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EDITORIALS

Invigorating SAARC
Regional cooperation can boost ties and trade
The South Asian Association for Regional Cooperation (SAARC) leaders, including Prime Minister Narendra Modi, begin their two-day meeting in Kathmandu on today. The ratification of the SAARC-related agreements on railway connections and movement of motor vehicles by the Cabinet is a clear indication of the government’s positive attitude. The expectations are high.

Daily Dairy Report
Milkfed gets a taste of Amul
Before ‘Utterly Butterly Delicious’, Amul’s ‘Taste of India’ tagline was ‘Purely the Best’. The change worked, the ad-makers said, because nonsense is always more memorable than sense. That's the logic of branding, but India's most successful dairy cooperative had a distinctive edge too: quality. It gets its name from ‘Amulya’, meaning priceless.


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Tragedy of errors
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Gold negates oil bonanza
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Same status
November 19, 2014
Not by words alone
November 18, 2014
BCCI's Srinivasan should go
November 17, 2014



On this day...100 years ago


lahore,thursday, november 26, 1914
War and Municipal Finance
The Government of India and the war


ARTICLE

Decline of institutions in Bangladesh
The independence of the judiciary must be ensured
Kuldip Nayar
W
HENEVER I return to Bangladesh, I find that one institution or the other has gone under. The last time it was parliament. This time it is the judiciary which, to quote a top lawyer, has been “decimated.”



MIDDLE

The agony of quiet waters
V. K. Sharma
I
am an avid walker and go for my walks across the Beas river at Beas town in Punjab. There are three bridges on the river — a railway bridge, a dilapidated old barricaded bridge and the in-use road bridge on NH-1. Whenever I travel by train from Beas to New Delhi, I see the quiet waters of the Beas flowing under the railway bridge. I see a few carcasses floating. I feel pity for the dead animals which, during their lives, served the humanity but the humanity denies them proper last rites.



Oped-Health

Be heart smart and avoid winter blues
For people who already have arteries filled with plaque, the narrowing of the blood vessels in winter raises the risk that it will become blocked, triggering a heart attack. The problem is higher in India as we do not live in artificially regulated temperatures as in the West.
Harinder Singh Bedi
Eating sarson ka saag and makki ki roti with a dollop of butter, gajjak, rewari and groundnuts, sitting around the fire, cuddling up in a warm blanket and — guess what — having a heart attack all have something in common : You're more likely to experience them in the winter! The risks of having a heart attack during the winter months are twice as high as in the summertime — and the winter attack is also more likely to be fatal.







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Invigorating SAARC
Regional cooperation can boost ties and trade

The South Asian Association for Regional Cooperation (SAARC) leaders, including Prime Minister Narendra Modi, begin their two-day meeting in Kathmandu on today. The ratification of the SAARC-related agreements on railway connections and movement of motor vehicles by the Cabinet is a clear indication of the government’s positive attitude. The expectations are high. The meeting of leaders of an organisation, which has been dormant for a while, is expected to yield results that will contribute to the “shared prosperity in the region”. Tempering such hope is the fact that bilateral issues have earlier overshadowed the substance of collective decisions made at such conferences, and domestic concerns that can dictate their own agenda.

SAARC was formed with the objective of helping this region achieve its economic potential while improving the life of the people and helping in their welfare. Much of this can be achieved by improving the intra-regional trade for which infrastructure — both physical and financial — is needed. The progress of the South Asian Free Trade Agreement (SAFTA) has been slow and till now the figures for the intra-regional trade and foreign investments have been rather low. Prime Minister Modi is expected to address this issue at Kathmandu. With the cooperation of other heads of the state, this intervention may well pave the way for more dynamic relations. The implementation of the proposal for the free movement of traffic between countries will give a fillip to both trade and tourism.

SAARC has the potential to be a powerful geo-political force. However, the member countries have to rise above the bilateral conflicts they may have so that they can collaborate at the regional level. This is better said than done. The spotty record in combating cross-border terrorist activities in spite of the Regional Convention on Suppression of Terrorism is an indicator of the kind of difficulties that lie ahead. Nevertheless, Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka have to work together to achieve for their citizens the kind of prosperity that the promise of SAARC holds.

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Daily Dairy Report
Milkfed gets a taste of Amul

Before ‘Utterly Butterly Delicious’, Amul’s ‘Taste of India’ tagline was ‘Purely the Best’. The change worked, the ad-makers said, because nonsense is always more memorable than sense. That's the logic of branding, but India's most successful dairy cooperative had a distinctive edge too: quality. It gets its name from ‘Amulya’, meaning priceless. Whether it has lived up to its name is for consumers to decide, but Amul did set standards for purity of milk products, better returns for dairy farmers with the middle man out of the picture and, of course, the importance of becoming a trusted household brand.

Upgrading the quality parameters at its plants, fixing competitive rates for dairy farmers and better branding are the new realities confronting Milkfed, the state-owned dairy cooperative whose brand Verka has been Punjab's answer to Amul for years. As the dairy giant begins its milk processing operations at a leased plant in Batala and talks of reinvigorating dairy farming in the state, Milkfed has a challenge on its hand. Verka is a credible product and more so considering its bureaucratic lineage compared to the professional setup of the Gujarat Cooperative Milk Marketing Federation which sells milk under the Amul brand. It may be a well-known commodity in Punjab, but Verka will not find it easy to match the reach and potential of Amul and the Amul girl, the social commentator with catchy messages, staring down hoardings.

The Punjab Cooperative Department has put up a brave face and played down Amul's market threat to Verka, though there would be understandable concerns over the new home competition. These now can be channelled by Milkfed into changes that would improve the quality of its products and ensure a better deal for dairy farmers. As for the consumers, choice is always good and what they can realistically hope for is that the prices remain static and they are not made to pay more in the name of improved quality.

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Thought for the Day

It does not matter how slowly you go as long as you do not stop. — Confucius

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lahore,thursday, november 26, 1914

War and Municipal Finance

An interesting proposal was discussed by the Calcutta Corporation on Saturday last. It was to the effect that rates and taxes should be reduced for the benefit of lower and middle classes. Dr. Suresh Ch. Sircar who moved the proposition said that traders, especially the Marwaris, had left the city and that the present high level of rates and taxes was too burdensome for people. Mr. Shirley Tremesrne opposed a reduction of rates and taxes but admitted that the city was empty and that house property had deteriorated in value. Unfortunately the question was not discussed freely nor was the undesirable effect of the present taxation on the poorer classes fully pointed out. Mr Tremesrne brought in the analogy of Lancashire Municipality for suspending the Corporation's contribution to the Sinking Fund and had the question referred to the Finance Committee.

The Government of India and the war

IN its issue of the 20th instant the Calcutta Englishman returns to the oft-discussed question of preparing this country for the titanic struggle. It reiterates the suggestion which the Tribune was the first to make as regards the formation of a territorial army. "India," our contemporary points out, "stands or falls with Great Britain and the measures necessary in the one country are also necessary in the other." If Great Britain can improvise an army of two millions, so can India do, and the loyalty and public spirit of Indians ought to be fully availed of by Government. Our contemporary has begun to view this national question in its proper perspective and it feels convinced that if a call to arms were issued "the response would be tremendous."

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Decline of institutions in Bangladesh
The independence of the judiciary must be ensured
Kuldip Nayar

WHENEVER I return to Bangladesh, I find that one institution or the other has gone under. The last time it was parliament. This time it is the judiciary which, to quote a top lawyer, has been “decimated.”

Yet what is disconcerting is that a country born out of people’s revolt against a distant exploitative government has become the status quo society. True, it is still living under the shadow of the army. It does not interfere in the day-to-day affairs. But to quote one top retired army official, “we ruled once, but we found the society preferring the confused people’s raj to the disciplined military rule.”

Today, the challenge is similar in a different form. Prime Minister Sheikh Hasina is concentrating power in herself and posting at key positions such officials as are loyal to her. She has become the law unto herself even though this goes against the grain of the people who are known for their defiance and independence.

Prime Minister Hasina controls parliament. Unthinkingly, the Bangladesh Nationalist Party (BNP) boycotted the last elections, leaving the field open to the Awami League, the party that Hasina heads. She “won” more than 60 per cent of the seats in parliament even before a single vote was cast. It was thought that a fresh election would be held to undo the farce of the polls the country had had. Instead, she found the house without the Opposition to her liking. Even the faceless MPs have begun to believe that their “popularity” had “elected” them as members.

This is bad enough. Worse is the beginning of the thinking of the ruling party that elections are tedious, cumbersome and uncertain. Some other apparatus should be devised to ascertain people’s opinion. I am afraid that Hasina, who hates opposition, may consider doing away with the elections after enjoying the unbridled power. The people may resist that in the streets, but a determined, authoritarian administration can cope with the situation as it has done in the past.

In these circumstances the independence of the judiciary is a must. However, a Bangladesh journalist who has covered the courts for more than two decades told me that corruption has corroded every part of the judiciary. “The judgments are sold,” he said. That the sons of judges are practising in the same courts where their fathers or uncles are on the bench. This has only aggravated the situation.

Prime Minister Hasina has played havoc with the appointment of judges. The Bangladesh constitution says that the President will appoint the judges in consultation with the Prime Minister. She has stretched the word consultation to mean concurrence. The result is that even brief-less lawyers, avowing loyalty to the ruling Awami League, have been elevated as judges.

Judgments are reportedly slanted and shoddy. None challenges the appointments because he or she would be shouted down as a supporter of "the enemy." There is no doubt that the BNP is attracting large crowds. But those who come to hear the party leaders are not necessarily their followers. The criticism of the rulers is music to the ears of the people. They are living under the burden of ever-increasing prices and the spiraling inflation.

The only faithful supporters are really the followers of Jamiat-i-Islami. Their fundamentalism still sells and surprisingly the pro-Pakistan elements are quite a few. One authentic report is that they number approximately 20 per cent. Without contradiction one can say that the solid supporters of the Awami League will be many more, around 30-35 per cent.

I was happy to find relations between India and Bangladesh friendly. It goes to the credit of Hasina that she has removed the irritants between the two countries. There are no anti-India militants operating from Bangladesh, a matter of concern for New Delhi until recently.

Alas, there is an absence of idealism of the days when Bangladeshis were fighting their liberation battle. People consider that as their finest hour. Surprisingly, there is no bitterness against Pakistan for having committed the worst atrocities in an attempt to suppress the liberation movement. “We only pity them,” say many Bangladeshis seeing that country beleaguered with many problems. And they take pride in citing facts and figures to show how an average Bangladeshi is better than an average Pakistani.

This may be true, but the dynamism which I witnessed in my earlier visits is lacking. It is as if the people are tired, if not reconciled to the authoritarianism of the rulers. Hasina has probably detected that. So it seems that she has decided to re-establish dynastic rule as is the suspicion that Sheikh Mujibur Rahman, the father of the nation, was doing in the case of his daughter, Hasina.

Her son is the most powerful person today, although he resides in America. She has even given him an official position in the technical field and he is reportedly on a salary. No doubt, it smacks of dynastic rule. But then she seems to have torn a page from the book of Indira Gandhi-Rahul Gandhi dynasty.

The army, the country's powerful chamber, is sitting pretty because it is more popular than any political party. Hasina has given the army personnel the best of perks and salaries to placate them and keep them on her side. This seems to work in her favour.

I asked a top editor why people did not revolt and throw out the armed forces. He said that they did not know what would emerge from the clash if there were to be a confrontation between the people and the armed forces. He said it might well lead to a situation of moving out of the frying pan into the fire. Maybe, the disciplined fundamentalists of the Jamiat might emerge victorious. This thought deters even the liberals who want change. It only strengthens the idea of why Bangladesh should not disturb the status quo.

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The agony of quiet waters
V. K. Sharma

I am an avid walker and go for my walks across the Beas river at Beas town in Punjab. There are three bridges on the river — a railway bridge, a dilapidated old barricaded bridge and the in-use road bridge on NH-1. Whenever I travel by train from Beas to New Delhi, I see the quiet waters of the Beas flowing under the railway bridge. I see a few carcasses floating. I feel pity for the dead animals which, during their lives, served the humanity but the humanity denies them proper last rites.

My evening strolls are generally across the other two bridges on the river. The dilapidated bridge connects Beas town with Dhilwan village. Since the bridge has borne the load of humanity for too long, it has structurally gone weak. Thus, no four-wheel traffic is permitted on this bridge. Punjab Police men guard the worn-out bridge which still sustains the load of a few walkers like me. Villagers get their herds of buffalos for “Beas snan” almost every day. I feel pity for these on-duty cops for they withstand the stink of the sewage of Beas town which flows into the river. The sewage water does not flow directly into the river but collects to form a pond right next to the bridge and produces an intolerable stink. The cops who guard the bridge stay in a makeshift barrack which exists between the dirty pond and the river. One can also see a makeshift room in which an old man is occasionally seen. He is an employee of the Irrigation Department and his main duty is to record the water levels during the monsoon for an alert on any possible flooding. The moment I step on to the dilapidated bridge from the Beas town side, I see the police cops relaxing in their off-duty attires. One finds buffaloes enjoying their bath under the watchful eyes of the cops.

To my surprise, I am instantly given a terrifying scare by a hefty monkey who tries to shoo me off from crossing the bridge. I give a few friendly looks to the look-alike creature and he relents. A few villagers crossing the bridge carry a stick to ward off the monkey, who is perhaps the sole creature with the onus of guarding the river. The sight of the river waters flowing beneath this dilapidated bridge is heart rending. The banks of the river are strewn by plastic bags, idols of gods and goddesses, empty bottles of liquor etc. Many devotees turn up at the river to offer their prayers, but I wonder if they are aware of the “abuse” of the river.

There is a temple under the bridge on one of the banks of the river which is under the direct watchful eyes of the cops. The heaps of garbage outside the temple on the bank of the river show scant regard for the health of the river. A number of cars, trucks and tractor-trailers stop at the bridge to discard all their offerings/waste into the river.

The other day I was amazed to see two young men unloading four heavy sacks containing charcoal into the river. I wanted to tell them that the rivers were common to the humanity and their safety and cleanliness is the responsibility of everyone. But I found myself weaker than that monkey.

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Be heart smart and avoid winter blues
For people who already have arteries filled with plaque, the narrowing of the blood vessels in winter raises the risk that it will become blocked, triggering a heart attack. The problem is higher in India as we do not live in artificially regulated temperatures as in the West.
Harinder Singh Bedi

Eating sarson ka saag and makki ki roti with a dollop of butter, gajjak, rewari and groundnuts, sitting around the fire, cuddling up in a warm blanket and — guess what — having a heart attack all have something in common : You're more likely to experience them in the winter! The risks of having a heart attack during the winter months are twice as high as in the summertime — and the winter attack is also more likely to be fatal.

Clot formation
Winters can be tough on elderly or those with an underlying cardiac condition. A few precautions can go a long way to enable you to remain healthy when the temperature plummets
Winters can be tough on elderly or those with an underlying cardiac condition. A few precautions can go a long way to enable you to remain healthy when the temperature plummets. Tribune photo: Pradeep Tiwari. The photograph is only for an illustrative purpose

Cold weather poses danger for those with heart disease, for a variety of reasons. Heart attacks usually occur in people with a build-up of fatty plaque in their arteries. For a heart attack to occur, some sudden event must cause the plaque to crack and rupture, at which point blood platelets get sticky and form a clot in the artery.

In a study published in Circulation the journal of the American Heart Association, The “Merry Christmas Coronary” and “Happy New Year Heart Attack Phenomenon,” by Dr Prof Robert A. Kloner, researchers found that the rate of heart disease-related deaths rose sharply between December 25 and January 7.

Even otherwise, a study carried out in collaboration with the Registrar General of India ( RGI) and the Indian Council of Medical Research (ICMR) has shown that heart ailments have replaced communicable diseases as the biggest killer in rural and urban India. About 25 per cent of deaths in the age group of 25- 69 years occur because of heart diseases. About 9.5 million deaths, which is about one in six deaths worldwide, occur in India every year. There is an increase of about 10 to 20 per cent incidence of cardiac arrests in winters as compared to warmer months. Temperatures often plummet to less than 5 degree Celsius in the peak winter months in North India. While the season affects everybody in the same way, increasing the amount of labour required by the heart, a person with a normal heart hardly feels the increased level of stress. The same can be dangerous for a person with a weak heart.

Risks of the cold

There is a combination of factors that increase heart attack risk in winter:

Spasm of arteries: When a person gets exposed to cold weather, the body’s automatic response is to narrow the blood vessels to the skin so that heat is retained. But for people who already have arteries filled with plaque, the narrowing of the blood vessels raises the risk that it will become blocked, triggering a heart attack. The problem is higher in India as we do not live in artificially regulated temperatures as in the West.

Increased blood pressure: Due to the narrowing, higher blood pressure leads to a strain on the heart. This has the effect of a double whammy. Not only does the heart have to work harder but its blood supply is reduced. While this may be tolerated well by a normal heart —in a diseased heart it can precipitate an attack. With every one degree centigrade drop in temperature, the blood pressure increases by 1.3 / 0.6 mm (systolic / diastolic).

Thicker blood: In cold weather, blood platelets appear to be more active and stickier and, therefore, are more likely to clot. In fact, even the levels of cholesterol too rise during the winter.

Feasting & unaccustomed exercise: People tend to eat and drink more, and gain more weight during the holiday season and winter months. This coupled with unaccustomed exercise is unhealthy. Every January 1, millions of people join gyms as part of their New Year's resolution to get in shape — and many may overexert themselves too soon. One should start an exercise regimen under the supervision of your doctor if you have heart disease risk factors.

Increased stress hormones: During the winter months, there is a change in the ratio of daylight hours to dark hours, which causes an increase of stress hormones eg cortisol.

Snow shovelling: Believe it or not, studies from Shimla show that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shovelling. One of my patients – a PT teacher at a boarding school in Shimla — suffered a heart attack as he was showing his students how to work in the snow.

Stressful season: Seasonal affective disorder (appropriately acronymed as SAD) is caused by the lack of exposure to sunlight during the winter months. People with depression are more susceptible to heart attacks.

Less daylight: Drinking plenty of milk and basking in the sun may make us less likely to have a heart attack. Less of sunlight in winters not only adds to depression but also lowers levels of vitamin D (which comes from sunlight falling on skin) – this by itself has been linked to heart attacks. New research published in a recent issue of Archives of Internal Medicine links low levels of vitamin D — the “sunshine vitamin” — with a higher risk of heart attack in men.

You can get vitamin D by drinking milk and eating foods fortified with the vitamin. But the body also makes vitamin D when exposed to sunlight. The typical Indian diet often does not provide enough vitamin D since few foods naturally contain the vitamin. Eating plenty of vitamin-D fortified foods, such as milk, cereals, orange juice, and getting lots of sunshine are key to maintaining adequate vitamin D levels. Some people may need to take vitamin D supplements, especially those over 50. Older adults have a higher risk for vitamin D deficiency because ageing itself makes it harder for the body to make vitamin D and convert it to a useable form.

Flu (Influenza): Winter also raises your chances of getting the flu due to low humidity brought on by cold weather and indoor heating. A flu infection can increase blood pressure, stir up white blood cell activity, and change C-reactive protein and fibrinogen levels in the blood — which is all bad news for your heart. Flu and other respiratory disease in winter cause inflammation – which in turn make plaque less stable and may dislodge it — contributing to heart attacks.

If you come down with the flu, a cold or a cough, ask your doctor before taking any over-the-counter decongestants as some of these can raise blood pressure, which can increase the chances for heart attack. Elderly people should get vaccinated against influenza in the winters.

Delay in seeking treatment: The risk of having a heart condition is also higher the holidays because people commonly delay seeking treatment for symptoms during this time of year. In the Circulation study, researchers suggested people might delay getting treatment because they don't want to disrupt Christmas and New Year's festivities. In fact, I vividly remember a polite elderly patient in Sydney who apologised profusely for having 'disturbed' me in the holiday season with a heart attack that he had been nursing for the last two days. Other factors may play a role, such as emotional stress and overindulgence. During the holidays, legions of Indians eat too much of rich and fried food and meat and drink more alcohol -— while ditching their exercise routine. Needless to say, this combination isn't exactly healthy for the heart.

 

Take-away tips for a healthy ticker

So does this mean you have to fear the winter and huddle indoors all the time? Not at all. The take-home message is not to be afraid of the winter but to know that winter is a period of increased risk and to look for ways to minimise that risk. So during the winter, try to keep your heart healthy by keeping the following pointers in mind:

  • Stick to your normal exercise plan
  • Take ‘sunshine’ walks and avoid going outdoors in the very early morning — wait for sunrise
  • Wear proper attire, that is a thermal inner, muffler, cap, warm socks and a jacket with a hood are good investments to enjoy a healthy walk. Wear clothes in layers. You can sport a monkey cap or a cap and ear muffs. For Sikh gentlemen, a turban offers good protection to the head and ears from the cold.
  • Start slow – avoid sudden changes.
  • Have a proper trained gym instructor chart a graded exercise programme for you . Don’t aim for a Salman Khan / SRK six-pack in a short time.
  • n If its really really cold and you just do not feel like going out, hop on the treadmill, find inner peace on the yoga mat or hit the dance floor with some friends.
  • Eat a prudent diet low in saturated fats and calories. Nuts and dry fruits can be taken in moderation if one is not overweight. Avoid fatty fried and non-vegetarian food. Drink adequate amounts of water as dehydration makes the blood thicker.
  • Avoid tobacco, coffee, tea or alcohol just to “warm you up” – the additional nicotine and caffeine put a stress on the heart. Alcohol or ‘holiday spirits’ cause vasodilatation and so produce a feeling of warmth — but the body loses heat. They also increase blood pressure and rhythm irregularity.
  • Skip the frantic shopping last-minute trip to the mall for gifts to give for New Year / Christmas. Plan well in time – gifting online is a good option!
  • Stop and smell the roses. Don't get stressed out about preparations — make time to enjoy celebrations with family and friends.

Get better of the weather

  • Take your medication as recommended
  • Get a flu shot (vaccine) to lower your risk of getting flu.
  • Do not postpone doctors' visits. Get immediate help if you feel chest pain or other symptoms, call for emergency help. The stakes are high so give yourself and your family a gift this season. Some patients tend to postpone treatment because they don't want to spoil the holiday merrymaking. The doctor on duty has to be in the hospital whether you show up or not !
  • Learn CPR. Effective bystander cardio pulmonary resuscitation (CPR) provides relief immediately after sudden cardiac arrest. It can double or triple a victim’s chance of survival. Basic courses in this procedure are taught in almost all institutes in India. The life you save could be yours.

The writer is Head, Cardio-Vascular & Thoracic Surgery, Christian Medical College & Hospital, Ludhiana. He was earlier at the St Vincents Hospital in Australia and the Escorts Heart Institute, New Delhi.

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