Expertise, politics of health and the Doctor as an Educator

This post is culled from an exchange in a medical group I am a member of. Mr. Srivats has kindly granted my permission to reproduce this gem of a letter. Pay particular attention to the last 3 paragraphs.

Dear Friends,

As I promised in my previous mail, I am adding to the question of the relation between expertise and the politics of health care based on the progression of the Gentamycin – Co-trimoxazole debate. I would remind those who don’t know me, that I am not a doctor, I have little knowledge about these drugs, or drugs in general, and my intervention is related to precisely how to negotiate expert knowledge and a democratic form of medicine.

The specific case here is the exchange between Drs. Sri and S about the pros and cons of discussing such a complex issue in a public forum. On the one hand, I am able to see entirely the validity of Dr. S’s concern that imprecise knowledge and opinions can result in confusion, especially in a multilayered group like the xx egroup. On the other hand, it is precisely the question of expertise and the need to give direction without causing confusion that runs against the problem of a democratic medicine. Should we prevent confusion? Yes, if possible. Should we discuss the matter openly with a group that doesn’t have expertise in the matter — Yes, certainly. Whether it is the case of medical intervention for babies or nuclear power at Koodankulam (I am taking this comparison because of the expert dimension and impact on populations here too), the answer has to remain positive. How do we resolve this dilemma? Not only at the level of health care professionals, but also at the level of patients and communities.

This is where I feel that the position of the doctor as an educator must be examined. Do we have general discussions with parents and the community about giving injections to new-born children? Or oral medication? They certainly won’t have any expertise but they will know what the baby is actually going through on a 24×7 basis. I also have it on some authority that in the rural areas and perhaps among the poor in general, injections are a sign of a ‘good doctor’. It is therefore likely that they would welcome injections for their children without in any way of knowing about the risks and consequences. But I feel since the risk is theirs — their children’s lives to be precise — they should know, confusing or not. I will stress here that there is no point in romanticizing the people in the neoliberal mode — ‘people know best and they must make an informed consent’ — as we all know from the clinical trials scenario, informed consent is a travesty of the right to know what is being done to your body. Yet, I can’t help feeling a discussion must begin, with a democratic education and consciousness raising practice among committed medical professionals. I hope this doesn’t sound like preaching — it is more an exploration of possible avenues for a critical medical practice.

About toxicity and side effects too. This is a general aspect of medical care in its history — the positive iatrogenic effects of medicine (i.e. not the failures of medicine due to bad practice) but the costs of the successes of medicine in patients lives and health over generations of research, shots in the dark, and development. In the final analysis it simply isn’t enough for the doctor to decide that a particular percentage is below the threshold of significance and that therefore the particular medicine can be treated as safe. How can a democratic medicine begin to function in such a way that people know about the risks they take. And yet, I am aware that the general consensus (and medical science’s opinion) is that such an approach is impossible, but isn’t such a conversation imaginable (at the simplest, individual level, and at a much more sophisticated community level): ‘One in ten thousand babies who are given this medicine die, however, it is also documented that the following benefits do occur to the majority who are given it — do you want to take the risk?” to which the parent replies “No” or “Ok, Inshallah!”

It is perhaps likely that doctors who ask these questions will lose their practice to the confident practitioner who simply goes ahead and gives the injection or the tablet — but that raises another problem. How do we educate people out of this blind faith in the expert? The question is how to make the engagement with the doctor a face to face encounter, rather than one of command and obedience.

Would the members of xx feel it is necessary to pioneer this difficult political practice of a critical democratization of expertise? Not in the sense of making everybody technologically equal, but in the sense of teaching people to think about a decision making process on an issue that has bearing on their infants’ mortality (or any such issue of medical care)?

R Srivatsan
Senior Fellow
Anveshi Research Centre for Women’s Studies

Take home messages for Indian activists from KONY2012

As far as metrics go, Kony 2012 was a success. some 10 million people have watched the video and I don’t know of another social justice issue that so many people have heard of, let alone watched a half hour movie on.

As far as the production goes, KONY2012 was a job well done. I don’t have the metrics for how many people watched it the whole 30 minutes, but even if half the total number did, they did because the movie was made well, it was gripping and reportedly moved millions to tears.

 

If all publicity is good publicity, there never has been a better justice campaign like KONY2012. The white house has taken notice, as have governments in many places.

Also, if the age-metrics of Youtube are taken into consideration, a remarkable number of young minds have been made aware that young children like them are living in awful conditions in this world and that they can, and should do something about it.

But

It was discovered that people closely associated with KONY 2012  have also been instrumental in arming the present regime, which is as despotic as Kony was.

The campaign turned out to have a specific political aim, which it disguised as a human rights issue.

It fed the white savior industrial complex and hid a lot of information that would have caused people to think and be better informed.

It lead to nothing more than ‘awareness”. Kony is still free, and will be for the forseeable future

So

Success or failure, it is worthwhile to learn something from Kony

People care about other people

People can be manipulated easily

For something to go viral, you need to do a lot of background work, call it creating a tribe.

If your message lacks a call to action and a way to act, it will eventually be forgotten

You might be successful at manipulating emotions, but it is likely to come back to haunt you.

Long-form Indian writing- Digest 001

In my last post I outlined that Longform writing on the web has found a new life thanks to apps like Readability, Instapaper and Longreads. My interest lies in finding indian writings that are long from and bring to focus my immediate surrounding. Every week I will present that weeks finds, and hopefully this list will grow as time passes.

Mumbai: Cities within

Sanjay Sipahimalani (SanSip on twitter) hosts a book-review carnival with around 10 recent books that are written about Mumbai.

It’s a chemical romance that begins and ends with the word “Bombay”, where all manner of depravity arising out of addiction is on parade. When the novel moves on from the Seventies in tracing the decline in the characters’ lives, you find an elegy for an earlier time: “Already now there were times when he could feel it slipping away, a way of life vanishing as he watched, the pipes, the oil lamps layered with years of black residue, the conversations that a man would begin and lose interest in, all the rituals that he revered and obeyed, all disappearing.”

He goes on to review Tajmahal Foxtrot, The Extras, Behind The Beautiful Forevers and more books.

A few God Doctors

Dilip D’Souza (DeathEndsFun on twitter)  takes us to the Ganiyari in rural Chattisgarh to a unique hospital. Here, around the year for close to a decade passionate Doctors from AIIMS and other top medical colleges work. The hospital is owned and run by a collective of locals, not by the activists who began the hospital. Some of my mentors and personal heroes work or have worked in this hospital, and so it was a delight to find a lovely long article on it.

As they work, the doctors keep up their steady discussion about what to do next, what drugs to give her. I know the two senior men especially, have years of training and experience to call upon. Even so, the impression they give is of addressing the situation not with jaded formulae from medical school, but with fresh minds, thinking on their feet. While their calm professionalism is impressive and reassuring. I cannot help a quick thought about the difficulty JSS has in attracting talent.

Conditions in Ganiyari are hard, the pressure is relentless. Nearly every day throws up fresh crises that interfere with plans for meetings, training programmes, or documentation. The pressures of their work often travel home with them, and there are the usual issues to think about; of the kids’ schooling, and indeed of life itself in this dusty backwater of India. These doctors gave up the chance of high-profile urban careers to come here, to work like this. And when they respond to this poisoning emergency, you can see why.
Hard work it might be, but it is greatly fulfilling too, working among the people who need their care the most.

 

Some you choose, some life chooses

Shubhra Gupta invites us into her home and tells us about her son who is autistic and what autism means to them. Reality is grim and gritty, and yet, humans find reasons to rejoice. She wrote this in the context of the World Autism Day.

We coast on little joys. He is a powerful swimmer, a fish in the water. We put him on a horse in the nearby stables a few years ago. A few weeks ago, I saw him trot, minus the stable lad, who has always had to accompany him till now; he sat upright, smiling widely, having a blast.

He has learnt to be very clear about his needs: not a silly burger, a pizza, okay? And he is on the whole, despite the now occasional meltdowns, a sunny, cheerful child. When he says a new word, it is celebration time. When he turns around and says good night, without having to be prompted. Or when he waves bye, and races off for his evening out. Little things, but for us, huge steps.

In our sobering moments, we are forced to introspect—what has all this meant for us as people, as professionals, as a couple. There is, of course, the cumulative wear and tear of bad-hair days. Sometimes just a few horrible seconds can be enough to wipe off the strength to face a working day.

Introspective confession of a silently fiddling worker ant

Dr.Swarna Rajagopalan (swarraj on twitter)about her journey as a worker ant in the world of politics and policy

And then at some point, something changed. The world became grey. Daily news became miniscule data points on longer-term perspectives. Outrage faded into observation. Opinion was replaced by study. I guess one way to look at it is that I became an academic. I do have strongly held values, but they became somewhat meta-political. What I am trying to say is they held in a place that was above the daily world of petitions and polemics.
….
The grey universe of the worker ant is strangely similar to that of Nero, who fiddled while Rome burnt.

The Language of High Art

Deepanjana Pal (dpanjana on twitter) discovers a new app that decodes the mystifying gobbledygook that comprises most curatorial notes in our biggest art exhibitions.

The Wall Text:

Art for Bose is a site of contest between context, subtext and pretext. Rather than passively see Banana: Braque, Warhol and Beyond, the viewer is encouraged to encounter the works and engage in the dialectics that inform Bose’s praxis. Bose’s work is part of numerous prestigious, international collections and thanks are extended to the following for their generosity….

Translated for the Critic:

Has thesaurus and isn’t afraid to use it. Photographs, paintings, sculpture and installation. Either the artist has studied abroad or has hired a postgraduate student to write wall text. Can use phrases from wall text if writing a review. Postmodern wanker.

Also featuring translations for Artist, Critic, Gallerist, Aficionado, Collector and Random visitor.

……

I hope you munch on these over the weekend.

Mail me at uberschizo at gmail with your favorite long-form writing from an indian author or tag me in your tweets on twitter. I am uberschizo on twitter.

Reading: Help a logophile out please

These last few months when I’ve been bed-ridden and vacationing, I read for over 8 hours a day. Yes, I counted.

I love reading long articles.

Most websites are not designed to help you with reading long form articles. Till Readability happened, I would tweak websites via firebug to make long articles readable. Readability has changed everything for me. One click and 2000 word articles in NYRB are not an eye sore.

I cant find Indian long-form writing easily

Yes, Caravan tries, ugly typography notwithstanding, but I have a suspicion that the best longform writing by Indians on the web happens in blogs. Are there other outlets? I know about Longreads. I was thrilled to find a movement that cares about reading. I even have my own page on Longreads. But Longreads, now, is all about American/British writing.

Help me out here

I care about the beauty of the writing. I care about what you have to say. I like writing that goes beyond the usual conclusions. I know this country is messed up, I know women are treated badly, I know healthcare sucks. Stating that much is not enough. Tell me a story. Or give me a new idea. Say something hilarious or outrageous. Make me think. Please.

I will help you

On my blog, I will run a regular digest of such long reads. I will also tag them with #longreads or #longreadsindia on twitter.

Oh, and spare me politics.

Thank you.

Anand

Long-form, for the web, is anything 1500 words or more but not 6000 words. Plus/Minus 10% is fine.

Morality, reason and Porn-gate (impressive title, eh?)

Three ministers in Karnataka’s legislative assembly resigned today following a TV expose  showing them watching a porn clip in the assembly. While the MLAs were defensive at first and claimed that they were doing research, their resignations and the multiple inquiries that have been ordered seals their fates.

Opposition MLAs and the media has painted this as a moral low for Karnataka. Twitter has responded (of course) and BJP supporters and detractors alike have bashed the ministers for having watched porn in the legislative assembly.

Two things have seemingly united the right and the left against the accused

  1. BJP and its allies are known to take a conservative stand on morality and culture, and watching of porn is blatantly immoral.
  2. One of the MLAs is the minister for Women and Child development and had previously made a remark to the effect of  “women should not dress provocatively or they are inviting trouble”.

Of the many hours of Lok sabha TV I have watched and what I gather from others, MPs and MLAs routinely sit around totally distracted, reading something unrelated, talking to each other and in general paying absolutely no attention. The grave error of these MLA’s was that they watched porn not that they  watched  porn. That these elected representatives were doing “research” or “entertaining themselves” is less relevant than that it was an obscene clip.

Call it prudishness or political opportunism, this episode  is a good reminder that when we take sides without paying attention to what we are taking sides about, we end up making silly arguments.

Do ministers dealing with women and children have to affirm to a “higher” moral code which includes abstaining from pornography? Is linking his statement about women to his watching porn not a case of confirmation bias? (I knew it, this is typical male chauvinistic behavior!) . Does the right have any objective or consistent standard of obscenity or morality? Does the BJP believe watching pornography is not suitable for people of high moral fiber and culture like its cadre?

How many of India’s ministers have any educational background related to the ministries they are handed? Is there any meritocracy in the handing out of cabinet portfolios?  Do we have any mechanism for public appraisal of personal beliefs and practices of our representatives  with relation to their  effect on their political decisions?

These questions are for examining of our biases and for finding the right reasons to condemn someone. For condemn we must, and from what I gather, these MLAs are condemned not because they watched porn but because they were caught.

Update: Edited for grammatical errors

Too crowded. A book review

Title: A Calendar Too crowded

Author: Sagarika Chakraborty

A calendar too crowded by sagarika charobarty book review

I’ve been putting off writing this review,  because  I don’t like what I want to say about the book. I don’t like being harsh and the book should be read widely, but I am harsh in my review and now, getting ahead of myself.

Sagarika Chakraborty is a lawyer and student at ISB. Her début book is “a collection of stories and poems woven around the theme of womanhood”. Throughout the year there are a few dozen days set apart for women and issues surrounding gender. As is usual, we hear a lot about these issues on the special days and then go back to routine stories for the rest of the year. She outlines her purpose in the introduction:

The attempt is to delve deeper and analyse whether it is merely enough to rely on statistics and be complacent in the knowledge that the numbers indicate a better society in the making, or whether there is an urgent need to look beneath the covers and realize that despite all such dedicated days, there are 300 days when there is nothing special that life has to offer.

The first story is narrated by a girl who has been blamed for everything that went wrong in the lives of people around her, right from when she was in her mother’s womb. At the end of the story, there is just no way not to feel immensely sad about how women are blamed all around us for anything that goes wrong around them.

I kept reading on and half way through the 3rd story it stuck me; I’ve read these stories before. Every single one of them. In fact, most of what I’ve heard about women in India are these stories.

The aim is to bring forth the bruises hidden beneath each lavishly draped body that needs to be highlighted even on days that are not dedicated to campaigns against domestic violence.

I’ve seen symptoms of these problems in my clinic, and the books and blogs I read constantly highlight them. I kept reading on, hoping for a “look beneath the covers” but all I could see was the nudity that I am already all too familiar with.

This made me sad. Not the sadness of facing the harsh truth about womanhood, but the fact that Sagarika falls short on her promise to talk about hidden realities.  News and media outlets constantly highlight stories of dowry deaths, female infanticide and rape.  While Sagarika’s stories don’t read as news does, they do sound overtly familiar, and sometimes follow stereotypical paths. There is the wife who is blamed for everything, the girl pushed into prostitution, the successful woman who is a prey to her own success and even a retiree who finally finds love in an old age home.  Let me be very clear here, these stories are not caricatures. Every one of these characters can be found in our neighborhood or families.

In spite of their familiarity, in many of these stories there are hidden, beautiful nuances of culture and social norms that are often ignored but are significant contributors to the oppression of women. Hidden, I say,  because while the author has great insight into the human condition, the nuances can barely be heard over the righteous indignation that her characters throw at me.

By the end of the book, I felt preached at and even a little manipulated.

There is a reason we refer to extreme imagery associated with development work as “poverty porn”. In their quest to draw the attention of the world to the horrors poor people suffer, they end up robbing the poor of dignity. As far as fund-raising goes, photographs of hungry naked kids do work, but at what cost?

I don’t want to label the whole book as womanhood-porn, not all her protagonists are helpless and undignified, but many are and most seem helpless victims of circumstances, societal injustice and of the supreme bad luck of being born as women.

The reason I am being so harsh is that a quick look around confirmed my great fear: that the those most receptive to what these stories stand for dont really need these stories. They know this already. And those who don’t,are going to be overwhelmed by the loud voices of Sagarika’s characters, and will miss hearing the soft voices and subtle realities that she tries to make accessible.

I hope her next book, for I sure do hope there are others, finds the right audience and the right voice . It would be a shame to see someone with Sagarika’s depth of insight and skill to get caught in the trap of  self-congratulatory writing aimed at the “un-emancipated” and read by the “emancipated” that  is unfortunately too plentiful in my world.

This review is a part of the Book Reviews Program at BlogAdda.com. Participate now to get free books!

India & the sex selection conundrum

Let us agree to go beyond billboard exhortations to ‘love the girl child.

 

What is the remedy to female foeticide in India

There is nothing to disagree about the thesis of the article. The girl child is precious and vital for the well-being of our nation. The girl child is not doing very well in spite of all that we are doing for her.

It is not just the poor girl child who faces trouble, but the rich ones too.

The authors, Farah Naqvia and K.Shiva Kumar, suggest that we need a

, a national communication strategy is key to a national policy response, and this must rest on acknowledging two things — one, behaviour change communication is a specialised field whose expertise must be harnessed, and two, the nature of reproductive decision-making in India is changing along with immense changes in the Indian family structure. A communication strategy needs to identify primary targets (decision-makers) and secondary targets (decision supporters), and reach them through strategic media platforms — traditional, conventional and new media. As for the core content of messages, a lot can be said, but for now let us agree to go beyond billboard exhortations to ‘love the girl child.’ And recognise that the girl will grow up to be a woman one day.

We feel, instinctively, that billboards are not very useful. But then, what is? How does one bring about change in culture, values and deep-rooted systemic ills?

 

What if Tebow were Muslim: Indian Edition

[quote style=”1″] what if Tim Tebow were Muslim? He’s not. So maybe it doesn’t matter. There is no way to separate the man and the religion. Some people praise him for it, others recoil. When this happens, avid defenders of Tebow invoke freedom of religion. But as Tebowmania makes its way into politics, sports, religion and the everyday life of the mainstream United States, it is important to think about how we approach religion in this country. How we approach religious freedom in this country. Do we accept freedom of religion, any religion? Or do we accept freedom of Christianity? Salon [/quote]

Tim Tebow is an American football player who made news because he knelt and prayed before a game. He was made fun of by night show hosts and other liberal media outlets tried to point out the Christianizing of sports. Christian preachers across the US spoke in glowing terms about Tebow’s faith, and fundamentalists like Pat Robertson used the incident to blast the anti-christian bias in the liberal media.

Everyone agrees, though, that if it were a muslim player who knelt to pray in the US, it would be the conservatives who would speak derisively and liberals would just wait for a conservative to say something racist and then harp on about the anti-minority Bias.

The most important take away for me, however, was that for Americans, the right to make fun of people’s convictions was as important as having those convictions. And that the media believed that derisive/satirical humor was a great way to deal with public displays of religion..

Free speech, religion and secularism have been in the public debate in India of late. What began as a reaction to the stringent and draconian IT Bill later spilled into the realm of politics and religion with Kapil Sibal’s recent posturing over content that “hurts sentiments”.

We have a very different set of values than the US. We believe in live and let live. If an Indian player makes a public display of his faith, very likely it would be talked about in a respectful way. The commentators would say something like “and here is Tim praying before he begins, and lets hope his prayers are heard because his team needs all the help it can”.  Sure,there would be religious extremists of every kind to condemn it, but for the common Indian, used to seeing religious icons in government offices, public transport and even schools, it would just be something to respect about the person.

But the audibility of extremists is increasing.

One measure by which I make this assertion is observing the successful vilification of the word “secularism”.  This, was achieved/is being achieved by a propaganda techniques called  Name Calling. Repeatedly using a word in a negative context or with a negative connotation leads to devaluation of the word or the idea, makes people wary of it, and can lead to complete destruction of its meaning. Since no propaganda technique is used in isolation, combined with cherry picking data (related to card stacking) about how the congress has mis-used secularism in India ( it has) to garner muslim votes, the very desire for secularism is being challenged and subverted. Which (coincidence? ) is what the Hindu supremacists desire, a return to the “Indian” way of dealing with minorities (of which Subramanian Swamy gave a great explanation of).

If an Indian muslim player were to kneel in prayer, to most of this country it would mean nothing special, it definitely wont get him called names by mainstream media, nor would there be any one of significance speaking of it. There would, however, be muslim preachers who will use this as a message of  fervor,  and many more who would make comments about ” that secular player” doing “secular things”.

Here is the interesting thing,  Not everyone understands or even sees the damage that is intended or the religious prejudice behind the usage. What is most saddening is that many of them have deeply secular values and latch on to this bandwagon because :

  • The power of Assertion (another propaganda technique) keep saying something over and over, it will seem like the truth.
  • They know nothing about Muslims, other than the cherry picked data about violence, oppression etc. Most Indians grow up in areas where people of other faiths are not common. In spite of my having grown up and lived in 4 states in India, i have all of One Muslim friend. the rest are Christians and Hindus. My knowledge of the Muslim world comes from stories handed down in the family (mostly how we are better than “them”), the news papers and now, the internet. A casual glimpse through various sites that talk about Indian muslims will tell you that the majority of information out there is written either by conservative/fundamentalist muslims, or Hindus. The voice of the progressive, secularism loving Muslim is buried under a lot of noise.
  • Desire to be part of the “cool kids” ie. the  bandwagon effect . I‘ve been hearing about a Hindu resurgence for the last 10 years. I have no facts to show if it really is happening, or what it means, but in spite of that, i believe it. In fact, most people do, and once a critical mass of people believe in something, it becomes easier to accept more without evidence and easier to recruit minds.
  • Disgust for Congress’ behavior.  This is the straw that broke the camel’s back. It does not take too much digging to realize that right from the beginning, secularism was used first as a protectionist strategy and later as a vote banking technique by the Congress at the center (individual states show a different picture). With the exposing of how deep and wide corruption runs in India, and with the growing discontent with it, everyone who hates the “rule” of Congress is left with little choice.
  • The linking of nationalism with anti-secularism. Religion touting political parties have always also linked nationalism with Hinduism, and so with the expected rise in patriotism (money coming in, lack of progress, increasing corruption etc.), there is an inadvertant clubbing of the secularism-bashing with nationalism.

One thing that contributes to the bowdlerization of Secularism is the way the liberal voices in India handle the conservative ones- with a patronizing, disdainful tone. We think that these “fringe” elements will never have any effect on “intelligent” Indians and that “most Indians” would not believe such crap. perhaps its time we wake up and smell the rotting roses.

The end effect is that instead of developing a moral sense to look for real secularism and promoting it, we are moving into times when a religious alternative to secularism (which, clearly is an evil thing, right?) is being introduced.

So today, if Tim Tebow were a Muslim in India, the majority would cheer him, a small group would beatify him, but here would be more people and louder voices that call him a  sikular Indian   than ever before. These voices continue to rise aided by the concurrent  increase in volume of the muslim fundamentalist, and hastened by government policies that care only about gaming the system for maximum profit.

Is that in itself a bad thing? How did we become a secular nation? Do we have alternatives to western ideas of secularism? What is this secularism anyway and is it any good?

These questions will be part 2. thank you for reading.

Book Review- Transforming Capitalism by Arun Maira

Transforming Capitalism by Arun maira, review by Dr. Anand Philip[dropcap style=”3″]T[/dropcap]he last decade has seen a rise in philanthropic businesses and big businesses investing in the society. The worldwide depression brought on by the wall street, stricter laws about environment, and the rise of laws about corporate social responsibility have contributed to this. There is also a growing awareness among businesses large and small that screwing over people and the environment is bad business in the long run.
Arun Maira, in his book Transforming capitalism, improving the world for everyone, makes the case that

  1. Capitalism, if practiced laissez-fair, is harmful for everyone involved.
  2. Businesses can and should do the right thing from a moral point of view when dealing with people and
  3. People/businesses with a lot of money should see themselves as custodians or stewards of their money and resources and so should help people with it.

Arun Maira is a journalist, for a large part of his life he was a business manager. Over the past decade, he has written in most of India’s top business magazines, as well as in the magazine Civil society about the various ways in which businesses can, do and should help people beyond the narrow confines of material profit. This book is a collection of these articles. This is probably why, though the book is divided into four sections, a clear progression or continuity cannot be felt in the writings.
This is not a progressive apologetic, this is not a case for marrying socialism with capitalism either, this is a cross section, through the writings of someone who has been in the field long enough to know what he is talking about.

What I like about this book the most is that instead of preaching or a prescriptive style of writing Maira exhorts. he points to what is happening, suggests gently and with authority that instead of formulas both sides have, what is needed, foremost is dialogue open, honest and constant dialogue. this behavior is quiet uncommon in columnists these days who are eager to preach, eager to repeat over and over how their ideas are the best and why the world will go to the dogs if they don’t follow their brilliance.

It would be foolish to think that leaders of environment killing or people-hurting businesses don’t realize that what they are doing hurts people, but a fundamental belief, a one in the free market ( and some healthy greed) keeps them and everyone down the chain chained to their course. They believe that the free market, which enables everyone to take part equally in wealth creation and ultimately in the pursuit of ones happiness without the state directing what one ought and ought not to do is the best way to eradicate poverty. And lets face it,free market creates wealth. Anyone who has lived through pre and post liberalization India can attest to this.

But what apologists of capitalism often forget to preach is that when it comes to creating wealth for the ultra poor, the trickle down effect is often like eating leftovers from a rich mans table. with our new humanist understanding of human rights, I don’t think it is acceptable anymore to knowingly let people suffer based on one’s belief in the market. The non-profit groups or the civil society who typically are the champions of the poor operate under a completely different set of beliefs. To many of them the idea of making profit for the sake of profit is abhorrent. And practically all of them believe that human beings cannot be trusted to do the right thing in an unregulated system. Their idea of regulation of course is not peer regulation but strict almost socialist regulation. What Mr. Maira does very well is explain why both sides of this divide need to have a sustained conversation that helps us achieve the goals of alleviating poverty,social justice etc.

To me this is probably not a book written for the CEOs of Fortune 500 companies. This is also not a book for someone who has been following the social business/enterprise sector for the last few years. This is the book for the MBA student or the new manager, for the young Indian who wants to enter the markets but still stay good.

A recent survey showed that the worlds highest number of social businesses or socially minded businesses of the last few years have started in India. This is a clear sign that a lot of young people in this country are interested in doing good and Mr. Maria’s book can serve as a good starting point showing that it can be done.

The only worrying thing is Mr. Maira’s adoption of Gandhian ideas about wealth and businesses.

This review is a part of the Book Reviews Program at BlogAdda.com. Participate now to get free books!

Top Criminals in Indian Hospitals

Criminals in hospitals Image by murplejane

Ten years inside hospitals gives you a great instinct to pick out criminals. Oh yes, there are a lot of them in the hospitals. Here are the greatest offenders and how to deal with them.

The Poor:

They can’t afford the services, yet they come. They never do what we ask them to, want multivitamins and “saline” and never come when we ask them to. They are dirty, and don’t pay even if they can afford it. Definitely deserve the long waiting times and getting sidelined for “paying” patients.

The old:

Slow, stubborn and forgetful, they can never come to the point. If they have bellyache, they start with the time they stubbed their toe back in 67 and the time they met a white doctor who gave them a red liquid for the belly ache. Definitely deserve the patronizing behaviour that we have perfected; don’t pay attention, just nod, agree and give them something for symptomatic relief. Talk loudly, most of them are deaf.

The very rich:

Scum of the earth, just the worst people in India. They walk around like they own the hospital and treat us like we are beggars. Clearly they deserve to be robbed. Such sense of entitlement, such low respect for the profession. Keep changing doctors, want results yesterday, stingy. Definitely deserve the over charging and the excessive tests, they ask for it.

Women:

90% of their problems are psycho somatic and they create such a fuss about the rest 10%. If you are a guy, they wont let you touch them, if you don’t, and get the diagnosis wrong, they curse you. In the labor room they wont push when they need to and scream like a banshee, as if it’s an elephant coming out. Never open their mouths if their husbands hit them, so we can’t do anything. Definitely deserve being given antidepressants for the vague symptoms and the slaps on the labor table.

Villager:

You can smell them from a mile away. Sure they work in the fields and have animals, but can’t they buy soap? or at least some chap perfume? many of them are rich but pretend to be poor, they don’t change their clothes and treat the women so bad. if you are a girl then you’ve had it, your old man wont spend a penny on you. Depending on the case, definitely educate them about taking bath and sending their girls to school.

Prostitutes and homosexuals:

Why can’t they just say it? how many times will I have to “guess” their tendencies and do the right test?  I mean I am a professional, trained to deal with them in a professional way, then why can’t they just open up? They hem and haw and beat around the bush and never tell you what’s really going on. As if they can fool anyone. Anyway, poor women, forced to live like this, sometimes I feel sad, but I have to do my job and I can’t care for emotions. For them always do STD panel, even if they complain of head ache, they actually mean something else, so no point in asking if you should do it, they will just say no.

Criminals in hospital Woody allen being chased by a gorilla

Image by JohnMcNab

 

Surely, I am joking. Right? How can an educated, cultured professional hold such beliefs. These show the beliefs of a micro minority, right? No lessons to be learned here, just how some people can’t be cured by education. Correct?