Tuesday, July 11, 2017

The Caste System follows Privileged, High-caste Indians everywhere.....

What a shame! Why are a small proportion of Indians, the high-caste minority, who daily enjoy the benefits of centuries of Privilege, determined to keep the caste system going, instead of tearing it down completely, and treating all human beings as created equal?

Read the article: Hindu Groups in UK Hit Back at British Government’s Plans to Ban Caste-Based Discrimination

"London: Caste is rearing its ugly head again, this time in an unlikely place – the United Kingdom. Under pressure from rights groups and sections of civil society, the Theresa May government has moved to take its first steps towards banning caste-based discrimination in the public sphere. It has called for public opinions on whether caste discrimination will be best tackled by a ban on it through a new law or not, a consultation which will end on September 18, after which the government will take a final call.

However, the backlash from Hindu organisations, several of them close to the Sangh parivar, has been swift. They are livid at the government’s move and have threatened to derail it with all their might. This has now made the May government’s resolve in banning caste-based discrimination wobbly – it doesn’t want to appear to be taking on these vocal groups.

In fact, from at one time promising to ban caste discrimination in 2013, the May government has made an about-turn already, by now inviting public opinion on whether such a ban is even required. The government’s reluctance in biting the bullet on caste discrimination is now being seen as the surest sign of the ascent of the Hindu Right in the UK, a rise propelled by the financial clout of its British Hindu supporters and the tacit support of the Hindu Swayamsevak Sangh, the overseas wing of the Rashtriya Swayamsevak Sangh, the far-right ideological parent of Modi’s BJP."

Read the rest here.

If this upsets you, please also read:
1. Untouchability in the 21st Century

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. ..


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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1. There's a time to parent like a dog, and a time to parent like a cat.....

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)."

If this article saddens you, you might like:
1. Simple steps you and I can take to protect our environment....

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

You might also like:
1. "To kill, to terrorise, to dominate, to create a pure and ideal kingdom."

Sunday, May 28, 2017

How a child is born

Photographer Lennart Nilsson spent 10 years of his life recording the growth of the human embryo, from conception to birth.

Have a look at these photos here

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1. Image bearers
2. Open Letter to M: Why abortion cannot be a matter of personal choice

Thursday, May 25, 2017

Untouchability in the 21st Century

It's not easy to shake off caste-ist ideas of untouchability when one has spent one's entire life under that worldview....

Witness the way these 2 BJP leaders responded to an unusual situation: (a Facebook post by Mohan Guruswamy)

There is something true to form about these RSS/BJP netas. First Yeddyurappa makes a much publicised visit to a dalit home for a meal, but the food is bought from a hotel and he primly eats it with a spoon off a socially neutral banana leaf.

Now our friend, the encounter Shah of Gujarat, visits a dalit family in Peretapalli in Nalgonda district for a dalit home meal with a troop of media persons to record this one time event it for posterity. But once again the food was prepared in the mango orchard of a upper caste landlord Manohar Reddy in the neighbouring Khammagudem village. The local dalit leader Chinta Sambamurthy stood by the table and watched while Amit Shah ate. This is a reversal of Modi's Na Khaunga, Na Khilaunga.

For the following day's dalit home lunch in Bhongir, the food was purchased from the Pedda Devulapalli Annapurna Mess. As the name suggests it is a upper caste eatery.
Amit Shah at a Dalit home in Nalgonda (via)

It's painful that this is still happening in 21st century India.....

Wednesday, May 24, 2017

Catastrophic maternal healthcare expenses push 46.6% mothers in India into poverty

Some time ago, I wrote about how I was first introduced to the idea that even small amounts of out-of-pocket spending, required to pay medical bills, can push families below the poverty line.

I was, therefore, not surprised (though terribly disheartened) to find that a large study has confirmed, and quantified, this problem.

"Catastrophic maternal healthcare expenses push 46.6% mothers in India into poverty–with the illiterate being especially susceptible–according to this December 2016 study by researchers from Jawaharlal Nehru University and Indian Institute of Technology, Roorkee. The expenses include childbirth, antenatal care and postnatal care expenses."

Pregnancy and poverty....

Read the rest of this article here

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1. Three Knocks on my door
2. More Knocks

Tuesday, May 23, 2017

Selection biases in NEET

This is my deepest worry about the proposed National Eligibility cum Entrance Test for admission to medical colleges..

"NEET plans to not only destroy the dream of poor, rural, non-Hindi mother tongue medium students (that is, a plurality of all students) of becoming a doctor , but also wants to create a cadre of doctors who want urban and foreign careers, with lesser ties to soil and the realities of rural areas, which is where the majority live.

Most states already find it hard to get qualified doctors for rural postings. An urban rich bias will destroy the system irreparably. The only beneficiaries of this regressive move will be private nursing homes, big healthcare chains and of course, the US. Medical colleges of the Indian Union will serve as supply factories for these entities, to an even greater extent than at present."

Is NEET going to create many more problems than solutions?

Read the rest of this article India's healthcare system will suffer because of NEET's bias towards the CBSE syllabus

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1. Is NEET the way to select potential medical students?

Sunday, May 21, 2017

"To kill, to terrorise, to dominate, to create a pure and ideal kingdom."

7 Muslim cattle-traders were lynched in Jharkhand by a mob who, on the basis of Whatsapp rumour forwarded to them, assumed they were child kidnappers.

This is heartbreaking, but only the latest in a long and regular stream of tragedies unfolding all over the country.

This author in Jharkhand fears that this incident is not connected to the other incidents of lynchings by gau-rakshaks to enforce a ban on cow-slaughter.

Moments before he was lynched on the mere suspicion of being a kidnapper

"The practice of mobs lynching people for possessing or consuming beef will be unlikely to become commonplace in Jharkhand, in my opinion, because the state, due to its remarkable Adivasi population, has traditionally been known to be a consumer of beef, pork, and whatever else might be considered taboo or inedible by the majority – for example, monitor lizards. Hence, what new story could be cooked up to create a situation of fear and distrust? What is most dear to people? Their children. Accuse some people of being kidnappers of children and have them lynched. In this age, when social media has become a carrier of hatred, is it that difficult to get anyone lynched? Be it beef or the abduction of little children, everything is just a pretext, an excuse. The purpose is to kill, to terrorise, to dominate, to create a pure and ideal kingdom."

Read the rest here...

At 65, This Doctor Treks and Drives to the Remotest Pockets of Odisha to Save Lives

"“If hundred patients come to see me at the hospital, I know there are many more people out there who are not able to make it to the hospital,” says Dr. Sr. Aquinas Edassery, who is out on her mission to reach the most needy and the most unhealthy.

To find them, she’s going to places where there are no roads, where the first four-wheeler that the people saw was the jeep that she came in, where teenage mothers are dying during childbirth and where the death of children under the age of five is heartbreakingly high."

Did you know there are places in India where people have never seen a jeep yet? Welcome to Bharat......

Read about this quiet hero here

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Thursday, May 18, 2017

Marriage wounds

An excellent article on the way God uses marriage to shape us and make us. Do read the rest here

"Having a spouse is like living with a mirror that constantly shows you where you are weak, where you are prideful, and how in desperate need of a Savior you really are. Chad and I never could have known, all those years ago when he slipped this ring on my finger, how much joy would really be in it or how much heartbreak. Jesus put a rare love in our hearts for one another, and He has used that love to wound us in the most wondrous ways. Ways that show us who we are and who we want to be. Ways that show us how likely our hearts are to falter. Ways that show us how great His love for us really is.

The mark on my finger is almost healed now. Soon it will go away, and all that will remain is the freckles and the gold and diamond that a young idealist once scrimped and sacrificed to gift to me. For half of our lives now we have loved and hurt and grown and agonized together. And still, we are idealists. Because we have learned in this life together that God can do what seems impossible. He can take two kids who only know that they are madly in love, and He can teach them how to sanctify one another, one wound at a time. He can use great pain to bring indescribable joy. He can bind up every hurt with His love and tenderness. And, He can use every scar to show the world how great He really is."

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Is NEET the way to select potential medical students?

The practise of medicine is equally art and science. Not everything can be learnt from textbooks. This video reminded me of my own MBBS admission interview at CMC Vellore many years ago. A carefully planned, well-rounded and scientifically justified admission procedure that, in addition to assessing knowledge through MCQ tests, also assessed character, ability to work with a team, ability to rationalise and think out of the box, ability to prioritise and work rapidly under severe time constraints, willingness to work hard and willingness and skill to work with one's own hands with dexterity.

That admission process is now under threat and is likely to be ended with the government and court push for NEET, which ranks you on the basis of your performance on a single morning in a single exam. This is going to sadly affect the practice of medicine in this country. It is good to see in this video that some universities across the world are moving in the opposite direction.

Tuesday, May 16, 2017

The Exodus

A Powerful poem by Dave Banhart. (Posted in full here for those who might not click over to https://davebarnhart.wordpress.com/2017/05/05/the-exodus/)

The Rich Man and Lazarus by Frans Francken III

I have seen your religion, and I hate it.
I have heard your doctrine, and I loathe it.
Take away your empty praise songs,
your vacuous worshiptainment.
Your mouth is full of religious words,
but your proverbs are salted manure.

“The sick deserve to be sick.
The poor deserve to be poor.
The rich deserve to be rich.
The imprisoned deserve to be imprisoned.”
Because you never saw him sick, or poor, or in prison.

“If he had followed police instructions,
if he had minded the company he keeps,
he would not have been killed,”
You say in the hearing
of a man hanging on a cross
between two thieves.

“People who live good lives
do not have pre-existing conditions,” you say,
carving these words over the hospital door:
“Who sinned, this man or his parents,
that he was born blind?”

“It is the church’s job, not the government’s,”
say you fat sheep,
defending your fat shepherds,
shoving and butting with shoulders and horns,
while you foul the water,
and air,
and scatter the hungry sheep.

You watch the melting glaciers and say to the waves of the sea,
“this far shall you come, and no farther,”
as if your will could change the weather,
as if your will could be done in the heavens as it is on this earth,
as if you could drill the sky the way you drill the soil.

In your telling,
in the story of the starving of the five thousand,
there are not twelve baskets collected of left-over food;
In your story, God’s abundance becomes scarcity,
and the crowds devour each other.
“Send them into the villages to buy food,”
and let the Invisible Hand’s miracle of the free market sort them out,
the worthy from the unworthy,
while you eat the two fish and five pieces of bread
volunteered by a child.
These ungrateful poor,
the welfare queens
with their anchor babies,
stop before your disciples’ raised palms;
they hear you say,
“The Master cannot be bothered to bless your children.”

You see Hannah drunk,
and you jail her for fetal endangerment.

Like Haman, you hide behind the skirts of the king;
you make laws and pay bribes
that allow vigilante violence
and private discrimination
against those you hate,
sheltering underneath plausible deniability.
“It’s not a Muslim ban,” you say one day.
“It’s about religious liberty,” you say another.

This Bible you wave, this word you claim,
it is sharper than any two-edged sword.
You wield it poorly; it slices you on the backstroke.
You know neither the scriptures nor the power of God.
You tie up heavy yokes for others
whose burdens you do not bear,
but you will not lift a finger to help them.
To some you say, “Do not marry, but burn.”
You lock them out of the kingdom of God.
You cross sea and land for your missionary work,
and teach others to be as hateful as you.

Your kingdom is not the public park of Zechariah,
where children play in the streets
and old men and women lean on their canes for very age.
It is not the land where every fearless household
has its own vine and fig tree,
their own means of production and shade for their rest.
It is not the land where everyone has a home.
Your kingdom is the one with gates,
where homeless beggars have their sores licked by dogs,
where people who have the audacity to grow old
pay a premium for their insolence.
Like Ahab, you covet all the vines, all the fig trees,
letting your domain stretch as far as your eye can see,
adding house to house and field to field
until, in your gentrified land
there is room for no one but you and yours.
Like Pharaoh, you call those who refuse you “Lazy, lazy.”
You build walls, and walls, and walls, and walls,
and you stuff your ears to the sound of protest songs
that will shake those walls down.

I have seen your christ, and he is my antichrist.
He is the herald of a violent god,
a god of fertility but not fruitfulness,
a god of embryos but not emancipation, pro-birth and anti-life,
a god of war and retribution but not of justice,
a god of order but not of peace,
a god of might but not of mercy,
a god of marriage but not of love,
a god of sex but not of pleasure,
a god of platitudes but not of wisdom,
a god of work but not of sabbath,
a god who demands sacrifice from the poor but luxury and reward for Pharaoh.

Your religion is the religion of pyramids pointed heavenwards,
towers built to reach the heavens.
Supported by their flat base, built by slave labor,
they are stable monuments to wealth and death.
You fill their secret rooms with gold so that
in the afterlife,
you may cross to paradise
on the backs of the oppressed,
and live in forgetful pleasure for eternity.
Your gilded gospel is rusty ruin.

You are why the ancient Hebrews
seldom talked about an afterlife,
weary as they were of working
for Egypt’s dead heaven.
Your idols and your religion
are why those slaves left the yoke of heaven,
the land of binding,
for a wide wilderness,
for a nameless, faceless God
who told them they—even they—
were made in God’s image.
You are why your churches are empty
of those who love and believe in freedom.
You are why the Gentiles blaspheme the name of God.
You are the reason for the Exodus.

And if you pursue, may God throw you into the sea.
And the horse you rode in on.

Amos 5:21-24
Luke 14:34-35
Matthew 25:31-46
Luke 23:33
John 9:1-12
Ezekiel 34
Job 38:11
Matthew 13:14-21
Matthew 19:13-15
1 Samuel 1:12-20
Esther 3:8-11
Hebrews 4:12
Matthew 22:9
Matthew 23:13-26
1 Corinthians 7:9
Zechariah 8:4
Micah 4:4
Isaiah 65:21-25
Luke 16:19-31
1 Kings 21
Isaiah 5:8
Exodus 5:17
Joshua 6
Genesis 11:1-9
Exodus 15:21

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1. Three knocks on my door
2. More Knocks
3. God's way of making us a part of His Kingdom
4. What is a Mission Hospital

Nothing Motivates like a Big Vision

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Monday, May 15, 2017

Inflated Girl Child Numbers Behind Haryana’s ‘Remarkable’ Improvement in Sex Ratio, Finds Audit

A Beti Bachao Beti Padhao audit has discovered the truth behind how Haryana achieved a massive improvement in its notoriously low sex ratio.

Inflated Girl Child Numbers Behind Haryana’s ‘Remarkable’ Improvement in Sex Ratio, Finds Audit

Do read on to discover how a little window-dressing, and fudging of the data can make it look like things are improving, (and that India is shining!) when, in fact, there has been no change in reality...

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In His Image

Recently, the Indian Express carried an interesting report on the RSS goal of setting up "Garbh Vigyan Anusandhan Kendras" in every state of the country. The goal of these kendras was to promote the delivery of 'fair, tall and customised' babies in India.

"THREE MONTHS of “shuddhikaran (purification)” for parents, intercourse at a time decided by planetary configurations, complete abstinence after the baby is conceived, and procedural and dietary regulations.

According to the Garbh Vigyan Sanskar project of the RSS’s health wing Arogya Bharati, this is what is needed for a woman to deliver an “uttam santati” — a perfect, “customised child”."

The Telegraph thinks this might be the explanation for the peculiar RSS obsession with Shashi Tharoor. Do read this fascinating article that ends with this analysis.....

"So the sangh parivar wants an India made up of light-skinned babies that grow up to be tall, light-skinned men. This 'nationalist' organization wants to liberate Indians from a very particular kind of yoke, the burden of being not-white. It turns out that the saffron brotherhood's beau idéal, its perfect man, is someone who looks remarkably like Shashi Tharoor, tall, light-skinned, even light eyed. Suddenly the obsession with Tharoor amongst the sangh's proxies in the media and the online world becomes more comprehensible. It must be thwarting for the RSS and its affiliates that this desi paragon remains stubbornly outside its fold, even as it tries to build an India in his image."

Wednesday, May 10, 2017

Prosperity and Adversity, Health and wholeness: A response to the Prosperity Gospel

I am very happy to introduce Rincy Cherian, a dear friend and brother, who has written today's guest blogpost.

Rincy has been involved in full-time ministry from 2001 serving as an Associate Pastor for many years at Life Fellowship, Trivandrum. With the primary calling of an Evangelist and Teacher, he travels across the country ministering at Youth Camps, Leadership Training Programs, Evangelistic Outreaches, Church Renewal Meetings, and Equipping programmes for new Believers.

He is blessed with a wonderful wife in Subha who is also a passionate lover of the Lord.


A child of God has experiences of both prosperity as well as adversity.  The apostle Paul describes his life experience for us.  "I know what it is to be in need and I know what it is to have plenty.  I know how to face situations where I am well-fed and having plenty, or in hunger and in want" (Philippians 4:12 paraphrase).  When we join with Paul and declare that "I can do all things through Christ who strengthens me", we must remember that the biblical context is primarily about being able to handle both plenty and poverty (Philippians 4:13).

Exciting mountain-top incidents and difficult wilderness experiences, favourable circumstances and unfavourable situations, abundance and lack are both guaranteed to come.  When we follow the Lord, there will be experiences of 'green pastures and still waters', and also instances of passing through 'the valley of the shadow of death' (Psalm 23:2-4).  God is a God of the mountains and valleys, enabling us to be overcomers whatever the circumstances (1 Kings 20:28).  We must learn to enjoy times of blessing as well as endure seasons of hardship (1 Timothy 6:17; Hebrews 12:5-11).  We should neither become proud when we are blessed nor discouraged when facing trials- we must keep our head in all situations (Deuteronomy 8:10-18; 2 Timothy 4:5).

It is wrong to focus on only one of these truths.  God has the right to 'give' and 'take away' (Job 1:21-22).  Jesus was born in poverty but was buried in a rich man's tomb. Hebrews chapter 11 strikes a healthy balance regarding the life of faith (vs 13-16, 32-38). By faith people "received" as well as "offered".  By faith they "prospered" as well as "suffered".

There were 'rich' and 'poor' people- both in Israel of the Old Testament and in the early church.

The rich believers of the New Testament church  were "neither condemned nor commended" for being wealthy; instead, they were given clear instructions regarding what do with their material abundance (1 Timothy 6:17-19; Romans 15:27; 2 Corinthians 8:13-15).

Similarly, poor believers were not treated as being “under a curse”.  Jesus spoke highly of the "poor widow" and did not feel she was under spiritual bondage (Mark 12:42-44).  Paul took the initiative to raise monetary support for the "poor saints" in Jerusalem- and was not looking at ministering some kind of spiritual deliverance (Romans 15:26).  The extremely poor believers in Macedonia were considered as an exemplary example to all the other churches for "out of the most severe trial, their overflowing joy and their extreme poverty welled up in rich generosity" (2 Corinthians 8:2 NIV).  Above all, we have the apostles themselves who were poor and without material comforts (1 Corinthians 4:11; 2 Corinthians 6:10).

It may especially be noted that being rich is not to be assumed as a sign of spiritual maturity.  Jesus looked at the church at Laodicea and told them that they were materially prosperous but spiritually poor (Revelation 3:17).  James talks about God choosing the "materially poor" to be "rich in faith" (James 2:5).

We are also warned against the dangers of trying to become rich.  Paul says that people who want to get rich fall into temptation and a trap and into many foolish and harmful desires  that plunge people into ruin and destruction (1 Timothy 6:9).  He says that godliness with contentment is great gain and calls on believers to be content with having food and clothing (1 Timothy 6:6,8).  He further states how the pursuit of money can become an obsession which leads to all kinds of evil- "some people eager for money have wandered from the faith and pierced themselves with many griefs" (1 Timothy 6:10).

Overall, what believers should recognise is that both prosperity and adversity have a purpose. When we have abundance, the purpose is to 'make us a blessing' and 'increase our giving' (2 Corinthians 8:13-14; 9:11; 1 Timothy 6:18).  And when we face adversity, God is trying to 'mould our character' and 'perfect our faith' (Romans 5:3-4; Hebrews 12:7-11; James 1:2-4).  So both must be joyfully accepted and cheerfully faced!  


Throughout the Scriptures, we find numerous statements and incidents revealing God to be our Healer.  He never created a world of suffering and does not delight in the pain of any person.  Ultimately, we will inherit a world free from everything that is wrong and evil.

Having said this, it does not mean that God would never allow sickness in our lives or that He will always heal us. Such beliefs are contrary to Scriptural teachings and examples.  For instance, God sometimes disciplines His people with sickness so they may come into a right relationship with Him.  King Asa of Judah started his reign in a godly way but later backslid.  The Lord afflicted him with a sickness to cause him to repent (2 Chronicles 16:12). The church at Corinth had people who were sick and some who even died as part of God's disciplining hand (1 Corinthians 11:29-32). Ofcourse, all sickness is not an expression of God's judgment but it would be wrong to assume that He never acts in this way!

God may also allow sickness and other trials to test our love and commitment to Him- the classic example being Job.

Again, God may allow a person to remain sick to show His strength and glory through that weak person.  There is a striking question which God Himself asks Moses, when Moses complains that God has not healed him of his stammering problem before sending him to deliver the people of Israel from Egypt.  "Who gave man his mouth?  Who makes him deaf or mute?  Who gives him sight or makes him blind?  Is it not I, the Lord? Now go; I will help you speak and will teach you what to say" (Exodus 4:11-12).

We also see that God may allow His people to die of a sickness without healing them. The prophet Elisha was mighty in power and worked unusual miracles.  But he died of a sickness (2 Kings 13:14).

Paul's description of his fellow worker's healing shows that while he expected healing to take place, he didn't believe healing was always guaranteed.  This is what he writes. "Epaphroditus was ill and almost died.  But God had mercy on him, and not on him only but also on me, to spare me sorrow upon sorrow" (Philippians 2:27).

A fundamental truth we have to grasp if we are to understand why there are strikingly different experiences or results from person to person is concerning the purpose of God for each individual.  The purpose of God is unique to everyone.  This is why we see Jesus not visiting John the Baptist in prison and thus allowing him to be beheaded while He visited the house of Lazarus and raised him from the dead even after 4 days.  This is why we see God not intervening in the life of the apostle James who is executed by Herod while He intervenes supernaturally to have Peter released from the grasp of the same Herod (Acts 12).  This is why Stephen is stoned to death but Paul survives after a similar stoning experience (Acts 7:58-59; 14:19-20).

Another vital aspect to take note of is that the Kingdom of God has a 'present' and 'future' dimension. We live in an age where the Kingdom of God has been 'inaugurated' but still needs to be 'consummated'! This means that while Jesus' sacrifice on the Cross is complete and perfect, its blessings are experienced over different periods of time, the culmination of which will be at the coming again of our Lord Jesus Christ.

So, for instance, salvation has various phases. None of us are fully saved yet. We 'have been' saved from the penalty of sin, 'are being' saved from the power of sin, and 'will be' saved from the presence of sin (John 5:24; Titus 2:14; 1 John 3:2; Romans 13:11).

Similarly, although we can experience healing from our sicknesses today, the blessing of a perfectly healthy body free from all physical limitations and defects will be received only at the return of the Lord (1 Corinthians 15:52-54; Philippians 3:20-21; Revelation 21:3-4). This is why even people who have been healed or raised from the dead still experience death later.  This is true both in the days of Jesus as well as today.

Again, we can experience total freedom from the curse of the Law (Galatians 3:13-14) but the effects of the curse which originated on the day of the Fall still awaits its full-fledged removal (Genesis 3:16-19; Revelation 22:3).  The “old order” is still to pass away (Revelation 21:4).  Death is still to be destroyed (1 Corinthians 15:26).  Creation, which is presently subject to decay, is still to be liberated from its bondage and brought into the glorious freedom of the children of God (Romans 8:20-21).  Till the return of Christ, we who "have the first-fruits of the Spirit groan inwardly as we wait eagerly for our adoption as sons, the full redemption of our bodies" (Romans 8:23).

Friday, April 21, 2017

A picture of the Incarnation

This video illustrates what happened in the Incarnation....when Jesus Christ stepped into human history, and took on human flesh, in order to bring redemption and healing.

Philippians 2:5-11 English Standard Version (ESV)

5 Have this mind among yourselves, which is yours in Christ Jesus,6 who, though he was in the form of God, did not count equality with God a thing to be grasped,7 but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. 9 Therefore God has highly exalted him and bestowed on him the name that is above every name, 10 so that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, 11 and every tongue confess that Jesus Christ is Lord, to the glory of God the Father.

Saturday, April 15, 2017

Life in Madhepura – A JMO's Point of View

A well-written post by Preeti Baweja, describing life in Madhipura Christian Hospital, Madhepura, Bihar.

Anybody else up for the thrill of the challenge?

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Saturday, April 8, 2017

Why the Trump presidency is bigly satisfying

"Sir/madam, I want to make it very clear that I have nothing against Non-Resident Indians. Also I have nothing but sympathy for the American people in this moment of crisis.

However, as someone who has spent many years hearing lectures on democracy from friends and family living in the U.S., the Trump presidency is giving me considerable enjoyment. Things had become particularly unbearable during the Obama presidency. Obama is like this. Obama is like that. He speaks like this. He jokes like that. He is ageing so gracefully. He speaks so nicely. He writes like Shakespeare. He runs like Carl Lewis.

And now? It is like Sachin Tendulkar has been bowled out after a double-century, and Radha Ravi is the next batsman for the U.S.."

Read the rest of this Letter to the Editor of the Hindu here

Thursday, April 6, 2017

Are we a racist country?

The Government denies that the recent attacks on Africans were racially motivated.

The same page of the newspaper contains a half-page ad for a whitening cream.

The stark contrast between what we say and what we think......

Wolf in sheep's clothing

A nice article about one of my heroes from many years ago....Javagal Srinath

Pundits said nice things about his passion and grit, but few called him great. Because he wasn't a genuinely great fast bowler, right?

Maybe the Srinath you saw wasn't. And I understand that, because that's the one I saw in 1992. But what I saw after that - a bowler exerting remarkable dominance over my team - has made me wonder.

You might have seen an honest toiler who could nip out a few here and there. But I saw a strike bowler who dismissed South Africa's batsmen at a better strike rate than Warne, Murali and McGrath. I saw a man coming back over after over, Test after Test, year after year; excellent to the end.

Read the rest here

Friday, March 10, 2017

The Scandal?

What do you think of this statement? What is the scandal? What is the cross?

(HT: Challies)

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Wednesday, March 8, 2017

Unwanted women (on Women's Day)

On International Women's Day 2017, I would like to remember the sad story of a woman patient we saw a few months ago.

For those who cannot understand the 'medicalese' let me annotate the antenatal card in the picture above.

This 50 year old patient came to us for an antenatal checkup. 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 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 finally conceived after IVF. 

We watched as she came for every checkup on time, faithfully taking her pills and 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.

I shudder to think of the life ahead of this beautiful little baby, born as the fifth unwanted girl child in this family.....

Monday, February 27, 2017

Watching birds keeps depression, anxiety, stress at bay, says a study

People living in neighbourhoods with more birds, shrubs and trees are less likely to suffer from depression, anxiety and stress, according to a new study.

The study, involving hundreds of people, found benefits for mental health of being able to see birds, shrubs and trees around the homes, whether people lived in urban or more leafy suburban neighbourhoods.
Read more about this study here

Then, Keep your eyes open. And consider moving to beautiful rural India!

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Sunday, February 26, 2017

The Kingdom of God

(This is the text of one of my last sermons in CMC, Vellore, before I left in Oct 2015)

If there is any one theme that runs through the entire Bible, tying everything together…..from the Old Testament to the New, from the story of Creation in Genesis, to the call of Abraham, and the choice of the people of Israel, to the coming of Jesus, and the teaching of the apostles, to the description of the return of the Triumphant King (described in Revelation)……….this is it: The theme of the Kingdom of God.

Understanding this theme is so critical and crucial, because it needs to shape our worldview, and influence the way we think and live. It helps us to understand the purpose for life, and discover the reason we exist. It helps us find our life work and vocation.

This is so vital for each of us.

Let me try and tell you the story:

The Great King, one day, decided He was going to create a beautiful and fantastic Kingdom. The Bible begins with these words.

In the beginning, God created the heavens and the earth. The earth was without form and void.

Empty and disordered.

Over the next few verses, we see how God went about Filling and Bringing Order to the earth.
He spoke, “Let there be light.” And there was. “Let there be earth and Sky”. “Let there be land and sea, plants and trees.” “Let there be sun and moon and stars.” “Let there be water creatures and birds” “Let there be animals and beasts of all kinds”

And things happened as God spoke. Immediately. Like clockwork.

But then there is a change in the pace of the story. Somewhere on the sixth day, we find a little conversation. We get the first clue that God is a Trinity, a Relational God, as Father, Son and Holy Spirit discuss together about the next amazing thing they were going to create. The peak of their creation.

Then God said, “Let us make man in our image, after our likeness. And let them have dominion over the fish of the sea and over the birds of the heavens and over the livestock and over all the earth and over every creeping thing that creeps on the earth.”
So God created man in his own image,in the image of God he created him; male and female he created them. (Gen 1: 26-27)

We learn that we were created by a relational God, in His image, to be relational beings. We were created to be related to Him, and thereby, to be related to each other. Moreover, we alone, of all creation, were created in His image, to reflect His beauty and likeness, His divine nature to all of creation.

And then a fantastic thing happens. God appoints man and woman as His stewards and representatives….to continue His task of Filling and Bringing Order to the world.

And God blessed them. And God said to them, “Be fruitful and multiply and fill the earth and subdue it, and have dominion over the fish of the sea and over the birds of the heavens and over every living thing that moves on the earth.” (Genesis 1:28)

Fill the earth, and bring order to it on My behalf. Rule wisely over all of creation as My stewards.

Some theologians call this the Cultural Mandate or the Creation Mandate or Commission. God was inviting human beings to create culture, and order in this world.

Let us pause here for a moment. John Eldredge, the American author and speaker, writes of how we tend to move too quickly from Genesis 1 to Genesis 3. From what he called “Original Glory” to our “Original Sin”.

This was our “Original Glory”: the purpose for which we were created. May we think long and deeply and often about our Original Mandate, and the glory and wonder of how it might have been if we had not sinned. This is the first picture of God’s Kingdom. “God’s people in God’s place, under God’s rule and blessing.”

Think for a moment about these two human beings. We often have this romanticized, Westernised mental picture, based on the images we have seen, of two blonde, fair people in the garden. I wonder how likely that was. These two were the peak of the un-corrupted, human race. All the races of the world were going to develop from them. Between the two of them, they contained the entire richness of the human genome. I think it is entirely possible that Adam and Eve were actually quite dissimilar. Perhaps one was black, and other was white. Perhaps one looked Mongoloid. I don’t know. I think, however, that it is quite likely the first marriage was actually inter-racial. I also think the Garden of Eden was not a small one, but a huge one, with every kind of fruit tree, and watered by many large rivers.

Now think of how it might have been if they had not sinned, but instead fulfilled their Mandate to fill and form the earth on God’s behalf, as stewards of the King. There are a lot of things we do not know about the Garden of Eden.

There are some things, however, we could speculate, using common sense, might have happened.

For example, in time, they would have had children. Over centuries, the earth would have filled with thousands of human beings, and though, as the Bible says, man was placed initially somewhere in the east, in time, we would have seen migrations of human beings to every corner of the globe. New races would have developed. Over time, new dialects would have developed, new idioms, and ways of expression, and eventually, new languages. Though we know that man and woman were originally ‘naked and unashamed’, I believe different forms of clothing would have developed in different parts of the world, primarily, perhaps, as a way of protection from the sun and mist and snow.

Because man is created in the image of God, man is both scientific and artistic, Rational and logical, observant and creative. Over centuries, in the Garden of Eden, different forms of art would have developed. Different forms of music, different musical instruments, different styles of poetry and song and literature, different ways of dancing: cultural differences in different parts of the earth with which people both entertained each other, and worshipped God

Because man, made in the image of God, is scientific and logical and rational, different scientific inventions and discoveries would have taken place, as humans discovered more about themselves, their environment, and invented ways to care for themselves and all of creation better.

Different styles of social organization and government would have arisen in Eden, with different models of business and trade. However, in the Kingdom of God, these systems would have been perfectly unselfish and fair, with servant leaders seeking the best for those they were leading.

Business and trade would have been fair and just, with each thoughtfully, carefully and lovingly looking out for the other, and not pre-occupied only with one’s own interests. Men would have lived at peace with each other, sharing all that they had with each other

Best of all, each human being would have been related to God, enjoying a personal unbroken relationship with Him, as He came down every evening to walk and talk with them in the cool of the day.

What a picture of wholeness and health! Shalom. Life in its fullness in the Kingdom of God.

But as we know, Genesis 3 followed. Man sinned. God’s plan was destroyed. And there were tragic consequences. In one cataclysmic event, all of the cosmos came under the curse and everything changed. Man and woman were cursed, as was the serpent. Our relationship with God and each other was destroyed. We stopped displaying godly nature in its fullness. Adam and Eve ran to hide from God, and began blaming each other. In the next chapter Cain kills Abel.

But that was not all. At the same time, the ground was cursed, symbolizing a curse on the ecosystem, and the entire cosmos. Everything changed.

But in the midst of the desolation and despair, God speaks a word of hope. He talks of the coming Redeemer. The Seed of the woman, who would crush the head of the serpent, set things right and make all things new. The Coming King.

The ‘Kingdom of God’ theme runs through the rest of the Old Testament. For example, God’s dealing with the nation of Israel. Jesus later calls the Israelites ‘the sons of the Kingdom’. The nation of Israel was chosen by God to demonstrate, to be a picture of what it would look like when human beings permitted God to rule over them, and chose to follow his laws, and experience His blessing. However, as we know, they chose to opt out of that covenant.

We also have many remarkable passages like the one we just read today from Isaiah 65, in which God expresses the cry of His heart, His longing for human beings to accept Him as King, and become a part of His Kingdom.

Let’s read again parts of the remarkable description of the Kingdom of heaven from Isaiah 65

vs 17 For behold, I create new heavens
and a new earth,
and the former things shall not be remembered
or come into mind.

18 But be glad and rejoice forever
in that which I create;
God describes what His Kingdom will look like

1. A place of Joy and celebration 
for behold, I create Jerusalem to be a joy,
and her people to be a gladness.

2. Relationship with God restored
I will rejoice in Jerusalem
and be glad in my people;

3. No weeping and distress
no more shall be heard in it the sound of weeping
and the cry of distress.

4. Good health and abundant life
No more shall there be in it
an infant who lives but a few days,
or an old man who does not fill out his days,
for the young man shall die a hundred years old,
and the sinner a hundred years old shall be accursed.

5. Economic prosperity and fruitfulness
They shall build houses and inhabit them;
they shall plant vineyards and eat their fruit.
They shall not build and another inhabit;

6. Justice for the oppressed
they shall not plant and another eat;
for like the days of a tree shall the days of my people be,
and my chosen shall long enjoy3 the work of their hands.
They shall not labor in vain
or bear children for calamity,
for they shall be the offspring of the blessed of the LORD,
and their descendants with them.

7. Close friendship with God

Before they call I will answer;
while they are yet speaking I will hear.

8. Creation at peace
The wolf and the lamb shall graze together;
the lion shall eat straw like the ox,
and dust shall be the serpent's food.

9. A place of holiness and peace
They shall not hurt or destroy
in all my holy mountain,”
says the LORD.

And as God expresses His longing to see human beings experience His Kingdom, many times we could think this passage is talking about some future heavenly kingdom. However, let me remind you of the references to infants dying, and young people dying at the age of hundred. Nobody dies in heaven. I believe that God is inviting us to accept His Kingship, and choose to obey His laws, so that we can experience His blessing to some extent even on earth.

And finally, the King arrived, the seed of the woman, the promised Redeemer of Genesis 3. When Jesus burst onto the scene in Galilee, His first message announced that the Kingdom of heaven was near. “Repent, He said, “for the Kingdom of Heaven is at hand.

Jesus called for a change in loyalty and allegiance.

He announced,
“God is ushering in His Kingdom. The King is at work! Come and be a part of this Kingdom. Come and be a part of this fantastic thing that God is doing. Come under His Lordship. Repent of being so preoccupied with your own small agenda and interests. Come, live and work for the King!”

Unfortunately, these days, we have made the gospel all about ourselves and our personal benefit. Repent, we hear, so that your sins can be forgiven, you can enjoy God’s blessings, and go to heaven when you die. And yes, all this is true. These are some of the spectacular personal benefits we enjoy when we become a part of this Kingdom

Ultimately, however, the gospel is not only all about ourselves. Jesus’ gospel is an invitation to come and become part of something awesome and big, the great canvas that God is painting, His Kingdom coming all over the world.

Do you know how many times Jesus spoke about being ‘born again’? 2 times, both in John 3. How many times did He talk about baptism? 2 times, though there are a couple of references more to Jesus’ disciples baptizing others. How many times did He talk about tithing? 2 times.

How many times did He talk about the Kingdom of God? More than 90 times! He talks about the Kingdom of God more than 50 times in the book of Matthew alone. In fact, He considered this so important that He advised us to Seek God’s Kingdom first, above everything else. To make it our top priority.

He taught us to pray, “Thy Kingdom come!” Most of His parables were about the Kingdom of heaven. For example, He said this was so important, like a pearl of great price, or a great treasure in a field, that a man would gladly sell all he had to buy. In a couple of other parables, He showed that this Kingdom would not come by force, overthrowing the corrupt and wicked systems and kingdoms of the world. Instead, like salt and light, and leaven in a lump of dough, like a tiny mustard seed, this Kingdom would bring change and transformation from within.

When Jesus died on the cross, taking our sin and curse for us, He transformed the curse of Genesis 3 into a blessing, inaugurating the Kingdom of heaven on earth.

For example, the curse of our broken relationship with God. Now, we can have a relationship with God again. “Behold, what manner of love the Father has lavished on us, that we can be called children of God.” 1 John 3:1

Now, we can again display divine nature, the uncorrupted image of God “For those whom he foreknew he also predestined to be conformed to the image of his Son, so that He might be the firstborn among many brethren” Rom 8:29

We can again find our role as stewards acting on behalf of the King. “For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them.” Eph 2:10

And that’s not all!

As Isaac Watts, the songwriter of ‘Joy to the World’ says, “He comes to make His blessings flow, far as the curse is found, far as the curse is found.”

Even the cursed ecosystem, the cursed cosmos, comes under His blessing again.

Colossians 1:16 For by him all things were created, in heaven and on earth, visible and invisible, whether thrones or dominions or rulers or authorities—all things were created through him and for him. And he is before all things, and in him all things hold together.

Verse 19 For in him all the fullness of God was pleased to dwell, and through him to reconcile (back) to himself all things, whether on earth or in heaven, making peace by the blood of his cross.

After Jesus rose from the dead, we read of the intensive coaching He took for His disciples, teaching them about the Kingdom of God, (Acts 1:3). And when He was finally ready to leave the earth, having accomplished His Mission, once again, He entrusted this task of filling the earth, and bringing order to it, to His disciples. The so-called “Great Commission” in Matthew 28:18

All authority in heaven and on earth has been given to me. (in other words, the Kingdom has been inaugurated again) Go therefore and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all that I have commanded you. (in other words, Fill the earth, and bring order to the mess by teaching all to live as Kingdom citizens, as stewards of the King, and teaching all nations to follow the laws of the Kingdom) And behold, I am with you always, to the end of the age.”

The whole Bible is about this: The Kingdom of God.

Of course, we do not experience the full reality of this Kingdom yet. We live in the gap between the Already and the Not yet. The King has come and inaugurated His Kingdom. The King is coming again, when we will experience the reality of this Kingdom in its fullness. We look forward to the day our King will return again to rule in person, when all that is wrong in this world will be burned away, when all the effects of the curse are removed, and only the glorious Kingdom remains.

In the meantime, we live as citizens of the Kingdom. Seeking God’s Kingdom first. Praying “Thy Kingdom Come”. Finding the small piece of the jigsaw puzzle that we hold, the small, but crucial role we must play, to see God’s Kingdom come. Like salt and light, like leaven in a lump of dough, we think and live as agents of the Kingdom, effecting transformation all around us.

Of course, we should care passionately that everybody should experience the love and grace of our amazing King, and be eager to share this good news with everyone. However, when Christians do good things only for the sake of evangelism, our motives can be smelled from a mile away.

Christians get involved in good deeds, because our King is a good King and the Kingdom belongs to Him. We are concerned for the poor, because our King is concerned for the poor. We stand up for the oppressed, because we represent a King who is passionate about justice. We care for the sick, because our King wants all of us to experience Shalom. We care about the environment because our King has entrusted us the responsibility of being stewards of all that He has created. We train ourselves to sing, and play musical instruments, and use all that is good about our culture to entertain each other and worship God, because our King is a happy King, who created art and creativity. We do research because our King has the treasures of wisdom and knowledge (Col 2:3) and wants us to discover better ways of running His Kingdom, and caring for each other. We even get involved in politics, and business, because, as Abraham Kuyper, the Dutch theologian and journalist who went on to become PM of the Netherlands, said “There is not one centimeter of human existence to which Christ who is Lord of all does not say, “That’s Mine!

So come. “The Kingdom of heaven is at hand!” Come and be a part of this fantastic thing that God is doing, as He draws people to Himself, transforming lives and communities and nations. His Kingdom is advancing! Consider what role you could play. Move beyond your own small agenda and self-interests. Seek God’s Kingdom first! Come and find your part on this incredible canvas that He is painting.


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Thursday, February 23, 2017

More knocks

My last post seems to have struck a chord with many readers, with almost 2900 views in the last three days!

Two of my friends have also written very similar accounts in the past from their experience. Do go over to their blogs to see what they have written.

1. Patients who taught me from the blog of Jeevan Kuruvilla
2. Quo Vadis, Doctor, Quo Vadis from the blog of Arpit Mathew

Sunday, February 19, 2017

Three Knocks on my door

Those of us familiar with the story of Aunt Ida (Ida Scudder, the founder of Christian Medical College, Vellore, my alma mater) know of how her life was changed by three knocks on her door one night. Confronted with the problem of three young women dying in childbirth because of the lack of trained women doctors, the young and reluctant Ida was convinced of the need to train in medicine, and return to India as a medical missionary with a desire to train Indian women doctors.

(If you are not familiar with this story, you could listen to a recording of Aunt Ida speaking of the Three Knocks here)

A few years ago, I also had my own Three Knocks experience, when the stories of three patients changed the way I practise medicine. At the time, in 2007, I was working in a 120-bed mission hospital in rural Uttarkhand.

Patient A was an elderly gentleman brought in with a perforated duodenal ulcer. He was very sick. His lungs were permanently damaged due to smoking, and he was now in shock because of the peritonitis. After we resuscitated him and operated, he was shifted to the ICU, where he was ventilated for 4 days. After a stormy post-operative period, he recovered well and was ready for discharge.

Before he left the hospital, his relatives came to talk to me in the OPD. After giving them the usual pep talk (about making sure he ate well and stopped smoking, and so on) I asked them whether they had paid the bill. They had. I was pleasantly surprised, because they looked quite poor, and I had been expecting them to ask for some concessions.

How much was the bill, I asked. About ₹ 10, 000, they said. They had paid ₹ 4000 as an advance, and had now paid the remaining amount. Again, I was quite pleased. ₹ 10,000 was quite reasonable for such a major operation and hospitalisation, and especially for somebody who had been ventilated for 4 days. I felt quite proud of my hospital.

More out of a desire to make some light conversation before they left, I asked them how they had managed to pay the bill. They had taken a loan. (Fair enough, I thought to myself, ruefully. Even I might need to take a loan if I require major surgery in the future! It’s good to hear that even the poor are able to get loans when they need…)

So, what type of loan is this, I asked. They replied that they were going to be paying a 10% interest. For every ₹ 1000, they would have to pay ₹ 100. (Sounds quite reasonable, I thought)

Since we were making pleasant conversation, and they had already received some advice from me with good humour, I thought I would give them some more. “Make sure you pay the loan regularly and quickly”, I advised. “After a year, the amount would have increased to ₹ 11,000. And unless you plan well, you will be stuck with a large debt.”

No, they corrected me. The loan would be ₹ 11,000 by the following month. And it would increase by a further 10 percent the following month.

My jaw dropped, as I realised that the family was, in fact, paying 10% per month as compound interest. I quickly did the math. The repayable amount, after 1 year, for the initial loan of ₹ 10,000 would be ₹ 31,386. A whopping 214 percent interest per year!

Horrified, I tried frantically to prove that my calculations were wrong. But no, the family assured me. Those were, in fact, the conditions of the loan.

However were they ever going to repay this, I asked, aghast. The family, now perhaps seeing how upset I was, tried to reassure me. “No problem, sir”, they said. “The money lender has said that we can work for him on his fields. He will not pay us any money, but give us food every day. We can work for him until the loan is repaid. Nothing to worry!”

Slowly, the realisation of what had happened sunk in. My Du perforation surgery had pushed a family into bonded labour. My colleagues and I scrambled to arrange money to give to this family as a gift, so that they could go and settle this loan quickly.

A few days later, the story was repeated. Patient B. Also admitted for Du perforation surgery and ventilated post-operatively. This time, we asked the questions before the bill was paid, but found the family had already taken the loan. Another ₹ 10,000 loan, being repaid at 214 percent interest. Another generous offer from the money lender that the family could work on his land as bonded labourers. But this story had another twist. The money lender had promised them that if they did not report for work anytime, he would send his goondas to tear down the small tin-shack in which they lived. They were going to be living under the perpetual threat of violence. Again, we tried to put together funds to help this family out of their debt.

A few weeks later, I had the third knock on my door. This time, it was the wife of Patient C, a middle-aged gentleman admitted with acute pancreatitis secondary to chronic alcohol abuse. He was now ready for discharge, and the family was asking for a reduction on the discharge bill. The bill was ₹ 1200, and they wanted ₹ 400 to be reduced.

At that time, I had a clear and firm policy on alcoholic pancreatitis. No reduction in bills allowed. My reasoning was simple: If they had enough money to buy alcohol and drink every day, it was safe to assume they had enough money for the hospital bill! I explained this policy to the wife.

A couple of hours later, a nurse came to my OPD. The patient’s wife had been asking the relatives of other patients for a loan of ₹ 400. She was offering that they could have her 6-year-old daughter until she arranged enough money to redeem her back. I felt like crying. My treatment of alcoholic pancreatitis was pushing this family into human trafficking, possibly even sexual trafficking. We promptly wrote-off the Rs 400, and allowed the family to leave.

I was very shaken by these three knocks on my door. As I read more about the problem of emergency out-of-pocket spending for hospital expenses, I came across this disturbing statistic:

39 million Indians every year are pushed below the poverty line directly as a consequence of emergency health-care related expenses.
(See this Lancet article)

Over the years, I have often remembered these three patients who changed my life. They have taught me some valuable lessons:

1. Even the poorest patients sometimes pay their bills without asking for concessions. They do so, however, at horrific personal costs. In our hospitals, we need to look out for these patients, and actively ask the questions about how finances are being arranged, and sometimes write off costs even when patients do not ask for reductions.

2. Even the highly subsidised treatment available at our charitable, not-for-profit hospitals can push poor patients below the poverty line, and even into human trafficking and bonded labour.

3. While health insurance does seem like the obvious answer to this problem (of out-of-pocket emergency healthcare spending, with its devastating effects on poor families), the insurance schemes available at present, (even those offered by the government to BPL families) somehow often seem to benefit the rich and middle class families, who are aware of their rights, and of available options and schemes. The poorest are often left out of the very schemes designed to benefit them.

4. The public health system is India has been designed to provide free and high quality healthcare to India’s poorest citizens. Unfortunately, due to a number of factors, (poor governance, corruption, apathy, and poorly trained staff, to name a few) our public health system is in shambles. I am convinced that it is our duty, as responsible healthcare providers, to do whatever we can to ensure that the public health system in India is strengthened and equipped to fulfil its role.

Finally, a word to my professional colleagues.

The World Health Organisation, in 1948, defined “Health” as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. When 39 million Indians are pushed below the poverty line every year as a result of healthcare expenses, it is well past the time for us to ask ourselves some disturbing questions. Are we truly promoting health? Or is this itself a symptom that the healthcare ‘industry’ is desperately sick, and in need of healing?

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