Sunday, December 28, 2008

Best fiction and nonfiction at The Middle Stage

I should be writing about what I am doing in Mexico - as I vaguely promised - but I really haven't had the time. A part of me insists strongly : "When you are traveling, focus on the travel, observe, talk to as many people as possible, and worry about collecting your thoughts later." And so I haven't gotten down to writing anything. But just to orient readers, I am in the southern state of Chiapas, which borders Gautemala.

Let me also use this opportunity to say Happy New Year to all my readers.

I do have something else to share. I've written earlier about Chandrahas Choudhury of the The Middle Stage earlier. Chandrahas is an exceptional interpreter of books and literature. And nowhere is the scale of his effort and the diversity of books he writes about more evident than in his end of the year list of best books. This year, his readers get an extra reward: a separate list for fiction and non fiction. This a great collection, and contains many books that you may not have heard of. But as you pause to read Chandrahas' notes on the books, you'll realize why they are good and how, especially in the case of non-fiction, they tell us something new.

Saturday, December 20, 2008

Traveling to Mexico City

Some readers of this blog know I am fascinated by Mexico. Why? There are many reasons, but one is certainly Mexico's history - particularly the history of Mexico City. There's an element of drama in how the city was founded by the Mexicas (who are known more popularly but imprecisely as the Aztecs). There's also an element of drama in the city's eventual conquest by the Spanish.

Bernal Diaz Del Castillo (1492 - 1584) provides in The Discovery and Conquest of Mexico an eyewitness account of Spanish soldiers entering the City of Mexico for the first time. The soldiers were led by the conquistador Hernan Cortes. It was a remarkable historical moment, and Castillo's account is one of the few glimpses we have of the Mexico City of the early 16th century - called by its then rulers as Tenochtitlan - before it was laid to waste.
We proceeded along the Causeway which is here in eight paces in width and runs so straight to the City of Mexico that it does not seem to turn much or little, but, broad as it is, it was so crowded with people that there was hardly room for them all, some of them going to and others returning from Mexico [City], besides those who had come out to see us, so that we were hardly able to pass by the crowds of them that came and the towers and cues were full of people as well as the canoes from all parts of the lake.


Gazing on such wonderful sights, we did not know what to say, or whether what appeared before us was real, for on one side, on the land, there were great cities, and in the lake ever so many more, and the lake itself was crowded with canoes, and in the Causeway were many bridges at intervals and in front of us stood the great City of Mexico, and we – we did not even number four hundred soldiers!

(Picture of the lake city of Tenochtitlan - the lake has since been drained - as recollected by Cortes, the conquistador who took over it; picture from here.)

Even today, Mexico City, with a population of somewhere between 15 and 20 million, is one of the great cities of world. Many parts of the city are capsules of history, markers of that dramatic collision between the Spanish and the Mexicas.


I’ll be traveling to Mexico City tomorrow, to explore some of that history. Especially the famous National Museum of Anthropology, where there is a model of Tenochtitlan and its spectacular pyramids, in addition to an inexhaustible number of exhibits on Mexico's long and complex history. I’ll be in Mexico City for a few days, and then will go on to Chiapas, the southernmost state of Mexico, bordering Gautemala, to get a sense of the country's Mayan past. There, my plan is to visit the ruins at Palenque (example relief from the museum in Palenque, left).

Blogging thus may be light until the New Year; but if I do have internet access and have the time, I will try to write from some of the places I am visiting.

Wednesday, December 17, 2008

Hurling size 10 shoes: What people do in a free society

By now, most of you would have seen this. As Falstaff says, reality can sometimes outdo fiction. What was President Bush's response? This:
“All I can report is it is a size 10,” he said, continuing to take questions and noting the apologies. He also called the incident a sign of democracy, saying, “That’s what people do in a free society, draw attention to themselves,” as the man’s screaming could be heard outside.

Tuesday, December 16, 2008


1. I've always put in a good word for the documentaries of Frontline, but now I've found another terrific source. This too a PBS production; it's called Wide Angle. The two documentaries I would especially recommend: Brazil in Black and White, which follows several Brazilian kids trying to get into college, and the effect of a recently implemented affirmative action policy. And Back to School - this one is an all time favorite - follows six children (one each in Kenya, Benin, India (in Rajasthan), Japan, Romania and Brazil and Afghanistan), trying to attend primary school, and the challenges they face.

2. Confessions of a xenophile:
Amitav Ghosh writes in this contemplative essay about his early experiences in the village of Lataifa in Egypt, which led to one of his best books, In an antique land. Ghosh ties his time in Egypt to something broader: a yearning for universalism. Some excerpts:
The world today is very different from that of 1980, when I came to Egypt. The conversations and exchanges that re-commenced in the post-war period are now in danger of being broken off again. Today, especially in the Anglo-American world, capitalism and empire are once again being packaged together, in a bundle that is scarcely distinguishable from the old ‘civilizing mission’. Indeed, one of the outcomes of the horrifying attacks of 9/11 was that it led to an extraordinary rehabilitation of imperialism, not merely as a political and military force, but also as an ideology – one that has led to the unfolding catastrophe in Iraq.


Against this background it is tempting to look back on the days of non-alignment with some nostalgia: and indeed there was much that was valuable in that period. Yet it would be idle to pretend that solutions could be found by looking backwards in time. That was a certain historical moment and it has passed. If I have reflected on it here, it is not in order to suggest that we should try to turn back the clock – as religious fundamentalists seek to do – nor in order to fall back on an ideology of permanent victimhood such as that which the French rightly castigate as ‘tiers-mondisme’. I have pointed to that period, rather, in order to evoke the desires and hopes that animated it, in particular to its strain of xenophilia, to its yearning for a certain kind of universalism – not a universalism merely of principles and philosophy, but one of face-to-face encounters, of everyday experience. Except that this time we must correct the mistake that lay at the heart of that older anti-colonial impulse – which is that we must not only include the West within this spectrum of desire, we must also acknowledge that both the West and we ourselves have been irreversibly changed by our encounter with each other. We must recognize that in the West, as in Asia, Africa and elsewhere, there are great numbers of people who, by force of circumstance, have become xenophiles, in the deepest sense, of acknowledging that in matters of language, culture and civilization, their heritage, like ours, is fragmented, fissured and incomplete. Only when our work begins to embody the conflicts, the pain, the laughter, and the yearning that comes from this incompleteness will our work be a true mirror of the world we live in.

Thursday, December 11, 2008

A visit to an emergency room

No, nothing to be alarmed about: I did not visit as a patient. My research focuses on developing methods that can make healthcare run more efficiently, and I’ve just begun to explore how emergency room (ER) operations can be improved. For a country that is the leader in just about everything – especially medical research, technology and innovation – the United States has a lamentable health care delivery system. And nowhere is it more evident than in emergency rooms across the country. Patients, even patients who have had a stroke, may have to wait hours before getting care. Some wait seven to eight hours. In major cities, ambulances carrying patients to an emergency room are diverted to other emergency rooms, simply because there is no capacity and queues are long. (Queues again! Haven’t we talked about queues before?)

The ER I visited is in Baystate Medical Center, in Springfield, Massachusetts. In terms of volume, this is one of the largest in the country. About 110,000 patients use it each year; about 300 patients come to the ER every day, 80 of them brought by ambulances. Others just show up by car, accompanied by friends or relatives.

Some have ordinary ailments, like a cold or sore throat. Instead of going to visit a primary care doctor, they use the ER. They do this probably because they don’t have a doctor. And that in turn is probably because they don’t have insurance. The statistic that crops up in just about every major discussion about the US healthcare system is that there are about 45 million uninsured patients in the country – a colossally high number; indeed an unforgivable number if you compare with other developed countries. Massachusetts is a bit ahead of the curve and has tried to fix the problem, but other states lag.

So if you don’t have insurance, and if you have a medical condition, you end up using the ER and pay a huge bill. But even if you have insurance, you might use the ER because you could not obtain an appointment with your doctor. ERs cannot refuse care; they have to treat everyone who shows up, irrespective of whether the patient has a trivial condition or is uninsured.

ERs, thus, are a safety net; they soak up the consequences of inefficiencies whose root causes lie elsewhere.


At the Baystate ER, patients with minor ailments are sent to a Fast Track section. That way they do not interfere with the more critical patients who are sent to the main area. But the name Fast Track has become something of a joke. Waiting times for getting into Fast Track can be very long. So to pacify patients and ensure they don’t feel mocked, the Fast Track area was recently renamed the General Treatment section.

Needless to say, only the name has changed; the waiting times have not.

When I visited the Baystate ER, it was about 2 pm in the afternoon. It was crowded. Early mornings are the least busy hours; but by noon things start picking up. By late afternoon, early evening, the ER is packed. This too is a US-wide trend – and perhaps true worldwide as well.

In the waiting area, there were patients and their relatives and friends. A couple of the patients were in wheelchairs; they were elderly, clearly sick, and their faces had a resigned and faded look to them. Their faces told also of the passage of time: seconds had become minutes and minutes hours, yet they were still waiting. If sicker patients arrive, they tend to preferred, thus increasing the waits for less sick patients. But assessments of sickness are to some extent subjective, inevitably so.

The main emergency area – entered from the waiting area through double doors – was a world apart. It was a buzz of activity and felt surreal. Constant activity and motion: like a video on fast-forward. There was a central square, the inner portion of which consisted of staff working hastily with computers, records, paperwork. On the outside, doctors, nurses, assistants swirled around immobile beds with prostate patients. These beds are supposed to be in rooms, but to create capacity, beds had been added to the hallway. Monitors displayed constantly changing information: how much time each patient had been in the ER, whether the tests that had been ordered had returned, which resident or doctor was assigned to the patient. The charge nurse, who was in charge of operations, had tough decisions to make. Whom to admit next? Which nurse to assign to which patient? Should another bed be added to the already overcrowded hallway?

The staff, even though busy constantly attending to something, seemed cheerful enough; their cheer was much needed, considering the bleak faces of the patients.

Patients, once they are treated, are either discharged or admitted to the nearby Baystate Hospital. And here too there is a crunch. Hospital beds are a scarce resource, and generally there is no availability. So the patients continue to wait in ER beds, effectively denying beds to other patients waiting for hours for treatment in the waiting area. Such as the elderly patients I'd seen upon entering, waiting in wheelchairs and with tormented looks.

So it goes. Emergency rooms are not supposed to be pleasant places. The nurses and doctors who work there know there is no room for sentimentalism. Work just needs to be done. But ERs are also a barometer of the larger issues that ail a healthcare system. The US healthcare system is badly fragmented and inefficient; and a large part of the cost is borne by ERs.

Friday, December 05, 2008

Elections in Ghana

Ghana, the first sub-Saharan country to gain independence - in 1957 - will have elections this coming week. After what happened in Kenya in December last year - that country too was regarded as stable until elections - and in Zimbabwe earlier this year, there might be some apprehension. Ghana also has recently discovered oil, always a problem - just look at neighboring Nigeria, whose oil wealth has been its bane.

(Video, via Ethan Zuckerman.)

But Ghana, everyone is saying, is different. Democracy has taken deep root there; the media and reporting scene is vibrant, the election commission strong. And the vote counting system - going by what this article says - is remarkably transparent:
During elections radio stations like the capital's JoyFM dispatch staff armed with mobile phones around the country.

The correspondent gives continuous live updates and reports by mobile phone to their media "election headquarters".

Once results are collated at the constituency, in the presence of party officials and electoral officers, the radio stations rapidly compile the results, broadcast them and a clear picture of the outcome is available within 24 hours.

The process has become too fast for old-fashioned election shenanigans.

JoyFM takes this a step further and publishes the results on the internet, thereby making it virtually impossible for a government to fiddle with results during a deliberate delay in their release by a government-controlled electoral commission as is the case elsewhere in Africa.
That's quite impressive; with such accountability, everything should be fine next week. Still, there will always be some some tension; besides the race is close. Fingers will be crossed.

New York Times: Best 10 books of the year

It's that time of the year. Everyone has their own list of best books, and the New York Times has put up what it thinks is best. Toni Morrison's A Mercy is there, so is Joseph O Neill's Netherland, and Jhumpa Lahiri's Unaccustomed Earth; in non-fiction, Patrick French's comprehensive biography of VS Naipaul, The World is What it is.

Tuesday, December 02, 2008

Innovation and improvisation in a constrained environment

At Ethan Zuckerman’s blog, My Heart’s In Accra, I came across this remarkable post. It’s all about how the scarcity of resources engenders creative solutions. Some of this creativity is evident in developing countries, where hardware odds and ends are put to unexpected use, or new devices developed from readily available materials. Here are two examples.

1. A pot-in-pot refrigerator

Suppose you are in a developing country with a hot climate. You lack reliable electricity, and a generator is too expensive. Suppose you sell fruits and vegetables. How do you keep your produce from rotting in the heat; how do you prevent it from being swarmed by flies?

The answer: a refrigerator, under $2, made only of earthen pots.

(Figure from here)

The idea seems similar to the earthen pots I used to have wonderfully cool water from in India. Still, this is different. There are two pots involved – it’s a pot-in-pot system – and the apparatus is a lot more versatile. It can store peppers, eggplant, spinach, and they can stay edible for up to twelve days; sometimes even longer. The Nigerian Mohammed Bah Abba, from a family of pot-makers, is credited with the invention. Details:
To the surprise of many, the world’s cheapest refrigerator costs less than $2 dollars to make, uses minimal resources to produce and runs completely without electricity. It’s called a zeer pot, or the pot-in-pot and was developed by Mohammed Bah Abba, who realized that he could put the second law of thermodynamics and transpiration to work for him. The zeer pot, is actually two earthenware pots (I’m assuming they are both unglazed), one pot smaller than the other. The smaller pot is put inside the bigger pot, and the space in-between them is filled with sand. The sand is made wet with water (twice a day) and a wet towel is put on top of the two pots to keep warm air from entering the interior. As water in the sand evaporates through the surface of the outer pot, it carries heat, drawing it away from the inner core, thus cooling the inside of the inner pot which can be filled with soft-drinks, water, fresh fruit, vegetables or even meat. A damp cloth placed on top keeps the inside pot away from hot air. In this way, fresh produce can be kept for long periods of time without the need for electricity, or camping coolers made high embodied energy. Tomatoes and peppers will last for up to three weeks, and African spinach, or rocket, which normally would spoil after just a day in the intense African heat, can and will remain edible for up to twelve days. Eggplants will keep for up to 27 days instead of three. It can even be used for storing sorghum and millets for a long time since it protects from humidity, thus preventing fungi from developing. The zeer will keep water (and other liquid beverages) at about 15 degrees Celsius, and even meat can be kept fresh for long periods.

The new technology is now being used by farmers at the market. Fresh produce is kept inside, with just a couple fresh items displayed on the damp towel resting on top. In this way, most of the produce is kept hidden away from both warm air and insects. In the past, all produce was displayed in the open air, attracting flies resulting in stomach disease such as dysentery. Now food can be kept fresh for longer and kept away from flies...even miles away from electricity or ice.

(Figure from here)

2. Pedal-powering a knife-sharpener

The pot-in-pot cooler is something new, designed and produced from readily available local materials. Now consider how something as simple and commonplace as a bicycle can be used, yes, for getting from one place to another, but also for a very different trade: knife sharpening.

Bikes are, as Zuckerman says,
“a platform that’s seen perhaps the most innovation in Africa. With a little bit of hacking, you can turn a bicycle into a cargo vehicle, loading it down with frightening quantities of bananas. Add a wheeled cart behind and a bicycle is an ambulance. Add a tiny one-stroke engine and it’s a motorbike, capable of propelling the rider over long distances… and she can start pedaling when she runs out of gas. In Uganda, bicycles become phone booths, with wireless phones attached to metal boxes mounted on the handlebars.”
But using a bike for knife sharpening has an altogether different appeal. It is remarkably simple and intuitive, as most improvisations often are. And it reminded me of something from my school days in India, in Ahmadabad and Nagpur.

My parents bought me a large, rather cumbersome black bicycle; I believe it was one of those hardy Hero bicycles. Others – I envied them – used colorful, pink and red ones, the BSA SLRs, with a side stand. This last detail about side stands is important. Mine didn’t have a side stand: the stand went symmetrically over the back wheel; you had to pull the weight of bicycle backwards to park it. The delightful thing about this feature was that you could sit and pedal in parked position, and the wheel would spin without the bicycle moving. It was always a pleasure to pedal like this, just for timepass.

But the power generated by the pedaling can be put to good use. And so it has been:
Bikes get really interesting when you let them change function. In my single favorite video on Afrigadget, Peter Kahugu shows off his knife-sharpening bicycle in Nairobi. I love the video because I owned the same damned bicycle when I lived in Ghana in 1993. It’s a heavy, Indian-made beast, but it’s indestructible, and has some cool features. One useful feature is a huge kickstand that surrounds the back wheel. This lets you park the bike with the rear wheel off the ground… which allows you to ride the bike and spin the rear wheel without the bike going anywhere.

That’s the key to Peter’s business, as he uses the power of that back wheel to turn a belt which turns a grindstone mounted on the handlebar… which lets Peter sharpen knives and scissors, a trade that pays him a solid wage, roughly $10 a day. His business is entirely portable, which lets him bring his services to his clients. And he can take his tools home at the end of the day. The bicycle is still a transport tool, but it’s also a power generation tool.
(Figure from here.)

Interesting, isn’t it? In India, I remember the knife-sharpener coming once in six months or so, checking if we had any work for him. I remember him riding a bicycle; I remember also the steady hum of his sharpener. But did he use the same system described above for generating power? I don’t seem to recall very clearly.

But Indian readers - maybe you have a better recollection?