THE POWER OF ONE - NUGGET FROM HISTORY OF MEDICINE

The year was 1957. A middle aged surgeon was working  in Uganda, in the Mulago hospital in Kampala.He was a devout Christian and considered himself a missionary. By his own admission, he wasn’t a great surgeon.What he lacked in surgical genius, he made up for in tenacity. One day a boy named Africa  walked into his clinic. The malnourished boy had a large swelling in his jaw-making him look grotesque. In a few days, the boy died of his tumor. A couple of weeks later another boy walked into his clinic, with the same kind of swelling and met the same end eventually. The surgeon was intrigued – by the striking similarity of the cases and the ferocity of the tumor. He decided to investigate.

He had a handicap though – a stray bouncer had damaged one of his eyes permanently during an adoloscent cricket match. He was aging and was working in Sub Saharan Africa -far from where the limelight usually shone in medicine. He had no funds or  great expertise to draw upon. The people he treated were poor and wanted some solace for their pain, not fancy research.

Nevertheless with characteristic zeal, he asked around if doctors had seen similar cases. They said yes – so he pored over the records and to his astonishment found several similar cases, all of them ending in death. No one had connected the dots till then. He then looked at the literature – sure enough, there was an article about a similar tumor in 1901 in an obscure tropical medicine journal. The tumor he had seen wasn’t new. The pathologists had reported each of these tumors as sarcoma.

He quickly wrote a manuscript titled “A sarcoma involving the jaws in African Children” and posted it to the British Journal of Surgery. The reply never came.

By sheer accident, he met a physician called Oettle in South Africa. Oettle was younger and his star was on the ascent. By now the surgeon had collected grim photos of his patients. He showed Oettle and asked about similar cases in South Africa. Oettle waved his hand and said these cases didn’t exist in South Africa.

With no formal training in epidemiology, the surgeon decided to send out questionnaires with the photos to doctors across the country. The pace was excruciatingly slow – it took around 4 years for 400 responses. Armed with the information, he represented each case with a pin on a map. Since he couldn’t afford colored pins, he painted the pins with his daughter’s paint himself. A pattern was emerging. The tumor seemed to have a geographical distribution.

He presented his finding in Middlesex. Little did he know that his presentation would trigger a multinational effort against a common enemy.Among the audience was a man named Tony Epstein, a British pathologist. The idea of an infectious agent causing the tumor began to emerge. There were skeptics – unlike other infections, there are no cancer epidemics. Nor did the brothers and sisters of these unfortunate children get the disease. What kind of infectious agent behaved like this?

The surgeon decided to do a ‘geographical biopsy’. He applied for funds and got a 15 pound grant from the British government. With that and the help of his friend, he took an old four wheeler, repaired it and started on a long Safari. In sweltering heat, he would travel to Johannesburg and then back to Kampala, covering a total of 12 countries! In each place, he collected data (even before that term became entrenched in medical literature). On a hunch,he got external review of the old  slides. The results surprised him. The tumors were neither sarcomas nor carcinomas. The originated from lymphoid tissue- a lymphoma. Under the magnification of a microscope, these small round cells resembled a starry sky.

Tony quickly enlisted the help of his friend Yvonne Barr. Since they coudn’t isolate the infectious agent – it was too small – they decided to try a different approach. They looked for antibodies to the small infectious agent – presumably a virus. Sure enough almost all the cases had antibodies directed against this agent and it even stained the tumor cells. At long last, they had discovered the first human cancer caused by virus, one that bears their name – the Epstein Barr Virus.

Meanwhile the surgeon’s name became popular in medical circles and he received an offer to try methotrexate in these children from Sloan Kettering. To his amazement the tumor melted in these children. It returned in some. So he begged for  cyclophosphamide from an American manufacturer, which managed to hold the emperor of all maladies at bay even if for a short while.

This is the story of how within a decade a cancer was discovered, its morphological fingerprint identified, its geography dilineated, its causative agent discovered and its  treatment started.It is  the story of how an one eyed Irish surgeon, saw what all others had missed. It is a story of discovery that spans several continents in the face of impossible odds. It is a story that shows than even the ordinary can achieve great things with perseverance.

So when you feel  overwhelmed that you are in some remote no man’s land fighting a lone battle, remember this surgeon.

The name is Burkitt. Denis Parsons Burkitt.

URBAN FLOODING – A RECURRING PROBLEM

Trying to the BEST of its ability

There’s a colloquial saying in Kolkata that every time a frog wets its pants, the city goes under water. The same goes for Mumbai, India’s shining commercial capital. A few hours of rain and the shine is smudged by knee-deep water. Chennai, which did not experience large-scale waterlogging even a couple of decades ago, has drastically changed since the debilitating floods of 2015. Have you ever wondered why this happens every year? Whether it is Mumbai or Kolkata or Chennai or Delhi every city gets flooded during the monsoons. Even the relatively newer cities like Gurugram suffer the same ailment. To say that the municipal corporations of these cities are negligent and corrupt is all very easy but this may not be the sole reason. Is our town planning faulty? Do we at all take into consideration the water levels in nearby rivers and seas before planning cities? We surely do because all four megapolis cities that I mentioned are ancient cities and flooding is a recent phenomenon. So are we not maintaining our drainage systems? Are we not updating and improving them to meet the added load of the exploding population or the changing climate?

What is the answer to this menace?

Acrobatics in Gurugram roads

In my own city of Lucknow I have seen water bodies being land-filled to construct the large township of Gomtinagar. A significant part of this township gets submerged in monsoon every year and ironically this is the place which has the most expensive houses! It is the same story in Gurugram where people staying in flats costing 4 crores are incarcerated and waterlogged. In Bengaluru, a rapid, unplanned urban expansion has ensured that barely a handful of its interconnected lakes still survive, robbing the city of its capacity of natural storm water drainage. No wonder it gets flooded in the monsoons!

We are hoping that industrialists and entrepreneurs from overseas will invest in our economy, but when they see our premier cities inundated with overflowing rivers and an atmosphere of careless chaos everywhere, do you think their instincts tell them to invest in our country?

If it was blocked drains and potholes on roads we would have solved this problem by now. Don't you think we are missing something big? After all why would Jaipur, the capital of the desert state of Rajasthan get flooded of all the places?  Short bursts of intense rainfall are expected to become more common and our cities cannot cope with the downpour.  I feel we should find out the potential role of changing land use, land cover, including urbanization on heavy rainfall. Climate researchers have opined that Chennai flood was due to the warming up of the Bay of Bengal and El Nino effect. Rapid urbanization, deforestation all cause carbon release and greenhouse gas-induced climate change. Monsoons are getting heavier over cities where they are a menace but drought prone farmlands are also on the rise. Is there an available science to rearrange the monsoon and redistribute the rainfall for the benefit of both the deluged urbanites and the draught affected farmers?

Let us now see what we can do to avoid floods. One thing is for sure, it cannot be the responsibility of the government alone, we all have to pitch in our bit.

Respect the floodplains

We have to understand one thing clearly; our rivers are not static but dynamic. They may become a thin stream or even get interrupted during the dry season but will swell to their fullest glory during the monsoon. This extra land which it inundates is called its floodplain and no construction should be allowed in this zone. This land belongs to the river and it will reclaim it every monsoon. Essentially, what floodplains do is retain and absorb water, thereby shielding nearby towns from the effects of heavy rainfall.

Creating Sponge City

Creating a sponge city is an option. Rather than funneling rainwater away, a sponge city retains it for its own use, within its own boundaries. The uses include: irrigating gardens and urban farms, recharging depleted aquifers, replacing or replenishing the water used to flush toilets, and processing it so that it can be clean enough to use as drinking water. Wuhan is one of China's 16 sponge cities.

Green roof top gardens

Green roof top gardens by their very nature absorb rainwater and help to mitigate flooding. They are good for all: for the building owner, it’s a rainwater management tool; for the community, it reduces rainwater runoff; and for the environment, it prevents combined sewer overflow, neutralizes the acid rain effect and removes nitrogen pollution from the rainwater.

Preventing rainwater enter the sewer system

Our rainwater invariably runs into the sewer system. This is wrong. They should never mix. The separation enables the wastewater treatment plant to function properly, without it being overburdened by large quantities of rainwater. The rainwater can be used to recharge groundwater and aquifers.

De-clog the sewage system

Keeping the sewage system clean is obviously vital. They can clog up with waste, debris, plastic, sediment, tree roots and leaves.  The more traditional sewer pipes have a tendency to rust and corrode, compounding the problem. Plastic sewer pipe systems and Tegra manholes never corrode, and are easy to clean and inspect.

Replace concrete in pavements and sidewalks

Our love for concrete in pavements, sidewalks and even gardens is also killing our environment. Concrete is impermeable and these surfaces should be replaced with permeable materials such as grass and gardens.  This will allow the rainwater to drain into the soil. The process, known as infiltration, also serves to sustain the plant life. Otherwise this water will flow into the drains and flood the system.

Invest in climate warning systems

Properly conveying advance warnings of impending storms and floods today have not only given people the opportunity to be proactive in preventing damage to their property, it has saved lives too. Our space research has helped us in forecasting natural disasters including floods and loss of lives and prosperity is much less today. Odisha has perhaps maximally benefitted from them only because they have a responsive government.

Kolkata deluged.

Our town planning needs our urgent attention. The time of covering the wound with a BandAid is over. We cannot postpone the surgery any longer. We too should do our own bit. Whether it’s collecting rainwater or building a garden on top of our roofs, it’s imperative that we take the steps necessary to be part of the rainwater management solution. Complaining about the problem will not take us anywhere. We have to be a part of the solution.

AVOID IDENTITY THEFT - SHRED THEM, DON’T THROW THEM

Identity theft is the crime of obtaining the personal or financial information of another person for the sole purpose of assuming that person's name or identity to make transactions or purchases. But that is not the only type of identity theft. Other more sinister types of identity theft include criminal, medical, financial and child identity theft. In criminal identity theft, a criminal misrepresents himself as another person during arrest to try to avoid a summons, prevent the discovery of a warrant issued in his real name or avoid an arrest or conviction record. In medical identity theft, someone identifies himself as another person to obtain free medical care. In financial identity theft, someone uses another person's identity or information to obtain credit, goods, services or benefits. This is the most common form of identity theft. In child identity theft the privileges and concessions that the government extends to your child for education and health can be robbed by the thief and sold for a profit. 

With government subsidies coming directly into your bank account the security of the latter becomes even more important. Synthetic identity theft is a type of fraud in which a criminal combines real (usually stolen) and fake information to create a new identity, which is used to open fraudulent accounts and make fraudulent purchases. And all this is often made possible by our carelessness or ignorance.

Many people don't know this, but the trash you have thrown out can be legally claimed by anyone who wants it, and that includes your utility bills, expired IDs, personal letters, and anything with your name and address on it. Now you might think why would anyone need any of these things? This is because your personal details, such as your name and home address, as well as your ID number or partial bank account details may be on it, and all this personal information can and is routinely exploited by scammers for all sorts of illegal purposes. In order to protect your privacy and identity, you must always run these seemingly useless papers through the shredder before throwing them out.

1. Plane or Train tickets: Both printed and virtual boarding passes to planes, trains, and other forms of transportation often contain plenty of your personal information, including your name, travel destination, and frequent flyer number, if you have one. Scammers can often use this information to log in to your frequent flyer account and see your upcoming trips or even cancel those if they want. So, always make sure to shred any paper tickets and never share files or screenshots of your virtual passes with anyone, let alone post pictures of these on social media.
2. Doctor’s prescriptions: The corporate hospital cards, OPD tickets and Discharge cards contain enough information on them for scammers to steal your identity. Your prescriptions can be misused and addictive pharmaceautical products can be purchased on them by addicts and black marketers.
3. Photocopies of PAN Card, Adhar Card, Voter ID card, Passport and Ration Card: If you have to dispose them at all always shred them. They are your passport to the virtual world. Too much information is easily available in these documents if you crumple them and throw them in the trash.
4. Bank Statements, Credit Card Statements and Corporate database reports: Even if you think that the statements have encrypted your valuable details for a professional deciphering them will not be a huge problem. Your corporate database or clinic database will give easy access to your customer / patient information records and this can make you legally liable.  
5. Receipts from Super markets and Departmental Stores: As benign as a receipt may seem, these papers often list the last digits of your card number, your signature, and other personal information that can be used to infiltrate your bank account. In addition, these documents may also give scammers the opportunity to file a return for your purchase. So if you have made a virtual payment keep the receipt safely, don’t toss it in the waste paper basket.
6. Pet’s documents: Your dog’s immunization record or the veterinarian’s receipts contain your pet's name, which is the most common password choice according to a Google Survey looking at the passwords of 2,000 participants. If your personal password doesn't match with your pet's name, throwing these in the trash without shredding is fine. 
7. Spare copy of your C.V.: Your resume is a documented history of your education and work experience, and also typically contains your address and personal details, such as your phone number and name. This is an absolute treasure trove for scammers who want to gain access to your bank account or want to steal your identity.
8. Unused invitation cards of your family wedding, engagement, annaprashan, upanayan etc: These have too many details about your family, your address, Email, phone numbers, the names of close family members, age, birthday, etc., that can be easily exploited if they get in the wrong hands.
9. Junk mails and envelopes of letters addressed to you: Junk mail, such as pre-authorized credit card offers and mail from insurance companies and lenders are a gold mine for people who want to make money on your sorrow.

In this world of online banking and the ability to do pretty much any legal action virtually, you must protect your personal details as much as you possibly can. Thus, run all your mail, every trace of your name and address through the shredder before you decide to get rid of them to prevent dire consequences.

AYODHYA – REDISCOVERING OUR PRIDE

It is a red letter day today. Sri Ram Chandra, the king of Ayodhya, who lives in the heart of every person of Indian origin all over the world, is going to have his own abode in his birth place in Ayodhya. The Prime Minister of India, Mr. Narendra Modi, who was the grand planner of Lal Kriahna Advani's highly publicized and politically invigorating Rath Yatra and the Chief Minister of Uttar Pradesh, Sri Yogi Adityanath, whose Guru, Mahant Avaidyanath was the nerve centre of Mandir agitation have come together to fulfill a long cherished dream of every Indian. 

Ayodhya is to Hinduism what Vatican is to Christianity and Mecca is to Islam. Still Ayodhya was left abandoned by successive governments even after seven decades of independence! An Uzbek invading army of Babur in 1528 plundered the Hindu heartland, destroyed a temple in the birth place of Lord Ram and strategically constructed a mosque in 1529 to announce their supremacy and inception of their Mughal Empire. This was expected of them because by doing so they attempted to hurt the faith of the vanquished and demoralized them so that they can present themselves as larger than life. If they can destroy Ram they must be mighty and should not be challenged. The destruction of this and many subsequent temples had the desired effect and a predominantly Hindu land remained under Muslim and subsequently British subjugation for almost the next four centuries. 

The vanquished do not have the privilege of writing the history and so first the British and then the left and left of centre Indian historians converted Ram into a mythological figure and despite the fact that his family tree can be traced right up to King Ikshwaku, his earliest ancestor, his very presence on earth was challenged. So naturally Ayodhya had no hope of resurrection. 

We were told that Kalidasa was Shakespeare of India though Kalidasa was born centuries before Shakespeare. We were told Chanakya was India’s Machiavelli though he mastered the statecraft thousands of years earlier. And we accepted it because we were the vanquished. The only thing the British historians found in our history was caste system.I do not blame the British for glamorizing the British rule and tarnishing our past but why did Indian historians not do a course correction? They did not because they believed if they can erase the pre Mughal history of India and highlight only the achievements of the Muslim rulers and brush their misdeeds under the carpet they will create a more 'secular' India despite overwhelming Hindu predominance. Muslim invaders destroyed universities, temples and knowledge system structured around them and our sense of self-esteem by destroying our centres of faith, our idols. The official records tell us that even after burning the Nalanda University and destroying Taxila and Vikramshila, burning libraries of temples even today, we are left with 3 million manuscripts in Sanskrit, Pali and Prakrit! Imagine the richness of our civilization! Our Marxist historians conveniently forgot to tell us about these misdeeds. We were told that India was never a nation but British had made it into a nation and Nehru ji was trying to create a new idea of India, so we can stay united. With this single argument, we were trained to forget our entire knowledge-based heritage that has at least 8,000 years of documented history. The historians were hand in glove with the rulers of independent India who had a long term plan. They sneaked in the term 'secularism' in the preamble of our constitution.

India has been secular since time immemorial. A Hindu considers the world to be his family by the virtue of 'Vasudhaiva kutumakam'. This is a verse which appears in Chapter VI of Maha Upanishad, composed somewhere between 500 CE and 1000 CE.  India is secular not because of her constitution but because every Hindu mother tells her children the virtues of all religions and teaches them to bow or fold hands in front of a mazaar, a mosque, a church and a temple without distinction. We are not just constitutionally secular but culturally secular. So why was a change in the constitution done? To create a division in the Hindu vote bank into secular and non-secular, an old British trick of divide and rule! The appeasement of the minority was so profound that giving back Ayodhya its lost glory was considered clearly non-secular.

What the post British rulers forgot was that faith never dies. When 4 centuries of foreign oppression could not eliminate our faith how could 6 decades of their divisive politics succeed in doing so. In 2014 faith prevailed and the so called 'seculars' were dumped into the oblivion of history. A court case resulted in a unanimous decision in favour of temple construction and people of all religion accepted the verdict with grace, dignity and tolerance. By debating about the existence of Ram, whose life and time is celebrated in the entire South Asia from Philippines to Indonesia, in Japan, Korea and China and wherever the Indian Diaspora migrated, we had become the laughing stock of the world. It needed the overwhelming will of the people of this great land to give Lord Ram his rightful abode, not only in our hearts, a place he never left, but also in Ayodhya. 

By performing the Bhumi Puja of the much awaited Ram temple in Ayodhya the Prime Minister is, on behalf of all Indians, apologizing to the Lord for his exile of nearly 500 years from his abode in Ayodhya and assuring Indians and the Indian Diaspora that Ayodhya will regain its lost glory in near future. The temple is just the beginning and faith will always prevail over politics. 

August 5, 2020 will remain a red letter day not only because the Ram temple started taking shape in Ram's birth place or janmabhoomi but also because this was the day we snatched the pen out of the hand of the British and Marxist historians to rewrite our own history. By decolonizing the minds of our fellow countrymen we hope to restore in their minds and hearts the pride of our glorious and ancient civilization. A country can never prosper if it her people are not proud of her history, her culture and her civilization. The construction of the Ram temple in Ayodhya is the first step of that sacred journey – our teerth yatra towards rediscovering our pride!

ROTE LEARNING – IS THIS THE VILLAIN OF OUR EDUCATION SYSTEM?

After the introduction of the New Education Policy once again there is a barrage of criticism against rote learning and how it is not allowing our students to grow into genuine thinkers. The policy makers have ignored teacher absenteeism, inadequate teacher’s training, poorly funded government schools, too much interference with private schools and a lack of understanding of the very purpose of education and pointed towards ‘rote learning’ and shouted “Eureka! Here is the villain!!” So I thought it was important to understand whether rote learning is really all that bad and what are the other smarter alternatives.

What is Rote Learning?

Rote learning is a method involving repetition and memorization. “Practice leads to perfection” is the tagline for rote learning. Students repeatedly read and learn the same topic several times to memorize it by heart. It is an integration of repetition, drilling, memorization and proper practice in a certain interval.

It is an effective means of motivation of getting basic knowledge in early stages of learning. Our religious schools of Buddhism and Islam have been using this system since time immemorial. They can afford to do so and stagnate but can modern education system afford to do so?

Rote learning is beneficial when we focus on factual (facts) questions. It is also good for learning lists of information that does not require any context. It boosts up our confidence and also motivates us to learn newer things. At early stages of learning, a child learns so many new things, i.e. rhymes, days, months, basic spellings, table, counting, basic facts, different useful sentences in day to day life. Parents and teachers motivate the child to practice several times. It becomes an active habit of learning. 

Are there any advantages of Rote Learning?

Surely there are and some undeniable ones. The fact that rote learning is way of developing a level of understanding through memorizing is an undeniable one. But we must not overplay its role.

Academically weak students gain confidence through rote learning techniques. They learn definition, day and dates, mathematical formulas, historical points, scientific fact, general rules and regulations, differences, certain points and regurgitate them in their examination. Rote learning is a means to cross the barrier. It is one of the best learning style in an examination oriented educational system but is passing examination the only purpose of education?

Disadvantages of Rote Learning

In primary and secondary education, you are learning building blocks, small pieces of facts and figures that you will expand upon when you go on to higher education. Rote memory will work to memorize these facts and figures, but once you move on to higher education, you will be unable to learn complex concepts in this fashion. It doesn't prepare you for higher learning or on the job memory applications. 

Rote memorization doesn't work for students because there is no engaging pattern or effort made to relate the content to students' lives. Rote memory allows for the memorization of base information, but it doesn't put that information into any sort of context. The lack of context for complex subjects means that the student has not learned anything about what they are studying. Likewise, an employee might be able to memorize a list of features of a product, but be unable to sell it effectively because they are not putting those features into a context that can be easily explained as benefits to the consumer.

Rote memory works primarily with short-term memory. When you repeat information again and again to memorize it, you are committing it into your short-term memory banks. To retain this information for longer than a few hours, you will have to commit the memory to long-term memory banks. This will require its repeated use. The more you access and retrieve the information from your memory, the more likely it will be that you will remember it long term. So I remember the Gayetri mantra because I recite it daily but have forgotten the Pythagoras theorem and Ohm's law because I have no use of them.

In our daily life, rote memory also has its place. You can memorize phone numbers by using rote memory, as well as other numbers such as your credit card number, PAN number, passwords, but you have to keep on using them otherwise you will forget them. Forgetting passwords is so common if you have to recollect after a very long time. 

Rote learning also does not allow for complex connections between previous and new knowledge. It can also be very difficult to understand a concept by only using rote memory. Rote memory doesn't give you knowledge. Rote memory will give you base facts and figures that you may remember for a short time but are likely to forget with disuse. To truly learn something, you must be able to make connections to your past experiences and the world around you. Without that context, the facts that you are memorizing are just facts, dates, vocabulary, or numbers. They do not represent true knowledge.

Other alternative forms of learning

Some of the alternatives to rote learning include meaningful learning, associative learning, and active learning.

Meaningful Learning

Meaningful learning is a learning strategy that gives deeper meaning to concepts and subject matter. The more meaning that is given to information, the more likely it is that you will remember that information long term. Information that is learned through meaningful learning is often remembered for years rather than only months such as with rote memory. This is because meaningful learning also promotes understanding over memorization, which helps with overall comprehension. It relates new information to prior knowledge and encourages active learning techniques. All of these points are proven to help one remember the information for years to come. An example - we are going to read a text about Nelson Mandela and before we read the text we show a picture of Mandela and we ask learners what they know about him.  We also ask them what they’d like to know about him. So we are trying to co-relate the new information to the already present knowledge

Associative learning

Associative learning is a theory that states that ideas reinforce each other and can be linked to one another. Close your eyes and try to remember how your mother’s left eyebrow looks like. Difficult, isn’t it. You will remember her face, her eyes and then perhaps her eyebrows. Our brain is not designed to

recall information in isolation; instead, we group information together into one associative memory. That's why it is difficult to recall just one eyebrow without seeing the whole face. Our ideas and experiences reinforce each other and can be mentally linked to one another. Associative learning help students connect with information more deeply and recall that information with greater accuracy. Thus Australia can be associated with South Australia, which can then be associated with Barossa Valley which in turn can be associated with good wine!

Active Learning

Active learning involves actively engaging students with the course material through discussions, problem solving, case studies, , peer teaching, debates, role plays and other methods. In active learning teachers are facilitators rather than one way providers of information. Interacting with content through active learning

has some compelling advantages over 'delivery mode' lectures. It helps to maintain student concentration and deepens learning towards the higher-level skills like critical thinking. It also helps to engage students who might otherwise struggle. The active learning process produces the students on having a lot more creative thinking by implementing into their basic skill of talking, listening, reading, reflecting as well as writing.

So yes, there are other modalities of learning which seem to be smarter but we cannot throw away rote learning lock stock and barrel. Rote learning is path to reach the destination of understanding, but not the destination. This is where our education system is failing our students. Rote learning is a ladder for starting from lowest point of learning to highest point of understanding and our students are not reaching that point.