In this era of transition, (I don't know how long this transition is to last, or will it really last!)we look at practices which are good. I mean. look at the issue of malnutrition - we spend hours (governments have spent years) to ensure nutrition - to the deprived, the hungry with the aim of reducing their hunger, their appetite. Wait a minute, let me correct myself, we do it to reduce deaths - of children below 6, people who may die due to hunger! We do it to reduce IMR! Or thats what we measure to what we did was correct or not...
I have not heard of any feast, meal, parties which is designed for this purpose. We do it to satiate us, or those who are enjoying it! We measure by asking them,"Hope you liked it". Now, when I go around looking at the Anganwadis, I look at the register but no children. If I meet them I look at their weighing scale's face for their weights but not their faces - happy or sad!
So, now I have been having some 'dip-tinking' about the Good Practices in RCH I which we had studied. The document is available on linkage given on the left side.
It talked about activities which increased RCH's programme outputs. outcomes and impact. I am now rephrasing it as 'Good Practice Study for Women, men and children happiness!'I may restrict it to health services only but isn't joy and happiness is a part of mental health! I am sure the study would definitely reduce one type of death - the death of sensitivity!
Wednesday, February 3, 2010
Saturday, January 16, 2010
I saw ‘3 Idiots’ at a conventional (not at a cinemax type one!) cinema hall.‘Vinod’ Chopra and Rajkumar Hirani once again pulled away the red carpet from under the elite feet. Space pen v/s lead pencil, electrified spoon as a ragging preventive mechanism, scooty v/s ambulance, theoretical v/s practical learning, cost v/s need etc. were demonstrated effortlessly and effectively.
‘Aliswel’ as the punchline has spread as a wildfire. (In the last few days, I have heard this phrase million time amongst co-travellers, roadside heros, co-eaters etc. Such non chemical anesthesia – a verbal acupressure at some day would be a refined art of non invasive anesthesia and I will not be surprised if clinical psychologists can also become eligible for an MD in this superspeciality. (They anyway deserve to be.)
We all have bumped into such idiots in our life. About thirty years ago, I and a well known activist were traveling on a mobike from Amravati to Nagpur. It was quite late in the night. Somewhere on the way, the mobike conked out. Plug, carburetor was checked and to our shock, we found that the floater had stopped floating! It was full with petrol. We cannot remove it and of course it needed to be soldered again. We decided to to dump it at a safe place. When we approached a local house, the farmer said, “Why don’t you consult a local mechanic in the nearby village. He repairs everything – a cooker, a stove, a diesel or electric pump, radio etc., etc..” Skeptically, we went to him. He was a 15 -16 year old boy! We told him the problem. With a lot of confidence he asked us,: Did you check the starter, battery and the plug.” We said yes. And showed him the floater. He said, “it is simple, do you have a matchbox?” My smoker companion gave him the matchbox. The boy gathered dry grass and lit them. Rotating the floater at a distance from the burning (rather just glowing) grass, he kept shaking it every minute. “The petrol would go out but the remaining solder would remain intact.” He said. In about five minutes the floater stared floating. Mentally, we were breaking our heads. My partner was a PG in Chemistry (this nacheez was also an inter science pass with chemistry as a subject!) and he knew about oil refineries and lead etc. but we never thought that burning grass would generate adequate heat which, if used cautiously can evaporate petrol without affecting lead! The 15 year old idiot (The Millimeter) did it! We reached Nagpur, about 100 km away safely without any stress.
Another example in our own field – the community health worker. A CHW - woman of about 60 or more year old. She belonged to a primitive tribe – Katkari. She was not trained with reading and writing skill but had developed her own system of memorizing medicines. During a monthly meeting, she shared her experience. As a part of medicine kit, CHWs had Gentian Violet as a standard drug for wound dressing. When a person with a wound under his left thumb came to her for dressing, she realized she did not have GV. She could not have been able to get it refilled because the whole community was working far away. She realized that the person needed an antiseptic medicine o be applied. So she prepared a paste using crushed and finely sifted sulfa tablet and oil! We had not trained her for using sulfa powder like Nebasulf etc. I asked her why sulfa. She said, ‘You had told us to use sulfa tablet for infected sore throat. Since the wound was also infected, I used it as a powder for dressing! (In the parlance of knowledge, she had reached the level of Application!)
We know of such great ‘idiots’ who have demonstrated changes even in our own fields. Fredrich Engels in public health, Florence Nightingale in statistics, Dr Jenner in immunization, David Werner in Rural Health Care System. They have demonstrated ideas and their application which spread like a wildfire. We have Collectives also - Dais for normal deliveries, Vaidus for herbal medicine or for that matter Dabbawallahs of Mumbai in Supply Chain Management, Bhishis in microfinancing are such examples. Incidentally, this film has been added to the syllabus of Management Science!
We need such idiots now for universal health care system. Today’s system is not easily available, accessible and affordable. Cost of health care is soaring up. We need them for ideas, not just 3 but many, many more. We also require a Suhas, who shouts at his fiancé because she loses a gift. Not because it is a valuable one but because it has a high price. After all, cost can be a concern.
Just a word of caution, however. The 3 Idiots have demonstrated that in unforeseeable situation their ideas were the best. But they are not always safe and appropriate. Bringing to a hospital, an unconscious person in a sitting position is not safe in every situation. But if no ambulance is available using whatever is available is better than not doing so. After all, before developing the Space Pens, conventional pencils were used. But there were flaws in them. The granite and so does the wood - break at the variable temperature in a space craft – 1500C in shadow and 1200C under sunlight. Broken pieces float in the space craft and can create a disaster. And both can burn in 100% O2 environment! (Please see http://www.snopes.com/business/genius/spacepen.asp) So, idiotic ideas should be tested – are they harmless or potentially harmful? So, we need a Silencer, too!
Moral of the story - Always say ‘Aliswel’ when you are applying an idea, even when it has been tested. After all, saying so is not harmful! Isn’t it?