Spring in the Yorkshire Dales

Easter walks in The Dales experiencing springtime abundance.

At Easter weekend I walked again with Les and Vera, this time in their own county. We had a fine 5-hour circular walk that took us up over the moor top and then down into the Dales. We started at Arncliffe village and climbed up Old Cote moor. The landscape there is treeless, open and bleak, later on in the summer there will be heather but now the moors are dark brown. On the moor top grouse sped up from their nests squawking away. We then wound down into Wharfedale past an empty grey stone farmhouse. Down in the valley the fields were green and the curves of the river glinted in the sunlight. I was bitterly cold and had to warm my frozen fingers with soup in the pub in Kettlewell. We then climbed up out of the Wharfedale with beautiful views of the horizontal layers of rock sediment laid down millions of years ago. We then descended through Hawkswick moor to the valley. The sun had warmed the valley and it brimmed with spring abundance. The lambs were skipping around but keeping close to their mothers, both lambs and ewes were numbered so we could see when there was ewe-lamb mismatch. Black and white oystercatchers were pecking for grubs in the pasture and sand martins had arrived early and were swooping up and down on the river surface. In the village there were spring flowers in the hedgerows, daffodils, primroses. The contrast between the grey bleakness of the moor top and the warm spring valley was striking. It was like an Alpine descent when one moves into a different vegetation type.

Easter Day (Apr 20) was bright and breezy and we walked on Ilkley moor, again experiencing the vast openness and the greyness of the bracken. Further down the gorse was in flower and giving the view a cheerful yellow aspect. Up here kestrels were hovering and ready for action. The bracken was not yet out and the view was unadorned. My iPhone weather reading was “6 deg feels like 2” that felt accurate. We were home for lunch of salad and cheese shared with Eve and Aleandro. Then I returned to London to be on call on Easter Monday.

It was a fine way to celebrate the spring renewal.

Team Lockwood at a Leprosy Conference in Le Corbusier’s City. (Mar 2014)

Participating in the IAL meeting in Chandigarh linked into leprosy science and politics and nutured my many friendships.

India has the largest national leprologist meeting so an invitation to speak at the Indian Association of Leprologists (IAL) meeting in Chandigarh, (Mar 2014) was irresistible. I brought my London team, Steve Walker, Saba Lambert (currently in Addis) and David Chandler an MSc student who did a project on the household costs of having ENL, a leprosy complication, in West Bengal. We had to leave our Sudanese colleague Omer Haroun in London because he could not get an Indian visa even though he spent 7 months in Mumbai last year doing new work on neuropathic pain. Team Lockwood stayed in the le Corbusier designed Punjab State Guest house, a 1950s building with a compact design, huge lobbies and mature cedar trees in the garden, we took morning walks by the lake. Our Punjabi hosts organized an excellent conference with talks and excellent open-air parties. The meeting was held in the Postgraduate Institute of Medical Education & Research (PGIMER), one of India’s leading medical institutes where the dermatologists remain committed to the work on leprosy initiated by Bhushan Kumar, a previous head of the department.

The programme included talks from leading Indian leprosy workers including Dr. Vishwa Mohan Katoch, overseas visitors and people working for leprosy in India- NGOs, National and state leprosy programmes. The challenging question of the numbers of leprosy patients in India was mentioned in many talks but more discussion was needed about how to assess the problem now. India achieved “elimination of leprosy as a public health problem in 2005” and this was achieved after patient numbers dropped precipitately between 2003 and 2007. I gave a talk based on my BMJ paper in which I, Vanaja Shetty and Gerson Penna showed that setting targets leads to innovative ways of reducing patient numbers. (1) There was agreement that there is now reduced capacity for diagnosis, highlighted by the talks by Dr. Krishnamurthy and Dr. Sundar Rao.

A new tension is developing because in some districts there will be enhanced case finding which means detecting more cases and this is not compatible with elimination at a district level. I was struck by the presentation of the dermatologist Archana Singal from Delhi who presented data on the numbers of children presenting to her hospital clinic, and showed a significant disability rate in these children indicating that they had been diagnosed late. The Delhi state leprosy officer disputed her data and maintained that there were low levels of children with disabilities in Delhi. The state leprosy officer in Odisha showed that there are districts with high rates, and this is compounded by a huge shortage of trained personnel for the leprosy programme posts. There were two key presenters missing, Dr. Barua from the WHO Leprosy Unit failed to attend, also absent was Dr. Kiran Katoch, she has been closely involved with the Indian national Leprosy sample survey. This was done in 2010 but the results have not yet been published, Dr. Vishwa Mohan Katoch (head of the Indian ICMR) assured us that Parliament would have to discuss the results first. We missed their talks and the opportunity to discuss their findings.

An early morning visit to the Nek Chand sculpture garden was a cultural reward. We were the first visitors and we wandered alone through Chand’s amazing grottos, sculptures and admired his work with figures decorated with glass bangles and abstracts made of old light fittings.
The Punjabis are great partiers and every evening there was an open-air party with abundant booze including Indian style mojitos, food and Punjabis disco dancing. I danced freely and found myself on the conference You Tube next day. When I looked at the clips with my friend Annamma she commented that it must be nice to be so free which is a sad reflection on the trappings of marriage and society.

After the conference I visited Bhushan Kumar and his wife Sarla at home. They have a well appointed house with interesting Indian art and effigies of Hindu gods. Both their children are working in the US, I met their California based IT son with easy openness and an American accent. Bhushan and Sarla retired over 10 years ago but continue to practice. Kumar sees about 10 patients a day in small clinic at the side of his house. It is a real contrast to his days as head of department but also a nice way of using ones medical skills in a low key way.

I was last in Chandigarh 20 years ago and on that visit I then went to visit the Manali valley and drove up to the Rohtang pass. This time I appreciated the lack of traffic in Chandigarh and the organization. I was sorry not to be able to stay on and visit the other le Corbusier buildings.
I travelled to and from Delhi on the fast Shatabdi express. Indian Rail has embraced electronic ticketing and many people showed the travelling ticket inspector their tickets on their smart phones.
I stayed with Jasjit Man Singh in Delhi, she treats me like a daughter welcoming me with green tea even at 3am when I arrived from the London flight and being part of her family enriches my visits. Last time I was there (May 2013) her mother aged 107 was dying; Jasjit had spent years looking after her mother at home. Jasjit is now freer, less sleep deprived and more relaxed, and also on her own spiritual journey. She is an established writer and has written a book about her mother’s life. She writes vividly about her mother‘s early life including a spell as a PhD student in London, marriage to an Army doctor and building an unusual Art Deco house in Haus Khaz. There were family tensions at the end of her life between one son wanting aggressive intervention and others for her to die quietly at home. I suspect that such disagreements are common where ever there are advanced medical facilities.

I left my iPad in Delhi, a disaster because I use it so much professionally. Fortunately I activated my network and within three weeks my iPad had returned to London via Budapest thanks to Leprosy Mission meeting there.

Saba commented on how happy I looked in India, I enjoy being there but it was especially nice having my team there. We all participated in the IAL meeting with different contributions and each took our own lessons from the conference. Many of my professional friends are in the IAL and I enjoyed the warmth of these friendships as well as meeting my close friends .I also met up with many friends and Sujai and Suman Jain from Hyderabad. Sujai was showing photos of his newly adopted daughter aged 6 weeks.

This visit encompassed the politics and science of leprosy, the architecture of Chandigarh and the warmth of friendship.

Lockwood DNJ, Shetty V, Person GO. Hazards of setting targets to eliminate disease: lessons from the leprosy elimination campaign BMJ 2014;348:g1136 doi: 10.1136/bmj.g1136 (Published 7 February 2014)

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

Wales through African eyes

I took my two African students to experience Wales and meet my mother. They were amazed by the greenness of Wales and surprised that the sheep were safe out overnight without boy shepherds to guard them.

My African PhD students, Edessa and Omer responded warmly to the invitation to visit Wales when I next visited my mother. Omer is from Sudan, Edessa from Ethiopia and Edessa has not been outside London during his nine months in the UK. The train journey from Paddington to Abergavenny gives fine views of the English countryside with views of the river Thames, small farms and villages. They were surprised by the sixe of the trees, Edessa surmised that we did not cut down so many of our trees. They brought gifts for my mother including soft dates.

Brecon is an ideal city for showing visitors, it is small, lively on Saturdays and one can walk everywhere. I took them to the city centre where we looked at the old Georgian house and inns. The Town Hall is a fine Victorian building. We also saw the City Hall, a Victorian building with cast iron interior, here the farmers market was just finishing with farmers from all over Wales selling their produce and interesting cheeses. We walked up to the cathedral through the cool green woods. Omer had not been in a cathedral before. Here a mixed voice choir was practising and we walked around looking at the memorials to soldiers and the local great and good. Brecon does have some modern architecture, a fine public library made of grey stone with long thin windows. One can see different ages in Brecon, the cathedral feels medieval but the city centre feels Georgian with town house where visiting lawyers stayed, and now there is a modern retail square and a huge Morrisons.

We all went up to the viewpoint Epint, here one is deep in the Beacons up on the peaty grassy treeless moorland and where one has contrasting views of the mountains with views down towards the green valleys and small scale farms.

We meandered back along tiny roads with high hedgerows and trees, green vistas everywhere. We stopped at St Cynog’s church, Merthyr Cynog. This is a 14th century church with a stout tower. Once it was a place for pilgrimage, then fell into disrepair. Now it has been restored but with an admirable plainness. There are no memorials on the walls and the space feels far more spiritual to me than the cathedral.

Brecon is a party place on a Saturday night., filling up with young farmers enjoying themselves boisterously.. We had supper in a beer garden drinking welsh Red Dragon beer en plein air with swallows swooping overhead and left before the party got rowdy.

We rose early on Sunday and Omer and I climbed up Peny Fan (890 m) It was a lovely walk, we did it early because we knew it would be hot and Omer was fasting for Ramadan. I was worried about having a fasting companion on the Beacons on almost the hottest day of the year. But we ascended easily and enjoyed the fantastic views. One looks down onto the farms and villages around Brecon. The beacons themselves have craggy tops and high lakes. The views down to south Wales are splendid with lakes and mountains, all glinting in the summer sun.. Back in Brecon Edessa enjoyed the Sunday roast Welsh beef in the cathedral café, a new experience for him. Omer sat in the cathedral to cool off.

We also squeezed in a stop at Llangorse lake, Wales’ shallowest lake and with a recreated ancient reed hut. The lake is now full of boaters, pedalos and windsurfers. The slow Sunday train services were a low point with a long hot trying bus and train ride back to Paddington. Omer could not drink until 9.20 and I was keeping an eye on him in case he dehydrated. If urgent he could have broken his fast. When we got back we also realized that this was the day that one of the TA soldiers died in the Beacons.

It was lovely seeing Wales through their eyes. They were amazed by the sheep, Edessa especially that the sheep stayed out over night and did not have little boys guarding them, fortunately we do not have hyenas in Wales. They were also surprised at how few people there were and the absence of buses. It is difficult imagining African style buses in Wales.

They loved meeting my mother although they were sad to see her living alone, and she warmed to them. When I went to work on Monday they were telling my research group what a beautiful old lady my mother is.

I had not anticipated how varied the rewards would be from taking Edessa and Omer to Wales.

Sri Lanka: Beautiful island in need of democracy.

The contradictions of Sri Lanka are a beautiful country with warm friendly people, a good health service but human rights problems caused by lack of democracy. 

Two weeks biking around Sri Lanka gives one a year’s worth of beautiful views and experiences. By the end of the holiday I was also aware of the darker side of Sri Lanka which relates to its political history and way the government has evaded questions about the military end to the civil war. I wrote about the journey every day on my blog and this is a post travel reflection.

I was on a biking holiday organized by Exodus and we had a lovely route that took us over the central and western part of the island. There were 14 of us from Australia (6), Ireland (4), UK(3) and one Canadian. We biked around 70 km a day, doing 102 km on one day. Being a cyclist really opens up a country, everywhere children shouted out to us. Our tea stops were in small cafes where they rarely see white people. Bananas fuelled my cycling, bought in the small shops with at least seven different varieties. I feasted on the ripe pineapples and water melons.

Sri Lankans are warm, open people, very welcoming. They also eat wonderful food.  Their main dish is so- called “rice and curry”, this dull name does not capture the feast one has of rice and about six other dishes of spiced spinach,  dahl, beetroot,  jackfruit, aubergine, ladies fingers, fish.  Every cook prepares the dishes in their own way and for me the spices were a treat.

Buddhism is very visible, we saw the ancient vast white stupas at Polonnaruwa, exuding a quietude that I appreciated. As we biked towards the south we saw many small temples beside the road with a seated Buddha. We often saw monks walking along with their begging bowls; many Sri Lankan families send a son to be a monk, and they they are celibate and study the scriptures. But we also saw the Buddhists enjoying a Hindu festival and worshipping Hindu gods enthusiastically. The festival had an Indian exuberance with crowds pressing forward to have their offerings blessed under garish pictures of the Hindu gods. huge Temple elephants, devotees carrying fire, colourful dancers and drummers were all part of the festival . Sri Lanka has a 10% Muslim population and I saw mosques in the commercial areas such as Colombo and Galle. People spoke disparagingly about the Muslims saying that Sri Lanka would have 100% literacy rates if it were not for the Muslims. They apparently drop out of school early to help in the family business. Nobody seemed to be asking what should we do to keep these kids in education. Christianity is a minority religion and I saw only few churches, in Colombo and Galle. However the Dutch reformed church in Galle was a vast building with a huge pulpit and organ, clearly built by colonists who thought they were in for a long stay but they only lasted for about 100 years before being displaced by the Brits.

I enjoyed comparing India and Sri Lanka, having visited India regularly over the last 38 years and Sri Lanka twice about 30 years ago. Sri Lanka is visibly better off and appears to have less inequality. The absence of beggars in Sri Lanka is very noticeable. The Sri Lankans have a health and social security system.  The health service is free to everyone at the point of care, there are small divisional hospitals in villages which are staffed by two doctors, patients needing operations are transferred in ambulances and do not have to pay for their treatment or drugs.  Another important difference is that this system works, India has a free government health service but is often non-functional. I also experienced the health service myself, I was bitten by a dog in a temple in Kandy and needed rabies booster jabs.  I had immediate helpful advice from my doctor friend Indira so I attended the base hospital in Nuwara Eliya for a rabies booster jab. It was a Saturday night, quiet in the casualty and I was quickly seen by a young doctor, bobble hatted because of the cool temperatures in Nuwara Eliya. who put me on the rabies injection protocol., I was given my rabies card with clear instructions about when I needed my next injection. The base hospitals are giving 250 courses of rabies injections per month. The vaccine was Indian made, in an Indian hospital the protocol might have been available but the vaccine would not be stocked and would have to purchased outside. The success of the Sri Lankan system are also visible in the statistics, Sri Lankans are more likely than Indians to survive childhood, their women are less likely to die giving birth and they live longer( 71 vs 64) , Sri Lankan also ranks above India in the world hunger rankings.

I was invited to Sri Lanka to speak at a dermatology conference , Sri Lanka still has a significant leprosy problem with over 2000 new cases being diagnosed each year, despite its better health system.  The new cases rates have been stable for the last 20 years leprosy will be a problem in Sri Lanka for a long time yet.

Surprisingly, Sri Lanka’s IT  is not as advanced as India’s, mobile phones arrived later on the island and through Indian technology. There are no call centres yet.;although they could do very well in this sector because many people are well educated and speak English.

We also experienced the plight of the tea pickers through the personal story of the bright intelligent young woman who was showing us around tea factory. She had hoped to go to university but had not got good enough grades in her A levels, retaking was not an option. Her mother was sick and she had younger siblings, so at 18 she had to start as a tea picker and pick 16 kg of tea leaves a day. It is a precarious life, they are only paid for what they pick and are permanent labourers employed on casual conditions. It seemed very difficult to escape being a tea picker. I also suspect that many of the families are in debt. It felt a very Asian scenario of limited opportunity and the needs of the family trumping everything.

I read Gordon Weiss's book “The Cage” about the civil war and the last days of the Tamil fight when the Tigers and thousands of civilians were stranded in the Nandikadal lagoon with the Sri Lankan army bombarding them.  This was a war crime but the current government has avoided censure. Both Canada and UK had questioned whether Sri Lanka should host the commonwealth Heads of government meeting (COHOGM) in Nov 2013 because of the genocide in 2009, but the meeting is going ahead. Weiss notes the absence of journalistic freedom in Sri Lanka., this is a striking contrast with India with its  lively opposition and a active media.  I could see this, few people read newspapers despite the high literacy rate, the news papers that are available all support the government.

In Sri Lanka the absence of concern for human rights has also mirrors the absence of democracy. There is no effective opposition so the president and his family rule and enrich themselves. In the presidents home area there were huge billboards with his portrait and that of his son and brother celebrating his achievements and reminding us of the ability running in the family.  When someone in power demands a place for a party it has to be surrendered.

I was sorry that I did not go up to Jaffna, the capital of the Tamil area, especially as I had discovered a tomb-stone there with my Dutch family name “Mom” in 1982. Stacey, a Canadian girl in our group had been there and had seen both the war destruction and the active rebuilding programme. She visited a hospital filled with people with post traumatic stress disorder. Because the government has not acknowledged the tragedies that occurred recently and because journalism is so weak there I fear that the resentments of the Tamils and others will grow and that there will again be racial strife.  There seemed to be no equivalent of the South African Peace and Reconciliation commission, and yet for a like that are very important for acknowledging wrongs and moving forward. The Uk Ngo Freedom from Torture have also reported that Tamils who returned after the war were being totorured even in 2012.

I also read a novel about the civil war, “Mosquito “ by Roma Tearne, it is a love story between an older writer and a young girl who has artistic talent. The war tears them apart, he is tortured by Singhalas and then Tamils,  but eventually they are reunited. The novel celebrates the power of love to overcome problems and also the importance of art. The author is also an artist and the novel is full of beautiful images. It was good to have a fictional contrast to the serious Weiss report.

The scenery in Sri Lanka is beautiful. The paddy fields were full of ripe paddy, with palm trees everywhere. The scenery also changed quite rapidly which is nice for a cyclist. On the day we biked up to NuwaraEliya we started in lush green paddy fields and half way through the morning the scenery changed to tea bushes and pine trees. On our descent from Ella we biked through the hills and then came down to the flat plains with huge lakes. The bird life is also spectacular , flashes of iridescent blue as kingfishers dived for lunch, spoonbill cranes and other waders in the paddy fields.

So I left Sri Lanka having enjoyed the holiday, I loved the scenery and the people. I would be happily return to bird-spot and snorkel and continue searching for the perfect rice and curry. But it also reminded me of how important democracy and human rights are and how important it is to protect them.

Diana Lockwood

Aug 2013

1.  India vs Sri Lanka statsDying under 5 12 versus 61/10 000; the maternal mortality rate is 35 vs 200 /10 000 compared with India.

2. The CageGordon Weiss.  Vintage 2011

3.The Mosquito Roma Tearne Harper Perennial 2007

4. http://www.freedomfromtorture.org/feature/out_of_the_silence/5980

day 12 Aug 16 Galle and Colombo

Lovely waking in the beach hotel to the sound of waves and to not have a 6 am wake up call. I went back to Galle to wander the streets and walk around the bastion ramparts. Then we went back to Colombo. It is a gentler city than the other Asian cities, without the huge crush of people in Mumbai nor the traffic jams of Delhi. I wandered around Colombo, there was a huge Hindu temple with a facade packed with gods. The festival we had seen earlier in the week was also being celebrated here with dishes of fruit being offered. Just down the road was the Anglican Church. They advertise their Friday night  miracle session from 5 till 7every week, I wonder what their miracle success rate is?.  There were about 50 people there with their arms aloft singing and chanting, being lead by a smooth voiced evangelical man at the front.

This has been a great holiday. I have enjoyed the contrasts of Sri Lanka. Biking was also a great way to see the country and I enjoyed the tea stops in the villages and talking to people then. The Sri Lankans are very warm and welcoming, extraordinarily nice people. We also had a great guide, Suresh who delighted in fixing things and did everything he could to ensure that we enjoyed ourselves and appreciated his country. I was last in Sri Lanka 30 years ago and it has developed hugely with better roads and communications. It is interesting to compare Sri Lanka and India,  the former has a visibly better health and education system. But Sri Lanka suffers from having less political debate and no effective opposition.  Rajajpaksa the current president is busy trying to deify himself. I read Gordon Weiss's book “The Cage” about the civil war and the last days of the Tamil fight when thousands of civilians were stranded in the Nandikadal lagoon with the Sri Lankan army bombarding them.  This was a war crime but the current government has avoided censure. Both Canada and Australia had questioned whether Sri Lanka should host the commonwealth Heads of government meeting (COHOGM) in Nov 2013 because of the genocide in 2009, but the meeting is going ahead. Weiss notes the absence of journalistic freedom in Sri Lanka., this is a huge contrast with India with its  lively opposition and a active media.

I was sorry that I did not go up to Jaffna, the capital of the Tamil area, especially as I had discovered a tomb-stone there with my Dutch family name “Mom” in 1982. Stacey, a Canadian girl in our group had been there and had seen both the war destruction and the active rebuilding programme. She visited a hospital filled with people with post traumatic stress disorder. The effects of 30 years of civil war will take many years to ameliorate.

On my last morning I met my Sri Lankan friend Indira Kahawita for breakfast. she has lived most of her adult life through a  civil war, the first serious Tamil riots were in 1977 when she was at school. She was relieved to see the end of the war. She lamented the absence of an effective opposition. She also commented on how well Sri Lankans do when they are abroad and hoped that this could be replicated back in Sri Lanka. Many people are learning Tamil as part of the peace process and her daughter speaks it easily. Maybe these measures will help.

We were a companionable group, we gelled and everybody talked easily and supported each other in different ways. The Ozzies were fit and good at enjoying themselves. There was a group of fast cyclists who raced ahead. I was happy in the slow group, savouring the landscape and taking photos. 

This holiday has been interesting, challenging and refreshing and I have returned with a love of beetroot curry a Sri Lankan specialty.

day 11 Aug 15 Old Dutch fort, Galle and Sri Lankan dogs

Another morning of fine biking along small roads and through the forest and besides fields. We stopped for tea next to a school where a huge mural had been made of the Bhuddist way of life including touching one's parents' feet. The teachers in the group were envious of this example of discipline.

We spent the rest of the day in Galle where  one can still fell the Portuguese , Dutch and British colonial influences with Dutch street names such as Leyn Baan (Line Street) and there is a huge sea wall bastion now 600 yrs old and withstood the tsunami in 2002 unlike the new town.   The town is an enjoyable eccentric mix of old and new with trendy art galleries alongside red tiled houses and vast maritime warehouses.  I went into the  Dutch reform church  and the pastor must have felt very important preaching from his vast pulpit but there are but no Dutch gravestones after 1720. On the central square was  a delapidated magistatrates court which looked like a museum but is still in use and 300 cases had been heard there  3 days ago. Next door a lawyer sat in her office typing on an old type writer. The  town museum was ancient and filled with antique junk and  had a new jewelry store at the back for shopping deprived museum goers tired of the old stuff .  We also stopped at a quaint reading room  which had 150 paying members and English books and magazines run by a very elderly man and a young girl reading Harry Potter.  We escaped from the afternoon heat with excellent coffee in a trendy cafe. The coffee in Sri Lanka has been execrable, clearly quality only counts if tea is being drunk. We then took a local bus back to our hotel. The driver behaved as though training for Grand Prix and needed all the help he could from the the flashing Bhuddist and three Hindu gods above the dashboard. I hope they are keeping his next reincarnation away.

Since my encounter with the dog I have been following news stories about dogs. Sri Lanka has 2.2 million dogs and there is awareness of the rabies problem with an article in todays paper. The minster of health has promised  the eradicate rabies by 2015. This will be impossible since many of the dogs are strays and in dreadful condition. There is also a Bhuddist reluctance to cull dogs. The campaign will run into similar problems as other eradication campaigns such as leprosy. Leprosy has been eliminated as a public health problem here which mean that they have over 2000 news cases annually and have done so for the last 20 years.

Better just enjoy my last night on the beach and stop worrying about rabies