One Nation in battle against Coronavirus

The battle is on. In India. Against Coronavirus transmission. With grit. With courage. With determination. Where victory is the only option. Every country to her own citizens. Save. Protect. Prevent.

In India. Everyday s a news. It is no more a battle happening in the icefields of Siachen. Or the deserts of Rajasthan. It is happening in my house. In my neighbor’s house. Yesterday, three apartment societies close to our apartment has been shut down. Shut down? We ask each other. What does it mean? Gates closed. We learn. Residents locked. Wow!!

Polio eradication. Was a different battle. An urgent but over a time. This one is almost a battle that I am watching on a bridge on the river Kawai. Hand to had fight. A general is speaking virtually. Stay indoors. Practice hygiene. Report if you have fever.

And commanding units are working 24-hours. At Indian Council of Medical research. At hospitals. Soldiers with stethoscopes around neck. Soldiers in white saris and aprons. Soldiers driving ambulances. In a battlefield. Soldiers dispensing medicines. Soldiers testing samples in laboratories.

This a battle against human race. And then came the grim news. The virus is killing our parents. Our grandparents. Our elderly specifically more. We are enraged. What? Papa-mummy. Grandpa-granny. Virus, you dare. We buckle up. We will win.

Report comes from Kolkata. Bus conductor pouring sanitizers on hands of passengers. Report comes from Kerala. Passengers coming out of a bus lined up for washing hands.

Report comes from airports. Our fellow citizens have returned from Iran. From Italy. We celebrate. In our homes. In our own way. Someone hugs a dear one. Someone clenches a fist. Someone claps.

And we call friends. How is your son in USA? How is your daughter in Amsterdam? Good. Great. Stay safe. This shall go away. We hear of our friend’s son returned from Germany. We clap. Mousumi and me.

Rumors fly. One says some nonsense. Others protest. With angry emojis. Speak science. Read ministry and WHO guidelines. We are in a battle. That we must win. No time for nonsense. We will have those later. Jokes? Fine. Good destress. But no rumor. No rumor.

The apartment society is full of people. Working from home. Basking in sun in their verandahs. Sipping tea. Children playing in green lawns. Running around. Club shut. Gym shut. Parlor shut. “Can we meet in the evening? Whiskey? They say alcohol is good for health in these times.” Laughs. “I was joking. But bore ho raha hoon. Can we meet? Only two three of us. Allowed. No? “

Life is different. But the battle is on. Our leaders have somehow given the message. This is serious business. And we will do what we can. But you must take care of yourself. And each other.

Maid comes. Coughs. Perhaps innocuous. Outside door. “Go on leave. We will pay you. Come after 14 days.” Poor lady is baffled. Walks away. At the entry of the Society there is a temperature monitor. And strict surveillance of visitors.

It is a unique state we are in. Uncertain. Nervous. But determined. Perhaps the national song today is the song that all of us know in our own languages. “We shall overcome some day”.

As we see the numbers rising. Maharashtra. Uttar Pradesh. Bihar. For the first time some stray morning walker asks “Why is Gujarat not reporting? Are they testing?” Science. Everyone is suddenly talking science. And science only.

The known critic of everything and anything that is government asks angrily “Why is the Protest still on in Shaheen Bagh? They are posing a health risk.” This is the same man who waited three hours in traffic jams happy that someone was protesting against the Government.

The Nation is united in its battle. Absolutely. As one. That is why India never fails. Because of her citizens. In times of crisis, in times of battles. One India, one Nation. Speaking science.

Three Stories of Love, Support and Courage.

Happy Woman’s Day.


Three Stories of Love, Support and Courage.

Remembering a sister. A daughter. A wife. On Wonen’s day.
(Because I remember my Mother every day).

Story 1: Sister’s Support


One of the the most memorable pictures I have clicked is from a village in eastern Uttar Pradesh.

I have told this story before. But on women’s day I remember this story again.

This was a village I had gone with a few colleagues to investigate a case. A case of encephalitis. A mother. Bed ridden. In dire state of health. The husband. Weeping at their helplessness. There was gloom in the air. Nothing much we could do. 

As I was returning, I heard a sound of laughter. Most unexpected in this gloomy air. I peeped. 

And here in a corner, a child was swinging in air and laughing. A girl was holding his swing and balancing him.

A brother and a sister. Children of parents in distress.

The sister was old enough to understand the crisis. The boy too young. Innocent. Laughing in joy in his swing. 

The sister supporting the boy. Giving him his moment of joy in times of duress.

This image lives with me and shall for ever. 

A sister. Support. In times of distress to a brother.


Story 2: Daughter’s Love


The flight was from Delhi to Hyderabad. Early morning. Me. Mousumi. Tintin.

After some time in the flight, I fell sick. Hypoglycaemia. 

I was sweating profusely. Also fainting. Tintin took care. He got sweet drinks and cookies from the flight attendant. 

The flight attendant. A young lady. Stood by me. As I sat recovering sitting in my aisle seat. She brought one sweet drink after another. Wiped my forehead with a napkin. 

As I recovered she asked ‘Are you feeling better?’ I said ‘Yes.’ And said. ‘Please take care. You must not neglect.’ And she held my hand and said ‘Stay very well. Please.’

As the flight was to land she came and gave me a folded napkin. I asked ‘What is this?’ She smiled ‘something for you to read and remember what I said. Do not neglect.’

I opened the napkin. It was a note from her for me. It began. ‘Keep rocking.’ And ended ‘Be happy. Always :-)’ .

I have kept that note. I take that note as a note from a daughter to her father. Caring. Reminding. To stay healthy and happy. Always.

Letter 1
Letter 2

Story 3: A wife’s courage


1992. Mousumi and I had moved to our new posting. Shortly after our marriage.

Churu. Rajasthan. 

I was much handicapped. Because of my poor Hindi. And because of a huge culture change.

I was the Chief Medical Officer. We lived in a staff quarter complex. With the other two Medical Officers. Nurses. And other staff. 

About two months into my job, one morning one of the Medical Officer’s Dr Chaudhury came and asked for something. I forget what. I could not because of administrative reasons. I denied. He argued. I stood my point. 

He was a local. And burly. 

When none of his options worked he threatened me. With dire consequences. He reminded me that he was local and I was from Bangal. He threatened that he would involve the Panchayat. By that time other staff had come. They tried to intervene. But Dr Chaudhury was ferocious. He turned a chair. Banged the table and walked out of the room abusing me loudly. 

The news was spreading. I could see staff members speaking in hush times. Everyone was afraid of Dr Chaudhary. Mr Compounder came and told me ‘Do not worry. Let Manager Saab come in the evening. He will sort matters.’ And he advised ‘Why don’t you go home and rest.’

I did not. I sat in my clinic. Patients started coming. And because I was alone, the load was very high. That day. 

Dr Chaudhury had disappeared. 

About an hour and half later, as I was examining  a patient, Dr Chaudhury came. And in a local dialect told the patients in the room to leave for a few minutes. 

The patients meekly left the room. And Dr Chaudhury shut the door. After the last man had left.

I was unsure of what was happening. I watched. 

Dr Chaudhury came to me. And extended his hand. ‘I am sorry.’ He said. I stood up. And embraced him. As men do. To settle issues. 

He sat down. Opposite side of the table. I said ‘Dr Chaudhury, let us have some tea.’ He nodded. I said ‘Well let’s go home then. Mousumi will prepare tea.’ 

He immediately stood up and said ‘No.’ I asked ‘Why? What happened?’ He looked at me and said in Hindi ‘Bhabhi is angry. Very angry. Bahut gusse meiN haiN.’ 

I was surprised. I asked ‘What happened? Did she tell you anything?’ 

Dr Chaudhury said ‘No. No. She did not say anything. But she is very angry. I will not go to the campus now. You also do not go. Let us have tea here. And see patients.’ 

He got up and opened the door. And we saw patients for the next one hour. Together. 

Lunch time. I came home. Mousumi was in the kitchen. Cooking. She smiled as usual and said ‘Have a bath. I am heating food.’ 

I did. Everything seemed normal. 

At lunch, we both sat with rice and roti and Dal. I asked ‘Did something happen today?’ Mousumi said ‘Meaning?’ I said ‘Between Chaudhury and you?’ She smiled and said ‘ I had heard otherwise. That something had happened between you and Dr Chaudhury.’ 

I said ‘And? After that? What happened?’ 

Mousumi said. ‘ I heard it from Mr Gandhi’s wife. I was furious that he threatened you. I took a pile of vegetables and that big dagger (bhojali) that your father had. The one that we keep under our bed. And sat in the verandah. And I was cutting the vegetables with that dagger. Brinjals. Lauki s. Sitaphal. Potato. All vegetable that I had in the house. I was cutting them again and again and again. I was very angry that he had threatened you. Dr Chaudhury saw me from his window. I saw him too. I looked at him and kept on chopping the vegetables. After some time, I saw him leave the campus. Why did you ask me? Did he tell you anything?’

I laughed so much that day. 

It took me at least three weeks before I could convince that my house was safe for him to have tea.

Many days later, I had asked Mousumi. ‘Why did you display your anger in public that day?’ She said ‘I was very angry. But more than that I wanted to show anyone who dared to threat you that I will be in his way. Ferociously. Protecting you.’

Mousumi, my wife. Has always been my strength. With love. Laughter. And when there was a need, with a dagger.

(I fortunately did not have a chance ever again to capture this mood of Mousumi on my phone or camera.)

I have been touched by women. Who have inspired me in many ways.

My sisters. My sister-in-laws. My batchmates from Medical school. My neighbors. My colleagues. Our extended family.

Julie Jacobson. My mentor. An inspiration. Who taught me so much at work. 

The Didi s that have become my very own special ones. Krishna Di. For one. With her unending love for me.

Life has moved on. With love care and blessings of many women beginning with my Ma.

Life is beautiful because of these women. May this women’s day be a reminder of the love, strength, inspiration that many women bring to our lives. 

Happy Women’s Day.

Conversation on COVID-19

COVID-19. I have received three questions today. Interestingly, all of them have an element of P in it.  

First from a cab driver: Sir,should I panic? Darna haiN kiya? (He had seen me using a hand sanitizer)

Second from a public health friend. If this is not pandemic, what is? Country after country, seriously?

Third from my wife. What do we need to protect ourselves in our house and outside?

On the first, to the driver I replied. “I will ask you not to panic but be cautious. Darna mat lekin sabdhan rehna. There are very good guidelines in paper from Ministry. Please read them. And call 011-23978046 if you have any doubt. Ministry number. You may have to call many times. But you will get authentic advice.” He nodded. Thereafter, I asked him casually. “What do you do when you panic generally?” He smiled. And said “Nakhun khata hoon. I bite my nails.” We laughed. I showed him my nails. He understood the familiarity. And he laughed loudly. Then I told him. “Most important thing. No nail biting. No putting fingers in mouth. And in nose. And ears.  Find something else to do when you panic.” He nodded. I said. “But this is very serious.” He asked, “When will I know I have Coronavirus?” I said “Only when you are tested. And you will go for a test only when you have high fever and cough.” Hesitantly then he asked “Can I ask you something, if you do not mind?” I said “If the question is about your sadi-shuda marital life, yes you can.” He folded his hands and said “Dhanyabad.”

To my public health friend, on his concern on pandemic issue, I said “Now that I know that you have read Park & Park and you know that I have read Park & Park to begin with, let us not debate on this issue. You will find a wiser person to advice. I am more interested in knowing when we will catch up over the long pending coffee and pakora treat from you?” He laughed and said “Now that ii is due for so long, let me upgrade the offer to a dinner. Come over the weekend.”

To my wife, to begin with there was no laughter. She had asked the question in all seriousness. And I had to be business like, prompt and clear in my answers. Those who know me will understand the difficulty. Those who know Mousumi will appreciate better. For her, I had the following advice.

  1. Take this seriously. Do not panic. Do not read WhatsApp. Do not advice others based on what you have heard from padoshan-Bhabhi. (To which she reminded me that this was a serious conversation and the moment she understands I am not serious, she will leave the room.)
  2. Wash your hands frequently. Frequently means before coming out of kitchen. Every half an hour. And rinse your hands please when you wash them.
  3. Carry a hand-sanitizer with you. Please use it. I have a few from Seattle. I had bought for my flight. Take one. (To this she replied “You use those. Tell me what I should get from here.” I said “Go to the medicine shop. Ask them for an alcohol-based hand sanitizer.” She said, “You should have told this in the first place.”)
  4. Wipe the surfaces you are working on with a cleanser. Tissue paper.
  5. When you sneeze, sneeze in a handkerchief or your elbow. You generally do that always. (I think I scored a brownie with the last point.)
  6. Take your regular medicines religiously. No skipping medicines. A weak body is vulnerable.
  7. For few days avoid crowd. (To that she asked, “When have you seen me moving in a crowd?” To which I answered “Never. But just in case.” I lost any and all the brownie points I may have gained with this point.)
  8. And you do not do these things, but just in case if you were to advise others in the house like Raju, all the Didi s and Bhagwan Ji, please tell them to keep social space. No hugging. No handshaking. No … She stopped me. A little furiously. “When have you seen Raju, Bhagwan Ji and the Didi s handshaking and hugging? Can you not give a proper answer to a simple question?” I knew I had failed. Utterly. Miserably.
  9. (As she started walking out of the room) I said “Mousumi, please however tell everybody that if they have fever and cough and any respiratory distress, they should tell you immediately please.” To which she said “That I know from TV. I need not have asked you for that advice.”

Sick? My foot!!

If you are a medical doctor or a health professional, you may want to skip the long write up below. For you and other readers, I have a pleasant news to share.

According to a very recent survey, of the States in India which scored very high in their performance in Adverse Events Following Immunization (AEFI) management for the year 2019-20, Bihar and Uttar Pradesh scored very high. Bihar was excellent with a score above 80% and UP close to 80%.

When I had begun Public health practice in India not so long back, we were taught an acronym. I found the acronym almost obnoxious, but it was a reality then. BIMARU, the Hindi of “sick”, States. It talked of Bihar (BI), Madhya Pradesh (MP), Rajasthan (R) and Uttar Pradesh (UP). The four BIMARU states of India with lowest public health indicators.

Today these States are marching rapidly and are nearing close to States that have traditionally been advanced in public health. And it is not happening by magic or divine blessings. It is happening because of the hard work, meticulous planning, dedication and determination demonstrated by health workers, physicians and public health managers in the State. To ensure that the State’s population receive the best of health care.

BIMARU in 2020, my foot!!

……………………………………………………………………………………………………………………………………………

Vaccines are precious commodities given primarily to precious people: children and mothers. With a hope and trust that in long run vaccines will protect them from infectious diseases. Infectious diseases that have the chance to kill and handicap healthy life.

Vaccines are given to precious human and animal lives. Therefore, they must themselves not cause harm to the body. They must have the highest standards of safety. While science and technology may not guarantee a full proof protection from an infectious disease after a vaccine against it is administered, it must ensure that no harm comes to these precious lives after the administration of the vaccine.

How effectively the vaccine will work in human body will depend on multiple factors. The four most important factors being the nutritional status of the recipient. The status of sanitation and hygiene. Any underlying disease condition that affects the immunity of the recipient. And finally, the condition of the particular vaccine administered.

Vaccines are generally very safe. Every vaccine passes through a rigorous phase of multiple clinical trials in animals and human body to understand human body’s reactions, response to the vaccine. How well does the body tolerate a vaccine administered externally to internal human systems? The results of these trials are meticulously studied by regulatory bodies at global and national levels before they are scientifically approved for use in human body.

But yes. Vaccines are biological and chemical agents. Developed to elicit a response in human body. They must provoke the body’s immune system and the agents that protect the body naturally to effectively fight and overcome any harmful infectious agent from outside. And they are administered by humans, health workers. Therefore, there are chances of errors in administration and chances that the external agent is not well tolerated by a particular body system. Therefore, at times, after a vaccine administration there are reactions within a normal human body that are averse to the normal human body system. These reactions manifest commonly in mild forms: mild fever of short duration; headache; swelling at injection site. In very (very) rare cases, serious events happen. Shock and if not managed effectively, death. Rare, very rare. Chances of severe reactions leading to major events like shock and death are so rare that they are almost negligible. For example, it may be expected that only 1 in 1 million (10 lakh) children administered with Measles vaccine will develop any adverse event according to WHO’s statistics. https://vaccine-safety-training.org/rates-of-adverse-vaccine-reactions.html

But every life, even a single life in the 26 million lives born in India every year is precious. And must be protected by every means at science’s disposal to predict and protect the rarest of rarest adverse event that may happen to a life following vaccine administration.

And what does this protection from adverse events following immunization (AEFI) mean? It means four things. To be carried out by trained medical professionals. Health workers, doctors, nurses, medical administrators. 1) every AEFI case must be identified early by trained eyes. 2) every case must be immediately managed following standard procedures. 3) every case based on its severity must be reported to the designated authority. And finally, 4) every case must be investigated thoroughly to find any association with the vaccine administered to the body. Based on the result of this investigation, countries will decide whether to continue with the use of the vaccine in its land for its people.

A strong AEFI management system is critical and essential component of an immunization program of a country.

Light in One Eye

An apocryphal story from life of Maharaj Ranjit Singh Ji : Light in One Eye

During the recent turmoil and killings in Delhi, one community that stood out in spreading harmony and help was the Sikh Community. Opening shelter in the Gurdwaras, distributing Dal-roti in the deeply affected lanes of North East Delhi they provided yeomen service.

I remembered a tale I had read long back on one of the doyens of Sikh kingdom Maharaj Ranjit Singh. I read it again today.

The tale is as follows.

A calligraphist has spent a large part of his life in making a copy of the Quran. Once done he approached many Muslim Nawabs and kings to sell his book. But no one purchased his work.

At last he reached Lahore and approached Foreign Minister Fakeer Azizuddin. Fakeer Saab appreciated the work much but would not buy the work. It was too costly.

Maharaj Ranjit Singh heard of this story and called the calligraphist. He took the book reverentially and pressed it against his forehead. And then scrutinised the book with his single eye. 

The excellence of the work impressed him. He bought the book.

After the calligraphist had departed, Fakeer Azizuddin asked him why he had paid such a high price for the book? He was a Sikh and what use was the Quran to him.

To this it is said that Maharaja smiled and said ‘ I have one eye. Because God wanted me to see all Religions with one eye. I do not have light in the other eye therefore.’

Today. March 3.

There is a common joke that colleagues crack on me. My obsession with 3. 

‘There are three reasons.’ ‘There are three challenges.’ ‘There are three factors that we must consider.’ 

Three is almost an obsession with me.

When random folks challenge. “Why 3?” My standard reply is ‘Because I can think of three. No more. No less.’

When kind colleagues ask, I joke ‘Because I was born on 3rd March.’ And we all laugh.

One day when I asked myself while bathing, why three, seriously, my inner self-confessed ‘I say three because I think two is too less and four is too much.’ 

Today is that day. March 3. My birthday. Thank you all for your love. Thank you for your friendship. I am truly indebted for your presence in my life: in reality, in virtual, in physical meetings and in social media.

I will tell you three stories. Briefly. On my birthday. Today.

These stories are very inconsequential but have had huge impact on me. Then. When these stories unfolded. And the impact has lasted. Changing me slightly perhaps but much meaningfully. I believe.

Story 1: 

The conversation was simple. It was post noon. I had had a heavy lunch in office. I was feeling drowsy. I was just out of a heavy loaded meeting. Planning to return home early, I was packing my desk. My cellphone rang. 

A female voice. Max Life Insurance. She introduced herself. Told me that the conversation was being recorded. And asked me a few questions. I was uninterested. And replied curtly because I was irritated but courteously because she was a female. 

She explained a new policy. And after she had spoken tole me ‘Have I explained everything well?’ I wanted to get out of the conversation. So I said ‘Yes. Very well. Thank you. I am not interested.’ 

She paused for a moment. And then asked ‘But I did not explain the returns. The benefits. The clauses. Will you not ask me?’ 

I said, ‘No. I am not interested.’ 

There was a pause. A longer one. I wanted to end the call. But I could hear her breath. And it just felt impolite. 

After a pause which was a few seconds but seemed so long, she spoke. Murmuring. As if to her own self.

‘If everyone says they have no questions, then how will I practice? Itna kuch sikha hi kyun? Why did I learn so much?’

And stopped. Silence.

I realized her pain. We professionals learn new techniques and knowledge so painstakingly. If no one allows us to apply that knowledge, practice and make it useful, what is the point in learning!!

I told her ‘Ok tell me more in detail.’

She asked ‘You really want to know. Please hear me out even if you do not buy. And if you have any feedback for me, please tell me Sir. I will try to improve.’

This conversation happened in 2004. The policy matured in 2019. It is one of those rare policies where I got a handsome return. And I remembered the girl the day the amount reflected in my bank account.

After that day, I have never put my phone down on anyone who had tried to explain a policy or a credit card to me sincerely. Even if I do not purchase, the least these men and women can expect is a patient hearing and an opportunity to practice their newly learned skill.

Story 2: 

It was a Diwali evening. A friend and his family were visiting. 

Evening. We stood downstairs. Children were lighting fuljhuris. And clapping. And having lots of fun. 

My friend. His son. And I. We were standing. Watching.

My cell phone was constantly ringing. And messages flowing in. These were SMS days before WhatsApp came into being. 

The noise on the phone was irritating. My friend looked at me. ‘Bandh kar dete haiN, iyar. Let’s shut off our phone. Damn irritating.’ 

His son looked at us bewildered. ‘But Papa, is someone not remembering you on Diwali? You are shutting off your friend. No?’ 

We laughed. I said ‘Nehi beta. These are just useless greeting messages that people forward at random.’

He looked at me for long. And said. ‘I can understand you and Papa, uncle. But I just hope some of those messages were for me from a friend. I do not have a mobile even. When I will grow, I will love receiving messages. Even the faltu ones.’

I still do not respond to all messages I receive on my phone as greetings. Particularly the forwarded ones.  But I read them all. And feel privileged that these messages flood my inbox today.

Tomorrow, who knows?

Story 3:

This one is a very insignificant story. But I write this because it had significant impact on me.

Many years back, I was in an organization where I was quite up the ladder of the HR Organogram. There was considerable authority that I held in administrative matters. And though Mousumi often told me that she was observing some not so good changes in me, I was not very mindful.

It was a workshop in a hotel. Something related to some new IT technology. I had already had the master training overseas. This was a cascade down at country level. I was not a trainer but there in the workshop.

Somewhere two hours in the meeting I walked to the corner where the coffee machine was, for a cup of Americano. I took a cup. And a hotel boy came in soft steps and whispered to me “Not now.”

I frowned. He smiled.

And said “I have been instructed not to serve coffee now during the meeting. It disturbs others.” I was amused. “Who has asked you not to serve coffee?” What I actually wanted to ask is “Do you know who I am?”

He looked towards the participants. And pointed to a man. He was an administrative assistant in the organization. I was about to tell the hotel boy “It is ok. I am his boss. You can serve me coffee.”

But something happened when I looked at him. He was quite resolute in his thoughts. And he was following an instruction. I ended up keeping the cup down and telling him “Sorry. I will wait.”

In the meantime, the Administrative Assistant had seen and anticipated what was going on here. He came in quick steps and almost rebuked the hotel boy “Arreh, Sir ko coffee doh. Serve Sir coffee.” The poor hotel boy immediately brought a cup and said, “Sorry Sir.”

I walked away. Not having the coffee. In my feedback, I had written a long note on the hotel boy. His ability to discharge his duty well. I had praised him profusely.

And that day I felt very happy. To be rightly denied a privilege that I wrongly thought I enjoyed just because I was somewhere up in the ladder.

Ladders are fragile. Discipline is rock solid. Always, in life.

Angels of Health with 3 Es : Efficiency; Empathy; Education

I have often spoken and written of my admiration for the Nursing profession. In clinical medicine and in public health. I have been blessed in my knowing and seeing some of my nurse colleagues in action – in clinical wards and in field as ANMs. And I shall not hesitate to say that much of my practical knowledge in medicine – from how to secure a vein for a fluid drip to how to administer an intradermal injection – techniques essential to providing care, I have learned from my nurse colleagues.

There are two qualities essential to nursing and for any medical health care provider. This was told to me by a health care worker. In her own language Bengali. I have translated this to two words. Efficiency & Empathy.

Therefore, I was very delighted to hold in my hand a book. Old edition and used. In my book shop. Left Bank Books. in Seattle. The book titled. “Nursing: A human needs approach.”

Back at my hotel, by a fireplace I turned pages. And became engrossed. Such a lovely simple language. And the previous reader had underlined key sentences. I softly prayed that she had adopted these lessons. in life. In profession. The ones she underlined. “Optimum care of the sick required education.”

I read the first chapter yesterday. Rich history of Nursing.

In very early days nursing was seen largely as a feminine role – an extension of mothering. The author states that the word may have actually been derived from the same words as “nurture and nourish.” Sounds very logical. Indeed.

The authors divide evolution of nursing in four phases. The folk image phase. The Religious image phase. The Renaissance image phase. The Modern nursing phase.  

The stories of first hospitals in India, of homecare nursing by sisters and mothers at home to the sick, the story of Phoebe, the first deaconess (servant) who cared for the sick, widows and orphans. The story of Olympias, a woman of Constantinople who set up the first hospital in Rome. And the story of Rofiada al Islamiah, wife to Prophet Mohammed, considered the mother of Nursing in Mideastern Muslim countries.

And then the story of the “lady with the lamp”, a light in times of darkness, Florence Nightingale.

Florence was born to wealth and a prominent family in Victorian England. Early in life she understood the essence of Christianity in her way. Service. Love. And shunning a life of luxury.

But as I read the chapter on Nightingale today, for the first time I understood the foundation she had made for the profession. Beyond the two E s of Empathy and Efficiency, she had stressed on a third E. Education.

To prepare herself in serving the sick and infirm, Florence studied with Pastor Fleidner at Kaiserworth for three months. In 1853 at 33 years of age, she was appointed to reorganize the care for the sick at a hospital established for “Gentlewomen in Distressed Circumstances”. Through hard work, she soon was noticed.

And Florence was sent to the front of the Crimean war in an Army hospital where wounded came in large numbers from the battlefield. And deaths were very high.

Florence’s genius lay in her observation. She identified three problems: 1) lack of essential medical supplies – drugs, bandages and equipment; 2) absence of sewers and laundry and 3) lack of proper food for the sick. Addressing these and efforts of her staff reduced the death rate drastically. Death came down to under 3 % among the wounded.

Post war Nightingale returned to England in poor health. She remained in poor health for the rest of her life. She lived to be 90.

And it is during this period that she laid the foundation of future nursing. A genius who foresaw the profession like no one else and whose teachings till day hold firm and true.

In 1860, Florence crated a school of nursing. The Nightingale School had three components: 1) a trained matron with undisputed authority over all staff; 2) a planned curriculum and course of theoretical and practical education and a home attached to the hospital where carefully selected students were placed under selected sisters. The word sister has its roots in the religious foundation of the nursing profession.  One key component of the nursing education as prescribed by Florence was the value of attending to health care needs as well as human needs of patients.

In due time, Florence set up two streams of nurses. One, the “Ward sisters” for hospital care, supervision and teaching. The second stream was “District nurses”. She said that the district nurses needed special education as they would be working more independently. These district nurses are todays Auxiliary Nurse Midwives (ANMs).

Nightingale lived a long life dedicated to service to mankind in distress. An Angel on earth. But it is her human quality that impresses the most. Her ability to see the service in its best form. In its future. District Nurses. Ward sisters. Empowered with the three Es of Efficiency, Empathy and Education.

# From pages of Indian history: When Treachery met Wisdom’s end


(Adapted from Sir Jadunath Sarkar’s ‘Shivaji and his Times.’ )


1660. Aurangzeb had returned North. The kingdom of Bizapur was recovering. Queen Mother Bari Saheba had left for Mecca.


It was time for expansion. For accession. And Shiva, a warlord Chieftain had to be tamed. To begin with.


The brave Abdullah Bhatari known as Afzal Khan was given the task. A first class blaster veteran Afzal knew the art of winning. By strength. By treachery.


In an open court, Afzal smirked and boasted before the King and his men ‘ I shall bring Shiva captures before you without alighting from my horse.’
And he set off. With his army.

Rampaging the Maratha land. Looting. Burning villages. And destroying temples. Ransacking holy deities.


Shiva had an army that fought in hills. Ambushes. Skirmishes. But he had not fought thought wars. Yet. Therefore the army panicked. Stories of Afzal’s looting and his army reached the Shiva camp. His army was in a dilemma.


Legend has it thus. Midnight. Shiva was awakened. As if in a dream. He saw MA Bhawani. ‘Go my son’ she said. ‘ Go fight the battle. I shall be with you.’


Meanwhile in the Afzal camp. There was despair too. For small counties and villages had fallen. Hindu zamindars. Tehesildar SS had subjugated.Surrendered. But Shiva was deep in the hills. Where he hid with his army. And it seemed almost impossible to capture him.


Therefore treachery must be adopted.

Afzal sent message to Shiva. ‘ Your father and I have been friends. You are no stranger to me. Come and meet. Leave it then to me to convince the emperor Adil Shah to leave you to your forts and to your Konkan land. Attend the Court if you wish to. Or else I shall arrange exemption to your attendance if you so wish.’


Spies from both camps visited the opponent camps to see preparations and understand strategies.


Emboldened by his dream, Shiva convinced his Council of Ministers and generals that he would fight. He would meet Afzal as proposed. But not surrender. He would play along on the treachery. Fight treachery with treachery. In equal measure.


Shiva’s mother came to the court and blessed him.’ Go, fight the battle and return victorious’. She said. Shiva prepared to leave. He had summoned the armies of Pingle from the Konkan and Palkar from the Ghata to be to defend the kingdom. He left minute instructions on how the kingdom must be run in case he never returned.


Afzal’s envoy Krishnaji Bhaskar came then to meet. He was treated with respect. At night secretly they met. Shiva appealed to Krishnaji as a Hindu and a priest to tell him the real intentions of Afzal. Krishnaji hinted there was a conspiracy. A mischief is harboured by Afzal. But thus far.
Shivaji sent back Krishnaji with his own envoy Gopinath Pant. Pant was a spy. He too tried to gauze the intention of Afzal from his army. And he understood Afzal had a plan. A treacherous plan.


Shiva sent message through Gopinath that no harm shall be done to Afzal during the meeting. Afzal reciprocated that no harm shall be done to Shiva during the meeting.
The meeting was arranged to take place at the crest of an eminence below the fort of Pratapgarh and overlooking the Koyna valley.


On both sides was deep forest where Shiva places his finest warriors for an ambush. And in the Koyna valley, Afzal placed his troops ready for attack. As need be.


A tent was erected here by Shiva. A richly decorated canopy was set up. And gorgeous cushions and carpets lay worthy of a royal guest.


Shiva then readied himself for the meeting. Under his dress he wore a coat of chain armour. Below his turban he wore a steel cap. On his left land was a set of steel claws (baghnakh) and up his right sleeve lay hidden a sharp thin dagger (bichwa or scorpion).


And with him would be just two men. Jiv Mahala, the swordsman. And Shambhuji. Each of them carried sword and shield.


As the three were ready to move a saintly female figure stood before them. Jija Bai. Shiva’s mother. ‘Jayatu’ She said . ‘Be victorious.’


Afzal too came with two soldiers with him as Shiva had. Afzal came in a palki. With him came the two swordsman. And a famous swordsman . Sayiid Banda. And two Brahman envoys. Gopinath. Krishnaji.
On entering the tent Afzal was furious. To see the decoration. How dare a son of a jaigirdar display such wealth. He was pacified by Gopinath. Gopi explained to Afzal that soon all of this would be his.


Shiva came. And objected to Sayiid’s presence. Two swordsmen it was agreed upon. He insisted. Sayiid was removed.


Afzal has his sword by his side. Shiva came apparently unarmed. As if to surrender.


With attendants standing below, Shiva mounted a raised platform to meet Afzal who was taller. Afzal advances a few steps and opened his arms to embrace Shiva. Shiva reached the height of Afzal’s shoulders.
Shiva was in Afzal’s embrace.

Suddenly Afzal tightened his clasp. In his left arm was Shiva’s neck. An iron grip. Shiva struggled. With his right hand Afzal drew his dagger and struck Shiva’s side.


Shiva’s hidden armour rendered Afzal’s dagger strike harmless. Shiva struggles in the iron clasp of Afzal’s arm. Yet he soon recovered. Shiva passed his left arm around Afzal’s waist and tore Afzal’s bowels open with the steel claws. Then swiftly with his right hand he drove the bichwa dagger into Afzal’s side.


Wounded Afzal relaxed his grip and Shiva tore himself free. He jumped down from the platform and ran out towards his own men.


Afzal shouted ‘Murder, treachery. Help. Help.’ Attendants from both sides ran up fast. Sayiid Banda struck Shiva with his sword. And cut his turban. A deep dint invite steel cap below the turban happened.


Shiva grasped a long sword from Jiv Mahala and fought back. But Jiv came round and with one quick movement cut off Sayiid’s right arm and then killed him.


The palki bearers meanwhile tried to carry wounded Afzal away. Shambhuji intercepted them. He slashed at their legs. They dropped the palki. Shambhuji cut off Afzal’s head with one quick stroke.


And carried off the severed head in triumph to Shiva.

The head was buried beneath a tower (Abdullah bur) on with-eastern side of the lower fort. A Temple dedicated to Ma Bhavani built by Shivaji is at a short distance

From pages of Indian history: Every action has an opposite reaction.

1509. King Vira Narasimha Raya was on his deathbed. Without a direct descendant. Mature in age and wisdom to rule. His sons were children.

He was perturbed. Worried. He summoned his Minsters. His council. For advice. For action. For counsel.

He had a half-brother. With his eyes on the throne. Krishnadeva Raya. Who had to be removed from his way. For if he ascended the throne. The King’s son would be betrayed. Of their right to the throne. 

His Minister In Chief. Was given the task. To ensure that Krishnadeva’s  eyes be no more focused on the throne. 

The Minister went. And soon later returned. With two bleeding eyes on a tray. Krishnadeva’s eyes had been removed from their sockets. And Krishnadeva left to suffer the pain. Blind in desolation. 

The king. Vira Narasimha heaved a sigh of relief. And died peacefully. 

Once dead, the battle for succession began. Krishnadeva overcame all odds and ascended the throne. And made the Minister who had ‘blinded’ him his minister too. Because the Minister had secretly told him the plan. And a goat’s eyes had been removed and placed before the king Vira Narasimha before he died. 

Krishnadeva Raya became one of the most powerful rulers in India’s history. With power. Wealth. Wisdom. Arts. 

Many years later. Krishnadeva lay on his deathbed. Sad. Very sad. For he had no male heir. To sit on the throne. After he died. He had daughters. 

He had had sons. Who died young. 

In 1520s, he lost a son born Yong and healthy. He became superstitious. And believed that the Minister had conspired to kill the baby boy.

11 years after the incident where the Minister had spared his eyes, the King Krishnadeva took the eyes of that Minister. And blinded him.

Such are lessons from history. An action of goodness repayed by an act of evil.

( Story adapted from Krishnadeva Raya by Manu S Pillai)

# From pages of Indian History: Chandra Gupta II

It was dark. Evening had crept in stealthily. Wiping out last rays of the afternoon Sun. There was a chill in the air. Faint sounds of jackals howling yonder floated in the air. It was dark. The Emperor had died.

From a State guarded by tight laws, lawlessness had become the order of the day. Theft and robbery had citizens on alert. Twenty four hours. War. Battles. Citizens of Magadha were fed up. And distressed. A kingdom that was the strongest was now on its knees. With misrule. Indiscipline. A kingdom at mercy of the Sakas. Who had defeated the king Rama Gupta.

Samudragupta. The Emperor. The Poet. The warrior. The administrator. Had breathed his last. Samudragupta. Who had performed Ashwamedh Yagna. And his son. King Rama Gupta had ascended the throne. The father and son were so different.

A lamb born to a lion. A crow born to a peacock.

King Rama Gupta was no administrator. He was no warrior. He was no ruler. And the message spread fast. Far and wide.

The Sakas who had not dared attack during Samudragupta’s reign came stealthily. And in battle defeated Rama Gupta. The coward Rama crawled in front of the Saka might.

And what did the Sakas do?

They ridiculed Rama Gupta and asked for his wife. The queen. As a gift for pardon. As a gift to spare King Rama Gupt his kingdom. The beautiful queen would now be in the Saka king’s court. As a gift.

Rama Gupta , the coward that he was agreed.

King Rama Gupta’s brother Chandra Gupta heard of this exchange. Kingdom for queen. And he trembled in anger and in insult. How could his brother?

DIn the dark of the night young Chandra Gupta disguised himself as a woman. As if he was the queen. And with his ‘sakhis’ – warriors dresses like women , Chandra Gupta came to the Saka King. For love making. And in the dark he killed the Saka King.

The disguised queen Chandra Gupta ripped open the Saka king’s belly with a knife. And his ‘sakhis’ – the soldiers massacared the Saka king’s men in the dark of the night.

The Queen was saved.

On return Chandra Gupta remained silent. For he did not want to add salt to his brother’s injured pride.

But a few years later he killed his brother Rama Gupta and ascended the throne.And thus began the brightest of reigns in ancient India.

The reign of Chandra Gupta II of the Gupta dynasty.

A glorious reign that brought stability to the Indian kingdom.

( From Devi-Chandra-Gupta by Vishakhadatta)


Note: This story is from an account by Romila Thapar in her chapter : The emergence of Empire: Mauryan India