Sunday, July 3, 2022

Moving from Sick-care to Health-care

 (This article first appeared in The Toad, the magazine of the Students Association of CMC Vellore, published in June 2021)

Moving from Sick-care to Health-care

Pradeep Ninan

Let me begin with the story of three patients sitting in the OPD in Madhipura Christian Hospital, a mission hospital in rural Bihar.

In Room 1, we meet 50-year-old Rani (name changed) who has come for a postnatal check-up. This was her 6th pregnancy.

Pregnancy no 1 had resulted in a normal delivery at home. Girl child. Now 31 years old.

And so on. All normal deliveries at home. Resulting in three more daughters who were now 29, 27 and 25 years old respectively. She kept conceiving and delivering at home.

Until 22 years ago, when she had finally managed to give birth to a male child. Relieved and overjoyed, she had undergone a tubal ligation.

Sadly, the story did not end there. The son passed away in a road traffic accident 3 years ago.

And so, this elderly braveheart underwent hormonal treatment and fertility procedures to try and conceive again. She had finally conceived after IVF.



We watched as she came for every check-up on time, faithfully taking her pills and tetanus vaccinations, looking forward to welcome a new son, 31 years after her firstborn.

Things did not go as planned. Baby no 6, also delivered by a vaginal delivery, was A GIRL.

Pause here for a moment to think of the life ahead of this beautiful little baby, born as the fifth unwanted girl child in this family.....

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In Room 2, we meet Ramini (name changed), a 42-year-old lady, who has come for an antenatal check-up. Her obstetric score is G10 P9 L8 END1. Feeling the pressure of society to produce a male child, she has been doing her best. Unfortunately, this has resulted in 9 daughters. 8 of them are still alive, aged 16, 14, 12, 10, 8, 6, 4 and 2 years. The last daughter had died soon after birth. (Let us not speculate too hard on what might have caused this death!). Now she is pregnant again, and wants us to do a scan. We explain to her that we would not be willing to reveal the sex of the foetus. The scan shows that she is pregnant with TWINS.


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In Room 3, we meet little Rajkumari (name changed). She does not know how old she is, but looks possibly 14 or 15 years old. She is dressed in a sari, because she is already married. Her presenting complaint is…………Infertility! She has been brought for evaluation by her relatives, because she has not yet been able to conceive.



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The WHO defined Health in 1948 as “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

I like this definition, partly because it is so close to the Biblical idea of ‘Shalom’.

Cornelius Plantinga in his book Not the Way It’s supposed to be: A Breviary of Sin helps us understand what ‘Shalom’ means:

“The webbing together of God, humans and all creation in justice, fulfillment, and delight is what the Hebrew prophets call Shalom. We call it peace, but it means more than mere peace of mind or a cease fire between enemies. In the Bible, Shalom means universal flourishing, wholeness and delight- a rich state of affairs in which natural needs are satisfied, and natural gifts fully employed, a state of affairs that inspires joyful wonder as its Creator and Savior opens doors, and welcomes the creatures in whom He delights.

Shalom, in other words, is the way things ought to be.’

It is clear that the English word ‘Peace’ is an inadequate translation for the Hebrew word ‘Shalom’. Shalom is not merely ‘peace’, or the absence of conflict. Shalom is the presence of wholeness and abundant life, a truly ‘healthy’ existence, ‘a state of complete physical, mental, and social well-being’

As ‘health-care workers’, we have the opportunity to help people live ‘healthy’ lives. We need to see our role as not merely ‘sick-care’, or the alleviation of disease and suffering, but ‘health-care’: the creation of a world with ‘complete physical, mental and social well-being’. Jesus once said, “Blessed are the Shalom makers, they shall be called sons of God’. (Mt 5:9). This was a startling invitation, not merely to resolve conflicts between people, but to be co-creators, with God and each other, of a world full of Shalom, with ‘universal flourishing, wholeness and delight’. This Shalom is possible only as people come into a right relationship with God, with other human beings around them, and with the environment or world around them.

Let us zoom out from the three women in our OPD, and try to get a birds-eye view of the health situation in our country.

It seems apparent that even if these three women receive good treatment in our OPD, (and even, theoretically, if we were to help little Rajkumari conceive!!), it would be very difficult to think of them as healthy…..

Can we call their marriages healthy, when they are treated as baby-making machines, whose primary purpose seems to be to produce a male child? Do they enjoy a ‘healthy’ relationship with their husbands?

Can we call their families healthy, when girl children are not valued, killed either in the uterus or soon after birth and discriminated against throughout life?

Can we call their communities healthy when girls are not sent to school and women are treated so shabbily? Are communities healthy when Dalits are consigned to Dalit ‘tolas’ (a part of the village) far away from the non-Dalit ‘tolas’, when Dalits are not allowed to use the same well as the forward castes and Dalit women are forced to go the fields to defecate at 4am in the morning to avoid meeting others and to protect themselves from rape (which is considered routine and normal in many villages)? Are communities healthy when Dalit children are not allowed to sit in the same classroom as their non-Dalit peers, and Dalit men are killed for having the temerity to walk on non-Dalit roads?

Can we call society healthy when such gross inequities exist, between men and women, Dalit and forward caste, educated and uneducated, urban and rural, rich and poor?

Can we call our nation healthy when a Muslim man can be lynched on a train, on the ‘suspicion’ that he was carrying beef, and his body thrown from the train? Is our nation healthy when such deep divisions, biases and hatreds persist? Is India healthy when India's richest 1 per cent hold more than four-times the wealth held by the 953 million people who make up for the bottom 70 per cent of the country's population, while the total wealth of Indian billionaires is more than the full-year budget?(2017 data)

We live in a world that is desperately sick and in need of a Healer…….

It is in this context that we have the privilege to be health care workers and Shalom-creators.

Of course, we need to start with the individual, the woman patient sitting in front of us in the OPD, and give her the best and most compassionate and ethical curative care possible.

But as a community of ‘wounded healers’ (can any of us claim to be truly experiencing this life of perfect health and Shalom ourselves?!), we need to strategically think and work together for the health of families, communities, societies and nations, and create Shalom in the world around us. No single person or profession can do everything. There are many ‘non-medical’ people who are also a part of this community of ‘wounded healers’, Shalom-creators together with us. Each of us has a small, unique and vital part to play, and every contribution is invaluable. Together with ‘curative medicine’, we need to collectively develop ‘preventive medicine’ that seeks to prevent ‘un-health’ or ‘dis-ease’ from developing. But at the same time, crucially, we also need to develop ‘promotive medicine’ which is aimed at helping individuals, families, communities, societies and nations experience true Shalom….health, joy, wholeness, flourishing, and abundant life.

 

“Seek the Shalom of the city where I have placed you…., and pray to the LORD on its behalf,

For in its Shalom you will find your Shalom.” Jer 29:7

 

 

 

What a Wonderful World!

Friday, June 30, 2017

20 years of Harry Potter



20 years of Harry Potter! Many, many hours of reading and re-reading, discovering how every little detail and sub-plot ties together. Months of waiting for the Deathly Hallows to come out, and reading through the night to find out how it ends. Thanks, JK Rowling, for the magic! Waiting to share this with my children. ..

#HarryPotter20

Tuesday, June 27, 2017

We've had this happen in our home as well!



The children and I had a good laugh looking at this. Familiar territory. ...

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Will it be our turn next?

Traveling from Delhi to Hyderabad with my family in a sleeper compartment yesterday...my wife took out the lunch lovingly packed by her mother. ..pooris with palak and chicken keema.

Before we ate, however, I surreptitiously looked both ways, remembering the story of Junaid Ahmed, the 15 year old murdered in a train while travelling between Delhi and Mathura a few days ago. Would somebody similarly lynch us first on the suspicion that we were eating beef, and examine our lunch box later to find it was, in fact, chicken?

What sort of country have we become?

#notinmyname #atmosphereoffear

Please also read:
1. What Mahatma Gandhi Said to Those Who Wanted Beef Banned in India

Saturday, June 17, 2017

Weep for the Garden City of my youth...


Read the entire article here: The dying of gulmohars heralds Bangalore's demise – and is a sign of urban India's forbidding future

"For every Bangalorean, there is now 0.1 tree, or a tenth of a tree. There should be 10 times that number if the city has to absorb the growing volumes of carbon dioxide from the 1,600 vehicles registered every day. "Since wide roads are being felled of trees across the city for road widening, this implies that Bangalore’s street tree population is being selectively denuded of its largest trees," wrote Harini Nagendra, a professor at the Azim Premji University, in this 2010 study. In the years since Nagendra's study, more than 50,000 trees have been lost, with only a few of the old gulmohars standing.

The dying of the gulmohars is a metaphor for unfolding urban disrepair and disarray. Its last rites were announced in 2014 when the city's chief conservator of forests declared there was no place for the gulmohar, the rain tree and other avenue trees that gave Bangalore its now-dead moniker of India's garden city. “The large trees with deep roots damage sewage lines, boundary walls, sumps and not to talk of traffic blocks caused by fallen branches [sic]," Brijesh Kumar, the official guardian of trees, told The Times of India. "The roads get choked and traffic blocked."

Kumar was right, except that despite thousands of trees cut, the roads are more choked than ever. The trees fall because they are constricted, imbalanced when their roots are hacked, or their branches are cut when builders add (often illegal) floors or when setbacks – the space between buildings and walls – are ignored. I have seen gulmohars being cut down simply to add a parking space or to stop the birds from dirtying cars.

Gulmohars, like rain trees, colonise the ground and air above them, making them particularly irksome to a city that has given itself the freedom to do as it pleases with a particular vengeance since it took on the mantle of India's second-fastest growing city in the 1990s (Delhi is the fastest, but that city's core has retained much of its greenery)."

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Friday, June 2, 2017

Simple steps you and I can take to protect our environment....


Trump Pulls Out of Paris: How Much Carbon Will His Policies Add to the Air?
A detailed analysis shows how much more CO2 each of Trump’s climate policy changes would send into the atmosphere

While it is completely appropriate to feel outraged and saddened at the irresponsible actions of leaders who seem intent on taking the planet down with them, here are 10 things we ordinary citizens can do starting today:

1. Carry your own cloth bags and plastic packets when shopping on the street for vegetables as well as in big stores. Stop consuming and discarding more plastic packets.

2. Avoid buying anything plastic that has a biodegradable or reusable equivalent, even though this might seem more expensive in the short term. For example, avoid buying plastic toys for your children, plastic storage jars for your kitchen, plastic racks and shelves and brooms and so on.

3. Go through your home and give away what you have not used or worn in the past 1 year. There are many people who need these more than you.

4. Please don't buy more stuff to replace what you have given away! It might lie unused and unworn on your shelves for 6 months later.

5. Stop using plastic plates and glasses for parties and get togethers. Either ask all those attending to bring their own plates and glasses from their homes, (most educated people would be quite happy to do this) or buy biodegradable or reusable equivalents.

6. Stop throwing your plastics out on the roads, from your homes or out of the car, and from train windows to litter our beautiful countryside, clog our drains and waterbodies, and lie unchanged without decomposing for the next few centuries. Collect this and deposit it in dustbins to be discarded properly.

7. Carpool and use public transport whenever possible.

8. Turn off the lights and put off the ACs and fans when nobody needs them.

9. Grow your own vegetables and flowering plants. On your terraces, balconies, corridors, and every free bit of land. And plant trees wherever you go.

10. Compost your garden and kitchen waste. Add value to the earth for all that you have taken from it.
Let's do the best that we can for the sake of those who will inherit what we leave behind. "You in your small corner and I in mine".



Monday, May 29, 2017

What Mahatma Gandhi Said to Those Who Wanted Beef Banned in India

"Rajendra Babu tells me that he has received some 50,000 postcards, between 25,000 and 30,000 letters and many thousands of telegrams demanding a ban on cow-slaughter. I spoke to you about this before. Why this flood of telegrams and letters? They have had no effect.


I have another telegram which says that a friend has started a fast for this cause. In India no law can be made to ban cow-slaughter. I do not doubt that Hindus are forbidden the slaughter of cows. I have been long pledged to serve the cow but how can my religion also be the religion of the rest of the Indians? It will mean coercion against those Indians who are not Hindus.

We have been shouting from the house-tops that there will be no coercion in the matter of religion. We have been reciting verses from the Koran at the prayer. But if anyone were to force me to recite these verses I would not like it. How can I force anyone not to slaughter cows unless he is himself so disposed? It is not as if there were only Hindus in the Indian Union. There are Muslims, Parsis, Christians and other religious groups here.

The assumption of the Hindus that India now has become the land of the Hindus is erroneous. India belongs to all who live here. If we stop cow slaughter by law here and the very reverse happens in Pakistan, what will be the result? Supposing they say Hindus would not be allowed to visit temples because it was against Shariat to worship idols? I see God even in a stone but how do I harm others by this belief? If therefore I am stopped from visiting temples I would still visit them. I shall therefore suggest that these telegrams and letters should cease. It is not proper to waste money on them."

Read the rest of this article here

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