Showing posts with label Kolkata. Show all posts
Showing posts with label Kolkata. Show all posts

Saturday, 30 November 2013

India Nov 2013: Leprosy and architecture in Hyderabad, Kolkata and Mumbai

An early morning walk opened up the history and architecture of Kolkata and was followed by the challenge of taking Yusuf Hamied, one of India’s richest men, to the leprosy project in Mumbai.

This visit started in Hyderabad where I attended the Blue Peter Research Advisory Committee; the research effort is dominated by work on TB and genetics and there is little clinical leprosy expertise in the organization. However a new bright keen young woman has been appointed, who I enjoyed talking to and whom I hope will stay. She and the physio have already collected some data on patients with ENL which was presented at the ILC meeting in Brussels in Sept. Dr Sundar Rao (age 76) is also now on his fifth post-retirement job and is advising Lepra-India on clinical research. We worked together on the Azalep study in the TLM hospitals so it was a pleasure to be planning research with him again. The Lepra India Board has recruited interesting women such as Geeta Thopal, who managed the building of Kolkata ‘s metro system, and Rukmini Rao a doctor working with tribal people and dalits in Rajasthan. I enjoy catching up with my old friends Sujai, Lavanya and Suman; they have daughters at university finishing degrees in dentistry and engineering respectively and so the next generation of Indian women are professionalizing. Suman gave me an Indian mobile, which made me feel very local, too local in fact because my answer-phone is in Telegu.


My next stop was Kolkata where I worked with my TLM team members Annamma John (research coordinator) and Pitchimani (research physio) on Azalep study report. I had an afternoon exploring Kolkata and visited the Victoria Museum, which I had previously avoided because it appears so colonial, with a High Victorian look that appeared to be exported straight from South Kensington. However inside is an anti colonial history of Kolkata from an Indian perspective and highlighting the negative impact of the division of Bengal in 1910 and important Bengali thinkers and activists.


We all explored the old city on an early morning walk with city guide Anup Saha who took us around temples, along lanes and into old buildings with an informed commentary. We admired the closed sewers that predated London’s sewers. We explored a Jain temple decorated with every type of tile across the centuries including a blue and white one of 17 century Dutch windmills, proof of the active trading from Europe through to China and showing how fashion can be seen even in temple tiles. The narrow lanes of the old residential area were quiet with few cars. I appreciated the elegant fronts of the 19 century houses with metal balconies where women were up their hanging out the washing and chatting. Shiva temples are popular here, because people can pray there without needing a priest, making life simpler and cheaper. Another old palace had mutated from being an audience hall into a ballroom with chandeliers and now had a small temple there. Kolkatan women were passing by in traditional white and pink saris. We had tea on the street in clay cups sold to us by a strong looking woman stall holder who was reading the newspaper very closely. Walking round is a refreshing contrast to sitting in the dense traffic jams that engulf Kolkata from mid morning. Tagore’s house is another oasis of calm and I imagined his life in the simply furnished rooms with his poems on the walls. The Chinese and Japanese governments had refurbished a suite of rooms apiece to commemorate his links with their countries, these rooms felt Japanese and Chinese and were air-conditioned and contrasted with the dusty rooms showing his Indian life where fans creaked away over poorly displayed items. Indian school children were visiting and seemed to be enthused by his life.


Kolkata feels gentler than other big cities but is a poor advertisement for prolonged socialist rule. Public services are poor, the trams are the oldest I’ve seen and the pavements are piled high with rubbish and goods. The taxis are also ancient Ambassador models and the internet seems undeveloped in comparison with Delhi and Hyderabad. I had been busy reading before my visit and Amit Chaudhuri’s book “Two Years in Kolkata” describes the city and its residents in over lengthy detail whilst from Jhumpa Lahiri’s book “The Lowland” I could easily imagine the city in the 1960s and the parents home in Tollygunge. Since my visit I have read Shanker’s novel Chowringhee and then imagined hotel life in Kolkatans in the 1970s.


In Mumbai I stayed in the upmarket Four Seasons Hotel, courtesy of Cipla and enjoyed the 27th floor roof top bar with breathtaking views of the city. I balanced myself with swims and yoga sessions. I took Yusuf Hamied, the last CEO of Cipla the Indian drugs manufacturer and one of India’s richest men to visit the Bombay Leprosy Project. We went first to a slum are where the leprosy workers were doing case finding, Yusuf was horrified by the standing water and the roaming dogs in the slum and was surprised that people could be so passive about their situation. We then took him to the project headquarters in Dharavi (Asia’s biggest slum) here he met patients and Drs Pai and Hawal talked about the challenges of doing leprosy work in India, the perception that elimination of leprosy as a public health problem has ended the leprosy problem, the management of reactions. He stayed 4 hours and I think that we captured his attention. I met him again before I left and he has offered Cipla support for some aspects of leprosy work, including providing some of the drugs needed for leprosy work, and supporting meetings in India. Whilst we were in the slum he asked me if I got depressed by seeing this situation. I counter that feeling by working in leprosy.


Whilst in Mumbai I also walked out to the Haji Ali mosque, a tiny mosque on a spit of land projecting out into the bay. This has been on my “to do list in Mumbai” for 25 years. Formerly one need a stack of one paisa coins to give the beggars who line the causeway but they are now outnumbered by the opportunities for shopping; I bought some flowers that I put down at the mosque in memory of my sister Laura. The mosque is a lovely small building with arches and a dome and surrounded by sea and I watched the sunset there.


On my last evening in Mumbai Jehanghir Sorabjhee and I had supper with a literary couple, Kabir and his wife Tulsi. They were entertaining Ian Jack who was promoting his book Mossufil Junction at Indian literary festivals. We had a fine evening talking about books and Indian culture. Sachin Tendulkar had played in his last test match whilst we were there. The Indian crowd poured out their adulation. Ian later described these Indian emotions as “India’s Diana moment” when a country is gripped by a collective emotion.


These two weeks were full of new work experiences; I enjoyed Hyderabad, Kolkata and Mumbai in different ways and my friends showed me different aspects of each city.

References
Ian Jack. Mossufil Junction Indian Encounters 1977-2012. Penguin India 2013
Sankar. Chowringhee. Dey’s Publishig Kokata 1962, translated From Bengali Arunava Sinha. Published Penguin India 2007
Amit Chaudhuri..Two Years in Calcutta
Jhumpa Lahiri. The Lowland 2013

Wednesday, 31 October 2012

Kolkata: Durga puja and a leprosy trial Oct 2012

City celebrates Durga and we do our leprosy sums
My next stop was Kolkata, this city has managed to avoid India’s dash to modernity. The place is full of crumbling buildings and the stately Ambassador car tootles around the streets.  The architecture is a treat with many interesting 19 century buildings but this does not compensate for the obvious poverty. I also find the sight of rickshaw pulled by men offensive to human dignity.
Durga Puja is Kolkata’s big festival, many people would flee the city but I had arranged a review meeting of one of our leprosy studies so glimpsed the city festivities. Durga Puja lasts for 10 days and is when Durga renews her energy and defeats the evil in the world, bringing her female shakti energy. The festival happens around the temples and now these are covered in LED lights and each temple has its own flashing images, Ganesh or arjun. The temples also compete over designs and there are competitions between the temples with even sections for the most ecological temple. People are out all night at the temples and the police set up elaborate crowd control giving 2/3 road over to pedestrians. I found a list of nine things to do in Puja which included dancing, eating, catching up with friends, surrounding oneself with lights and wearing bling, sadly i had left my bling at home in London.
Instead of being out dancing all night in the temples we sat by day in a deserted leprosy hospital and toiled over the trial report. This is a big study involving 350 leprosy patients and we have added a new immune-suppressant drug to their treatment. As we have done the trials so people’s different strengths have emerged; Sundar Rao may be 78 and retired but he still has a very sharp statistical brain and keeps us on track.  Joydeepa is an enthusiastic clinician in West Bengal who skilfully enrolled and encouraged patients.  We also discovered that our young Tamilian physiotherapist has a great facility with data sets and understands what has happened to all the participants better than anyone else.  Disappointingly our treatment does not improve outcomes for leprosy patients with reactions.   Many trials do not have positive results and these results are just as important to generate to prevent people receiving useless treatments. But the intellectual satisfaction of having done a study properly does not compensate for the wish to find an improved treatment. 
Jan 2012