Tuesday 29 March 2016

WHY ARE EUROPEAN MUSLIMS TURNING TO JIHAD?



While no continent is immune to terror, Europe has very often been the victim of late.  Since September 11, 2001  there have been multiple home-grown terror plots in Europe - the 2004 attack on the Madrid trains (191 dead) by a Spanish-Moroccan gang, the 2005 suicide bombings in London (52 dead) by four British Muslim friends,  2015 Charlie Hebdo shooting, in Paris (12 dead), followed by November 13, 2015 a series of simultaneous attacks again in Paris claimed by ISIS (129 dead in restaurants, the Bataclan theatre and the Stade de France during the France-Germany international friendly football match). On March 22, 2016 Islamic terrorists bombed the Zaventem Airport and a metro station in Brussels, Belgium. And the list is unending! So the question is why are European Muslims angry?


Unlike the United States, where immigrants achieve average socio-economic status and education within a generation, in Europe even after three generations, depending on the country, they’re 5–19 times more likely to be poor or less educated. So the first reason is failure to integrate with the mainstream. France has about 7.5% Muslims but they make up to 60–75% of the prison population. Terrorism breeds in prisons. Terrorists have a history of petty crime that landed them in prison. Stays there often proved seminal experiences on their path to radicalization,  prisoners often come under the influence of — and form lasting bonds with — radical Islamists and terrorist networks.


Almost all European extremists and terrorists are second- and third-generation immigrants, stigmatized, rejected and treated as second-class citizens. Many extremists come from broken families or deprived areas, lack education and are unemployed. But then smaller number are well educated, have held jobs and have middle-class lifestyles. Some are in stable relationships and have young children. The characteristics that extremists seem to share are resentment directed at society and a narcissistic need for recognition that leaves them open to a narrative of violent glory. For them jihad is the only systemic cultural ideology that’s effective, that’s growing, that’s attractive, that's glorious — that basically says to them “Look, you're on the dropouts, nobody cares about you, but look what we can do. We can change the world.” So is this a ready-made population for groups such as the Islamic State and Al Qaeda to recruit from?


Failure to integrate with the society compels them to live in ghettos.  Muslim ghettos in Paris and Brussels are incubators of Islamic extremism where police fear to tread, crime and unemployment are rampant and radical imams aggressively recruit young men to wage jihad.  Those who perpetrated terror strikes in Belgium and France hailed from Molenbeek, a Brussels slum that has long been a hotbed for radical Islam, drugs and lawlessness. The Charlie Hebdo attackers lived in the “banlieues,” or suburbs of Paris, desolate, run-down neighborhoods of shops, mosques, and high-rise apartment buildings built 50 years ago to house waves of immigrants from former French colonies in Africa.


While the recruits come from these backgrounds what about the recruiters? They are much smaller in number and are true “jihad entrepreneurs”. These seasoned, ideologically driven activists are part of transnational terrorist webs linked both to extremist groups throughout Europe and to armed groups in conflict zones of Syria, Iraq, Yemen, Afganistan and Pakistan. They are the ones who bring structure and organization to the disaffected majority, through recruitment and indoctrination.


I will invite you to read this book ‘Eurojihad: Patterns of Islamist Radicalisation and Terrorism in Europe’ by Angel Rabasa and Cheryl Benard, two writers who, since 9/11, have produced a number of books tracking the al-Qaeda threat. The authors after extensive research have concluded that the three main factors behind Euro-jihad are poverty, religion and cultural alienation. Many terror suspects did not have jobs commensurate with their education and a sense of relative deprivation may have been a contributing factor in their radicalization into violence. Far from being religious zealots, a large number of those involved in terrorism do not practice their faith regularly. A typical Euro-jihadist is male, in their twenties or early thirties, with some education, narcissistic, lacking in empathy, lonely, unsuccessful with women, often with a history of petty crime.


Suicide bombing is an act of self-hatred that violently enacts the psychological splitting that has tormented the bombers through their lives. What makes these terrorists different from other bellicose young men is that these individuals have found a cause that validates their anti-social tendencies – a doctrine that teaches them that they are angry, not because there's something wrong with them, but because there's something wrong with everyone else. Their indoctrination is so profound that they are convinced that a glorious and amorous life awaits them after death and that door will only open with the detonation of the suicide belt!  


Like communism, fascism and every other -ism that promises a new dawn, terrorism makes no concessions, either to past tradition or to human nature or even to its own professed religion. It holds out a vision of something so pure that it can, in practice, never be achieved. This purity is precisely what appeals to a certain type of youngster. They call it religious idealism or ‘jihad’ and you and I call it terrorism! 

Thursday 17 March 2016

EVERY FISH NEEDS A DREAM POND



With the health sector getting slowly corporatized in India, the doctors are, for the first time, getting the taste of the corporate world. They now have to make a vital decision early in their career – what do they intend to become – a small fish in a big pond or a big fish in a small pond? Both the situations have their own advantages and disadvantages, but the twin desires of professional satisfaction and hassle free life coupled with the recent epidemic of ‘get rich quick syndrome’ is making this a difficult choice.


The Corporate Hospitals sponsored Clinical Establishment Act, which aims at smothering the life out of small and medium sized hospitals, which remain the backbone of healthcare in non-metropolitan urban India, where public hospitals are either overburdened or understaffed or both, will surely make healthcare expensive for those who have no insurance to fall back upon. It took a lot of courage and talent for a fresh M.D or M.S to arrange for finances, get innumerable permits and permissions, and put all his happiness on hold to start a small hospital but the recent surge of consumer protection adventurism, violence against medical personnel, and now the Clinical Establishment Act will surely dampen the spirits of these would be entrepreneurs. So much about Start Up India and Stand Up India!!


The corporate mentality in large hospitals can be positively stifling. Big corporations tend to become ossified, and with this ossification people get promoted not on the basis of knowledge or skills, but on the basis of their ability to brown-nose and toe the corporate line, or on the basis of an often false perception of their past successes without regard to their actual talent (the Peter Principle). Mediocrity and stupidity reign in such a situation and even though they are poorly run, large hospitals tend to continue to keep the same strategies and the same business culture, as though by following the same failed policies over and over again they will somehow find success. While this is true of many small hospitals as well, at least in a small hospital you have the chance to make a difference and to demonstrate your skills. In large corporate hospitals, knowledgeable and skilled health professionals are often kept deep below the corporate decision making stratosphere where their voices cannot be heard. Since when did hospital management guys start understanding what patients want, only the corporates know!


So here is the easy answer to the fish and pond question: If you have a passion for your work and are seeing others lead your hospital to failure, this situation will be intolerable and you should seek to become a big fish in a small pond, fight the system and set up your own hospital. If, on the other hand, you just want a paycheck but no responsibility, then perhaps being a small fish in a big pond might make more sense. So it depends on what type of work ethic you have and what type of career you would like to see.  When you're a little fish in a big pond, it is extremely difficult for people to see your worth and you'll likely get lost amongst the crowd, especially when lay-offs are a threat as well as when promotions are available. On the other hand when you're a big fish in a small pond, you can show your worth.  You can create more lasting relationships.  Your accomplishments stand out more.  How I wish this was the only answer!


But alas, we doctors are usually not easily satisfied. Once we start growing and accomplishing we start envying the small fishes in the big ponds because they are getting more exposure, meeting newer people, seeing newer things and now we want to be a part of all this. Our small pond starts restricting our growth. Smaller pond was maybe easier at start but we cannot be satisfied as that would mean stagnation. But migration to the big pond comes with a statutory warning: if you want to be in the Big Pond, then you better have perfect skills. Yes, the Big Pond is a great place to swim, but beware of getting left behind. That’s right–if you can’t take the heat, then stay out of the kitchen.


If your ambitions and your worth are in balance with each other and you are really the big fish you think you are, then I feel, you should ask for a bigger pond. If there is none in your environment, it just means you might be at the wrong place. This is simply because you do not know what the newer and more challenging atmosphere has in store for you. When you move up to the top you might be in a position to create the significant contribution, or even be part of changing the world of medicine.  This rocket propulsion is often not available in a small pond. But no matter how big a fish you become you need to have a small fish mindset. The moment you stop challenging yourself, or stop being curious, you are bound to fail. Never rest on your laurels and strive to always take it one step further and swim out of the confines of your safe harbor.


Though this is a very personal decision and I know and appreciate many of my colleagues who regularly create wonders in smaller ponds, I have a feeling that a stage comes in your life when you know you are prepared to take on the best in the world. Being a big fish in a small pond for ever is a bad idea because there would be no close competitor you lose a sense a competition. You start living with a false sense of superiority as you never get to face the tough challenges on a regular basis. You move around with same set of ideas, theories, and philosophy as there are no more intellectual person to guide you and so you never really get an opportunity to explore your real potential. Since you are constantly looked upon as the superior one you lose the thrill of getting appreciated. So a stage comes in a professional’s life when he/she doesn’t want to live in a delusion of superiority but wants to explore his/her real self!


There are advantages to every fish size too. I’ve been both the Small Fish and the Big Fish, and I’ve loved and struggled with both. As a Small Fish, I enjoyed the freedom to be a “freshman” and work on career, at a pace that’s as quick as I could make it. I loved having mentors, being able to ask questions, and absorbing content from dozens of sources. There was no pressure to succeed at everything because I was the Small Fish! On the other hand, the Big Fish is a fun position too. I set the standards, I do the treatment planning; the success or failure of the strategy is on me, and that pressure forces me to get up every day and try to be great. I have to be self-taught. That’s much different from being taught. But one thing is sure…..I could not remain a small fish all my life.



Being a big fish in a small pond is perhaps good for beginners but one hits the ceiling on what one can achieve quickly, and nobody will care. We must optimize at all times for being in the most dynamic and exciting pond we can find. That is where the great opportunities can be found. We doctors understand this challenge, do the corporate running the mega hospitals understand it too? One should try to be the biggest fish in the world and shouldn’t tolerate the confines of even the ocean.

Saturday 5 March 2016

MISTAKEN HEROES AND THE GET RICH QUICK SYNDROME



A society is often defined by its heroes. People admire them, fans worship them, writers eulogize them, bards and poets immortalize them and they are presented larger than life so that the younger generation can be inspired by them and aspire to be like them. This has been so historically and so we had a generation being inspired by Netaji Subhash Bose, Bhagat Singh and Chandra Shekhar Azad. This led to our independence! Then our requirements changed and the independent but horribly poor nation needed to be self reliant in food and come out of the PL 480 stigma. This era produced Prof. M.S. Swaminathan and Dr. Varghese Kurian, the father of green and white revolution respectively. Meanwhile we had a road bump – the Indo-China war and the hurt and disgraced nation needed heroes like Field Marshal Sam Manekshaw, Marshal of the Air Arjun Singh and Param Veer Chakra Abdul Hameed to tide us over the setback and establish our military supremacy. Then came the era of Captain Rakesh Sharma who when asked by Smt Indira Gandhi how India looked from outer space said those historic words “Saare jahan se accha!” and set us in the scientific path of space research. Our generation and the generation before that had clear concept of heroism and that did not clash with what we read in our schools about heroes like Shivaji, Maharana Pratap and Gandhi. Values were important but material worth was not even mentioned. Then things changed.

Angry heroes appeared on the silver screen and real life who were prepared to do anything to earn a lot of money to take revenge against the traditional exploiters. Anti heroes like Haji Mastan was immortalized on the silver screen and his rise was justified! The real world too had many such anti heroes like Ketan Parekh and Harshad Mehta, who became trail blazers, and though eventually the good triumphed over the bad, people like them were never short of admirers! They introduced the ‘get rich soon syndrome’ and were the new heroes.

Today things have progressed further and the society and the social media are making heroes out of not so deserving persons. In the age of 24 X 7 news channel and competing TRPs whoever sells valuable prime time news becomes a hero! When an Indrani Mukherjee or an Afzal Guru gets so much media attention, the impressionable youth cannot be blamed for mistaking them as heroes and heroines. We do not talk about the jawans who die in the inhospitable terrains of Siachin, we do not write about the policemen who are burnt in Malda, but we make a hero out petty pseudo-students and would be politicians…..that is the irony of the day! Think how much airtime was given to the martyr Hemant Karkare and how much of news deluge was there for the terrorist Kasab and you will realize that though unwittingly, but the wrong guy is being presented as a hero.

There is another totally different dimension to this problem of mistaken heroes and is especially acute among young people, especially the youth in today’s inter-connected, hyperventilating world. The social media today has taken the peer comparison game to whole new levels. Stories of starting from modest background, struggling against all odds and eventually becoming triumphant do not inspire anyone in today’s world. It is not respect, not bravery, not effort, not talent but money which has become the only currency of triumph and the only criteria of success. A poor school teacher, who shapes the destiny of the nation, because he has remained poor since ages, is not a role model for the youth. However, his rich cousin with a fancy coaching centre in the city, churning out unemployable degree holders has many admirers. Easy money and quick gratification has seeped into our psyche and today we are admiring money and not talents. Parents want their children to become Sachin Tendulkar not because he is the God of cricket but because he is very rich!
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Our children want to get out of university with superb grades, breeze through that necessary evil that is internship or apprenticeship and land a plum job in a prestigious organization. Do I have to mention the expansive home, the ritziest car, trips to exotic destinations abroad and excellent in-laws – that is, if one decide to drop the badge of ‘sexy, bad playboy’ or ‘high octane, classy, choosy, upwardly mobile lady’ – and get married. And if all these happen before you turn 35? Excellent!

The reality couldn’t be drabber. What is more likely to happen is get average or slightly above average grades, get a few knocks before the clarion call comes calling, work one’s ass off and maybe, just maybe land that fancy job title – and that’s just the beginning of one's professional slavery. As for the home, car, accolades, peaceful in-laws and that trip to London, all that will also happen but that will take time. How’s that for reality? Now add to it corruption in public life, abysmal educational performance, dilapidated infrastructure and the rise in expectations of friends and family. So is early gratification possible? Can one cut through all the shackles and obstacles of the society and transport oneself into the life in the fast track? Yes one can …..by money. And if one does not have that money then what does one do? Do something that brings quick money and early gratification. And what is that something, no prizes for guessing - it is crime and notoriety.

It is the desire for instant reward that drives a contractor to inflate rates, a public official to make a false declaration, or ‘sit’ on a file and delay the implementation of a policy move until he/she receives a kickback, a traffic official to detain you for committing a traffic offence, until of course, you produce the customary bribe or political outfits indulge in huge scams. And if by foul and fouler means one is successful, one becomes a poster boy for the social and news media, a king of good times and a role model for the impressionable youth! How about 

The tragedy is that desperately in search of instant gratification; we are losing the real plot of growth and development of individuals, families, society and the nation which comes from a phase of constant back breaking effort and eventually a delayed gratification. Delayed gratification, in the simplest terms possible, is associated with resisting a smaller but more immediate reward in order to receive a larger or more enduring reward later. But the idea of waiting for a good job, earned through working from the bottom up, frequently upsets and frustrates emerging adults in today’s society.


Don’t get me wrong friends. I am not asking you to stop dreaming big. Do so by all means but put in matching efforts and give some time for the tree of success to grow and bear fruits. By deciding to dwindle your expectations of instant gratification a little bit may not be the silver bullet that jump starts an accelerated push toward a better state of well-being for India but it will at least nudge us in that direction. All of us cannot keep ‘hustling’ our way to individual prosperity without taking the nation along. The nation will have to prosper and our poor will have to come out of poverty. If we keep up with this present national attitude of instant gratification there will be only one casualty – India.

Wednesday 2 March 2016

THE CLASS TEACHER’S HOME VISIT




Our parents were different. They not only brought us up but played an even better second innings while voluntarily bringing up our two sons. While both Neeta and I were busy, first with our studies and then with our profession, our sons were having a jolly good time with their grand-parents! This is a story of my elder son and his class teacher.

My son was studying in Class X and was a student of City Montessori School in Lucknow. This school demanded a lot from its teachers and every student was designated a teacher in charge who was responsible not only for their academics but the overall grooming of the students. Ms. Aditi was the teacher designated to my son and she was fortunately his class teacher too. Among all her duties, which included  noticing whether he was dressed properly, had polished shoes, trimmed nails, shining teeth, clean eye glasses, wrinkle free shirt and a properly knotted tie, she was also supposed to visit our home to have an idea about the environment we provide to the child and suggest improvements if any were required.

One day Miss Aditi rang up Neeta and informed her that she would like to visit our home next Monday. Neeta promptly extended the invitation but forewarned her that both she and I would be busy with our patients on a working day but she need not worry because the child and his grand-mother would be home and as the grand-mother is the one who is teaching the child at home, she is the best person to talk to. I could almost hear her hiss on the other end of the phone before she disconnected.

Come Monday, Neeta prepared some snacks for the teacher in the morning before going to her hospital and gave explicit instructions to our son how to re-warm it in the microwave, make tea for her and grand ma, arrange the tea table and serve. A glass of cold lemonade as soon as she comes because she is obliging us by paying a visit in the hot summer afternoon, and a box of sweets for her to take back home was all explained in great details.

At 2 PM our son returned from school and at 3 the teacher arrived. He promptly escorted her to his grand-mother and introduced her. This was followed by the chilled lemonade and skin-freshener tissue. The two ladies discussed not only about our son’s studies but about the purpose education. While the teacher emphasized that she wanted to turn my son into an outstanding scholar, my mother opined that that is secondary and she expects the school to make an outstanding human being out of him. Now it was snacks time and again my son performed the drill to perfection. The teacher was so impressed that for the first time she let her guards slip and said that she was surprised that despite being a boy he was so efficient in the art of hospitality. That was a nasty slip and my mother would have none of it. “What do you mean by that? Since when has courtesy become an exclusively feminine attribute? If he cannot make his own tea and warm his own food how on earth will he ever be self reliant? Why should girls and boys be brought up differently? …………….”and this monologue continued for the next 20 minutes. Needless to say that my son, whose class teacher was on the receiving end of the firing line, was petrified.

The meeting ended pleasantly and my mother gifted her box of sweets, petted and cajoled her with her customary motherly affection and escorted her across our lawn and garden to the gate. And then hell broke loose! Standing there was a scooter on which the teacher had come. She was about to start it when my mother sternly asked her “Where is your helmet?” She could very feebly murmur that she forgot to wear it in the morning. “No, I can’t let you leave my house on a scooter without wearing a helmet. Go, park it in the garage, I am ringing up my son; he will come and drop you home in his car. Tomorrow you can come with your helmet and take your scooter.”


And that is what exactly happened.

Tuesday 1 March 2016

JUST WHAT THE DOCTOR ORDERED



If you had read my previous blog ‘FARMING SECTOR CRITICALLY ILL – ON VENTILATOR’ then it would appear to you that the Finance Minister too went to the ICU to see the same patient! As for the hapless and anaemic opposition, which came to the budget party with their cliche phrases and catch words like ‘Suit boot ki sarkar’ and ‘Ambani Adani ki sarkar’, when confronted with a fiscally prudent and ‘far left of left’ budget to address the aches of the farming sector and groans of the non farming rural India, their gramophone records got stuck! With this budget the government’s strategy of rural development in India mainly focuses on poverty alleviation, better livelihood opportunities, provision of basic amenities and infrastructure facilities through innovative programmes of wage and self-employment.

Rural Development in India is one of the most important factors for the growth of the Indian economy. Both agriculture and non-agriculture sector in rural India was crying out for help. For a change, the law makers have responded. In order to increase the growth agriculture, handicrafts, fisheries, poultry, and diary, which are the primary contributors to the rural business and economy have all been given a boost. The major highlight of the budget was the big push on agriculture and rural India - a package of Rs 87,765 crore in fiscal year 2017!
Though Rural India only contributes 18% to our GDP, 50% of Indians live in villages. If these 50% Indians do not have money in their pockets to spend on tooth paste, talcum powder, two wheeler and tractors then how will the industries manufacturing these products and many more continue to grow? If the consumer bases of our companies shrink by 50% then how will the economy of the nation grow?

Quite justifiably the government targets to double the income of farmers by 2020 and has taken special steps to address the quality of life of rural Indians. Rs 2,000 crore for new LPG connections, Rs 35,984 crore for the farming sector, Rs 86,500 crore on irrigation for five years, and Rs 15,000 crore interest subvention for agricultural loans are few of the important assistance offered to the rural poor. The budget further plans to electrify all Indian villages by 1 May 2018 and allocates Rs 8,500 crore for rural electrification in fiscal 2017. So this is not mere intention but intention backed with hard cash ………..a departure from the past practice of giving hollow rights – right to education, right to food but no road map to achieve the lofty ideals. The budget also address issues of optimal utilization of water resources, create new infrastructure for irrigation, conserve soil fertility with balanced use of fertilizer and provide connectivity from farm to market.

Farm animals are a part of the farmer’s family. The budget has come up with 4 schemes for farm animals an animal wellness programme and provision of Animal Health Cards, an advanced breeding technology, creation of an e market portal for connecting breeders and farmers and lastly a National Genomic Centre for indigenous breeds and Rs. 850 crores have been allocated for these projects!

The rural economy is an integral part of the overall Indian economy. As majority of the poor reside in the rural areas, the budget aims at alleviating poverty through the instrument of self-employment and wage employment programmes, by providing community infrastructure facilities such as drinking water, electricity, road connectivity, health facilities, rural housing and education and promoting decentralization of powers to strengthen the Panchayati raj institutions.

Just as implementation is the touchstone for planning, people's participation is the centre-piece in rural development. And this has been strived for in this budget. An effort has been made at improving rural people’s livelihoods in an equitable and sustainable manner, both socially and environmentally, through better access to assets - natural, physical, human, technological and social capital, and services. Equally important is control over productive capital in its financial or economic and political forms. This will enable us to improve the livelihoods of the rural poor on a sustainable and equitable basis.

With the basic objectives of alleviation of poverty and unemployment, attempts have been made to create basic social and economic infrastructure, provide training to rural unemployed youth and offer employment to marginal farmers/labourers to discourage seasonal and permanent migration to urban areas. The MGNREGA has been very imaginatively tweaked and is now no more an aimless dig here fill there programme!

At present, technology dissemination is uneven and slow in the rural areas. All efforts of organizations developing technologies, devices and products for rural areas have failed to yield high success till date and we hope many Start ups will take up this challenge.  Technological development fueled by demand has a higher dissemination rate. However, in India, technology developers for rural areas have been catering to needs (with small improvement), rather than creating demand. Steve Jobbs did not wait for the world to ask for a smart phone. He created the product and made us realize that we cannot do without it!


Propagation of technology/schemes for rural development is slow and there is a lacking in wider participation of different stakeholders. An ideal approach may therefore be to include the government, panchayats, village personals, researchers, industries, NGOs and private companies to not only help in reducing this imbalance, but also to have a multiplier effect on the overall economy. The budget is just a good beginning.