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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A weekend of Gulzar

This weekend my phone was abuzz with messages from every whattsapp group and friends possible. And surprisingly all of them sent in lines from Gulzar’s poetry. As though, it was the most ‘in’ thing now, to send a few of his couplets. The fact that Gulzar has written poems on every emotion and circumstance possible in human life and penned the most memorable songs in the history of Indian cinema, was used quite conveniently by my friends, to depict their moods, or the weather, or what they were hoping for. The man is a genius. Not only has he mastered a subtle way of depicting life through his poetry, he has written plays, scripted films and directed some too.

His poems make me thank my Hindi teachers at school, for letting me learn and understand, one of the several languages that he writes in to reach the masses. There is a rich regional literature treasure in India, each state has its own language and often writers have used regional languages to communicate. However, Hindi and English are spoken throughout the country and taught at schools, in addition to the local state language in some states. Although there are some good translations of regional literature into Hindi and English medium, much of these remain unknown and unread in other parts of the country. Personally, I am not fond of translated literature, since I always feel that the original author’s perspectives are lost or dulled by the translator.

But I am grateful to those who take time in researching, understanding and translating, otherwise, we would never have known about the epics from all over the world, Coelho would sadly be absent from our lives, Love in the Times of Cholera would not have reached the girl growing up in Southern India and Tagore would have not won his Nobel in literature.

Here are a few of Gulzar’s couplets that I have attempted to translate. Hope that these convey his thoughts as closely as possible (courtesy: Rekhta)

  1. From ‘The Melting snow’

When the snow will melt on the mountain

And fog will lift its veil from the valley

The seeds would stretch their limbs

And open their sleepy lazy eyes

And even though,

the new young grass, will begin to green the mountain slopes

Notice carefully, the new spring

Would still have memories of the past season

For even now there would be remnants of tears of yesteryears,

In the melancholy eyes of the new buds that sprout.

My short understanding from the above- Dang! The memories….they never fade. Although we transform from one year to another, one goal to the other, who can forget the past? For as human, we carry our past into our present (maybe that’s a gift?).

  1. From ‘Books’

The books steal glances from within their unopened book case

Sometimes with a lonely, longing gaze

For we haven’t met in months

The evenings that were once spent in each other’s company

Are now used up viewing the computer screen

The books have begin to get restless

For they have now learnt to sleep walk

The books look on with a lonely, longing gaze

 

The values that they once narrated

With their endless passion

Those values don’t live in my house anymore

The relationships they had once proposed

They seem unstitched, undone, incomplete to me now

 

When I turn their pages, I begin to sigh

For many of their words have lost their meaning

For many of their words remain unused now

Terminologies forgotten, meaningless

 

The crystal utensils have made the earthen pots obsolete

For once a turn of a page would vet my appetite

And now at a click of a finger and in an instance

So many pages, pages within pages open by themselves

 

The bond with books has been forgotten

For sometimes they would rest on my heart as I lay,

Or sometimes carried possessively on my lap

Sometimes I would face them on my book stand of knees

Sometimes I would read them like a holy book

And touch them to my forehead in a prayer

 

Perhaps their contents are still accessible

But those dried flowers hidden within pages,

Those fragrant messages from companions

Those relationships forged by an excuse of lifting a fallen book for another…

What would happen to those?

Would those be now forgotten as well?

My two bits- Although we now depend on e books and audiobooks, how can we forget the emotions of reading a thriller….. page by page, so many of those nights in our younger years, of being unable to sleep till we could finish a book?

Books were more than paper pages, they were ways to disappear into an imaginary land, of forging new relationships and being inspired….

Ahh! Gulzar….you made my weekend!

Regrets

I have come to realize that the only regret I will ever have when there is a loss in communication with people whom I had once known in the past, would be the inability to share my happiness or sorrow when I need to, in the present time. Relationships change and distance, death, differences of opinion create gaps, hollow vacuums. New people, new circumstances slowly reinstate the balance. But it is difficult to let go of familiarity, of knowing that someone who is no longer with you could have understood your view, understood you exactly the way you wanted to relay it.

This wall you have built around you,

That which now exiles you,

Does sunshine pass through on its way?

For, the same sunshine has warmed my heart,

Before it passed to you, through your wall

Hence, we are bonded in some way

Sometimes, little thoughts of delight

And sometimes, those that I try and fight

Stop me in my steps, midway

And then I wish I could share

These small things with those gone by

With whom I had traveled once

This road of life, for a short while….

MD

Summer or Simmer!

It is hot in my city, absolutely scorching and I miss my walks through the office garden. I feel my skin burn everytime I have to be in the open and the tap waters are perpetually hot, be it early morning or late evening. This dry kind of heat penetrates my soul and dehydrates it to the core. I am snappy and irritating to be around and always dreaming of ice creams and popsicles, so yes, when I am in office meetings, I am really not listening, my notes are usually full of doodles of ice cream cones and faces transform to chocolaty glaciers. I am not used to extreme temperatures and every summer, I suffer a heat stroke. My family members have gently advised me that it’s only a state of mind; that I need to shut myself off to the surrounding heat. Is that really possible? Would imagining myself in an igloo solve the problem? I don’t think so. The constant ice cream images dont help either.

And I am humbled by everyone who has to work outdoors during this peak heat, especially those indulging in physical labor. Yesterday, my daughter’s homework (she is in grade III) was on interviewing the person who cooks at home and find out their struggles and how she could support them in their work.

I had tried pushing myself as the cook at home, as a potential interviewee, which she quickly ‘shooed’ away as ‘you are not the official cook, only the weekender experimenter’ and I clearly heard the Thank God! in her expressions that the household did not have to bear my recipes during most of the week. Instead she interviewed Manju who makes dinner for us at home every night. Manju is the representative of a quintessential Indian support system for working mothers like me. I am only blessed to give her full independence of my kitchen on weekdays, so that I don’t have another ‘to do’ item on my never ending list. And gratefully, my daughter likes Manju’s culinary skills, so I am fine with it too.

Manju was very amused with my daugther’s questions and it came as no surprise that her main struggle was to tolerate the kitchen heat, the hot stoves in the several households she sustains with the food she makes everyday. As to the support she requires from my daughter, it was a measly glass of cold drinking water after her chore at our home. Even though Manju and I share ups and downs in our otherwise healthy relationship, my appreciation and respect for her and for all those champion support system reps like her, did increase after yesterday. It also helped my daughter be more cognizant about everyone around. Though she is a better and far more empathetic person than I am and I hope this trait stays with her as she grows older.

As a public health research enthusiast, I am glad that several cities have a ‘heat action plan’ this year and are attempting to generate awareness amongst community on ways to beat the heat, in addition to capacity build care givers on responding to heat related illness.

Temperature tolerating clothing based on chemical and electrical principals is also in the market. These can bear extreme temperature shifts and are suitable both for cold and hot weather. Some of these are being tested in soldiers who are posted at extreme weather conditions. I look forward to a day when cheaper versions can be worn by construction workers, road repair men, community care givers and the Manjus at every home. Here’s to innovations for community health and to a safe summer everyone!

Strength of Prayer, of wanting nothing

When I was sixteen years old, I traveled on my own on a train for 2 days to see my relatives in another city. Even though I grew up in a very protective environment, my parents did give me the independence to discover myself from time to time. And although my parents called every day during that particular trip and came to take me home after two weeks of what was originally planned to be a full month of ‘independent’ vacation; at the end, I did get to stay with all my cousins for a good enough time and had a great summer that year.

On that train journey when I was greatly enjoying being on my own, I chatted up with some of my co passengers. It was the age of bewilderment and innocence. Not even for a moment did I feel nervous about talking with total strangers. I remember some of them bought me snacks and tea and I accepted gratefully. If it was today, I would have thought multiple times about accepting things from strangers. I have also killed the innocent urge to strike up conversations with people I don’t know.

On this trip for at least a part of the journey; one of my co passenger was a young yogi who would probably be in his early twenties. He had a pointed beard and knotted his hair on top of his head in a bun. He wore orange garments, sat straight and had ear phones in both ears. He would open his eyes from time to time and look outside the window, not to gaze at anything particularly but probably to add meaning to whatever he was listening. At some point, we had started talking. He was on his way to North India to help people devastated by a recent flood. He worked with Bharat Sevashram and seemed very happy with his life.

We were talking about God and divine presence and he had asked me if I prayed. I have never been overtly religious. My parents are practicing Hindus, actually quite orthodox, but have never forced me to abide by or follow any practice. As a result, my faith has been an evolution, metamorphosing over the years with my own life’s experiences, changing with my perceptions of the divine. At sixteen, I had laughed and told the Yogi that I prayed before exam results came out. He had asked me not to request for anything the next time I prayed.

I had been amused, how could one not ask for anything while praying. Wasn’t this the sole purpose of believing in a greater presence, of having an assurance that the most powerful can fulfill every need?

I did not understand him then, but now, over time, I have realized how powerful it is to pray and not ask, but thank. I find a deep peace in my daily prayers and praying for others. It has allowed me to overcome the biggest obstacle in my own life; my own self. One does not have to follow any religion to pray. You could think of the universe, the strength of the cosmos as being the most powerful and pray keeping that strength in mind. It is wonderfully satisfying to think of oneself as the tiniest dot amongst the vastness and that one doesn’t have control over everything.

Like many conundrums in my life, I am a partial atheist. An unusual believer. I did study science, but have never felt a need to give up my faith in both the divine and in science. Cant they co exist? I understand how Darwin would have felt, while learning to be a clergyman and discovering that evolution was the key to life forms. However, he may have been an unusual believer himself.

Like my parents, I do not expect my daughter to practice any particular faith, however, I do not think I could bear the thought of her traveling on her own, away from home, not at sixteen and perhaps not even at twenty!

Ship of Theseus

ship-of-theseus

If a ship is replaced part by part up to a point where not a single original part remains in it, is it still the same ship?

This is a central theme of the philosophical paradox and has been reflected in the 2012 movie of the same name (which I happened to watch yesterday….yes I know, I am late by a mere 5 years!). The film depicts the journey of three people who have had an organ transplantation, cornea, liver and kidney respectively. I wish the filmmaker would have delved a bit more on how the transplantation changed the recipients. Especially since the corneal transplant was done on a blind woman who was a talented photographer and would rely on sounds to capture pictures, before the surgery. After the surgery, I wonder if there was a difference on how she would perceive photography, now that she had both sight and sound to rely on.

But on a deeper level, we have all gone through periods of breaking down, learning and then moving on in life. At each of these ‘episodes’ we have given up a part of ourselves as in our beliefs, and gained some qualities to face life, become stronger. So even if we may not remain our ‘original’ factory setting self, the constant learning, re-learning has made us the person we are. Hence, by the Theseus paradox, we may not be how we started, but we are still our own unique self.

I believe that life’s constant motion of shaping our thoughts takes us on our path to spiritualism and our higher selves; however, we have made a mess of everything with soul, re birth, immortality etc. in this mix.  It would be simpler to just focus on the process of creating and re creating ourselves and getting through life, while being ethical with our surroundings.

However, ethics for me can be different from for instance, the monk in the film, who would walk miles and miles without footwear so that he doesn’t hurt insects on his path. A part of the monk did change though, as he was shown advocating against using animals in research at the beginning of his story and finally made peace and went through a liver transplant and medication regime, to survive liver cirrhosis. Both transplant technology and pharmaceutical industry use research on animals at some point in their development, and that was something the monk had to come to terms with.

It’s very difficult to go through the metamorphosis of having our principles crumble and regain our strengths, but that is exactly what makes life interesting as well. And perhaps we should not tag it with whether it was the right thing to do or wrong, since it was for that moment in our lives, we chose the best thing for ourselves.

One health- isn’t it a bit late for that?

While discussing a school assignment on different birds with my second grader, we watched videos of humming bird drawing out honey from flowers and weaver birds weaving artful nests. I also told her about the first time I had seen green pigeons. A pair of these green birds had made a nest close to my window and I had watched over them for a couple of months, till two young little birds were added on their family and then the four had flown away together… on their onward journey. There is something satisfying in bird watching and the way they conduct themselves. Unlike any other member of the animal kingdom, birds are perhaps the most sober and dignified and sometimes great entertainment!

The assignment also had a question regarding which birds had her parents seen when they were young and were rarely seen nowadays. When I was growing up in my grandmother’s house, we were often surrounded by sparrows and sometimes a couple of cawing crows. I don’t see sparrows anymore, especially in the cities I have lived as an adult. I tried finding some data on sparrows, unfortunately there is not a lot of research done on them. Their numbers are low and the ones who made it have migrated to greener, less polluted suburbs and villages. Two things caught my eye in the past week. The term ‘one health’ which really means to have everyone who deals with human, animal and environment health on one platform. Since 60% of diseases in man have some sort of origin in animals and since in turn, man has contributed to effectively denude the environment off more than 60% of its resources, now man has decided that we should all work together if we are to save ourselves from animals and the depleting environment. This is the big health jargon of 2017 that will be used over and over on all research applications, debates and talks this year and perhaps till we move on to something more ‘in’.

The CDC page on One Health, mentions “One health recognizes that the health of people is connected to the health of animals and the environment (www.cdc.gov/onehealth/)”. Isn’t it funny that it took us till 2017 to recognize that our health is connected to other beings around us? The real reason is perhaps that as researchers, we have all built our silos of working with our own folks with our own perceptions, like a medical professional may not be seen as a talented basic researcher, a  PhD is seen to be focused only on their bench work and not understand diseases, and veterinarians, well they have been completely dismissed from participating in any ‘serious research’ related platforms. As researchers, we have let our insecurities and sometimes dire selfishness keep us from sharing our results, collaborating and even talking openly about our interesting findings. When we cannot build bridges across our own fraternity, how will we come together on an unified ‘one health’ platform and work together to better our environment?

And why veterinarians alone? We should also partner with anthropologists who learn from living with communities who are closer to nature. The indigenous tribesmen of any country have been practicing living in harmony with nature for as long as the human civilization. We should perhaps seek our ‘one health’ answers from them.

The other item that I found interesting was that telomeres seem to grow longer in space. Isn’t it interesting that telomere which dictate ageing in an individual, grow longer in space? Was the incident a one off, or was it due to space being untouched by pollution, untouched by man as yet? Anyways, since we haven’t been able to find another earth to call our home yet, we should like our own spiritual growth, ‘look inwards’.

Would one health change our perceptions about working with each other for a better world?….only time will tell. Till then, I hope someone somewhere works on sparrows and  brings them back to my neighborhood!