The Abandoned and the Abused – 1. In Hospitals

(This is the first part of an article I wrote along with Sundar in 2008-09. We failed in getting it published.)

On 8^th March, 2008, which incidentally was the International Women’s Day, a daughter visiting her mother at the Pavlov Mental Hospital, Kolkata, was shocked to see everybody in the female ward naked. The reason, apparently, was that the patients have only three sets of dress each and the washerman comes only once in a fortnight. The question remains why the patients do not have more dresses, and why the washerman does not come more frequently. When Anjali, the Kolkata based NGO, and the West Bengal media raised hue and cry, the government ordered an inquiry. The inquiry may come up with answers and the government may initiate some remedial measures. This would soon be forgotten and another Inquiry Committee would be constituted to look into the next blatant human rights violation reported.

This incident is only the tip of the proverbial iceberg. Three years ago, a sweeper of another Kolkata hospital kissed a woman patient and the hospital staff refused to perceive this as sexual harassment. Beating the patients who ‘act difficult’ or ‘refuse to be medicated’ was also perceived to be ‘normal’. Government mental hospitals in India are often run in an irresponsible manner, violating many of the rules stipulated by the government itself, as report after report has shown. Hospitals lack sufficient infrastructure, are under-resourced and overcrowded. Patients are abused, bullied, molested, harassed and physically assaulted and their rights, ignored.

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Dehumanising

In most mental hospitals, you would not be allowed inside, unless you are a prospective 'inmate'. No visits to the wards even if you are a journalist; especially if you are a journalist. The hospital authorities apparently want no interference from outside. They apparently don't want the public to know what is happening inside. Every one of us has the right to know what exactly is happening inside hospitals, any kind of hospitals. Not only because they are spending public money, the money we pay as taxes. In the case of mental hospitals, it is also because they are supposed to take care of one of the most vulnerable sections of society. And, we as citizens have a right to know what is happening there. Especially because tomorrow one of us also could be a patient there.

The authorities may say that everything is fine inside. But when someone found that the female patients in the Pavlov Mental Hospital, Kolkata, had no clothes on, they cried foul. Not because the patients had no clothes ("what is wrong in that?" said the nurses), but because someone discovered it! What happens inside the closely guarded gates, apparently, is purely the business of the "authorities".

A hospital with 800 patients may have 400 beds and even fewer mattresses. This may be the situation in most public hospitals. But mental patients are people without voice because no one takes them seriously. So, we have to speak for them. The food is often of low quality. The amount ear-marked for a meal might have been based on an estimate made a decade back, and not revised. There does not appear to be a system for regular revision and adjustment for inflation. The mentally ill are, anyway, it is perceived, not going to know what they are eating. Even if they know, who is going to listen to their complaints? We need to change this notion. Most mental patients do understand what is going on around them. All mental patients are not totally devoid of consciousness or feelings. And they too are humans and have their rights.

The patients are never taken out. Once inside, it is almost forever. Even prison officials at times refuse to take back the prisoners admitted to mental hospitals for treatment. Very few are lucky enough to be discharged and accepted back by society, and there seems to be no reliable data on the number of persons who have been cured but still languishing in the hospitals. Sometimes, the hospital refuses to discharge a patient who has been cured if his/her family is not willing to come and receive him/her. This could mean hospitalization for life. If a person has recovered, (s)he should be discharged voluntarily, on her/his own responsibility. Being mentally ill doesn't mean that they cease to be human beings or that they could be deprived of their human rights. "Few dispute that mental hospitals have long since been dehumanized through neglect, and had failed to meet patients' needs" write Philip Bean and Patricia Mounser (Discharged from Mental Hospitals, Macmillan in association with Mind Publications, 1993). Though written in a somewhat different context, this is valid even today in our country.

Most mental hospitals lack the infrastructure needed to handle the number of patients they get. And they lack the manpower too. Even the employees who are there are often posted as ‘punishment transfers’, says the report Quality Assurance in Mental Health by the National Human Rights Commission, 1999. Electro-Convulsive Therapy (ECT) is used routinely, though it is a controversial treatment and adverse effects have been reported (http://www.issuesinmedicalethics.org/154oa157.html). As per law, ECT can be given only with the consent of the patient, and that too, only under anaesthesia. And it has to be modified ECT, where the so-called peripheral seizure (the epilepsy-like effect that is often frightening) is suppressed using a drug. Most hospitals do not even have an anaesthetist. Patients are hardly consulted. And ECT without anaesthesia is most often used instead of modified ECT, according to the 1999 report of the NHRC.

"The study shows that all relatives signed consents; many reported that the details of ECT were discussed with them and alternative treatments offered and they were happy with the outcome. Yet many relatives also perceived that they were forced to provide their consent. Even the minority of patients who signed the consent form could not recall the details of the procedure. Many patients also reported coercion." report A.P. Rajkumar, B. Saravanan and K.S. Jacob (Indian Journal of Medical Ethics, Oct-Dec 2007). "After much brutal experimentation and research, the developed world banned direct ECT in the early 1960s. Many European countries have phased out even modified ECT, while in the US its usage has come down drastically after the 1980s, following class action." ECT was apparently abandoned after it was found that up to 20% patients suffered vertebral fractures and many of them suffered from terror and trauma. In this respect, India remains a primitive country where 52 per cent of institutions still use ECT without anaesthesia and only eight institutions have facilities for routine electroencephalography monitoring. (Voices of people who have received ECT, by A.P. Rajkumar, B. Saravanan and K.S. Jacob)

Perhaps the overall Indian experience of institutionalized care is far from civilized. "The findings reveal that there are predominantly two types of hospitals," the report by the National Human Rights Commission (cited earlier) evaluates. "The first type does not deserve to be called 'hospitals' or mental health centres. They are 'dumping grounds' for families to abandon their mentally ill member, for either economic reasons or a lack of understanding and awareness of mental illness. The living conditions in many of these settings are deplorable and violate an individual's right to be treated humanely and live a life of dignity. Despite all advances in treatment, the mentally ill in these hospitals are forced to live a life of incarceration."

"The second type of 'hospitals,” the NHRC report continues, "are those that provide basic living amenities. Their role is predominantly custodial and they provide adequate food and shelter. Medical treatment is used to keep patients manageable and very little effort is made to preserve or enhance their daily living skills. These hospitals are violating the rights of the mentally ill persons to appropriate treatment and rehabilitation and a right to community and family life".

Not that there aren't well-run mental hospitals in the country, but they are too few and too far apart. One such is the National Institute of Mental Health and Neuro Surgery in Bangalore. Another is the Institute of Human Behaviour and Allied Sciences (IBHAS) in New Delhi, the only mental hospital where the public can enter and take a look around, like most other ordinary hospitals. So, not that it is impossible. Mental hospitals can be run just like any other hospital, and maintained clean. If only there is a will.

There have been changes in some of the hospitals in the country after the report came out, which have been discussed in the updated 2008 publication Mental Health Care and Human Rights from NHRC and NIMHANS. There are some positive changes in some hospitals, but a tremendous lot remains to be done.

"It resembles like a jail (sic). There are two closed wards. The rest are barracks and cells." says the NHRC report about the hospital in Varanasi. "Surprisingly, there is not a single nurse posted in the hospital, or nurse's post." says the report about the Bareilly hospital. "The attenders use long lathis to control the patients (who) often get beaten up." This is about the Agra Manasik Arogyasala. According to the report, the nurse-patient ratio here is 1:225, instead of the stipulated ratio of 1:3!

The updated report of 2008 says: “Insufficient seating, no drinking water or toilet facilities for out patients and their families. There is no proper facility for registration and recording of out patients. No separate MRD. … No managing committee to oversee day to day management of the hospital and to take decisions. No PSWs, Clinical Psychologists, Psychiatric Nurses.” The report doesn't say whether more nurses have been appointed, or whether the patients are still locked up in cells.

Remember the Erwadi incident where mental patients chained to their beds died in a fire not long ago (see Box 1)? Some action was taken at that time, but matters seem to be becoming as bad as before. As in any other, in the case of mental hospitals also, we need to keep a constant vigil.

But that is not enough. “According to NIMHANS, there are over two crore persons in our country who are in need of treatment for serious mental disorder and about five crore people who are affected by common mental disorder. About 30 to 35 lakh persons need hospitalisation at any time for mental illness. In contrast, there are about 29,000 beds available.” says Sri Akhil Kumar Jain, IAS, Secretary General, NHRC, in his preface to the report Mental Health Care and Human Rights published by NHRC and NIMHANS in 2008. As per an estimate, around 12% of all patients in India are mental patients, yet only about 1% of the health budget is allocated for mental health. There is a ten-fold shortage of psychiatrists in India. There are only 3,000 psychiatrists in India as against a demand for over 32,000.This means that mental hospitals are under-staffed and lack sufficient infrastructure, reflecting our society's lack of concern for mental patients.

Mental patients, being what they are, are extremely susceptible to abuse and exploitation. A mental patient who is on the streets can deliver a child every ten months. Even women in a hospital may not be safe: they can be sold for a night, for a consideration, in cash or kind. Or be exploited by the hospital employees. There have been allegations of boys being sodomised. There were allegations that men were surreptitiously allowed into the women's ward in a government mental hospital at night. That was a quarter century ago. In 2003, a young schizophrenic in-patient at NIMHANS was raped by an out-patient while she was sitting outside. The rapist happened to be HIV positive. The hospital refused to take the responsibility for the incident. Recently, it was reported locally that a patient who asked for some more curry was beaten. Remember Oliver Twist?

There was a case in which a person was admitted to a mental hospital and given treatment for four years to make his sexual orientation "normal". "During counselling therapy sessions, the doctor explicitly told the patient that he needed to curb his homosexual fantasies, as well as start making women rather than men the objects of his desire. The doctor also administered drugs intended to change the sexual orientation of the patient, providing loose drugs from his stock rather than disclosing the identity of the drug through formal prescription. The patient reports experiencing serious emotional and psychological trauma and damage, as well as a feeling of personal violation, due to these actions. This form of psychiatric treatment, reflecting an understanding of homosexuality as a disease, represents a serious contravention of internationally recognized psychiatric guidelines and human rights standards." (see here) The case was raised before the NHRC in 2001.

Pathetic, to say the least, was the case of Machal Lalung of Mikir Chuburi in Morigaon district, arrested in 1951 for voluntarily causing grievous injuries. Since he was mentally unfit to stand trial, he was sent to the mental hospital. He remained there, as the case never came up for trial. His release in July 2005, after more than 50 years in prison, came after the National Human Rights Commission intervened.

In 2007, Mr. Deenadayalam, 54, was admitted to the Institute of Mental Health at Kilpauk in Chennai on an order by the Tambaram Judicial Magistrate, although he had no mental illness. He was illegally detained for 30 days. In this instance, the person could escape through a habeas corpus petition filed in the High Court. Else, the story itself would not have come out.

And, allegedly, at least some hospitals have become dumping grounds for aged people who are no longer needed by their families. And not just the elderly. It was not long ago that Tehelka exposed a doctor who was willing to certify a woman as mentally ill without even seeing her. The deal was settled for just Rs. 10,000, so that a journalist could get rid of his "undesirable wife". While this was only a story used by Tehelka to expose the racket, who knows how many women would have spent their "married" lives in the several mental hospitals in the country! Remember the story of Anjana Mishra!

The question naturally arises, "How come, if things are so bad, no one has been complaining?" The question, unfortunately, is based on a wrong premise that no one has complaints. Remember what a patient told one of the authors (Sundar) about the condition of their cell. Patients do have complaints. But who will listen to them? They are, after all, "mad". Their relatives, in most cases, are not bothered. They would like to somehow get rid of the “lunatic” in their family, delete them from their lives.

Box 1: The Erwadi incident

Mental patients are often locked up, chained and sometimes even beaten. They are treated like criminals. See what happened in a mental hospital in Erwadi. “The chain is blackened and the ring is horribly twisted but still fastened to the charred stump – of a leg. Mentally challenged and physically shackled he was, yet Murugaraj had desperately tried to free himself. Twenty seven more mentally ill people died with him in the early hours of August 6, 2001, when a fire engulfed the thatched roof of the Moideen Badhusha Mental Home at Erwadi, a fishing village 27 km south of Ramanathapuram town in southern Tamil Nadu in India. They were stripped of dignity when they lived - chained, confined and ill treated. The manner of their death was even worse.” wrote Asha Krishnakumar in Frontline (Vol. 18, Issue 17, Aug. 18-31, 2001) about the incident that suddenly brought the issues of the mentally ill into public conscience.

As usual, the hullabaloo died out soon after and people forgot everything about it; perhaps they thought that everything would be taken care of. Yet, when the Punjab and Haryana governments submitted affidavits to the Supreme Court stating that no one in the state was kept chained, the Tribune showed that there were still persons with mental illness kept chained in various places, though may not be in hospitals. In 2007, NDTV visited a famous dargah in Hyderabad only to find that the mentally ill still continue to be chained in gross violation of human rights

The Erwadi incident did make a difference. Enquiries were conducted. The licences of mental hospitals in the private sector were examined and some were cancelled. But "violation of human rights is committed in hospitals where basic amenities and services are not provided, inhuman and degrading treatment is very common and patients are subjected to ill treatment and abuse." says a report.

Box 2: Hell on Earth

Conditions in mental hospitals have been intolerable always. “A total of 200 women. Some in dark cells. They have to piss and shit into a small pit…In front of a cell, a plate full of shit. There are no toilets in the cell. Everything has to be done into a pit. A woman might intelligently have done it in a dish and shoved it out of the grill and could have gone to sleep. Or else she would have to sleep on the floor. The stench is unbearable. No one will remove that plate. It would be the plate from which she eats…In one cell a man lay hugging another. ‘You should have come before 10 a.m. You won’t be able to stand anywhere. Shit will puddle everywhere. They will pour a bucket of water over it. Then it will have a unbearable stench!’, says a patient.’ This was what one of the authors (Sundar) saw in one of the hospitals that he visited in the mid 1980s. (Ee Bhraanthaalayathinu Naavundaayirunnenkil (Malayalam), Mathrubhumi Publications, Kozhikode, 2007).

Things did improve, certainly. But not necessarily everywhere, and never as much as it should have. "As one approaches the wards, a strange stench hits the nostrils. The sight is even more horrifying and nauseating. To the wooden railings of the long verandah are tied — actually tied with ropes — the patients diagnosed as violent, sitting on their own human waste. On either side of the verandah are located the two toilets – unusable and filthy. The toilets have absolutely no water, either running or stored." wrote Anjana Mishra in Manushi (No. 120) about the Central Institute of Psychiatry, Kanke, Ranchi, where she was forcibly admitted by her husband. "Fortunately, I came out of that hell alive but the nightmarish memories continue to torment me, constantly reminding me of other women, young and old, whom I have left behind, probably doomed for life, and whose desperate letters, pleading to be rescued, remain unanswered." she wrote. This was in late 1990s.

The way food is served to mental patients in hospitals leaves much to be desired. Look at what Anjana Mishra (real name) has to say: "The dining hall, situated a little away from the wards, constitutes the most unhygienic part of the entire establishment. Dirty wooden tables line the wall, with the remnants or leftovers of earlier meals, especially, rice and dal particles. Almost a dozen dogs loiter around. The afternoon meal consists of coarse, half-cooked rice, watery dal and a tasteless, odourless curry. All of this put together can kill the appetite of even the hungriest human being. Again, privileged patients, like myself, were entitled to a piece of fried fish, a little curd and a pappad. All the patients eat in a child-like fashion, hogging a mouthful and then taking a walk, then coming back for a second mouthful. The dogs happily lick the plates in this interval. ... Some of the very ill patients even put their food on the floor and have it along with the dogs, while the ayahs in charge exchange gossip." (Manushi, No. 120)

Recently, in a mental hospital in West Bengal, a woman who asked for an extra serving of curry was beaten with the ladle by a woman employee! The unionized militant employees of the hospital apparently believe they have every right to do that.

The names of all persons mentioned in the article are changed to protect their identity.

(This article is published under the Creative Commons Attribution Share Alike Licence India 2.5. The article may be reproduced in any media in its original or modified form provided this note is also included.)

Shame! India

And another Olympics has come to an end. Predictably, India can return with memories of brilliant performances by athletes from other countries. And be proud of the record three medals it won. Three precious medals for a population of a billion people. Let us weep for them for a minute.

A country with a similar population has ended up with a record number of gold medals. China has won more gold medals than any other country in the history of the Olympics. And more than half the medals they won are gold. Another first. One athlete has won more gold medals than the total number of medals that India has won in the last fifty two years. Shame!

You may protest. After all, India is a poor country. We don't have enough money to spend on promoting athletics or sports. Bullshit. Sorry. There cannot be a milder response. Look at the medals won by the other countries. Is Ethiopia a wealthier country? And Kenya? Ethiopia won FOUR gold, one silver and two bronze, seven in all. Better than India. And Kenya got FIVE gold, five silver and four bronze, total fourteen. More than three times what India won. And tiny Jamaica won SIX gold, three silver and two bronze. We have gone out of the Olympics in hockey, a game that used to win our only medal once.

"Ah, just some games. How does that matter? We are becoming the world's top economy soon. We are a power to reckon with in software, in science and technology." Is that what you think? Sorry. I strongly disagree. World's top economy with the country's sixty percent or so struggling for three square meals a day? A software power through doing some routine work for other countries? How much real development work do we do? Isn't what we do just repetitive, boring work? What challenge is there for our best brains? Won't our entire IT industry collapse if China, for instance, builds up the English skills of their people?

The point is that it is simply not a question of some games or sports. It is a question about how well, how effectively, we do things. We have been waiting and waiting for our athletes, our sportspersons, to become world class. This country of one billion people have been waiting for more than half a century. And they are seeing only deterioration in performance. Yes, we won a record number of medals this year. A record number of three medals. I would see it as just chance. I can't see that as the result of a planned programme to promote sports and games. If it really is so, I would still say "Shame!". Say that more vigorously. How can we be so absolutely incapable of doing anything well?

We need to start asking this question. Because our sports and games infrastructure is spending our hard-earned money. The money the poor Indians have paid as taxes. And we need an answer. The authorities have to answer, answer the questions raised aloud by the people who have given the money. We have a right to an answer. And not just any wishy washy answer. The establishment, beware. The people are fed up with your self-serving incompetent performance.

Richard Peet---Geography against neo-liberalism

This is an interview I had with Prof. Richard Peet at Tata Institute of Social Science, Mumbai, when we met during the International Conference on Critical Geography in December, 2007, which no one wanted to publish.

Prof. Richard Peet is a well-known Marxist Geographer. He has a B.Sc. in Economics from the London School of Economics, an MA from the University of British Columbia and a Ph.D. from the University of California, Berkeley. He works in the Clark University in the United States. His areas of interest include: social and economic geography, political ecology, liberation ecology, development theory, geography of consciousness and rationality, philosophy and social theory, iconography, semiotics, and critical policy studies. He has published several popular books including Geography of Power, Unholy Trinity: The IMF, World Bank and WTO, Liberation Ecology and Theories of Development (with Elaine Hartwick). A very friendly and sensitive individual, he speaks with a lot of passion especially when he talks about poverty and neo-liberalism. He was recently at the Tata Institute of Social Science, Mumbai, to participate in the 5th International Conference on Critical Geography. In this interview that was started in Mumbai and completed through e-mail, Prof. Peet speaks about poverty in India, neo-liberalism, the Indian left and so on.


Q: Prof. Richard Peet, Welcome to India. Is this the first time you are visiting India?

A: Yes, it is. I have been in India only five days.

Q: How do you find India?

A: India has made a deep impression on me. I have never seen the depth or extent of poverty I have seen here anywhere in the world. I have visited many poor countries, and lived in such countries, as for example South Africa, one of the most unequal countries in the world. But nowhere have I seen so much poverty. I was in Delhi before I came to Mumbai, and one moment stands out. When traveling in Delhi by car, beggars come up to you when you stop anywhere, especially when they see a white person. This has happened many times. But one moment stands out. A little girl, about 5 years old, came begging in the usual practiced way, mournful face, hand pointing to mouth, and
everybody rejected her. I did too. She was talking to herself as she went from car to car. She has lost her childhood in this way. I was thinking what it must be like for a child to grow up being rejected a thousand times a day, instead of being re-inforced, told she is wonderful, hugged and kissed by her Mum and Dad. That night I called my wife and tried to tell her about this. I could not complete the conversation because I became so emotional. And here in Mumbai, along the road, little naked kids play inches away from trucks, cars, taxis. I even saw a couple of boys flying a home-made kite over the traffic. What a mess. India needs hundreds of millions of new houses, with good services, in pleasant places, so its children can grow up ... happily.

Q: That leads to a very important question. Why do you think, after sixty years of independence, we have failed to effectively address the question of poverty?

A: I think it failed because the development model that has been used has been totally inadequate in meeting the problem. What we need is to be able to generate a large number of productive jobs, you know, to make most of the people productive in society making useful goods and useful services. There were some indications of that in the early days when there was still some degree of socialist commitment in India. But that has dissipated. And now we have the neo-liberal model but it's never going to do it. That model will never be able to produce the number of jobs necessary to end poverty. Even China, which has been supposedly successful using this development model for the last fifteen years, is ridden with inequalities to the extent that, even in difficult circumstances, there are eighty thousand major protests each year. And protesters in China are not only beaten with the cane, as with India, but also imprisoned, tortured and shot for taking part in those demonstrations. So even the most successful case of using the neoliberal model has produced that level of inequality. It just shows the whole neo-liberal model to be completely inadequate to solving the kinds of problems faced by the masses, the peasants and workers in China, India and elsewhere in the Third World.

Q: We are standing in Mumbai, which is possibly the most industrialised city in India. But we find abject poverty also here, with people living even inside concrete pipes meant for drainage. Why does this happen?

A: It is because this model deliberately siphons income to super rich people. It disguises this by saying: "Look, to develop we need people to invest. For investment to happen we need people with money. So rich people should have large incomes in order to raise capital. They are the people who are going to invest and create jobs.'' This is a corrupt idea. Rich people may or may not invest, may or may not keep their money in India, and so on. There is nothing that forces them to invest in productive jobs for people. They can invest in movie production, they can gamble on the international market, all they want to do is make a profit. So siphoning income to super rich people is a totally inadequate way of producing jobs for the masses. What you need instead is more a bottom-up model of development, where you subsidize co-operative production, small scale production, medium size industries, where you have land reform to enable the peasants there to use their surplus in increasing
productivity capacity. And in the end what you get is a more productive agriculture leading to smaller scale industrialisation, the two sectors interchanging goods with each other. To generate an internal field of this kind of productive exchange you need protection against competition from the global market, at least for a while. Economics emphasizes competitive efficiency far too much. The more important thing is for the economy to produce jobs that bring
income and dignity. "Efficiency'' needs rephrasing to mean efficiency in generating income for poor people.

Q: As you said, there was a socialist approach in the initial days after the independence. The left was very strong then, though not in a position to influence the government since the ruling party had a large majority. But now the left is split into several parties. And some people believe that the split has actually helped its growth. What do you think about that?

A: I think you can have very productive discussions among people in the left that do not splinter the left. It's difficult I know. But in the case of dialogue among the far too many Communist parties in India, we have to remember that Marxism is not some dogmatic doctrine that forces you to think along a certain line, though it is often interpreted to be exactly that---as though its been learned by heart, through class recital. It is a way of thinking creatively on behalf of the working class. If you are an intellectual, you are well educated, you can think generally, you can think theoretically, then you should be using that capacity to think on behalf of the people. Not that you just impose your views on people. But you take their ideas and help restate them in a more theoretical and general way. Then, of course, you have lots of discourse among people who hold different kinds of opinion. Because all these ideas are extremely creative. But don't let that split the left. There is a difference between discussion and splitting into factions. Splitting is just selfishness.

Q: We find the left parties coming out and saying something like "We made a mistake when we did that. We admit our mistakes.'' This is good, in a way, that they admit mistakes. But this seems to happen rather frequently. They seem to continue to make mistakes. One would have expected them to learn from the mistakes and take care not to make new mistakes.

A: You would think that the left is the most pretentious, egocentric and split-prone group of people in the whole world! All that they want to do is split and form splinter parties. This has always been a problem, it seems almost to be a natural characteristic of the left. However, we can learn from the past, without being imprisoned by it. The differences among left parties are insignificant in comparison with the tasks faced by the left, by anyone who has a conscience, in India. This country is ready to explode! You cannot have such a degree of inequality in a country without having major uprisings. Be the spokesman of those people, say it eloquently, concentrate on your real enemies, don't dissipate energy on inter-factional in-fighting.

Q: Yes, it is a wonder that, with so much disparity, this place has not exploded.

A: Neo liberalism is actually a very effective ideology. Somehow it gets people to think that maybe they can be one of them, one of the rich and powerful. A lot of new capitalists have come up. But it does provide also a very nice entertainment system---I have never in my life seen more people dancing on TV. So the misery of the masses is reflected at the utter opposite pole in the super happiness of the movie idol. I have never seen an entertainment system that is more opposite to the conditions faced by the majority of the population than I have witnessed in India.

Q: It sometimes appears that the left has vacated spaces that one would think should have been naturally theirs. The first thing that comes to my mind is the environment movement that the left rejected as a conspiracy of the developed countries. Some of the environmentalists were even branded as CIA agents.

A: Let us take the environment movement. I was a socialist when I heard the first environmental discourse. I thought it was a diversion, you know, from the main issues of class, power, poverty etc. I didn't realize the connection between capitalism and the destruction of nature and I didn't know the extent to which the damage has already been done, to the point of being irreversible. Climate change is a massive transformation in the natural system. Even now, with the
little bits of realisation we've achieved experiencing "natural catastrophes'', we go on doing the damage. Even when people realize what they are doing to nature, they still consume and produce in careless ways. This resembles some kind of mass suicide which says, "I know I am destroying nature, but let me get my bit in first''.

Q: Interestingly, our conversation almost appears like a conversation with an economist or a politician. However, you are a geographer. You have also written that you do take a definite political stand when you teach geography. We understand geography as something related to the surface of the Earth, distribution of people and so on. How is politics involved in this?

A: I think, write and teach as a social scientist not encumbered by disciplinary limits. But I emphasize issues of space and nature more than, say, an economist. For example, my recent book Geography of Power looks at concentrations of power in hegemonic global cities and the outward diffusion of power as policies, the re-shaping of these in sub-hegemonic centers, like New Delhi, and the interactions among different power centers, as with Mumbai (financial power) and Delhi (political power center).

Q: We are now in the middle of a conference on Critical Geography. Most people have little idea about this subject. Can you please explain what Critical Geography is?

A: Once you understand what Geography is---for example, the study of power in global space---the notion of a critical geography becomes easy to realize. We are critical of the existing globalization. We want a different kind of globalization. We stand for the oppressed in this globalization. We want to help in a political process that might be summarized as; "Poor people of the World, Unite ... you have nothing to loose except your Chains''.

Q: Can you say something about how popular is Critical Geography in the US and in other countries?

A: We call it radical geography, and it appeals to students and the public on a wide scale. In the US, students have a lot of freedom to take classes that they are interested in, rather than just courses that are prescribed. They come to radical geography en masse, and leave ... changed for ever.

Q You have written that you take a Leftist stance when you critique geography in your classroom. I would imagine that you would have to face quite a bit of criticism in the US for doing that. Have you faced problems because of your Leftist ideology?

A: Not really in the sense of censorship. I say what I want, in and out of the lecture theater. The students protect me. Where they get you is by not awarding grants to openly Marxist faculty, not appointing you to endowed ``chairs'', not giving you pay raises. But who cares? Contributing to the global struggle is satisfying at a level far above these petty punishments. We live our lives saying interesting things to interested people. They live their lives doing
petty things, going to boring meetings, writing memos, reading trivial texts, and so on. I feel sorry for administrators, for powerful people in general. They have no meaning in their lives.

Q: Hope you will be coming to India again, sooner rather than later. Are you thinking of any work in India?

A: I'm going to write a couple of things based on my experiences here, and I will send you copies. I will return if I'm invited.

(This article is published under the Creative Commons Attribute No Derivatives 3.0 Licence. The article may be published in any media provided this note is also included. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nd/3.0/)