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An archive of the blog posts at indiainlondon.com which is no longer maintained. We hope you enjoy delving back into some of our past musings and thoughts.
Showing posts with label Culture. Show all posts
Showing posts with label Culture. Show all posts

Thursday, 26 March 2015

India's new minister for Yoga - a blueprint for the West?

[caption id="attachment_1608" align="alignleft" width="300"]Yoga_Mariko_Bhakti_Hirakawa_at_Veerupaksha_Temple_India See below for attribution[/caption]

Towards the end of last year, Modi announced his new bid for global dominance by appointing a new  Minister for Yoga.  To give him his full title, Shripad Naik is now India's minister in charge of the department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH).

What a fantastic idea, I thought.  Every country should have one of those, and that might actually inspire me to live my (fantasised, ideal, probably non-realistic life) when I get up every day at 5.30am for an hour's meditation, before a wholesome breakfast of porridge and peppermint tea.  That is all before working the next 12 hours saving lives and soothing souls, to come home and relax with 45 minutes of yoga followed by chamomile tea, a light vegetarian meal and an early night.  Yes, well we can all dream and in the meantime live with Reality.

I'll start with his grand title:  Yoga, Ayurveda, Unani and Siddha medicine - I will give him those, as somewhat related to India and South Asian traditional medicine and practices (although Unani originated from the Greeks and developed in Persia and Arabia) .  Naturopathy, however, has its origins in the Nature Cure movement in Europe in the 19th century, and is now practised mainly in the US and Canada - although many osteopaths in the UK will still call themselves, 'osteopaths and naturopaths'.  Not much of an Indian connection, though.  Similarly with homeopathy, created in the late 18th century by Samuel Hahnemann, a German physician who created this system of medicine of treating 'like with like'.  Homeopathy seems to have been introduced to India via European involvement in the 19th century.  What is clear, though is that both naturopathy and homeopathy are mainly European inventions and imports and really nothing to do with Indian philosophy or traditional practice.

But let's not forget the Chinese equivalent perhaps under Mao, of 'barefoot doctors'.  Once a practising acupuncturist, I felt duty bound to have a copy of 'the Barefoot Doctor's Manual' on my bookshelf - proof positive that low tech traditional medicine such as Chinese medicine and acupuncture were the future, in being both affordable and effective.

It does actually seem that China's system of giving basic training to many 'village doctors' who then went out into the resource-poor villages, was indeed effective in reducing infectious diseases and improving infant and child mortality rates.  But it seems their efficacy lay not so much in the application of traditional Chinese medical practices, but more in basic hygiene and public health measures taken out to the village level that really made a difference, compared to the concentration of medical services in high tech, inaccessible urban hospitals.

I am quite sure there have been many efforts at similar schemes in India - but just think how much could be achieved if similar, traditional village doctors could be trained in a similar fashion in India. Perhaps, though, their impact might lie in the implementation of basic public health measures such as hand washing, clean water, sewers and vaccination rather than reliance per se on yoga or ayurveda.  Used in this way, emphasising low-tech medicine culturally embedded in India, could prove to be an acceptable way of transforming popular health beliefs and practices.

Modi, however, could be making a purely commercial move.  Apparently a keen practitioner of yoga himself, it could prove to be a savvy commercial decision aiming to capitalise on yoga's popularity in the West.  For example, a 2012 study estimates that the US spends more than $10.3 billion  year on yoga classes[i].   That is a lot of revenue if India can claim it's right to 'own ' the yoga and Eastern medical 'brand'.  The 'hippy' era is perhaps itself being drawn into the commodification demanded by late capitalism, where even health and spirituality is marketed and packaged for profit.   Despite its lack of scientific proof demanded by evidence-based medicine, it can be seen as part of India's quest for its own identity, it's own USP, squeezed out by British colonialism and dominance of Western medicine.

The binary distinction between West and East, however, might not be so easily imposed.  Not only is yoga big business both in the USA and UK, so are many different types of 'alternative medicine' - with advocates right at the heart of the British establishment.  Prince Charles is a well-known outspoken supporter of alternative medicine, founding his 'Foundation for Integrated Health' in 1993 - later rebranded as the 'College of Medicine'.  Both Princess Diana and Cherie Blair consulted alternative 'New Age' practitioners for counselling and advice.  More recently, David Tredinnick - a former officer in the Grenadier Guards and Conservative MP is both a supporter of astrology and alternative medicine - even advocating for the integration of astrology into the National Health Service.

So perhaps India is just capitalising on a global trend as seekers of the esoteric leave rationality behind in their quest for the transcendental.  And where the market might prevail over the language of scientific proof.  As long as the consumers purchase, the profits are made and the brand identity is protected, who needs evidence?

Photo: By Ramnath Bhat (Flickr: Mariko Bhakti Hirakawa) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

[i] The Telegraph, 3rd December 2014

Sunday, 9 November 2014

Gandhi and Parliament Square: but where are the women?

20140307_124627Mohandas Gandhi was once very unpopular with the British Establishment and was imprisoned on many occasions under colonial rule for his protests and campaigns for an independent India.  No longer, though.  Gandhi already has pride of place in Tavistock Square with a statue installed in 1968 and, earlier this year, it was announced is also due to have a statue placed in Parliament Square sometime next year.  This week, it was announced that Westminster City Council has granted planning permission for the statue to go ahead.

William Hague (then UK Foreign Secretary), announcing the statue on a visit to Delhi back in July said, ‘Gandhi’s view of communal peace and resistance to division, his desire to drive India forward, and his commitment to non-violence left a legacy that is as relevant today as it was during his life. He remains a towering inspiration and a source of strength.”[1]  George Osbourne (UK Chancellor of the Exchequer), on the same visit also joined in, ‘As the father of the largest democracy in the world, it’s time for Gandhi to take his place in front of the mother of parliaments.  He is a figure of inspiration, not just in Britain and India, but around the world.”[2]

Cynics might question the timing of the announcement back in July, uncomfortably juxtaposed with confirmation of a UK £250m arms deal with India only the day before.  It seems the UK government is willing to go to great lengths to woo the power of the Indian rupee and access to the burgeoning Indian consumer market.

Lord Desai (Indian origin economist) plans, apparently, to go on hunger strike to raise awareness of the £1 million needed to build this new Gandhi statue[3]. It has so far raised £100,000.

As I take a walk around Parliament Square, I am reminded of Brian Haw’s long-term protest camp here from 2001 until his death in 2011.  On one side stands the new UK Supreme Court – a place I have entered once just to lodge papers for a hearing, as a lowly trainee solicitor.

I am struck by the tourists who flock there, to take photos of our Houses of Parliament.  I look around the other statues and wonder how Gandhi will get on with the other incumbents here.  Winston Churchill, of course, was an adversary of Gandhi, having once said of Gandhi’s campaign of peaceful resistance that he "ought to be lain bound hand and foot at the gates of Delhi, and then trampled on by an enormous elephant with the new Viceroy seated on its back."  He later went on to say, "I hate Indians. They are a beastly people with a beastly religion."[4]  Despite this, however, Britain was happy to recruit thousands of Indian soldiers in both world wars to fight on behalf of the Empire (see our blog at here).  Indian women also took an active role as nurses, drivers, mechanics and other operational roles, as well as millions of others in India providing indirect support.[5]

But why Gandhi?  Undoubtedly he was one of the most prominent leaders of the Indian Independence Movement, the ‘Father of India’.  But, with one statue of Gandhi already in London’s Tavistock Square, why not mark that other great statesman of Indian Independence – Dr Babasaheb Ambedkar?  Ambedkar, born an Untouchable went on to receive degrees in economics, politics and law and, like Gandhi, was called to the Bar in London.  He served as India’s first law minister and drafted the Indian Constitution.  But Ambedkar is also remembered for rejecting Hinduism and the caste system in India, instead embracing Buddhism along with thousands of other Dalits (‘untouchables’) in 1956, only to die six weeks later.  As far as I can tell, there is only one statue of Ambedkar in London – at the LSE, where he once studied, though not in public view.  Perhaps Gandhi – in embracing, rather than rejecting Hinduism – is a safer bet to appeal to the current Hindu Nationalism of Modi [though here a more ironic connection might be that Nathuram Godse, Gandhi’s assassin was once a member of the Hindu Nationalist organisation the RSS, with which Modi also has close links and for which he was once a full time worker].

But, in Parliament Square, there is one glaring omission among the statues of the great and the good.  There is not one woman.  So, where are all the celebrated women throughout history?  Perhaps, in India, like the wives of Gandhi and Ambedkar (and millions of other women), they were married off at a young age, to spend their life in domestic servitude – without the freedom, means or the backing to go off themselves and pursue degrees abroad or train as barristers.

There are certainly outstanding women in India, though, who managed to pursue education.  For example, Cornelia Sorabji was the first woman to read law at Oxford University and to practise law in the UK and India (see our blog about a play of her life at  http://www.indiainlondon.com/cornelia-calling/).  Also Lotika Sarkar – lawyer and campaigner for women’s rights - was the first Indian woman to graduate from Cambridge University and later also the first woman to receive a PhD in law from Cambridge.  Or perhaps, more controversially, Indira Gandhi, the first female Prime Minister of India.

But my vote might go for a statue commemorating the heroism of ordinary women everywhere, but particularly in India.  Women who are given no choice about their lives, married at a young age and then a lifetime spent raising children, cooking, cleaning and facilitating the comforts of their husband’s and other’s lives and participation in the wider world.  Perhaps a statue to the every day heroism of millions of women such as these would also be a fitting tribute.

[1] The Independent (UK) 8 July 2014

[2] Ibid.

[3] The Economic Times, 6 November 2014

[4] The Independent (UK) 28 October 2010

[5] See http://www.cwgc.org/foreverindia/context/indian-army-in-2nd-world-war.php

Saturday, 25 October 2014

Durga puja - Western style

cropped-puja.jpg

For us it was always Christmas that was the major festival during the year and not an Indian or Hindu one.  School life built up to Christmas with special meals and carols, there was a large decorated Christmas tree at home with masses of presents, and Christmas lunch was probably the only time in the year when we sat down to eat together. As the numbers of Bengalis in the UK increased there were more Durga Pujas festivals held.

Religion didn’t play that great a part in our parents’ lives. My father had a mini-shrine in his bedroom with icons of various Gods bought from India, and a bottle of Ganges water – very holy in the Hindu religion. Prayers were said very much in the Western manner with the palms together. Apart from some visits to Durga Pujas, that was really our only exposure to Hinduism. My first trip to a Hindu temple wasn’t until I was in my early 20s on an extended holiday in India. We went to a temple in Tarakeswar, about 40 miles from Calcutta, where my father had partially been brought up. The head priest was an old school friend of my father’s and said prayers with us. I just remember being appalled at the lack of hygiene in the temple but that was redeemed later by probably the best shingaras - Bengali samosas – I have ever had in the priest’s quarters. By contrast the Hindu temple we visited in Delhi a couple of years ago was very clean and well-kept.

A couple of weeks ago I was researching into London Durga Pujas which is the main Bengali festival. Amongst Bengalis Diwali – the Festival of Light – does not feature prominently. A Bengali festival, Kali Puja, generally coincides with Diwali. I don’t think I was I was aware of Diwali until I was a grown-up. Perhaps this is another example of the “Bengalis are different” sentiment. My understanding is that most other Hindu groups from India celebrate their own festivals at about the same time as Diwali. Having been in Calcutta at Diwali I found Bengalis were aware of it but there seemed to be no active mass celebrations. The main hotels did, however, make great efforts with beautiful flower displays and floating candles in swimming pools.

Talking to my cousin in Seattle recently he recounted that when he was resident in London in the late 1960s there were numerous separate pujas and remembered a particular one in Hampstead that he attended. I found there were at least ten separate Durga Pujas in and around London which I think shows both how important the festival is and the numbers of Bengalis in the UK today.

In Birmingham where I grew up there were at least three separate Durga Puja events and the staging, organisation, and personalities were often very political. For my parents in particular it was a great time, and in the main a social event. My mother would attend one puja on her own during the day, and then another in the evening with my father. She would cook large pans of vegetarian food, chickpea curry comes to mind, to serve to worshippers and revellers. As I recall food was a very important part of the festivities. Rather sadly it seems there are fewer Durga Pujas held in the Midlands than in the past. Perhaps gradually most of my parents’ generation have retired and most of the new first generation arrivals have settled in the South of England.

Durga Puja generally takes place over about a week, and most organisations in the UK would rent a church hall or similar facilities. There would be a huge display on a dais or stage of a papier mache Durga – generally imported from Calcutta - dominating the hall like an altar and a place for offerings. An uncle on a Puja committee would store the Durga in his garage the rest of the year. Each day and evening there would be various pujas or religious services followed by lunch and dinner, and sometimes entertainment such as Tagore plays and music. We as children often attended but we had very little cultural context or education, and the thought of just sitting there while the adults were engaged was not really appealing. I think most nisei Bengalis disappeared from Durga Pujas during their teenage years perhaps to make a reappearance in their 20s wanting to reconnect with both their culture and local aunts and uncles.

It was only recently that I went again to Durga Puja. We went to events in Kings Cross and Ealing Town Hall. Both were very crowded, and it was very difficult to understand what was going on; perhaps my lack of religious education made it harder. In addition, we felt most of the attendees were first generation recent arrivals from Bengal. I suppose I was quite surprised at the lack of second generation or nisei like me. Trying to find food, not knowing anyone there and the crowd density made the event difficult to enjoy and I sadly felt rather at sea.

Certainly the Durga Pujas held in the UK have had fresh impetus from new arrivals of Bengali origin, but it is striking that few second generation appear to have an interest in maintaining their parents’ tradition although that might be just be a mix of intermarriage, greater integration rather than an outright rejection of their parents’ culture.

Sunday, 19 October 2014

Happy Birthday Sunita

I've been doing a lot of motorway driving recently - which I find incredibly tedious.  The only upside (if a good DAB radio is available) is the opportunity to listen to radio programmes I might not otherwise have the time for, or - sorry if this makes you cringe - singing along to old Genesis CDs.  If I'm in the right space this might extend to Yes or Bollywood classics such as 'Dil Se'.  There is also a kind of rootless anonymity I quite like in the motorway service stations - as with airports -  even if the price of coffee is over-inflated. And so, somewhere on the M40 I managed to catch a delightful interview with Shabana Azmi on last Friday's 'Woman's Hour'.

The daughter of Urdu poet Kaifi Azmi and actress Shaukat Azmi,  Shabana Azmi was perhaps destined for a life in film and theatre.  Her parents were also members of the Indian Communist Party and Shabana has combined her career as an actress - having appeared in over 120 Hindi and Bengali films - with social activism.  She has campaigned on a number of issues including HIV / AIDS and also women's rights.  Since 1997 she has also been a nominated member (ie. not directly elected member) of the Rajya Sabha - the upper house of the Indian Parliament.  You can see why I was drawn to her.

Recently, she has been touring the UK with Rifco Arts - an award-winning British Asian Theatre Company.  In the play 'Happy Birthday Sunita', Azmi plays the mother Tejpal Johal.   In the Woman's Hour interview, Jenni Murray started by asking Shabana what drew her to the script.  Her response:

'....because I thought it had a very simply message that would reach out to older women and I have been working with women for a long time now.  So, that was something that attracted me – it’s an uplifting play.  Plus the fact that Rifco Arts itself is a charity – it is funded by the British Arts Council and what I really appreciate about it is that it has successfully weaned away what was largely a Bollywood-watching audience into regular theatre–goers.  They have done that by telling stories about the British Asian community located in situations that they understand by keeping the tickets rates really low.  And since I come from a theatre background, to me that is an extremely important contribution that Rifco Arts is doing'.

Jenni Murray then went on to ask Shabana what was it about the character that fascinated her, that was so special about her?  Shabana's reply really struck me:

' Because I know many women such as Tejpal Johal who have really struggled very hard and made enormous personal sacrifices to keep the family going.  Her husband has been away, she has brought up in a strange country 2 children on her own.  She works in a surgery and she has really never been anything other than ‘Mum’ for the family – they have just seen her in the stereotype of what a mother is – which is basically just serving them food and looking after their needs.  And she then says that I have played by the rules of the game.  I have done all I have to do. You are all grown up now.  I am now going to follow my dreams because all along I have been told that women who speak their minds are dangerous and so I have kept quiet.  But keeping quiet hasn’t made my life any better.  And so she springs a surprise on the family and suddenly comes alive as just a person rather than just ‘Mum’ as you have seen her.  And I have seen that in so many women and I have seen they become invisible in a way.  They fit into a slot, they make your life convenient and they’ve never looked beyond that.  And suddenly there is a spark and you realise, my God, they are special women'.

I found this reply so moving - because, exactly as she says, the reality for many women in traditional families is that they are the ones who are in the background, who keep the family together, the 'show on the road'.  They cook, clean, do the washing - all to smooth the paths and facilitate the lives of their children, husbands and relatives.  But where are their dreams?  Where are their hopes and aspirations?  And once they are not there, the family realises just how special their invisible Mums actually are.

'Happy Birthday Sunita' - is currently about to head overseas to Dubai, Delhi or Mumbai though is set to return to the UK next year.

http://rifcoarts.com/

http://www.bbc.co.uk/programmes/b04l3nnp

Thursday, 9 October 2014

What's in a name?

Jemima Khan (née Goldsmith), it is reported, is considering reverting back to her ‘maiden’ name.  Once divorced, she said she was keeping her married name as she wanted the same surname as her children.  Now her children are older, and Imran Khan (her ex-husband) is re-marrying, the time has come, it seems, to consider changing her name back.

Surnames for women have, to my mind, always been problematic. As a child, it was already in my consciousness that one day my surname might be different.  This caused some uncertainty.  For example, once I had a savings account I decided I needed a signature of my own.  So I invented one and practised it – but with always the proviso at the back of my mind that I might have to change it one day if, or when, I got married[1].  Surnames for women are only borrowed, never owned.  First, you have the surname of your father and then, on marriage you assume the surname of your husband.  So, where are you in all this?  A conduit for the continuity of the male lineage, never a person in your own right with a title to confer to future generations.

So, I decided that on no account was I going to change my surname.  It was my name (albeit that of my father’s) and, while not the most exotic sounding name (‘Jackson’), it was mine.  It was a matter of principle.

Then, in my 20s, friends starting getting married – and all changed their names immediately to their husbands!  Why?  Did they not feel a sense of betrayal to the principle, the cause?  Apparently not (unless in a situation like my Pakistani friend, where cousin marriages are common, who already shared the same surname as her future husband – problem solved!)

For my son (whose father I was never married to), I opted for a double barrelled surname with both father’s and mother’s.  This worked well in his case as they went well together.  Actually, it never occurred to me that this might not be my choice – the UK, in its typical liberal muddling-through kind of way, has no prescriptions about changes of names or what you should call yourself.  It’s up to you, albeit heavily influenced by tradition and convention.  For my son’s first name, I chose ‘Ewan’ – to bring back my mother’s maiden name of ‘Ewen’, now lost as there was only her and one sister.  I realise the spelling of ‘Ewan’ is not quite the same – but therein lies a tale that perhaps is best not told in this space.

My son’s middle name (and his father’s first name) comes from the Northumberland tradition of turning the grandmother’s maiden name into the first name of the grandson – which seems an interesting adaptation to keeping the matriarchal lineage alive [albeit in my son’s father’s case he was further named after an uncle who died during WW2).

Using a double barrelled surname for my son seems to work quite well - for example, in travelling abroad.  Coming back to the UK this summer after a trip to abroad, I checked through immigration with my son.  I was asked what my relationship was with my son: of course I said he was my son.  This was unproblematic as he had my surname as half of his surname – a more problematic question if my surname was completely different to his.

This reflection on surnames was actually prompted a while back, on reading a ruling from the Mumbai High Court in 2012.  The Times of India reported that women can now retain their maiden name after marriage[2]. Prior to the amendment, it seems, the court would not accept divorce, or related applications, from women unless they bore their husband’s surname.  After the ruling, however, a woman can file for divorce in her maiden surname, married surname or any other name she may have adopted.

This follows a French ruling in 2003 that allowed parents to give their children the father’s surname, the mother’s surname or the surnames of both parents in whatever order they chose.  This was, unfortunately too late for the De-Ram-Berou children as the ECHR decided it could not be applied retrospectively and was not upheld in that court[3].

Another 2013 ECHR judgement ruled that the impossibility of married women to use their maiden name in Turkey did amount to a violation of Article 8 (right to privacy and family life) in conjunction with Article 14 (prohibition of discrimination).  They ruled that the difference in treatment between men and women (men could keep their surnames) amounted to discrimination and had no objective and reasonable justification [3]

This is a welcome advancement from the normal cultural practice of adopting the husband’s surname – or indeed, on marriage, often in India, of adopting a completely new name, both first name and surname, presumably to signify the re-born status of the newly married woman, fully integrated into her new family.

But in another – closely associated part of Europe – the opposite exists.  My Serbian friend, on marrying her Peruvian husband, followed the Spanish tradition.  This is where the woman keeps her own surname, because she is not of his own genetic family.  So, for example –hypothetically – if I were to marry Susen, I would be known as Sue Jackson de Sarkar, not as Sue Sarkar as I would be in the UK.  To my mind, that’s slightly more female friendly – although there is still a sense of ownership involved – that you are ‘of’ someone.  I believe the tendency now is more towards both men and women in Spanish speaking countries having 2 surnames – one from their father and one from their mother, and neither party changing their names on marriage.

Perhaps, though, we should not be so rigid about holding on to our given names.  In my involvement with the Triratna Buddhists (formerly the FWBO) in my 20s – on ordination, people were given a Buddhist name (ie. Pali name – from the language spoken by the Buddha at that time, closely associated with Sanskrit).  From that moment on, they had to be addressed by their Buddhist name, not their former first name.  I really did my best to go along with this but, I must confess, at times, it just felt weird.  It was perhaps exacerbated by (mainly) white British people suddenly adopting a Pali / Indian name – Dayasri, Punyavati, Srimati, Gunabhadri, Suryagupta, Dhammachandra, Prajnagupta and so on.   My mother refused point blank to refer to an old school friend of mine – Garry – as ‘Dhammavijaya’ once he was ordained.  I briefly tried to reason with her, before giving up.  So now, I refer to him as ‘Garry’ with her and ‘Dhammavijaya’ with everyone else.  Just makes life easier.

Still, the confusion this name changing causes continues even now, on contacting old friends and acquaintances from my Triratna / FWBO days.  Not only have they adopted Pali names on ordination, but then quite a few have married as well and changed their surnames to their husband’s.  So, with both first name and surname changed, it becomes virtually impossible to identify the person you once knew.

Should names evolve, as we evolve and mature throughout life?  Why do we necessarily cling to a given name at birth by own parents, when it might not reflect who we truly are, the core of our being?

I remember going to the funeral in Birmingham of the brother of a (Buddhist) friend of mine.  She had changed her name on ordination, and always referred to her brother as ‘Anthony’.  Sadly, her brother died at a relatively young age and I attended the funeral in Birmingham.  Imagine my bewilderment then when I attended his funeral and they kept referring to him as ‘Sidney’.  I thought I was at the wrong funeral.  But, on questioning my friend afterwards, she said yes, Sidney was his name but she always preferred to call him by his middle name Anthony.  For her, names were fluid, contingent on the times and on the occasion.  In fact, when she came over to the UK from the Caribbean as a child, she had mulled over what surname to use.  Her father had died, so she decided to use her grandmother’s surname on her passport.

So, maybe names are more fluid than I have been led to believe?  Yes, I was called Susan Jackson at birth – but that was before either of my parents had any idea who I might turn out to be, or what my personality was.  Should we all have contingent surnames?  And first names?  How many times should we be able to change our names?  And decided by who?  An opportunity or a curse?

[1] I am still using the same signature today

[2] Times of India 26/02/2012

[3] Leventoğlu Abdulkadiroğlu v.Turkey - ECHR 160 (2013)

[3] European Court of Human Rights – ECHR 267 (2013).  19.09.2013.

Saturday, 19 April 2014

Forever India - the Commonwealth War Graves Commission

[caption id="attachment_1254" align="alignleft" width="300"]Khadki war cemetery, Pune, India Khadki war cemetery, Pune, India[/caption]

Just today I came across the Forever India pages of the Commonwealth War Graves Commission website and it appears to be the only separate country to be awarded this distinction - although that may be because other countries (Canada, New Zealand, Australia, and South Africa) make greater efforts in commemorating their fallen servicemen.  These other countries, however,  became independent much earlier than India and modern India and other countries such as Pakistan, Bangladesh, and Burma may seek to minimise their contribution to the defence of the Empire.  The pages are a great resource to anyone interested in the Indian contributions.

This India section puts in context the great commitment and sacrifice of Indians in both World Wars in a variety of theatres.  Some of the stories of heroism exemplified by holders of the Victoria Cross are very poignant and moving, as are excerpts of letters home.

The short video on the main page focuses mainly on the work of the CWGC,  its cemeteries,  short insights into the lives of Indian soldiers in WW1, the Chattri Memorial, about which we wrote a short blog and the Commonwealth Memorial Gate on Constitution Hill, again the subject of a blog.  In another blog, a review of a lecture on Indian soldiers in World War 1, we offer some insights into the issues in managing soldiers of different religions. In this centenary year of the beginning of the World War 1 it is more important than ever that we remember the sacrifices of all servicemen.

In an article by Fergal Keane on the Basra Memorial, in modern day Iraq, where the deaths of 1,771 Indian soldiers are commemorated,  he concludes with a quote from Plato: “only the dead have seen the end of war”.(http://nlwmemorial.tripod.com/nlwmemorial/pages/pagesmisc/basramemorialfergalkeane.htm)

 

http://www.cwgc.org/foreverindia/

http://www.indiainlondon.com/the-indian-army-in-world-war-1-national-army-museum/

http://www.indiainlondon.com/there-is-a-corner-of-a-foreign-field-that-is-forever-india-the-chattri-memorial-service-9-june-2013/ - the Chattri Memorial

http://www.indiainlondon.com/commonwealth-memorial-gates/

Thursday, 3 April 2014

“Days and Nights in Calcutta” – My Guide to being Bengali

Being brought up mainly in Birmingham in the 1970s I had very limited exposure to Indian and Bengali culture despite the English Midlands being a centre of immigrant communities.  I had spent a few months in India when I was about 5 and then didn’t visit again till I was 19; relatives were always seen through the prism of old photographs and I had little or no experience of meeting them.  I was always aware of the fact that we were Bengali but it wasn’t until I spent one summer working in a pharmacy with people coming up to me and speaking unknown languages – Hindi and Punjabi probably -  that I realised how different we were.

My mother always wore a sari which I’ve now learnt is quite unusual – most of my Birmingham aunts wore Western clothes sometimes.  There were numerous air mail letters from India each week – thankfully my father and my uncle wrote in English which meant I could at least read my uncle’s letters – and my father received an international edition of The Statesman – printed on very thin paper to minimise air mail charges - the Calcutta newspaper, each month.  I don’t think I had been to an Indian / Bengali event in the UK till I was about 10 or 11 and when we did go no one explained to us the symbolism or rituals so we felt rather left out.  The Durga Pujas, the Bengali equivalent of Christmas, were more of a social event for my parents.  Probably at about the age of 12 I stopped going to Bengali events.

I still have vague memories of our extended visit to Calcutta when I was 5 years old.  I remember my grandfather’s house mainly because of all the personalities there from my grandfather to my uncles and aunts and 3 girl cousins. There is one wonderful photo of me dressed as a geisha – don’t ask why, I don’t know – with a cousin dressed as a Native Indian.  Perhaps we were off to a fancy dress party.  I think I would have been in my element with so many trusted relatives around me.

The house, in what had previously been an upmarket part of Calcutta, had apparently been bought from an Englishman and extended with a small pedestrian bridge connecting two separate buildings.  Generally the ground floors of buildings were vacant, or let out to tenants, possibly because there was always in Calcutta the fear of monsoon floods.  I don’t know exactly when but I believe my grandfather bought the house in the 1920s before my mother was born.  My mother remembers a telephone in the house from a young age.  Milk was apparently bought from a farmer who brought his cow to the front door so the household could watch the cow being milked.

During the short time in Calcutta I went to two reputed schools: Calcutta Boys School and Don Bosco, both of course English medium.  In the intervening period we had spent a few months in Assam, in Gauhati the capital, in the middle of monsoon and I remember our bungalow being on stilts and the monsoon rains.  The flight to Gauhati must have been my first flight as we had come to Calcutta by boat and train.  Thankfully my father’s quest to find a role befitting his hard won surgical skills and qualifications failed to bear fruit and after exactly a year in India we returned to the West, and the west of Ireland where I must have picked up an Irish accent.

Sadly there were no visits to India again till I was 19, and I think the intervening years were the time to instil Indian values and culture.  I think because I was denied them I go looking for that culture nowadays.  We were royally treated on that trip; my uncle was a very senior policeman and access to hard currency bought us high status in India. I remember being met at Dum Dum Airport by perhaps 40 or 50 relatives who I didn’t know nor was I introduced to.

That trip, despite also touring the sights of Delhi and beyond, was the most shocking.  Calcutta was in the midst of its genteel decline almost at its nadir.  The poverty was almost literally in your face; old women, maimed children would come up to your car and beg.  There were frequent power cuts, quaintly called “load shedding” and houses had their own generators or one was left with just candlelight.  The educated left, for other parts of India and the West.  If you were influential and connected life was good.

In retrospect I was probably arrogant and if any cousins read this I apologise.  We were Westerners visiting a Third World nation and, of course we were young and superior.  But in my defence I had no exposure to the breadth and depth, and the wonder that is India.  I would be looking upon the country in a very simplistic way: the poverty, the limited and inadequate infrastructure, the lack of consumer goods.  Cousins asked us to bring Walkmans and Levi jeans.  I should have given thanks for being born an Englishman but not felt superior about it.  There was one incident that I think summed things up: we took photos with our Polaroid camera, which deliver instant photos, and there was widespread astonishment.

At Bagdogra Airport, the gateway to Darjeeling, my father bumped into his niece, my cousin, who was married to the manager of a tea plantation.  Her son was quickly introduced to his great uncle, my father, but for some reason we were not introduced to my cousin.

Returning to the UK I must have found that my interest in India was unsated.  In terms of my need to connect with my "Bengaliness" the trip was superficial.  There was in those days very little to connect me to India in the UK; there was little interest in the press, I would not have been interested in Indian politics, we didn’t see Bollywood and there were few books.  Ironically on a coach tour around Europe a couple of years later, while I was accompanying my policeman uncle, an American woman recommended The Far Pavilions and was rather surprised I hadn’t read it.  So on my return to Birmingham I bought a copy.

Like most of the available literature on India The Far Pavilions was written from a British perspective.  MM Kaye was Indian born and wrote what might best be described as a romantic adventure.  I would probably have stalked Dillons in central Birmingham, probably then the best book shop in the Midlands, for India related books.  I would have bought Lives of the Indian Princes, a coffee table book, EM Forster’s Passage to India – I was a sucker for anything with India in the title – and Paul Scott’s The Jewel in the Crown, which was a TV drama series.

Then one day I found Days and Nights in Calcutta in Dillons and to some extent I had secured my connection to India; thus ended my initial search for my Bengali roots.  It might be rather grandiose to ascribe such attributes to a mere book but I can assure you it furthered my understanding of what it was to be Bengali.  It was in many respects a revelation.

Days and Nights in Calcutta was already dated when I first read it but nevertheless compelling.  It is written by two married North American based academics and writers Bharati Mukherjee, of Bengali origin, and her husband Clark Blaise, a Canadian. They had met in the 1960s at a writers’ workshop in the USA and forged a life together.  During the 1970s they had decided to spend a year in India with their young boys and the book is largely an exploration of their time in India.  The book is divided into two parts, the first written by Blaise and the second by Mukherjee.

I was always drawn more to Blaise’s chapters because like him I view Calcutta and Bengalis almost as an outsider. Blaise talks about learning to speak Bengali fast and eating Bengali food with his fingers neither of which I can do. When arriving in Calcutta without his wife he steels himself to “pronam” his wife’s uncles i.e. touch their feet in respect, but finds he cannot do it.  Blaise excuses himself by admitting the gesture is not his culture.  I have the same feeling: I have done it a couple of times and felt very self-conscious but I think my relatives are accepting of the fact that I am an Englishman.  I don’t think I have ever pronamed my own parents.

There were nuances of “respect” that I was completely unaware of, certainly well into my 20s.  One should not drink or smoke in the presence of an elder.  Mukherjee’s cousin asks Blaise to play table tennis just so he can go outside and smoke.  The cousin could not smoke in front of Mukherjee’s father.  To my chagrin I broke this rule; I certainly drank in front of my father and my uncle.  It was only when we were all at a pub in the UK and I was asked what I wanted to drink that I was aware of my faux pas.  I asked for a scotch and a UK uncle retorted: “he (my real uncle) has allowed you to drink?” (My italics).  I didn’t know I needed anyone’s permission to have a drink.

Family names were a complete minefield for me and Blaise did simplify matters.  Names of relatives are generally dependent on whether one is on the paternal or maternal side and by one’s position in the hierarchy by age.  So, one might have a number of names depending on who is referring to you.  As an example Blaise uses Choto Mama, which means mother’s youngest brother.  No wonder I was confused for a while not having grown up in Calcutta or within an extended Bengali family.

Blaise says of “desh”: “the all-important Bengali word that means more than just birthplace....”. I’m not entirely I get the concept of desh, but I know Bengalis ask it of each other.  Is it perhaps to say that we have roots in the country? And it’s asked of people whose families have been in Calcutta for many generations.  But despite being in Calcutta most families keep an ancestral home and land in their desh.

I learnt about caste for the Mukherjees are Brahmins and one of the centrepieces of Days and Nights in Calcutta surrounds an arranged inter-caste marriage.  Blaise is involved as the only younger male relative on the bride’s side.  Some of the issues around arranged marriage are discussed and how a bride might move into her husband’s home to be “broken in” by her mother-in-law.  It’s not as bad as it sounds in an upper caste Bengali home. The choice of the partner is examined: “The margin for error is very narrow....she cannot refuse to marry”. Thankfully this culture has changed in upper caste Calcutta today.  Blaise puts the Western counterpoint: “How can you marry someone you don’t know?”

It was interesting to compare my mother with Mukherjee’s mother, who would refer to her husband as” my husband” and never by his proper name.  I can never recall my parents using their names to refer to or call each other.  In retrospect I do find this quite shocking. “She (Mrs Mukherjee) lives only for Bharati’s visits every three summer...” and for visits from other relatives.  “Family is all”.  Again it’s sobering to realise that some Bengali women have no lives outside the family or the family home.  It must in those circumstances in particular have been a wrench for my mother to leave her own family to come to the UK.  But my mother followed the same pattern in the UK in not having another life despite the educational, work and leisure opportunities that were available.

“The Bengali palate is the least easily appeased in all of India” – there is a considerable focus on food, how it is prepared, how it is eaten.  My parents were perhaps not so food oriented but main meals were eaten late and with a variety of courses.  My mother complained it was far easier to make the children’s Western food.  A speaker at a lecture attended by Blaise in Calcutta remarks that he, a Bengali, returns to Calcutta for the rosha-golas, the very sweet sticky dessert beloved by all Bengalis.

Blaise devotes a considerable part of his chapters in Days and Nights in Calcutta to Bengali culture and in particular Tagore and Satyajit Ray, neither of whom I had explored as a child or even a young adult.  I have seen a few of Tagore filmed works and seen a number of Ray films.  But from my perspective I need to explore further in order perhaps to understand my roots better.

There are a number of references to Bengali positioning within India: “Why are Bengalis hated so, why were they feared by the British (the British capital was moved from Calcutta) and every other conqueror...because of a daunting intelligence, an ability to learn the rules of any conqueror and to overcome them with their own mental sluggishness” (my italics).  You can see why I warm to Blaise.

Mukherjee’s section is well-written and compelling being written by someone a little younger than my mother and also someone who has made the long journey overseas.  I rather think that the English education she received in Calcutta was better than mine in the UK.  She wonders if she should have left Calcutta, Bengalis, her family, to make her life teaching and writing in another language.  I rather think most Bengalis have that longing for Calcutta.

But it is Blaise’s section that has the most resonance for me and there are many facets of the book I have not discussed.  Each time I read Days and Nights in Calcutta, perhaps once a year, I find a new nuance that I had missed.  It is not an exaggeration to say it is a primer of life for me.

Thursday, 27 March 2014

Elephants, Lord Ganesha and the Indian Independence Movement




Ganesh Festival, Bombay 1987

I remember it like it was yesterday.  It was 1987 and we had just arrived in Bombay (as it was then) around 5 weeks into my first sojourn into India.  By this point we were probably a slightly sorry looking and certainly grubby group of 3.  Goodness knows what the staff thought when we decided to ‘splash out’ and have tea in the Taj Mahal Palace Hotel (costing the equivalent of 50p each at the time I recall – which seemed extortionate compared to what we were used to paying).  I definitely felt very out of place among the other guests: women looking immaculate in beautiful shalwar kameez or saris in stark contrast to my very worn jeans and T-shirt.

Unplanned by us, we had arrived just in time for the annual Ganesha festival.  The streets were full of people dancing, throwing red powdered paint everywhere and statues of Ganesha being paraded down towards the beach.  Chowpatty beach was filled with people taking the clay Ganesha statues down to the sea, to float away and dissolve back into the water – symbolically representing the cycle of creation and destruction. So sad to think of that same location – including the Taj Mahal Hotel – in 2008 being the scene of an horrific terrorist attack, killing at least 167 people.





Elephants feature prominently in our household.  My son is mad about elephants - he insisted the website logo had to include an elephant.  Our house has many elephants but one large cuddly elephant called Peanuts (who made his way via Ikea) seems to dominate.  But woe betide anyone who says he is a cuddly and not a real elephant.  For Peanuts (my son loves stories and has a fertile imagination) eats millions of peanuts every day (and only peanuts) and robs banks all round the world to fund his peanut consumption.  He leaves his clone in place in the house while he is away so it looks as though he is still there.  Nothing I say can dissuade him from robbing banks (a criminal activity, very wrong, police will be onto him etc.) – surely the real cause of the world’s economic crisis.  Recently Peanuts pronounced himself King of Elephants – then decided he was not only King, but also the God of elephants, at which point I said I would call him Ganesha since there is only one elephant God.  Such is the rich imaginary world of life with a 12 year old.

Last Saturday we decided to make use of Susen’s British Museum membership and have a look at the Viking exhibition currently on.  The exhibition was busy and we were given timed tickets, with 20 minutes to wait.  After our thali lunch at Masala Zone, it was perfect timing to have a look round the small (free) Ganesha exhibition that was also on.

Rather frustratingly, the exhibition had been sponsored by the Japanese Asahi Shimbun Company (a major national newspaper in Japan), instead of Indian sponsorship – which seemed slightly incongruous.  There were several images of Ganesha including one contemporary picture of Ganesha with a cricket bat - which made me smile, also a shrine to Ganesha and a short video about the manufacture of statues of Ganesha.  To the uninitiated, I have to say it does seem quite bizarre worshipping an elephant God – not to mention a clay statue of an elephant God.  Through my own medium of Buddhism, however, I can relate to it in terms of what that figure is representing.  So a Buddhist might bow down before a rupa or statue of a Buddha, symbolising the aspiration or worship of the ideal of Enlightenment.  In the same way, Ganesha in Hinduism is said to represent wisdom and the remover or creator of obstacles and this is what is worshipped.

The video showing the hand crafting of the statues was fascinating.  First a mould has to be made by covering a statue with latex.  This mould once dry is then filled (by hand it seems) with a mixture of clay and a straw-like material.  When set, the latex mould is removed and the idol is then painted by hand[1].

The exhibition also featured a section on Bal Gangadhar Tilak – also known as  Lokamanya Tilak – an Indian Nationalist Leader.   Born in 1856 in British India, as it was then, he was a journalist, social reformer, lawyer and early prominent leader and activist for Indian Independence.  It was Tilak who started the worship of Ganesha as a public festival – known as Ganesh Chaturthi.  The British had banned Indians holding large gatherings for political purposes, with an exception for religious festivals.  By promoting the worship of Lord Ganesha at a well-organised public event Lokamanya Tilak could bring people together and promote nationalism under the guise of a religious festival – a festival still celebrated long after India gained its independence.

Time then for the Vikings and a whole different story – and one that almost certainly made up some of my ancestry - with family roots in Scotland, North of England and Denmark.  Then a cup of tea and home.





[1] This hand crafting has, apparently, been overtaken in some parts by a more mass production of idols using Plaster of Paris, leading to environment problems.  Heavy metals used in the production were leading to water contamination, together with accumulation on the sea or river bed of non-biodegradable parts of the statue.  The local authorities have been trying to encourage original clay moulds only, or non-destructible statues that are only symbolically immersed in water and then re-used.




Thursday, 27 February 2014

Medicine - art, science or business?

A couple of years ago I had an ear infection.  I had never had an ear infection before and can honestly say it was the most painful thing I have ever had (I was going to say worse than childbirth but seeing as I had a planned caesarean under spinal anaesthetic which was completely painless, I wasn’t sure the comparison stood up).  The ear infection started at work one Tuesday morning when I was a trainee solicitor.  At lunchtime I went to a walk-in clinic where they gave me antibiotics.  By that evening, however, the side of my head had gone numb, was throbbing and I was convinced something serious was wrong so went to A&E.  More antibiotics and heavy duty painkillers.  5 days later, 3 days off work, 2 GP visits (more tablets) and it didn’t seem to be getting any better.  It was Sunday by this time and I was desperate.

Susen had an ‘uncle’ (a family friend and colleague rather than real uncle) in Birmingham who was an ENT surgeon (now retired) and he sought his advice over what to do.  His uncle kindly offered to see me that afternoon at his Birmingham house where he had a fully equipped clinic attached to the house where he used to see his private patients.  This shows how desperate I was as normally my middle class conditioning to not bother anyone, or be a burden would have won over.  Instead I gratefully agreed and we drove up to Birmingham.

As we sat in the lounge and chatted initially it was mainly social catching up, but I was also aware that Susen’s uncle was carefully watching me, looking at whether I could move my face and talk easily.  Examining me in his clinic, what struck me was his focus and craftsmanship in his work, obviously honed through years of experience.  It was his profession and an art.  He tactfully waited until Susen had gone to get something from the car to ask if I was pregnant (concerned about all the medications I was taking by that point) – just in case I was but Susen didn’t know (I wasn’t).  His diagnosis differed from the GP’s but turned out to be spot on.  I followed his advice and thankfully the ear infection cleared up over the next few days.

After the examination, we talked over tea and mishti (Bengali sweets).  He reminisced about meeting Susen’s father when he first came to the UK from his Calcutta medical college, about how pleased he was to find a fellow Bengali doctor and eating Susen’s mother’s lamb chops (not chops as we know them, but a spicy fried snack made with minced lamb or mutton).  He said something that struck me at the time, and has stayed with me.  Talking about his work as a surgeon he said he usually went in on a Saturday as it was his duty to see how his patients he had operated on the day before were getting on.  It was the use of the word ‘duty’ that was interesting.  For him, there was nothing about having to because of a rota, or concern about possible negligence if he didn’t.  Instead it was his duty to his patients to make sure they were OK and recovering.

I know quite a few doctors (and indeed had a long relationship with a doctor (of Indian origin) during my 20s) and it has long been the profession of choice for first and second generation immigrants to the UK, as a sure route to stability, money and status.  I have heard quite a few stories of counting down the minutes to 5pm then switching off their bleep on the dot of 5pm so that anything that happened after that was the on-call’s problem, not theirs.  Or now, as consultants, of being very well-paid for what they do – too much to consider leaving – but having very little interest in the practise of medicine, or duty to patients.  I am sure they are very good at what they do, but it’s just a job where you go in and do what you have to do, then leave.  Or of female GPs who keep on working their part-time hours purely because they earn too much from it to give it up – it pays for their children’s private school fees.

I absolutely understand that a lot of the behaviour of junior doctors was due to long hours on call, stress and overwork.  I am also sure there are many doctors out there who do have a sense of vocation and duty.  For Susen’s father, medicine – or surgery in his case – was his life.  It occupied both his working and leisure time, as he attended conferences, kept up with medical journals and set up groups and events in the UK for graduates of his Calcutta medical college.

But something has changed.  At the moment, many consultant’s contracts say they cannot be required to work at weekends – something Sir Bruce Keogh, medical director of the NHS is trying to change.  The absence of senior doctors in hospitals at weekends has been linked to higher death rates and complications at weekends than during the week, with an estimated 4,400 people dying every year as a result[1].  For similar professions in the private sector – such as law or accountancy - it would be rare to never have to work at weekends when required on occasion – although many doctors will use time at the weekends to practise privately.

Then there is the advent of evidence-based medicine, NICE[2] guidelines, protocols and care pathways which have all sought to change medicine into a science.  No longer relying on the doctor’s own clinical judgment from years of experience, with an individualised therapeutic encounter between physician and patient, evidence-based medicine seeks to standardise the diagnosis and treatment with evidence of efficacy demonstrated through the latest randomised controlled trial or meta-analysis.  The doctor’s own clinical judgment becomes constrained by guidelines and fear of legal proceedings for negligence if the standardised treatment plan is not followed.  It’s easy to mourn the loss of the art of medicine in this era of trials and evidence-based medicine, but it’s important to remember the huge benefits and gains as well.  We might still be using ineffective or even downright dangerous treatments such as mercury or blood letting if medical science had not intervened.  Or, even more recently, still think that stomach ulcers were primarily caused by stress or lifestyle rather than a bacteria[3] - not to mention the development of modern anaesthetics.  It could be argued that doctors today have a greater duty towards their patients than in the past – when, perhaps, mistakes went unchallenged or unnoticed.

Of course, development and testing of new treatments costs money with the potential to make pharmaceutical companies huge profits if successful.  So, medicine is not now an art or a science, but a business.  Nowhere is this more obvious than in a mainly private healthcare market such as the US – where healthcare expenditure is currently around 18% of GDP – and growing – compared to around 9.5% in the UK.  Nirmal Joshi, writing in The Guardian this week[4] says, ‘Being a doctor was once a job with a great purpose.  Now it’s just a business’.  Joshi, an Indian-trained doctor has been working in the US for the past 3 decades.  He writes of his frustration at being pressured to see more and more patients in less time where they have become ‘more like business transactions rather than what they should be: rich and intensely human interactions potentially resulting in tremendous fulfilment for both parties’.  Joshi wants a ‘spirited discussion’ on ‘real healthcare reform’ and says he is looking for ‘the simply joy that large compensation packages will never bring: the joy that my father felt in treating the poor farmers and others in the small Indian town of Nainital’.

It is perhaps the loss of this human interaction and individual-focus in the therapeutic encounter between doctor and patient that has made alternative medicine so popular in the last few years.  An acupuncturist or homeopath can undoubtedly give the kind of time and attention in a consultation lasting 45 minutes or an hour that your average GP or hospital doctor cannot.  And it is this human interaction that can be so important in a healing process – and probably the mechanism by which many alternative treatments work (via the powerful placebo effect) than through the particular efficacy of acupuncture needles or homeopathic pills.

Many professionals, including doctors, want to feel that they are practising for a more noble purpose such as helping others in need or improving society, rather than seeing their profession as ‘just a business’.  Doctors working in the NHS in the UK have the luxury of not directly having to think about the costs of treatment and so can claim more noble motivations than being in it purely for the money or sullied by such notions of financial transactions.  This belies the fact, however, that doctors are in fact richly rewarded in the UK for their efforts, being paid for not directly from the patient but indirectly through the tax system, funded ultimately by you and me.

By downgrading business ideas as Joshi does by saying medicine now is ‘just a business’ it also ignores the contribution that innovative business models and ideas can make to improving healthcare.  A rich and intense human interaction bringing ‘tremendous fulfilment’ to both parties is no good if the treatment is ultimately ineffective (except through a placebo effect) or if the cost of the encounter is prohibitive to the majority of the population.

It was precisely by taking one of the oldest business model innovations – the assembly or production line model invented by Henry Ford more than 100 years ago – that the Narayana Hrudayalaya Hospital in Bangalore is revolutionising heart surgery in India[5].  Sometimes referred to as the ‘Henry Ford of heart surgery’ Dr Devi Shetty, who founded Narayana Health in 2000 has brought economies of scale and a factory-like style to the provision of cardiac surgery in India where surgeons carry out around 12% of all India’s cardiac procedures[6].  The average cost is around $1600 for coronary bypass surgery, compared to over $100,000 in the US[7] and Dr Shetty wants to reduce this price to $800 in a decade.  This has not been at the expense of quality, as one might suspect.  The Narayana Hrudayalaya reports a 1.4% mortality within 30 days of coronary bypass surgery – compared to an average of 1.9% in the US, despite the fact that the Indian patients are often higher-risk[8].  This model has shown it is possible to bring high quality health care at a low cost to a large number of people.

Other innovations in healthcare, borrowed from other sectors or businesses include the use of checklists[9].  The idea of checklists was taken from the aviation industry where their use in standardising procedures for pilots contributed to a huge improvement in aircraft safety.  The same idea is now being used in anaesthesia and surgery, where a similar improvement in patient safety is also being seen.  According to Brian Jarman, of Imperial College London, the introduction of checklists in 3 hospitals in 2007 was associated with 255 fewer deaths than the previous year. Checklists, together with better team working and flattened hierarchies within teams are said to have led to better patient safety and fewer deaths.

So, while perhaps mourning the decline of medicine as an art, with a unique relationship between doctor and patient, let’s not forget the value and benefit of medicine being developed as a science and a business.  The best would probably be to combine all three.









[1] As reported in The Telegraph 15/12/2013




[2] National Institute for Health and Care Excellence - UK




[3] Helicobacter Pylori




[4] The Guardian, 22 Feb 2014




[5] Featured recently on ‘IndianHospital’ broadcast by Al Jazeera TV




[6] From the INSEAD blog – Karan Girotra 5 Feb 2012




[7] Figures from Bloomberg.com 28 July 2013




[8] From the INSEAD blog – see note 6




[9] See ‘The Checklist Manifesto’ – the much acclaimed book by surgeon Atul Gawande


Thursday, 13 February 2014

“This is our community.....These are our countrymen” - Khalsa Aid


Sikhism Symbol CYesterday morning was quite windy and blustery in central London but despite the conditions I still took my regular walk around St James’s Park. In the space of 10 minutes one got a wonderful impression of London and pride in being English and British: a Guards band was parading, small children in dayglo from a nursery were excited to watch, a chocolate Labrador was being cocooned in its owner’s coat, and then the resplendent red-coated Horse Guards trotted up The Mall.

When I got back home I was glued to some of the coverage of the recent floods on the 24 hour news channels. It is somewhat of a shock when our own institutions cannot mobilise themselves to act quickly on behalf of its own citizens. But in the midst of this perhaps climate change precipitated carnage there have been some rays of sunshine.

On both BBC and Sky a splendid bearded and turbaned Sikh – whom I later learn is Ravi Singh – is interviewed outlining why his organisation, Khalsa Aid, is in the Somerset Levels, offering whatever help and assistance it can. In one interview I saw Singh had come from Slough with supplies for those distressed by the floods. Other filmed packages saw the group making and moving sandbags into position to try and hold off the water.

Not having heard of Khalsa Aid before I found, via their website, that it was founded in 1999 in Slough as an offshoot of the Gurdwara, the Sikh temple, originally offering aid to Kosovo and Albania, and then offering assistance in times of other overseas disasters. Its Roll of Honour now includes the Philippines, Haiti, the tsunami, as well as ongoing projects in India and Pakistan such as preventing drug abuse. There is also a focus on water, sanitation and anti-malaria projects.

My knowledge of Sikhs and Sikhism is to my chagrin very limited. You can, however, read about Sue’s visit to the gurdwara here http://www.indiainlondon.com/sikhism-and-a-visit-to-the-gurdwara/ . But I do know that Sikhs have a public service ethos that is second to none amongst groups in India. Sikhs have served with honour and distinction in both World Wars for the British Empire, as well as for post-Independence India. It appears that this public spiritedness has been maintained amongst the Sikh diaspora. It is an ethos that other groups from the Indian sub-continent could learn from.

In his interviews Singh seemed to decline any opportunities to laud his organisation merely suggesting that they felt it was the right thing to do with the country in crisis. He asked that more volunteers come and offer assistance. Singh commented “This is my community” nailing the lie of Mrs Thatcher’s statement “There’s no such thing as society”. Singh was also keen to stress that this was his country, “These are our countrymen” – there was no ambivalence there – and it was almost his civic duty to help in times such as these. Singh appeared to be proud of being British and of his Sikh heritage too. This country should be proud too.

http://www.khalsaaid.org/

http://www.huffingtonpost.co.uk/claudia-tomlinson/khalsa-aids-humanitarian-_b_4762401.html?utm_hp_ref=tw

Tuesday, 4 February 2014

Indians and their servants

India USAThe case of Devyani Khobragade has become a cause célèbre in India but I would contend for the wrong reasons. In December 2013 Khobragade, then Indian Deputy Consul General in New York, was arrested for visa fraud by the US authorities and for underpaying her Indian domestic help Sangeeta Richard. It was Khobragade’s treatment in being arrested at all, strip searched and held in a cell with common criminals that has enraged the Indian media and authorities. Richard has reportedly said that she worked 17 hours a day and at an hourly rate that was considerably below the US minimum wage.

The situation was quite nuanced with some uncertainty about Khobragade’s status – she was entitled to consular immunity not the fuller diplomatic immunity – Richard’s family being taken from India to the US for their own protection. Her current location and status remain uncertain. Eventually Khobragade was afforded full diplomatic immunity after a transfer to the Indian UN Mission, and then asked to leave the US. It appears that Khobragade’s husband and children, all US citizens, remain in the US. In retaliation India expelled a US diplomat, believed to be the same person who engineered the removal of Richard’s family to the US. What was troubling were the other retaliatory measures the Indian government set in train from downgrading security at the US Embassy, to closing the American Club in Delhi, to withdrawing the IDs of US consular officials, to threatening same sex partners of US diplomats with visa withdrawal following judgments in the Delhi High Court amongst others.

What was also troubling, to my mind at least, was the reaction in India, with support for Khobragade but limited attention given to Richard. It was as though Richard was the culprit here and not Khobragade. Ironically Preet Bahara, the US District Attorney of Indian origin himself, responsible for prosecuting Khobragade, was accused of unfairly targeting Indians.

Then a couple of days ago I read a column in the New York Times entitled “A Maid’s Pay and Moral Choices”, by Ellen Barry (http://nyti.ms/1ij4uKH) . The column highlighted a film made by an Indian, Nishtha Jain in Mumbai, which focused on the relationship between herself and her maid Lakshmi. You can see the trailer on YouTube (http://www.youtube.com/watch?v=BtWK_2jdmGg ). Jain is clearly not uncaring or callous, and calls herself a feminist, but there is strict divide between herself and Lakshmi. The maid sweeps around the feet of Jain who lifts up her feet perhaps without thinking, and later Lakshmi makes tea for both of them but sits on the floor to drink it when there is a spare chair. Jain pays Lakshmi cRS600 per month, that’s £6 or about $10, for 45 minutes a day. One presumes that Lakshmi has other employers. Apparently there are minimum wage statutes pending in the Lok Saba (India’s Parliament) but have stalled.

The film and the Khobragade case got me thinking about my Indian family and their servants. In the early 80s we as a family went on only our second trip to India. For me arriving was a complete culture shock akin to a similar situation in The Namesake film. We stayed in Kolkata at the 3 bedroom flat of my uncle who was then a very senior policeman. It was a unique arrival for us as our uncle was waiting for us at the foot of the aircraft steps and accompanied us through the formalities. I remember being completely jet-lagged; at the time I couldn’t sleep on planes and then slept for almost 18 hours.

After awakening from my deep slumber I got an idea of the household. There’s my aunt and uncle, their two children, a boy and girl, both teenagers, and at leading schools in Kolkata. My aunt speaks to us in Bengali only, and my mother or my cousins have to translate our responses. We are well provided for, 4 meals daily, including the new meal, to me anyway, of tiffin, served in the late afternoon. There is an endless supply of Campa Cola and somehow an Indian equivalent of Corn Flakes has been procured for our breakfasts.

My parents are having a great time; my father visits his former classmates, now often Professors at Calcutta Medical College, and my Mum her relatives all over Kolkata. Together we visit various relatives and there is a trip to Tarakeswar where my father was born. I still remember having the best ever shingaras (Bengali samosas) in Tarakeswar.

After a while one begins to notice servants in all the households we visit. Shockingly to us my aunt has a houseboy, Ranjit, who appears to be about 12. At first it’s rather good to be brought tea in bed in the morning, to be fed before leaving for an early morning flight, and welcomed home with snacks and drinks. I don’t know where Ranjit sleeps, there is no spare bedroom, but later realize he must sleep on the floor in the corridor. My aunt makes the meals but it is Ranjit who does the chopping and all the cleaning up afterwards. My brother asks my mother why Ranjit is there, and she is brutally frank in her response: “If he wasn’t here, his family wouldn’t eat”. It is difficult to argue with that but from a Western background where we make our own tea, our meals, clean our homes it is hard to justify. When we left my father gave my aunt money to give to Ranjit, perhaps trying to assuage some guilt.

Apart from Ranjit the household is reliant on many other servants. There is a permanent car and driver, to take my cousins to and from school, my uncle to work. We are dropped off right outside a cinema and picked up, and earlier in the day someone has been sent to buy the tickets. (Nowadays it is even easier, as one gives the driver a missed call to indicate time to pick up). My uncle has procured another car and driver for the period we are there for the size of the household has doubled. Endearingly one of the drivers calls my brother and me, Chota Sahib and Burra Sahib, a reflection no doubt of our Englishness. But a driver’s life is relatively easy, on duty but working perhaps only an hour a day, as Kolkata is a fairly compact city.

Most days a woman comes to sweep the floors, completely ignored by the household, and a man comes to clean shoes. I remember that at first I refuse to hand over my shoes but my uncle says “Look, we have this service, you should use it”. Although I didn’t see them a washing service must exist too, for all our clothes.

At my mother’s childhood home there is a cook, unfailingly kind, and several other servants. As soon as I arrive I get tea and misti. But some of the expectations of the servants are shocking; I’m playing cricket with a cousin on the roof, sometimes the ball is lost in a rubbish dump at ground level and a middle aged woman servant is sent to recover the ball. However there is affection between the masters /mistresses and servants; on a visit in the mid-90s in the middle of the afternoon after television services were “liberalized” the servants were watching Bollywood movies with my aunt. There was a degree of separation: my aunt was sitting in a chair, and I as a grandson of the house was offered a chair but the servants sat on the floor. All the servants’ lives are an open book: the marriage of one is being arranged and one hears about the qualities of one prospective suitor against another.

Employing servants so cheaply has certain costs: almost everything in the house has to be locked up securely. When my mother stays in her house her handbag with credit cards, cash etc has to be kept behind several layers of padlocks. (One is reminded that in Days and Nights in Calcutta, Clark Blaise’s mother in law spends part of her overseas vacations at locksmiths buying padlocks). In Amit Chaudhuri’s Calcutta he relates how servants can be quite brazen with some being caught in the act of stealing cooking oil and rice. For the single person there are added complications. One cousin with a busy job can only have a cleaner visiting when she is in the house; no one in India would give a servant a key to their flat or house.

There is also the issue of trust particularly when children are involved. Nannies (ayahs) are employed to look after babies and small children, but how can one leave a child with someone almost unknown? A friend in Delhi brought a trusted nanny from West Bengal to look after her young daughter but family problems (more frequent now it seems with mass use of mobile phones) meant the nanny had to return home. With a busy job and life finding childcare was very difficult as my friend was unwilling to trust to a new local nanny.

The level of disdain one might see for servants in Indian homes is also replicated in other environments. In almost every decent hotel or restaurant in India one gets standards of service that are equal to anywhere else in the world. But the Indian customer is often dismissive, rude and insensitive, frequently speaking in grunts, not being able to say thank you or please, and not making eye contact. In Indian eyes the waiting staff, often very well educated, English-speaking, is like a servant. I hope by contrast I am much better; I might have a conversation with a waiter or a coffee barista if there is time, and leave a tip for good service.

Indians coming to the West must have thought they had the perfect life; Western salaries for themselves but paying Indian salaries to their cleaners and nannies. I’m guessing many Indians in the US are now paying their Indian staff appropriately, or employing local staff. Who knows how many Indians will now have to learn how to cook and clean for themselves.

Friday, 24 January 2014

Another day, another gang-rape...

woman in sariJust over a year on from the brutal gang-rape, torture and death of Jyoti Singh Pandey in Delhi, (see our blogs: 1, 2 and 3) another story of a gang-rape has hit the international news.  This time though, the gang-rape was at the orders of a local village council, or panchayat, in West Bengal as ‘punishment’ for a liaison with a married man.  The 20 year old woman had reportedly been having an affair with the man from another community and as punishment the council of village elders fined the couple 50,000 rupees (around £500).  When the woman’s family could not pay, the council told the men in the village they were ‘free to enjoy the girl and have fun’.  The woman was allegedly then raped by an estimated 5-13 men – including neighbours, teenagers and men old enough to be her father.  The gang-rape apparently took place on a bamboo platform with many onlookers.  Even more shockingly, the other villagers seem to have been united in their approval that this was the correct ‘punishment’.  The woman, although badly injured and losing a lot of blood, survived and is now in hospital.  This is not the first time village elders in Birbhum have ordered brutal punishments for social transgressions.  Four years ago, they ordered tribal women to strip and walk naked in front of large crowds as punishment for ‘unauthorised’ relationships. Such punishments are often seen as justified to restore the ‘honour’ of the village, damaged by the women’s behaviour.

To the educated urban elite in India, as well as the more liberal West, it seems inconceivable that such an attack could be carried out - even more so ordered as a punishment.  It is perhaps also the juxtaposition between the tribal villages in India and these attitudes with the more liberal urban areas that makes this attack all the more shocking.  This gang-rape took place in Birbhum district, in a village with no school or electricity.  Only 60km away, however, is Shantiniketan, the university town founded by Tagore, whose alumni include Nobel-prize winning economist Amartya Sen and renowned film maker Satyajit Ray, among others.  Birbhum is also only around 245km away from Kolkata itself – where many women pursue higher education, speak 3 or 4 languages fluently and hold down high status jobs on par with any city in the world.

Soutik Biswas, reporting for the BBC from Delhi, comments however, that even among this tribal community, such a violent attack is unprecedented[1].  The Santhals make up the community in Birbhum – one of India’s largest and oldest tribal communities with a population of around 10.5 million across five states.  Biswas reports that the Santhals have generally been known for their peaceful traditions.  If a man or women marries outside the community, they cannot participate in the rituals and festivals.  If they don’t agree to this, they can live away from the community peacefully.  There has previously not been a question of unofficial village councils ordering any kind of violence against them.

For the last 10 years, however, the community has been confronted by a rapidly changing society where modernity and tradition coexist uneasily.  Traditional livelihoods are being lost as farmers in the villages are forced out into the cities as manual and construction workers.  Mobile phones and television have also brought exposure to pornography and other detrimental outside influences.

In many respects it is good that these cases are gaining more prominence and being widely reported on main news channels in the UK – the BBC World Service, Sky News, BBC News have all covered this story extensively.  James O’Brien on LBC, a London-based talk radio station, hosted a phone-in discussion about this case this morning.  Anyone familiar with the Indian press though, will know that rape cases are reported almost daily, including gang rape cases.  Just searching on the term ‘gang rape’ on the Times of India website this morning came up with 5 alleged gang rape incidents in the last 3 months alone.  One was of a Danish woman in New Delhi, 3 of young girls in West Bengal and one of a Dalit girl in Haridwar District.  2 of the victims subsequently died from their injuries.  These are almost certainly only the tip of the iceberg, however, as campaigners say fear of social ostracism or a prejudiced criminal justice system means perhaps only 1 in 100 of rapes are actually reported in India

Social media certainly seems to play a role here in highlighting these cases.  Extensive mobile phone use - as well as bringing in pornography - also facilitates reporting and dissemination of incidents such as rape.  One report or tweet can spread to mainstream domestic and international media very quickly.  Hopefully this increased reporting and comparisons with the norms of behaviour in other more progressive parts of the world will serve to decrease such incidents, or at least cause the perpetrators to think twice before committing such crimes – knowing that images and reports could quickly reach national and international authorities. In addition, perpetrators might receive exemplary sentences on conviction to deter other such attacks.

I can immediately think of 2 possible reactions to this Western (including my) condemnation of such treatment of women in India:

Firstly, there will be the accusation of Western imperialism all over again – that we are trying to take the moral high ground in condemning such treatment of women in India, when actually we need to firstly take a look at ourselves and what happens here (in the UK) – such as with Jimmy Saville, a celebrity BBC presenter who abused young girls and boys over many decades, and his many hundreds of victims.

Secondly, the cultural relativists will complain that the West does not understand Indian culture, or the context in which the villagers in Birbhum support such judgments by the village elders.  And in turn many in the West will worry about being branded ‘racist’ by criticising other cultural practices.

My response would be that such treatment of women is unacceptable in whatever country it takes place – the UK or India or wherever.  The West is very far from perfect – it was not so long ago that many victims of domestic violence in the UK were dismissed by the police as ‘just being a domestic’.  But thankfully times have changed, moved on to,  I think, a better place in the UK where women do stand a better chance of respect and equality of treatment.  Jimmy Saville was one individual who got away with his abuse because of a system too scared to confront him: but at least his victims now have some chance of recognition and redress.

I would not put ‘off limits’ any cultural practice that harms and abuses anyone – men, women or children.  Female genital mutilation, selective female abortion and honour killing all take place in the UK, primarily in certain ethnic communities within the UK.  Listen to this caller to LBC this morning – ‘Simon’ from Surbiton in London – who admitted almost having his daughter killed because she ran away with the ‘wrong’ man:

http://www.lbc.co.uk/i-almost-had-my-daughter-killed-after-she-fell-in-love-with-the-wrong-man-84935

It is quite chilling to hear his attempted justifications of honour and the need to protect his other daughters in reasoning why he thought about killing her.  As it is, he changed his mind but nevertheless says despite loving her, he will cut her out of his life and never speak to her again.

There is really so much more work to do, both in the West, India and all over the world to protect basic human rights – we should not be complacent.

Elephants, Lord Ganesha and the Indian Independence Movement

Ganesh Festival, Bombay 1987 I remember it like it was yesterday.  It was 1987 and we had just arrived in Bombay (as it was the...