, Thulasiraj Ravilla, that is not only eye-opening, but also shows several innovations (when did you last hear of telemedicine being used to help the rural population in India?).
TED is a conference that brings together thought leaders from the fields of Technology, Entertainment and Design, and the best of the talks at the conference go up for free at ted.com.

To end, I loved the quote that Dr. V cited in the film,
"Intelligence and capability are not enough. There must be the joy of doing something beautiful."