Beginning of a New End

If I get a chance, a single chance, to rewrite my life,

Would I take it? Would I seek the wishes that fleeted from time to time?

Or those that returned to knock at my doors like long lost childhood friends.

Would I have been happier with the choices I never made, the paths I never tread?

Or would everything somehow have brought me back to where I am?

Is this the beginning, is this the end? Is this how it was always intended?

 

Or perhaps, I would still make the same choices I made

And reach the same place I am at, whichever path it led

The lessons I learnt on this way, made me me, who I am today

The path I chose taught me a lot, with gifts of unforgettable moments

and golden memories

The path I chose brought me my little darling, my pride

For her, I think I have been blessed, to have found her with the choices made

Or would she be waiting at every road I would tread?

To hold my hand whichever choice I made?

 

No matter whichever way I walked

No matter whatever mountain I crossed

I think I would still have reached here

The place for endings and new beginnings

The place from where I would start again

To seek new paths, new dreams and new friends

To give new beginnings to old ends!

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Gender Views

We received a wedding invitation last week from our professional network. The invitation card mentioned the name of the groom (whom we know) and the bride to be. Her name is ‘Trophy’. Now I know, one can only imagine how she would have gone through school and college with that name, and also of the innumerable puns (intended) that would have surrounded her at all ages. However, I was thinking of the day she was born. She must have made her parents so happy and I can practically visualize the pride and delight her parents would have felt in holding her and showing her off….you know…like a prized possession (almost like Lion King!)

Though gender bias exists throughout the world as per scientific literature, I may be one of the fortunate few who is yet to document this from any practical experience. In fact, my family may be quite weird. I am an only child and all my uncles and aunts (5 of them) have only a single girl child. Maybe it’s a genetic predisposition, but we have been a very contended lot with a house full of women. Sometimes I do feel, we have sidelined the male population to a background in our family. We do include them in decision making processes, but just so they don’t feel left out (J).

It is however, extremely important to have different perspectives while making important decisions for the family like health choices, financial choices, education for children, marriage decisions, buying a home etc and a balanced view emerging from all family members irrespective of their sex is valuable. I also think children and adolescents make good decisions too and should not be undermined in the process. More than stressing on gender, I am of the view that each person is valuable and has a lot to contribute. The dynamics of power distribution will change when we start valuing each person, instead of attaching adage of male female, girls boys etc.

The fact is that my family may be part of a very small microcosm. I have women colleagues who have felt domination every day of their lives, I have male colleagues who are constantly overruled by their mothers while making family decisions with their wives for their children. Power has and will always lead human kind through all ages.

There are three delays in obtaining timely healthcare, type 1 delays are those made at the family level, where the decision that the ailing person in the family needs urgent healthcare in a timely manner can lead to survival or death of the person. Type 2 delays are often transportation or means to get to the closest healthcare and can depend on decisions, economic conditions etc of the family or surrounding community, terrain and accessibility in remote areas and the type 3 delays are adequate and timely healthcare provided to the patient in a healthcare facility. All three delays together or individually can lead to survival or death. Gender plays an important role in all these delays and is particularly crucial at the type 1 delay stage. There is a lot of research evidence that type 1 delay causes extensive bleeding at child birth in mothers who deliver at home, especially in low and middle income countries and together with type 2 delay causes the largest portion of maternal death. Same is true for neonatal deaths.

What are the barriers? Gender is only one of them; social, traditions, customs, faith, economics, illiteracy, ignorance make up the rest. What are the solutions? Education of every child, awareness of family and community, more participatory mechanisms to include women, men, community in government health schemes are a few answers, together with greater outreach of front-line health workers into urban and rural communities.  Often in Maternal and Children Health programmes, the men are sidelined, however, they should know the programmes and their views are as important as the women and mothers. Community empowerment and education of all will lead to better understanding of men and women in general and build stronger families. As part of a public health research organization, the best we can do is to include a equal gender lens in all our studies. To be inclusive and create projects that benefit everyone and don’t exclude men and/or boys. Health should be gender free, it is for and by all.

 

 

Being Present for the Future

Last weekend was a long weekend with 5 straight days at home. After a long time, I caught up with the movies I wanted to watch and also a marathon of the mentalist, season 6 and 7 from a while ago (don’t ask me why, no reason!). Since I am intrigued with sci-fi and hypothetical imaginary situations, I watched the Arrival, Coherence, Dr Strange(for the second time, mostly for Benedict and Marvel Comics) and Secret Superstar (new Bollywood movie, not sci fi, not based on anything hypothetical, but this was a family watch with my daughter).

I like the aspect of alternate realities and different lives in different times in different worlds, and Coherence was a great watch. I have watched Triangle a few years back and found that quite interesting as well. What if we get into that sort of a time vortex where our lives just get stuck in the present and we cannot move forward without breaking the cycle somehow? On the contrary, if we are happy and content with ourselves in the present, then probably it’s all alright. Why would I want to change my present if I am perfectly contented with it? And if the present is not perfect, I guess there is enough power in each of us to change ourselves and our environment in the pursuit of happiness. We all take different approaches, methods and preparations for changing our present and future, but the toughest and also the fastest way to get results is to perhaps change ourselves first.

In management, there is something called the SWOT analysis. A four square matrix where one can put down the Strength, Weakness, Opportunity and Threat while planning future strategies especially for an organization. I have found this very helpful in making individual decisions too, mostly for professional choices (although I have found these equally helpful for personal ones as well). The trick is to start with a very structured question (often driven by a very unstructured emotional need, in my case, such as happiness, prosperity, family security etc) such as how will this particular job provide me good career prospects in the future or how will this career position help me in self development or what would I need to change in my career path in the next 3 years to reach a career of my choice. The strengths and weaknesses help me figure out my present status and the opportunities and threats have future implications.

Even Secret Superstar, the Indian film did portray the strength within ourselves to change our own future. The story is about a 15 year old talented singer who is struggling with her stagnating family environment to build a future for herself in singing. She finds ways to express herself and inspires her mother to take steps to change the family environment in a positive direction. Plus the movie has Amir Khan who is superbly talented and I enjoyed his role of an obnoxious rockstar of yesteryears, who otherwise has a heart of gold. I asked my eight and a half year old, one thing she liked about the movie and one thing she did not like. Children have an amazing way of summarizing things and even if I don’t appreciate children enough for being emotionally cognizant or sensitive, she did say she liked the fact that the girl got recognition for her talent as a thing she liked and the scene where her father breaks her guitar as a thing she did not like. I am sure in her own way, she can connect emotional sensitivity with life.

I understand sometimes life throws a tough shot and we feel like we will never recover from the blow. There are often circumstances which are immobilizing, paralyzing. But it is important to know especially in those periods that self strength can bring in small changes that have longer implications. During those times, I quickly do a self appraisal of the good things I have in my life which I may otherwise not even appreciate routinely. The power of being positive and strong during adversities helps in a speedy recovery, though it takes a long time to bounce back and one has to be prepared for a lot of self work.  Reaching out is important too and one will always find supporters and positive company if one seeks it. A strong social fabric helps and I cannot say enough about empowered communities even in resource limited settings. Even if we are perfectly content about our present lives, it doesn’t take too much effort in recognizing people around us who need a little bit of reassurance. My own social experiments have demonstrated that listening helps in attitude upliftment, even more than providing tangible resources.  And though I have to work a lot on myself for being patient and understanding around my little girl, I hope she realizes that she has the power to change her environment for the better, through efforts that start with her and for the goals that she is free to set for herself.

 

Things that I miss from my Childhood

  • The bread van– I saw a four wheeler van shuttling bread from one shop to another today morning and it instantly took me to a time in my childhood when bread vans were a routine sight every day. In Kolkata, where I spent most of my summer vacations while growing up, these vans used to stop by early morning at every house. My cousins and I would rush out to see the goodies the van plied. The vans then, were not the four wheelers seen nowadays. Those were usually a three wheeled cycle. A tin box with two wheels on the side and one behind with a small seat atop, for the cyclist to sit on and paddle the box forward. The box had two hinged doors in the front which usually locked in the goodies. Sliced Milk Bread, Sweet Buns/Rolls, large unsliced loaves and an assortment of bakery cookies, including cylindrical cream puffs peeked from within the box. We would be ecstatic both eyeing those goodies and with the aroma of fresh baked bread. Sometimes we bought the large loaves to eat with sweetened milk and sometimes an elder in the house would buy us cookies. On special occasions, the family treated themselves with toasted bread and spicy yellow pea Ghugni. I have a large family of two uncles and three aunts and a few handful of cousins and family breakfast, lunches and dinners were always special occasions then. My paternal grandma’s house was also open to extended family members, friends of my uncles and aunts and the house would always be bustling with noise and activity. Compared to the quite solitude of my parent’s house in another city where I went to school, grandma’s place during summer vacations was a special treat. The bread van did wake the kids of the house with promise of a great day, each morning. I don’t see them anymore.

 

  • Family weddings- I was ten when one of my aunt got married. It is till date the best wedding I have ever attended. During those days, there were no event planners or marriage halls, hotels to be booked for guest etc. Instead, the football ground next to my grandma’s house was cordoned off with a makeshift frame of bamboo pillars on which satin red and pink colored fabrics were tied to create an enclosure (marriage pandal). For two days, the wedding rituals and the wedding feast both took place within the enclosure. Cooks were hired to create sumptuous meals. They came with their huge pots and pans and made makeshift stoves with bricks and wood. Guests who arrived from out of town stayed at Grandma’s house, or were housed with extended family in Kolkata and houses of family friends. But all meals for those two days were eaten at the marriage pandal. Each family member was given a responsibility and I am not sure of how things were managed internally, however, the marriage ceremony went so well, that I am sure there was great coordination between the members. The entire house smelled of roses and tube roses for weeks after the wedding. I may still have the gift my aunt gave me from the ones she had received. A small black flower vase with gold painted flowers. Now when there is a wedding in the family, it is more mechanical, there is always a go to agency for a defined responsibility. Weddings are now held in cemented buildings designated as marriage halls. Instead of cooks and makeshift menus, there are caterers with specified list of dishes. Guest houses and hotels are aplenty close to the marriage hall to house the out of town guests.  There are advantages to both, but there is a lesser family involvement in family functions now a days. I guess we have all become busy with our lives and unfortunately, with each generation, the strength of being in a family, of having elders around oneself, of making decisions together, of coping during personal and family loss are all reducing. Perhaps my daughter’s generation would never know their extended family members like I do and certainly not like how my father does.

 

  • Tales of witches and saints- My maternal grandmother (Dida) had migrated to India from Bangladesh during the partition. Not only she brought with her the legacy of a great culinary tradition from Bangladesh, but was also a great story teller. I still remember some of the tales of witches and saints she used to narrate to my cousins and me during summer afternoons. Sometimes, we would ask her to tell us about her life in Bangladesh. She would narrate with joy the carefree life she had had, the simplicity of people, the whistling torrential storms which would bend the tall coconut palms at crazy angles, the types of sweets that were available in every shop (usually of enormous sizes) and fishes that she caught with her own hands. Nothing went waste in Dida’s kitchen. She would make amazing fries with potato skins and squash skins, fritters with coconut and banana and tasty daals with any vegetable. All these without any electronic device in the kitchen (I may soon write on kitchen gadgets used and forgotten, another time). Dida had a way of subtlety around her even in her cooking, her speaking and would melt into the background without anyone noticing. But when she narrated stories, she would be driven with energy. Each character would have a different voice and sometimes there was a roar or a grunt, if the character demanded so. The witch would have a nasal tone, the damsel in distress would always be weepy, the saints would be grave and her story sessions would always come with sweet and savory snacks for the kids to enjoy.

 

  • A Sense of belonging at school- I went to a public school and because I was a girl child, my parents paid one fourth the fees the boys paid in my class (I pay more for my daughter’s primary school education now than the cost of my entire education; school, college and beyond). Our school was within a defence campus, beautiful and clean. It was shaped like a pentagon, with an assembly ground in the center. There was a larger playground, adjacent to the pentagon and a basketball court behind the school. We wore uniforms to school. Students from all over India with their parents working in defence came to study here. Each lunch time was a buffet of regional food, each class had a mini India feel. We celebrated every festival and took part in every co-curricular activity. On Independence Day, 15th August, we used to go to school, attend assembly, enjoy a cultural program put up by students, usually songs about our independence or a small theater on stories from that era. I had a deep sense of belonging at my school, of being a part of a wonderful institution. I have never felt the same about any other organization where I have studied or worked till now. Was it only childhood innocence coupled with a huge dose of ignorance? Of not judging or being judged. I do not know. But those years of being easily awed with everything, seeing everything as new with wonder….I wish I could have them back.

Organizational Leadership

“Leadership consists of nothing but taking responsibility for everything that goes wrong and giving your subordinates credit for everything that goes well”-Dwight D. Eisenhower

Last week Prof David Peters from Johns Hopkins University (JHU) was in our institute, addressing our faculty members for a short while. As an established public health practitioner, overseeing his division of 140 plus researchers and academicians with research network and collaborations across most countries in the world, he took up an impromptu session on career building with our faculty members at a mere notice of 5 minutes.

Through an informal discussion, Dr Peters examined the current level of research engagement in each faculty, where they wished to see themselves in five years and the opportunities and support they would need to do so including self work. He also helped acknowledge the challenges in our systems and ways to deal with them. These are not aspects that our faculty is unaware of, and given that solutions in the context of JHU may be quite different from our own indigenous solutions, there is always a scope for deeper introspection. However, the leadership quality he demonstrated was impressive. For the two hours, he held everyone’s attention. The engagement was participatory and there was an element of mentorship without being patronizing. Nor did he express his mastery over any particular area. He was more facilitative than overbearing.

The next day, the new Director of our institute (another seasoned public health practitioner) sat down with all faculty members and helped them devise a personal research plan, based on each person’s training and expertise, interests and where they wished to reach in some year’s time. There was an accountability plan as well along with it, each faculty was asked to write milestones, deliverables albeit self assessed and self proposed. I have worked in many organizations, however, this was the first time I came across a true leadership driven activity where a career plan was being devised for individual member with an accountability framework. I certainly hope that a supporting and enabling environment is provided to fulfill these individual goals. Our institute is small with a small team of faculty, hence face to face meetings, individual plans may work. In bigger groups, especially where there are 140 researchers involved, a lot is derived by setting an example that trickles down from top to bottom. More like stewardship that has been explained in a number of journal articles.

It’s not always about salary increments and benefits. Sometimes employees stay back in an organization because of self and career development plans that override benefits. Leadership involves looking outside oneself, creating an atmosphere for team members to rise and also be accountable for their actions, while mentoring them throughout. Most importantly, a leader understands the practical realities of their team members, resources, limitations and designs future plans accordingly.

  • How important is it for organization leaders to have social interactions with their colleagues?

“Sometimes you have to take a break from being the kind of boss that’s always trying to teach people things. Sometimes you just have to be the boss of dancing”.-Michael Scott, The Office

The answer to some extent lies in a mutual attitude. From my personal experience, Directors of institutes who had a regular faculty and staff meeting with their colleagues over a cup of tea had greater commitment from employees to solve organizational issues in a collective way. Not just issues, but volunteering in organizational activities also rose.

  • How important is it to reiterate organization values amongst the employees?

“Ten soldiers wisely led will beat a hundred without a head”.- Euripedes

There is no harm in reiterating organizational values like quality, accountability and trust at employee meetings. However, the leadership should also demonstrate these values amply before harping about them. Sometimes honesty goes a long way, real life stories also help where the leadership may explain that they set out to achieve something and were unable to, however they learnt something more important in that process. Being a leader doesn’t mean 100% success rate, it just means that one is able to cope with life in a much better way.

  • People management vs time management

“The best executive is the one who has sense enough to pick good men to do what he wants done, and self-restraint to keep from meddling with them while they do it.” –Theodore Roosevelt

The answer is in making an impact. Organizational leaders are hard pressed for time between internal, external engagements, overseeing all the activities within organization, making decisions and also traveling around the world. Yes there is a need for balance in everything, however, making an impact in everything one does, adding value to meetings, however small these are, would be one way to leave a lasting impression. While delegation is a part of management, even more important is to know who can accomplish what in the given time.

  • Being able to take risks

“You miss 100% of the shots you don’t take”. –Michael Scott, The Office

In spite of having a deep understanding of whether a team can accomplish a task, the leader is still open to taking risks and challenging the norms. Yes there is a line between taking an intelligent risk and stupidity, but the leader has a sixth sense in terms of understanding that their team would rise above their own comfort zones to achieve a certain goal. Sometimes trust and confidence go a long way. For the first time, our new Director is moving the academic section from paper copies of books to kindle/tab versions. This is not a new aspect in India. Most Indian Institutes of Technology’s have moved to e-books a long time ago. But someone had to come to our institute of 10 years and make that move.

Leaders are perhaps not born, but made through their experiences, ambitions and will to work hard. Mostly importantly leaders are made through their undying faith in others and their undying faith in their own strengths.

Summer Holiday!

This year during my daughter’s summer school break, we visited my parents in Kolkata, a city in the East of India. We were visiting the city after a gap of 4 years and were pleasantly surprised how much it has changed in the few years. For one, the city looks much cleaner and greener. The roads are wider and the parks near my parents home have been given a ‘facelift’ with fancy park benches, sculptors and lovely landscaping. The streets have decorative lamps and a lot is being done in terms of connecting the ends of the city through subways and roads. Kolkata reminds me of my own childhood, where my parents used to take me for every summer vacation. It reminds me of my grandmother’s home, where the kids used to have their fill of sweet juicy mangoes, tart tamarinds or homemade rice wafers during the lazy afternoons, while the adults religiously took their afternoon siestas. Kolkata is also the city where my father took me to see my first museums, planetarium and zoo.

This year, my dad took my daughter to visit some places in the city. I also realized (with a slight jealous pang) that my dad may well be my daughter’s favorite person on this planet. Unlike other cities of India where I grew up or worked, Kolkata is very unique in many ways. Everything can peacefully co exist in this city. Like the buildings from the 1800s and high rises, that may be neighbors and yet have managed to keep their places. From the first Chinese colonies in India to Armenian and Jewish heritage, people of every race, ethnicity, qualification, can find a place to co-exist here.

No wonder I liked New York City during the two years I spent there. It reminded me so much about India and particularly Kolkata. The sea of people of all races, the street carts selling gyros, dosas, biryani and the most wonderful Jackson Heights. With its rows of Pakistani, Bangladeshi and Indian shops. In NYC, I also sampled international cuisines to my heart’s content. I think my heart is tied between a pho and a sushi, but still, I cannot turn down a warm toasty bagel with spinach cheese spread or a soft pretzel with apple almond dip!

The small street side independently owned shops in NYC are very similar to those in Kolkata. In Kolkata, people from different ethnicities have bonded well over food via their will to extend the boundaries of their cuisines, by way of flexibilities or through experimentation. I had my fill of traditional Bengali vegetables which I cannot cook or are unavailable in my city. One of my delectable is unripe green figs, which can be cooked with potatoes in tomato garlic gravy. I was fortunate enough that the lady who helps my mother at home brought us some young figs from her fig tree. Another dish that most Bengalis have tasted is a paste of Taro stems with fresh coconut. Traditional recipes that require more effort to cook are slowly being wiped out from our daily lives, but in Kolkata, many restaurants have begun to spring up which promise food from yesteryears which are now being replaced at home by quick fixes.

A book that I own named ‘The Calcutta Cookbook’ by Minakshi Dasgupta is quite a favorite and it covers recipes beyond all ethnicities that have now added to the Kolkata heritage. This year I had my fill of sweet mangoes and juicy litchis too. Of the 30 varieties of Mangoes available in India, Himsagar is my favourite. It is very sweet and has more flesh than other varieties. It is available only for 4 weeks in Kolkata, just like the litchis. The production of Himsagar is small, but to the Kolkata dweller, one Himsagar a day is a must while it is in season.

Below is a list of a few videos of Kolkata from the view point of a foodie-

https://www.youtube.com/watch?v=LLeEK2YjC4Y

https://www.youtube.com/watch?v=saIU-ahpsdE

https://www.youtube.com/watch?v=KHiLQYwZ0jo

https://www.youtube.com/watch?v=AJblfGmlsE4

https://www.youtube.com/watch?v=2KBXfV9NsGg

 

Mother’s day- How do we save our mothers?

We have recently celebrated the woman who has helped us cope with life not only during our childhood, but also adulthood. We showed our appreciation to the superwoman, who shields us from everything that could cause us pain, and sometimes, to our embarrassment and sometimes joy, tries to guard us even when we are supposed to have found our own footing in the big world outside home. She is universally revered across cultures, religions, countries or the n number of divisions we have made to segregate ourselves.

But something isn’t right. Why are our mothers dying and why haven’t we been able to curtail this, even in 2017?  Maternal death is a serious issue especially in developing countries. Although we have brought down global maternal mortality by 47% since the 90s, as per the World Health Organization (WHO), about 830 women die due to pregnancy/delivery related problems around the world each day. These are mostly preventable. 99% of these deaths occur in the developing countries.  The odds of a 15 year old dying due to pregnancy/delivery related issue in developed countries is 1 in 4,990. In the developing nations, it is 1 in 180. Sadly most of these deaths occur due to reasons that are within our control.

Severe blood loss during pregnancy and post delivery is the main reason, followed closely by infections. In most cases of severe hemorrhage, injections of Oxytocin are enough to slow down blood loss. The many reasons for maternal death are health inequities, aka, basic services are not available to those who cannot pay for care. Distance to the nearest health care facility, availability of medicines in the facility, inadequate services are also key reasons adding up to the issue. A UNICEF led project in 6 states in India based on verbal autopsy of family members and community members of mothers who had lost their lives during child delivery, showed that cost for transport to the nearest health facility, literacy level of the mother, community awareness were leading cause of maternal deaths.

Personally I find the lack of awareness and non adherence to hygienic practices during childbirth and subsequent death of mothers due to infections, is most unsettling. Sepsis is a major problem, both in maternal as well as neonatal death. These defy all norms for extent of negligence. Additionally, through our incessant use of antibiotics we have successfully created microbes which are now resistant to most drugs, hence can easily compromise an infected mother and her newborn.

The WHO has recently adopted a resolution on sepsis that urges member nations to be more cognizant regarding causes, prevention and treatment of sepsis and tighten policies and regulations of activities leading to Antimicrobial resistance (AMR), to develop AMR stewardship activities and strengthen hygienic practices, clean childbirth practices and improvement in sanitation and nutrition.

Some of the basic things that we could do at our levels would be to create awareness amongst everyone we come in contact with. Every time we visit a clinic or a hospital, we could inquire about guidelines followed in infection management, waste management and AMR. We could also remind the health practitioners about hand hygiene and seek their advice in ways to prevent infections at our homes.

Every family needs a mother and every mother deserves a good healthy life, especially one that can be met by a few prevention steps

 

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