A community health oriented Indian Christian

‘The Jews expected a messiah, and perhaps they had hopes of Jesus. But they were soon disappointed. Jesus talked a strange language of revolt against existing conditions and the social order. In particular he was against the rich and the hypocrites who made religion a matter of certain observances and ceremonial. Instead of promising wealth and glory, he asked people to give up even what they had for a vague and mythical Kingdom of Heaven. He talked in stories and parables, but it is clear that he was a born rebel who could not tolerate existing conditions and was out to change them. This was not what the Jews wanted, and so most of them turned against him and handed him over to the Roman authorities.”

- Jawaharlal Nehru (1949, 85)

“Christ took pity on people and came to their aid, whether they were spiritually ill as a result of sin or physically sick. His attention was given to the sick person with whom he frequently talked, showing his preference for the poor but without excluding anyone in need who appealed to him.

Jesus considered suffering and sickness as forming part of the ‘less human’ situation and we are asked to endeavour to make these ‘more human’.”

“Since Christians are the leaven, we must reach out towards the masses by providing simple, accessible and promotional health care according to our own possibilities, modest as they are, or in conjunction with the public services, where this is allowed.”

- cf populorum progression, 20

“And because the life of Jesus has the significance and transcendence to which I have alluded, I believe that He belongs not solely to Christianity, but to the entire world; to all races and people, it matters little under what flag, name or doctrine they may work, profess a faith, or worship a God inherited from their ancestors.”

- Mahatma Gandhi

Action Heroes Wanted

Blank Noise is a public and participatory art project working both online and on the streets of Bangalore, Mumbai , Delhi, Chennai and Hyderabad. Blank Noise seeks to recognize eve teasing as street sexual harassment and establish it as an issue.

Blank Noise project Bangalore calls for women/ girls/ ladies/ of all ages, languages, colour, and shape to be participate in a street intervention on Sunday January 28th. By participating you will be celebrated as a BNP Action Hero. Confirm /ask questions at 98868 40612. This street intervention will be approximately 1.5 hours ( 5 - 6 30 pm).

Find out more at the Blank Noise Project Blog

Communicable disease among rabbits

Untitled

Rabbits they say
Are very scarce to-day
My diagnosis?
Myxamatowsis.

- Spike Milligan
-------------------------------

Myxomatosis

Caught in the center of a soundless field
While hot inexplicable hours go by
What trap is this? Where were its teeth concealed?
You seem to ask.
I make a sharp reply,
then clean my stick. I'm glad I can't explain
Just in what jaws you were to supporate:
You may have thought things would come right again
If you could only keep quite still and wait.

- Philip Larkin (1955)
-------------------------------

Myxomatosis

The mongrel cat came home

Holding half a head

Proceeded to show it off

To all his new-found friends

He said, "I've been to where I like.

"I've slept with who I like.

"She ate me up for breakfast.

"She screwed me in a vice.

"But now,I don't know why I feel so tongue tied."

I sat in the cupboard

And wrote it down in neat

They were cheering and waving

cheering and waving

twitching and salivating

like with myxomatosis.

But it got edited fucked up

Strangled beaten up

Used as a photo in Time magazine

Buried in a burning black hole in Devon

And now, I don't know why I feel so tongue tied.

Don't know why I feel so skinned a- live.

My thoughts are misguided and a little naïve

I twitch and I salivate

like with myxomatosis.

You should put me in a home or you should

Put me down

I got myxomatosis.

I got myxomatosis.

Yeah and no one likes a smart arse

But we all like stars(Oh please)

That wasn't my intention(blah blah)

I did it for a reason (reason)

It must've got mixed up

Strangled

Beaten up

I got myxomatosis.

I got myxomatosis.

And now, I don't know why I feel so tongue tied.

- Radiohead. Hail the Thief (2003)

-------------------------------

Myxomatosis

A baby rabbit
With eyes full of pus
This is the work
Of scientific us

- Spike Milligan

-------------------------------

Myxomatosis (from the Greek μύξα (mucus), and ματώνω (to bleed)) is a disease which infects rabbits. It is caused by the myxoma virus. First observed in Uruguay in the early 1900s, it was deliberately introduced into Australia in an attempt to control rabbit infestation there.

Novartis, drop that case!

In August 2005 I had written two articles on this blog on the rewriting of the Indian patent laws using the controversy surrounding Gleevec, an anti-cancer drug by Novartis to illustrate the issue. Under the new patent regime, large pharmaceutical companies could take out product patents which would allow them to monopolise production of new drugs and increase prices.

In January 2006, Novartis' patent application for Gleevec was rejected on the grounds that the drug was a new form of an old drug and therefore was not patentable under Indian law. This enabled patients with certain cancers to access the drug at a price of around Rs. 9000 ($200) a month as opposed to a price of 1,15,000 ($2600) which was the price of the drug elsewhere.

Currently Novartis is suing the Indian Government in order to have the patent decision overturned so that it can sell Gleevec at the same price in India as in other countries. If Novartis wins the case and succeeds in getting the provision of Indian law changed to resemble patent laws in wealthy countries, it could mean that fewer and possibly no generic versions of newer drugs will be able to be produced by Indian manufacturers during the first 20 years after discovery of a drug and India will no longer be able to supply much of the developing world with cheap essential medicines.

Sign a petion to demand that Novartis drop its case against the Indian Government.

Read more about the issue at the Medecins Sans Frontieres site.

Another acorn!

How can you resist a blog subtitled "Epidemiology, truth and counter cultures" ? Rakhal has been a great friend, philosopher, guide and cousin over the years but seems to have kept his blog in the closet. Until now.

The oak tree out of which the acorn fell

After a large amount of persuasion and calming of apprehensions the NarayanBlog is up and running! Read and leave sweet encouraging comments here.

Must Reads: Medical Nemesis

I've been reflecting recently on some of the books I've read as a medical student apart from our volumnious textbooks and I think it would be interesting to start a series on this blog about essential additional reading for any medical student particularly in the Indian context.

I think the hands down winner for Most Influencial Book is Medical Nemesis: The Expropriation of Health by Ivan Illich simply because it humbles you. In an atmosphere where doctors are becoming sickening self-congragulatory about the increasing use of technology in medicine which enables us to intervene and control bodily phenomena like never before, Illich reminds us that medicine, just like everything else has is limits beyond which is cannot hope to do good. Here is a sample.

Increasing and irreparable damage accompanies present industrial expansion in all sectors. In medicine the damage appears as iatrogenesis. Iatrogenesis is clinical when sickness and death result from medical care; it is social when health policies reinforce an industrial organisation which generates ill health; it is structural when medically sponsored behaviour and delusions restrict the vital autonomy of people by undermining their competence in growing up, caring for each other and aging or when medical intervention disables personal responses to pain, disability, impairment, anguish and death.

The book was first published in the 1970's and is sadly almost unknown among medical circles today. I have still not found a bookshop in India that stocks it though it is available on amazon.com. I myself had to fall back on the time honoured technique of photocopying the only remaining library copy. Read it.

The social context of Indian medicine

I'm currently posted in Chamrajnagar, a rural district in South Karnataka and am practising in a social setting that gives me a lot of food for thought ..

Indian medical practice is largely based on clinical research conducted in the West. Most of the internationally recognised standard texts are by North American or European authors. The teaching methodology used here is largely an outdated, didactical approach which was imported here in the 50’s and 60’s when a large number of medical colleges were set up post independence.

However the social context in which our system is embedded is radically different from the one on which our system is based. While the Westernised elite are more likely to demand and have access to health care it is the poor, who are in an overwhelming majority who really require good, relevant health care. This is because poverty is intrinsically linked to sickness, a large component of which is preventable or easily curable.

It is quite evident that a majority of doctors respond to this difference between theory and reality with a range of practical modifications which range from the simple and obvious to the highly sophisticated. However they still exist only at the level of individual endeavors and as yet there is no large systemic acceptance and addressal of our unique reality.

Doctors in India are also handicapped in their understanding of the social context in which they practice for two reasons: One is that since entrance to medical colleges is highly competetive and students from private schools have an enormous advantage during entrance exams, doctors as a group come predominantly from upper class, upper caste backgrounds whereas a majority of people in real need of health care come from lower class, lower caste backgrounds. The second reason is that since admission to medical college is open to students only from science streams in India, doctors complete their education with only a miniscule component in social sciences as part of their Preventive and Social Medicine syllabus which exists more for namesake than anything else. Hence they are ill equipped to analyse, research and act upon any problem that is not quantitative and out of the realm of pure science.

It is this lack of understanding of social context that has prevented modern Indian medicine from being truly relevant in rural India, where the medical need is immensely greater than in urban areas. The crying need of the day is for Indian doctors to move out of the biomedical paradigm and become anthropologists, communicators and true practioners of revelant social medicine.

Pixels

Thanks to Snake Anthony I have finally managed to put a whole lot of my pictures online on Flickr. Check them out here.

A mere two Israeli generations ago

"In Germany first they came for the communists
and I did not speak out-
because I was not a communist.

Then they came for the Jews
and I did not speak out-
because I was not a Jew.

Then they came for the trade unionists
and I did not speak out-
because I was a Protestant.

Then they came for me-
and there was no one left
to speak out for me."

-Pastor Martin Niemoller (1892-1984)
A leader of the church's oposition to Hitler.