Wednesday, February 3, 2016

Tanker Awards Nite and Speech

The Tanker Foundation in Chennai is one of the oldest trusts in the country doing amazing work for dialysis patients. They have 4 dialysis centres and are offering free dialysis to patients who cannot afford treatment. The trust was founded by Dr. Georgi Abraham, one of the leading nephrologists of the country, an extremely down-to-earth person and one who genuinely cares for the well-being of dialysis patients.

The Tanker Foundation has an annual awards nite where they have a lecture and give away some awards to people who have done exemplary work in the field of nephrology and dialysis.

I am very happy to let you all know that I was asked to deliver the Malathi Venkatesan Memorial Lecture at the Annual Tanker Awards Nite on the 25th of January in Chennai. I was also selected for the La Renon Tanker Foundation For the Sake of Honour Award which consisted of a gold medallion, a citation and a cash award.

The speech was very well received. Here is the video of the speech:

Click here to see the presentation.

Here is a video of me receiving the award:

Here are some pictures from the event:

Monday, January 11, 2016

Healthcare or Education - what should the Government prioritize?

If you removed the most basic priorities of the Government of India such as food, the next two most important sectors would probably be healthcare and education. It would be simplistic to assume that one can be prioritised over the other. The argument, "who will you educate if people die of disease?" can be countered with "who will treat the sick if you do not educate?"

India spends only about 4% of GDP on healthcare and only 1.4% is public expenditure. India spends 3.35% of GDP publicly on education. While about 74% of Indians are literate, only about half have access to basic healthcare.

Which side you would gun for largely depends on your personal and professional background. For someone battling a chronic condition, it might seem a no-brainer that the Government must prioritize healthcare spending over education. For someone who has struggled to gather resources for education, education might be more important.

India has extremely poor outcomes when you consider some of the most basic healthcare metrics. While Indians living in large cities have fairly good access, the conditions among the rural population can be abysmal. This inequity in healthcare has to be addressed on an urgent basis.

A paper published in the Lancet authored by Balarajan and others says, "...the infant mortality rate among the poorest and richest wealth quintiles was 82 and 34 per 1000 births...". Interestingly, it added, "...the under-5 mortality rate among mothers with no education compared to those with secondary or higher education was 106 and 49 per 1000 births, respectively."

This shows that both healthcare and education probably go hand in hand.

While we can debate on which sector needs to be prioritised and compelling arguments can be made for both, rather shockingly, the Finance Minister, Arun Jaitley has reduced Government spending as a percentage of GDP on both these sectors in the last Union Budget. India can never hope to be a developed country if Governments do not recognize the urgent need to improve markers pertaining to these two sectors. Acche din, anyone?

Without achieving basic levels of both healthcare and education, progress on many other sectors may be moot. We absolutely need to get our priorities right. While other sectors need not be neglected, we need to understand that it is these two sectors which will determine our long term progress.

Friday, January 8, 2016

Maharashtra shows the way, now the rest of the country must follow

The Maharashtra State Government recently exempted dialysis machines, consumables and drugs used commonly by dialysis patients from all taxes. Speaking to The Hindustan Times, an officer of the state government said:

"The drugs used for dialysis attract 5% VAT in the state, while medical equipment are sold with a VAT ranging between 5-12.5%. Import duty on dialysis equipment (dialyser and tubing) is around 44%, making the procedure very expensive. The decision will bring much relief to patients.”

So true indeed!

Most developed countries fully cover dialysis expenses for their citizens. This is based on the realisation that kidney failure is a chronic disease and the entire life's savings of families can get wiped out in paying for its treatment. In India, we have no such luck. Most patients cannot afford the treatment and simply die. The rest stutter along barely managing to make ends meet.

In these circumstances, the least the government can do is to not burden the patients and their families further. What kind of a state would impose taxes on equipment and drugs for such a condition?

The Government of Maharashtra has shown the way. By abolishing all taxes on equipment, consumables and drugs, they have taken a decision that deserves all the praise and support they can get.

The Government of India and other states should take this initiative to its logical conclusion. These taxes must be abolished with immediate effect in the rest of the country as well.

Another important measure that would go a long way to alleviate the problems faced by dialysis patients would be increasing the exemption on medical expenses from Income Tax. Currently patients must pay tax even on the amount spent on dialysis sessions and associated expenses. This is yet another example of how lopsided some of our policies are. The Government must make a clear distinction between healthcare expenses and expenses on luxuries.

The Right to Live is the most fundamental of all rights. Let us not mess with this at any cost.

Thursday, December 31, 2015

When my kidneys went on strike - Henry P Snicklesnorter

Back when I was fifty eight, my kidneys called a strike
The body soon objected, but was told to take a hike.
“We're sick of doing all the work,” the kidney spokesman said
“And if we're not here to do the work, you other parts are dead.”
Well the body wasn't happy, and so that very day,
A summit meeting was proposed, to find a different way,
To keep old Henry going, for at least a few more years,
And all the different body parts, spoke up with their ideas.
“We'll just carry on regardless,” said the brain, with great bravado,
But the other parts said, “break it down, fair dinkum, what would you know?”
“Your thinkings getting fuzzy, removed from us down here,”
“We need a real solution, and bloody quick, that's clear.”
“That pair of lazy mongrels, have got us by the throat,”
“We've got to pull together lads, to keep us all afloat”
The haemoglobin had it's say and said, “I'm fading fast,”
“Unless we work out something quick, I don't think I can last.”
The bones said “we're degrading,” the skin said with a twitch,
”I'm breaking out in little sores, and a really nasty itch,”
The feet reported swelling, the eyes began to dim,
The way things were progressing, it was looking rather grim
The heart said “I'm in trouble,” the lungs said “we are too”
The liver and the pancreas, said “what else can we do?”
Just then a quiet voice was heard, from somewhere down below,
“I am the peritoneum - and I'll give it a go”
“I can do a year or three,” it said, “at least we'll all survive,”
“While Henry works out long-term plans, to keep us all alive.”
And so it was, though not without some trauma on the way,
Then Henry moved to Home HD, to fight another day.
Long hours on slow nocturnal, near good as transplant some will say,
And the body wakes up feeling great, looks forward to each day,
And what about those kidneys, who thought they controlled the play?
They're just a pair of bludgers, - who needs them anyway?

Friday, December 25, 2015

Now, subsidised dialysis for Hepatitis B positive patients in Hyderabad

"...the Bhagwan Mahavir Jain Relief Foundation Trust, the NGO that is doing phenomenal work in the area of dialysis in Hyderabad today inaugurated an eight bed dialysis centre at Mahavir Hospital in Hyderabad. The dialysis sessions are all going to be single use and are going to be offered at the same rate as negative sessions despite the additional costs incurred by the trust due to single use dialysis sessions. The trust provides dialysis at Rs. 400 per session which is a huge discount from the price charged by regular dialysis centres."

Click here for more details.

Saturday, December 19, 2015

Kerala Diary

Despite being a self-confessed travel lover, I hadn't ever been to Kerala, if you don't count the trip I did when I was only a couple of years old. So, when my brother Karan (who was coming for a month-long holiday to India from the US) suggested that we go to Kerala for a few days, I was excited. Finally I would get to visit God's own country!

Vembanad Lake

We landed in Kochi airport and after lunch at a hotel close to the airport, we headed towards Alappuzha or Alleppey as it is commonly called. We checked into the Lemon Tree Hotel by Vembanad Lake. We got rooms right next to an infinity pool that overlooked the lake. The view was truly heavenly. The next three early mornings were spent sipping tea sitting on the banks of the lake and enjoying nature at its best - birds fluttering, chirping and the gentle morning breeze causing the leaves on the countless trees around to wake up.

Experiencing the backwaters in a Houseboat

We decided to take a houseboat on our last day in Alleppey and hired one from the Lemon Tree Hotel itself. The 5 hour trip on the houseboat through the backwaters was one of the high points of our trip. The houseboat is well-equipped with two bedrooms, a dining area and an open-to-air jacuzzi. Meals are cooked on the boat to your liking.

The houseboat makes its way through the lake into the backwaters and then takes you around in the network of waterways that make up the backwaters. The narrow waterways flanked on both sides by palm trees make for a beautiful sight.

We spent a couple of hours in the open top jacuzzi while the boat was going through the backwaters. As we were about to get out, it started raining. This was really an awesome experience.

Athirapally Waterfalls

On the penultimate day of our trip, we headed out to Athirapally Waterfalls. This was the same waterfall where movies like Raavan and Bahubali have been shot. The waterfalls are in their full glory during June and July. At this time of the year, the flow of the water was about 25% of what it is then. We were staying at the Rainforest Resort which offers a spectacular view of the falls. All the rooms are facing the waterfall and you can see the waterfall while you are showering as well!

The next morning, we hiked down to the base of the fall with the help of a guide. I was wary of doing this given my recent heart condition but then I threw caution to the winds and decided to go for it as the thought of getting wet under the gushing water was too tempting to resist. The guide was an expert who knew exactly what he was doing and led us to the base. No one is allowed to go right up to the base of the falls as the water can sweep you away. But he led us to one of the streams of the river that has many mini-waterfalls where you can sit and enjoy the force of water on your head and back. This was easily the best part of my trip. From afar, you feel that the water would hardly have any pressure but when you actually sit under it, you cannot sit for more than a minute at a time.

After returning to our hotel, we got into the infinity pool here and relaxed for an hour.

Dialysis at NephroPlus Alleppey

I needed two dialysis sessions during the trip, both of which I took at the NephroPlus centre in Alleppey. I could sleep through most of both the sessions and everything went very well. Gijo and Reneesh there took very good care of me. I generally judge the quality of dialysis by how I feel after the session. At the end of both the sessions, I felt totally fine and rearing to go!

Elephant Shower

On the way from Alleppey to Athirapally, we stopped at an elephant camp where we are allowed to sit atop an elephant and the elephant takes water in its trunk and gives you a shower! For some reason, the elephant was not in the mood when I was sitting on top of it but began the shower when I was patting it after getting down!

Hot Dishes

Our best culinary experience during our trip was at a very simple, homestay place called Hot Dishes. The food there is prepared only after you arrive. We had a simple 'Kerala Sadhya' or a meal which consists of rice, avvial, sambar, rasam, pickle, curd and papads. They added dosas on special request and the meal was very good. It is prepared and served by the owners themselves. The place is open generally only for breakfast and dinner but I called them around lunch time and requested them to serve lunch and they agreed! Traditional Kerala hospitality, for you!

Tuesday, December 1, 2015

Thinkers and doers

I find that in any group of people that comes together to take up some activity - a company, a project team, a non-profit organisation etc., there are broadly two groups of people - the thinkers and the doers. The thinkers are the ones with the ideas and the doers are those that implement them. Both are essential and equally important to the success of the group.

The thinkers come up with what should be done. They often will have some ideas on how they should be done. They will come up with a lot of really great stuff. A lot of it would be out-of-the-box. A lot of it could be described as visionary. They can think big. Almost revolutionary. But ask them to actually do any of those things and they would feel lost. They wouldn't know where to start. They would have absolutely no interest in doing anything.

The doers, on the other hand, are content well, doing stuff. They can't come up with the big ideas. They are great executioners. They know how to get things done. They are also ready to pull their socks up and get down to doing things themselves. They know their team (if they have one) and who's good at what. They often have a lot of respect for the thinkers and wonder why they can't come up with such great ideas!

The thinkers get frustrated when their ideas don't get implemented like they envisioned or don't get implemented soon enough. They find the doers incompetent at times and wonder why their great ideas are not being crystallised.

The doers get frustrated when the work they're doing is not appreciated. They believe that the thinkers, who come up with all these ideas can't do anything themselves and all they can do is instruct.

The truth is that both the types of people are extremely critical for the success of any team. One without the other is a sure recipe for failure. It is important for both to realise this and appreciate the other.