Tuesday, October 30, 2012

Ellie Goulding - Your Song


Live @ the Nobel Peace Prize Concert 2011

It's a little bit funny, this feeling inside
I'm not one of those who can easily hide
I don't have much money, but boy if I did
I'd buy a big house where we both could live

So excuse me forgetting, but these things I do
See I've forgotten if they're green or they're blue
Anyway the thing is what I really mean
Yours are the sweetest eyes I've ever seen

And you can tell everybody this is your song
It may be quite simple, but now that it's done
I hope you don't mind, I hope you don't mind that I put down in words
How wonderful life is now you're in the world

If I was a sculptor, but then again no
Or a girl who makes potions in a traveling show
I know it's not much, but it's the best I can do
My gift is my song, and this one's for you

And you can tell everybody this is your song
It may be quite simple, but now that it's done
I hope you don't mind, I hope you don't mind that I put down in words
How wonderful life is now you're in the world

Saturday, October 27, 2012

Health is a development issue

Delhi is in the grip of Dengue outbreak again. To date, over 800 cases and 2 deaths have been reported this year. People panic. The blame games do the rounds. Monsoon passes. Winter sets in to dry up the mosquito breeding sites. Cases come down. And it is forgotten. Come next year and the story repeats itself. 

Aren’t all seasonal diseases supposed to be that way? The worrying part is that Dengue and vector borne diseases like Malaria, Japanese Encephalitis, and Chikungunya (the sister diseases caused by the bite of mosquitoes) are preventable. Other seasonal diseases like Typhoid, Acute Diarrheal Diseases, and Influenza are also easily preventable diseases. Yet season after season, year after year, we are caught off guard. To a large extent, we ‘let nature take its course’ and we do too little to stop the cycle. 

Diagnostic facilities have become more refined, medicines have become better, and hospitals have become more equipped to handle complicated cases. But the result of improved health services has not resulted in a clear cut fall of prevalence and incidence of these diseases. The history of malaria control program in India is not a straight forward success story. The interesting thing about malaria is that this is a disease where cure was discovered before the cause. But in spite of the facts that the disease is thousands of years old, its pathology well understood, preventive measures are well known, diagnostic facility and treatment are freely and widely made available; yet it continues to be a major cause of morbidity and mortality. This is a very important observation for the main point of this article drawn below. Dengue follows urbanization, unplanned urbanization in particular. The Delhi experience illustrates that well. The posh colonies have pockets of slums where mosquitoes breed and the disease is spread to the surroundings. Construction sites, open ditches and water tanks, potholes, clogged drains, and other stagnant water bodies are the favorite breeding sites. Dengue vector mosquitoes breed in/near places where humans reside and therefore its preponderance to unplanned and overcrowded urban habitation. Japanese Encephalitis (JE) has more danger of going rural and affecting huge geographical areas like wet paddy fields. Also because of its attack on the nervous system and danger of permanent nervous system damage, the issues of timely diagnosis and management of complications are major concerns for JE. In all the three diseases, prevention measures are very similar and there is a good chance to control them that they cease to be a public health problem.

The problem of communicable diseases like malaria, dengue, and JE is not purely a medical problem. Medical technicalities of these diseases like pathogenesis, diagnosis, treatment, etc are not even the primary issues. In many of the developed countries, these diseases are not a public health problem; not because they have better medical facilities, but because the diseases are simply not common. There is no substantial number of cases or deaths. It is also not because the western people have developed immunity to these diseases because of their genetic make-up. The differences in prevalence and incidence are therefore not primarily medical. We have the disadvantage of living in the tropics where the climate suits the breeding of vectors. Other important differences are that we have little/no town planning whereas they have got it, our development roadmap is chaotic whereas they have fine blueprint; they have more civic sense and awareness than us, their health seeking behaviors are different from ours, and so on. 

Cliff Analogy. Source: internet
Prevention is better than cure. This is over-said but hardly done. Let’s make the line more dramatic with an analogy used in public health circles called the ‘cliff analogy’. There’s a spot from where people accidentally fall off the cliff. It is a common occurrence. So, what did the people do? They put an ambulance at the bottom of the cliff to pick those who fall so they can be brought to the hospital. That saved many lives but people continue to fall off and some people even lost their lives. To cut the analogy short, then it was decided to build a fence around the spot. This fence prevented the people from falling off the cliff. Building of the fence is symbolic of prevention of diseases before they occur (fell). One may go a step further to move people away from the spot at the edge of the cliff (which signify addressing social determinants of health). Preventive measures as you can see from the analogy are easier, cheaper, and more effective than the management of diseases after they occur. 

And so must prevention of diseases be an important component of development planning. While constructing buildings, roads, canals, dams, and drainage, whatever; health concerns must be a priority right from the planning process. In agriculture, economics, housing, etc. health concerns such as food security, poverty alleviation, healthy living conditions, etc must be taken into consideration. If health is a given priority in all of the development processes, many of our public health problems will be solved on their own. Health is a development issue. Medical service is only one of the many components necessary for good health.

Sunday, October 21, 2012

Celebration of the ordinary

If I want to increase the rating of this newspaper column, the easiest thing to do is to say something controversial or outrageous. The more bizarre, the better. That’s the way to become popular today. I don’t have to work hard; to be notorious is enough. I might ‘sex it up’ a little. A reference to sex can shoot up sales of magazine, soap, car, color paint, mobile phone, jewelry, movie, book, anything. Or I might say something outrageous against someone. Notoriety can turn a person without talent into a celebrity overnight. In this generation, no one wants to be ordinary. Everyone wants to rise above the crowd and be celebrated. We don’t want to be normal. We want to be special. The world doesn’t bother what means we use to become famous. It doesn’t matter if we have to sell our dignity, our self-respect, our very soul for it. To become popular has become the ultimate goal.

Online social media like facebook provides platform for every ordinary person a kind of podium or a world audience. The stage is all yours. It reminds me of the movie The Truman Show, the only difference is that the hero in our case knows that he’s the hero. In the movie, Jim Carey did not know that he lives in a make-believe world and that his whole life is a television show. With more and more of reality TV shows, we have come to live as though our life itself is a show and we are the main star. We manage how we should be perceived with our facebook status updates and our profile information. On such flimsy grounds, we derive our dignity and self worth.

We are made to believe that we can be the next slumdog millionaire. In the talent search shows, it is shown again and again that ordinary people like you and me can become the next great sensation. The show anchor points finger at you through the TV screen and say, ‘you can be the next great star’. And you believe that somehow, somewhere, you have it in you to sweep the world off its feet. 

How stressful!!! How stressful it would be to keep up with such make-believe image that we try to project day in and day out. It’s a recipe to fall into a ‘celebrity mental breakdown’ if you like. Behind the images of happy-go-lucky, on-top-of-the-world lives that we see onscreen, so many celebs suffer mental depression, drug addiction, and disintegration of private lives. It is when accolades get into their heads and they can’t cope with the realities of life. 

The antidote to the pursuit of fame is to choose and celebrate the ordinary life. Let’s face it. There are millions of people all over the world who are as good as you and me. Chances are that with all the moves and tricks you pull to impress (gather as many Likes, to use facebook lingo), you might just not make the cut. To the restless wannabes, wise men say that in the rush to the top, it is told that there’s nothing up there. In the rat race, there is no reward at the finish line. The best things in life are in the ordinary everyday stuffs. Marilyn Thomsen says, ‘And while it takes courage to achieve greatness, it takes more courage to find fulfillment in being ordinary’. To go to work and come home on a usual day is a blessing. To find joy in the company of a friend over a cup of ordinary tea; to mind one’s own business and to work with our hands, as the Good Book says - These are precious gifts that we so often ignore. We remember heroes and great people. We draw inspiration from such people and their extraordinary acts. But they are few and far in between when we count all the days that pass us by. But the more important thing is to live the ordinary days well. ‘The growing good of the world is partly dependent on unhistorical acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs’ (George Eliot). If you don’t have as much oomph factor, set-the-stage-on-fire stuff in you, or Nobel Prize-worthy piece of work, don’t bother. Just live on. Life itself is amazing.

Sunday, October 14, 2012

The future of drinking water in Nagaland

‘It would appear that water as a commercial good has replaced the State’s obligation to ensure availability to the community of basic minimum quantities of affordable water’ - Wilfred D’ Costa  

‘Water promises to be the 21st Century what oil was to the 20th century: The precious commodity that determines the wealth of nations’ - Fortune

‘Global crisis in water claims more lives through diseases than any war claims through guns - UN

If you have been going to wedding parties for the last 25 years or so, you might have noticed many changes, one of which is the way you are served drinking water. Now, you pick mineral water bottles. That would have been unimaginable quarter of a century ago when water was served from water filters and jugs and you drank from metal cups. It is more convenient for the host to serve bottled water than to boil. To serve water in metal cups is also passé. But why I draw your attention to the way water is served at wedding parties is to use it as an illustration to ‘the great water debate’ that is going on in the wider world: the commercialization of water; an example being the fact that drinking water is becoming increasingly bottled. Activists argue that water is a basic human need; access to safe drinking water is a human right and should not be a ‘good’ that only some people can afford to buy.

If you are an average Joe living in Kohima, you probably have felt the pinch of having to pay for water not just for drinking but even to flush your toilet. Nothing’s for free anymore. A friend remarked that someday, we have to even buy air to breath. In a way, we do. Air Conditioners. Nagaland is blessed with beautiful fresh water springs and rivers, more than sufficient to meet every Naga’s water needs. In many places, there’s no need to treat or pump but only to connect pipes and share (thank goodness, gravitation is still free). Some villages do have a good water supply system and each khel has community water taps where crystal clear water flows 24x7. I once commented to a villager that if it were in Kohima, money is flowing down such tap every minute. But not just Kohima, many of the growing towns in Nagaland are facing water shortage. The problem will only become bigger.

The modus operandi of our government is firefighting. It requires a situation to reach crisis level to jolt the government into action. And the solution is usually whitewashing the surface. Send a tanker or two in the worst affected areas during the driest month. There is no proper planning for water supply system or the result of which we are yet to see. Those whose decisions matter do not feel the pinch. They can flush-wash their cars every morning while their neighbors have never experienced the ‘luxury’ of ‘running water’ in their kitchens. Our situation is complicated by our customary laws. What was meant to protect us from exploitation from outsiders becomes our own bondage when it comes to sharing of water. Water is considered as a common good but is privately owned. And love for our neighbor (e.g. by sharing water) is a dying virtue in our society. In India, right to property is not absolute and it is not included in the fundamental rights. For the common good, the government has the authority to acquire water sources for common good. But that doesn’t seem practicable. What should be the way out?

Community based water management is an option. We have communitisation of public institutions in Nagaland. But it has been observed that devolution of power to communities is not accompanied by allocation of resources. The resources continue to lie with the government. It creates a conflict by forming a parallel community authority with the existing government authority. Convergence has not taken place well. Or community leaders collude with government officials in corruption. The weakness of the government is taken advantage of by the private sector. But giving free hand to the private in delivering public good like water supply is a worse option. For example, in Kohima, the price of water rises according to the whims and fancy of the water tanker boys. It is not equitable and pushes the poor out of access to safe drinking water.

How do we make community based water management work? The rights and needs of the landowners and locals need to be taken into account from the conception of planning. The communities need to be empowered, not only in name, but with resources. The government should play the role of providing expertise in knowledge and supportive supervision. In a collection of essays called ‘Water Democracy: Reclaiming public water in Asia’, several case studies were presented from all over Asia on the title. According to the publication, democratization and not privatization is the way out. One of the success stories is from Tamil Nadu. In a village, there was acute water crisis: Ground water was 1200 feet deep and wells were all dry. Illegal tapping of water was common and people do not pay their taxes on time. The villagers came up with a detailed plan. They held scores of meetings in a year involving all sections of the society and emphasizing on the need for participation and cooperation from all. They sought the expertise of the engineers of the State water agency. Everyone had to change the way things are done in order to solve the water problem. The villagers created 32 water storage structures by deepening, repairing and constructing dams.  To increase vegetation cover to attract rain and raise water table, they planted over 7000 tree saplings. They were planted by children in their names, names of their pets and grandparents. Encroachments on the water storage areas were removed. Also with consensus of all, illegal tapping of water was stopped. Water was equally distributed to all villagers and on time. The quality of water was good and complaints were redressed promptly. This instilled confidence among the villagers. The results were evident within a short time: the water table rose from 1200 to 800 feet. The trees attracted birds and changed the biological profile of the village. The villagers were satisfied with the transparency and equal distribution of quality water in their community. The collection of annual taxes reached 100%. The village council received a State award. This was not a one-off case but such community based water management was carried out in 153 villages in 29 of 30 districts in Tamil Nadu. This was a part of a unique process known as the ‘democratisation of water management’ which was launched by the State water agency.

More people die from diseases due to water shortage than by the barrel of a gun.  Diarrhea and respiratory tract infections are the most common causes of child deaths in India. UNICEF says that hand washing with soap especially after contact with excreta can reduce diarrheal diseases and respiratory diseases by 40% and 30% respectively. It is useless to talk about sanitation without adequate and quality water supply. ‘Water wars’ are on the rise and conflicts across communities and social classes will only increase. Experts say that what oil was to the last century, and so will be the struggle for water in the future.

In places like Kohima, water problem has reached crisis level. Ground water is not a sustainable method of water supply. With urbanization, streams and rivers are becoming polluted. Bottled water is not only costly but plastic pollutes the environment. Loss of forest cover poses a threat of drought-like situations and lowering of water table. Irrigation and therefore food production will be affected. So, the future of drinking water can head in two directions: either we plan ahead for sustainable, equitable, affordable, and quality water supply; or prepare ourselves to fight ‘water wars’.

Sunday, October 7, 2012

Is my faith anti-science?

Christianity is committed to truth and is not afraid of what science may find. But many Christians are wary of science thinking that it is forever locked in battle with religious faith. Such people reduce faith to something that science cannot explain. They believe in a God who is confined to the gaps in our scientific knowledge. The mysterious, the supernatural, and the unexplained are attributed to God. But when scientific knowledge progresses and what could not be explained is now out in the open, the space of God shrinks. Such a God therefore becomes smaller and smaller as scientific discovery expands.

I was brought up with the thought that if I go too much into science, I may lose my faith. When it comes to matters of faith, I must not ask anything or have any doubt. I must simply believe like a child. To even think or rationalize seemed evil. I must not use my brain too much. I must give my heart fully to God and everything will be OK. Such infantile belief is still pervasive in our society. So, atheists often call Christianity as a thing for the simpleton and the feebleminded. And Christians think that they have to defend their faith against scientists and intellectuals in a hostile world.

But Christians who have such anti-science views are often people who know very little about the nature of science. They do not care to know the details. It is enough to believe that science says that God did not create the universe and we came from monkeys. They read the Bible the same way: say a prayer; open to a random page, put finger to a verse, and believe that God has given them that verse for the moment. Forget about the verses and chapters that precede or follow; forget whether it is a psalm, a parable, or history; forget the context in which it was written; and what the passage meant to whom it was originally written. The Bible to them is a collection of stand-alone verses of timeless truths. They think that what they believe is universally true for all Christians or others are not Christians at all.

At the other extreme are militant atheists who are at war with religious faith. They think that religious faith is superstitious and dangerous. Faith they say is blind to reason and evidence. Fanatics indoctrinated by religious beliefs kill other people in the name of religion. Through the use of Reason and scientific technology, they believe they can bring world peace. They think science is on their side and with its progress, religion will/need to lose relevance. But the shrill voice of those atheists doesn’t mean that most scientists think like they do. Those scientists who have anti-religious views attack religion not on the basis of their scientific knowledge but on their a priori belief that they bring to their scientific study. Science and atheism are not conjoined twins as they would believe. There is a substantial gap between the two and scientists like Richard Dawkins are said to connect the two not by evidence but by mere rhetoric. Majority of the scientists on the other hand think that the God question or religious faith cannot be settled in scientific ground. On the existence of God, a scientist remarked, ‘we neither affirm nor deny it. We simply can’t comment on it as scientists’. Those scientists who deny the existence of God or attack religious faith do so not on the basis of their study, but only when they jump (a faith exercise, if you like) to a totally different realm.

Many Christians have come to peace with science, I being one of them. As a Christian, I believe science is the study of the works of God. God is not threatened that through science man may someday sort him out and do away with him. Instead, it blesses the heart of God. ‘Great are the works of the Lord, studied by all who take pleasure in them’ (Psalm 3:2). This verse is said to be inscribed at the entrance to the Cavendish laboratory in Cambridge where pioneering breakthroughs in nuclear physics were made. Till 2011, 29 Cavendish researchers have won the Nobel Prize. Driven by the passion to study God’s Book of Nature, modern science grew out of the works of people from Judeo-Christian tradition rather than the traditions of the East (Buddhism, Islam, Hinduism, etc). Like the scientist who commented that scientific study does not affirm or deny the existence of God, scientists are well aware of the strengths but also the limits of scientific study. Science is what science does. It has its premise and methods of study and its findings are what they are. But it does not give value judgments on things such as ‘this landscape is beautiful’, ‘I know I can trust you’, etc. To use an illustration of John Polkinghorne, science can explain the phenomena of water boiling in a kettle, but it cannot and does not try to explain the purpose why I’m boiling water in the kettle, which is to make tea because I love drinking tea. But because I cannot use science to explain why I’m boiling water or why I love tea, it doesn’t mean that what science explains about water boiling in a kettle (its temperature, amount of water, metal of kettle, etc) is wrong. Neither can I conclude from my scientific study that there is ‘nothing but’ water boiling in the kettle. That I love tea is also true and is not without evidence.

I believe that the Bible is the Word of God and whatever it asserts to be true is true. But Bible is not a science textbook. It has a very different purpose. If there are passages which are in harmony or contradictory with scientific facts, the purpose/intend of the Bible is still not to show scientific facts. Therefore it is important to know what the Bible is trying to say lest we draw inferences which the Bible doesn’t intend to say. It is important to know what type of writing it is. For example, when we read a satire, we don’t interpret it like a clinical research paper. The Bible has different types of writings. Also when we read any writing, it is important to know the context, the date, the people to whom it was written, their culture, what it meant to them, etc. These are not to divert the reader from the text, but to help the reader understand the text better. Application of such rigor especially to texts like the creation account in Genesis 1 and 2 can perhaps throw light especially in regard to the notorious creation-evolution debate. Evolution is a prickly topic and before I get myself into trouble, let’s hear what the Evangelist Billy Graham has to say,

I don't think that there's any conflict at all between science today and the Scriptures. I think that we have misinterpreted the Scriptures many times and we've tried to make the Scriptures say things they weren't meant to say, I think that we have made a mistake by thinking the Bible is a scientific book. The Bible is not a book of science. The Bible is a book of Redemption, and of course I accept the Creation story. I believe that God did create the universe. I believe that God created man, and whether it came by an evolutionary process and at a certain point He took this person or being and made him a living soul or not, does not change the fact that God did create man. ... whichever way God did it makes no difference as to what man is and man's relationship to God.

Salvation of a person does not hang on the view of science vis-à-vis faith that one holds. It comes from believing in the redemptive work of Jesus Christ. On the interpretation of Genesis 1 and 2, Saint Augustine has this advice:

In matters that are so obscure and far beyond our vision, we find in Holy Scripture passages which can be interpreted in very different ways without prejudice to the faith we have received.  In such cases, we should not rush in headlong and so firmly take our stand on one side that, if further progress in the search for truth justly undermines this position, we too fall with it.

And Faith is not blind as some atheists think. The definition of Faith is summed up well in W. H. Griffith-Thomas’ words:

[Faith] affects the whole of man’s nature. It commences with the conviction of the mind based on adequate evidence; it continues in the confidence of the heart or emotions based on conviction, and it is crowned in the consent of the will, by means of which the conviction and confidence are expressed in conduct.

Science is a gift of God and it is liberating to know that instead of conflict, science and faith can be complimentary. Especially for those who are in Biology, Astronomy, Geology, etc. they don’t need to live with the contradiction that their discipline is opposed to their religious faith. Rather, in pursuit of scientific knowledge, the fingerprints and the character of the Creator may perhaps be discerned, ultimately leading one to bow down in worship, ‘How great are your works, O Lord’.