Category Archives: Health and Medicine

Wifebeating in India (updated w/ child abuse figures)

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In the past, discussions of domestic abuse have run aground because of the lack of good information. In general, we end up agreeing on three points:

  • Women are assaulted by their partners in South Asia
  • South Asian women are assaulted by their partners in America
  • Non South Asian women are assaulted by their partners all over the world as well

but we always lack the numbers to talk about how bad the problem is in different places and for different communities. For that reason, I thought it was worth flagging this statistic I saw in the recent NEJM article on AIDS in India:

37.2% of women in India who have been married have experienced spousal violence.

That’s more than 1 in every 3 women in India who has had a husband at some point. The numbers in the article varied by state, and unfortunately they provided these figures for only a handful of states (those where they had HIV figures). Still, here’s what it says:

State %age of women abused
India overall 37.2%
Delhi 16.3%
Andhra Pradesh 35.2%
Karnataka 20%
Maharashtra 30.7%
Manipur 43.9%
Nagaland 15.4%
Tamil Nadu 41.9%

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NEJM on AIDS in India today

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The New England Journal of Medicine recently published a short “perspective” piece on the state of HIV/AIDS in India. This is the first article in what appears to be a series, the next one is on the challenges involved in containing HIV in India. Here are a few points from the piece:

We don’t know how many people have HIV in India

The best estimate right now is 5.7 million HIV infected Indians, that’s one in every eight cases world wide (India has one in every six people in the world). However, there is a great deal of uncertainty around this number:

The epidemiologic data for India (estimates of the number of infected persons range from 3.4 million to 9.4 million) are far less precise than for South Africa … In 2005, no data were available for many of India’s more than 600 districts. [Link]

See the image to the right? The data come from the National AIDS Control Organization. The northern states are all blank because there isn’t enough data. That’s really distressing.

Estimates indicate that rates are not (yet?) high in the general population:

The estimated HIV prevalence among people 15 to 49 years old in India is 0.5 to 1.5%, whereas in South Africa it is 16.8 to 20.7%. [Link]

But higher in high risk subgroups:

Female and male sex workers, men who have sex with men, and injection-drug users have the highest rates of infection — surveys typically find a prevalence of 10 to 20%…. [Link]

Prevention faces many hurdles, especially amongst women:

Across India as a whole, only 35% of women know that consistent condom use can reduce the risk of infection. However, since 37% of women who have been married at one point have experienced sexual abuse, not all women have much leverage to negotiate. Continue reading →

Pushing Polio Out Of Pakistan: Don’t Give Up!

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poli_prcs.jpgHello, I’m Namrata, a new contributor. I broke into the North Dakota headquarters a few months ago and ANNA decreed I was too small to be kicked out into the winter cold. When it warmed up everyone had gotten used to me, so finally Abhi and Ennis said I might as well earn my keep since I keep stealing their magazines out of the mailbox. One of the ones I like to steal is New Scientist, and there was some sad news from the desh in the latest issue:

Last month Abdul Ghani Khan, a senior Pakistani doctor, was killed by a remote-controlled bomb shortly after urging villagers to vaccinate their children. [link]

According to the Daily Times of Pakistan Dr. Khan was killed in Bajur Agency after trying to convince addressing a convening local jirga, or council; he was greeted angrily in an area where opposition to the vaccine has spread by word of mouth and radio sermon.

“As soon as we reached there, an armed prayer leader warned us against visiting the area. Some locals said: ‘On one hand, our enemy (a reference to the United States) is bombing us for no reason while on the other hand you are coming here disguised as polio campaigners to spread vulgarity,” [an injured companion of Dr. Khan] told Daily Times at the hospital. (link)

The day before the Daily Times had reported that 24,000 children in Northern Pakistan have gone unvaccinated, and earlier Pakistan confirmed a sharp uptick in polio cases (28 to 39), concentrated in the borderlands with similarly troubled Afghanistan. To put this all in perspective, the two nations apparently did successfully immunize 2 million children only a few months ago. Continue reading →

The Science of TWA

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Absolutely zero Desi Angle (TM) here per se, but a whole heap o’ relevance for anyone who frequents the comment threads here (and if you are one of those happy souls who only reads Sepia Mutiny for the blog entries, feel free to skip this one, as I’m about to get a little parochial). But I noticed that today one of the most-emailed articles from the New York Times is an essay by Daniel Goleman on the scientific explanation for why people say, uh, intemperate things online that they would rarely say — or at least say the same way — in person. So if you’ve ever wondered what it is that causes folks on discussion boards to insult each other, call each other idiots or worse, flagrantly mis-characterize each other’s points in order to drive home some strident and ill-conceived argument of their own, and generally stink up the joint — and if you’ve perhaps caught yourself doing so, whether here on in any other online exchange — you need look no further for your answer than your orbitofrontal cortex. (I trust that one of y’all medical/scientific macacas can explain the details to the rest of us, or indeed, critique the article — politely, natch.)

The emerging field of social neuroscience, the study of what goes on in the brains and bodies of two interacting people, offers clues into the neural mechanics behind flaming.

This work points to a design flaw inherent in the interface between the brain’s social circuitry and the online world. In face-to-face interaction, the brain reads a continual cascade of emotional signs and social cues, instantaneously using them to guide our next move so that the encounter goes well. Much of this social guidance occurs in circuitry centered on the orbitofrontal cortex, a center for empathy. This cortex uses that social scan to help make sure that what we do next will keep the interaction on track. (…)

Socially artful responses emerge largely in the neural chatter between the orbitofrontal cortex and emotional centers like the amygdala that generate impulsivity. But the cortex needs social information — a change in tone of voice, say — to know how to select and channel our impulses. And in e-mail there are no channels for voice, facial expression or other cues from the person who will receive what we say.

But wait, what about 🙂 and 😛 and 😉 ???

True, there are those cute, if somewhat lame, emoticons that cleverly arrange punctuation marks to signify an emotion. The e-mail equivalent of a mood ring, they surely lack the neural impact of an actual smile or frown. Without the raised eyebrow that signals irony, say, or the tone of voice that signals delight, the orbitofrontal cortex has little to go on. Lacking real-time cues, we can easily misread the printed words in an e-mail message, taking them the wrong way.

And if we are typing while agitated, the absence of information on how the other person is responding makes the prefrontal circuitry for discretion more likely to fail.

TWA – Typing While Agitated. Never happens to me. No, sir. I keeps cool calm and collected. But just in case… Continue reading →

The hand that rocks the cradle

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Our site administrator Paul tips us off to an article over at the BBC today that highlights a unique new program launched by the government of India:

The Indian government is planning to set up a network of cradles around the country where parents can leave unwanted baby girls.

The minister for women and child development, Renuka Chowdhury, told BBC News the cradles would be “everywhere”.

It is the latest initiative to try to wipe out the practice of female foeticide and female infanticide. [Link]

In my opinion anything that will help mitigate the foeticide and infanticide scourge is a good thing, but the imagery of little cradles set up around the country is kind of bittersweet.

“We will have cradles strategically placed all over the place so that people who don’t want their babies can leave them there,” Ms Chowdhury told the BBC News website.

The cradles could be in places as diverse as the local tax collector’s office, or where local councils meet.

Ms Chowdhury said parents would be able to leave their babies secretly. The important thing was to save their lives…

“They will be collected and put into homes,” she said. “There are plenty of existing homes and we will be adding some more also…” [Link]

Apparently there is actually a precedent for this type of program (in Japan):

The drop-off at Jikei Hospital in southern Japan will consist of a small window in an outside wall, which opens on to an incubator bed, officials say.

Once a baby has been placed inside, an alarm bell will alert staff. [Link]

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Sugar and the City

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New York City has just released preliminary results of a health study that shows that more than one in eight adult New Yorkers have diabetes, while twice as many have abnormally high blood sugar that could be a sign of conditions leading to diabetes. Moreover, of the city’s diabetes sufferers, at least one-third do not know that they have the disease, while many of those who know they have it are not managing to treat it properly. Here’s the NYC health commissioner quoted in the New York Times today:

“This confirms that we as a society are doing a rotten job both preventing and controlling diabetes,” said Dr. Thomas R. Frieden, the city health commissioner. “We can do a much better job helping people with diabetes get their condition under better control. The fact that there are over 100,000 New Yorkers with seriously out-of-control diabetes, and over 200,000 who don’t even know they have diabetes, is a real indictment of our health care system.”

As disturbing as the overall figures are, he said, they were not unexpected. They resemble estimates made by public health officials, who expected that the disease would be more common in New York City than nationally; diabetes is less prevalent among whites than among most other groups, and New York is a mostly nonwhite city.

Which brings us to the Desi Angle (TM), and it’s a deadly serious one:

But Dr. Frieden said he was startled by some of the specific findings, including the very high numbers among Asian-Americans, especially those from South Asia. The study indicates that more than half of the New Yorkers whose families are from the Indian subcontinent have either diabetes or prediabetes.

Here’s more:

Asians have the highest rates in the city, 16 percent diabetic and 32 percent prediabetic. The cityÂ’s report does not differentiate Asians by region, but officials said that the data in their study and others show that East Asians have below-average rates of diabetes, while South Asians have by far the highest of any large group.

Diabetes afflicts about 14 percent of the cityÂ’s non-Hispanic black population, 12 percent of Hispanics and 11 percent of whites.

If I can get a hold of more details I’ll update this post accordingly. Tomorrow the Brian Lehrer show on WNYC (93.9 FM in New York, and live and archived online) will be discussing this topic including the specific case of the South Asian community. Continue reading →

Who nose the secrets of the stars?

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Since we have been talking about California doctors I thought I would share a news item that just came to my attention. Do you knows which desi male is in such high demand in Hollywood for his magic hands? He’s not a yoga instructor or a masseur, instead he’s Dr. Raj Kanodia, surgeon to the stars!

What do Jennifer Aniston, Ashlee Simpson and Cameron Diaz have in common? When Aniston recently underwent rhinoplasty, she turned to Dr. Raj Kanodia, the plastic surgeon behind Simpson’s and Diaz’s new noses. [Link]

Would you trust a bald barber?

Not only is this a major nose job, but (surprisingly) it’s confirmed by Aniston’s own people:

Aniston’s rep confirms the operation. “Jennifer had a procedure done to correct a deviated septum that was incorrectly done over 12 years ago,” [Link]

While the official story is that she hated her original nose job and came to Kanodia for correction, nosy parkers insist that that a broken nose is just balm for a broken heart.

Am I the only one who finds it ironic that all these famous actresses are coming to a desi doctor to get demure little noses? I imagine him doing these operations with an cartoon angel on one shoulder and a cartoon devil on the other. The angel tells him to just do what the client wants, and the devil tells him to go ahead and do what he really wants – to give these women beautiful, majestic desi schnozzes instead. The poor doctor’s hands twitch, caught by conflicting impulses, until he leaves the room crying and his associates finish the surgery instead.

More on Kanodia: Champa And Tulsi Go to Hollywood

Our earlier post on him: Of Course…A Desi Doc on Dr. 90210

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Hungry children failed by state and market

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This is a week of good news and bad. The good news is that Goldman Sachs thinks the Indian economy is growing even faster than previously expected:

India could overtake Britain and have the world’s fifth largest economy within a decade as the country’s growth accelerates, a new report says… By 2050 India’s economy could be larger even than America’s, only China’s will be bigger, the bank predicts. [Link]

The bad news is that child malnutrition rates are still startling high in India. This week the PM felt a need to deal out thapars:

“Our prevalent rate of under-nutrition in the 0-6 age group remains one of the highest in the world,” Mr Singh said. “These are startling figures and the situation calls for urgent action.” [Link]

The situation remains astonishingly dire:

Last year the UN children’s agency, Unicef, said that the average malnutrition rate in some Indian states – such as densely populated Uttar Pradesh – was 40%. That is higher than sub-Saharan Africa where it is around 30%, Unicef said. [Link]

… Unicef report said half of the world’s under-nourished children live in South Asia….”South Asia has higher levels of child under-nutrition than Sub-Saharan Africa, but Sub-Saharan Africa has higher rates of child mortality…” [Link]

Most striking is the fact that the economic growth of the past 15 years hasn’t necessarily translated into better child nutrition, and that malnutrition has actually risen in some places:

A recent health ministry survey said that the number of undernourished children below the age of three had actually risen in some states since the late 1990s, despite higher incomes and rapid economic growth. [Link]

Continue reading →

Turban vs. Terminator

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Arnold Schwartzenegger has a new opponent, and this time he’s battling a desi [Thanks Chick Pea!]. The governator’s latest adversary is the head of the the California Medical Association, Dr. Anmol Mahal.

The Fremont, Calif., gastroenterologist admired Schwarzenegger’s goals–coverage for all of the state’s 36 million residents and improving health care for kids. “It’s in some ways very visionary,” Mahal said later. But Mahal’s admiration soured when Schwarzenegger revealed that his plan would force doctors to give up 2 percent of their gross incomes to help fund coverage. “We are very discouraged and disappointed,” Mahal complained. “We had no warning.” [Link]

It is strange enough for me to see two of the highest profile Republican governors in the country pick up Hillary Clinton’s banner of universal healthcare, but stranger still for me to see a turbanned face (wearing a turban almost the same shade of blue that Manmohan Singh wears) staring back at me from the pages of the MSNBC article on the subject.

The racial aspect of this is striking because this is a plan designed, in part, to cover the health expenses of illegal aliens. This is a complete about face from former Republican Governor Pete Wilson’s strategy of demonizing illegal aliens. Having a desi doctor as the face of the opposition adds another twist, framing this as a debate between wealthy legal immigrants and poor illegal ones. That makes the politics more interesting, but also more complex.

The crux of the doctors’ disagreement with the plan is the way in which it will be funded:

… nearly 30 percent of the plan’s costs [will be covered] by levying a $3.5 billion “coverage dividend” on doctors’ (and hospitals’) gross revenues. “Why not tax teachers to provide money for better schools?” complains Dr. Samuel Fink, a Los Angeles internist. [Link]

Some medical practices would suffer more than others, doctors complain. Assessed on gross revenues rather than net income, the 2 percent fee hits doctors with high overheads harder, including oncologists, pediatricians and general practitioners–whose overhead costs may amount to 50 to 60 percent of their revenues. [Link]

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Sex by the numbers

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Last November, India Today (with AC Neilsen and others) reported on their fourth ever national sex survey [Thanks reader sohwhat!]. This time round they focussed on India’s youth. Here are some highlights (from behind the subscription wall, although you can see a summary of their findings in this Reuters article):

  • “46% single 16-25-year-old males have had sex, 10% higher than the 2004 survey”
  • “37% single young men have had a homosexual experience, compared to 31% in 2004”
  • “The average age of first sexual encounter for men has come down from 23 in 2004 to 18.”

Some of these findings, by the way, don’t quite add up. For example, while only 46% of young males claimed to have had sex, “49% young men have had sex with sex workers. In Ludhiana, it as high as 63%.” That seems a bit bizarre. After all, if you’ve had sex with a sex worker, you’ve had sex.

Also, the idea that close to 50% of all males have had sex with a sex worker, if true, is trouble from the perspective of the spread of HIV.

As for the women, some admit to having sex, but not as many, and they’re starting later than the boys:

  • “In 2005… only 24 per cent single women between the ages of 18 and 30 … had had sex.”
  • “42 per cent [of single women] said they had their first sexual encounter between the ages of 19 and 21.”

Despite this busyness in the sack for both sexes, both men and women say women should stay virgins until they are married:

  • “63% single young men expect the woman they marry to be a virgin, 10% lower than in 2004”
  • “In the 2005 survey of single women, 66 per cent agreed, saying women should remain virgins till they are married.”

The most disturbing finding was one about the prevalence of incest, which implies that a large number of females are having forced sex with family members:

  • “14 per cent [of single males] claim to have had sex with family members.”

That number is horrifying enough, but when you consider that there was likely under-reporting, it’s even more disturbing.

All quotes from the India Today Sex Survey Cover Article, “Men in a Muddle“

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