Thursday, January 18, 2007

Kidneys for sale

Over the last few days a terrible scam has come to light in Chennai. During a public hearing about 2 weeks ago on housing and land rights for the tsunami affected communities, a person suddenly got up and mentioned how deep they were in poverty and how the women in the community were being forced to sell their kidneys. It subsequently came to light in the press that upto 100 women have resorted to selling their kidneys for an average of Rs.40,000 . with poverty and the fact that there were 12kms from the seashore and thus could hardly continue their traditional fishing....

While there are many groups of people in distress - what has driven these people to sell their kidneys? Why are all the 'donors' women? What are the rights of donors after they have donated their kidneys?

These are some of the questions that strike you as the shock and numbness of the initial phase recede....

How does one respond.... i am tired of reacting....

Thursday, January 11, 2007

From Western Science to Liberation Technology - A book review

From Western Science to Liberation Technology by Winin Pereira
Winin Pereira was a nuclear scientist in the 60's till he abandoned his career. He has put together a remarkable body of documentation and analysis on social and developmental issues, now accessible at the Centre for Holistic Studies, Mumbai.
While the themes in this book are reflected in the writing of other authors like Ivan Illich, Claude Alvares, Vandana Shiva, Ashis Nandy, Shiv Vishvanathan and Manu Kothari and Lopa Mehta, this little booklet presented these themes in a comprehensive and simple way. It is a very accessible and readable presentation of the main arguments about the limits of western science and technology. The other interesting feature of this book is an attempt at presenting at least the framework of a possible alternative – Liberation Technology – this is done using examples from the Warli Tribals in Maharashtra.
Periera proposes that Traditional Science may offer insights into a possible alternative to Western Science, however he hastens to add that the traditional science is talking about is the 'people's science' rather than more institutionalized forms of ancient science. For example in the field of health he is talking about the lay and folk healing systems, rather than Ayurveda. This is an important point as I am beginning to realise. Traditional systems are neither homogenous nor necessarily representative of all sections of ancient society. Like today world, ancient communities too were hierarchical and patriarchal (as reflected in the various mythologies and religious beliefs and traditions), thus the more institutionalised systems, which are more recognized nowadays are probably those more dominant systems which marginalized other 'people's systems'. I met a person recently who is infact researching this very theme of the marginalization of lay systems by institutionalized systems.
He discusses the intimate links between science and its development and the war. This is a common theme but it presented very logically, with lots of examples and references. His question is, “Where does one draw the line of moral responsibility separating those who were culpable for the production and consequences of nuclear weapons and those who are not? At Oppenhiemer, at Sakharov, at Fermi, Rutherford, Becquerel, at Lise Mietner? Western science gives unconditional absolution to all. But is it morally right for a scientist to carry on such work knowing that her / his results would surely be appropriated for the production of greater violence?” I would even add, is it morally right to allow the use of toxic chemicals and other materials that have been incompletely studied (and that possibly can't be studied give the complex system reality of the real world). This is an essential question especially as there is a gap between the production, the use, the ill effects and the profit and reward. Obviously the profits go to the scientists and capitalists cocooned in their air-conditioned offices, while the people who die and are maimed are the poor and marginalized landless labourers.....
He concludes the section on western science with the following, “The search for Western Scientific knowledge looks like a pure and noble striving but it has become a total, obsessive desire for domination that supplants all external ethical consideration. We can carry out western scientific research and develop or use western technology only if we make, unconsciously perhaps, a Mephistophelean pact to exchange a little bit of our souls for each little bit of western science and technology.”
In the next section he builds up a framework of liberation science and technology. Here he very lucidly explores the differences between peoples science and research and formal research. This is one of the highlights of the book. In another very thought provoking passage he says, “ Even if one does not believe in the existence of a cosmic order, an admission that, because of the immense complexity of natural systems, human understanding is necessarily limited constrains interventions in the environment to be made with outmost caution. Interventions need to be minimised simply because the natural system is too complex to meddle with. Such an admission of the limitations of human knowing is itself alternative knowledge. The absence of particular theorising is not a deficiency of method, but an acknowledgement of the complexity of reality and the limitations of the human mind.” It is indeed an interesting question as to which is better science – a simple technology / innovation in agriculture which is widely used and accessible and provides huge benefits to all or an expensively developed chemical molecule that is costly and out of reach to 2/3rd of the worlds population and pollutes the environment irreversibly during the process of production??
He makes the interesting point / argument: that as the context is changing so rapidly – it has been argued that traditional systems cannot keep up and that that is the reason for their decline. He shows that in fact traditional systems are continuing to innovate and create, that the reason for the extremely rapid and negative change in the context is western science itself, and that probably our ignorance of the innovations in peoples systems is a problem of the paradigmatic definition of 'innovation'. He sees western science (the people sensitive practitioners at least) as possibly helping with shortening the 'time to innovate' by working somethings out 'scientifically'. This point was made more recently by Darshan Shankar of the Foundation for Revitalization of Local Health Traditions at the South Asian Regional Conference on Traditional Systems of Medicine and Right to Health, he described the possibility that western science can help in explaining things (with its reductionist approach) and these can set of alternative paths of innovation... again a short cut!
Periera concludes with the following call, “Revitalizing peoples' science can restore to millions the creativity and the power that has been appropriated from them. Their urgent preservation and restoration appears to be the only way to rebuild a sustainable society.”
All in all a fascinating, comprehensive and accessible booklet. A must read.
Distributed by Earthcare Books, 2 Anand, 17 Carmichael Road, Mumbai 400026, India.

Tuesday, January 09, 2007

A poem by Faiz

If poetry is looking at the truth from a different angle, then epidemiology is very much the same! maybe that is why i find poetry so inspiring... here is an example about a theme that is central to epidemiology.

Bol ke lab aazaad hain tere....

Speak, for your lips are still free
Speak, for your tongue is still yours
Your body, though frail, is still yours
Speak, for your life is still yours

Look, in the blacksmith's workshop
The flames are hot, the steel is red
The mouths of the locks are beginning to open
The links of the chains are coming undone

Speak, for the little time you have is enough
Before your body and tongue die
Speak, for truth still lives
Speak up, say that which you must!

Faiz

Faiz has written what is certainly a manifesto for epidemiologists!

Wednesday, May 10, 2006

on truth

Dear Friends,

The recent supreme court judgement on the petition filed by the NBA has seriously challenged my concept of truth and tested my faith in the judiciary and judicial processes. In its attempt to
establish "truth" it has wantonly destroyed the lives of thousands of persons. Like Ramaswamy Iyer has written in the Hindu, "What was illegal and unjust till the morning of Monday, 8 May 2006, ceased to be unjust or illegal that afternoon by virtue of the Supreme Courts order."

Recently I came across an interesting line in a letter from the Prime Minister Manmohan Singh to Baba Amte where he says that at the central level the government of India has to go by the
information provided to it by institutions authorized under law for providing it. This is a new
definition of truth! Truth is thus defined by the authorized institution rather than the reality on
the ground.

There is obviously one truth for the rich contractors and politicians and one truth for the poor
adivasis. In fact whether it is the slums of Mumbai or the banks of the Narmada, the poor whose sweat and blood subsidize our life styles are taken for granted. Whenever convenient or under
pressure from the industrial captains or the international financial institutions they are
illegalized in a system that has proven itself truly blind, and whenever convenient they are made to work in inhuman conditions to subsidize our obscene luxuries.

The more one tries to use 'legal' measures the more one is pushed to a corner. The rest of society is so oblivious to a few crores loosing life or livelihood, that any struggle is automatically
marginalized or becomes at most an object of curiosity.

I went to the valley, I saw that village after village were not rehabilitated, I saw the pathetic
state of the rehab sites, I saw the pain in the eyes of those whose villages, lives, cultures and
histories were being drowned.... I saw it all, I felt it, I cried....

I heard stories of children dying in boats as they stuggled across the now untamely Narmada to
access medical care. I heard of and saw villages where even today children have never had a drop of OPV, a singly vaccine and obviously no ANC care at all....

So what is the use?

I can write an article, get it published, by that time perhaps (after the necessary peer review) the monsoons would have come and the shunglu committee may or may not have got ready of its interpretation of the truth, but what would certainly have happened is that thousands of years of culture, scores of villages and livelihoods would have been submerged. People may or may not die, but they will be forced to move to slums, or tin sheds and rocky land.

If nobody cares for the truth and people's reality is less important that typed statements from the 'relevant authority', what is my role as an epidemiologist? What is my role as a citizen? What is my role especially when I have lost faith in the legan frame work of the land?

ON TRUTH
Today I learnt
of lesser truths, and greater truths
Today I learntthat a drop of printers ink
on an official report
from the relevant authority
is better quality truth
than the tearsof a widow
whose home, livelihood and whole community
is going to be submerged
or the tearsof the elderly man
who can't afford to pay the bribe
so that his propertyis valued - for rehabilitation.
It is obvious that
the big contractors
and politicians
and money-lenders
are more true
than adivasis
dalits
and other common people.
It is also clear that those who are supposed
to protect the people
to work for the people's welfare
who are elected
who are paid from taxes
prefer one truth over the other
And as I watch in horror
this whole obscene drama
in the name of truth,
the concrete is poured
and the river is strangled to death
and a few lakhs of insignificant lives
are displacedand reduced to penury.
The country will develop
and be lit upI am told
thanks to the tears and blood of these people
whose truth is lesser
and collaterally damaged...

Thursday, May 04, 2006

Pol-khol yatra and truth

The Pol-Khol Yatra (Lay bare the truth) that I attended between the 25th and 27th of April along the banks of the Narmada, has made me think very deeply on the meaning of truth. While I saw village after village which were fully inhabited - official statements and affidavits filed in the supreme court showed these villages as fully rehabilitated.

In one village an elderly woman said, "this is our truth - rehabilitation has occurred only on
paper".

In a letter to Baba Amte the Prime minister wrote on April 7th 2006, "You will kindly appreciate that at the Government of India level, it has to go by the information provided to it by institutions authorized under law for providing it like GRA (grievance redressal authority) and the state governments. Neverthless in view of the human dimension involved, the team of ministers have been sent for a field visit and we are awaiting their report".

We have seen the report and history has recorded the duplitous response of the Government of India to its ministers reports.

In light of all this:
1) What is truth?

2) What is truer - what the eyes see and the heart feels and the nose smells or what is recorded by authorized institutions?

3) Can there be anything called "truth" (that can be contested) for people with pre-concieved
notions (and paradigms of reality and development)?

4) How does an epidemiologist respond - with papers or by going to the street?

Sunday, April 30, 2006

my first blog entry

This is my first entry, and i am looking forward to sharing and getting feedback from a number of co-bloggers out there. I see the blog as an extremely useful concept to share and learn, most times we end up talking to ourselves and a close group of friends....who rarely challenge.... and i hope that is going to change!