yum. indian food. reading this article made me miss my sangeetha's fast food in t. nagar, near pondy bazaar. what i would do for some pongal and sambaar...
]]>over the years, i know that i've changed, probably for the more conservative or tradition bound ways, thanks to this wonderful process known as medical school.
but this is one thing that i feel strongly about - there really is no substitution to dissecting an actual human body..." which forces the student ... to confront human mortality."
of course, the argument can be said that human mortality is our (medicine's) business, and if we don't confront it in dissection, we will confront it again and again throughout our career. but there is something to be said about the socialization process that brings physicians in training together in those first few months. and honestly, there is very little that deals with human mortality in that visceral, in-your-face way in the first two years of medical school - those are years esentially spent holed up, *hidden* from humanity. curling up with robbin's pathology is not curling up with issues of life and death, and isn't conducive to deep contemplation about the profundity of donating one's own body to the pursuit of science, medicine and education.
however, i can say that in my anatomy lab, the entire class was so moved by the experience that we collectively had a ceremony to honor the gift that the people who taught as anatomy- dead or alive - had given us (bad sentence structure, i know).
i hope that more people consider donating to science. will i do it? my dillema is between donating for education or for transplantation. but regardless someone's gonna get something that'll help someone. and i hope you consider doing it as well.
well actually, it's more brain drain than outsourcing, but both are a pain at the "glocalization" level. i was just chatting with a nurse here in chennai who has a telephone interview scheduled with saint barnabas health care system of new jersey. there's a huge shortage of nurses in america. there's a plethora of nursing colleges in india. and they speak english. so it's a pretty easy decision for a nurse to choose between a Rs. 4,000 job or a US$ 40,000 job. and for a research center like ours, the loss of quality nursing to america can be difficult.
but once again, friedman. do read:
]]>How can Kerry persuade moderates to throw out Bush? By turning the president's message against him. Bush is steady and principled. He believes money is better spent by individuals than by the government. He believes the United States should assert its strength in the world. He believes public policy should respect religious faith. Most Americans share these principles and think Bush is sincere about them. The problem Bush has demonstrated in office is that he has no idea how to apply his principles in a changing world. He's a big-picture guy who can't do the job.
From foreign to economic to social policy, Bush's record is a lesson in the limits and perils of conviction. He's too confident to consult a map. He's too strong to heed warnings and too steady to turn the wheel when the road bends. He's too certain to admit error, even after plowing through ditches and telephone poles. He's too preoccupied with principle to understand that principle isn't enough. Watching the stars instead of the road, he has wrecked the budget and the war on terror. Now he's heading for the Constitution. It's time to pull him over and take away the keys."
Confidence Man - The case for Bush is the case against him. By William?Saletan
]]>Op-Ed Columnist: The Secret of Our Sauce
something struck me after a late last fall when travelling in asia (another armchair economic analysis):
china's development is *because* of the government, india's is *despite* of the government.
as friedman writes unapologetically at the end of this article, bangalore is a tough city to work and live in. sure, it has some of the most sophisticated infrastructure in all of india, but it's still rife with problems. and all these beautiful buildings rising up everywhere function as indepndent economies, separated from the government as much as possible.
you don't see that in beijing or shanghai. corporations (state-run for the most part) meld into the beautifully laid highways and ports of these chinese megapolises.
indians love to discuss about why india will rise above china over the next fifty years - arguments range from the patriotic to the racist, economic to the political - but invariably fall upon the fact that 'democracy will prevail'. personally, i hope both will rise up - heresy to whisper in these parts, but anything that provides a better quality of life to two billion people - i can't oppose. additionally, i don't know how much i buy the argument that democracy is provides a better ground for development, though i'm sure my old professor dietrich rueschemeyer at brown undergrad would convincingly argue otherwise (See book: capitalist development and democracy).
but re: innovative thought. i have to agree with friedman when he says that the american education system allows for flexibility in intellectual development. people in india can not fathom why i would take eight years, plus an additional year out, to get a medical degree that can be obtained in five years in india. why would i possibly need to study development and politics to be an effective doctor? why would i spend a year away from school to practice in india? i'm not going to write more about this - i'm sure people who are reading this have bought into one system or another.
back to my last thought... america might be a more innovative society. but i wonder... does that innovation translate into money? america can innovate, but the indians and chinese will find way to make those innovations cheaper and more efficient.
and back to the elections - i've read that only about 4-10% of america's current job loss is due to outsourcing. so what's happened to the other 90 or so percent? that's what bush and kerry have to answer over the next long long eight months.
]]>globalization 3.0. i have to agree. i'm in bangalore right now, perhaps down the road from friedman, researching my own ideas with exira technologies (www.exirasoft.com). i've been so taken by this outsourcing business, that i had to investigate some of my own business ideas in healthcare information technologies. let's see how it goes. in the meantime, read on:
]]>but i would go farther than friedman... i know plenty of people here in india who think that call centers are career limiting. it's algorithmic thinking. of course you can make good money, but you aren't forced to learn skills. in a highly competitive market, you can't afford to take two years in a call center to make money and then try to re-enter a software market that's moved light years ahead.
you can't afford to take a call center job if you can afford to take risks for two years with very little pay - thus the middle class and above look higher, the poorer, with the taste of money, are more likely to take these jobs. hightech sweat shops? far from, but just thoughts...
so these call centers jobs are good for those who are looking to make quick money - but lots of graduates shun these jobs for a more entrepreneurial route.
but the end argument of friedman still holds true, if not stronger by what i've seen - these jobs are providing the promise of a better future. and it gives credence to the BJP's campaign - india shining.
the intelligent discussion that needs to happen next is what will happen in america... kerry seems to understand how nuanced and confusing this issue is... but he understands it by not really explicitly taking a stance. neither has bush, really... let's see how this all turns out.
]]>my friend is an animator in bangalore. was surprised to see this article - all i know about this is that these animators work some crazy ridiculous hours...
]]>friedman writes about the zippies of bangalore in this article. i'm currently in chennai, just spent a week in bangalore, finishing up some research, hanging out with many of the people friedman writes about. every discussion about politics i have with people here in india focuses on two issues: 1) what do americans really think about bush and 2) what do americans think about outsourcing.
i can make a fairly coherent statement about the former, but being in the medical field, i'm not sure how to answer the latter. there are few jobs in the medical sector that face outsourcing - medical transcription, radiology consultations and perhaps medical billing - but at this stage of my career, it's hard for me to gauge how this outsourcing will impact health care in america.
in a recent article about outsourcing by charles herbert, he argues that americans are upset because they were promised that 'menial tedious' jobs would be outsourced (such as manufacturing and computer programming (the IT equivalent of manufacturing, i guess)) and that a new wave of information age jobs would rush in to fill the void. but herbert correctly points out that these new jobs never arrived. Multinationals are doing well, thanks to outsourcing, but the american economy still sputters along...
its really interesting to see friedman have to confront the US challenges to globalization. this piece seems like a clever backtrack from his book the lexus and the olive tree.
anyways, this piece caught my eye because of how hot an issue it is here in india. read on - it's definitely going to be an issue in this year's presidential campaign - and if it's not big domestically - it'll be watched with hawkeyes from abroad.
]]>A quest to battle HIV in India
Monday, January 26, 2004
By JOSEPH DEE
Staff Writer
WEST WINDSOR - Sreekanth Chaguturu is willing to let someone else grab for the glory of an AIDS cure.
The fourth-year Brown University medical student, who grew up here starting at age 6, has a slightly less ambitious mission - to spare India's approximately 1 billion people from the public health nightmare that would result from an explosion of HIV infections.
The Indian government estimates 4.5 million of its citizens already harbor the virus that causes AIDS. That translates into a relatively low infection rate, but it's rising, Chaguturu said.
"The U.S. government projects that by 2010, 20 million people in India will be infected," he said. "So in that sense, time is running out. As more people get the infection, the faster it will spread. The low infection rate provides a perfect opportunity to address this epidemic before it devastates the country."
The 25-year-old, whose parents immigrated to the United States from the subcontinent in the 1970s, spent last year in the southern Indian city of Chennai, working at the YRG Care Center for AIDS Research and Education.
At the center, he and his colleagues are developing what they hope will be a big part of India's response to the disease. Among the realities shaping Chaguturu's research are the stigma of AIDS, cultural obstacles to proven prevention techniques and the high cost of AIDS drugs.
His temperament seems perfectly matched to the challenge. During a prolonged interview recently in his parents' spacious home, Chaguturu was a model of equilibrium, simultaneously focused and laid back. His broad smile flashed easily beneath large, brown eyes. If Brown University's medical school has a course in bedside manner, he'd ace it.
When he's not studying, Chaguturu likes to exercise, read and listen to music. "I like to keep in shape - I play a lot of squash and tennis, and I play the violin and piano."
Drugs have transformed AIDS from a virtual death sentence to a chronic condition, at least for those who have access to an increasing number of expensive but effective medicines. Most of the estimated 40 million people worldwide who are infected with HIV, however, cannot afford them.
An Indian pharmaceutical company, Cipla, is producing inexpensive generic copies of AIDS medicines, U.S. patents be damned. The company combines three separate drugs in a single pill and charges a patient about $30 for a one-month supply, Chaguturu said. It's a fraction of the price charged here, but even $30 is beyond the means of many Indians, he said.
So Chaguturu and his colleagues are studying a drug-stretching tactic called structured intermittent therapy.
"Right now, when you are diagnosed with HIV and start taking drugs, you have to keep taking them for the rest of your life. We're looking at whether you can take the drugs in short bursts and still get the same outcomes," Chaguturu said. "This could cut costs in half, potentially."
Drug treatment, however, brings with it the added cost of monitoring patients. State-of-the-art tests measure how well the drugs are working, but they are simply too expensive for most Indians, Chaguturu said.
Here, too, Chaguturu and colleagues are looking for innovative approaches to reduce costs.
"My philosophy is that the great should not be the enemy of the good," Chaguturu said. "In America, we have a certain standard of health care, including expensive tests to monitor progression of disease and outcome of therapy. What we're trying to do is to develop less-expensive tests that would substitute for the gold-standard tests here in America."
The substitute tests include tracking body weight and inexpensive blood tests, he said. "Our research has shown that these are good markers," Chaguturu said. "Now the World Health Organization is working to incorporate these tests into guidelines for HIV care in resource-limited settings."-- -- --
Traditional Indian culture presents a set of problems for anyone aiming to stem the spread of AIDS, Chaguturu said. It is a land where most marriages are arranged and where many women defer to men.
Asked if a woman could demand her husband-to-be to submit to an HIV test, he simply shook his head and said, "That doesn't happen."
The imbalance of power doesn't shift much after marriage, either. "And if he wants to have unprotected sex without a condom, she'd be compelled to because of cultural constructs about marriage and what a devoted wife should be."
Asking a husband to wear a condom is tantamount to accusing him of infidelity, Chaguturu said. Housewives make up a significant number of India's AIDS patients, statistics show, which indicates that such accusations wouldn't be entirely unwarranted.
Men whose work takes them away from home often return with HIV, thanks to a tryst with a female prostitute, or, if money is tight, a less-expensive male prostitute or eunuch, Chaguturu said.
Instead of embarking on what presumably would be a lengthy effort to change social attitudes, Chaguturu is seeking solutions that mesh with the cultural landscape.
The center's research shows women who might not feel entitled to demand condom use are receptive to the idea of using vaginal microbicides, which kill HIV, prior to having sex. "Now it's a matter of testing products and then introducing them on a large scale," he said.
Indians promote a perception that infidelity is rare, Chaguturu said, so the sudden appearance of HIV in a family fuels a particular stigma. "AIDS is primarily a heterosexual disease in India," he said. "The stigma isn't that you inject drugs or are homosexual, it's more that you're immoral."
Chaguturu says India needs its own Magic Johnson or Rock Hudson to help shatter the stigma.
"India reminds me of the early years of the epidemic here," he said. "We've treated politicians and actors, but none are wiling to come to the center. They'll get a room in a hotel, and we'll go to them. Because there has not been a high-profile person who has come forward, there is still a lot of stigma, especially in the rural areas."-- -- --
Chaguturu said he looks forward to being part of another research project the center is sponsoring with international partners. AIDS treatment and prevention measures often compete for funding, but Chaguturu says research will show whether treatment can be considered a form of prevention.
"The idea is, if you treat someone and control the level of HIV in their blood, they'll be less likely to transmit it to an uninfected partner."
Upon completing medical school in the spring, Chaguturu faces a three-year residency in internal medicine and then plans to seek a two- to three-year fellowship to specialize in HIV and infectious diseases.
He hopes to practice medicine internationally from a base in the United States. "As one of the richest diaspora or minority communities in America, it's our responsibility to provide something back to India," Chaguturu said.
What drives him is a sense of being part of an international effort to fight the pandemic of AIDS. "It's not you yourself trying to change the world but being part of a larger effort to make the world a better place."
Copyright 2004 NJ.com. All Rights Reserved.
]]>well, long story short, somehow, my phone fell into the trash, and as part of the hotel-departure routine, i failed to check the trash for any of my personal belognings. luckily they were able to retrieve my phone, and send it to me the next day in shanghai.
but, really, that can't compare to this story... read on!
The Worst Place to Drop a Cellphone? Here’s One