Doctor's Dilemma

An email from Dr. Ashok Sinha of Agartala, Tripura is doing rounds among Medical Fraternity. I feel that this particular mail requires wider public exposure than read by only Doctors.

' The recent controversy regarding the village posting of doctors has put the medical community on one side and the whole world on the other side. I remember, 35 years ago, when I was selected for medical college I went to one of my elderly aunts to seek her blessing. She was not very happy about the issue, no, she was not jealous, but she expressed her anxiety very eloquently. "You are such a nice boy, but now you'll become a bad man". That, I think, sums up the attitude of the society towards the doctors. The problem possibly lies with the doctors. They work for money, they do not bother about the society, they can kill female fetuses for a few bucks more, and they can refuse treatment for want of money; they are not up-to-date with knowledge, they do unnecessary tests to get a share of the booty. Most of the complaints are probably true. I have seen ultra-sonologists giving shamelessly false report to assist another shameless gynecologist in going for an unnecessary surgery, and I have seen many more un-parliamentary linen that I should not wash in public. All are true and more. My worry is about the ways the society is trying to go about solving the problem. The society is trying to find a solution without assistance from doctors. It was the same when the consumer protection act came. Most of the sane doctors protested, some insane ones also did. No one listened to us. I remember having told one gathering of legal experts, that they were putting the patients from the frying pan to fire; from doctors clutches to lawyers. I asked them, why did they want consumer protection act for the medical community, to improve services or getting compensation, or did they want just to teach a lesson! I assured them none of these would be possible. People refuse to learn from history. Has the road accident compensation policy improved the quality of drivers? It has only raised the insurance rates and probably helped the family of the dead. If consumer protection act implementation for medical community was intended for compensation, it was good, but if it was meant to improve services, it was useless. People gave us funny looks, thought we were `so bad'. Now the great thinkers of the nation are again at it. They want doctors to go to villages, and because the anti-social doctors do not want to go to villages, they'll have to be forced. I am surprised at the cerebral quality of the people who rake up such ideas. Has any one tried to find out why doctors are not interested in going to the villages! Is it only money! By the way, one of the lowest paid employees in India is a junior doctor. As a junior doctor I was paid a princely sum of Rs. 225/- PM, while the ward boys were paid Rs 400/-. Their duty was 8 hrs, mine 24 hrs; they had one weekly holiday, I had none. They had time for lunch; I did not. I survived because the `sisters' were real sisters; I shared their food. If the barber failed to turn up, I had to `prepare' the patient for surgery; the ward boy would not even have a nightmare of doing it. If the ward boy were absent I had to `ensure' that the patient reached the OT on time, riding on the trolley, guess who pushed it through the corridors of the hospital! But I tell you; I enjoyed my stay as a house surgeon. I am still proud of what I did. Because that was when I learned. That was what prepared me for the future. That is where I learnt how to give a painless suture, how to tackle a violent patient, how to tackle grief. I do not think a Lal Bahadur Institute trained babu will ever understand that, they do not have the training. Look at the position of medical education today. MBBS is a five and a half years course. Already the longest course in the country. But an MBBS degree is truly nothing today. At one time an MBBS degree was equivalent to an M Sc degree. One could become a lecturer after MBBS, could do a Ph D, or D Sc after MBBS. But no more, now MBBS is equivalent to B Sc. MD was a doctoral degree, Doctor of Medicine, now a postgraduate degree, a three years postgraduate degree. A two years postgraduate diploma is not equivalent to M Sc. Even the MCI is trying its best to degrade the status of medical degrees. I invite the society to understand the problem first. Force should come as the last option, not the first. Today an MBBS degree holder is a pariah in society, to be accepted by the people he has to have a postgraduate qualification. `Only MBBS', or `simple MBBS', or worse `plain MBBS' are terms we hear often, but do not understand the agony of it all. MBBS entrance is one of the toughest in the country, but let me introduce you to a tougher entrance, the PG entrance. The number of seats for PG is one third of the total MBBS seats, so in any case two thirds of the MBBS shall remain `plain and simple'. This cutthroat competition has prompted the students to treat MBBS degree as a qualifying benchmark for PG entrance tests. They prepare for the test rather than trying to become doctors. This one entrance test would make or break their career. It is better to be a simple B Sc then to remain a simple MBBS. There are instances where MBBS students are paying smaller hospitals to get internship certificate without going to the hospital so that they can utilize the time studying. What is the result? They do not become a `doctor' after MBBS; they remain students. One third of them get into PG, two- thirds fail. No, not because they are stupid, because the know-all government has put a rationing in the number of seats for PG. Imagine the fate of these students, they are plain MBBS, did not spend time learning during internship, now they are out in the open, no respect, no knowledge, official quacks. This is the most serious wastage of trained manpower the country is facing today, all because of our policy makers. Who is responsible? There was one know-all TV talk show, which said if you cannot become a doctor in five years, you could never be. So cerebral! These are the people who control the society, God help us. One does not become a `doctor' immediately after passing MBBS; it takes at least 2-3 yrs of fulltime work under supervision to be able to work independently. That was what house jobs were. Earlier house jobs were compulsory before MD entrance. After 2 house jobs if one did not get in to PG one could still practice. Now house job has no PG entrance value. Practicing medicine without a House job does not prepare a doctor well. Is there a solution to the problems in villages? It is there, if our great parliamentarians bother to listen to us. By the way I have a few more proposals. I want to make it compulsory for the parliamentarians to stay in a village for one year as MP and fulfill all promises made during election campaign otherwise their Membership would be cancelled. Make it compulsory for IIM graduates to stay in a village for one year to work for betterment of rural finances, before they get their degree. I want High Court judges to stay in villages at least 2 months a year to help solve the pending cases in the villages to be eligible for promotion to Supreme Court. I want the IAS officer to be posted in a village for one year before they are confirmed in their jobs.They can all stay in the excellent accomodation provided in the villages for the doctors. Sounds funny? Who started the jokes! Here is what I suggest. The entire medical course needs to be revamped. Instead of hundreds of confusing degrees there should be one degree, MD. It should be a nine years integrated course, equivalent in status to a Ph D. All students, after four years, would get a provisional registration to work as doctors under supervision. They would select their specialty at this juncture, depending on the merit and other government policies of the time. Even a surgeon would be MD. All the diploma courses would be abolished. There would be specialties in family practice, clinical medicine, hospital based internists, surgeons, ophthalmologists, and all other specialties that we have today. One year out of this course will be a village posting where they can learn the problems of the villages and unlearn some hi-tech solutions to simple problems. There would never be a shortfall of doctors in villages, happy doctors and not frustrated ones. I do not think there would even be a murmur of protest from anywhere. No forcible "Cultural Revolutionary" tactics would be needed. The GPs that we get would be trained ones, not untrained ones as we get now. How does a patient differentiate between a physician MD and a general practitioner MD. The same way they do now, between MDs in Medicine, pharmacology, biochemistry and pathology. In any case, government can recognize certain associations, memberships of which can be made compulsory. (For example, MD, Member of Indian College of Pharmacology, or MD Indian College of Surgeons.). This way every doctor that comes out of the college would have some special skills, and have worked independently for at the least 4 years before being released to the society. There is no wastage of doctors as `simple MBBS'. The super-specialties should be limited to a few, the brightest ones. There should be no further confusing degree like M Ch, DM. The super-specialists would be offered fellowships of the college, e.g. MD, Fellow of the Indian College of Cardiac Surgeons, equivalent to postdoctoral degree, D Sc. By the way this does not solve the problem of the bad guys in the profession as mentioned in paragraph two of this article. I'll share a bitter truth with you. The patients are as much responsible for this situation as the doctors. The ratio of good doctors and bad doctors is exactly the same as the ratio of good guys and bad guys in the society, not more, not less. There is something very wrong in the way patients select their doctors. Name and fame does not depend on skill, knowledge and sincerity. Sound business tactics, sometimes not so ethical, makes one doctor more popular than the other. This article is aimed at sensible people who want a solution, not revenge. The next doctor could be your son; the next patient could be your son. '

New Year Juhu Molestation

Reading Posts on Juhu Molestation here, and here .i wonder why Sexual Molestation in Public is treated so differently than other crimes. Saksi's suggestion for women to be safe in crowded public places is perceived as 'Blaming the Victim' for the sad, harrowing incident. But when you keep your car unlocked and someone steals your bag, or get mugged in deserted street at night in Crime infested area,or your chain is snatched/pocket is picked in suburban train, part of the blame will be yours. You cant blank it, you cant say that i will not take precaution to be safe, but perpetrator of the crime has to improve and change his mindset. If that were possible then there would be no crime in this world.There will be sexual offenders in any society. Molesting,Raping,taking women as sex slaves after defeating enemy is historical. Major wars are fought on such issues. If anyone thinks that this will be erased from the mind of the males and they will behave, than it's Utopian dream. Being drunk is more dangerous than being high on drug. Alcohol removes the moral and behavioral control that we have acquired by good upbringing. A drink too many makes you reckless and one takes more risks. Even when one is with friends, its better not to allow anyone to cross that limit.In spite of taking all these precautions, there will be cases of sexual offense, but that will be unfortunate.Time and better upbringing will reduce it but wont eliminate it altogether.---PK

Old Family Planning Fraud in New Bottle

TOI reports that Govt. has announced 'Incentive' scheme to spur acceptance of Vasectomy operation. Those who undergo Vasectomy operation will be paid Rs. 1200/-,'Motivator' will receive Rs 150/- and even surgeon will be paid incentive. Govt. hopes that this will help make Vasectomy more acceptable. Of course women undergoing Tubectomy operation will also be paid similar amount as incentive.
This news brought memory of those good(?) old days when Vasectomy had pride of Place in Family Planning Program. During Emergency Scion of Gandhi family and heir apparent Sanjay had taken up Vasectomy as part of his 5 point program. Teachers,Govt. officials, Police and all those who were in power were given Vasectomy operation targets and they HAD to fulfill the target. Result of this misplaced zeal was forced Vasectomies. Police and other Govt. functionaries rounded up people and forced them to undergo Vasectomy,even those who were not eligible for operation.Surgeons aware of this state of affairs simply gave incision on Scrotal skin and did not Tie/cut the Vas. Ofcourse he was paid off to do this.Incentive money was shared by the staff of Family Planning Dept. I remember people arriving by train from U.P./Bihar etc were rounded off and forced to undergo Vasectomy at V.T. station. After emergency was lifted, Vasectomy program was severely criticized and was held responsible for defeat of Indira Gandhi.
As Vasectomy operation virtually disappeared from the scene, incentive program was introduced. But by this time FP staff had learned the trick. As a person who had worked in the dept. then, I can confidently say that more than 95% of the cases done between 1980 -86 were fake cases.we used to call then as 'D' cases. Everyone including driver/cleaner of the Mobile Vasectomy Van of BMC had share of this loot. In city like Mumbai, Patient could never be traced if address given was in slum. Each center had a team of 'Motivators' who would bring patients for Vasectomy. Everyday 5-6 cases were done. Same people would come again n again for operation and all forms were duly filled and money distributed.Biggest problem was to give names to the patient.Here Marathi newspapers would come handy and Names were lifted from Navakal,Sakal etc. Injections,syringes,Gauze, Cotton and other material was pilfered. There was scramble to get posting at centers doing cases and on Mobile Vasectomy Vans. Vasectomy operation figures improved dramatically. There were cases which were not eligible for Vasectomy, age more than 40 yrs or spouse had undergone tubectomy etc. but those were the days of Dr. Datta Samant led Mill Strike. Many Striking Mill worker opted to get operated to get Rs. 800/-as incentive money.In 1983 this was good amount. Unemployed youth,migrant workers, teenage streetchildren were lured by Motivators to undergo Vasectomy operation. Obviously this FP program couldn't make any dent in burgeonig population. When in 1986 ,incentive program was stopped, number of Vasectomies dropped precipitously and now it is just few thousand cases.
Fate of this program is not going to be different.Crores of Rupees ,badly needed to provide Health care to poor will be diverted and siphoned off. May be this is a pay off to political party worker in Pre Election year. As it is even Female Tubectomy program is not picking up. There should be rethink on Permanant Method like Tubectomy/Vasectomy. Their acceptance is very low these days. Couples prefer to use Temporary methods like Condoms,IUCD or Pill and Emergency contraceptive pill. In case of failure Medical Termination is preferred.This new incentive scheme is invitation to fraud and new generation of FP worker will be initiated into this fraud and will stop promoting temporary methods as well. ---PK

Holy Wars--Religious Conversions

TOI in its Edit today(here) have asked Hindus to do introspection and try find out reason for converting from Hinduism. Then proceed glibly to provide the reason as " Social ostracism of Dalits and Tribal s". But does converting to Christianity or Islam remove social ostracism? It was true when Islam or Christians were the rulers and they protected converts from Hindu social discrimination. In society Converts belonging to ruling class were higher than "Native Hindoos".But in today's Constitutional Democracy conversion brings no benefit,rather it adds one more hurdle.For Hindus they are now Christian/Muslim Dalits or Tribals. Upper caste Hindus are not going to accept Dalits as equal just because they have converted to Christianity or Islam.Conversion is historically associated with defeat and conquest by other religious group and converts invite ire and hate of their birth community.Converted Dalits even loose the constitutional reservation in Jobs and Education. Thats the reason for increasing clamor for extending benefits to Converts.
The question we have to ask is 'why are they converting from Hinduism.?'It is not Caste or other Social evils like Dowry.Because Dalits are discriminated after conversion.In India Christian and Muslims are equally conscious of their Caste,and they share equally other social evils like Dowry and female foeticide. Women's Social status in Islam is worse than that of Dalits in Hindu society,but are Muslim women converting to other religion? Liberal Hindu religion should be able to get more converts from other religion which are more regimental,dogmatic and dictatorial.
Main reason for Hindus converting to other religion is not reasons advance glibly, but fact that there are no efforts to Propagate this Glorious Liberal Philosophical religion.If you want to Propagate Hindu religion than immedietally you are branded 'COMMUNAL'. Only religious organization which tries to do this work is 'Communal' VHP. Missionaries do lot of good work like establishing Schools, Colleges, Hospitals,Health Centers,Shelters for poor and underprivileged.But from where do they get the money to carry out these activities? From donations given to Churches. Hindu Temples(Churches) are flushed with money donated by Hindu devotees but these funds are managed by Govt. appointed committees as per guidelines issued by State Govt.of the day.They are not interested in propagating Hindu religion,running schools or Hospitals in tribal areas,or providing help to poor with the aim to attract/keep them to Hindu religion.Recently Shri Saibaba Sansthan spent 60Laks of the donation money on President's visit to Shirdi.Tirupati Devasthanam and Jagganath temple of Puri are not known for running School,Colleges,Hospitals or Health Centers/Shelters in nearby Naxal infested Tribal Belt of Andra Pradesh and Orissa.Sabrimalai Temple is under the control of Athist Communist Govt.Vaishno Devi temple Trust in Jammu has done nothing for thousands of Hindu refugees from Kashmir.
This great religion has now only 900Million followers-90% of them in India.If this trend continues and it will, then by next millennium fate of Hindu religion and Civilization will be same as that of other ancient religions-it will be on the brink of extinction-like Zorastrian(Parsis).--PK.

Winds of Change- Greetings

Till 3-4 years ago, during Diwali and New year I would receive 70-80 Greeting Cards from Friends, Colleagues, Diagnostic Centers and Pharma firms wishing me and my family, a year full of happiness, peace and Prosperity. This gesture would be reciprocated by me and month before Diwali I would go through the process of selecting Card-CRY, Helpage or cards from some other Charitable organizations.Then would come the matter to be printed on the card. As these cards served as surrogate advertisement, informing receiver about attachments to various hospitals, Consulting timing and New facilities being offered, lot of time was spent in drafting the subject matter. Then came printing of the cards and most difficult part-writing names of the recipient,signing the card and writing address on the envelope. It was practice session which proved very useful when there was wedding in the family. Posting was easy with advent of courier service.
This year I have received only 5 greeting Cards. 3 from the Pharma cos. and two from the relatives who always send Greetings on Post card-reminding me that Post Card still exists. But Inbox of my Cell Phone is full with 50 messages,some very simple and other elaborate, some are in Hindi. Inbox of my email has many messages and flash cards with sound and noise of the Crackers bursting.( Now I pay to receive and download!!).
With SMS and e mail, it has become very easy to select Greeting and send it. Selected email-flashcard can be sent- in seconds- to entire contact list which includes all friends and relatives who matter. As sending email and flash card is free, it can be sent to everyone by click of the mouse and receiver feels that I am still a close friend who remembers to send him greetings. SMSing Greeting is more personal and effective as recipient has to view it and then delete to make space for more SMSs. This has virtually finished the Greeting Card business except for Valentines Day cards.

Winds of Change

Today I went to Udipi restaurant in Andheri West for Cup of south Indian Filter Coffee. Person who took my order was Marathi manoos. Two waiters were North Indians-one was Bihari and other appeared to be from Haryana-Delhi. Surprise ! Nepali Boy was cleaning the Tables and other one was serving water( First thing you get as soon as you sit in Udipi Hotel).
Gone are the days when shetty boys came from Manglore and worked in Udipi Hotels of Mumbai at the bottom of the ladder-cleaning tables and serving Water-gradually moving up to finally own/manage a Restaurant. Kutchhi Shopkeepers who used to get people from their native place to work in the shops have now switched over to employing people from Bihar and Orissa. IT/BPO has definitely changed employment avenues in rural areas.

HIV Capital of the World??

Finally the Cat is Out of The Bag !!. For years India was suppose to be HIV Capital-having highest number of HIV cases. This year on World AIDs day,Health Minister has finally accepted that we did not have correct figure of HIV infected population. Pune based organization has finally done Scientific Survey of HIV infected people and brought down the figure from 5 million to 2.5 million !!. This should now help to understand how disease spreads and what should be our strategy to reduce the spread. Unfortunately awareness level is going down. Free sex without protection is acceptable. Young generation is more worried about Pregnancy than HIV infection. Multiple partners,casual sex,one night stand is again in the vogue. Are we heading in the direction of Sub Sahara Africa? There whole generation is affected by HIV and the workforce is depleted. We cant even decide what and how should we impart sex education to High School teenager. All our efforts are directed in working on Economic Miracle and Double Digit Growth rate. If HIV spreads at present rate than by 2015 we will have to spend much more on providing Health care and recent example of USA has shown that Health care expenses can drag economy down. It's time to wake up.

Good Bye my Blacki Baby. Rest In Peace.

Finally it happened.
After week of treating my baby Blackie with IV fluids,Lasix,Rantac,Dextran,Sucralfate. We felt that he is improving. His tongue was regaining pink colour. He was weak but could move around in the room. we were force feeding him and he was retaining it. He was passing good quantity of Urine. Stools were of normal colour. His Blood values were not increasing. He would recognize us and would wag his tail. we were getting hopeful. it was taking heavy toll on me. Giving just 400 cc. in 3 hrs to a dog is real effort and to do it twice a day , more so. we had to lift him and take him down so that he could pass urine. If he cant then I had to Catheterize him.
I had started his Iv drip and gave Inj. Lasix. after 100 cc he got up and started making cooing sound to indicate he wants to eat something. He drank about 300cc Water mixed with electral solution. We were overjoyed. His Iv drip was discontinued. He was taken downstairs where he passed good amount of Urine. We put him in his room and with much releif sat down to watch 'Main Hoon Na' on cable. After an hour or so he walked out of his room and came to his usual place in Drawing room. He stood there swaying a little. I took him back to his room and made him to sit in dog position.
After the picture was over K wanted to sit there for a while. We were feeling at ease. Blacki has started taking feed and passing urine on his own so now things should get better.There was glimmer of hope.We sat there for an hour or so,planning for Diwali.Before going to sleep K went to see Blacki. He was standing and his breathing was fast. She called me. i tried to make him sit. I was wondering whether i should get oxygen cylinder to ease his breathing.
Suddenly he ambled towards K. put his head on her lap. She started patting and baby talking to him.I was stroking his back and could feel the very rapid breathing and fast heart rate.He sat down and K called out to me that he is going, i felt that breathing had stopped and heart was going into Fibrillation(Flutter). He slowly lied down, Took 2-3 gasps and it was all over. I felt more pain and sorrow than ever before. More than what I had felt when my parents,close relatives died. There were no thoughts about what future holds for me-thoughts I had when my parents died. There was only sense of very very deep loss. He had demanded/wanted nothing from me but always gave me lots of love. No conditions were attached to that love. i didnt have to reciprocate. His love, affection and joy on meeting me were always there.Everyday,every hour,every minute. This memory of unconditional love will always remain with me. we will always miss him and remember him.
Good Bye my Blacki baby. Have a nice higher life. Rest in peace.

Pet Problem

For a month now I am busy with my Pet Blackie's treatment. He is 12 yrs old Pom, and in these 12 yrs I never had to visit Vet except for his Vaccination and occasional check ups. Two yrs ago he developed a Cystic Lump below Anus. It was not troubling him and Vet was not sure about the origin of the lump- it was not Malignant tumor. Last May the cyst burst but healed on its own. Last month the Cyst burst and there was lot of bleeding. Vet advised that the cyst be removed. So Blackie was admitted in Parel Vet.Hospital. At his age there were risks and we were worried. His Blood reports were normal but Heart was enlarged. His operation went off without any problem and next day he was moving about, eating milk and bis.,passing Urine and stools. But his stools were Black and Sticky. His recovery was fast and on 4th day Vet at Parel gave permission to bring him home. We found him little weak, wouldnt go for his daily rounds in Soct. and stools were still Black. we suspected that this is altered Blood and he may be Bleeding in Intestines due to Operation stress Ulcers. Now he had developed cough and would sit down after walking a short distance and had stopped taking feeds. We took him to Vet in Juhu(near Pratiksha) and he felt that it was 'Kennel Cough'. Blackie was treated with usual mix of dext-Saline,Antibiotics,etc. He was going down. We could see that he was getting weaker by the day but his Vet or Vets. at Parel Hospital couldnt diagnose the cause . They continued to treat it as Chest infection-Bronchitis- and we gave Nebulisation,Asthalin,Higher Antibiotics and IV fluid.Our repeted suggestion that this cough can be due to LVF ( Left Ventricular Failure) were ignored. By this time he had stopped eating completely so we started force feeding him with milk. Then we realized that his Tongue had become very pale. He was loosing Blood somewhere( Most likely from Ulcers in Stomach or Intestines). We were desperate. My baby was very very sick and these Vets cant even diagnose the cause. We decided to go for Blood Tests and new Vet. Blackie was taken to Vet. Swali and he felt that Blacki is in Renal Failure.Urgent Blood Tests confirmed this. His Haemoglobin was just 4 Gms(30%) S. Creatinine was 9 mgs and BUN 63mgs.
He was still passing Black stools. he was put on Sucralfate (which covers the ulcers and stops bleeding), Inj. Rantac,Lasix and Iv fluids. He had Post Op. Acute Tubular Necrosis or Low GFR due to Anaemia and LVF. At last we knew what was wrong with him and can now focus on treating the cause rather than just shooting in the dark.Now we are giving him IV fluids and Lasix and hope to get his Creatinine down,stimulate the Renal function. Luckily he doesnt have Pain. He is not breathless. His stools have become normal.He still not taking feeds and we are force feeding him. But prognosis is not very good.We are late by some 10 days. Had his Vet. diagnosed the problem earlier,Vets at Parel Hospital( who are teachers/Proffessors at Vet College) listened to us and been more proactive than he would have had better chance of recovery.We can only pray for his recovery and treat him and give support so that he can give his best shot at recovery.
I feel sorry, when I Google Searched his problem I find that we are so much behind the West in treating our Pets.We dont have decent hospital or equipments.Our knowledge is inadequate and most important there is feeling of Deja Vu.Its just a Dog! When humans are not getting proper treatment who can advocate better treatments for Pets? Even commercial interest is not stimulating better facilities for Pets. Huge stray population has increased the negligent attitude of Vets and ordinary people. ---PK

E Pill-Emergency Contraceptive pill

I am really pissed off with the TV advertisement of Cipla's Emergency Contraceptive pill. Don't get me wrong. I have no cultural or moral objection to this advertisement. On the contrary I feel its very very effective advertisement, and there lies the problem. Since the airing of these films I have had patients who had used these pills and were pregnant. There are girls who are sexually active and want to use this pill as contraceptive method. Now this pill is meant to be 'Emergency' contraceptive and one should not have emergency every month or 3-4 times in a month. Inadequate knowledge, easy availability in Chemist shop without prescription and lack of supervision by medical personnel can result in complications. If one is Sexually active on regular basis then Regular,more effective Contraceptive methods under Medical supervision should be preferred.
First of all , it's Emergency contraceptive pill, so it should be used only in an Emergency.That means that if you suspect that contraceptive method used by you may not work( Condom broke or slipped off or semen entered the Vagina. or you missed to take the pill or safe period was calculated wrongly. In the case of Rape it should be routinely given.) It is not as effective in Preventing Pregnancy as regular contraceptive methods like Condoms, Birth Control Pills or IUCD-Copper T. Its no more effective than 70-80% ( There is no good Clinical data for this as well). It contains Hormone Estrogen and Progesterone and will alter Hormone Balance and period can be delayed. multiple use may make period irregular. Besides there are side effects like Nausea and Vomiting, Venous Thrombosis etc. Though these side effects are not usually serious.
Finally my pet grouse. E-Pill does not protect from Sexually Transmitted Diseases like Candida and other infections, Herpes and fatal HIV and Hepatitis B & C. This is more dangerous then Pregnancy! Most effective Emergency Contraceptive is to Carry good quality Condom in your purse and ask the Man to use it properly if he wants Sex. If he refuses then walk out for your own good.

Media coverage and frenzy of the fans seen for last 1 month during Court Judgement,arrest, their stay in jail and finally release on Bail and homecoming in the case of Sanju and Salman, makes me wonder what makes Film Stars such a celebrity. Their fans are from across the Class and Caste, Religion and Social Status, Industrialists & Politicians to Dons.Highly trained professionals to humble daily wage earner. Its not Bachchan or Khans, even chhota mota filmstars/TV actors,Anchors, item girls with 2 dances to their credit and even 'Kallumama ' has fan following. Anyone working as an actor in Film or TV becomes famous and has fan following. Sometimes it is short lived-from few months to few years- but for other Lambe Race ka Ghodas, it is lifelong. They even get elected defeating political leaders with years of experience in Politics. If Amitabh or Shahrukh were to stand in an election against even Soniaji and Rahulbaba, no one will predict the outcome. Unfortunately many of them are petty,megalomaniacs with inflated egos and self worth. Uneducated,ill mannered, uncouth and habitually they throw their weight around. In a Public functions they are given more importance as guest then performer or person in whose honor the function is being held.
I fail to understand why this particular community -Actors-are given such a high celebrity status. Directors,Music Directors,Writers,and all other professionally connected/Creative people don't find even mention in Media and are virtually unrecognized. Is it something to do with our inability to come to terms with and accept concept of 'Film',where you can see a person doing everyday things on screen?. Is that the reason for amazing success of 'You Tube' and hundreds of clips-many absolutely useless and bad- it receives daily. It is excellent subject for research.
Similar to this is our fascination about Aeroplanes and Flying. Most of us would look up to see a plane when we hear their Engine sound. Few years ago when 'Air Deccan' came out with Tickets in Rs. 500/- ,my car driver wanted to fly in plane. He wouldn't believe that flying in plane is one of the most boring experience. Pilots are held in very high esteem. I can understand about Fighter Pilots but Commercial Airlines Pilots receive so much help from technology that flying in most of the cases is made simple and safe. Compared to them Drivers of ST/BEST and Blue Line buses have real difficult task. Is it that after 100 yrs we have still not come to terms with and accept that we/Machine can fly.--PK.

Salman-Jekyll & Hyde

After a week long drama,which received widest Media coverage, Salman Khan got Bail in Chinkara Case and returned home from Jodhpur jail, a tumultuous welcome from 3 F's, family, friends and fans. His family and friends have suggested that Salman received this harsh(!) sentence from court as he is a Celebrity. His image as Spoiled Brat is because of undue coverage given to his drinking binges, Brawls in the party, Midnight calls to Vivek, Banging door of Ms. Rais home for hours, his alleged links with underworld etc,etc..... He is in fact suppose to be really nice person,helping friends with tips on acting and Body building, giving presents to friends, helping unit hands with money and he even gave money for treatment to Mr. Dhasal.He still resides in modest 2 BR flat -a floor below his parent's home. If this is true then his behavior is typical of Dual Personality and he needs psychiatric help from competent person. If people like Salman-forget everything else but he did go hunting with his co-artists and killed Chinkara knowingly. At that time he was filming for Rajashri film and his cherector in that film is very soft spoken,non violent one, who doesnt get angry or raises his voice ! If after pack up he changes to a person who picks up gun and kills Hiran-Chinkara,then it calls for probe in his personality and behavior. I am amazed by the frenzy of people( And Media as well) in Jodhpur and Mumbai, who wanted to have glimpse of their favorite star and idol. If for todays youth-this is not youth which is in TV studio- but one which takes part in College Elections, is present in large number in protests and venting anger on Professors and VC's. by breaking furniture- Salman and Sanjubaba are the idols then fate of "Rising India" of UPA will not be different than 'Shining India" of NDA...PK

Reading news item about ms. Mallika Amar Shaikh's efforts for Financial help for her husband Fiery Dalit writer/poet Namdeo Dhasal brought back memories of 70's when Dalit Panther movement took off and had some relevance. But to my mind it brought memories of Mallika's autobiography, which I had read then. Mallika who is daughter of Leftist Shahir Amar Shaikh had vividly described her experience during her first pregnancy and particularly-her delivery in B.M.C. run Nair Hospital. She wrote about behavior of staff in labor room, where she was made to lie on dirty delivery table and at the height of unbearable labor pains, she was slapped, pinched on thighs and buttocks and taunted with most sexually explicit remarks.

Having worked in labor wards of Municipal hospitals, I know that each and every word was true-no exaggeration. Patients are left on Delivery table with no one around them, If she shouts in pain ,she is abused, shouted at and even slapped. Sometimes hours pass before resident doctor in charge ( busy with other emergencies) realizes that particular patient has not delivered and then she is re examined and future action carried out. Usually there is no feedback from the Nursing staff to Doctors regarding progress of a patient. What surprises me the most. Nursing staff,Ward boys and Ayahs come from the same 'class' as patients. Many of them stay in the same locality.Even then why there should be such an animosity and poor behavior and treatment with no compassion? In case of Medical needs they patronize the same BMC/Govt. hospitals. Doctors who usually belong to higher(Richer) class have better attitude and are more compassionate. People belonging to same class should treat them better, instead reverse is true. Is it because of the frustration of their lives and daily grind they face, force them to take it out on people who cant hit back?

I hope situation must have changed now but I doubt it. BMC/Govt. has no money, desire or expertise to run Maternity Homes or Hospitals. They would gladly hand them over to Pvt. parties in the garb of Charitable trusts, if they can navigate the deal through political minefield of BMC. If this cant be done than they are allowed to get dilapidated by willful neglect and then discontinued as in the case of Cooper Hospital or many Maternity homes,to be rebuilt and run by Pvt. Charitable trusts. Besides only those who cant afford services of Pvt. Nursing Homes or Hospital patronize BMC hospitals. These hospitals could provide one with best of treatment at almost no cost,provided Paramedical staff can give service with compassion and authorities have will and desire to infuse much needed funds and resources.---PK

New IT Return

Finally last week I could manage to file my Income Tax return.Though everything was ready in April but new IT form had not come. Last week I had appointment with my Tax Cons. Gone are the days when one could sign the return,give all relevant challans and papers and let consultant file return at his convinience. Now everything is online and this year no enclosures,so you have to be present when he fills in details,computes your income,tax payable,tax paid and refund -if any -and take print out and then sign it.
TC checked everything on his computer screen,cross checked with me and then clicked 'print'. HP printer got into action and in minute or two print outs were in the tray. TC collected the bunch.
I asked him: "How many prints you need?"
"Three".t th
"But these are lot of papers"
" Yes,but this is one copy. From this year IT return has 30 pages. From last year's one page SARAL form now we have 30 pages Improoved,Taxpayer friendly return."
and he called in his peon and asked him to get 2 sets of Photostat copies.
From next year onwards when you apply for Loan, Visa to travel or even credit card, you will be asked to submit last 3 yrs. IT retuns with computation. You will have to submit almost 100 pages of IT return and sign each and every page. Dont be surprised if your application is rejected! Because it will be difficult to asses what is your income from this confusing return. What Fun!!---PK

A Game of Rummy

Friend called in the morning.
"What are your plans for the weekend?"
"Nothing in particular."
"OK. we are meeting on Saturday/Sunday for card session.One day at my place and next day at your place."
"Sure. Will you contact everyone?."
"Yeah."
"see you on Saturday, 5 pm."

This is the usual conversation on Thursday for last many yrs. Majority of weekends are spent playing cards-Rummy. we are 11 people in the group so dealing 13 cards to everyone is a painful task. Game takes time and those who have packed indulge in small talk on Politics, Markets,Family matters etc. Stakes are low so there are no opportunities to win significant amount. We tried out other games. We played Bridge, Tin Patti with various variation, but nothing would be attractive after 2/3 sessions and we would go back to playing Rummy. Agreed Rummy doesn't need level of skill and intelligence of playing Bridge nor it requires aggressiveness,false bravado or financial strength and ability to take risk as in Tin Patti. Rummy is slow game and gives you time to socialise, converse and interact with other players. Ideal game for group of old friends. But more than this, it is the nature of the game which attracts people.
* You have cards where everything is ready. Suits(Sequences), Jokers, you have to just show your winning hand!
* You have good cards. 2-3 Jokers, chances for sequence but no true Sequence. one card and you can win! but... you don't get the card and you pay highest amount.
* You have 2-3 Jokers,a sequence but you are waiting for that one final connecting card( 4th card). Its not your day so you don't get that card,you loose.
* You have a sequence,1-2 Jokers, you are progressing slowly. Next pull and you can show and win. But.... you loose.
*You have one True sequence,1 Joker but your game progresses with each pull and .. you win!!
* You have 4-5 Jokers but rest of the cards have very poor connection. No way you are going to get that true sequence. You pay the highest amount. Its punishment game. You know you cant win but you have to play.
* Same scenario as above but luck favours you and you get the true sequence. You don't win but don't loose much.
* Some days your Luck has deserted you. You don't get good cards. You pack up more games than you play. Ones which you play goes nowhere and you steadily loose small amounts.

Yes. Attraction of Rummy lies in these similarities to our everyday life situations. when you look back you will find numerous occasions which resembles various scenario described above.As in life, LUCK plays major and important role in shaping your Progress and Destiny. Your education,intelligence,connections and every thing is second to the element of Luck.If you can play the game of Rummy with equanimity than you will be able to handle triumphs and disappointments in your everyday life.

After the evening walk in Mountain View Park, We sat down on the bench next to barbecue . I realised that there was a Cell Phone lying in the corner.My first thought was that someone forgot to pick up phone after his sojourn in park. But years of staying in India had made me weary of picking up unattended items in Public places. It can be a IED-we are always warned. I hesitated. Best thing, do nothing and wait for some time.Owner will show up.But if it rings? Then should i answer the phone? How insecure our life is in modern times !! Waiting there, I thought about the owner of the phone. If he cant get this phone back he is going to have tough time.I remembered the amount of time & effort it took to put in all the contacts and other data from my old phone to new phone. Poor guy is in for lot of trouble. I hoped that he had not put in his favourite songs or photos in the phone.
After waiting for some 30 mts or so, I decided to take risk. This is US and not India. Probably less likely to put IED in cell phone. So I picked it up,it was Nokia phone.Unlocked the keys.Nothing happened and then Screen lighted up,From menu went to contacts. Few American names-so this doesn't belong to Desi or Asian. Next in the list-Dad,Home,Mom ,work- ah ! this is no IED. Now confidently I selected the Call log-received call-and called the first # in the list.After few rings a lady answered the phone.
Me: "Hello, whose number is this?"
: Dan, my Boy friend's. Hey... did you find the phone?
Me: " ya, I am in Public park in Mntn.View. Come over and collect it."
: " Dan, someone found your phone in park." to me" He will be ther in 10 minutes"
Me: "Sure, i am sitting opposite car park"
I disconnected the line.
In 10 mts Dan was there with his Dogs. Visibly relieved to find his phone. Thanked me for my effort.
But I wondered. Would I do the same thing in India?May be not---PK

Alaska Cruise

For almost 2 years, I was planning to take cruise vacation. Star Cruises from Singapore and now Mumbai was always an easy choice. But visiting Penang, Phuket,Goa, Cochin etc was no fun as i had already visited these places and they offered same shore excursions/activities that one can have by visiting Goa. Alaska was ideal choice. It was very different from the all the places i have visited earlier. But Alaska Cruises are costly and one is not sure of weather conditions in Alaska. There may be severe cold or rain and fog that can spoil your trip completely. But big Cruise ship was an added attraction and those on Alaska trip are best of the lot.

For Alaska cruise one has to start preparing from Nov. for next June cruise. Cruise calender is out in November with all the sailing for the next season-Mid May to October. Its a difficult task to choose a cruise that is good but not very costly,and visits places that interest you. Normally cruises start from Seattle(US),Vancouver(Canada) and go north and return or it starts from Seward ,Alaska(US) and travel Southward. Usual port of call are Seward,Janue,Skagway,Kitchikan and Price Rupert among other. I had selected round trip from Seattle with halts at Januea,Skagway and Prince Rupert. One requires Visa for both US and Canada (Single entry).By March one should have Visas ready as its time to make full payment which is non refundable.

My cruise sailing was from Seattle in may end.Cruise Liner was Royal Caribbean. We reached Pier. Our luggage, tagged with special tags with my name and Cabin No. was screened and checked in.Now we had to wait in long que for our check in. As everyone had done e-check in,the process was quick and soon we had our Plastic cards which would work as our Cabin door keys and as Credit card for all the transaction on the cruise. Since our luggage would take some time to arrive, we decided to explore the Ship. Unfortunately Cruises are hyped up vacation. Though the ship was big, facilities were on par with any good resort on land. Rather Five star resort would score highly on every count. Our ship had two main Dining areas.On 9th floor deck was Self serving buffet which had something for everyone. There were Fruits, salads, Veg and Non Veg. main courses, special Dish for the day, soups and Deserts. Sodas and juices were available a plenty.But menu was same everyday,very few changes. Other was Main Dining area, where one can have sit down four course dinner with Salad, side dish, Main dish and desert. The choices were good for Non Vegetarians -especially Sea food lovers as Salmon,Cod,Shrimps were always on the menu,and Lobster and crab alternately- but for vegetarians , it was really tough.They hardly liked anything -except desert. For them Fast Food at Solarium on 9th Floor deck serving Fries,Pizzas,Burgers, Cookies was heaven. They survived on them. Then there is 24 hrs Room service. There were number of well stocked Bars. As one is not allowed to take Alcohol on board , if you want to have drink you have to visit bar.Many bars were located at vantage location and one can really have good time in the bar. There was Disco. after 10 pm. Shows in the afternoon and Evening. Bingo sessions, Magic shows, Culinary ,Yoga, Dancing classes.One can read in Library -though their collection of books was poor.- or play Cards in Card Room. There was well equipped Gym. and Spa. Two heated swimming pools and 6 Jacuzzi or Whirlpools.There was Casino with slot Machines,Poker,Roulette Table. For Children there was special Playing area. On board shopping was Tax free and Duty free-but their inventory was not great. There were speciality restaurants.
But it was confined space. As if one is under house arrest in 5-7* Resort.On the day of cruising there was nothing to do. With sea all around you as far as one can see and waves which makes you sea sick as you walk about unsteadily, after a while it gets boring. To top it, The cabins are really, really small. Though I was prepared for Cabin size after my experience with Nile River Cruise in Egypt- i expected little bigger room in such a big Cruise liner. Room and bathroom were compact and small. It makes one Claustrophobic. So on Cruise ship feeling of Isolation and Claustrophobia is always there. You don't like to go to your 'small' room. On the Decks vast sea all around gives you the same feeling. If you are prone to Sea Sickness then only God can help you. Nausea and Drowsiness makes your life really miserable. You long for Terra Fir ma-Land-under your feet and when Ship docks at port you are impatient to get out of the Ship and on to the land, where you feel at ease. Unfortunately this Cruise vacation comes at pretty high price-never less than $150/per night per person.Cost of Shore Excursions are extra(Say about $500-700 p.p.).
So Is it worth to go on Cruise vacation? Well, I am not sure. One thing I am sure of 'It is not very good Value Vacation for the Money spent.'

It's pleasure to be in cool Bay Area after very hot and humid Mumbai.In the evening, went to the Public park in Mountain View. There were about 70 people enjoying the cool evening. Soccar was played in central area.There were elderly people taking their walk, young couples with Baby in the pram. Children cycling, toddlers on the slide and swings under the watchful eyes of Grand parents.It reminds you of your park in Mumbai/Delhi san the heat.
What surprised me the most was that most of the visitors were Asians-( South Asians (Desi) and East Asians-mainly chinese) and Maxicans. White Americans-may be couple of them jogging,but no African American. May be this walk in the park is legacy of British rule in India, which Indian middle class has adopted and transported to US.--PK

Do We Own Our Icons ?

Shobha De in her column in today's Sunday Times (here) asserts that Public Icons are owned by Public. Our Bollywood first family of Bachchans owe their name,fame, wealth to Public adulation. Fans, Journalist have all the right to invade their home and take part,photograph the Ash-Abhi wedding. This is a dangerous assertion and makes mockery of Personal Privacy laws. If Amitabh doesn't extend invitation to Journos or his fans,is it ethical to insist on attending the function?
Shobha De is also an Icon. She is what she is today because Millions of readers -me included- read her column, Books for last 30 yrs or more. Does that give me right to attend her Daughters wedding or insist on taking wedding Photos. Should I insist on knowing their plans for quite(!) Honeymoon?
It's difficult for me to understand why Media-the so called important pillar of our great Democracy-insist on covering such events for days. What national or Social cause is served by knowing thee Menu of Dinner served in Ash -Abhi wedding or number of sweets served in Karishma Kapoor's wedding. There are so many other topics concerning people.Media's creative energy is better spent in highlighting social causes. People and even fans do not have right to know stupid mundane things about film stars life.

Beaches of Konkan--Hirnai

During last long weekend. I went to Hirnai near Dapoli.It is small village with 3 seaside Resorts/Hotels. It's off the Mumbai-Goa highway,some 300 km. from Mumbai. You travel to Khed on Goa highway and get off towards sea passing through the Khed town.It's hilly region and one passes along winding road through Dapoli. Now the air is clean and fresh. The foliage of Goa is missing but there is sufficient greenery to soothe the eyes.There are Coconut groves and Supari and Cashew plantations.But most famous export of the region is Ratnagiri Mangoes and there are many Mango farms. This year Mango trees were blooming and one can expect good crop. Suddenly road takes a turn and you are facing sea--shining in afternoon sun with Fishermen's boats giving it a perfect picture.
Beach was beautiful,nice ,soft sand and absolutely flat for almost a km or so. Very safe for swimming. Even at full tide,children can go in 100 mts and water would be just waist deep.No undercurrents or shifting sand.Most amazing thing was, waves would not break till end and if you know how to float or have Life jacket than you can just float on water bobbing up and down,no breakers to hit you and throw you off balance.There is hardly any drift. Swimming was more fun than what I have experienced in Goa.
But downside was that there were no other facilities.No sundecks Sunbathe,no shacks for Beer and Fish/Prawns. You have to keep your clothes on sand and a stray Dog may go through them for food or pee on them. It wont get stolen because except for the tourists staying in resorts there is no one on the beach. 3 hrs. of Load shedding in the afternoon is the worst. .Hotel Sea Face where we stayed provides 2* facility and Sea food is really good,the service is really poor and housekeeping is non-existent.The place is good for a short vacation if one is tired of going to same old places like Matheran or Mahabaleshwar.

Swiss Rail-Not so perfect.

Lalu Yadav presented dream Railway Budget. Rs.20000 Cr. earning from Railways is way beyond any ones expectation. But this success story doesn't mean that Rail travel is comfortable or Trains are punctual ,clean and safe to travel. Far from it. when traveling experience of Train in India will match that of European or other developed nations than trains will be 1st choice . There is tremendous mismatch between the two. At present train travel is preferred by those who can't afford air travel or to places where air link is not available.
Swiss Travel service-especially the Rail Line is famous for its comfort,punctuality and works like clockwork.Trains are impeccably clean,very comfortable seats,Map of the route is everywhere,it is punctual to the minute,regular announcement on PA system in train,Timetable which is easy to understand and best of all-not crowded at all.One wonders at the Economics of running almost empty train.Unfortunately during my stay train travel in Switzerland was marred by glitches in Rail service. On the first day traveling from Geneva to Interlaken via Bern,train was terminated at Thun as there was accident between Thun and Spiez. We had to travel by bus with all the suitcases,and Bus was more crowded than BEST bus in Mumbai !!.On 3rd. day,while visiting Luzern,train was terminated at Hergiswill and we had to complete onward travel by Bus. As we had Swiss Pass this was possible otherwise one has to buy costly ticket. On final day returning from Interlaken to Geneva Airport,train arrived on time at Lausanne,but halted there for more than 15 mts and was late.It was terminated at Geneva City and started it's return journey to Bern on time but I had get off at Geneva with all the luggage, change the platform-had to pay for the luggage trolley- take next train to Geneva Airport.
Swiss Rail Line usually runs perfectly but it's single line system at most of the places and hence even a small problem can potentially throw the system in disarray. They can put the system back on rails in short time besides number of people traveling by train in Switzerland is far less and easily manageable.

Transfer of Power

Kanchanben first visited me 15 yrs ago. She was a Gujrati lady from Saurastra region,wore bright colored Sari in Guju style and a big round Red bindi adorned her forehead.Kanchanben had an air of authority which was palpable. Her writ run in the family matters.She accompanied her Daughter in Law Manjula,who was Pregnant. Kanchanben's husband was Cloth Merchant and had shop in Mumbai. Her eldest son helped in family business. Manjula was fair and beutiful. She had to cover her face with Ghungat and talked very softly. It was difficult to hear her and take proper history. Kanchanben would prompt her and admonish Manjula to tell me about all her complaints.
Investigation and Medicine that I had prescribed had to pass muster with Kanchanben.I had the feeling that Manjula was not allowed to follow all the instructions,especially about rest and exercise and food she should eat. Manjula had no say in the matter, everything was decided by Kanchanben. Manjula had normal delivery and Kanchanben was present in the delivery room.She was first to cradle her Grandson.Post delivery, Manjula had to follow all the traditional things thats carried out post delivery.Me and Neonatologist were completely ignored and hospital routine was tossed out of window.Same routine was followed when Manjula delivered again after few years. Kanchanben was in charge of all the social and family matters and had last word.
Last year Kanchanben lost her husband.
Last week Manjula came for consultation.Kanchanben was with her. I just couldn't recognise her. she had changed completely. She was wearing very plain,pastel colored saree.Big Red Chandlo had disappeared.Her hair were disheveled and face was haggard. Manjula was in charge,and did not allow Kanchanben to say a word. She readily agreed to get investigations done and took appointment for follow up visit to show the report.
Manjula kept her appointment but she had come alone.

Doctor's Dilemma

I know Mrs. Arora for last 25 yrs. Her youngest son was born in my Nursing Home. Since then she and her daughters have consulted me often for their Gynaec. Problems. I have attended her Daughters weddings. Her elder daughter delivered a baby boy 9 yrs ago. We had very good Patient-Doctor rapport.

Last year, I was in my consulting Room one evening and a young man rushed in. He was Mrs. Arora’s neighbor. Mr. Arora had severe Chest Pain with Sweating and apparently he had Heart Attack. He wanted me to visit and examine Mr. Arora. I explained to him that I am a Consultant Gynecologist and I don’t have Doctor’s bag, Injections etc. I would be of little help to Mr. Arora. At the most I can give Pain relieving injection. He should contact G.P. who can be of more help to Mr. Arora. I promised to contact G.P. of the area and ask one of them to visit Mr. Arora. Young men hurried off. I phoned Dr. A. and requested him to visit Mr. Arora urgently.

Dr. A. visited Mr. Arora, who had a Heart Attack. Already a Doctor was there. GP. gave him necessary injections, and even Oxygen from Portable Oxy. Cylinder he had in his bag. He called up Cardiac Ambulance and in 30 mts. Mr. Arora was in ICCU receiving treatment. He had massive Heart Attack and couldn’t make it. Mr. Arora died on 3^rd. day. I attended the chautha.

After 2-3 months, Mrs. Arora met me in Shopping mall. She was little miffed and didn’t return the greetings. She told me that she felt very bad that I did not visit when Mr. Arora had Heart Attack. Had I visited him and given treatment,Mr. Arora would be alive today. I tried to explain to her that in these emergencies GP.s are better than consultants as we don’t have Injections and other tools necessary to tackle these emergencies. GPs deal with these on day to day basis and they exactly know what to do and how to transfer such cases to nearby Hospital. But no explanation was good enough for her. Till this day she holds me responsible for her husband’s death.

With rapid advance in Medical Science, it is very difficult to keep in touch with other branches of Medicine. As a matter of fact it is very difficult to keep abreast with new theories and treatment modalities in our specialized branch. It is a loosing battle. We don’t have sufficient time to read all the new treatments being offered today. I find it difficult to read completely ‘Year Book’ which gives synopsis of Papers published 3 yrs ago in various Journals!! If I have to appear for MBBS exam. for renewal of Registration-as suggested by our Heath Minister Dr. Ramdoss- I don’t think I can clear it at First attempt!! A frightening thought. But I am sure I will be in good

Kingfisher Airlines Credit Card Fraud

Last month Kingfisher Airlines was hit by Credit Card fraud to the tune of Rs.1.5 Crore. Modus Operendi was very simple. When the credit card was given for Bill Payment in ‘Time & Again’ Restaurant-an upmarket Restaurant in Andheri Mumbai, person preparing the Charge slip would memorize 3 digit ‘CCV’ printed on Signature panel of the Credit Card. 16 digit Credit Card No. is already available on copy of the charge slip. He would then pass on this info to his colleagues, who started a Travel Agency and would book Tickets online on Kingfisher Airline Website. These tickets were then sold at discount. Almost everyone on Blogosphere must be using Credit Card extensively and can be victim of this type of fraud.

IT IS VERY EASY TO PREVENT THIS FRAUD.

Please scratch out the last 3 digit printed on signature panel of your Credit/Debit Card, after noting it down at safe place as you would do for Online Log In username and Password for your bank account.

When Credit/Debit Card is used for any transaction in Shop or Restaurant, it is swiped and Machine reads data from Magnetic Strip. ‘CCV’ is needed only when online transaction is done.

A year ago, I had scratched out ‘CCV’ nos. from my Citibank and Standard chartered Cards and I have been using these cards for transactions of Rs. 250.00 to Rs. 21000.00.

Incidentally I have sent repeated e mails to VISA Security and Citicard-India, suggesting that ‘CCV’ should not be printed on Credit Card but sent to Customer by Courier as is done with Passwords. VISA promised to consider the suggestion. There was no response from Citicard or SCB Card.

Rural Service for Doctors.

Out of Blue, doctors who are going to complete their internship this year, are asked to work for a year in Primary Health Centre in Rural Area. They have signed a Bond when they took admission in Medical College, but for last 4 years this bond was not enforced.Now our enthusiastic Health Minister in Delhi want to enforce the Rural Service clause in entire country, so in next 5 yrs not a single village in India will be without the services of trained MBBS doctor. Predictably Doctors who have faced this farce off and on for last 30-40 years have not taken kindly to this dictate from govt. In Maharastra about 50% have paid the Bond amount of Rs. 1 lac and will not do this Rural service. State is richer by Crore or so and has found out new avenue to fill up state's treasury. Next they will increase the Bond amount so that they can get more money.

But it is more pertinent to try and find out why Doctors are not opting for Rural stint.Usual perception is that these citybred doctors don't want to serve Rural poor inspite of getting expensive Medical Education -paid for by the state. This impression is reinforced by media ,especially Print media. Reporter dont finds it necessary to talk to those who have done Rural Service and find out ground realities. This year those graduates who were preparing for Post Grad.CET for a year would not like to go to Rural area for a year and then appear for CET. Its better to give CET when you have just passed MBBS and have prepared for CET. But others are refusing job that will pay them about Rs. 17000 P.M. There must be reason for that.Past experience shows that many Rural Posting don't have adequate basic facilities to stay. The food is another problem. One can imagine plight of a Lady Doctor in Rural PHC. There is pressure from the local politicians. Many Govt. M.O. dont want them to interfere in the local set up they have established. Sometimes they are asked to do work they are not trained for -like performing Post Mortems. Unavailability of Medicines, Pathological Lab, X Ray and Sonography and other items is another big problem. Just posting a Doctor in PHC doesn't always solve the health problems of rural areas.

Solution to this should be provided by preparing a Model Action plan. This can be done as project by IIM's. Doctors are available and if given just basic facilities they are willing to work in Rural areas.Govt. has no clue about how to carry out project to provide medical help in rural areas and may be they don't have necessary funds to do so.As in past ,for 2-3 years Doctors will be forced to go to Rural areas and then govt. will discontinue the scheme, which will result in great mess for Post Graduate admissions as happened just 4 years ago.

Party time in the Morning- F.M.Radio

For last two months or so, I am using FM radio as Wake up alarm. Since most of the FM stations have limited stock of songs and they play the same songs almost at the same time everyday, I change the FM station everyday. I keep the Radio on while I go about my morning chores-read Newspaper, my Cuppa of Tea or get ready for work. As Radio is playing in my bedroom, I recognize the song by tune. Most of the songs being played are remix version and one thing is common in all these songs, their rhythm. There is only one Rhythm-THIG..THIG…THIG.. THIG….. There is no variation, no change, nothing. For the entire period of about 2 hrs or so, one feels as if one is in Disco or pub. The different beats, sounds used in original song is completely lost. Sure these songs-remix version are good for party or in disco, but why should it dominate our music so completely? With these songs there is no difference in style and sound used by different music directors. There are songs with very special beats or sounds which has elevated them to classics. In these remix version they sound like any other mediocre composition. Its necessary for FM stations to play original version of the songs in their morning programme as well and not to relegate them in programme after 9 pm.

'Que' mannars

We were visiting Hoover Dam, It was hot afternoon and we decided to have some soda and Ice Cream at the cafetaria. It was a small place and there were only 2 people behind the counter. There was a long Que of some 15-20 people and person taking order was not particularly quick.We had to wait for some 30 mts. before we were at the counter.she took some time to get what we wanted and more to calculate the charge and change to be paid to us .But during this entire period, people after us in the Que were waiting calmly,talking among themselves,joking. There was no murmur of protest, nothing.

We had gone to Naaz 8 to see 'Chup Chup Ke'. It was weekend and 'Krrish' was just released. There was a long Que, as tickets for Krrish were sold out for all the shows that day, line was of people who wanted to pick up their tickets booked by phone or on net. But there were few who wanted to see other movies running there and their showtime was fast approaching. Only one ticket counter was open but there was no protest and everyone waited for their turn at ticket window. when we entered the moviehall,we had missed the begining.

Imagine situation at Andheri station ticket window. There are 3 ticket windows,the line has some 10-12 people. Ticket clark sitting in poorly lit and poorly vantilated room where temp. is around 38-40 C (110+) has to give ticket for stations between Andheri and Churchgate and Dahanu Rd. on W.R.. Andheri and C.S.T. by main line and Harbour line,Andheri and Karjat,Khapoli,Kasara and Belapur-Panvel.One way or return for all different lines. He has to exactlly know the location of the station,its fare, calculate 'orally' the amount to be collected and change to be paid.He issues the ticket and gives the change. This takes about 15-20 secs. This is what actually happens every day.

But what's the reaction of people in the Que?

" Abe, Haath jaldi chala."
" Saala, soya hua hai kya"
" Chal Fatafat,deri ho rahela hai"

And it goes on.Ticket clark ignores all these barbs and continues to issue ticket nonchalantly.

Cinema Theatres in US

While taking part in discussion on Movei expirience in Single screen and Multiplexes in India, I felt strong urge to pen my expirience-as a visitor from India- about Movie expirience in USA. During my stay in LA and San Jose I saw six movies-4 Bollywood movies and 2 produced in Hollywood and realesed in US.

Hollywood movies were realesed with lots of pre realese advt./actors being invited to talk shows of Jay Leno & co. Trailors on almost all news channels giving some detail of the storyline.Jokes about the storyline by stand up comics etc.I did not come across any "critical" reveiews of the movie in any newspaper or on News channel, may be I missed it. Only thing I could know was 1st week's collection and it's standing in just realesed movies- at present 'Click' starring Adam Sandlar is in 1st position. Theatres are usually in big malls and have multiple screens. They are nice with jazzy lights and very good ambience.Unlike our multiplexes inMumbai, only basic snacks are available. Tickits are checked at the entrance and there are no assigned seats no. or screen no. is printed, so theoratically one can see any movie screened there and as often as one wants to.Sound is good so is picture quality. Its enjoyable expirience.But this account is incomplete as I was persuaded not to go to Theatre in UV Village near USC,as crowd there is not good(?).

For Bollywood movies there is only one theatre-Naaz 8. I saw movie in Naaz8 of Artesia and in Fremont. Its really difficult to differentiate the two though they are some 400 miles apart. Its collection of 8 single screen theatres!Naaz8 reminded of Chandan and Chitra and Naaz(remember it?) in Mumbai. Dimly lit(Subdude lighting!) entrance and corridors with very poor ambience. Walls had posters of forthcoming movies mounted in old wooden frames, clenliness was not high on the list and Naaz in Fremont had such small Mens Restroom with just 2 urinals!!Men! was it dirty? Though sound and picture quality was ok,it was not great expirience. Unfortunatelly 'Desis'-well behaved everywhere- were transported to India. Popcorns littered the floor,Children were running around and shouting,few laughed so loudly and for so long that it would drown Paresh Rawal's comedy. In the interval the Indian Chai and Samosas were as bad as it used to be some 10 yrs back in India.I almost felt that I was watching movie in single screen theatre in India.Same callous attitude of theatre owners toward their customer. Same run down, poorly lit,dingy and dirty theatre.If i had encountered a rat or two, the expirience would have been complete. My host said that this is better than nothing,so we have to tolerate it. This is the only place we can see Indian movie so....

Should it be like this? Will Indian producers like yashRaj films,Karan Johar and Rakesh Roshan insist on Hindi movies to be exhibited in good theatres-mainstream theatres? May be a show or two daily or on weekends.Naaz8 charges are not less than other theatres, its just making more profit by exploiting Indian viewers.Indians in US can and will pay more to watch Hindi movie in good theatres.Who knows they will make more money as Hindi movies will be realeased in more theatres and for more shows.

" Solution " to Reservation in Higher Education

Sunil Joshi, guest contributor to Gaurav's Vantage Point has interesting, market oriented solution for Reservation in Education. Simply put. he advocates liberlising the education sector so that anyone can provide any type of education, at a fee that market can bear.Dr. Devi Prasad Shetty advocates the same thing while talking to Shekhar Gupta in" Walk the Talk".

Idea is good,but can it be implemented successfully? our past expirience is not encouraging. Today all the educational institutes have to take permission from Govt. Dept. of Higher Edu.,Proffessional bodies and various other authorities including UGC. Still IIPM and Amity flourish. When Jharkhand Govt. liberalised education, many institutes of Higher(!) education opened in that state with 2-3 room campuses. Finally Supreme Court had to intervene in the matter and banned them. Maharastra and Karnataka have highest number of institutes for higher education , and when there is inspection after public outcry,it's reported that many dont have basic facilities,faculty or staff and equippments/Labs.Medical colleges dont have clinical material(Patients).I know many Doctors with MD/MS who cant perform simple operations independentlly.Many have not seen routine operations during theirMedical edu..These days almost all commerce colleges in Mumbai offer Diploma/Degree in management, are these worth anything?Many of them get job offer with salary of 1-1.5 Lac/PA.

Now imagine the state of affairs if we liberalise the educational field completelly. Yes if stringent conditions are applied than we will get a good institution, but buisnessman is not interested in that. He will get it sanctioned by providing minimum of facility,paying low salary to teachers, and bribing or bringing political,communal or castist pressure. How will a parent or student will evaluate these institution or their fees, their programme & courses offered(Whats that in indian Context?). You must have seen advt. for computer classes-NIIT,APTECH etc- how many student understand what is offered and whether fees are appropriate?.

To liberalise education completelly, we require dedicated educationists,philanthropists who will donate huge sums to start good institutes and vigilant govt. and knowledgeble public. Unfortunatelly we have none and wont see them in forseeable future.

Home Again

After almost almost a month, I could manage to get my internet service.In February end my contract with BSES ended and my net closed down. To compound the matter, my apartment required repainting and it was not possible to work on desktop or even use laptop.I had applied for MTNL triband but they couldn't supply router as they were out of stock!! There was waiting period of 2 months.Even as I write this the Versova Tel Exchange has cleared workorders of 16 January and there are more than 1000 pending applications!!.
I have been unable to understand this. We are talking about increasing net connectivity for almost 3 years. Mr. Maran had announced his plans for Triband as soon as he became Minister at Centre.Is it difficult to manufacture Triband router in India?If they are easily available in all computer stores then why should it not be available with MTNL? Or is there something fishy here? Most of us would not like to wait indefinitely for net connection ,so we would buy it from the open market.Is there kickback to mandarins in Communication ministry or to Ministers party ? Do people in Singapore or Kuala Lumpur, Seoul, Tokyo face same problem? what about US/UK?
Anyway after a month I can now log on to blogs and renew friendship's realized how much I missed reading blogs.It was like being cut off from your friends and didn't know what was happening in their lives.Like serials on TV one gets attached/addicted to Blogs and Bloggers.Has Gaurav got new Job? What Amit is doing after returning from Pakistan? Is he writing on England series? Is Vikrum in India? or has he returned to his home? Missed very interesting scientific essays of Sunil.Has Umas's indian writing or Sonia has added new colour ? So many things to read and ponder about.After a month I feel that I have returned home and it's time to relax and read interesting stuff.

STD/ISD Booths.

Last month I attended Conference tour of Egypt organized by our Association.Tour was conducted by reputed tour organizer from Mumbai.Ours was of group of some 110 or so Medical Consultants from Mumbai,and many are owner of small Nursing Homes in Mumbai.Few of us had Mobile Roaming facility, rest depended on Phone service in Egypt. Now Egypt has good Telecom facility.With so many visitors from Europe,UK,USA and different parts of world, this is not surprising. We purchased Calling Cards from shop in our Hotel in Cairo.But things are not as simple as it appears. With so many companies operating in Cairo,its difficult to find Kiosk having phone whose card you posses. Ofcourse most of the public places have phone kiosk but during tour or while visiting a monument you don't have enough time to search for a particular phone.Since you don't know the pulse rate and charges,suddenly in middle of conversation you are cut off.. At that odd hour its almost impossible to find store selling phonecard. Few had purchased calling cards of Airtel from Mumbai airport,they had to purchase phone card of Egyptian company to call local number, then punch in card number and then punch in home telephone number..You need someone to prompt the 16 digit number or you are going to miss out or punch a wrong number and have to start all over again.Sometimes it was frustrating.
My experience in Bangkok, Kuala Lumpur,Singapore or US /UK is no different.Then one realises the ease with which a visitor can make Local/STD/ISD call in India.Thanks to innovative scheme of MTNL/BSNL, we have STD/ISD booths all over India.Any small town or even district place will have number of booths and one can choose and select from which booth to call.With advent of cheap mobile and STD calls,big cities and towns are witnessing decline in these booths.But in smaller towns and District places they are doing roaring business.We instruct our maidservant to call us from her native place-Rajapur in Konkan-before she boards ST bus for Mumbai.Its so simple,transparent and hassle free. Its easy to punch in number,and one can check whether correct number is dialed can talk as long as one wants to,keeping watchful eye on charges!.The booths are open for more than 18hrs a day, so calling is almost 24x7.Besides it gives employment or additional income to large number of people,thus serving a social cause in this country.Really one of the really innovative idea !

Our group had gathered at friend's house to usher in 2005.'Group" consists of friends who had met for the first time when they were students in 5th std. in Bharda High school opp. V.T. A common passion for cricket had brought us together though we were not in the same class in subsequent years.After S.S.C. all of us joined Science stream in KC. college and after passing out Inter Science, I joined medicine in Mumbai,others went for engineering used to meet during vacations,go for cricket matches, evening walks on Marine Drive, party together-Prohibition was just removed from Mumbai- go for Christmas and New Year eve parties, go out on picnic together and over the years, group became cohesive.We were close friends. Luckily for us, all of us got married in'74-'76 period,shifted to suburb Juhu-Andheri at the same time,had first child -all daughters-in '76-77' and second child -sons-in '81-'82 period.Because of these happy coincidences we could remain together as group.
Now we were partying with families, go on vacation tours together, and though the children had their set of friends, the unwritten rule was that they had to be present in group's parties and tours arranged during vacations. Years flew by. Here we were ushering in 2005. we,friends and spouses were present. Children had moved to US for studies. Girls had graduated and were holding good jobs, all of them except A..... were married and Boys were doing their Masters in US. There was sense of satisfaction and happiness in the air. As if our life's goals, mission had been achieved. What more could one ask from life?
All the friends had good prosperous lifestyle, could give good education to children, daughters was married, and sons were planning to settle in US( They will manage, wont they?). Now we were free to plan and live life as we wanted to. Do things or pursue hobbies which we had put off for years.
Anchors on the TV show had started countdown and 2005 had arrived. We hugged and wished eachother and then as if on cue, children phoned in from US wishing us Happy New Year, all of them had to wish all the uncles and aunties !!. Everyone was in high spirit but H... was not well, she had upset stomach, so she wouldn't join for dinner.In the euphoria of the celebrations no one noticed.
Next day afternoon she phoned me.She was passing blood in stools. I immediately fixed up her appointment with the surgeon friend. He phoned me in the evening.There was a Large Colorectal Polyp. she was posted for Colonoscopy next day. There was large Polyp in colon.we took biopsy and now had to wait to find out whether it was cancerous or not. we spent anxious 5 days and then the verdict was out-it's benign tumour.Second opinion was taken and CT scan done. Same finding. Non cancerous Polyp. Gastroenterologist was confident that he would be able to remove it by Colonoscopy. As it has broad base he may need 2-3 sittings.H... had undergone 2 c-sections and was not willing for surgery. Besides she feared that colostomy will be done and she was not prepared for that.No amount of arguing could convince her, so we decided to go for colonoscopy. But 2 session of Colonoscopy removal convinced us that surgery would be the best option. By then it was time for her daughter to come to India to purchase her wedding dress and jewelry. Then there wasn't sufficient time between Surgery and her US visa interview date. (There was 4 months wait for Visa interview!). They got their Visitor's Visa and now there wasn't sufficient time to recuperate from surgery before she was to fly to LA. So she went for her daughter's marriage, friends from the group went to US to attend the wedding. She returned to India and we took appointment for Colonoscopy.News was bad ,Polyp had grown in size and CT Scan had suspicious area. She was posted for surgery in Lilavati Hospital. I accompanied my friend and we waited in the big lobby on the 1st floor.After long wait-operation lasted for 5 hours- surgeon came out.we hurried to meet him.
He just said " She will need Chemotherapy".This almost shattered us but I recovered,
You could get clear margin and remove the tumour?
yes.
Nodes involved?
No,
Liver metastasis?
No,
Local metastasis?
Ya, in Paracolic gutters and P.O.D.
He walked away. So much for breaking the news gently.!! Such are vagaries of life. This Slow growing Cancer did not spread to the surface of Polyp, instead it chose to spread towards the base, through the wall of the colon to the area outside. Not a single Biopsy showed even a suspicious or pre cancerous cell.!! Here we were faced with Stage III cancer.This is the reason why people believe in Luck,Destiny and stars!
That one sentence had shaken my friend.Now onwards life is going to be different. Ours is generation which made transition from Joint family to Nuclear family. We grew up in large families -what you see in 'Saas Bhi Kabhi...Grand-parents,parents,uncles,aunts,cousins and even guests from native place lived under one roof.There was solid extended family support for everything.The strength was in number and families could take illness,financial disasters, scandals,deaths in it's stride without flinching.But we had moved out from this big comfortable shelter, and were living independently with wife and children.the extended family was there, but it was scattered. After 25 yrs it was not possible for the family to be together as cohesive force.Ones brothers and sisters and cousins were just a phone call away,but they had limited time for you and years of separation had weakened the bonds.They will phone ,come and meet but for an hour or two.Then they have their life,children,and other problems to take care of. One realizes comfort and strength of joint family during such phases in life. We had added disadvantage. Children were far away from us.They would phone everyday but it was not possible for them to come and be with us. With this cancer ,its treatment and possibility of complications, it will be difficult to manage work and look after his wife.He had to go out of town often on business trips.Now it would be difficult to leave H... alone. But the group became the extended joint family.After being together for almost a lifetime we were one family. Circumstances had conspired to force us to be together,to join forces to face the adversary. We were there to give support,to comfort each other,to allay fear of unknown future, and to let everyone know that he/she is not alone.H... has completed Chemotherapy. She did not loose her hair( Her biggest worry) rather she tolerated chemo. very well and had no adverse reaction.She is 'CURED' at present.
We have gathered to usher in 2006. Mood is sober.Events of 2005 has not dampened our spirit. This year children have come home to celebrate Christmas and New Year.There is hope in the air,K.... will be leaving for US in Jan to be with her daughter who has on 28th delivered a healthy baby boy ! The first of the Grandchildren. Life is beautiful once again.We have something to look forward to. God willing 2006 will be year of Grandchildren and group will visit U.S. to bless them. Anchor has started reverse countdown.... but mentally we are already in 2006.

Million Missing Girls

The recent article in Lancet has again focussed on Female Foetecide that is practiced in some parts of India.There will be edits in Newspapers-TOI- has it as lead edit today.There will be seminars and discussions, but at the end of the day whats the solution? how do we tackle this problem?
As this study has shown, all the 'established' causes have fallen on the wayside.
Its not poor but Middle class and rich are major offenders.
Dowry is not the cause for aborting girl child.
It's not illiterate mother, rather well educated mother prefers to have male child. It also absolves husbands who were accused of forcing their wives to get Sex determination done.
Our society is supposed to be agrarian so extra pair of hands(Son) was preferable. But now statistics show that even in rural economy females contribute more economically, so its not an issue.
As obstetrician I feel really helpless.As technology advances, with 3-D Ultrasonography, better resolution on good machine,it's very easy to know sex of the child. It is now possible that on 3D USG machines even mothers will be able to know sex of the child when USG scan is in progress.
With newer technique even Abortion is easy to perform.Few tablets and female foetus is dead.It will abort on its own or Doctor will have to do to protect mother from severe infection.
In ART methods , its possible to Pre select sex of the foetus before Embryo Transfer.
So where do we go from here? You cant educate well educated mother. All that we have done so far is to show danda of PNDT act to doctors.But there will be black sheep in every field and there will be greedy doctors who will be willing to carry out USG scan.With these newer machines he wont have to even say anything.Mothers will recognise sex of the foetus.
I sincerely hope that we will be able to find out some ways to reduce this.I believe that there is steady decline in demand for sex determination tests.May be after few years ratio will correct itself. But till than I will keep my fingers crossed.---PK

On World AIDS day

Today is World AIDS Day.Once again its a day to take a hard look at the year gone by and reflect on what we have been able to accomplish. In this battle against one of the most unusual Infectious disease,are we Winning or Loosing? Well, the answer is loud and clear. Right now AIDS has upper hand.We simply have no clue how to handle this epidemic.There are as many solutions as the stakeholders.Poor HIV positive person is bewildered, frightened,helpless person, who has no idea about the disease,and prognosis.Today he is in good health.there are no apparent symptoms to indicate that he is harboring a deadly Virus which is rapidly multiplying in his body and is annihilating his immune system.He knows that he is HIV +ve, but is not aware of what he should do.He has been told that this disease is not curable.He has no knowledge about ARTreatment,and even if he knew, he cant afford it.Large chunk of the funds to fight AIDS is spent on awareness programme.There is little money for subsidizing tests and treatment.He will work today and will wait for the day when Virus will decimate the Immune system and opportunistic infection will strike to begin the end.Then he will be shunned by friends and relatives.But will it matter? He will be already isolated in his mind, waiting for the end to come.
There is no solution in sight.We have to change the approach but what should be the new approach to tackle AIDS?.Awareness can go only this far.There is urgent need to define AIDS as "Infectious Viral Disease" which is not curable.( All Viral diseases are not curable -they can be prevented by Vaccines).This epidemic should be tackled like any other Infectious disease epidemic.There is need to bring change in our Sexual Behaviour.There should be more emphasis on "Safe Sex".These days there is more promiscuity and matching ignorance about STD and 'Safe sex'. Girls- even well educated ones- dont practice safe sex, have unprotected sexual intercourse,and are more worried about getting pregnant than contracting killer diseases like AIDS or Hepatitis B or C !!
In today's TOI there is article about HIV testing done without consent.Why this privileged status for HIV testing? Do you need specific consent for Hepatitis B, Diabetes,Kidney disease, cancer testing ? Should we take special consent for X-ray chest for T.B. and ECG for heart disease. Two years ago when SARS virus hit the S E Asia, anyone transiting through these regions were quarantined on airport.Did anyone take permission to test?
Till last year Blood Banks were collecting blood from donors and then testing it for HIV and other tests. If +ve the blood was simply destroyed after disinfection. Donor was not made aware of HIV status as it was legally forbidden to do so.He would infect his wife,children and donate Blood twice a year which was never used.!Thank God this absurd rule is now removed.TOI article goes on to add that this clandestine testing has actually reduced the spread of infection.Doctors can also act as counselor and HIV +ve person can spread message of awareness better than anybody.
Surprisingly HIV +ve person is treated by Dermatologist and not by Physician!!Its throwback to the time when AIDS was cosidered as part of venereal disease!If there are complications than Physician is called in.In US HIV +ve person is looked after by Physician.Obstetrician - the most vulnerable medical practitioner in contracting disease from patient- has no role in any AIDS programme.This sunday there is a conference on AIDS, arranged by IMA-Mumbai.In the speakers list Obstetrician is missing! Lets hope that in 2006 we may find new, more effective way to contain this epidemic.Amen.