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Step back, move forward Cleaning up the Ganga |
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The West confronts Islamic State
'How come, you know everything?'
Today is World Heart Day
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Step back, move forward The face-off between the Indian and Chinese troops has been resolved, with both sides agreeing to retreat to the previous positions on the Line of Actual Control (LAC) by the end of this month. The announcement came shortly after External Affairs Minister Sushma Swaraj met her Chinese counterpart Wang Yi at the United Nations. The two have agreed on a joint schedule for the pullback. The massing up of Chinese troops in the Chumar sector of Ladakh while Chinese President Xi Jinping was visiting India did cast a shadow over his state visit. What was widely expected to be a major effort at improving commercial relations between the two countries became somewhat of a damp squib, with China announcing much less investment than had been envisaged. Prime Minister Narendra Modi had rolled out the red carpet for his counterpart, but he took a tough stance on the border issue, which intruded on the discourse around the visit. Since the border dispute is a longstanding one, it is not likely to be resolved anytime soon, but both sides need to be mindful of each other’s sensitivities. The key lies in effective management of such clashes. India's recent foreign policy initiatives, especially Modi's visit to Japan and his condemnation of the “18th century expansionist mindset” of encroaching on other countries, might have caused concern in Beijing, which is quite aggressive in asserting its maritime borders in the East and South China Sea. The border incursions could be seen as a part of the same strategy. Beijing lost a chance to recalibrate relations after a regime change in India. Prime Minister Modi was perceived as pro-China, but he acted tough on the border issue. True, there are tremendous business opportunities, but it must be remembered that peace is a prerequisite for commerce. The retreat on the border gives diplomats a chance to build on the more positive aspects of President Xi's visit.
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Cleaning up the Ganga Taking action to clean up the Ganga is one thing, and having it cleaned up is another. That is the gap various governments since Rajiv Gandhi's in 1985 have realised with major efforts under the Ganga Action Plan (GAP) having little to show despite major civil works. The UPA government renewed it by setting up the National Ganga River Basin Authority in 2009, which is now also backed by the World Bank. A few thousand crore have already been spent under this, mostly on sewerage and treatment plants. That is important work, but do water tests show any improvement? No. That is something Narendra Modi promised his Varanasi voters he would change. Given the frustration of the sincere efforts over the past three decades, he would be hard put to deliver on this promise. That there are no magic solutions also became clear last Monday when the government gave the Supreme Court an 18-year plan to clean up the Ganga. But at least the government has now presented a time frame to check the work against. One worrying aspect of the plan is that it seems strikingly similar to the plans that have been tried earlier. First prepare sewerage treatment plants, build crematoriums, and then clean up the ghats and riverfronts. All this is good but the problem is that the plans break down in the absence of coordination in implementation by the Central and state governments, local bodies and
the stakeholders. Plans have to meld with the lay, architecture and culture of the 118 towns identified in the first phase. Then the action has to shift to the rural hinterland, where it becomes more complicated. The Ganga is practically a drain that receives all water that has washed the vast territories from the Himalayas in Uttarakhand to the plains of UP, Bihar and West Bengal. All human, industrial and agricultural refuse enters the 'holy waters'. Cleaning the river thus means cleaning up the entire way of life in all these states.
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Thought for the Day
Love dies only when growth stops.
—Pearl S. Buck
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AT the last meeting of the Punjab Legislative Council during the consideration of the Punjab Courts Bill the Hon'ble Mian Mahomed Shafi pointed out that if at the time the Punjab Courts Act was amended by the substitution of second appeals in the place of further appeals their advice to make the provisions of the Code of Civil Procedure applicable to the Punjab had been accepted, there would have had been no need for his special measure. Evidently in that case limitation of these appeals would have been governed by the Limitation Act. A perusal of the provisions of section 41, of the Punjab Courts Act however, made it clear, said the Hon. member, that the certificated second appeals provided therein with its provisos and limitations, do not come within either the letter or the spirit of the Limitation Act providing a period of limitation for second appeals. He said that a better way of dealing with the question would have been to add a sub-clause to section 41 of the Punjab Courts Act laying down second appeals.
After the war THE duration of the war in Europe is uncertain, though the Allies' success in the end is a foregone conclusion. A long war would only call upon all the resources of the parties engaged and the sacrifices to be made will be great. But the victory must be on the side of the Allies. Probably encouraged by this general impression of thoughtful men, the Morning Post has ventured to suggest what will happen to Germany after the war and what will be the gains of the victors. England for her part would take nothing and wants no gains. Her sacrifices are made in a purely moral sense -- to maintain the peace and integrity of nations which have been violated by the aggression of Germany.
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The West confronts Islamic State In light of this, Obama made Washington's policy clear: “We will degrade and ultimately destroy [IS] through a comprehensive and sustained counterterrorism strategy.” His Secretary of State John Kerry also told the US Congress that the IS “must be defeated, period, end of story. And collectively, we are all going to be measured by how we carry out this mission.” The US Congress has gone ahead and approved President Obama’s plan to train and arm moderate Syrian rebels. Part of Obama’s strategy is to train and equip Free Syrian Army rebels to “strengthen the opposition as the best counterweight to the extremists” and to prevent US troops from “being dragged into another ground war.” Facing resistance from war-weary lawmakers in Obama’s own Democratic Party, the administration reached across the aisle to Republicans for support, a rare bipartisan moment in an otherwise polarised US Congress. Opinion polls show that while Americans support Obama’s campaign of air strikes against Islamic State militants, they largely oppose a long military campaign against the group. With this in perspective, the US and its allies will not do the fighting on the ground. But they will provide the key enablers —air power and the means to ensure that the application of that air power is effective. The West has framed the use of Western air power so far largely in terms of helping Iraqi forces on the ground. But debate has already begun if this will ultimately lead to pressure for putting western troops on the ground. The Chairman of the Joint Chiefs of the US, Martin Dempsey’s comment regarding the prospect of greater involvement of US “advisers” on the frontlines against IS has underscored the tensions in the West’s military strategy. He admitted that President Obama has left open the possibility of employing US troops in more exposed combat-related roles on a “case-by-case basis.” The White House was forced to clarify that no US combat troops would be deployed to Iraq or Syria. The strategy of the West is also complicated by the ground realities in the Middle East. Though the Syrian government is fighting IS, The West remains reluctant to have any explicit links with Damascus. Clearly in this is a case of my enemy’s enemy is not my friend. It is the chaos in Syria that has helped IS establish itself and then export its brand of barbarism back into Iraq. The focus of the West on IS has freed the Syrian government to put its military might behind exterminating the moderate rebel forces. For its part, IS will relish the prospect of confronting a superpower. The imagery of their murderous behaviour is perfect: They can slaughter Americans like sheep, giving them not only publicity but also credibility in the unique regional milieu. The scale and scope of IS marks it out from other jihadist groupings insofar as it already controls a significant swathe of territory across Syria and Iraq. It continues to be well-funded and well-organised. Its success is also making it possible for it to attract a large number of foreign fighters. Obama's new strategy is also hobbled by what many of Washington's Arab allies see as Mr Obama’s vacillation and unwillingness to act decisively. He is seen as a reluctant fighter and was forced to confront IS only after it became impossible to ignore the threat though America’s Arab allies were asking for a more robust response ever since IS came into the picture. For many in the US, on the other hand, the more US allies inside and outside the Middle East get the impression that Washington will increase its military support, the less incentive they will have to bear more of the military burden. According to this reasoning, the US needs to be less active in the region, not more. Britain along with Belgium and Demark has joined in this fight against IS, given the threat from home-grown radicalisation that it faces and the beheading of a UK aid worker. The Australian government has already announced that it is sending 600 troops to the Middle East to assist in the fight against IS. Australia, like many countries, including Britain, is worried about the threat from Islamic State, not just abroad but at home. At least 60 Australians are believed to be fighting with jihadist groups in Syria and northern Iraq, and 15 Australians have been killed so far in these conflicts, including two suicide bombers. One of the largest anti-terror operations in Australian history was carried out by the Australian police after intelligence reports emerged of a plot which reportedly involved beheading random members of the public after draping them in the Islamic State flag. In his address to the American people, Obama asserted that “we will hunt down terrorists who threaten our country, wherever they are. That means I will not hesitate to take action against ISIL in Syria, as well as Iraq. This is a core principle of my presidency: if you threaten America, you will find no safe haven.” It is far from clear if the strategy he has outlined will be enough to tackle the challenge from IS or if it will be the beginning of another costly American military involvement in the quagmire of the Middle East.
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'How come, you know everything?' My brother-in-law, having retired from a private company at Mumbai, sleeps well, watches TV the whole day and hesitates to go out even for the most essential errands, saying “I have retired and have done enough.” Hence his poor wife has to run around to fetch daily necessities. They have a perpetual complaint that whenever they ring up, I am either out of home or busy with someone. This question — “How do you keep busy having retired?” —has been put to me umpteen times by friends or visitors, and I feel at a loss as to how do I explain to them that I have no time to relax. Retirement does pose a challenge to some, but I think it is more so in your mind. It is not the end of active life which is mere reading newspapers and enjoying cups of tea or watching TV. I do not know when and how I got into helping all the needy friends and relatives from arranging tradesmen like a carpenter, plumber, mason, painter etc to sometimes even suggesting solutions to their problems. There are others who consult me for making or renewing passports, getting visas, booking international tickets or simple things like arranging a taxi. Some seek my help in making an Aadhaar Card or a PAN card. My foreign friends who come to India also get help from me in making property transactions. I have a few of my close relatives who go abroad for a few months to visit their children. In their absence I am entrusted with paying their water/electricity and phone bills, collect the rent from their tenants and deposit the amount in their bank accounts, renew their FDs, start their cars periodically to keep the battery charged or get the tyres inflated etc. We also go abroad to visit our son and his family in Canada . There too I have a lot to do. Since labour is expensive there and I am a bit of a handyman, therefore I do paint walls if needed, even patch repair concrete, mend their broken frypan handles /cookers, replace the battery in the wrist watch and children's toys, fire alarms or repair photo frames, inflate kids' footballs and bike tyres. I can also wash spinach or chicken for my daughter-in-law or can cook some simple dishes. If need be, I can make simple stitches by hand or with a sewing machine and even iron clothes. There is no end to remaining busy, provided you have the will to do your bit for others. This also causes a bit of problem in my friends’ lives, when their wives give my example and coax their husbands to emulate me. The biggest compliment I got from my eight-year-grandson was when he asked me: “Dadaji, how come you know everything?”
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Today is World Heart Day It
is estimated, according to WHO data that by 2020 cardiovascular disease will be the cause of over 40 per cent deaths in India as compared to 24 per cent in 1990. (http://www.who.int/gho/ncd/en/). With over 3 million deaths owing to cardiovascular diseases (CVD) every year, India is very soon set to be the “heart disease capital of the world”. Globally, heart disease causes 17.3 million deaths annually. In 2020, 2.6 million Indians are predicted to die due to coronary heart disease.
Burden of disease Currently, Indians experience CVD deaths at least a decade earlier than their counterparts in the West. The Global Burden of Disease (GBD) study estimates that 52 per cent of CVD deaths occur in young and middle-aged individuals (30-69 years) in India. The contributing factors for the growing burden of CVDs are increasing prevalence of cardiovascular risk factors, especially hypertension, dyslipidemia, diabetes, overweight or obesity, physical inactivity and tobacco use. At the same time, Indian coronary artery disease is very peculiar as compared to the West. We are seeing in younger patients, the disease follows an accelerated course and affects mostly the entire length of the artery (diffuse disease). This, coupled with the fact that 40 per cent of these patients are diabetic, makes it deadly. The precious asset of our nation is its young population. Ironically, it is this population, our demographic dividend, that is becoming the most vulnerable to heart disease. Four people die of heart attack every minute in India and the age group is mainly between 30 and 50 years. Twenty-five per cent of heart attack deaths occur in people less than 40 years. Women too can be targets WORKING MEASURES n
Pack it up: Packing your lunch, instead of eating out, enables you to control your calories and fat accumulation. Prepare larger healthy meals for dinner to have leftovers for work. n
Step away from the desk: No matter how busy your day is, go outside for lunch or take a break in the cafeteria. Do not eat at the work table. You'll be more satisfied and recharged, so paying attention to your food, not e-mail. n
Get moving at work: The best is to cycle to your workplace. I was pleasantly surprised to find a professor of orthopaedic surgery at my institute cycling to work. He stays fit and healthy. n
Park your car away from the entrance: Take the stairs rather than the lift and take a short walk at lunch time. If you come in a bus, get off one stop earlier. People working in malls have the advantage of an excellent airconditioned environment to walk in. Some malls open up early before shopping hours for walk enthusiasts! n
Team up: Partner with a co-worker for a nutrition and fitness plan. A 2008 American Heart Association survey revealed that adults are 76 per cent more likely to walk if someone else is counting on them. n
Break for water, not coffee: The human body loses about 10 cups of water during daily activity, so it's important to replenish it. The American Heart Association recommends drinking six to eight glasses of water per day. n
Laugh for life: Minimising stress is important for wellness, and laughter is the best medicine. Crack jokes at work. n
Say "no" to tobacco: A smoke-free workplace is easy to implement now with the new laws in place. Employers must encourage and help those attempting to quit smoking. n
Insist on healthy food options in your canteen: Get your management to ban colas, fried and junk food. Snack on fruits. Canteens should cut down on greasy, salty food. This could add a few years to an employee's life. n
Start yoga classes at work: Just a 15-minute break and group yoga therapy is not only good for the heart, but can also inculcate team spirit and create a feel-good atmosphere. We have devised work-based yoga therapies which can be used by individuals at any time at work. Employers should designate exercise areas for employees and hold counselling sessions to address workplace stress. They should be given a daily break with the option of a recreational activity. n
Stress management: Employees should be made to learn skills to manage work-related stress. Encourage people of all levels to take pride in their work. Studies suggest that people who take pride in their work are less likely to suffer from cardiovascular disease. Men who suppress their anger about unfair treatment at the workplace are two to five times more likely to die from heart disease. Hostility and anger management sessions at the workplace are a must. Perks like retreats, picnics, free health check-ups and the services of a game room, gym and spa should be offered. n
Ensure healthy snacks at meetings: Change the culture of offering coffee and biscuits at meetings to water and fruit. n
Limit alcohol intake: Office parties should not be an excuse to binge on alcohol. “Official" restrictions on alcohol intake are not a bad idea. Excessive alcohol intake damages health, raises blood pressure and weight, and reduces productivity. Common causes The most common causes causing heart disease in young persons and women are as follows : Diabetes Mellitus: The rise in the incidence of diabetes is a major factor in youngsters developing heart disease. Diabetics have an increased tendency to form blood clots and developing bockages in the arteries. Smoking: Basically an addiction which starts in school / college, it is the single largest risk factor for a young individual developing a heart attack. Smokers not only develop disease earlier but are at a two-fold increased risk as compared to non-smokers. They are at a four-fold-increased risk of sudden death due to MI. Women who smoke are at a higher risk. High cholesterol levels: Excess cholesterol deposits enter the inner lining of the coronary arteries gradually, building into larger deposits, thereby making the arteries narrower. Consequently, the blood supply to the heart gets obstructed leading to a heart attack. Though the total cholesterol levels are a predictor of heart disease, many Indians who develop MI have normal total cholesterol levels. This is because even though their total cholesterol levels are normal, they have low levels of good cholesterol (HDL cholesterol) and a very unique, dangerous type of bad cholesterol (LDL), which has a higher blood clot-forming tendency. Hypertension: Changing food habits leading to increased salt consumption in ready-to-eat processed super-market food, stress and a sedentary lifestyle — have all contributed to the rise of young hypertensives. Most of us grab snacks — fried food, namkeens and samosas between meals when hungry. Not only do these have a high salt content but they are also sources of harmful trans-fat. Obesity: We are in the grip of an obesity epidemic. Obesity is a combination of poor physical activity, stress and an unhealthy food culture. With obesity comes the risk of developing diabetes, high blood pressure and high cholesterol. Indian obesity is different in the form of abdominal obesity where there is excess fat deposit around the belly. Unfortunately, it is this belly fat, also called “apple-type obesity,” which is especially dangerous. Unhealthy food habits: Junk food joints have become hang-outs for college students and young professionals. I get a fair number of patients from the traditional totally vegetarian communities (eg Jains) who are at risk because of the liberal use of milk, ghee, oil and a higher intake of refined carbohydrates, saturated fats and trans-fats. They are surprised that they have got heart disease in spite of not eating meat or smoking . Physical inactivity: Physical inactivity starts from school as most modern-day teaching hardly stresses the importance of physical education. Eighty per cent of our young population is physically inactive; the remaining 20 per cent that frequents the gyms concentrates on muscle building rather than aerobic training — a Salman Khan like six-pack is the goal instead of overall health! Stress: The good news is that youngsters today get paid handsomely but the bad news is that the work at MNCs and BPOs is mostly desk work, long working hours, unhealthy eating habits at work and at home, stress and poor sleep quality — all risk factors for heart disease . Lack of awareness: The rural and urban poor are more susceptible because they tend to ignore the disease due to poor access to healthcare, high cost of treatment, social stigma and illiteracy. Seeking treatment will also mean missing wages and reduced productivity. The numbers are not going to decrease and unless drastic steps are taken at collective and individual levels, the future will be bleak. Now for the positive news. Most of heart disease is preventable. A study published this month (September 2014) in the Journal of American College of Cardiology showed that refraining from smoking, being physically active, having no abdominal adiposity and sticking to a healthy diet significantly reduces the incidence of heart disease. This World Heart Day, the focus is on creating heart-healthy environments. Ensuring that people are able to make heart-healthy choices wherever they live, work and play, encourages us all to reduce our cardiovascular risk factors. Interestingly, build up of fatty plaque and early heart disease can be reversed by simple measures. At least 80 per cent of premature deaths from cardiovascular disease (CVD) could be avoided if four main risk factors — tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol — are controlled. Simple heart-healthy choices include getting active in simple enjoyable physical activities / games for just 30 minutes per day, five times a week. The effort should be to eat a prudent heart-healthy diet that is basically a vegetarian diet low in fats and deep fried food. At least two to three servings of vegetables per person should be ensured. Processed food should be avoided and abstaining from tobacco is a must. Also mandatory is a yearly checkup; maintaining a healthy weight; managing stress in a positive manner and engaging in positive social activities. Yoga is a good way of de-stressing and maintaining a healthy lifestyle. On World Heart Day, let us all pledge to be heart smart by making simple heart choices and not hard choices. —
HEARTY FACTS n
Cardiovascular disease (CVD), which includes heart disease and stroke, is the leading cause of death globally and unfortunately kills 17.3 million people each year. n
Half of all deaths occur in women, and CVD kills more women than cancer, tuberculosis, HIV/AIDS and malaria combined. n
Children are vulnerable too: 1.35 million babies are born with congenital heart disease every year. Moreover, children may have to face the emotional consequences of seeing a loved one becoming ill with CVD. A healthy heart starts from childhood, the best time to adopt heart-healthy behaviour and reduce risks. n
By 2030, it is expected that 23 million people will die from CVDs annually. That is more than the population of Australia.
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Even women — who till now were relatively immune to heart disease — at least till menopause — are catching up. “I can't have heart trouble, I'm a woman,” is a general perception whenever a woman gets pain in the chest. She could certainly be wrong. The number of women who attribute symptoms of chest discomfort or pain to “asthma,” “gas” or “indigestion” and land up on my operating table after suffering a needless heart attack is just not funny. What is equally alarming is that even doctors are prone not to take symptoms of heart attack seriously in women because of the misconception that women are immune to heart attacks. The index of suspicion tends to be lower when treating a female patient. Thus when a woman comes to the emergency room complaining of indigestion, she is treated for indigestion. If a man comes with the same symptoms, the first investigation is an ECG. This has been proven in numerous published studies from major centres all over the world. Even healthcare workers just don't think about heart attack when it comes to women. It is this misconception that kills. In America, one in two women die of heart disease (one in six die of breast cancer). This is because of the fact that in a heart attack scenario “time is muscle.” That is, sooner the appropriate treatment is started the more heart muscle can be saved from death. In women, the classic heart attack symptoms (crushing, squeezing pain in the chest) may be replaced by “atypical” symptoms (chest discomfort, shortness of breath, indigestion etc). A disturbing trend that I and many of my colleagues have noted with concern is that heart disease is now attacking younger women too, even before menopause. Possibly the increased stress of working, being part of the rat race and managing the home is one of the important risk factors.