Innovation, Artemis Fowl & Dawkins; What I have been reading

The Other side of innovation by V GovindarajanOne of the things that have been holding my attention for quiet a while now is innovation in healthcare, and what a pleasant surprise to discover Prof. Vijay Govindarajan on HBR, where he talks about his idea of reverse innovation. Prof. Govindarajan was kind enough to send me a copy of his book for review and I must say I was blown by it. I have read quiet extensively on innovation, but almost none of the authors I have read so far give a structured, rational, and scientific approach to implementing of innovation. In his book The Other Side of Innovation: Solving the Execution Challenge he has given us a great field guide on how to go about ensuring that the innovative idea doesn’t die on the drawing board. I will be posting a detailed review later, but to get an idea of what the book is like you can read his latest post on HBR  10 Tips for Creating Distinct-but-Linked Innovation Groups.

Related to, but not inspired by his idea of reverse innovation is this initiative by Open Source House, a team that conducted a competition for an open source house based on eight design principles. Interestingly prof. VG and Christian sarkar recently wrote about a 300 dollar home. His design wont win any competitions in its present form, but its a stimulant and so are the comments.The Art Of innovation by Tom Kelley

Not a co incidence, but I also managed to lay my hands on the classic The Art of Innovation by tom kelley of IDEO. as reputed, its an amazing read and reads like a lovely travelogue of a creative journey fueled by innovation.

I dont think I have said this before, but I LOVE Artemis fowl, who cares that its supposed to be teenage fiction. And so I was as delighted to come across the latest book The Atlantis Complex. it is written in the usual pan-novel humor style that Eoin Colfer is loved for.  The story is that

Artemis is suffering from Atlantis Complex, a psychosis common among guilt-ridden fairies – not humans – and most likely triggered by Artemis’s dabbling with fairy magic. Symptoms include obsessive-compulsive behavior, paranoia, multiple personality disorder and, in extreme cases, embarrassing professions of love to a certain feisty LEPrecon fairy.The atlantis complex by eoin colfer, an artemis fowl mystery

Unfortunately, (obviously) Atlantis Complex has struck at the worst possible time, a badass fairy is going to destroy the REAL Atlantis (don’t you love the coincidences and puns?).

While i loved the book, it is worrying that over the years Artemis is gradually becoming less and less devious, and I hope Mr. Colfer doesn’t forget that we love Artemis because of his dark side.The lone genius crusader with a borderline psychotic personality and the right tinge of pink is what made this teen criminal mastermind special. So Mr.Colfer don’t forget the criminal part of “criminal mastermind”, we cant have Fowl turn chicken can we?

Dawkins delusion a book by alister mcgrathI am yet to read Dawkin’s God Delusion, so I will not say too much about this one, but reading “The Dawkins Delusion?: Atheist Fundamentalism and the Denial of the Divine” by Alister McGrath was an enlightening experience. while the book was more of a brief review of Dawkin’s book, it made me realize that I want to read both Dawkin’s book and McGrath’s full length and better book on the topic.

Decoding Intolerance - hindu muslim riots in india a history and evaluationFinally, now I am reading Decoding Intolerance: Riots And The Emergence of Terrorism In India by PK Lahiri. I have only started reading the book, which documents the history, mechanism and possible solutions to the bloody wars that are called religious riots, but it seems like a good read.

Medical prosthetic arm from london of the 1800s

To finish of with, here is some steampunk-esq medical prosthesis goodness for you from the late 1800s. Medical Prostheis from 19th century London

I am elsewhere; Healthcare as social enterprise blog

Have started working for a company called 4B Healthcare. Am exploring the concepts of social enterprise and what role the market or a for profit model has in Healthcare for the poor or healthcare as a whole. my main outlet is the  Healthcare as Social Enterprise blog, courtesy, the company.
Some of the new posts there are

The question of whether a hospital can be self sustaining, high quality, affordable, and poor centric all at once is a knotty one.

Will using a For-profit model cause the company to drift into a money hungry monster most of the present day corporate hospital chains are?

Is the philosophy transferable on to a realistic business plan?

Can the business plan actually work?

will creating such a hospital system actually help the poor in a long term, meaningful way?

Obviously, I dont have all the answers, and while I believe in the idea fiercely and the people behind it are personal heroes, some things only time can tell. Oh, dont worry, the business plan exisits, a good one that too, and so far, it seems to be working quiet well.

for now, to make better sense of what i have been saying, perhaps you should head over to the site to get a picture of the philosophy and workings of 4B healthcare

Satyameva Jayate- The Truth about truth in India

“Satyameva Jayate” (satyam-eva jayate सत्यमेव जयते) (Sanskrit: “Truth Alone Triumphs”) is the national motto of India. It is inscribed in Devanagari script at the base of the national emblem. The origin of the motto is a well-known mantra 3.1.6 from the Mundaka Upanishad. Full mantra as follows.

satyameva jayate nānṛtaṁ
satyena panthā vitato devayānaḥ |
yenā kramantyṛṣayo hyāptakāmā
yatra tat satyasya paramaṁ nidhānam ||

In devanāgarī :

सत्यमेव जयते नानृतम् सत्येन पन्था विततो देवयानः ।
येनाऽऽक्रमन्त्यृषयो ह्याप्तकामा यत्र तत् सत्यस्य परं निधानं ॥

Meaning:

Truth alone triumphs; not falsehood.
Through truth the divine path is spread out by which
the sages whose desires have been completely fulfilled,
reach where that supreme treasure of Truth resides.

From: Wikipedia

In the last week or so, I am sure you have bemoaned the corruption and general mess that prevails in India at least once. Corruption is so ubiquitous so pervasive that many times, we hardly notice it.  And while speaking about corruption is easy, doing something about it is very hard. It requires courage, integrity and an immense store of patience. If you speak out against it, you will be admired in private, ridiculed in public and harassed throughout your life.  In spite of this, it is reassuring to see that there are individuals and groups all across India engaged in fighting corruption using various tools and mediums.

I hope to introduce, as I get involved, Various such groups. I would like to begin with

1. Sanjay Uchav- @Nobribe who writes on the No Bribe Website and runs the Corruption free India Facebook group. Follow the site for regular articles about fighting corruption and practical ideas about how to do it yourself. He also regularly points out to both corruption and anti-corruption news from across the country. Mr. Uchav fights corruption from Bihar. You can even  see and contribute to a bribery rate card to see what the prevalent “rates” in your area are.

2. Sanjeev sabhlok author of the fabulous book “breaking free of nehru”  and founder of The Freedom Team of India, a political party in its inception that dreams to bring clean governance to India. he has started a group called “Boycott  Corrupt Politicians” on facebook, and you can join for updates on how to join the good fight. More about him

Now for an Explanation of the Post title.

Over at No Bribe, a great new post is up, about what truth really means in india for example

  • Law will take its own course actually means that it would go round and round forever without ever converging on the issue.
  • We will look into the incident actually means that everyone will soon forget it.
  • We will not leave the matter alone actually means that the matter will be given a silent burial.

Head over there for the full article – The art of Double speak.

Jalliyanwalla Bagh Mein Vasant: A poem by Subhadra Kumari Chauhan

April 13th 1919, Amritsar, the city was celebrating Baisakhi a traditional festival on which people celebrate the beginning of the harvesting season by congregating in community fairs. Unfortunately the biritsh had passed martial law in most of punjab expressly forbidding the meeting of more than 5 people. About 2000 people were packed in the garden called jalliyanwalla, in defiance of the prohibitory orders.

General Dyer, who later said;

I think it quite possible that I could have dispersed the crowd without firing but they would have come back again and laughed, and I would have made, what I consider, a fool of myself. –

ordered his brigade to open fire at the unarmed gathering.

The garden is surrounded by walls and has only one narrow entrance and so served as a death pit with no escape from the machine gun fire that followed the orders.

1579 was the body count by the civil surgeon.

In the memory of this incident, Subhadra kumari Chauhan wrote this touching poem.

यहाँ कोकिला नहीं, काग हैं, शोर मचाते,
काले काले कीट, भ्रमर का भ्रम उपजाते।

कलियाँ भी अधखिली, मिली हैं कंटक-कुल से,
वे पौधे, व पुष्प शुष्क हैं अथवा झुलसे।

परिमल-हीन पराग दाग सा बना पड़ा है,
हा! यह प्यारा बाग खून से सना पड़ा है।

ओ, प्रिय ऋतुराज! किन्तु धीरे से आना,
यह है शोक स्थान यहाँ मत शोर मचाना।

वायु चले, पर मंद चाल से उसे चलाना,
दुःख की आहें संग उड़ा कर मत ले जाना।

कोकिल गावें, किन्तु राग रोने का गावें,
भ्रमर करें गुंजार कष्ट की कथा सुनावें।

लाना संग में पुष्प, न हों वे अधिक सजीले,
तो सुगंध भी मंद, ओस से कुछ कुछ गीले।

किन्तु न तुम उपहार भाव आ कर दिखलाना,
स्मृति में पूजा हेतु यहाँ थोड़े बिखराना।

कोमल बालक मरे यहाँ गोली खा कर,
कलियाँ उनके लेये गिराना थोड़ी ला कर।

आशाओं से भरे हृदय भी छिन्न हुए हैं,
अपने प्रिय परिवार देश से भिन्न हुए हैं।

कुछ कलियाँ अधखिली यहाँ इसलिए चढ़ाना,
कर के उनकी याद अश्रु के ओस बहाना।

तड़प तड़प कर वृद्ध मरे हैं गोली खा कर,
शुष्क पुष्प कुछ वहाँ गिरा देना तुम जा कर।

यह सब करना, किन्तु यहाँ मत शोर मचाना,
यह है शोक-स्थान बहुत धीरे से आना।

Many died to grant us freedom, let us be careful lest we live ungrateful to their sacrifice.

Jai Hind.

He is NOT a nice guy

Update: 30/8/2010 : It was brought to my notice that my view on the abuse-perpetrator is a bit misleading. Not all people who abuse their partners have a substance abuse problem or stressor, more over they do not abuse BECAUSE of these stressors. Men behave the way they do because that’s how they’re socialized and because society condones their behavior. While the above might contribute in their violence, the act of violence is a behavioral problem, not primarily an environmental

Some time ago a friend of mine told me about a friend of hers who was in an abusive relationship. This girl’s boyfriend would smack her around even in front of her friends and humiliate her in public but the girl “refused to see light” and stuck to the guy. It might have been the horrified look on my face, of her continued vilification of a friend which made her hastily add “but he is actually a nice guy”.

Abuse in relationships is an underplayed reality. This is because most of the time there is a certain criminal-victim exchange happening, people dont talk about it directly, but the defensive ejaculation by my friend is a small evidence for it. She knows that the guy beats her friend, she has seen her humiliation and tears, in spite of which she thinks he is “nice”. To her credit, among all the abused girls friends, she is the only one who has had the courage to stand up to the guy and ask him to back off in such situations. Yet, even she is unsure of what to do and what to believe.

What she means by “nice” is, when he is not beating up his girlfriend, he is pleasant, often doting towards her, works hard, is not beating up other people.

The had truth is, we believe that the girl deserved it. Else, why would a bunch of doctors who have witnessed a crime happening continue to hide behind the weak excuse of it being a “personal matter” and “she needs to help herself”.

I am willing to concede that ignorance about how to deal with the situation contributes to such beliefs and that most people have no idea how such relationships end or what harm they do to the people involved. Before I get into statistics, here is the basic thing to keep in mind :

The DEFINITION of a good person excludes someone who beats up his girlfriend/ wife. So think this, he is the enemy, the bad person, the criminal, He is NOT a nice g uy. Someone who runs a brothel and uses the profits to educate slum kids is TWICE a sinner, first for running the brothel and killing the souls within it and second for poisoning the children he feeds. He is NOT a nice guy.

Now, the Science and statistics.

Physical abuse has not just physical effects, it affects the woman’s mental emotional and social health also.

A significant portion of women who have been abused do not seek medical help for the injuries themselves, but those who do, present with non specific and chronic pain and bruises from having “bumped into something”. Women who suffer long term abuse, and are battered are found to have more injuries in the head, face, neck, thorax,  breasts, and abdomen when compared women injured in other ways. 1

Many women also have to put up with forced sex from intimate partners, which results in sexually-transmitted diseases, bleeding or infection, fibroids, genital irritation, pain on intercourse, and urinary-tract infection. Studies show that the odds of having gynecological problems is upto 3 times more in victims of physical abuse.

Mental effects of abuse are quiet profound too, some studies have shown that the risk of depression and post traumatic stress disorder was higher for abuse victims than even those who have had childhood sexual abuse.

  • Fractures
  • Miscarriage
  • Depression
  • Major Surgery
  • lacerations requiring stitches
  • Sexually transmitted infections including HIV
  • Loss of vision/hearing

These are some of the prominent outcomes of intimate partner violence that most studies find. 2

In more than half of the cases of abuse, children are witnesses to it. And in upto 5% cases even the children are abused by the partners.

A study from rural south India showed that thirty-four percent of the women surveyed reported having ever been hit, forced to have sex by their husbands or both. Women belonging to lower caste, poorer households, having greater economic autonomy, and whose husbands consumed alcohol were more likely to report violence. Women’s economic autonomy and husbands’ alcohol consumption were significantly associated with violence,independent of caste and economic status. 3

Why does she not realize, react and seek help?

This is typical of a situation in abusive relationship. The reasons are a complex mixture. Many times health care workers who are the first to see the results of intimate partner violence fail to identify it or do nothing about it. This and the social approval for domestic abuse ensures that she “normalizes” the abuse. She is deluded, as people around her that she deserves it, or that he is otherwise nice, or that there is nothing that can be done to help her.

We need to realize that at this stage, it is no longer a personal matter, it is public. We need to step in. Perhaps there is a stressor, maybe the guy is mentally unstable, or there might be substance abuse, or maybe he is just a jerk, whatever be, if we stand by looking, we are accomplices to the slow murder of usr friend, soul first then her body.

Does she deserve it?
Is there any excuse for beating up ones spouse/girlfriend? Suppose she did provoke him, does that mean she should be beaten up?

Let me tackle the “its their personal matter” excuse again

If you see a robber getting into the house next door, do you go back to sleep because it’s a personal matter?

There is absolutely no difference, abusing ones mate is a crime and cases can be registered under Protection of Women from Domestic Violence Act 2005. Not just that, abuse, as you have seen above, has far reaching consequnces. If you know about it, you should react to it, you might be rejected or ridiculed or even shouted at but not doing anything is akin to abetting murder.

She cannot help herself, people like us who compose the society further make it difficult for her to come out, also she is probably lead to believe that it is her fate or that its ok.

He is not a nice guy.

photo by eyesonmephotography

References
1 Health consequences of intimate partner violence Jacquelyn C Campbell Lancet 20012; 359; 1331-36
2 Berrios DC, Grady D: Domestic violence-Risk factors and outcomes. West J Med 1991 Aug; 155:133-135
3 Krishnan, Suneeta(2005)'Gender, Caste, and Economic Inequalities and Marital Violence in Rural South
 India', Health Care for Women International,26:1,87 — 99

Are Rapists Victims?

There seem to be a serious confusion in the minds of our leaders and the common man alike about who is responsible for rape, the victim or the rapist. Things are so confusing that some even wonder if the poor rapist isn’t a victim of the crime of “incitement”.

“You can’t blame the locals; they have never seen such women. Foreign tourists must maintain a certain degree of modesty in their clothing. Walking on the beaches half-naked is bound to titillate the senses,”

This is a quote in response to the rape of a 6 year old Russian girl from no less than the deputy director of tourism of Goa, Pamela Mascarhenas.
So, should Ms Pamela release the rapist, who was apprehended the same day the quote was made, because after all he was titillated into the crime by an immodestly dressed six year old!

Unfortunately this is not an isolated sentiment of an ill-informed politician, a brief look at comments and discussions on eve-teasing would tell you that a majority still hold that more “obscenely” dressed dressed women get eve teased more, and that the onus is on women to avoid eve teasing. Why go on-line, even the deep philosophical discussions every Indian has at the tea shop echo the sentiments that women are somehow responsible for what happens to them, if not always, most of the time.

The reason why such an asinine logic has become so pervasive evades me, and if you dont think it is asinine, take a look at the root arguments:

if X does something “wrong” then Y is justified in doing anything wrong to X

(could be Hindi movies, bec the few Hindi movies I have seen have angry young men avenging the death/rape of their mothers/sisters by extreme violence. )

By this standard, if Ms. Pamela’s dog barks too much in the night, it is perfectly alright for her neighbor to poison it.

It is important that we separate the two actions from each other, and therefore the crime from the victim. Sure, a nocturnal canine opera is awful, but just because your sleep has been wronged and she is and idiot, you cannot poison her dog. You can picket, go on a hunger strike, or even talk things over with the owner, as impotent as these sound, but that’s the way, not murder.

If we all start killing irritating dogs, none of us would have any.

There is of course a bigger and more ignorant assumption underlying such statements. And that is that the human male, particularly in India is somehow a slave to his primal urges, never really having evolved his frontal cortex enough to be able to decide right from wrong. And so, like we would tip-toe around a sleeping giant, lest we wake him up, we should mollycoddle the male lest he be titillated and incited into doing something “unfortunate” and uncontrollable.

For those of you who didn’t catch the sarcasm of the previous paragraph, let me spell it out. Human beings, Indians, Pakistanis French or Greek, have the ability to resist their sexual urges, particularly in socially unacceptable situations.  If we did not, this world would have been one big orgy.

Why  a molester or a rapist commit the crime is a subject much studied and there is good evidence to show that it has nothing to do with the amount of flesh shown. Sexual assault of almost all kinds is related more to issues like power and control than sexual desire or urges. There is also a certain amount of risk-seeking or thrill seeking behavior involved. The rapist/molester gets his thrill by overpowering women and displaying his dominance. Almost all molesters started with less severe and easily overlooked forms of sexual assault and progress to more severe forms.

Dont belive me, read this paper [link]

The wonderful initiative by blank noise has made it very clear, not that we need evidence, that molesters don’t care about what you do or do not wear, people have been raped, whistled at, touched and pinched wearing burkas as well as saris. This adds to the clear evidence that victims of sexual crimes have absolutely no culpability.

This blatant criminal-victim-exchange not only increases the trauma to those affected, but it also makes the power hungry predator more confident of terrorizing women and getting away with it.

This post is a bit too late in joining the petition that blank noise has sent to the deputy director of tourism, but the fight doesnt end with a petition or a hundred, minds need to be enlightened, societies need to be changed, its a war out there, not a lover’s spat.

Having said that, I hope to write about the flip-side also, not about this particular case though, but about what the difference between personal responsibility and culpability is.

Salvageable?

Salvageable Adj: capable of being saved from ruin;

I was shocked the first time I heard my then boss asking a PG if the patient was “salvageable”. Comparing sick people to shipwrecks didn’t seem respectful or right but before long I found myself asking the same question when dealing with a sick patient, particularity one who was very sick and needed expensive and intensive care.
Wreck

If the patient was not “salvageable” and there was a “salvageable” patient waiting for that bed, then by unsaid rules, less time, effort and money would be spent on him/her, particularly if the patients relatives could not afford the treatment.

The truth about the god-like (read: Inhuman) choices that doctors working in resource-limited circumstances is rarely spoken about outside medical ethics seminars. On the rare occasion a news paper, a novel or even a sit-com decides to take up the topic, it receives nothing more than a few over the shoulder cliché’s about how real life is different from the books.
Salvageable? malnourished child
Chances are, no senior doc will sit a house surgeon down and explain tenderly that while all human life is sacred and deserves equal effort in saving, the ground realities force us to give preference to the young, the “salvageable” over the old or “un-salvageable” patients. That this does not make the old, terminally ill patient any less important or deserving of ones time and effort.

Yet day after day, thousands of “cases” are categorized and differentially treated. It is foolish to think that our actions do not affect us, the rare some learn to love humanity and do their best to bridge this unfair and gap while others learn to value life in terms of productivity and “salvagability” and are forever condemned to be less than human, for that is what you turn into, if you cannot see sanctity of life.

Someday, I hope there is reckoning and justice for the young lives scarred by the inhuman task they were given though we are not mere victims of our circumstances.

Compulsory HIV testing; Violating or protecting Human rights?

On October 9th the Parliamentarians’ Forum on HIV/AIDS (PFA) declared that HIV testing will be made mandatory for all pregnant women. They said that passing HIV from mother to child was a human rights violation and that for a generation that is free from HIV, this needs to be done.

Making the test compulsory raises hopes as well as questions. On the positive side is the fact that if the HIV status of the mother is known, the delivery can be made safer for the mother, the child and the health worker. Up to 40% mothers with HIV transmit the disease to their children without being aware of having HIV. A child has a 25-45% risk of contracting HIV during delivery from its mother, which can be brought down to under 2% if adequate precautions are taken and the mother is treated.

The most important question it raises is that of a woman’s right to autonomy. This is closely linked to the fact that in spite of the male partner being the source of HIV in majority of the cases, women are the ones who have to bear the brunt of the social stigma and abuse. Even though as per guidelines, the person getting tested for HIV has absolute rights about who gets to know about the result, in practice this rarely happens. Privacy and autonomy are alien to our culture, as a result of which chances are that if you are diagnosed with HIV in a typical Indian hospital, everyone from the ward-boy to the sweeper knows the results. There is no doubt that making this test compulsory breeches the fundamental dignity of women, and makes them vulnerable to the anger of their families.

It must be kept in mind that in many states in the south, all pregnancies followed up in government hospitals are already screened for HIV and Hepatitis B under the RCH scheme. But there is a big lacuna in this scheme and that is the home deliveries. Depending on the state and region of the state anywhere from 25-50 percent of children are born in homes, with no access to a doctor. The PFA has suggested that leaders at village level be involved in ensuring they are screened. This might be a good way of reaching health care to the most interior places, but it is obvious that this is going to expose women even more to hostile forces. Unless the forum comes up with a unique way of ensuring privacy while maximizing health care cover, such a drastic move is going to adversely affect lakhs of women.

While the intentions of the PFA are good, and their science is accurate, they fall short in keeping the ground realities in mind. One of the ways they can do better is by involving grass-route level organizations that work in the HIV/AIDS field. Also, there needs to be public debate about medical issues in the country. It is sad that the media and other sources are mostly silent, and even when this is a decision that will affect millions of our countrymen, there is a pitiable lack of public interest.

In the end the decisive question is whether protecting the unborn from a preventable disease outweighs the risk of ostracism and the moral duty of respecting women’s autonomy.

From the Archives: The New East India Company

Published on The Blog Of Dysfunction on September 18 2008

Indians of any background should have reason enough to celebrate their historical or cultural association with Nagarjuna’s penetrating philosophical arguments…Maitreya’s searching questions, Carvaka’s reasoned skeptisism, Aryabhattas astronomical and mathematical departures, Kalidasa’s dazzling poetry, Sudraka’s subversive drama, Abdul fazal’s astounding scholarship.. or Ravi Shankar’s and Ali Akbar Khan’s music, without first having to check the religious background of each

Sen, Amartya,The Argumentative Indian (Penguin Books 2005), p75

Among the many good habit I am nurturing in me of late is reading books about India. This stemmed from the realization that for someone who claims to be a patriot I know pathetically little about my nation.I began with “In Spite of the Gods by Edward Luce” and now am reading this delightful book.

Dr.Sen is a genius and a scholar sans comparison, yet his language is engaging and easy arguments to understand. One of the essays, from which the above quote comes from, examines the Hindutva movement very closely, and in the wake of the renewed violence against minorities in the country, this passage is particularly relevant.

The unfortunate truth is that in the name of “true Indianness” the proponents of the militant Hindutva movement (and those of other religions) are just peddling fascism, and are using the tactic the British East India company is famed to have used to rule India; “divide and rule”. Our colonial overlords were driven out amidst united slogans of “quit India”, I think it is time the same happens to intolerant and militant religious fundamentalism, be it of any religious conviction.

mażhab nahīñ sikhātā āpas meñ bair rakhnā
hindī haiñ ham, vat̤an hai hindostāñ hamārā

Religion does not teach us to bear ill-will among ourselves
We are of Hind, our homeland is Hindustan.

Quit India Hate mongerers!!

Jai Hind

Schizo

Stuff I linked to from twitter last week