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.)

What is Life?

Recently I saw a report that stated that scientists have found that prions undergo Darwinian evolution. The study from the well-known Scripps Institute at Jupiter (not the planet) in Florida, the US, is striking because prions have always been considered as lifeless molecules. The discovery that they cause illness and death was itself shocking. But the recent discovery, I think, raises fundamental questions about what is life. Let me explain this a bit.

Prions were so named by Stanley Prusiner, M.D., a professor of neurology at the University of California, San Francisco School of Medicine, won the Nobel Prize for this discovery in 1997. Prions were found to be responsible for the disease Bovine Spongiform Encephalopathy (BSE), popularly known as Mad Cow disease. This disease was found to affect humans who eat the meat of cattle affected by BSE. In humans, the disease is known as Creutzfeldt-Jakob disease, It is a degenerative neurological disorder and is fatal. "The first symptom of CJD is rapidly progressive dementia, leading to memory loss, personality changes and hallucinations. This is accompanied by physical problems such as speech impairment, jerky movements (myoclonus), balance and coordination dysfunction (ataxia), changes in gait, rigid posture, and seizures. The duration of the disease varies greatly, but sporadic (non-inherited) CJD can be fatal within months or even weeks", says Wikipedia.

Now prions are just molecules of protein, nothing more. Prions are not cells, have not DNA, and cannot reproduce. This was the reason for the astonishment when prions were found to cause a disease. How can prions cause a disease? It was found that they really do not reproduce themselves in the cells they infect. Prions become problematic because they are not in "proper shape". Proteins, you see, are large molecules and they normally exist in a folded form. The way they are folded is very important for their function. If they are folded differently or get opened out, they do not function in the normal manner they are expected to. Some proteins open out, or denature, when they are heated or cooled beyond the temperatures they are normally expected to encounter. Apparently, this is the reason for egg white becoming, well, white when heated.

Now, what happens with prions is that they induce other protein molecules to fold in the way they (prions) are folded. That is, though prions cannot reproduce themselves, they get other protein molecules to become prions. Thus, when prions infect a cell, the population of prions in these cells increases. And those molecules of proteins lose the ability to function properly and contribute to more protein molecules getting converted to prions. This goes on till the infected animal dies. The new discovery is that prions also undergo evolution. "The study from Scripps Research Institute in Jupiter, Fla. found that prions can develop many mutations. Mutations that help the prions to withstand threats then tend to persist in a population of prions, while other prions are destroyed. This eventually leads the prions to develop adaptations such as drug resistance.", reports World Science. In other words, prions seem to show all signs of a living organism, including the capability to evolve according to changing environment.

Once upon a time, people believed that life could be formed from inanimate matter. Later we realised that inanimate matter cannot lead to the formation of life, that it was tiny, invisible, seeds or eggs that led to apparent growth of life forms from "dead" matter. But then, the theory of evolution came along and we explored the possibility of life having evolved from non-biological matter on the Earth. Then came Fred Hoyle and Chandra Wickramasinghe who declared that life originated in space and the Earth was seeded from space, and even that it may be life that is controlling the Universe. And, of course, in the 1960s, James Lovelock put forward the Gaia hypothesis where he defined Gaia as "a complex entity involving the Earth's biosphere, atmosphere, and soil; the totality constituting a feedback or cybernetic system which seeks an optimal physical and chemical environment for life on this planet." So was the whole system acting like a living organism?

Long ago, people thought of plants as non-living things. When bacteria were discovered, they were thought to be the smalles living organisms. Then came viruses, and they did not have a complete cell, only the genetic content, the DNA, or the RNA. Now how could that be a form of life? Should viruses be counted as life forms? It is essentially just a molecule, a molecule of DNA, though. But still just a molecule. How can it be a form of life?

And now here comes a simple molecule of plain protein (Imagine, just a molecule!) that appears to show signs of life. It not only creates more of its own kind, but also apparently undergoes evolution. Now, where is the "life" part here? What is it that gives it "life"? What really is life? Is the Earth living? Of course, we don't see any signs of life. The Earth doesn't reproduce itself as far as we know. We know so little about the Universe that I wouldn't dare to say that we know that planets do not produce more planets. Yes, this may sound totally absurd, but remember, I am only saying that we don't know. Once upon a time we hardly even imagined that a molecule could cause diseases, let alone reproduce and evolve. Once upon a time we believed that life on Earth is unique and that life formed on Earth. No longer. There is solid evidence to show that much of what we see as interstellar clouds could be microscopic forms of life. Once upon a time we believed that the Universe is expanding at an increasingly slower rate, and that it would stop expanding and start collapsing one day. No longer. We now understand (I wouldn't say know) that the expansion of the Universe is becoming faster, and we are not able to explain why.

In short, so long as we don't know what exactly is happening, we have to assume that anything is possible, however absurd it may sound, so long as we know that it is impossible. I know that the above statement is also ambiguous. What do we mean, for instance, when we say know? What we know today could turn out to be wrong tomorrow. Of course, that is how knowledge progressively approaches "truth". We cold go on wondering about such things, but let me stop before it becomes too metaphysical. My intention was just to point out that we hardly understand "life" and when we say that something is lifeless, we may soon have to change our opinion. Let us, at least, remember that we know so little about the world we live in.

Say No to Wars

"The concept of a just war emerged, suggesting that war is justified only when it meets certain preconditions: if it is waged as a last resort or in self-defense; if the force used is proportional; and if, whenever possible, civilians are spared from violence." said Barrack Obama in his speech accepting the Nobel peace prize. It echoes a feeling often repeated, that war could be more "just" or "morally acceptable" if civilian casualties are low or even absent. I think this is a rather dangerous sentiment. Let me try to present my reasons below.

Let me start with the following statement, "Killing is unacceptable, except for food". I would include killing of all kinds, whether people or animals. Many people may question this premise, but I consider this the basic "law" of nature. No animal kills another except for food, and I am yet to hear of an animal killing another of its kind for whatever reason (even for food). I am supported by the popular saying in India that translates roughly as, "You are absolved of the sin of killing if you eat it".

If killing, except for food, is unacceptable, then killing a person, for whatever reason, is unacceptable. This would include killing even the worst criminals. This may be difficult for many people to accept, but I don't see any way in which we could morally justify killing even a serial killer. We could, perhaps, find reasons based on other considerations, but not on moral ones. This becomes a difficult question and I shall try to look deeper into it later. But right now let me proceed with the problem of the morality of 'civilian deaths' and 'military deaths'.

Why do we feel that civilian deaths cannot be justified? I can think of only two reasons: i) civilians are unarmed and defenceless, so it is not fair to attack them; and, ii) they are not directly involved in war. Let us analyse these reasons. Yes, civilians are generally unarmed. They are not trained to fight. So they do not get a fair chance to defend themselves. But, does this mean that soldiers can be killed because they are armed? Because it is "you or me"? This is true in hand-to-hand combat, especially as in olden days when people used to fight with swords or spears, the better man survives. But, in today's world where one could be killed by a shell fired from kilometres away, by a land mine or a bomb dropped from an aircraft (or even a cruise missile fired from the other side of the globe), this argument does not seem to be valid. It is not one-to-one fight any longer. The individual soldier, however brave he is, or however good a fighter he is, simply has no chance against the killing power of the opposite army. So it hardly matters whether a soldier is armed or thoroughly trained in warfare. Anyone could get killed in a war irrespective of whether he is armed or not.

But, yes, soldiers are directly involved in any war. In a way, wars are all about killing the soldiers of the other party. But everyone would agree, I hope, that that is not the end. A war is almost always about territory - land and the people who live there. So, it is really about the civilians and the power over them. Soldiers are merely "civilians" who take the responsibility to defend the territory. And, of course, the land and the civilians provide them support in the form of food, medicines, arms and ammunition and an assurance of a comfortable retired life if they are not killed. No army can survive without support (voluntary or forced) from land and people. That is why cutting off supply routes is one of the important tactics adopted in any war. In other words, we cannot deny that it is the countries that are at war, the lands and the peoples, not just the militaries.

I hope this won't be interpreted to be a justification for killing civilians. I am trying to say that killing soldiers is as bad. Killing human beings, especially in the name of war, is totally avoidable. No other animal on earth indulges in such cruel and wasteful activities. And the death of a person, whether a soldier or not, is equally painful to his/her family. Nothing can really compensate for the death of a person. In my opinion, it is this pain inflicted on people, often people who never wanted any war, that makes killing immoral. And that pain remains the same, whether the person who died is a civilian or a soldier.

Most people in any country would want peace, and not war, except in certain situations. Such situations are often caused by a few people in search of power. While at one time it was the kings who wanted to expand their empires, today it is again such megalomaniacs who create wars. The difference is that today, perhaps, more wars are started also for economic reasons - access to resources or markets. But that is just another kind of power. Of course, wars could also be triggered by the actions of a country that cause problems for a neighbouring country. Even these, I think, could be avoided if global pressure could be brought on such countries.

Apart from all this, we need to remember that wars waste a lot of resources - resources that could have gone to reduce hunger and malnutrition. I am not aware of any study in that direction, but, possibly, climate change would have been less severe if the fuel used for all the wards during the twentieth century had been saved. We are already talking about peak oil (oil production reaching a peak before declining), and people have started talking about such peaks related to other resources (even water!). And the environmental wounds caused by a war takes a pretty long time to heal. We certainly cannot afford to go on causing such extensive (and intensive) damage to our environment.

So rulers of the major countries need to sit and decide about abolishing war. It cannot be just about nuclear weapons. A nuclear war today can easily lead to total destruction of the life on earth. So, talking about using nuclear weapons is like talking about suicide. One good part about suicide is that one does not survive and suffer. But conventional war is more like a failed suicide attempt where the person suffers serious injury that maims him for life. He has to live and bear it. Let us not do that.

World Mental Health Day, October 10

October 10 is observed as World Mental Health Day. I was not in a position to write this earlier. But I had the satisfaction of seeing an article I wrote in Malayalam on the status of mental patients and mental health centres in India published in the newspaper Thejas on that day. I am reproducing it below.

ഒക്‍ടോബര്‍ 10 ലോക മാനസികാരോഗ്യ ദിനമായി ആചരിക്കുകയാണു്. മാനസികാരോഗ്യത്തെപ്പറ്റിയുള്ള അറിവു് എല്ലാവരിലും എത്തിക്കുക, മാനസികാരോഗ്യ പ്രശ്നങ്ങള്‍ ഉണ്ടാകാതിരിക്കാനും ഉണ്ടായാല്‍ ചികിത്സിച്ചു് ഭേദപ്പെടുത്താനും മറ്റും ആവശ്യമായ സൌകര്യങ്ങള്‍ എല്ലായിടത്തും സൃഷ്ടിക്കുന്നതിനുള്ള സാഹചര്യം ഒരുക്കുക എന്നൊക്കെയുള്ളതാണു് ഈ ദിനാചരണത്തിന്റെ ഉദ്ദേശ്യം. അറുപതിലധികം വര്‍ഷങ്ങള്‍ക്കു മുമ്പു് സ്ഥാപിച്ച മാനസികാരോഗ്യത്തിനുള്ള ആഗോള ഫെഡറേഷനാണു് ഈ ദിനാചരണത്തിനു് മുന്‍കൈ എടുക്കുന്നതു്.

ഏതു് സമൂഹത്തിലെയും ഏതാണ്ടു് പന്ത്രണ്ടു് ശതമാനം പേര്‍ക്കു് മാനസിക പ്രശ്നങ്ങളുണ്ടു് എന്നാണു് കണക്കാക്കിയിരിക്കുന്നതു്. ഏതാണ്ടു് നാലു് പേരില്‍ ഒരാള്‍ക്കു് ജീവിതത്തില്‍ ഏതെങ്കിലും സമയത്തു് ചികിത്സകൊണ്ടു് പ്രയോജനം ചെയ്യാവുന്ന മാനസികാരോഗ്യ പ്രശ്നമുണ്ടാകുന്നുണ്ടത്രെ. എന്നിട്ടും മാനസികാരോഗ്യത്തേപ്പറ്റി നമ്മള്‍ അപൂര്‍വ്വമായേ സംസാരിക്കാറുള്ളൂ. ആരോഗ്യരംഗത്തെപ്പറ്റിയുള്ള ചര്‍ച്ചകളില്‍ മാനസികാരോഗ്യം വരാറേയില്ല എന്നു പറയേണ്ടി വരുന്നു. ഇതിന്റെ കാരണത്തിനു് ഒരുപക്ഷെ അധികം അന്വേഷിക്കേണ്ടതില്ല. ഒരു വലിയ വിഭാഗം ജനങ്ങള്‍ക്കു് മാനസികാരോഗ്യത്തെക്കുറിച്ചുള്ള അജ്ഞതയും മാനസിക രോഗങ്ങളോടുള്ള ഒരുതരം ഭയവും വെറുപ്പും ഒക്കെത്തന്നെയായിരിക്കണം കാരണം. ശാരീരിക രോഗങ്ങള്‍ പോലെ തന്നെയുള്ളതാണു് മാനസിക രോഗങ്ങളെന്നും അവ ചികിത്സിച്ചു് മാറ്റാവുന്നതാണെന്നും മനസിലായിക്കഴിഞ്ഞാല്‍ മിക്ക സമൂഹങ്ങളിലും ഇന്നു് നിലനില്‍ക്കുന്ന മേല്പറഞ്ഞ കാഴ്ചപ്പാടുകള്‍ മാറേണ്ടതാണു്.

മാനസികരോഗമുള്ള ഒരു വ്യക്തിയുടെ പെരുമാറ്റം മറ്റുള്ളവരില്‍ ഭയമോ നിസ്സഹായതയോ ഒക്കെ ഉളവാക്കുന്നതു് സ്വാഭാവികമാണു്. അതുകൊണ്ടുതന്നെ ആയിരിക്കണം ഏതോ പിശാചിന്റെ ഫലമായാണു് മാനസികരോഗങ്ങള്‍ ഉണ്ടാകുന്നതെന്നു് പണ്ടു് വിശ്വസിച്ചിരുന്നതു്. ഇന്നും അങ്ങനെ വിശ്വസിക്കുന്നവരുണ്ടു്. പല ശാരീരിക രോഗങ്ങള്‍ക്കും അത്തരത്തിലുള്ള കാരണങ്ങള്‍ ഒരുകാലത്തു് പറഞ്ഞിരുന്നല്ലോ. എന്നാല്‍ അതു് ശരിയല്ലെന്നും രോഗങ്ങളുണ്ടാക്കുന്നതു് പ്രധാനമായും രോഗാണുക്കളാണെന്നും തെളിഞ്ഞതിനു് ശേഷം അത്തരം വിശ്വാസങ്ങള്‍ വളരെ കുറച്ചുപേരേ വെച്ചുപുലര്‍ത്തുന്നുള്ളൂ. എന്നാല്‍ മാനസികരോഗങ്ങളുടെ കാര്യത്തില്‍ അന്ധവിശ്വാസങ്ങള്‍ നിലനില്‍ക്കുന്നതു് രോഗത്തിനു് ചികിത്സ നല്‍കുന്നതിനും രോഗിയെ ശരിയായ രീതിയല്‍ ശുശ്രൂഷിക്കുന്നതിനും തടസ്സം നില്‍ക്കുന്നുണ്ടു്. അതുപോലെതന്നെയുള്ള മറ്റൊരു പ്രശ്നമാണു് ശാരീരികരോഗങ്ങള്‍ പോലെതന്നെ പല തരത്തിലുള്ള മാനസികരോഗങ്ങളുണ്ടു് എന്നുള്ള തിരിച്ചറിവില്ലാത്തതു്. അതുകൊണ്ടു് എല്ലാ മാനസികരോഗികളെയും `ഭ്രാന്തന്മാരും ഭ്രാന്തികളും' ആയി മുദ്രകുത്തുകയാണു് സമൂഹം ചെയ്യുന്നതു്. ജലദോഷം പോലെ നിസ്സാരമായതു മുതല്‍ അര്‍ബുദം പോലെ കഠിനമായതു വരെയുള്ള മാനസികരോഗങ്ങളുണ്ടു് എന്നു് നമ്മള്‍ തിരിച്ചറിയേണ്ടതുണ്ടു്.

കുടുംബത്തില്‍ ആര്‍ക്കെങ്കിലും മാനസികരോഗം ഉണ്ടെങ്കില്‍ അതു് ഒളിച്ചുവയ്ക്കാനാണു് നമ്മളില്‍ പലര്‍ക്കും താല്പര്യം. മറ്റുള്ളവരറിഞ്ഞാല്‍ നമുക്കു് ജീവിതത്തില്‍ പ്രശ്നങ്ങള്‍ ഉണ്ടാകുമോ എന്ന ഭയമാണു് പലപ്പോഴും ഇതിനു് കാരണമാകുന്നതു്. ഈ സ്ഥിതിവിശേഷം മാറേണ്ടതുണ്ടു്. എങ്കിലേ മാനസിക രോഗങ്ങളെ മറ്റു രോഗങ്ങള്‍ പോലെ തന്നെ കാണാനും അതിനു് വേണ്ട ചികിത്സ നല്‍കാനും കഴിയുന്ന സാഹചര്യം ഉണ്ടാകൂ. കൂടാതെ ഇന്ത്യയിലെ തന്നെ മാനസികരോഗ ചികിത്സാ കേന്ദ്രങ്ങളിലെ ഇന്നത്തെ ദയനീയാവസ്ഥ മാറണമെങ്കില്‍ അത്തരം ആശുപത്രികളും മറ്റു് ആശുപത്രികളേപ്പോലെ ജനങ്ങള്‍ക്കു് കയറി കാണാന്‍ കഴിയുന്ന സ്ഥിതിയിലാവണം. പൊതുജനങ്ങളെ മാനസികാശുപത്രികളിലേക്കു് കടത്തിവിടാനാവില്ല എന്നു പറയുന്നവരുണ്ടാകാം. എന്നാല്‍ അതു് സാദ്ധ്യമാണെന്നു് തെളിയിച്ചുകൊണ്ടു് പൊതുജനങ്ങള്‍ക്കു് പ്രവേശനം അനുവദിക്കുന്ന ഒരു ആശുപത്രിയെങ്കിലും ഇന്ത്യതില്‍ തന്നെയുണ്ടു്.

ഇന്ത്യയിലെ മാനസികാരോഗ്യ കേന്ദ്രങ്ങളുടെ സ്ഥിതിയെപ്പറ്റി ഇന്ത്യയിലെ മനുഷ്യാവകാശ കമ്മീഷന്‍ പഠിച്ചു് 1999ല്‍ ഒരു റിപ്പോര്‍ട്ടു് പ്രസിദ്ധീകരിച്ചിരുന്നു. അതനുസരിച്ചു് മിക്ക ആശുപത്രികളുടെയും അവസ്ഥ കഷ്ടതരമായിരുന്നു. "രണ്ടു തരത്തിലുള്ള ആശുപത്രികള്‍ ഉണ്ടെന്നാണു് ഈ പഠനം കാണിക്കുന്നതു്. ആദ്യത്തെ തരത്തിലുള്ളതിനെ ആശുപത്രികള്‍ എന്നോ മാനസികാരോഗ്യ കേന്ദ്രങ്ങളെന്നോ വിളിക്കാനാവില്ല. സാമ്പത്തിക കാരണങ്ങളാലോ മാനസികരോഗങ്ങളെപ്പറ്റി അറിവില്ലാത്തതിനാലോ മാനസികരോഗമുള്ള ബന്ധുക്കളെ കൊണ്ടിടാനുള്ള സ്ഥലങ്ങളാണവ. ഇത്തരം പല ഇടങ്ങളിലെയും ജീവിത സൌകര്യങ്ങള്‍ പരിതാപകരവുമാണു് ഒരു വ്യക്തിയ്ക്കു് മനുഷ്യത്വത്തോടെ ചികിത്സിക്കപ്പെടാനും അഭിമാനത്തോടെ ജീവിക്കാനുമുള്ള അവകാശം നിഷേധിക്കുന്നതുമാണു്."

``രണ്ടാമത്തെ തരം ആശുപത്രികള്‍ അടിസ്ഥാനപരമായ ജീവിതസൌകര്യം നല്‍കുന്നവയാണു്. അവയുടെ പ്രാഥമിക കര്‍മ്മം രോഗികളെ കസ്റ്റഡിയില്‍ വയ്ക്കുക എന്നതാണു്. ഭക്ഷണവും താമസിക്കാനുള്ള ഇടവും അവര്‍ നല്‍കുന്നുണ്ടു്. എന്നാല്‍ രോഗികളെക്കൊണ്ടു് ബുദ്ധിമുട്ടില്ലാതിരിക്കാന്‍ ആവശ്യമായ മരുന്നുകള്‍ മാത്രമാണു് അവിടെ നല്‍കുന്നതു്. സാധാരണ നിലയില്‍ ജീവിക്കാനാവശ്യമായ കഴിവുകള്‍ വളര്‍ത്തിയെടുക്കാനുള്ള ശ്രമങ്ങളൊന്നും അവിടെ നടക്കുന്നില്ല. ശരിയായ രോഗചികിത്സയും സമൂഹത്തിലേക്കു് മടങ്ങിപ്പോകാനുള്ള പരിശീലനവും ലഭിക്കാനും സമൂഹത്തില്‍ കുടുംബത്തോടൊപ്പം ജീവിക്കാനും ഉള്ള രോഗിയുടെ അവകാശം ഈ ആശുപത്രികളില്‍ നിഷേധിക്കപ്പെടുന്നു.'' 2008ല്‍ മനുഷ്യാവകാശ കമ്മീഷനും ബാംഗ്ലൂരിലെ നിംഹന്‍സ് (NIMHANS) എന്ന മാനസികാരോഗ്യ കേന്ദ്രവും ചേര്‍ന്നു് പ്രസിദ്ധീകരിച്ച പുതുക്കിയ റിപ്പോര്‍ട്ടില്‍ 1999നു് ശേഷം ആശുപത്രികളില്‍ വന്ന മാറ്റങ്ങള്‍ വിവരിച്ചിട്ടുണ്ടു്. പല ആശുപത്രികളിലും കാര്യമായ മാറ്റങ്ങളൊന്നും ഉണ്ടായിട്ടില്ല എന്നാണു് ഇതില്‍നിന്നു് കാണുന്നതു്.

``മൊത്തം ഇരുനൂറു് സ്ത്രീകള്‍. അതില്‍ കുറച്ചുപേര്‍ ഇരുണ്ട സെല്ലുകളില്‍. അവര്‍ക്കു് മൂത്രമൊഴിക്കാനും വെളിക്കിറങ്ങാനും ഒരു കുഴി. ... ഒരു സെല്ലിനു മുന്നില്‍ ഒരു പ്ലേറ്റില്‍ നിറയെ മലം.'' കാല്‍ നൂറ്റാണ്ടു് മുമ്പു് കേരളത്തിലെ ഒരു മാനസികരോഗാശുപത്രിയില്‍ കണ്ടതു് എഴുതിയിരിക്കുകയാണു് ഈ ഭ്രാന്താലയത്തിനു് നാവുണ്ടായിരുന്നെങ്കില്‍ എന്ന പുസ്തകത്തില്‍ സുന്ദര്‍. പഴയ കഥ, ഇതൊന്നും ഇപ്പോള്‍ ഉണ്ടാവില്ല എന്നു തോന്നാം. കേരളത്തിലെ ആശുപത്രികളില്‍ ഒരുപക്ഷെ സ്ഥിതിയില്‍ മാറ്റമുണ്ടായിട്ടുണ്ടാവാം. എന്നാല്‍ 1996-97 കാലഘട്ടത്തില്‍ റാഞ്ചിയിലെ മാനസികരോഗാശുപത്രിയില്‍ അഞ്ജന മിശ്ര എന്ന യുവതി കണ്ടതു് എന്താണെന്നു് നോക്കൂ. "വാര്‍ഡിനടുത്തേക്കു് ചെല്ലുമ്പോള്‍ ഒരു വല്ലാത്ത നാറ്റം. കാണുന്നതു് അതിനേക്കാള്‍ ഭീകരവും ഓക്കാനം വരുത്തുന്നതുമാണു്. നീളമുള്ള വരാന്തയുടെ കൈവരികളിലേക്കു് കയറുകൊണ്ടു് കെട്ടിയിട്ടിരിക്കുന്നു അക്രമാസക്തരെന്നു് കരുതുന്ന രണ്ടു് രോഗികളെ. അവര്‍ ഇരിക്കുന്നതു് അവരുടെ മലത്തില്‍. വരാന്തയുടെ രണ്ടറ്റത്തുമാണു് കക്കൂസുകള്‍ -- ഉപയോഗിക്കാനാവാത്തവണ്ണം വൃത്തികേടായതു്."

2008 മാര്‍ച്ച് 8നു് കൊല്‍ക്കത്തയിലെ പാവ്‍ലോവ് മാനസിക രോഗാശുപത്രിയില്‍ അമ്മയെ കാണാനെത്തിയ മകള്‍ കണ്ടതു് വനിതാ വാര്‍ഡിലെ രോഗികളെല്ലാം പൂര്‍ണ്ണ നഗ്നരായിരിക്കുന്നതാണു്. കുട്ടിയെ കൂട്ടിക്കൊണ്ടുവന്ന ഡോക്‌ടര്‍ ഇതില്‍ പ്രതിഷേധിച്ചപ്പോള്‍ ആശുപത്രി ജീവനക്കാര്‍ അദ്ദേഹത്തെ തടഞ്ഞവച്ചു് മാപ്പു പറയണമെന്നു് ആവശ്യപ്പെട്ടു. വിസമ്മതിച്ച ഡോക്‌ടറെ സൂപ്രണ്ടു് വന്നു് മാപ്പുപറഞ്ഞാണു് രക്ഷപ്പെടുത്തിയതു്. രോഗികള്‍ നഗ്നരായിരിക്കാന്‍ കാരണം അവര്‍ക്കു് മൂന്നു് വസ്ത്രങ്ങളെ ഉള്ളൂ, പക്ഷെ അലക്കുകാരന്‍ രണ്ടാഴ്ചയിലൊരിക്കലേ വരൂ, എന്നതാണത്രെ. എന്തുകൊണ്ടു് കൂടുതല്‍ വസ്ത്രങ്ങളില്ല, അല്ലെങ്കില്‍ എന്തുകൊണ്ടു് അലക്കുകാരന്‍ കൂടുതല്‍ തവണ വരുന്നില്ല എന്ന ചോദ്യം അവശേഷിക്കുന്നു.

മാനസികരോഗാശുപത്രികളില്‍ കഴിയുന്ന രോഗികള്‍ നമ്മുടെ സമൂഹത്തിലെ അംഗങ്ങളാണു്. നമ്മളേപ്പോലെയുള്ളവരാണു്. നമുക്കോരോരുത്തര്‍ക്കും, മറ്റേതു രോഗവും എന്നതുപോലെ, മാനസികരോഗവും ഏതു് ദിവസവും ഉണ്ടാകാം. നമ്മളാരും ഒരു രോഗത്തിനും അതീതരല്ല. എന്നാല്‍ മാനസികരോഗം ഉണ്ടു് എന്നു് നമ്മള്‍ വിശ്വസിക്കുന്ന വ്യക്തികള്‍ പറയുന്ന കാര്യങ്ങളൊന്നും ആരും കാര്യമായി എടുക്കാറില്ല. അതുകൊണ്ടുതന്നെ അവര്‍ നിസ്സഹായരാണു് എന്നു നമ്മള്‍ ഓര്‍മ്മിക്കണം. പകപോക്കാനായി മാനസികരോഗിയായി മുദ്രകുത്തി ആശുപത്രിയിലാക്കുന്ന കഥാപാത്രങ്ങളെ നമ്മള്‍ സിനിമയിലും സീരിയലുകളിലും കാണാറില്ലേ? മുന്‍പു് സൂചിപ്പിച്ച അഞ്ജന മിശ്ര അതുപോലൊരു ചതിയില്‍ പെട്ടു പോയ സ്ത്രീയാണു്. പകപോക്കാനല്ല, ഭാര്യയെ ഒഴിവാക്കാനായി ഭര്‍ത്താവു് ചെയ്തതാണെന്നു മാത്രം. ഇത്തരം അനേകം സ്ത്രീകള്‍ മാനസികരോഗാശുപത്രികളില്‍ ഹോമിക്കപ്പെട്ടിട്ടുണ്ടു് എന്നു് അഞ്ജന തന്നെ പറയുന്നു. ഇതെല്ലാം നമ്മുടെ സമൂഹത്തിനു മേലുള്ള വലിയ കളങ്കങ്ങളാണു്.

മാനസികരോഗചികിത്സാരംഗത്തു് വലിയ പുരോഗതി കൈവരിക്കാന്‍ ആധുനിക വൈദ്യശാസ്ത്രത്തിനു് ആയിട്ടുണ്ടു്. ആത്മാഭിമാനത്തോടെയും സ്വന്തം കാര്യങ്ങള്‍ സ്വയം ചെയ്തുകൊണ്ടും ജീവിക്കാനുള്ള കഴിവു് മിക്ക മാനസികരോഗികള്‍ക്കും ശരിയായ ചികിത്സയിലൂടെ നേടാനാവും. ആ സ്ഥിതിക്കു് നമ്മുടെ സഹോദരന്മാരെയും സഹോദരികളെയും ഇങ്ങനെ ക്രൂരമായി ശിക്ഷിക്കുന്നതു് മഹാപാപമാണു്. മനുഷ്യരാശിയോടു ചെയ്യുന്ന അപരാധമാണു്. ഇതെല്ലാം മാറ്റാന്‍ നമ്മളാലാവുന്നതെല്ലാം ചെയ്യുമെന്നു് നമുക്കു് ഈ മാനസികാരോഗ്യ ദിനത്തില്‍ പ്രതിജ്ഞയെടുക്കാം.

(ഈ ലേഖനം ക്രിയേറ്റീവ് കോമണ്‍സ് by-sa ലൈസന്‍സില്‍ പ്രസിദ്ധീകരിച്ചിരിക്കുന്നു.)

The Future of Governance

What will be the kind of government people will have in different parts of the world after, say, thirty, forty or fifty years? I am sure there are people who believe that the capitalist system will become prevalent all over the world, becoming the predominant form of society. There will also be people who believe that socialism will spread to many countries in fifty years' time and continue to spread to other countries. There also are people who believe that there could be other forms of society that would develop in the coming decades.

One indication of the form that may soon evolve is the new modes of production witnessed in the development of Free Software. Here, people collaborate to create something with apparently no incentive. Well, there is the incentive of popularity, recognition and even fame that contribution to Free Software may bring. But not money, at least for a number of developers who are not employed by Free Software companies like Red Hat or SuSE or even companies that contribute to Free Software like Sun Microsystems.

But, if we take the case of Wikipedia, for instance, contribution to it brings you nothing. Not even the names of contributors are mentioned anywhere. Yet, millions of articles go written in more than 250 languages! This is simply stupendous! Unbelievable even a few years ago. And inexplicable from the point of view of any kind of economics. Does this indicate a new and evolving form of collaborative production? Can this kind of production be extended to other areas also? Can, in other words, a new form of economy come into existence where production is no longer centralised, controlled by a few people? Can there be an economy that needs no money?

While these may sound absurd to many people who cannot escape from the modes of thinking that we are familiar with in this money-based economy, there are many people who think that it could be possible. There are different groups in different parts of the world, such as the P2P Foundation established by Michel Bauwens and the Oekonux group established by Stefan Merten, who are seriously discussing such possibilities.

I had the good fortune to meet and interview Mr. Bauwens and Mr. Merten earlier this year. The interview with Mr. Bauwens has already appeared in Malayalam in the latest issue (July 17, 2009) of the magazine Samakalika Malayalam. The English version of the interview has appeared in Infochange India. The interview is under the Creative Commons Attribution No Derivatives India 2.5 (by-nd) licence. So it may be reproduced in any media provided this licence statement is also included. Just for your information, in case you would want to reproduce it somewhere :-)

Humanity in a Trap

Well, this is not really a post, but a link to an earlier post. I have to do this because the earlier post was started in December 2008, but completed only today. Yet, the post lies somewhere, far below, and no one may get to see it unless someone takes the trouble to search it out. So, I thought, I will give a link here so that people will see it. It is about Climate Change, the impending energy crisis and what we should probably do. The post is here. Please do read and comment.

Slumdogs and Millionaires

Interesting story in The Age, an Australian newspaper (thanks to my friend Sundar for sending me the link):Who'd want to be a (Slumdog) Millionaire? It seems the producers have become millionaires with the film succeeding both in the box office and the Oscar nominations. But two of the main actors, Rubina and Azharuddin, who were paid very little for their efforts (that lasted one year) are back to their poor squalid surroundings and struggling to live and study. Rubina was, apparently, paid $ 1060 (something like Rs. 50,000) and Azharuddin $ 3600 (about Rs. 1,76,000) for one year's work.

"The child actors' parents have accused the hit film's producers of exploiting the eight-year-olds, disclosing that both face uncertain futures in one of Mumbai's most squalid slums." says the report.

Is it fair to expect someone taking a movie to help the people in his story financially? I don't know. But I know one thing. When the producer makes such a movie, it is only fair that (s)he pays his/her workers properly, whether they are established actors or children from a slum. Is Rs. 50,000 good enough for a year's work? I don't think so, but I am sure there are people who are paid less in the country. But I don't think that justifies a low pay either. In any case, I think it is really low for a child who did a role in a film, and that too working for one year. Is what Azharuddin got low? Well, to be frank, I don't know.

But the point is not simply that of paying a worker. It is also a moral question of making use of the pitiable state of some people to make money abroad and then leaving them in their misery. Just today I was told that the people who made the Tamil film Thannir Thannir, the story of a village that thirsts for water, left the people to their fate after making the movie. I can already hear people ask, "Then what should a film maker do? His job is to make movies. And, in any case, the movie helped to bring attention to the plight of the people, did it not? What more do you expect?"

True. But why did these people decide to take a movie on the plight of the poor? Was it out of empathy? Did they hope to find some solution to the problems these people are facing by letting others know about it? Or, did they think that this theme would sell well? In the former case, it is empathy that drives the decision. Therefore, one would expect empathetic behaviour from them -- at least use some of the money the film makes to help these people. In the latter case, it is only fair that the people who contributed to the film share some of the economic benefits. So, I think, in either case, there is nothing wrong in expecting some contribution from the film makers to alleviate the misery of the people whose story they are telling. But we didn't see that happening in either of the two cases mentioned above. At the same time, someone just mentioned to me this evening that all profits from the movie are earmarked for charity by its producer Anil Kapoor. I don't know how far it is true. But if it is, and he keeps his word, I withdraw all the above comments and apologise.

PS: Today's newspaper carried a report that said that the profits from the movie have been earmarked for development of the Mumbai slum that featured in the movie. If this is true, and they do indeed put money from the movie into the slums, then I sincerely apologise and withdraw my criticism. (Added on February 1, 2009)

Mere Desh Ki Dharti

"Mumbai-based filmmaker Sumit Khanna first embarked on the pesticides trail when he noticed the absence of the common sparrow from the green fields of Punjab. "Why is it, I thought to myself, that the sparrows have stopped making the fields their home despite the apparent presence of food? And then I discovered that the crop is so heavily sprayed with pesticide that no bird or beast can hope to survive in the fields," says Khanna. This process of discovery took the route of a 58-minute documentary film, financed by the Public Service Broadcasting Trust (PSBT). To add a touch of irony, Khanna titled his film Mere Desh Ki Dharti, a popular song from a Hindi film that pays tribute to the abundance of food, water and happiness in India." This is a quote from an article in Infochange

I am reminded of very similar ideas expressed in a book that ultimately turned out to be one of the pioneering books on the environmental movement. It was written by Rachel Carson and was called Silent Spring. She starts with the concern about birds disappearing, and along with them, bird songs. And she goes on to show, in chapter after disgusting chapter, how technology in the form of chemicals that kill insects has destroyed bird populations. How nature has been silenced. How humans took 'control' of nature and came pretty close to destroying themselves.

Have we not learnt any lesson from all the heart-breaking episodes that Ms. Rachel described almost a half century ago? Do we have to replay all those absurd scenes again? Do we have to repeat all the mistakes that the West made? Are we always going to be followers of the so-called "developed" world? Why are we afraid of following our own path of progress? I admit that the 'West', or the 'North' as some prefer to say, has succeeded in brainwashing us into believing that theirs is the only way to achieving "development". This is a word I dislike using in this context, since it signifies growth, and I believe that growth is not the way to go forward. Continuous growth signifies infinite resources, since growth generally is taken to mean increasing consumption of resources. So I prefer the word "progress", which really does not imply growth (as in "progress along our way", for example).

Even if there is no destination, which seems to be clear, let us look for progress on our path, than for growth and development. Let us look for more equitable sharing of resources, less conflicts within society, less contradictions with nature. Let us think more of co-operation that competition. Let us forget about efficiency and think more about equity, for instance. Yes, that should be our path, and we could, perhaps, progress continuously along this path without creating trouble for other species. We are quite suited to set an example for the world in this matter, due to our unique history and philosophy of 'live and let live'. So let us lead the world rather than follow others.

Thoughts about New Year

Today is supposed to be New Year day. I looked around in the morning to see what was new about the day. I found the day to be very similar to yesterday. It was rather cool outside my house, the same as yesterday. I heard the same kind of bird songs. The same plants and trees stood in the same places, fortunately. The house also looked the same. The newspapers for the day were lying in the courtyard. And I read about people killed in accidents, about people murdered by individuals or state machinery, about people who committed suicide, about poverty, about joblessness and about political manipulations. And my house maid did not turn up, just as yesterday. So what is new? What was the big celebration people indulged in yesterday about? I hope you understand my doubt.

If I had a paper calendar, I would have had to replace it with a new one. Since I didn't have, well, it was just like any other day. Just that, hence forth, I would have to write 2009, instead of 2008, when I want to write the date on a cheque leaf, for instance. Well, but this kind of thing happens often, every day, in fact. Because every day the date changes. Once in a while the month also changes. So, of course, it is only fair that once in a longer while, the year also changes. This happens to be how we record the passage of time. Yes, sometimes we also need to write the time somewhere -- for instance, in a gate pass when we enter some institutions. Why fireworks and drunken displays when the date changes from December 31 to January 1?

In Kerala, India, where I stay, the year does not start on January 1. It starts on Chingam 1, where Chingam is the first day of the local calendar. But that is not celebrated. In many parts of the country, New Year is celebrated on April 14, the day when the Sun, the provider of all wealth, reaches the first point of Aries. In Kerala we have the traditional Onam festival some time in August or September. This is considered as a harvest festival. This was the time when paddy was harvested and people got their basic food grain. This was the time when the heavy rains from the South West monsoon ended and made life easier for the people. This would naturally have been a gime to celebrate. April 14th is also celebrated in Kerala as Vishu (interestingly, there is a similar celebration, Bihu, in the northeastern state, Asom, on the same day). But this is a short, one-day celebration. Interestingly, Vishu is also considered as a harvest festival. What I am trying to say is that such celebrations have always been associated with something good that happens at that time. But what about January 1? I am not able to find anything special about that date, in Kerala, India or anywhere else. In fact, in much of the northern hemisphere, which has most of the inhabited land, the temperate regions will be in the middle of winter and very cold.

Come to think of it, almost any day must be a new year's day in some part of the world. Even within India itself people follow different calendars in different parts of the country. And each one of them must have some history related to that region, and, therefore, related to the geography of the region. And, therefore, there could be reasons for celebration at that point of time. But what relevance does January 1 have for people in Kerala? Apart from the fact that many employees of government and private organisations get their salary that day? Aren't we aping the West again here?

Let me make one thing clear. I am not against using a common calendar all over the world. It does make things easier for a lot of people (though computers and the Internet should be able to handle the problem of multiple calendars easily). And New Year's eve has become an occasion for people to get drunk and drive madly. It is good that the police has put an end to the latter this year, but this was not always the case. What a waste of energy both human and fossil fuel! And what a meaningless and vulgar adoption of culture from the West.

Hospitals or Hell?

This is the title of an article on mental hospitals that I wrote along with my friend Sundar. The article finally got published in Counter Currents. I am happy that something finally has appeared in the media, but sad that this did not happen earlier. A more elaborate article by both of us on mental patients and their pitiable condition in India is pending with Frontline for quite some time, though they have agreed to publish it. A slightly longer version of the current one was not accepted by another web magazine because they felt a study on a specific hospital was more appropriate. I am happy that this has finally appeared and hope that someone will take notice of the matter. And, maybe, do something about it. In any case, I urge you to read it and talk about the issue. Thank you.

The link to the article once again: http://www.countercurrents.org/sasikumar011208.htm

Climate Change, Energy Crisis and Development

The Intergovernmental Panel on Climate Change (IPCC) says that climate change is real, that human beings are causing it and that we seem to be heading for a real bad time. Global mean temperature and temperature at specific locations could go up by a few degrees by the end of this century and the mean sea level could rise by several centimetres as a result of polar ice melting and water expanding with increase in temperature. The global warming could lead to reduction in total rainfall, while, at the same time, increse in severity of rainfall events and drought. All this could result in reduction in food productivity especially in the tropics (while productivity could increase in the temperate regions for temperature increases up to 3 degrees but would reduce for higher temperatures), increased sea erosion and loss of land to the ocean, and various other problems. The main cause for all this is the increasing concentration of carbon dioxide and other so-called greenhouse gases in the atmosphere. This, in turn, is a result of the large-scale consumption of fossil fuels on the one hand and deforestation on the other.

There is a group of people who still believe that all this is humbug, that the changes we see in the atmosphere are simply normal changes. They, therefore, argue that there is no reason for us to change our life styles. Unfortunately, the United States has accepted this argument and refused to ratify the Kyoto protocol that aims at reducing the emission of carbon dioxide and other greenhouse gases, mainly by developed countries. A major mistake such people are making is that, if they, by some chance, happen to be wrong and IPCC happens to be correct, entire humanity could be severly affected, if not wiped out. That is, of course, assuming that they are sincere to themselves. If global warming continues, it could possibly even lead to a major catastrophe that could even wipe out life on this planet. We could hardly do anything beyond a point. As of now, it is the poor nations and islands who suffer most, and, of course, the poor in the developed countries.

Fortunately or unfortunately, this is happening at the same point in time when petroleum is runnign out. In a way, this is good, because that would certainly put a halt to our consumption of petroleum and tend to reduce the production of carbon dioxide. But in a way it is bad because we will have to face two crises at the same time. While, on the one hand, we could be faced with changes in the distribution of diseases and the availability of food grains in some regions, we will also have to tackle the problem of fuel for transportation. This is complicated by the problem that real figures on petroleum availability are not available because observers believe that the figures given out by the oil producing countries are not reliable.

Let me also point to a third potential crisis that may be approaching. And this is the loss of traditional knowledge. A lot of knowledge that could probably have helped us face some of the problems that could arise in the near future, as discussed above, is being lost because they are not properly documented and because they have been replaced by new knowledge from the West that is considered "superior".

There is no need to emphasise the role of the West in creating the atmosphere for causing these problems and the role they have to play in solving them too. We should ralise that the problem of global warming and climate change has its roots in the Industrial Revolution, when human power was replaced by machine power, which, in turn, required power from coal and then petroleum and electricity. All this did, certainly, lead to an improvement in human living conditions. But we should not forget to also see the misery that it created. Admittedly, much of that misery has disappeared from the developed world, and, maybe, given enough time, it would disappear from the developing world too. But we are running out of time. More importantly, we have lost many of the skills that we had before. We have come to a high energy economy and it would be really tough to go back to a low energy economy. Humanity is simply consuming much more than its fair share of resources. And, in the process, we have destroyed much of the flora and fauna that we had.

India and China have a big role to play in both mitigating the crises and in protecting the traditional knowledge. These are two countries that have the largest populations in the world and also are wealthy in terms of traditional knowledge. And this traditional knowledge is disappearing fast. And, while it may be possible to regenerate the lost flora and fauna, though extremely improbable, it may take eons to recreate lost knowledge. We have to admit that we have behaved badly with our Mother Earth.

The way I see it, the greatest tragedy is that we have not learned a lesson. We are still trying to find technological solutions to the problems we have created in nature. We are still trying to find alternate sources of energy. We fail to see that no one expected any problem when humanity started using petroleum as a source of energy. It became a problem when the use of petroleum became widespread. When millions of automobiles started running on petroleum. Are we sure that the alternate sources of energy that we are looking for also will not create such problems when they become ubiquitous? Do we know what problems await us when millions of square metres of solar cells are manufactured and deployed? Or when millions of windmills are deployed all over the world? Or when thousands of nuclear reactors are built and they start producing spent fuel?

I feel that humanity has got into a trap -- the trap of over-ambition and over-confidence. The consequences of the actions of my generation, and of the previous couple of generations, are going to be borne by my children and theirs. And this is certainly not a comforting thought.

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.

Dressing Up and Down: The Answers

So very few people seem to be interested in the question why we dress up. Is it that they do not realise the importance of dressing up? Is it that they do not realise to what extent we are influenced by the way others dress up? In any case, at least one person has responded, and now it is my turn to give a detailed reply.

It appears that humans must have started wearing clothes some 40,000 years ago. If we can believe modern studies in palaeontology and palaeo-anthropology and related branches of science, we have to believe that the entire population of homo sapiens sapiens on the earth today are descendants of one short female, named Lucy, an Australopithicus afarensis--a species that lived in Ethiopia some 2.5 to 4 million years back (see, for instance, http://www.wsu.edu/gened/learn-modules/top_longfor/timeline/afarensis/afarensis-a.html or Wikipedia)). Lucy would certainly have not known that her descendants would migrate to all parts of the world and virtually exterminate all other species. If she had known, perhaps, she would have committed suicide before she gave birth to any child.

But her children and grand children and great grand children and so on were born, and did grow up and have their own offsprings and did migrate to all parts of the world. Including much warmer and colder places. And they evolved. At some point, at least some branches of the family, started shedding their fur. This could have been in response to a warmer climate or, as some experts in body lice tend to believe, in response to body lice! Ugh!? "Dr. David L. Reed, a louse expert at the University of Utah, said the idea that humans might have lost their body hair as a defense against parasites was a ''fascinating concept.'' Body lice spread three diseases -- typhus, relapsing fever and trench fever -- and have killed millions of people in time of war, he said." (see this article from New York Times). Anyway, at some point in time, humans or proto-humans started losing their body hair. Maybe this also led to people getting a darker skin. But that is beside the point. Our question is about clothes. So how did this induce humans to wear clothes?

We know that human beings, before or after homo sapiens sapiens evolved, migrated to the extremes of the Earth. And they would certainly have faced extreme cold climates. And they would also have met animals that have thick coats of fur. Look at the polar bears, for instance. And look at the Eskimos who live in such conditions. Humans must have'borrowed' the clothes from the local residents. Just as they do today also.

That seems reasonable. But when did homo sapiens start wearing clothes? One idea is that this is approximately the time body lice started appearing on human body. Though this appears far-fetched, it may sound reasonable to a scientific mind. After humans lost their fur, the only place lice could have comfortably curled up on humans is on clothes. At least, that is how one argument goes (see, for instance, this ezine article). So, it seems, lice caused humans to loose their fur and it also helps us understand when we started wearing clothes. Great, uh?

But then, how does one find out when the lice appeared on the human body? Simple. Just take a modern day louse and ask it. ;-) No, not joking. I did not mean, ask it in so many words. There is another way os asking. And that is to do a kind of DNA analysis that would tell you something about the species. Of course, I hope you know that the human body lice is a species by itself. As the article cited above says, someone actually went to the trouble of asking this question and the lice gave the answer as 107,000 years. Fine. But not so fine. Someone asked the same question to other members of the lice society and they gave a different answer: 540,000 years. This is the problem with asking questions to individuals. Each guy will have his version of the events.

The article cited is rather recent (2008), but there seems to be an earlier report, from 2003, that gives a date like 40,000 years before present (see this abc article). And some recent results from anthropological studies seem to show that humans started wearing shoes some 40,000 years ago (see Softpedia or Livescience). This was deduced from the shape of the toes! What these guys will find out, god only knows!

So, it seems reasonable to believe that people started wearing clothes some 40,000 to 100,000 years ago to protect their body from extremes of weather. It possibly even prevented them from getting soaking wet in rains because in the initial days clothes must have been made from animal skin.

But look at what clothes have become today! They have become a form of self-expression, a means of projecting an image that one wants to be seen, a means of subjugating others, and so on. Apparently everything other than the purpose it was originally meant for!

Dressing up and down

There are a number of things that we simply take for granted and never think about. For instance, when we dress to go to work, we normally follow a pattern, a certain kind of dress, maybe we have selected items of our attire that are kept for the purpose. We dress differently when we go for, say, a wedding. It will be different for, say, an outing. We do take a lot of care about our dress, even if we are not generally very careful about dressing up by the standards of our society. I wonder how many people have thought about the need for being so choosy about our dress. Have you?

What I am going to ask here may shock you. So be prepared. Keep your thoughts about conformity, norms, social customs and so on far away from your mind. Done? Ready? Here goes:

Why do people wear clothes? ..... I mean, why do we at all wear clothes? Did your face change colours? Yellow, red blue ... ? Now you know what I meant. Hope the explosions are over. If so, just think of an answer.

Of course, the standard answer is there: How can we move about in society without clothes? That is preposterous, indecent, unlawful, atrocious, shameful, ... blah blah. Well, I am not interested in these answers. If all other animals in this world could get along pretty well without clothes, why should we, humans, homo sapien sapiens, have to wear clothes? Why do we have to hide our bodies from others?

Now, think of the consequences of wearing clothes. Clothes are used to project an image of oneself on others--an image that is not truly that of oneself. Think of how a rather ordinary looking girl/woman can make herself appear like a real beauty with the help of very pretty clothes (and, of course, makeup). Think of how a person can look imposing with the proper kind of clothes, and how some professors (very knowledgeable person, quite possibly) look like tramps because they do not care to take care of their clothes. And so on, and so on. Just think of how often clothes deceive us.

Think of how it might have been helpful if we were not wearing clothes. For example, someone would notice that there is an unusual discolouration behind one's neck, and the person would be able to meet a doctor before the discolouration developed into something bad. Some of us would also get rid of allergic reaction to synthetic fibres. Or escape the consequences of sweat remaining for a long time at some places. With all those disadvantages, we still wear clothes. Why?

Does anyone have any answers? Let me see. I will wait for some time and see what responses I get. Then I will give my reasons. Scientific reasons, believe me.

Ignorance of Science

Perhaps because I had always been interested in science, and was a researcher till recently, I find it astonishing that many apparently well educated people have a lot of misunderstanding about natural phenomena that have been more or less understood by science. Interestingly, some of these things are taught at school level, and some at college level. Somehow, they don't seem to realise that these facts that they studied are really related to the world around us.

I remember a classmate in M.Sc. whom I met again after about three years or so. Learning that I was doing research in atmospheric physics, he asked me a question about the atmosphere (something like why the sky is blue). I told him that he should know because we had studied this in our M.Sc. class. After listening to my answer, he gazed at the sky for a few seconds and said, "Oh, so all that is real?" I was shocked to say the least. Apparently, many students think that what is taught is just for the examination. I hope things have improved now.

I have had the experience several times, while speaking to school students, that they say that thunder and lightning are caused by two clouds colliding. Some of them have even told me that their teachers told them this. Of course, a couple of school teachers too have told me this. In these situations, I have asked them about their concept of a cloud, and also how they think that there can be two winds from opposite directions that cause the clouds to collide. These have generally led to doubts in their minds.

Now let me explain briefly, for those who do not know, what we believe causes lightning and thunder. There is a type of cloud that stretches from close to the ground up to what is called the tropopause of the atmosphere. (The tropopause is at a height of about 18 km at the tropics and comes down to about 6 km at the poles.) This type of cloud is called cumulonimbus by meteorologists and is popularly known as thunderstorm. Because of its nature, it has strong circulation inside and is therefore avoided even by large aircraft. Since temperature decreases as one goes up, ice crystals exist in these clouds above some height. Though the process is not exactly understood, these ice crystals help to generate electric charges inside the cloud. The top of the cloud is generally positively charged and the bottom negatively charged. As the charge builds up, the voltage increases and eventually it becomes possible for the charge to flow and neutralise. This can happen either from the bottom of the cloud to the ground, between charge centres within the cloud or, if two clouds happen to form close together, from one cloud to the other. This is just like an electric spark that forms when the positive and negative terminals of a battery accidentally get short-circuited or power lines sometimes come close together in strong winds. Thus, a lightning discharge is a huge electric spark and thunder is a huge crackle that is produced in an electric discharge. As electric current passes through air, it heats the air suddenly. This leads to the sudden expansion of the air, which creates a wave that we call thunder.

Recently, I met a well-educated elderly person, with degree in science, and employed in a senior position. He told me that he had always been wondering about how clouds can cause such a huge sound and recently found the explanation in a general knowledge book. He told me that the sound is caused when two clouds collide because there are millions of ice crystals in them. I told him what I know but I am not sure that he was convinced. But then he came out with an astonishing observation. He said that if we go to some height, there is no gravitation, and therefore we can float in the air! He had apparently seen visuals of skydiving and thought that the people were actually floating! Again, I tried to tell him that they were not floating but were actually falling. But again, I am not sure he believed me. He asked whether it is not true that there is no gravitation on the Moon. He had seen people leaping over long distances on the Moon in Apollo videos. I tried to tell him that the gravitational force on the Moon was one sixth that on the Earth, but again I doubt that he believed me.

It is unfortunate that our education system fails to convey scientific facts to the students. This makes people easy targets of charlatans who make a living out of cheating such gullible people.

The Ten Commandments of Mathematics

While I was rearranging my books and papers, I happened to come across this sheet of paper with the Ten Commandments of Mathematics written down. I thought this may interest others too. So here they are:

1. Thou shalt not divide by zero;

2. Thou shalt not multiply any inequality by zero;

3. Thou shalt not mix up different values of a multiple valued function;

4. Thou shalt not invert the order of operations unless inversion is valid;

5. Thou shalt not proceed to determine a quantity unless thou hast established its existence;

6. Thou shalt not generalise from particular cases;

7. Thou shalt not employ divergent series and divergent integrals;

8. Thou shalt not believe by seeing;

9. Thou shalt not depend on intuition alone; and

10. Thou shalt not mix-up the two-way implication and the two one-way implications.

Hope you find these useful!

The Plight of Mental Patients in India

We call a mentally ill person "mad" and throw him/her into an "asylum", and then forget about the person. I don't mean that everyone does that, but a lot of families do that. We think that mental illness is something very different from physical illnesses, something that is probably caused by some "spirits", something incurable. And many people find this a way of eliminating a claimant for property. And some even find this an easy way to get rid of an unwanted spouse. Remember the case of Anjana Mishra, who was put in a mental hospital without even her knowledge, apparently to get rid of her. Fortunately, she found her way out, but how many other women might not have been so fortunate? Remember Ervadi where several mental patients charred to death because they were chained to their beds? We and our hospitals often tend to treat mental patients as though they were not human. This has to stop.

Some time back, when the daughter of a mental patient went to meet her mother in the hospital (Pavlov Mental Hospital, Kolkata) along with a doctor of the hospital, they found all the women in the ward totally nude, as I have explained in an earlier post. Recently, in another hospital, when a patient asked for some more curry, she got a rap on her wrist instead. (Remember Oliver Twist?) These are really nothing compared to what Anjana has written about her stay in the hospital (see the magazine Manushi, issue no. 120). Just a short quote: "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." Hospitals give Electro Convulsive Therapy (ECT), what we call "shock treatment" without following the norms laid down for it. ECT is supposed to be given only under anesthesia, but then, many hospitals have no anesthetist. ECT is sometimes used as a punishment for not obeying instructios. In most developed countries, ECT is banned. Even the so-called modified ECT is not used in most of Europe and America. Because adverse effects of ECT are reported. There are doctors who admit people without even seeing them, for a consideration. Some time back Tehelka exposed one such doctor. In short, while the condition of mental patients is very bad inside or outside a mental hospital, clever people use these hospitals to get rid of people they don't want.

On the other hand, the social stigma of mental health is so strong, families refuse to accept even relatives who have been cured. Once out of the hospital, former mental patients have often nowhere to go. In most of the cases, they cannot get back to their former jobs, and they cannot find a new job either. Their only recourse most of the time is to go back to the hospital and live the rest of their lives there.

All mental hospitals are overcrowded. The budgetary allocation for mental health is much lower than the need. It is a small fraction of the health budget, but mental patients form a significant fraction of all patients. Many hospitals in the country have no nurses. Sometimes, the hospital Superintendent is not even a psychiatrist.

All this is a big tragedy, and all this has to change. But who will take the initiative? Political parties cannot be interested because mental patients cannot vote, anyway. The hospital staff, doctors, nurses and others, are not interested because the present set up is good for them. The public does not get to know about the issues because hospitals are out of bounds for the ordinary public. But there has to be a change, and the earlier the better. This is a blot on our country, our civilization.

The Story of Stuff

Where do all the stuff we use come from? What happens when we throw them away? For an interesting insight into these questions, take a look at www.storyofstuff.com. Though the story is meant for the US, I think it would be good for every human being to see it, and be sure to watch the entire show. It taught me a couple of things that I never knew. You, too, may gain something. So do not miss it!

Sanal Edamaruku refuses to be killed!

Sanal Edamaruku challenged a senior tantrik, Surinder Sharma, to kill hum using tantra. The encounter was telecast on India TV and the video is now available on YouTube. Be sure to watch all the three parts and spread the word. The tantrik tried four times, every time promising that his victim will feel pain and lose consciousness and finally die. However, Sanal refused to oblige and was finally seen laughing. Interestingly, the tantrik was seen pressing Sanal's forehead, doing something with his hands, moving his head around, and so on. If the tantrik needs physical access to the person, then, I guess, the easiest way is to poke a sharp knife (which the tantrik was seen brandishing at one time) into his heart! Congratulations to Sanal for this feat! I am pretty sure there would be people who would explain this off. They are sure to have excuses. The presence of the camera disturbed the tantrik, Sanal was protected by his god (an excuse the tantrik himself gave, to which Sanal said that he did not believe in any god!), the tantrik was not given sufficient peace to be able to concentrate, and so on. I am sure there would be many to believe these excuses, too.

Every few days or so, we see news about some tantrik killing or injuring someone in the name of revenge or treasure. It is pitiable that in this age we still have in India people who blindly believe such things. Recently, a woman was tied up and beaten on the excuse that she is a witch! All this is due to the failure of our economic and educational system. People resort to such things, I guess, mainly due to a sense of insecurity aided by ignorance. Can we hope that this episode will bring some relief from such exploitation? I wonder.

Incidentally, Sanal is the son of Joseph Edamaruku, who was a leading rationalist in Kerala. Joseph, I think, was the person behind the Rationalist Association and the magazine Yuktivadi.

Female Mental Patients kept Naked

Female patients at the government-owned Pavlov Mental Hospital in Kolkata were found to be kept naked. This was found out when the daughter of a patient was taken to the ward to see her mother. The excuse given was that the clothes had gone for wash!! This is shocking, by itself. But what I found really shocking is something else. When the patient's doctor, who took the patient's daughter to see her mother, reacted to the treatment meted out to the patients, the employees there protested and started an agitation against the doctor!! The doctor refused to apologise. Peace returned only after the Superintendent apologised on behalf of the doctor! Apparently, the nurses thought that keeping the patients naked was not a big issue!!!

I am not going to discuss what happened. Information is available from several websites such as The Hindu, the Telegraph, FRIDA and so on. But I would like to look at the reasons why such things (which are not all that uncommon) happen.

When something like this becomes known, what the government does usually is to order an enquiry (which has been done in this case too). However, no one seems to look into why such things happen. I think this is more important than understanding what happened. How can some employees leave some helpless women patients totally naked? In fact, how can hospital employees leave any patient naked? How can women employees feel that there is nothing wrong in this? How come people become so insensitive? What is happening to our society?

I have to give special emphasis to these questions since people go to hospitals because they have problems, not for a holiday (though, apparently, there are hospitals where the wealthy go for a holiday). And what they expect are solutions to their problems, not more problems. And answers to these questions are essential if we are to ensure that such things are not repeated.

I have a few possible answers, one or more of which could have some truth. The first is that the hospital does not have enough money or manpower for proper functioning. This is a possibility since this is the condition in many government institutions.

Another possible answer is that the employees are not given proper training to handle patients, real people with real problems (mental or physical). In the case of mental patients this is particularly important since they are unable to react or demand their rights. Their situation is worse than that of criminals in prisons. No one takes what they say seriously. Therefore, nurses and other staff in mental hospitals need to be trained especially to be sensitive and empathetic to the patients and not treat them like objects, like just names in the register, like numbers in a roll. Are they trained for that at the nursing schools or after recruitment? This has to be ensured by the government. Ill treating mental patients is not going to help bring cure, even if they are given medicines.

But a question may be asked whether people can be trained to be empathetic, to be sensitive. The question is very appropriate, since these qualities are often imbibed or cultivated over a number of years. And this leads to my third explanation: Is the recruitment process appropriate? Does it select people who can handle this kind of a job? It is heartening to see that a doctor protested the treatment to the patients. We sometimes (often?) see doctors behave without empathy to their patients, doctors who behave as though their patients are just like the cadavers they have operated upon in their medical school. I have heard of doctors who wait for their bakshish to reach them before fixing the surgery of cancer patients who are suffering, whose relatives are running from pillar to post to save their bread-winner. This happens because individuals who have no aptitude for service (after all, treatment is a service) become doctors due to various reasons. What the government should do is to ensure that the selection process weeds out such individuals. This may not be as easy as it sounds, but I feel that aptitude is not one of the considerations in recruiting people for jobs, especially such jobs.

Will the government of West Bengal consider these aspects in the enquiry they conduct? Or will the enquiry remain a fact-finding mission and some scapegoats be found to tide over the present problem? I hope they will not, though my mind tells me they will.