Thursday, December 19, 2013

To my family (November 11, 2004)

I’m home for Christmas. Today is December 19, 2013. Yesterday, as I was cleaning the house and dusting old books, I found this letter I wrote to my family on November 11, 2004 from Imphal. I was in my final year MBBS and the final university exam (the toughest exam I have ever faced) was fast approaching. It is funny somewhere but here it is, unedited.

It is 3:00 in the morning and I haven’t slept yet. A friend passed away at 10:00 pm and we went to condole the family. I couldn’t slip out and come to bed early as I was leading the singing. She had been suffering from Leukemia/blood cancer and there is no cure in our college. Anywhere in the world, chance of complete cure is just one in a million (about).
Rukuwe’s mom came to visit him and I thought maybe I’ll send a letter to my family through her. A letter about me. The phone line is not working and even if it’s functioning, I can’t talk for long as I want with everyone of you.
I wish to come home for Christmas but I have exams on 23rd Dec and 27th. I’m a little older now and maybe wiser too; I have learned to accept the truth. Many times, all we care about is our feelings and we don’t care about the truth. The truth must come before our feelings, Nevertheless, I’m going to miss you all. In case you miss me too, this may be a small consolation if I tell you how your Imphal boy is doing.
Physically I’m in a fine shape except that I get drowsy very quickly. I’m eating regularly and my appetite is good. I may or may not pass my exam this time but I’m not going to worry about that anymore. I’ll labour hard yet try to keep my head cool. But trying to keep my head cool, I go to the extreme that I’m not serious anymore. That’s my problem. I’m not in a hurry, not ambitious nor competitive, “if not this time, then next time”; this kind of attitude or complacency has some good with a lot of bad, I suppose.
I’m praying that I’ll utilize every hour usefully. Help me.
I have this feeling that everyone is getting tired of running. This world is getting tired of spinning round and round. There is speed and anxiety in every walk of life. People are getting fed up of violence stories, hip hop music, fast food, busy city life. Chasing after things that glitter, career, business etc and after having all the necessary gadgets for a comfortable living, people are finding out that there is something missing – satisfaction in life and rest. Here are a few examples. (1) The dance floors in Delhi and Mumbai are becoming empty, (2) the impact of godliness of the candidates on the USA election results, (3) Hollywood stars starting to embrace old religions. What about us? If this life is all we are living for and everything we have dies with us, how miserable! Then should we stop the things we’re doing? No. Actually the most miserable people are those who have nothing to do. In between the two extremes is a way. The narrow way.
The Naga Students’ Union is organizing an advent Christmas program on the 1st December. As we sit around the fire, I’ll be leading in singing Carol songs. But don’t worry about me, I’ve started to lead singing without practice beforehand and it wouldn’t affect my studies. Because of God’s grace, people often entrust me to sing or lead singing, be it in Students’ Union or Evangelical Union. And my confidence in the Lord has been growing. Talking in between the songs is a problem because my voice does not sound good if I talk. Once the singing starts, no problem.
I have plans that in the future, I’ll continue to do praise and worship singing. Join a group or form one praise group.
I’ve been thinking that doing housemanship in Delhi will be beneficial and interesting. housemanship comes after internship. In Delhi, study materials for PG entrance exam will be easily available. And if I go there, I hope to learn and discover surprises which I’m now not aware of. Broaden my horizon. The pay will be good and if there is a change of plan, I can leave the job anytime. These are some positive points but there are also negatives to consider. Nothing is finalized and for now, it’s just a thought.
I have not talked to mother for a long time and she’s the one I want to talk to the most. I prayed for her headache on 30th October and Aunty (Azho) also informed me on 2nd November that she is doing fine. Aunty also informed me about the harvest. Mother wouldn’t be able to read this and she need to be informed.
Regarding the land in Dimapur, do we still have a sufficiently large area? And how is the encroachment? When the Referral Hospital opens soon, we can make good use of it. We also should be aware that greed has no shame. Some may do the unimaginable to claim it.
Rs. 5000 is a little too much. I never expected to receive that much. I’ll buy a wrist watch for my exam. I need it to measure the heart rate and respiratory rate of my patients. My blanket is too thin for winter and I’ll buy one bed cloth too.
Not right now but soon, it can save a lot of inconveniences if I can have a laptop computer. In my works and plans, the necessity for a computer always arises. The one which is easily transportable like a briefcase.
I’m the editor of our newsletter and I have learned a bit of what a computer can do. There are lots of short term computer courses and probably next year right after exam, I can get time for a 2-3 weeks course (a few days a week). Taking training along with a personal computer can speed up learning by many times. The prices are coming down and presently it may cost about 35 thousands.
Atsolu, if you are reading this. I join you in praising God for giving you a job. If you are getting a pay of Rs. 5000, Rs. 500 is not actually yours. It belongs to the Lord. And the salary is secondary, be a workman whom God approves!
Father, how is it like to be a pastor? I want to know. You know? I can’t pray in our dialect. The thoughts are there but I couldn’t find the words. After exam, I’ll read the Tenyidie Bible I took from you. And maybe I will come down to the village.
Sao Tunyi

Wednesday, December 4, 2013

Three books, late 2013

I bought three books recently. Two from the internet, and one from attending the program where the book was launched. It is too early to write Review of the books as I have not read them completely, but this is only an introduction.

1. Indian Economy (For Civil Services Examinations) by Ramesh Singh.

This was recommended by a friend who is appearing Civil Services Examination. I have sounded to him my interested to learn some basic economics and he recommended this. I have just read a couple of Chapters. The language is very simple and the concepts are made easy to understand, good for someone who is not from Economics background. In an economy, there are certain 'public goods' or 'social goods' which should not be 'marketized'. These are Education, healthcare, sanitation, water, nutrition, etc. Another interesting concept is that the Indian Economy jumped from Agrarian Economy to Service Economy, skipping the stage of Industrial Economy which was experienced in stages of Economy transition in the West. This may be nothing for the Economics major students, but it is interesting for a public health student who is trying to make sense of the society even in a small State like Nagaland.

2. Status Anxiety by Alain De Botton

I have for long wanted to get hold of this book. The price came down and I took the chance. It was always somewhere around Rs. 700 but have come down to less than 500 recently. is competing with other online stores like flipkart, infibeam, homeshop18, etc. It is giving good discounts. I usually go to which compare book prices from several online stores. 'We all worry about what others think of us. We all long to succeed and fear failure. We all suffer - to a greater or lesser degree, usually privately and with embarrassment - from status anxiety'. What are the causes? The Content says they are (these are the names of the chapters):

i. Lovelessness
ii. Snoberry
iii. Expectation
iv. Meritocracy
v. Dependence

The solutions that he offers (again these are the names of the chapters):

i. Philosophy
ii. Art
iii. Politics
iv. Christianity
v. Bohemia.

Again I have not read enough to give any critique, but I hope the above list is enough to stimulate thinking or make you reach for your credit/debit card to buy the book.

3. Four Shades

This is the first book by Penthrill Publication House, Kohima. I attended the program where the publication house was inaugurated and this book launched. It is a collection of 60 poems written by Vishii Rita Krocha (owner of the publication house), Robert Seiboi, Aboli Chishi, and Temjenrenba Anichar. The book is priced at Rs. 150. They are mostly modern poems, easy to read, and are about life, love and simple thoughts. Rita read out a poem during the program which is found in the last page. It is my favorite from the book. It is called 'Simple things'. 'The feel of sun dried clothes and clean sheats, The kindness of a stranger; just like finding a friend in the crowd'. It talks of the simple things in life which we may take for granted, but on closer look they are things that make life sweet and worth living/carrying on. Like 'sitting by the fireside eating roasted corn on a cold rainy day'; Rita says these simple things in life 'come with double pleasures'. How true.

Monday, December 2, 2013

Addiction to salt

Published in State Dailies

The recent ‘Salty rumours’ has little relation with this article. But while salt is still in our mind, let me put forward this pressing health concern. Salt is addictive. Research shows that salt addiction is like addiction to hard drugs or cigarette. The easy availability of salted processed food from the market results in increased intake of salt. The human tongue can be trained that it gets accustomed to food with high salt content. It is not only for preservation; salt produces a craving and helps in sales of such food products. 
In Nagaland, salt intake is mainly from the added salt while cooking. The use of processed ‘junk’ food is on the increasing trend. So, we now have the dual problem of high dietary intake of salt in the normal meals and increased intake of salted processed/packaged food. Salt intake varies between individuals, families, and tribes. The amount of salt intake is determined not by biological need but by culture and individual behaviour.

Daily salt intake is increasing all over the world. In most countries, an average person consumes about 8-12 grams every day. The WHO daily recommended salt in diet is 5 grams (equivalent to 2 grams of Sodium). An average American consumes about 9 grams daily (which is about 2 teaspoonfuls). Majority of this comes from processed and restaurant foods.  In India, according to a multi-centric study in 1996, daily intake ranges from 7 to 26 grams. The study says that the most salt-sensitive population is in the North Eastern part of India. In contrast to the western countries, most of the salt is added while cooking and/or at the table, in our part of the world.

High salt intake leads to high blood pressure. High blood pressure (Hypertension) leads to a number of heart, kidney, and brain problems. About 25 health problems are listed which are related to excess salt intake. WHO says that the best evidence of a dietary factor causing cardiovascular disease is the connection between high salt intake and Hypertension.  In the South East Asian Region, one in every three adult is hypertensive and it kills 1.5 million people annually. Sodium in salt retains fluid and makes the heart work harder leading to cardiovascular diseases. Cardiovascular diseases are the leading cause of death worldwide. They are difficult to treat. Management takes time and are expensive. Therefore in resource poor setting like ours, prevention through reduce in dietary intake of salt is a cost-effective option. 

What are the practical ways to reduce salt in the diet? You can start the day by watching what you have for breakfast. Look for sodium content in the food products you eat and select the ones which have low sodium content (not more than 120mg/100gm). Opt for unsalted food products or prepare your own unsalted-breakfast. Strike out from your shopping list processed foods which have high salt content. Buy more vegetables and fruits. If you want to add flavour while cooking, choose alternatives to salt like vinegar, spices, or local herbs. This is important in our context because traditionally we cook meat with a lot of salt as flavour. We can try to retrain the tongue to appreciate meat with less salt, however hard that may be. Or there can be a compensation somewhere where we cut down on salt intake. If I eat meat, I can avoid eating potato chips that day. 

In Mexico City, authorities have removed salt shakers from the restaurant tables. We can remove them from our dining tables. If you are visiting a family with kids, you can buy them stuffs other than coke and potato chips. Families can decide to cut down on salt in their curries, chutneys, salads; and revise their shopping list. There are multiple ways to reduce salt intake.

What about the risk of too less salt in diet? Such situation will hardly arise in a normal setting because we have multiple sources of food from where we get the daily sodium requirement. And common salt is not the only source of dietary sodium. Foods containing sodium are egg, carrot, garlic, broccoli, etc. What about the danger of Iodine deficiency when we don’t take sufficient iodised salt? Iodine is a micronutrient required in micro-amount. There are other sources of Iodine like milk, cod, shrimp, boiled egg, green beans, banana, etc. To prevent the loss of Iodine in iodised salt, it is advised that salt be put towards the later part of cooking. What we can do when trying to put less salt and retain iodine is in adjusting this timing of putting salt. There is also a way to neutralize excess sodium in the body. It is through increase in Potassium intake. Potassium rich food are beans, dark leafy greens, potatoes (with skin), dried fruits, mushrooms, bananas, etc. 

We find a lot of hypertensive patients in our villages. It is not because of sedentary lifestyle or processed food (although the village lifestyle and food habit are fast changing). It is because of salt in our meals (there are other reasons too). So, diseases which were considered as diseases of the urban rich are also being seen in the villages. Our urban population is already facing the heat of the problem. Price of organic food is skyrocketing. Processed foods are cheap and easy to prepare. Lifestyle and dietary habits are changing with urbanization, modernization, globalization, westernization. Pattern of diseases is changing. We are on the brink of (or, it is already) an epidemic. Unlike the outbreak/epidemic of communicable diseases like malaria or typhoid, these salt related non-communicable diseases happen very slowly. We call them ‘Silent Epidemic’. 

 Spread the awareness. This is not a rumour.