Jesus has them too

I guess that even evangelists occasionally manage to slip up. Especially when introducing a new convert to Christian culture and foreign sounding Christian names. So it happened that a few days ago a heavily pregnant Jesus walked into our labour ward providing me with ample opportunity to scream at the top of my voice "Push, Jesus, Push" and generally blaspheme in bad Tamil as she delivered a perfectly cute baby into my hands. Not many doctors from Catholic medical colleges get to say that two months after graduating they were already good enough to successfully deliver Jesus (smirk).

Mein Akela Nahin Hoon: The Story of Dr. Binayak Sen

Return to Slow Medicine

Today I walked in on a scene in our labour ward that would have been unusual in almost any other hospital I have known. We have two beds for women in the first stage of labour and Dr. R., the other junior doctor at Tribal Hospital was sprawled out on one of them, fast asleep. His hand however, reached out towards the other bed where it was grasped lightly in the hand of a sleeping woman exhausted by her prolonged labour. Both had been up for the last twelve hours, ever since the woman stepped into the ward. Dr. R., whose inclination for working with obstetric cases I must admit far surpasses mine, had spent a good bit of the preceding hours talking to the patient, massaging her back and generally coaxing her through a difficult, prolonged labour.

The idea of a doctor and patient falling asleep together while holding hands has the potential to cause a variety of responses amongst those in the medical field ranging from disapproval to alarm to dismissal as something that can occur only when a doctor has absolutely no other demands on her time. All these responses stem from the fact that as doctors we are trained to see patients as clinical cases first and as scared and suffering neighbours second. Right through my medical education at a big city hospital I had to imagine the situations and surroundings from which my patients came from and what it would like to be one of my patient's neighbours. None of my actual neighbours was ever seen by me since we were only allowed to practice our skill on the poorer patients in the general wards.

Working at Tribal Hospital in a re-education of sorts. There is no need to imagine my patients as neighbours. They are in fact my neighbours, working and living in the same environment as me. Almost all the staff except the doctors are women from the adjoining villages. Patients are no longer a row of bodies clothed in identical hospital garb. Instead most of them are personally known or related to the ward sisters. If you work here for a few months you would have visited a good number of the villages from most of our patients come from. I no longer send discharged patients to imaginary places but to streets I may have walked down myself.

The reason we spend time with our patients is simply because in such an environment ignoring someone who is sick or frightened is plain rude.

Can I still disagree?

I wont discuss the intricacies of the arrest of Dr. Binayak Sen, a noted paediatrician and human rights activist in Chhattisgarh. Much has already been written about it. The SaveBinayak site is an excellent starting point. The internet activist can sign petitions here and here. What is troubling for someone not involved in the local intrigues of the case is the strong statement that the Chhattisgarh State Government makes with such an action. By going after a man who strongly sided with non-violent, democratic means of countering State excesses and negligence the government is slamming shut the door to democratic activism and dissent. Taking up the line of George Bush, people can now choose to be either 'with us or against us'. The Chhattisgarh Special Public Securities Act, under which Dr. Sen is charged has sweeping powers and contains wording that can be interpreted in such a manner that a number of seemingly innocent acts can be construed as 'waging war against the State'. The Act seems to be targeted more towards so called 'Naxal sympathisers' than any armed revolutionary. Here is where the danger lies. Since the Naxal movement claims to represent and fight for the most oppressed sections of Indian society, the landless farmers and tribals, any person seen as sympathising with these people is now seen as a potential Naxal. I grew up in the heart of the democratic movement that hoped to represent the poor and the oppressed in India. Never have I heard anyone openly admire Naxalite violence or any other sort of violence for that matter. People on the ground do sometimes however, acknowledge the frustration and hopelessness that occasionally drives people to take up arms. For the first time I am witness to a new fear within the community. People are now acutely aware of the value of political correctness in an atmosphere where a single careless sentence or act can be misconstrued as supporting violence aganist the state. Overnight the community has woken up to the fact that the political support from the middle class which viewed activists as people who have taken a much respected but less beaten path has evaporated. Any sort of activism is now seen as a bunch of idealists creating a nuisance at best and at worst activism is seen as terrorism. The line between democratic and non democratic dissent is fast eroding. An environment in which you can get away with anything provided that you can create enough spin to make people believe that your enemies/victims are 'terrorists' is deeply disturbing. The vulnerableness of groups with no access to mass media and other channels where they can sufficiently and honestly portray there version of the truth is great. Skillful control of most Indian media by a nexus of businessmen, politicians and corporates contributes to this environment in which all protest has become theatre whether the script involves violence or not. Any free and just society needs to provide space where citizens can confront the government and other powerful institutions. It is imperative for concerned people to fight to maintain and expand this space for democratic, constitutional ways of disagreeing with the Powers That Be. While there is still time and space.

Phoenix blog

Its time to resurrect the blog. Again. A quick update. My long drawn out medical studies are finally over and from August 2007 I will start work at the Tribal Health Initiative in Sittilingi, Tamil Nadu as a junior doctor. I hope this change in my setting will be reflected in a change in perspective and content of this blog. I hope to delve deeper into understanding the chaos which is the Indian health system and use this blog as a platform for opinion and discussion. As of now I am using this rare free month to travel as much as I can within North India.

Brecht sums up my reflections on the near completion of my degree

To The Students Of The Workers’ And Peasants’ Faculty

1
So there you sit. And how much blood was shed
That you might sit there. Do such stories bore you?
Well, don’t forget that others sat before you
Who later sat on people. Keep your head!

2
Your science will be valueless, you’ll find
And learning will be sterile, if inviting
Unless you pledge your intellect to fighting
Against all enemies of all mankind.

3
Never forget that men like you got hurt
That you might sit here, not the other lot.
And now don’t shut your eyes, and don’t desert
But learn to learn, and try and learn for what.


A Worker’s Speech To A Doctor

We know what makes us ill.
When we are ill we are told
That it’s you who will heal us.

For ten years, we are told
You learned healing in fine schools
Built at the people’s expense
And to get your knowledge
Spent a fortune.
So you must be able to heal.

Are you able to heal?

When we come to you
Our rags are torn off us
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more. It is the same cause that wears out
Our bodies and our clothes.

The pain in our shoulder comes
You say, from the damp; and this is also the reason
For the stain on the wall of our flat.
So tell us:
Where does the damp come from?

Too much work and too little food
Makes us feeble and thin.
Your prescription says:
Put on more weight.
You might as well tell a bullrush
Not to get wet.

How much time can you give us?
We see: one carpet in your flat costs
The fees you earn from
Five thousand consultations.

You’ll no doubt say
You are innocent. The damp patch
On the wall of our flat
Tells the same story.

- Bertolt Brecht

Look at the Dalit basti!

Look at the dalit basti
What plight of humans!
From the belly rises fire,
But the chulha can not be lit.
- Bahinabai Chaudhari (1888-1951)

I am not in chains, not in chains:
I a neither diseased nor I am a healer.
Am not a Moman nor a Khafir am I,
Neither a Mulla nor a Saiyed,
Why ask Bulle Shah his caste?
Neither I created caste, nor am I born in one.
- Bulleh Shah (1680-1748)

Brahmin, Vaishya, Shudra or Kshatriya,
Dom, Chandal or Mlechchha: All have the same soul.
They can all attain purity, singing hymns to God:
It will liberate both – self and generations.
- Ravi Das (1398-1448)

Sugar cane is rough; the juice in it is sweet,
The bow is not straight but the arrow is,
River zigzags, but not the water in it.
Chokha isn’t beautiful but the God in him is.
Why get misled by outward appearances?
- Chokha Mela (14th century)

Actions, says Dadu, rank higher that one’s caste,
Think not, therefore, of anything else;
Social ranking is tainted,
Illumined are only noble thoughts.
- Dadu Dayal (1544 – 1603)

Immortal is the land I come from;
There are no Brahmins, Kshatriyas, Shudras or Vaishyas
No Mughals or Pathans, nor Saiyeds or Shaikhs;
The message humble Kabir brings, in essence, is:
Let’s go to that land.
- Kabir (1398-1518)

This set of poems is from a calender designed by Loknaad.

The Aphorisms of Rudolf Virchow

Rudolf Ludwig Karl Virchow (1821 – 1902) was a German doctor, anthropologist, public health activist, pathologist, prehistorian, biologist and politician. His famous report titled Report on the Typhus Epidemic in Upper Silesia is an absolute classic and established him as one of the founding fathers of social medicine. Among his many talents Virchow was adept at coming up with catchy aphorisms. These are some of my favourites:

“Medicine is a social science, and politics is nothing but medicine on a large scale.”

“It is the curse of humanity that it learns to tolerate even the most horrible situations by habituation.”

“Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.”

“The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.”

“My politics were those of prophylaxis, my opponents preferred those of palliation.”

“Virchow had a comprehensive vision. Pathology, social medicine, politics, anthropology. My model.” – Paul Farmer. Mine too :-)

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