Santhosh's ramblings

As we look around, and listen to the global, national, and systemic and structural discussions, there are a few words that seems to describe the “spirit of this age” in which we are living. Uniformity - the quality or state of being the same : the quality or state of being uniform or identical, Conformity - behavior in accordance with socially accepted conventions or standards, Singularity   - the state, fact, quality, or condition of being singular, though this word is also uses for a hypothetical moment in time when artificial intelligence and other technologies have become so advanced that humanity undergoes a dramatic and irreversible change: These three emerges out of the desire to have a Predictability – which is the degree to which a correct prediction or forecast of a system's state can be made either qualitatively or quantitatively. Ultimately these emerge from a need to be in Control - the power to influence or direct people's behavior or the course ...

“See I am doing a new thing. Now it springs up; do you not perceive it? I am making a way in the wilderness and streams in the wasteland…...” This is the God we worship and follow. This is the God who has put His nature and likeness into us. The nature of creativity, newness, innovation, and disruption. The ability of creativity – for Him to create out of nothing “ex nihilo” but His creation, humanity – creative engagement from the created and revealed things. The character of “new ways of doing things”, freshness and newness every morning – for humanity - to thinks through ways of doing things differently and with newness. This newness being “innovative” – better solutions to meet new requirements, un-articulated needs or existing needs. And many times, these innovations – being a disruptive way of doing things from the existing paradigm of ways. In God’s creation – we find Him creating “Ex Nihilo” – out of nothing. In the redemption process – he uses a disruptive and inn...

Traveling through the roads in the state I currently reside, I was taken back in memories to 20 years. 20 years back, there were no real roads or to call something a “road”. We used to say, the fields are better than the so-called road. But the 50 kilometers to nearest town with all these challenges used to take only 1 and half hours. 20 years later after 10 years of constant development we have now a half built road. And the same distance takes anywhere between 2 and half to four hours. The so-called half developed road is daily being dug and rebuilt for the last 10 years.  Where there were about 1500 trucks crossing this Indo- Nepal border town 20 years back, today you find more than 3000 trucks. From 12 wheeler it has gone to 32 and 64 wheeler. Many a day half the road, up to 30 kilometers is blocked with 2 lines of parked container lorries awaiting crossing of the border. And the town as usual is filled with dusty trucks and horse carts, rickshaws and cycles, cars and buses wi...

We were traveling in the neighboring state visiting friends. And listening to friends share stories of contexts and challenges. We heard about patients traveling 100km or more in search of accessible and trust worthy health care. We heard about many maternal deaths in villages. We heard about rupture uterus's presenting to institutions every other week. We saw in small clinic 7 cerebral malaria patients all with Hb less than 5 or 6 gm/dl. We heard about 80% institutional deliveries of which only 20% only happens in institutions, rest at home, the data cooked up for reimbursement of health care staff under NHM. We heard about early data from a study on malnutrition where 80% of kids are completely off the road to health chart - they needed to create a separate chart (weight was off the basic minimum). We heard about the need of a bribe of Rs 3000/- to get blood from a state blood bank. We heard about large numbers of patients with partially treated TB landing up in these clinic...

I had a haircut on Sunday. Well, this is nothing unusual, nor something special to write about, but the experiences of this routine activity left be wondering….so I thought I will pen down by wonderings…. Living in a gated community, generally we have a “home delivery” haircut every month. Our home delivery person has been missing for last few months, the story is that the business is poor and he has migrated to Kathmandu, (told by my friend who cut my hair on Sunday). But this absence has forced many of us to venture out and try out the various other providers around our campus. I for some time resisted trying these out. Mostly because of a “laziness” and because of a story that keeps reverberating in my mind whenever I think about barbershops in Bihar. My father who left this world almost a year back, while visiting in 1995, had one experience of haircut at a local shop. He loved the town and the community, and he always wanted to come back and stay here with us. But that was ...

It was a month back that an 18 year old girl, from a middle income household, who was seen by my colleague in the OPD was brought to me for second opinion. Unwell with profuse watery diarrhoea for many years, she was anaemic edematous, and quite sick. The parents seemed to be a disengaged from the condition she was in. A quick history and evaluation led us to think about a protein losing enteropathy and or malabsorption, leading to anaemia and hypoproteinaemia. In the conversation with my colleague, the girl told that her younger brother was quite sick and had underwent intestinal surgery at Lucknow. A possibility of a rare genetic disease crossed our mind, and we advised them admission for evaluation. The parents had not given this history at all. A colonoscopy done next day, confirmed our diagnosis, of “Polyposis Coli”, and I was now to talk to the father about the only option for the disease being colostomy and intestinal resection. As I started talking to him first question I ...

I remember my early years in the Medical college where I studied. We had Hindus, Muslims, Christians, Atheists all under the same roof. We knew where each one was in terms of their religion and faith. But it never mattered. What mattered was, we were the batch of 1978. We are still the batch of 1978. My roommate was a Hindu and a Marxist. Yes we had our share of politics, but that was in line with the dominant political movements of those times, but never in the name of religion. Some of us who were not happy with the dominant political movements, remained apolitical and that was respected by the politically active. Some of us were strong in their religious faiths. I being one such example. But that never reduced our friendship or relationships in any way.  We respected each other’s faith and beliefs and gave space for that.   I did not even know the caste of any one - nor do I know till today! I remember five of us deciding to go on a tour. This tour took us to a C...