Frank Turek, co-author of “I Don’t Have Enough Faith to be an Atheist,” and Christopher Hitchens, author of “god is not Great: How Religion Poisons Everything,” met at VCU in Richmond, VA to debate the subject, “Does God Exist?”

Christopher Hitchens in 2010

Not because I agreed with everything he said (his unforgivable mistake as John Cook characterises it), neither for the condescension with which he characterised believers (often entertaining!). He was a courageous man, never afraid of his vices, never hiding his talents and unhindered by ignorance of the topics he spoke on. His debates kept me company on cold Belgian winters and set off month-long reflections on fundamental fixed convictions that we can get off our backs in a jiffy…if only we knew we carry them. His books, talks and articles pushed boundaries – never taking the missionary position on topics of religion, nor sparing poor arguments when he came across one, he will be remembered not for the entire content of his views but the way he put them across.

One person who (tried to) overcome the slavery of reason to emotion, which perhaps explains his hitchhiking along the long-winding road from the political left to the political right and somewhere in between. Who could have faced the inimitable George Galloway on US turf when the war on Iraq felt like egg on the faces of those who advocated it? If there was reason, he never feared the consequences of standing in for it. If there was anybody who could expose the farce of portraying the divine origins of morals and ethics, it was he – see this debate with the Rev. Al Sharpton for example, where Sharpton was introduced (to a smattering of applause) as being ordained a minister when you are 9; much to Hitchens’ glee for he remarked “What does it say about the seriousness of religion if you can be ordained a minister when you are 9?” – an exchange used for the “religious slap” by Bill Maher in Religiulous to much amusement and some theatrics.

For those who are not yet introduced to him, I would much recommend “God is not great” or for shorter introduction to his literary style, his review “Newtopia”, expectedly a scathing critique of a book by Newt Gingrich. Or the God debate with Dinesh D’Souza, one of his more peaceful ones or perhaps for his debate with the mathematician Alister McGrath, or his more animated one with Rabi Boteach. And among the numerous well-written remembrances on his life, the unmissable ones are the ones by Graydon Carter in Vanity Fair and by Ian McEwan on ‘the consummate writer, the brilliant friend’. And not to miss Dawkins’ interview of Hitchens quite recently and here’s the preview.

And here is an entertaining debate he had with Turek (would encourage scrolling directly to 70 minutes for to avoid permanent damage to your sense of sensibility). Definitely not one of the best adversaries that Hitchens has met in a debate, but clearly one of the more entertaining ones. :)

Turek vs. Hitchens Debate: Does God Exist? from Andrew Ketchum on Vimeo.

Frank Turek, co-author of “I Don’t Have Enough Faith to be an Atheist,” and Christopher Hitchens, author of “god is not Great: How Religion Poisons Everything,” met at VCU in Richmond, VA to debate the subject, “Does God Exist?”

Everybody loves a good drought under Indian Fiction

I was myself reminded of a photo I took from Crossword, where his oft-quoted book on famines “Everybody loves a good drought” was (perhaps?) inadvertantly placed under “Indian Fiction”, when he spoke about the time when he was invited to talk on “Indian fiction” on one of his foreign trips which he accepted for he was an authority on the Government documents.

Sainath started in earnest with the rise in petrol prices and deftly manoevered that to a paragraph he read out from a few sheets of scribbled stuff he had brought to the podium. He reassured us that this is not what he often does – read a prepared text. It was from the budget speech of 24th July 1991, when the present prime minister, Manmohan Singh was the finance minister. We got to know this only later though because the context around which “liberalisation” was brought in still exists today….at least for most of rural India. Sainath reminded us that line “…Budgetary subsidies, with questionable social and economic impact, have been allowed to grow to an alarming extent”. Since then, how many such “subsides” have had great impacts?

It appears that such “subsidies” are available for all to see as an inconspicuous annexure to all budgets – “Statement of Revenue foregone” – here it is for 2009-10. This document lists the special tax exemptions and concessions given to individuals and corporates and calculates the revenue ‘lost’ or foregone by the central government as a result of these. The figure is somewhere near 35,000 crore rupees – Sainath reminded us that this is around the money it takes to run the entire NREGA programme for a year – yes, that is what was “foregone” – the new word for corporate subsidy which has now replaced those budgetary subsidies of pre-90s days which had questionable social impact! This foregone revenue is climbing year after year and one of its greatest components has been the custom subsidies. And for those of us who were wondering if our good government was keeping the interests of many of us in mind while it was perhaps waiving off taxes on essential drugs, here is  the list – precious stones and jewellery, mineral fuels and oils, animal or vegetable fats, machinery and electrical machinery. The first one in this list – a Rs 48,798 crore exemption on customs duty for imported jewellery in one year alone – nearly the size of our entire annual food subsidy all for the great drain robbery.

Indian has more billionaires than all Scandinavian countries put together! And this is not merely from the richest cities, we were told. Sainath described those nice weddings in rural India particularly those of Gadkari’s son held in Vidarbha – that place where farmers are killing themselves for debt. Seems a bit exaggerated right – why would farmers kill themselves in a place where 2,00,000 people attended the wedding and aircrafts replaced the usual tractors and trucks for ferrying wedding guests. And who says a village cannot get 24-hour power. No load shedding during gadkari wedding! And no party-specificity with such rich rural weddings – so is the case, Sainath reminded us of the weddings of several others from all parties. India was so shining in these areas, that it was mostly blinding for many who didnt catch the irony. So much so that mass weddings with food were understandably the best social programme in Vidarbha for a long time.

The next 45 minutes was a series of anecdoetes from the 80s and 90s. The wisdom and experience of covering real India for decades was showing – he discussed the problem of “footloose migration” – those people for example from Orissa and Jharkhand who work for a few months in Hyderabad and later in Mumbai who do not get picked up by any census. We heard about that wonderful scheme that was pooh-poohed when launched – the midday meal scheme. The farmers rally or the strike at Maruthi’s Manesar plant for better working conditions that mainstream media took so late to cover. And of course, how many “luminaries” have rubbished all this tripe about farmers’ suicides and have proven it to us by legally deleting famine from their vocabulary through a parliamentary act! More followed on the food security bill.

All in all, it was a brilliant display of wisdom, erudition, spontaneity and a sense of conscience that Sainath demonstrates. He stands today as a conscience for several self-aggrandised and charismatic civil society who forget that it takes more than values and integrity to build a country. Describing himself as a member of the “un”civil society, Sainath repeated his thoughts on the Jan Lokpal Bill from that Berkeley lecture and gave tips on feeding our billionaires. 

And for those who would rather listen to Sainath himself and trust me the talk was one of his best  (the recording is not!) – see http://dl.dropbox.com/u/2047439/sainath/data-2011-9-16-19-05-15.3gp and http://dl.dropbox.com/u/2047439/sainath/data-2011-9-16-19-59-12.3gp (Thanks to Anush)

See also

• Indian media – politically free, prisoners of profit
• Three weddings and a funeral
• Reception after reception for Gadkari’s son
• Revenue foregone, but not forgiven
• Corporate socialism’s 2G orgy and all his other articles archived on India Together

Alfred Alcock, the physician-naturalist who was instrumental in the creation of the Zoological Survey of India

and research leading to the advancement in our knowledge of various aspects of exceptionally rich life of the erstwhile British Indian Empire” (Emphasis mine). Alfred William Alcock was a British physician-naturalist, a common breed in those colonial days when doctors were still excited about working in “difficult” and remote areas and doubled as explorers, naturalists and prolific writers without any of those “rural area incentives” under the present-day National Rural Health Mission that miserably fail to entice doctors to work even in small towns, let alone remote areas. Those were days when being a doctor in the service of the “empire” was still a reputed member of the “civil service” – a cadre of the service was designated the Indian Medical Service with illustrious doctors such as Ronald Ross; a cadre undone ever since. Alcock turned out to be a prolific writer, traveller, doctor and a scientist. He worked in many parts of the country ranging from the North-west Frontier Province in today’s Af-Pak region and as a Surgeon-naturalist on the Indian Marine Survey. His survey results are in 17 volumes and he also wrote an 8 volume narrative of his experience in Indian seas as “A naturalist in Indian seas”. 

Like many other doctors who left their medicine behind to pursue natural history, Alcock in the course of time found himself superintending the Indian Museum in Calcutta when one day in 1903 he was ordered by the Viceroy, Lord Curzon to “to vacate the gallery of Fishes at a moment’s notice.” His protestations and support from trustees of the museum prevented the damage to the fish and other collections. Considering such experiences and the wealth of knowledge to be gained by his and future generations, in a letter that was apparently taken seriously by the British administration, he urged for the creation of the Zoological Survey of India. He wrote “…zoology is…a branch of pure science pregnant with human interest, important to the state in matters of education, in matters agricultural and veterinary, and in the vital matter of public health. He suggested the establishment of an Indian Zoological Survey with a museum and laboratory administered by zoologists along the lines of the Geological and Botanical Surveys.”

I can’t but miss the irony. Today the website of ZSI boldly proclaims that it “..has maintained its primary objectives unchanged from its inception”. Apparently, this is true – for none of their collections are accessible to researchers, let alone lay people. While the 5-odd million specimens sitting at the National Museum of Natural History (Smithsonian) far away at Washington DC are indexed and searchable online through a simple search our own “premier organisation” wrote to me in bold letters in their RTI response that the details of the 41,291 bird specimens that they hold cannot be shared with me

"...registers are old and fragile" says ZSI

because “..some of the registers are old and fragile”.

The ZSI holds some very important and heritage collections – the collections of the Asiatic Society of Bengal and the erstwhile Indian Museum were inherited by them. In addition to this, several other type specimens of extinct and extant species are held at ZSI – albeit in secret. The sheer apathy of the institution in making information available is evident in its website – a type-specimen of terrible design conspiring with lack of information to make the user experience as unproductive as an application under RTI.

And reform does not come easy either. When our maverick minister with the coolest haircut in the cabinet tried to shave off a bit of the apathy through structural reform of the ZSI, the bureaucratic machinery swung into action to scuttle all such moves. Although thorough evaluations have proposed specific suggestions and new organisation structures and mandates, nothing has come even two years after the most recent task force report. Shyamal captures this wonderfully in his essay “Tax-payer funded science in India” – where the mere apathy and lack of access to public collections and repositories hinders research. It is not for lack of a secure job, poor infrastructure, lacking mandate or unavailable data that organisations like ZSI are not producing. It appears to be sheer apathy that our premier institutions can get away with such responses under Right to Information Act. It is another matter that I never needed to establish that I have a right as a citizen to ask for such basic details of heritage collections for which this nearly 100-year old body has been established!

This is of course merely a rant before I send off the first appeal. I am not the one to accept “old and fragile records” as an excuse for not making available details of our heritage collections on the internet or through RTI. Perhaps, a letter also to the “Panel on scientific data of public interest”?

—

* Update: Another RTI filed with yet another premier institute, the Wildlife Institute of India, Dehradun. Lot more data will be out in the open if this works.

* Thanks to Shyamal and Kullu.

* Download my RTI application and the response from ZSI. RTI filed with ease through RTI nation

The first of its kind event, the First Global Symposium on health systems research organized by WHO sought to focus on "science to accelerate universal health coverage"

The setting? The official dinner of the First Global Symposium on Health Systems Research organized at the Montreux Casino. A photo of the dying TB patient formed the background for 20 minutes of a talk on “Why Health Systems Fail” by Atul Gawande, a surgeon and writer, to an audience obviously more interested in the wining and dining and, of course, the party that followed.

November 16 to 19 of 2010 saw the global public health giants gather in Montreux, Switzerland, for the First Global Symposium on Health Systems Research under the auspices of the World Health Organization and partners. Some of us Emerging Voices from the Global South (52 of us from 29 countries) got a unique chance to be a part of this experience by getting selected through an essay competition organized by the Institute of Tropical Medicine, Antwerp.

However, for us it was a stark lesson in the “dichotomy” in practice. On the one hand, we hear all the time about “gross injustices in the way globalization takes place” and 20-40 percent inefficiencies and waste; on the other hand, we clearly have “wasteful spending” and a “culture of entitlements” to these perks and privileges among international health technocrats themselves. We talk about the need to send the right message and then hold such global events far away from the settings being discussed, with fee structures that exclude many of the very people affected. How can well-meaning people in global health maintain that we need to organize structural solidarity and transfers for health via multilateral mechanisms, when many of these organizations waste resources at the same time?

What Message Are We Sending?

We are by no means shifting blame. A portion of it rests squarely and surely on our shoulders as well, for we were very much a part of this particular event. However, one has to agree that there is something odd in talking about “reaching the marginalized” and “those who cannot afford health care” at an “official” symposium dinner in a casino. After all, an official event organized by WHO and partners sends a strong message. What message did this particular event convey? Is it an echo of this timeless verse from ‘The Development Set’ penned by Ross Coggins?

We discuss malnutrition over steaks
And plan hunger talks during coffee breaks.
Whether Asian floods or African drought,
We face each issue with open mouth.

Perhaps, we should revisit the purposes of a conference:  sharing knowledge, networking and building collaborations. Of course the setting, dinners and gala events are all important to achieve these goals, but at what costs? Lot of networking at venues like these happens for reasons of fundraising. Sometimes, fundraising for research and pet projects becomes more important than the proclaimed overall goal: “Universal Coverage.” From that point of view, the casino event was certainly very appropriate, more along the lines of “meet the President” fund-raising dinners in the United States.

This also brought into stark contrast the World Health Report 2010, which for the first time stressed that, for decades to come, many low-income countries from Sub-Saharan Africa will need external financing support to help them on the path towards universal coverage (as they can’t do it themselves). We are essentially talking about 150 million victims of catastrophic health expenditure. Do we have the right to dishonor them or our cause by acting so callously?

As far as the WHO is concerned, we have to admit that this event was probably a bit atypical, but this double culture we are referring to seems all too obvious in many international organizations. “The Lords of Poverty,” whether multilateral or bilateral, transfer very large sums of money, which should ideally make them more accountable to the public and transparent in their dealings. Unfortunately, that is not the case. The allocation of official aid follows a set agenda and its rationale has been likened to the need for champagne: “In success you deserve it, in failure you need it.”

Are Cutbacks Only For Common People?

Incidentally, a similar paradox exists with respect to the climate challenge: there are still far too many “happy fliers” among the global health big shots, in spite of the fact that climate change could turn out to be the biggest global health threat of the 21st century. Cost cutting and limiting carbon footprints have become international buzz words, but in practice the responsibility seems to rest solely on the shoulders of common people.

Maybe, it is time to stop being such hypocrites. No matter the reality, many look up to the WHO as the face of global health and the institution that should play a key role in global health governance. Lead by example, even in the face of current adversities. That is the least we expect.

It is indeed great days for learners, especially for those who are self-directed, auto-didactic as they are apparently called. With the explosion of those delectable tablets made by that company Lieutenant Dan invested in and the claim that many other products are what evoulutionary biologists would call Batesian mimics, the access and availability to information has multiplied much more than one can manage. In the 3 hours per day that I often spend in my car, Maher pokes fun on hypocrisy of hyper-religious groups in celebrating the killing of an enemy proscribed by ‘the book’ even as I take longer detours around Cubbon Park so that the super-slow Bangalore Metro construction lazily centimetres ahead. While I have coffee, I can load my daily dose of caseblog’s latest take on social media in medicine and Myers‘ or Katti’s daily trysts with creationists and bad science onto Instapaper so that I can read while I lie down in the evening after a long day at home. On other days while I wait in Gubbi or in Pavagada for interviews in course of my work, I can complete my daily module of Empirical Research Methods course offered on Carnegie Mellon’s OLI. Several such open courses offered online and free by leading universities means that the limiting factor for learning is merely curiousity! Further narrowing the tendency of knowledge to concentrate among a few are wikipedia, medpedia and several citizen science initiatives that aggregate and help make sense of information generated by individuals. As the Guardian proclaims as well as shows, “comments are free but facts are sacred“. One one hand is migrantwatch that tries to unravel the mystery of pied cuckoo’s residency or migratoriness, on another site is Anush’s three pence on the freely shared malaria data. Elsewhere somebody is putting up free illustrations of birds and somebody else is sharing photographs of some rare birds of which perhaps are only a few hundreds remain and only a few hundred people in the world have perhaps even seen, yet freely available for all on the commons. Even as a twittering wildlife photographer traces his wild journeys through the hinterland of the blazing hot central Indian tiger reserves, another one vividly describes his encounters with the snow leopard. In other corners of the internet, a scientist on one hand and a bereaved father on the other lament State apathy. This is merely a sample of any day’s syndication through flipboard and their ilk onto the few digital hours of my life before and after my work!

The internet is still quite a luxury for more than 90 percent of India and that day when right to bandwidth joins the yet unrealised rights for education and health in our country may be still far. Yet, for those who do have such extensions to their phenotypes, the glut of information (most of it quite poor and others patently false) can be quite disabling. And even as I celebrate the huge amount of information that I have access to and every day, I ask myself how much worse off would I have been without all this.

Autodidacticism, or self-directed learning has been described much before the onset of the internet of course. Malcom Shepard Knowles seems to be  a new age pioneer of this learning method with the roots of such learning going back to 12th century middle-east (See Ibn Tufail). The number of open courseware available and the high quality of the courses are overwhelming. My dream of pursuing logic as a course (as opposed to wasting time quoting logic in losing arguments!) is today possible with OLI. Leading universities now offer their material online, not merely as a dump of lectures, but as courses with clear learning objectives and the use of high quality teaching and learning material – Yale and MIT merely an example of many more. Other wonderful lectures are freely downloadable through ItunesU such as Michael Sandel’s wonderful lectures on ethics.

Such apps, software and portals have merely facilitated a chaotic access to the autodidact(!). However, I often hear an argument that all of this information is quite wasteful and has not amounted to anything. That all of this amounts merely to noise. In contrast to this, for me,  the way we use technology to manage the information is going to determine how we make sense of the internet. And choosing the right software or app is not merely a matter of being fascinated by the interface or its presentation, but to see how well we adapt it into our lifestyle. Else, we will merely spend most of our mouse-clicks hitting like and retweeting bunkum.

(As you must’ve noticed, this was a very ‘linky’ post, in keeping with the theme. The post would have to be much more lengthy if not for this ‘linkiness’.)

A neglected statue and a neglected message

Some things are better assumed and neglected, than acknowledged and attended to. In public health research, these often find a passing mention in “Discussion” section where findings are explained, and worse still, may be as a “contextual” element. Prime among this is corruption. Corruption in health services is nothing new. Perhaps merely a sub-set of the general corruption prevalent in administration of public services, the corruption in health is much more than merely a “contextual” element to be taken into consideration in planning and implementing health programmes. Nor is it merely a feature that may explain some of the poor health outcomes that we often find. Corruption is directly, causally linked to poor health service delivery. We KNOW this and we SEE it. Yet, when I read several reports and documents at national and global levels, there is an obvious glossing over of this feature – as if this is some minor itch that governments will eventually get to.

In writing this comment to the Lancet, I had the privilege of partnering with somebody who has led a tirade against corruption in health services in my state, Karnataka in South India. As a chairman of a government appointed committee on health care for our state, he took a bold and courageous step in putting “corruption” as the main problem that the health services ail from. As I describe in the comment, this led to a long chain of events including the strengthening of the Lokayukta, an ombudsman institution that helps uncover corruption.

Yet, this is not enough! Over a decade of very active ombudsmen in Karnataka have not achieved much beyond making corruption a public issue. It continues to parasitise the reforms and innovations that we so fondly and techincally design for health systems strengthening. Of what use is a good HR policy if people accept money for transfers? Of what benefit is drug price control orders if there is collusion among officials and companies for mutual benefit at the cost of the system?

I really do not know what it is – lack of evidence? lack of resolve? In fact, I wonder sometimes, if corruption is a feature of the system or a bug?

NB: This appeared as a guest post on the International Health Policies Blog of the Institute of Tropical Medicine, Antwerp as a part of the Emerging Voices Initiative. Thanks to Kristof Decoster and David Hercot for the help and support.

Pasted below is the article from there:

We cannot stay silent. Do your bit – raise your voice, write letters, support campaigns and make the ones in high places aware that they cannot sit quiet. Sign the online pettition or write to the president, as these people did. Write in your local languages and local press and spread the message.

A recent photo of Binayak Sen: Courtesy NDTV

Reproduced below is the statement of Jana Arogya Andolana from Karnataka.

We, the Jana Arogya Andolana Karnataka (JAAK), the Karnataka chapter of the People’s Health Movement, which is a coalition of Karnataka State level networks, organizations and persons actively working for health rights in the State, express our outrage at the verdict of the Raipur district and sessions court judgement declaring Dr Binayak Sen guilty of criminal conspiracy of sedition.

Dr Sen has an illustrious record of over 25 years of selfless public service in areas of health and human rights. He has been the General Secretary of the Chhattisgarh People’s Union for Civil Liberties and Vice-President of the National PUCL and has contributed to the democratic movement in the country. He has been closely associated with the Jan Swasthya Abhiyan, the Indian chapter of the People’s Health Movement.

In recognition of his work, the Christian Medical College, Vellore conferred on him the Paul Harrison Award in 2004, which is the highest award given to an alumnus for distinguished service in rural areas. He continues to be an inspiration to successive generations of students and faculty. Many of his articles based on his work have been internationally appreciated.

His indictment under the draconian and undemocratic Chhattisgarh Special Public Security Act, 2006, and the Unlawful Activities (Prevention) Act, 1967 and the sentence of life imprisonment is utterly condemnable. Not only has the farcical nature of the trial been reported in the media, the charges against Dr Sen, of engaging in anti-national activities, have been widely held as baseless.

This judgment is an unacceptable attempt to intimidate and vilify those who advocate for the rights of the poor and the marginalized, and reveals the indiscriminate use of state machinery to stifle democratic dissent.

JAAK believes that a great derailment of justice has been done, not only to Dr Sen but also to the democratic fabric of this country. We consider this as a typical case where the judiciary has betrayed the cause of the poor and the marginalized of this country. JAAK salutes Dr. Sen’s work, and also demands that the unjust and erroneous judgement be reviewed immediately.

Many global initiatives have brought this up. The Global Forum for Health Research popularised the now famous, 10/90 gap in research – 90 % of health research focussing on 10% of the world’s health problems. Initiatives such as the Global Fund and WHO TDR tried to shift focus to the world’s major health problems – Tuberculosis, Malaria and neglected tropical diseases. Much rhetoric and some action has gone into fight against the Pareto gap in health.

One of the most sincere of such attempts is the small and silent steps that the Institute of Tropical Medicine, Antwerp (ITM) has been taking with the support of the Belgian Government. The school, little known in India has been popularising the agenda of ‘switching the poles’ – trying to put the Southern nations in the drivers’ seat. One of the initiatives under this was the ‘Emerging Voices’ initiative – an effort to choose 52 emerging voices in health research and help break the monopoly of the usual suspects at global fora. ITM provided training in research writing, presentation skills and science communitcation during a run up to the grand WHO symposium on health systems research in Montruex, Switzerland. We, emerging voices received inputs from senior faculty at the Institute as well as language coaching from Linguapolis, the language school of the University of Antwerp. It was a brilliant idea that sought to choose researchers from the South and present new ideas at the international forum.

Emerging Voices stall at the symposium

My essay on Public-private Partnership in primary health care tried to present an arguement for using health systems research to understand the conditions under which internventions work and not go in for grand scaling up, the way things happen these days in policy making. I was indeed happy to have been chosen to speak at the event in Montreux. But, the most interesting outcome of the entire Emerging voices initiative was the fact that a school in the North made a sincere attempt to support researchers from the South and provided an environment for greater collaboration between Southern researchers.

Research in health today is dominated by researchers from the richer countries. While research institutions in the South grapple with poor research budgets, poor teaching and skills and the lack of a ‘culture’ of research, most Northern institutions have had the benefit of long years of colonisation and Western science and greater budget allocations. Even when global research grants are given, the agenda is often dominated by the richer countries. In ITM, many of us emerging voices saw a genuine commitment to shift gears.

At Montruex was waiting for us a gala event. It was a gather of over a 1000 health researchers from all over the world. It was quite a well planned symposium with sometimes over 10 parallel sessions. Ranging from methods in health systems research (complexity, action research) to small gatherings of activists from the people’s health movement, the symposium was quite a diversity of actors in international health. The venue was a bit strange of course – a symposium focussing on the problems of lack of even basic access to health care being held in Montreux, Switzerland was quite an irony – in this short piece, ‘WHO Pokerface’, Meena Daivadanam, one of the emerging voices raises this concern on a blog here. We even brought this up in our own pecha-kucha presentation at the closing plenary of the symposium, when 3 emerging voices (Lalit Narayan, Aida Zerbo and Wilfred Gurupira) presented the take-home message of the emerging voices to the entire symposium. Some uncomfortable, yet important questions to the international health research community.

A great initiative by ITM, Antwerp. I hope many more schools and institutions in the North will recognise the importance of supporting south not merely with money but with building capacity and commitment. Thanks ITM for being sincere, committed and passionate about putting Southern researchers in the drivers’ seat.

NB: Special thanks to An Applemans, David Hercot, David Hendrickx, Kristoff Decoster, Jos Assayag, Wim Van Damme and several others at the Emerging Voices Secretariat and department of public health at Institute of Tropical Medicine, Antwerp

- Douglas Adams

It was just another among many Novembers for the Head of department of Anatomy at Mysore Medical College. However, it was a special moment for the close to hundred eager minds assembled amidst the dust and echoes in the biochemistry hall. It was here on that November in 1997 that I heard the first ever words of a doctor while I was not ill. It was first day of medical training for nearly a hundred of the 1997 batch at Mysore Medical College.

We were quite a motley crew – Karnataka itself well represented from Bidar to Coorg, and the usual smattering of PM/PD candidates, mostly from the hindi-speaking belt. Beside me was a lean boy from Andhra who is now a surgeon and on the way revolutionized Mad-ads and cartoons in the college, and on the other side was an eccentric looking ‘localite’, today a psychiatrist in UK. Discussing CET ranks was quite a pre-occupation on the first few days – as if all our lives, these ranks would be the defining moments! It felt quite like the end of a struggle (for the medical seat), and we felt like winners. Little did we know the struggle for the seat was only a trailer for the action-packed movie awaiting us!

As I sit today trying to retrace this new path, I took 13 years ago; I am reminded of all the things apart from medicine, that MMC taught me. There

The surgeon and the psychiatrist among the other crazy guys that made this team

was the magazine of the batch, Doctales we called it, which did not see more than 4 issues; yet, we learnt what it is to edit articles. There was the music band, Bandwith 85, as we called it with the origins of its name shrouded in mystery. The department Q, which a few of us started for late evening quizzing and other pre-occupations had little to do with medicine. There was INFEST, a mega cultural event that drew support from many batches of students and the staff alike. I saw three of these while I was in (and later near) MMC. Loke’s tea and the discussions around him should have made him a wise man. The waterless pond and the unrepresentative sample of MMC’ians, which it drew, were a constant inspiration for hanging around the reading room. And of course the new auditorium, the gift of the alumni, thanks to which we never did have to go crawling for permission to Kalamandira.

The wonderful hostel with the Late Mare Gowda and the cobbler and the innumerable idiosyncrasies that surround each member of the hostel kitchen; the wonderful movies we watched and the arguments about life, universe and everything on the stone bench; the prefectship which signified a system or the lack thereof; and inter-batch politics – these were early preparations for the real world. I cherish all the memories of the hostel, which were indeed life skills education that no medical school could have given! The long hours of group study in 137, the eccentricities in 91 and the wall art in 122. Each room seemed to acquire a history of its predecessor as well as the character of the occupant.

Yes, I learnt medicine too. I remember the pride in showing off knowledge of ossification dates and trivia about eponymous syndromes; my pride only to be dashed by RJ Last, who asked the reader never to judge the medical competence of a man who can reproduce these eloquently for they were akin to logarithmic values that could be looked up whenever necessary. Yes, I learnt case taking and diagnostic skills as a means to an end; an end of passing examinations. Soon to discover during internship how the best of diagnostic skills would not help me connect to an injured 60-year-old farmer from Bandipur mauled by an elephant and his crop lying in a heap of waste. It would not help me communicate death to the daughter or birth to the mother. These, I had to learn by myself as most of my colleagues did. Often did I seek the Corrigan’s door (as described in that red-green-yellow companion of all interns).

Some wall grafitti from Room 122

There was plenty of opportunity to learn all of these when I went off to work in BR Hills. The real thing – where there is no ‘respondeat superior’ to fall back upon! My quest for challenging settings to work took me to Arunachal Pradesh where I helped train PHC health workers in difficult settings. I saw new health problems that were very easy to diagnose but complex to treat – poverty, illiteracy and such. My later work as a medical officer in primary health centres showed me how difficult it is to work and survive in some of these settings and that explained why only a handful of us chose to work in these settings.

The journey that began on that November in 1997 with the best batch in MMC (that is what each batch says about itself!) continues today. Indeed, it is much more for the rich diversity of experiences with my batchmates and hostelmates at MMC that I remember and thank the college for. It is after all these life skills that make my journey enjoyable to this day.

Today, I work on trying to understand and solve a paradox. It is the paradox of inequity; that in a country with nuclear power we have anaemic mothers. Is it then enough to blame it on illiteracy? Is it not the responsibility of a just society to organize such services for its people? Among many determinants of this paradox is poor district health management. A complex issue that contributes to the poor performance of health services in several places in India, and the topic of research for my PhD.

As I sit back, I know that my collective experience at MMC and the hostel was very important in my life. I wonder about my batchmates and the young minds who are right now going through the experience.