Category: Health and Hygiene

Patient Observations

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In the past few months I have had occasion to visit three hospitals, as a patient. A small private hospital, a medium-sized corporate hospital, and a public hospital. Each one had its standard procedures and code of conduct. It was interesting to observe and experience the similarities, and the differences. It was also an opportunity to think about a subject that would not normally feature in my list of ‘explore and discover’ topics.

Perhaps the biggest trail of exploration was triggered by my visit to the Civil Hospital in Ahmedabad. Locating the building that we had to reach was the first step. The real eye opener was the sight of hundreds and hundreds of people going and coming, and waiting…One would imagine that such a huge moving population would end up in a railway station-kind of melee with noise, jostling, shoving, and seeming chaos. Here however, there was no unnecessary noise, people (patients as well as their accompanying members) were seated in an orderly fashion on chairs as they awaited their turn to reach one of the several registration desks. This was the first step in what would become the ‘case file’ that would be the key document for their future treatment. This process certainly involved a great deal of filling of forms, and being sent off from section to section to go through the numerous steps required. It was heartening to see that most of the staff were helpful in guiding a large number of people who were from all walks of life, some obviously from distant rural areas who had come here for treatment. This was creditable considering that the continuous stream of people certainly could have tried the patience of a saint. All said and done, things were moving. We too joined the flowing mass of humanity, as we were directed from counter to counter and building to building, over a large part of the day; experiencing how a large part of India’s population encounters the public health system, but also discovering some fascinating facts about the civil hospital.

The Civil Hospital as it is loosely described, is in fact a complex of a number of large medical institutions spread over area of 110 acres in the Asarva area of Ahmedabad. The complex includes facilities for specialized diagnostic, therapeutic and rehabilitative care starting with the general outpatient department to dedicated institutions providing medical and surgical treatment for specific diseases including cancer, TB, kidney and heart, and dental ailments. The campus also houses the BJ medical college, the Gujarat  Medical Council, Gujarat State Pharmacy Council and Gujarat Nursing Council.

No wonder then that this complex, familiarly called Civil Hospital is Asia’s largest public hospital, and possibly the oldest. It’s unique history and heritage goes back 168 years.

 It origins as an institution can be traced back to 1841 when it started operating from the Collector’s Office. The brick and mortar building of the hospital was constructed in 1858 at a cost of Rs. 96,000. This was an immense sum in those days, and the then colonial government had no role in its funding. But Ahmedabad also has a long history of philanthropy, when the affluent merchants of city contributed generously to public causes. Two prominent citizens Shri Hutheesing and Shri Premabhai were among the key donors for establishing the hospital, along with an Englishman, D. Wyllie, who was the Surgeon General at the time. A block of the hospital was named the Wyllie Ward after him. The objective was to provide free health services, aid and treatment to the people. The Old Civil Hospital was located at the Collector’s Office in Gheekanta. There were 12 wards and rooms for 92 in-patients. A medical school attached to the hospital was started in 1871 with 14 students who were designated as Hospital Assistants. As patients continued stream in, there was a need for expansion of space and facilities. Once again, the philanthropists of the city stepped in. Over the few decades, donations helped to open a Medical College, an eye hospital, outdoor patients section, and construct a maternity unit and women’s and children’s wards. The common people of Ahmedabad also contributed. From funds collected by the public, a well-equipped surgical ward was created; it was named the Mary Lambert Operation Theatre.

Despite these extensions and expansions, the hospital could not meet the huge need and demand for its services. Thus work, funded by the government, began on new premises in the Asarva area, starting in 1952. The New Civil Hospital as it was called shifted here in November 1953. Over the years, the campus has grown and spread to earn its distinction as the largest public hospital in Asia. The New Civil Hospital has more than 2000 beds and 44 wards for indoor patients. Over 1 lakh indoor patients are treated here every year. And over 9 lakh patients avail of the OPD facilities annually. And all treatments and investigations are provided free of charge, or at minimal charges. Mind boggling, to say the least.

No doubt, the system is not without its flaws and issues. And an equal number of stories may be shared about harrowing experiences. But the fact that such a complex of facilities continues to function, where even a common person can avail of medical treatment at minimal cost, is certainly worthy of commendation. Yes, there are crowds, there are long waits, there are points of confusion and frustration. But then, one hears of months-long wait in Britain’s NHS system to get a bed for a routine surgery; and the American system where one needs to wait months before one can get an appointment to see a specialist, or an MRI when quick diagnosis and treatment are of the essence…

In our own quest to be leaders in ‘medical tourism’ today we are seeing an upsurge of huge corporate hospitals springing up. These are bewildering concrete and glass jungles in themselves, where even a critically-ill patient cannot be admitted until the Billing Desk declares them “fit to pay”. Where every breath, and every procedure and pill is billed, and from where it is a challenge to emerge sound in body, mind, and bank balance!

In such greatly changed times, and certainly in the face of huge challenges, it is humbling to know that the Civil Hospital continues to adhere to its original mission of “Providing the best healthcare services to all sections of society at free of cost through unrelenting strategy of motivation, quality improvement, value addition and dedication towards humanity with selflessness.”

–Mamata

A Month for Pain

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Pain is one of those things we know intimately but understand surprisingly little. We know it when we stub a toe, burn a finger, bite our tongue, pull a muscle or discover that the corner of the coffee table has been lying in wait for our little toe. We know exactly what to say: “Ouch!”

But what exactly is happening when we say it?

September is Pain Awareness Month, an annual campaign dedicated to improving understanding of pain, pain management and the experience of people living with pain. It was established in 2001 and is now marked internationally. This September, the International Association for the Study of Pain (IASP) is particularly focusing on understanding, advocating, partnering and advancing pain science, with 2026 also being its Global Year on Neuropathic Pain.

Which seems like a good time to ask a rather basic question: why does pain hurt?

The body’s alarm system

The old-fashioned explanation was wonderfully simple. Something goes wrong in the body, nerves send a message to the brain, and the brain says: That hurts.

There is some truth in this, but modern pain science has made the story considerably more interesting.

When we touch something dangerously hot or injure ourselves, specialised nerve endings called nociceptors detect potentially damaging stimuli. They send electrical signals through nerves and the spinal cord towards the brain. But pain itself is not simply the signal travelling along a nerve. It is the brain’s interpretation of those signals, influenced by a whole set of factors including context, memory, mood and expectation. This is why pain is both remarkably useful and remarkably complicated.

People born with rare conditions that prevent them from feeling pain demonstrate just how important that unpleasant sensation is. Without the warning system, burns, fractures and other injuries can go unnoticed, sometimes with devastating consequences.

When the alarm refuses to switch off

Acute pain generally has a useful purpose. You injure yourself, the area hurts, the body repairs itself and, eventually, the pain subsides.

But pain does not always follow this tidy script.

It can persist long after an injury has healed, or occur without an obvious injury. Chronic pain can become a problem in its own right, while neuropathic pain arises from damage or disease affecting the somatosensory nervous system. It can feel burning, shooting, electric or stabbing, and can be extraordinarily difficult to treat.

There is another fascinating category: nociplastic pain, in which altered pain processing is involved without clear evidence of ongoing tissue damage or a lesion of the somatosensory system. In other words, pain is not always a faithful reporter standing at the scene of the crime.

But can pain actually be measured?

This is where things get delightfully strange.

If someone tells you their pain is 7 out of 10, what does that really mean? Is your 7 the same as my 7? And is either of us using the same scale as the person who describes childbirth, a broken bone or a paper cut as “about a five”?

Pain is subjective, which makes it notoriously difficult to measure objectively. As an article in National Geographi article explains, scientists still do not have a reliable physiological instrument that can simply be attached to a human being and announce: “Your pain is 6.73.”

Enter Justin O. Schmidt, the American entomologist who apparently looked at the problem and decided that the obvious solution was to get himself stung by lots of insects– more than 150 species.

Schmidt spent decades studying insects and recording the character and intensity of their stings. His work eventually produced the Schmidt Sting Pain Index, a scale from 0 to 4 that ranks the relative pain of insect stings. The honeybee, familiar to many people, scores 2 and became a reference point for comparison. Schmidt also asked other experts to provide their assessments.

The Pain Olympics

At the bottom end are relatively mild stings. Fire ants and paper wasps score 1. Then comes the upper end of the scale. The tarantula hawk wasp, warrior wasp and bullet ant all reach 4. The bullet ant is particularly notorious, and Schmidt’s description of its sting is so dramatic that it sounds less like entomology and more like a rejected line from an action movie.

Schmidt’s descriptions are one of the most entertaining features of the index. He did not merely write “pain = 3.” He attempted to describe what the pain felt like. His yellowjacket entry compares the sensation to a hot, smoky experience involving a cigar. The warrior wasp, at the top of the scale, provoked the wonderfully candid question: “Why did I start this list?”

One can only admire the commitment to science.

Pain is not the same as damage

Schmidt’s work also illustrates something important about pain: the intensity of pain does not necessarily correspond directly to the amount of physical damage caused.

Venom has multiple effects. Some components can trigger intense pain, while others contribute to toxicity and tissue damage. These are related but not identical phenomena. A sting can hurt spectacularly without producing equivalent lasting tissue damage.

There is an evolutionary reason for this. For many stinging insects, the purpose of venom is not necessarily to kill a predator. A predator that survives a painful encounter can learn a valuable lesson: perhaps don’t eat that particular insect again.

As one of the scientists quoted by National Geographic puts it, a painful experience can be more useful as a defence if it leaves the predator alive to remember it.

Which brings us back to us humans.

We tend to think of pain as the enemy. But pain is actually one of the body’s oldest protective systems. It tells us when to withdraw, when to protect an injured part, when something may be wrong and, sometimes, when we need to seek help.

The trouble begins when the alarm becomes the illness itself.

Pain Awareness Month is therefore not simply about telling people that pain exists. It is about recognising that pain is real even when it cannot be seen, that different people can experience the same stimulus differently, and that persistent pain deserves to be understood rather than casually dismissed. IASP’s 2026 campaign puts this neatly into a broader framework of understanding, advocacy, partnership and better care.

And as for the Schmidt Sting Pain Index, there is a final lesson.

You can measure pain comparatively. You can describe it, investigate it and study the biology behind it. But there is still no universal “pain-o-meter” that tells us exactly what another person is feeling.

Perhaps that is why pain requires not only science, but empathy.

And perhaps, when somebody says, “This really hurts,” we should resist the temptation to reply, “It can’t be that bad.”

Unless, of course, they are volunteering to test the bullet ant!

And perhaps we should occasionally thank pain.

Preferably after it has gone away.

–Meena

National Insurance Awareness Day: Protecting What Matters Before It Is Too Late

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Every year, National Insurance Awareness Day, observed on 28 June, reminds us of a simple but often overlooked truth: life is unpredictable. While we cannot foresee accidents, illnesses, natural disasters or financial setbacks, we can prepare for them. Insurance is one of the most effective ways to do exactly that.

Ironically, insurance is often appreciated only after a crisis strikes. A medical emergency, a road accident, a house damaged by floods, or the sudden loss of a family’s breadwinner can instantly transform insurance from an overlooked expense into a financial lifeline. National Insurance Awareness Day encourages us to make that preparation before adversity strikes rather than after it is too late.

Why National Insurance Awareness Day?

Unlike many officially designated observances, National Insurance Awareness Day appears to have originated as an industry-led initiative to encourage people to review their insurance needs and better understand the role insurance plays in financial security. Over time, it has gained wider recognition as an occasion to promote financial literacy, preparedness and responsible planning.

The day is particularly relevant today because the risks confronting individuals and businesses have become more complex. Healthcare costs continue to rise sharply. Climate change has increased the frequency of floods, cyclones, heatwaves and other extreme weather events. Cybercrime threatens businesses and individuals alike, while economic uncertainties can disrupt livelihoods with little warning. Insurance cannot prevent these events, but it can prevent them from becoming long-term financial catastrophes.

At its heart, insurance is about sharing risk. Millions of policyholders contribute relatively small premiums into a common pool, enabling those who suffer losses to receive financial support. This principle has made insurance one of the cornerstones of modern economies, helping families recover from setbacks, businesses resume operations after disasters, and communities rebuild after crises.

The State of Insurance in India

India’s insurance sector has expanded dramatically over the past two decades. Today, the country has 74 insurers operating across life, general, health and reinsurance businesses. Together, they offer protection against a wide range of risks, including life, health, motor, property, travel, crop, marine and cyber risks.

Yet, despite this growth, India remains significantly underinsured.

According to the latest data from the Insurance Regulatory and Development Authority of India (IRDAI), insurance penetration—measured as insurance premiums as a percentage of GDP—is about 3.7%, almost half the global average of roughly 7%. This suggests that millions of Indians either have no insurance at all or lack adequate coverage.

Health insurance presents a similar challenge. While government schemes such as Ayushman Bharat, employer-provided insurance and private policies have expanded coverage, only about 40–45% of Indians have some form of health insurance. Consequently, out-of-pocket medical expenditure remains among the highest in the world, often forcing families to dip into savings, borrow money or even sell assets to meet healthcare expenses.

Recognising this protection gap, IRDAI has articulated a vision of “Insurance for All by 2047.” Achieving this goal will require not only greater availability of insurance products but also improved financial literacy, stronger consumer confidence and wider public awareness of the role insurance plays in protecting financial well-being.

More Than Just a Financial Product

Many people still view insurance as something they purchase only because it is compulsory. Motor insurance is mandated by law. Health insurance may come through an employer. Home insurance is often bundled with a housing loan.

But insurance is far more than a legal requirement or a financial product. It is a vital component of sound financial planning.

Savings help meet planned expenses and short-term emergencies. Investments help create wealth over the long term. Insurance serves a different purpose—it protects against low-probability but high-impact events that can wipe out years of accumulated savings in a matter of days.

The COVID-19 pandemic offered a powerful reminder of this reality. Families with adequate health and life insurance were generally better equipped to cope with hospitalisation costs, income loss and financial uncertainty than those relying solely on savings. Insurance cannot eliminate hardship, but it can prevent adversity from turning into financial ruin.

A Good Time to Review Your Cover

National Insurance Awareness Day is not simply about buying another insurance policy. It is an opportunity to review whether existing protection is still adequate.

It is important to understand that as life changes, so do insurance needs. Equally important is understanding what a policy covers—and what it excludes. Reading policy documents, updating nominees and checking whether the sum insured remains adequate can save considerable stress later.

A few simple questions are worth asking:

  • Is my health insurance sufficient given rising medical costs?
  • Does my life insurance adequately protect my family’s future?
  • Are my home and valuable assets insured?
  • Have I updated my nominees?
  • Do I fully understand my policy’s terms, exclusions and claim process?

Investing in Peace of Mind

Insurance ultimately provides something that is difficult to quantify—peace of mind. It allows individuals, families and businesses to pursue opportunities with greater confidence, knowing they have a financial safety net should the unexpected occur.

On this National Insurance Awareness Day, perhaps the wisest investment is not simply buying another insurance policy, but understanding the protection we already have, identifying the gaps that remain, and taking timely steps to safeguard what matters most.

–Meena

Surgeons’ Day and the Extraordinary History of Self-Surgery

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Every year on 15 June, India observes Surgeons’ Day, an occasion promoted by the Association of Surgeons of India and other medical institutions to recognize the contribution of surgeons to healthcare. The day is marked by professional meetings, public awareness programmes, health camps, and discussions on advances in surgical practice.

In the Indian context, it is also important to remember Sushruta, the author of the Sushruta Samhita, who over two millennia ago, described surgical instruments, operative techniques, wound management, and reconstructive procedures. His work is among the earliest known systematic texts on surgery anywhere in the world.

Self-Surgery

While surgery is usually associated with teams of highly trained professionals working in carefully controlled environments, history records unique cases in which individuals performed surgical procedures on themselves. These episodes occurred under very different circumstances, but each has become part of medical history because of the unusual challenges involved.

Leonid Rogozov: Appendectomy in Antarctica

One of the best-known cases is that of Leonid Rogozov, a Soviet surgeon stationed at the Novolazarevskaya research station in Antarctica in 1961.

Rogozov developed acute appendicitis while serving as the only physician at the base. Weather conditions made evacuation impossible. On 30 April 1961, assisted by colleagues who handed him instruments and held mirrors, he performed an appendectomy on himself using local anaesthesia.

The operation lasted approximately two hours. Rogozov recovered and resumed his duties within weeks. His case is widely cited in medical literature as a unique example of self-performed emergency surgery.

Evan O’Neill Kane and Surgical Experimentation

In 1921, American surgeon Evan O’Neill Kane carried out an appendectomy on himself at a hospital in Pennsylvania.

Kane’s purpose was not emergency treatment but the demonstration of local anaesthesia for abdominal surgery. He believed that local anaesthesia offered advantages over general anaesthesia in selected cases and used his own operation to support that view.

In 1932, he reportedly performed a second self-operation to repair an inguinal hernia. These procedures attracted significant public and professional attention at the time.

Inés Ramírez Pérez and a Self-Performed Caesarean Section

In 2000, Inés Ramírez Pérez, living in a remote rural area of Mexico, carried out a self-performed caesarean section after prolonged labour and the absence of medical assistance.

Following the delivery, she sought help from local residents and was transported to a hospital. Both she and her baby survived. Medical reports published subsequently documented the case, which is considered one of the rare recorded instances of a successful self-performed caesarean section.

Aron Ralston’s Self-Amputation

In April 2003, American mountaineer Aron Ralston became trapped in Utah’s Bluejohn Canyon when a falling boulder pinned his right arm.

After remaining trapped for several days and exhausting his supplies of food and water, Ralston amputated his own arm using a small multi-tool and then climbed out of the canyon to seek assistance.

His experience was later described in his memoir Between a Rock and a Hard Place and dramatized in the film 127 Hours.

Claude Martin’s Procedure in Lucknow

An earlier and less widely known example has a connection to India.

Claude Martin (1735–1800), a French soldier and entrepreneur who spent much of his life in Lucknow under the East India Company, suffered from bladder stones. Around 1782, he devised an instrument that he used on himself over an extended period in an attempt to break down or remove the stone.

Martin later described the procedure in correspondence and records that came to the attention of medical practitioners in Europe. Historians of medicine have noted similarities between his approach and later methods of lithotripsy, the technique used to break up urinary stones without major surgery.

Today, Martin is better known as the founder of the La Martinière schools in Lucknow and Kolkata, but his medical experiment remains a noteworthy episode in the history of self-treatment.

As India marks Surgeons’ Day each year, the occasion serves not only to recognize today’s surgeons but also to remember the long and often remarkable history of surgical practice, innovation, and human resilience.

–Meena

Another Day, Another Breath

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We mark days for everything—as we have seen over the last few weeks, serious ones like World Environment Day or International Women’s Day, and then the quirkier ones that sneak into our calendars and make us pause, smile, or wonder. Tucked quietly among them is World Breathing Day—observed each year on April 11th—a day that, at first glance, feels almost unnecessary. After all, breathing is the one thing we do without reminders.

But that is precisely the point.

Breathing is so automatic that we rarely stop to notice how we breathe. Or that something as ordinary as your nose is quietly running a sophisticated system in the background. One of its most fascinating features? The nasal cycle—a built-in rhythm that ensures your two nostrils are never quite doing the same thing at the same time.

The Nose That Works in Shifts

Try this: close one nostril and breathe, then switch sides. Chances are, one side feels clearer than the other. That’s not a cold coming on—it’s your nasal cycle at work.

The nasal cycle is a natural, unconscious process in which airflow alternates between nostrils every few hours. At any given moment, one nostril is “dominant,” allowing more air in, while the other is slightly more congested and handling less airflow. This swap happens throughout the day without you noticing.

Think of it as a relay race. One nostril takes the lead while the other steps back—not idle, but recovering, recalibrating, and preparing to take over again.

Why Two Nostrils, Not One?

It may seem redundant—why not one efficient airway instead of two? But evolution, as always, prefers nuance over simplicity.

Your nose isn’t just a passage for air. It’s a full-fledged processing unit. Before air reaches your lungs, it is filtered, warmed to body temperature, and humidified. Without this preparation, the air would irritate your airways and make breathing far less comfortable.

Having two nostrils allows this system to work continuously without burnout. While one nostril handles the bulk of airflow, the other gets a chance to restore moisture and recover from constant exposure to dust and microbes. This explanation is widely accepted, though the exact mechanisms are still being studied.

It’s like having two alternating air-conditioning units—one working, one servicing.

The Secret to Better Smelling

Here’s where it gets even more interesting: your nostrils don’t just alternate breathing—they may also influence how you perceive smells.

Air moves faster through the dominant nostril and slower through the less active one. This difference in speed can affect how odour molecules dissolve and interact with receptors.

Your brain combines these signals into a single perception, giving you a richer sense of smell than you might expect from something so routine.

Built-In Backup (and Defence)

If you’ve ever had a cold, you’ve probably noticed how one nostril feels completely blocked while the other carries on. That’s not entirely a flaw—it’s partly a reflection of how your system already works.

Because of the nasal cycle, your body is used to relying more on one side at a time. So when one nostril becomes congested due to infection, the other can often compensate more effectively.

There is also a suggestion that this alternating congestion may help in dealing with infections—for instance, changes in airflow and temperature might influence how certain viruses behave.

So your nose isn’t just breathing—it may also be quietly supporting your body’s defences, even if the details are still being understood.

What Yoga Figured Out Long Ago

Long before modern physiology described the nasal cycle, practices like pranayama in yoga had already drawn attention to the idea that the two nostrils behave differently.

In techniques such as alternate nostril breathing (often called Nadi Shodhana), practitioners consciously switch airflow between nostrils, believing it balances energy, focus, and calm. Interestingly, this mirrors the natural alternation your body is already doing on its own.

Some modern studies suggest that breathing through one nostril versus the other may have subtle effects on heart rate, attention, or relaxation. But—and this is important—these effects are often small, context-dependent, and sometimes overstated in wellness spaces.

So while yoga didn’t “discover” the nasal cycle in a scientific sense, it certainly noticed something real—and built a practice around paying attention to it.

A Rhythm You Never Notice

What makes the nasal cycle so remarkable is how invisible it is. Unlike your heartbeat after a sprint or your lungs during a yoga session, this system operates entirely under the radar.

Most of us go through our days unaware that we are breathing unevenly—that one nostril is doing more of the work at any given time before switching later.

It’s a reminder that the body is full of such quiet rhythms—processes that don’t demand attention, but deserve appreciation.

So when World Breathing Day comes around, it might be worth pausing—not for a grand gesture, but for a small awareness.

Take a breath. Then another.

Notice which nostril feels clearer. Notice how the air feels as it enters—cool, filtered, softened. Notice that what feels effortless is actually the result of a finely tuned biological system working in shifts, balancing efficiency with care.

In a world that celebrates constant output, the nasal cycle offers a quieter lesson: even the body alternates between effort and recovery.

And perhaps that’s something worth marking on the calendar too.

–Meena

Dedicated to Serve: Dr Ida Scudder and Christian Medical College, Vellore

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A young American girl, born and brought up in a missionary family in a small town in Tamil Nadu was expected to continue the family’s tradition of service to the neediest of the people. Ida Scudder, born in 1870, the only sister to seven boys, was exposed at an early age to the poverty and deprivation of the local population through her parents’ work.  But Ida was repelled by all this. She was young and pretty, and dreamt of enjoying life, and eventually making a comfortable marriage. Her parents, both long-time missionaries in South India returned to the United States for a few years with their large family when Ida was eight years old. The comfortable life in America was a huge change from the challenging missionary work in India. After a few years of school, Ida moved to the Northfield Seminary for Young Women in Massachusetts while her parents returned to Tamil Nadu.

When Ida was 20 years old she came to visit her ailing mother in Tamil Nadu. While she was there, one night three different men came to seek medical help for their wives who were about to deliver, and were in distress. They appealed to Ida to attend to them. Ida had no medical training; her father was the doctor in the family. But the conservative community would not let their women be treated by a male. The next morning Ida heard that all the three young women and their babies had died in the night due to lack of medical attention. This was a life-changing experience for Ida. She found her calling.

But in order to be in a position to really help women medically, Ida herself had first to undergo medical training. She returned to the United States and enrolled in the Philadelphia Women’s Medical College, and studied further at Cornell Medical College where she was among the few female students. After 10 years of rigorous study and training she returned to India where she hoped to work alongside her father. Sadly, her father died not long after her return.

But Ida was here to stay. She determined to carry on his work, now focussing on women’s health. Her vision was that women should have the same access to quality and compassionate healthcare that men did, regardless of religion and ability to pay for it.

She began her practice from her family home in Vellore, 135 km west of Madras, by opening a small clinic for women. Ida was initially unsure how her presence and engagement would be received by the local community; but patients trusted her, and the numbers grew greatly.

A donation from an American who wanted memorialize his late wife, led to the building of the 40-bed Mary Taber Schell Memorial Hospital for women in 1902. Ida also started organizing roadside medical camps in villages around Vellore, travelling across difficult terrain to treat people and give health education.

Given the huge need and demand for medical care for women, Ida realized that as a single person there was only so much that she could achieve. It was critical to train and educate more people in this field. In 1903 she started to train compounders, and in 1909 nurses. Her vision was to set up a world class medical college. Many scoffed at such an ambition, but Ida was tenacious and managed to raise funds to support her cause.

The Union Mission Medical School for Women was set up in Vellore in 1918. Sceptics felt that there would be no takers. But the very first year there were 150 applications, and 18 women were selected for the first batch who went on to secure a Medical Practitioner Diploma.

Dr Ida Scudder’s words to the first batch of graduating students to pass out, reflect her professional dedication, her tenacity, as well as her missionary spirit: “You will not only be curing diseases, but will also be battling with epidemics, plagues and pestilences and preventing them. Face trials with a smile, with head erect and a calm exterior. If you are fighting for the right and for a true principle, be calm and sure and keep on until you win.​”

In 1938 the British Government announced that it would only recognize an MMBS degree, and not a diploma. This necessitated that Ida’s medical school, be upgraded to a medical college. Thus was born the Christian Medical College of Vellore. The original women’s college also became co-educational in 1945. Ida was completely engaged in every aspect of the institution—teaching, medical practice, as well as administrative responsibilities including fund raising.

Even after Independence, Christian Medical College continued to draw dedicated doctors from across the country and abroad. They came not for money or glory, but inspired by the founder Ida Scudder and her single-minded dedication to the cause of service to the sick.

Over a century after Dr Ida Scudder sowed the seeds that gave form to her vision, her legacy has blossomed into a spreading banyan tree. The tiny clinic has grown into CMC Vellore—one of India’s top-ranked educational, healthcare and research institutes.

The 40-bedded hospital has grown into a 3000-bedded multi-specialty health care system spread over six campuses. CMC cares for over twenty lakh patients, and trains one thousand doctors, nurses and other medical professionals each year. People from all walks of life and all parts of the country and beyond come here for the ethical, compassionate, and quality care that it is reputed for. Ida Scudder’s vision and work have outlived her.

This month, we have been celebrating women who have broken barriers, and led the way in many different ways, in widely diverse fields. We have shared stories of women who have truly “made a difference.” Who better epitomizes this than Dr Ida Scudder! 

–Mamata

Sandow in our Lives

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The end of the year is a time of going back in time and re-living memories.

And one of the enduring memories for those of us who grew up in the  1950s, 60s and 70s, is the word Sandow. It was a part of everyday lives—an integral part of the pencil box, a dirty grey rubber that erased pencil marks.

For us in India, “rubber” was the term for eraser, a usage inherited from British English and reinforced through colonial schooling. A child did not “borrow an eraser”; they asked for a rubber. And the most trusted rubber of all in our times was the Sandow.

These erasers were made of natural vulcanised rubber, not vinyl or plastic as most modern erasers are. They were firmer, slightly gritty, and erased by abrasion — scraping graphite off paper rather than gently lifting it. They left dark crumbs behind and wore down slowly. A new Sandow rubber meant clean pages. A worn one told the story of errors made and lessons learnt.

Where did Sandow rubbers come from?

The earliest Sandow erasers were almost certainly manufactured in Britain and exported to India during the late nineteenth and early twentieth centuries through British stationery suppliers. During the colonial period, Indian schools depended heavily on imported notebooks, inks, slates and erasers.

Stupid Toy Day (December 16) is a celebration of the wonderfully useless things from childhood—rubber chickens, yo-yos, slinkies, and strange plastic objects that made no sense but brought endless joy. From ridiculous toys to unsettling antique dolls that now star in creepy museum contests, this post reflects on how toys—whether silly or sinister—stay with us long after childhood ends. A nostalgic look at why useless never really meant unimportant.

After Independence, Indian factories began manufacturing erasers using similar formulations and — crucially — the same name. By the 1950s, most Sandow erasers sold in India were produced locally. However, the word “Sandow” was never firmly trademarked in India, allowing multiple manufacturers to use it freely. Over time, it became not a brand but a category. “Sandow rubber” simply meant “the regular school rubber.”

Sandows were not the only erasers available. There were white, scented rubbers, with a gel-like coloured top. But alas, most of us never possessed one, given they were about four or five times more expensive!

And a Strongman called Sandow

Another Sandow (though of older vintage) was part of our childhoods too. He lived on barbershop calendars and tattered posters: a muscular European strongman frozen in permanent flex.

Eugen Sandow (1867–1925) was a Prussian-born showman, athlete and entrepreneur who became the world’s first international bodybuilding celebrity. He toured Europe, Britain and America performing feats of strength before royal families and packed audiences.

Sandow was much ahead of his time, and would have done great in the current days, surely becoming a hero of Insta reels, posing as he did to deliberately display his muscularity. He was also a businessman. He published training manuals, endorsed health products, sold exercise equipment, and promoted physical culture as moral discipline. King George V even appointed him “Professor of Scientific and Physical Culture” in Britain — a title that further elevated his image as a respectable authority on fitness.

In India, encounters were through his images — black-and-white posters, calendar art, tins, and labels that travelled through imperial trade routes. But nevertheless, his name was well known, whether with urban kids or rural youth.

Were the rubber and the strongman officially connected?

There is no evidence that Sandow ever licensed his name to an eraser manufacturer. No contract, no advertisement, no endorsement exists in any reliable archive.

However, the naming may have had a connection. The two existed at around the same time, and the name ‘Sandow’ symbolised durability, strength and European modernity. Calling an eraser “Sandow” suggested that it would last, work hard and not fail easily. In an era with loose branding laws, borrowing famous names for product credibility was common.

Today…

Now, erasers come in neon colours and cartoon shapes. Eugen Sandow is remembered only by historians and fitness professionals. But for those who grew up in that older India, the word still carries a double image: fingers dusted with graphite, and a chest forever flexed on fading paper.

Sandow was never just an eraser.
And Sandow was never only a man.

Both were a part of our simple, innocent youth!

–Meena

Photocredit: Wikipedia for Mr. Sandow

ebay for the Vintage Tin advertising the eraser

Food for Thought

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October 16 marks World Food Day—the day in 1945 that the Food and Agriculture Organization (FAO) was set up. FAO is a specialized agency of the United Nations that leads international efforts to defeat hunger. FAO’s goal is to achieve ‘food security for all and make sure that people have regular access to enough high-quality food to lead active, healthy lives.’ 194 countries and the European Union constitute its membership and FAO works in over 130 countries worldwide.

World Food Day aims to raise global awareness about food security and hunger, promoting actions to eradicate hunger and malnourishment. The day focuses on sustainable food systems, healthy diets, and equitable food distribution to ensure a better future for all.  The theme for World Food Day 2025 is “Hand in Hand for Better Foods and a Better Future”.

One would hope that with world attention on this critical issue, things would have gotten better in the decades since the establishment of FAO. Well, in fact measures of world hunger over time do show a general decline from that time. But the bad news is that progress has stagnated and reversed in recent years due to factors like conflict, climate change, and the pandemic.

Food Sufficiency

One area of concern in this turbulent world of conflicts and tariff wars is a country’s food self-sufficiency. The alarming fact is that as per a study reported in Science Alert, carried out by researchers from the University of Göttingen in Germany and the University of Edinburgh, only ONE country in the world can is self-sufficient in all seven key food groups (Fruits, Vegetables, Dairy, Fish, Meat, Plant-based protein, and Starchy staples).

And is Guyana! China and Vietnam were the runners-up, producing enough food to meet their populations’ needs in six out of the seven categories. Less than 15% of countries are self-sufficient in five or more food groups. Half a dozen countries– Afghanistan, the United Arab Emirates, Iraq, Macau, Qatar, and Yemen – are unable to meet self-sufficiency in any food group.

This is bad news in a world which cannot count on peace and fair trade across borders. Governments have to urgently re-think their agricultural policies.

India

India’s agriculture has come a long way from the days of ‘ship to spoon’ when we dependent on the largesse of developed countries. Today, we are net strong in staples (cereals including rice, wheat and coarse grains) and dairy.

But we have our vulnerabilities. The weakest points are pulses and oils.

We depend on pulse imports because production fluctuates.We produced around 24-25 million tonnes of pulses in 2024-25 and imported about 4.65 million tonnes. Domestic production fluctuates due to weather etc.

India meets only ~ 40-45% of its edible oil demand through domestic production. The rest is imported (for oils or oilseeds). In 2023-24, imports we imported approximately16 million tonnes of edible oils. Domestic production is increasing but yield gaps, land use, and competition with other crops are constraints.

The issue is not just the macro-numbers. The context of persistent malnutrition and food insecurity due to rising food prices, food wastage, farmer distress and the increasing impact of climate change on agricultural production must be kept in mind.

Respect Food and Farmers

While we hope our governments and institutions will sharply focus on this, as individuals, this World Food Day is an opportunity to think about where our food comes from; how we can eat healthy without imposing enormous costs on the earth; how we can bring food-waste down to zero. And renew our respect for the farmers who feed us, often without due return.

–Meena

DESIGN GURU ASHOKE CHATTERJEE: A TRIBUTE ON HIS 90TH BIRTDHAY        

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Ashoke Chatterjee (AC) does not like to be called ‘design guru’. But it is really not possible to come up with a better title for this piece on him. For though not a designer, his influence on design and design education in India has been immense. After all, he was Executive Director of India’s first and leading design school, the National Institute of Design (NID) from 1975 to 1985; a Senior Faculty Advisor for Design Management and Communication from 1985-1995, and Distinguished Fellow at NID from 1995 till his retirement in 2001.

AC played a critical role in conceptualizing the meaning of design in the Indian context. In 1977, he brought together UNIDO and International Council of Societies of Industrial Design (ICSID) members, designers, design-educators and others from across the world to the NID campus at Ahmedabad for a 2-day symposium. The meeting ended with the historic Ahmedabad Declaration which embodies the value of humanism in design. The core of the statement affirms:

  • ‘Its firm conviction that design can be a powerful force for the improvement of the quality of life in the developing world;
  • Its firm belief that designers must have a clear understanding of the values of their own societies and of what constitutes a standard of life for their own people;
  • That design in the developing world must be committed to a search for local answers to local needs, utilising indigenous skills, materials and traditions while absorbing the extraordinary power that science and technology can make available to it;
  • That designers in every part of the world must work to evolve a new value system which dissolves the disastrous divisions between the worlds of waste and want, preserves the identity of peoples and attends the priority areas of need for the vast majority of mankind’.

AC has lived this spirit and has helped designers and design-students across the country imbibe this spirit. He made it a fundamental principle of design education that students needed to understand that design is not restricted to contributing to business profits but also includes contribution made to the livelihoods of artisans, farmers, and the marginalized; and that designers must grapple with social issues. He was one of the early votaries of sustainability and brought this understanding to the education of designers.

As AC is always the first to aver, he is not a designer. He went to Woodstock School, after which he took an Economics degree at St Stephens College, New Delhi. Following this, he did his MBA at Miami University in Ohio, USA. He was with the International Monetary Fund in Washington DC, where he worked as a communications specialist, the Indian Tourism Development Corporation etc., before finding his home in NID and Ahmedabad.  He has advised, and advises, several national and international agencies including INTACH, Water Supply and Sanitation Collaborative Council (Geneva), the Gujarat Ecology Commission, the Government of Rajasthan Department of Health.  He served for many years as honorary president of the Crafts Council of India.

We have had the good fortune to regularly interact with AC over the decades. He was a not-infrequent visitor to the Centre for Environment Education where we worked for many decades, and each occasion brought its laughter, learning and a warm sense of having a caring mentor. He has been on the Governing Council (GC) of CEE from the early years, and as a local GC member, was invited for brainstorming, meetings, events, certificate-distributions and what have you—and if he did not have any prior commitments, he would attend.  He generously served on the advisory committee of several large projects that CEE was involved in, and brought his wisdom to bear not only on the content and design, but also on stakeholder management. As programme leaders, we would often be called into the GC meetings to make presentations on our projects; the butterflies in our tummies would settle when we met his twinkling eye, and he nodded ever-so-slightly to us. And after the presentation, he would sometimes pass us a little chit saying that we had done a good job. That truly made our day!

Ashoke Chatterjee played a key role in the National Drinking Water Mission, which in the late 1980s was tasked with ‘providing safe drinking water to all villages, assisting local communities to maintain sources of drinking water in good condition, and for specific attention for water supply to scheduled caste and scheduled tribe communities.’ AC prepared a road map on the communications aspect of this initiative, without which the gains could neither have been attained nor sustained. He worked closely with CEE in developing communication and education on fluorosis, a disease endemic to large parts of Gujarat.

With all his commitments, AC writes too. Dances of the Golden Hall on the art of Shanta Rao, and Rising, on empowerment efforts among deprived communities in rural Gujarat, are among his well-known books. His latest work (with Harji Malik), in English and Hindi, is titled Learning Together at Jawaja and chronicles the 50-year journey of the Jawaja project.

There is never a meeting with AC when we don’t come away feeling enriched—both as professionals and as human beings.

THE RURAL UNIVERSITY, JAWAJA

One of the criticisms against academic institutions is that they are far removed from every day realities and seldom contribute in solving real-life challenges. The Jawaja project undertaken by IIM Ahmedabad in partnership with the National Institute of Design (NID), Ahmedabad is an early exception. Ashoke Chatterjee was a key part of this.

It was in 1975 that Ravi Matthai, IIM-A’s legendary first fulltime director, set out on a journey to see how corporate management principles could be used to solve the major problem facing India–poverty. Ravi Matthai had stepped down as Director in 1972, and could now devote time to such a project.

The decision was taken to work in Jawaja, a drought-prone district of Rajasthan, consisting of about 200 villages and a population of 80,000. There seemed very little scope for development there, given the arid landscape and lack of water and other physical resources. But Prof Ravi Matthai had a different perspective, because he saw people as the biggest resource.

As the project team understood the area better, they found that the area had a 300-year tradition of leather-craft. The communities there were also skilled at weaving. And so the project decided to build on these skills to develop sustainable livelihoods for the communities there. Prof Matthai roped in NID to join hands with IIM-A, to work on livelihoods and empowerment of the communities in Jawaja. Thus along with Ashoke Chatterjee, his counterpart in NID, he started the journey which involved many faculty from both institutes.

The idea was to connect traditional artisans with contemporary disciplines of management and design, and knowledge institutions which had this knowhow. There were some important basic principles underpinning the effort. The first and foremost was that the relationship was one of mutual respect and learning—after all, even as the communities learnt new skills, the faculty of the institutions were learning how their knowledge could be put to use in solving social problems. Another important aspect was to see how much of the value chain could be controlled by the artisans and communities themselves, so that their incomes could be enhanced. The idea was to innovate and design new products which would have new markets, so that the traditional value chains could be broken and the craftspeople could play a greater role in more areas. The focus was also on working in groups, to give greater resilience and strength to the efforts.

The process was, by design, a gradual one, moving from basic products which did not need very high quality craftsmanship, such as leather school bags and woven floor mats, to higher value ones like office supplies, trendier bags, and high-end furnishings.

The challenges were, of course, many. Apart from the need to design new products which would use the old skills, technologies and equipment, another major concern was quality control.

To quote Ashoke Chatterjee on the subject: The Jawaja project was one experiment which integrated many aspects of craft: heritage, culture, social structure, design vocabulary and NID’s design inheritance. But it was not a craft project; it was development defined as self-reliance for those who have been the most dependent in our society. Ravi Matthai explained self-reliance thus: Can people do something for themselves tomorrow that others are doing for them today and they should be released of that dependence? Ultimately, Jawaja taught us that the whole is about people and you have to attend to people first and last or else nothing you do will be sustained.

The depth of AC’s understanding of craft traditions in India, and his humanity are reflected when he says: Jawaja provided a benchmark in crafts: first focus on and understand the community before we intervene in crafts. Who are the people? What are their earnings? What are their aspirations? What is in it for them? Before we start giving people lectures about their ancient traditions, ask what’s in it for them to stay in the tradition? In the case of Jawaja, many of the heritage problems for leather workers were things they wanted to run away from. Their caste elders told them they must not be identified as leather workers; they must have some other identity. When they stopped flaying animals they were left stranded without an identity. We often look at tradition and heredity as some exquisite artefact, but for them it was centuries-old discrimination.

The Jawaja project was an educational experiment-in-action based on the idea that development activities must be a vehicle for learning. The enduring success of the bold experiment is seen even today at several levels.

The first was the creation of self-reliant institution of crafts people–the Artisans’ Alliance of Jawaja and its associations. These started to manage all links of the value chain in Jawaja, from raw material procurement, finances, bank dealings, design and technology know how, and marketing processes. These are active even today, and continue to innovate, produce and market products which are highly valued.

The second is the impact of the project on the larger development scene. It was the learning from running this grassroots education and empowerment project that the idea of setting up a specialized institution for education in rural management came up, and the Institute of Rural Management (IRMA), Anand, was born. This was given shape by Prof Ravi Matthai and two other professors who had been with IIM-A—Dr Kamla Chowdhry and Dr.Michael Halse.

The Jawaja experiment’s widespread legacy is that it influenced development sector thinking on how to approach community-based livelihood interventions in a spirit of mutual respect and learning.

–Meena

From: Inspirations: Individuals and Institutions That Defined India’s Sustainability Journey. Mamata Panday, Meena Raghunathan.Bookwell Publications. 2025.

See also: The Jawaja Project https://millennialmatriarch464992105.wordpress.com/wp-admin/post.php?post=3624&action=edit

Pic: NID site

The Stroop Effect and Other Sneaky Brain Games

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Having been associated for long with Vikram A. Sarabhai Community Science Centre (VASCSC), the pioneering science centre in the country, I always source STEM education materials and kits from them.

A few weeks ago, we received one such package I had ordered. The wonderful thing about VASCSC material is that they don’t let an inch of space go to waste. So the large envelope in which the kit came was also printed with any number of science games and puzzles.

The one that my 6 year old grand daughter and I really had fun with was the Stroop Effect.

It was all giggles as she held out the sheet with a bunch of words and asked me to look at them.  The word “RED” was written in bright blue ink. She asked me to say the colour, not the word..

“Red!” I said instinctively.

“No!” she giggled. “It’s blue ! You have to say the colour of the ink!”

Oh.

And just like that, we stumbled headfirst into the Stroop Effect—a clever little quirk of our brains first identified by psychologist John Ridley Stroop in 1935. Stroop, an American psychologist conducted a series of studies as part of his PhD research. He was fascinated by how automatic processes—like reading—can interfere with other tasks, such as identifying colours. In his now-famous experiment, he showed that when colour words (like “red” or “green”) were printed in mismatched ink colours, people took longer to name the ink colour. This delay, or interference, revealed something profound about how our brains handle conflicting information.

So what is the Stroop Effect?

The classic version of the Stroop test asks you to name the colour of the ink in which a different colour name is written. Like the word “Green” printed in red ink. Sounds simple, right? But our brains are wired to read words so automatically that it slows us down, or even trips us up, when the word and the ink colour don’t match.

This interference between what we read and what we see is a fascinating peek into how our minds juggle competing bits of information.

Why does it matter?

What seems like a party trick actually has deeper implications. Psychologists use the Stroop test to study attention, processing speed, and cognitive control. In clinical settings, it helps assess brain injuries, dementia, and even ADHD. The longer it takes for a person to respond correctly, the more it can reveal about how their brain is functioning.

But even beyond labs and clinics, understanding the Stroop Effect has very real applications.

Take driving, for instance. Ever noticed how highway signs use simple fonts and colours? Imagine if a stop sign said “Go” in red letters—confusing, right? Designers rely on principles like those revealed by the Stroop Effect to make sure our brains process the right cue first.

It’s not just colours and words

Once you start noticing, these mental speed bumps are everywhere. Consider this: we all know that when we try rubbing our stomach with one hand and patting our head with the other, we run into hilarious situations. It is tricky, because your brain is trying to coordinate two conflicting patterns of movement. That’s a bit like motor interference, another cousin in the Stroop family.

Or think of the McGurk Effect, where what you see affects what you hear. If a video shows someone saying “ga,” but the sound is “ba,” your brain may hear “da.” Vision wins over sound, just like reading wins over colour in the Stroop test.

And then there is change blindness—when something in a visual scene changes, and we don’t notice because our attention is elsewhere. Magicians depend a lot on this trick, as also UX designers, who try to guide user attention in websites and apps using visual cues.

A lesson in humility

For me, discovering the Stroop Effect was a gentle reminder that our brains, for all their wonder, are not infallible. They’re predictably imperfect, prone to biases and blind spots. Well, that makes life more exciting!

–Meena

Image: Venderbilt University site