a corrupted week – examples from ktm

here is a brief schedule of the week, where I noted some examples of corruption. Plain and simple corruption.

1. Wednesday – a taxi fare for 3.2km – Chabahil to Kupondole Height took me Nrs 250. We went there to attend one of our friends wedding. Good wedding reception and yes, great food. Met ten of the forty-five friends from medical school. This is by all account, a good number. corruption – when coming back – the taxi fare suddenly inflated to Nrs.450. Same distance, Same sets of lanes, and roads taken; but somehow, within a span of two hours, we were to pay more. We ended up paying Nrs.300 on a very sour note.

2. Sunday, Monday, Tuesday – We were called back and forth to Ministry of Health, Department of Health Services and few other Government Departments – for the approval of an expansion that Team Nidan was looking forward for the Dhanauji COPC. There is a government Health post in the outskirt of Dhanauji VDC, which has a capacity of 15 beds, a minor surgical room, and posting of three to five medical personnel (doctors, nurses, and paramedics). Currently, for teh last five years, there is only one paramedic working there. Its in a state of coma, non-functional and dying. corruption – for the last 15 days, we have been asking around if Team Nidan could take a responsibility of this health post and make it a community managed health facility. No one in the ministry is ready to talk, or give us more information on this. There is already an example of this in Nepal (NyayaHealth) – a Public-Private-Partnership. Our goal is not to run a tertiary health center like Nyaya Health but to see a functional primary health post with community engagement. No one in all the health related departments of the government is ready to divulge more information on this. There answer was that, Nyaya Health was a foreign funded and with big money backing.

so being a junior doctor, with good intention, to improve on a thing that is already broken (health post) needs us to find a big player?

Infuriating ! every one in the health related department of the government is associated with one or two of his/her own NGO and INGO. I cannot yet prove it, but this is what I found. Every able and smart person has an affiliation with at least one source of outer income in the health ministry, and department of health sciences. A sorry state considering that this somewhat illegal.

3. Friday – This was the day when I listened to a BBC documentary about the richest non-profit in the world. I didn’t knew this, but FIFA is a non-profit.

corruption – yesterday I learned the deep dark secretes of Football in Nepal, and how corrupt it is. I will not be writing the whole story here, but it turns out few top brasses in Nepal Football Arena, are controlling everything. They do not let healthy competition, new ideas, new team, and better utilization of the international fund money that comes to Nepal. A huge amount of money is being siphoned into their personal coffers.

4. Sunday Newspaper – Its about the Government Officials and there transfer into different government department. The Undersecretary disputes between the Law Department Vs all the other government department. As soon after a Supreme Court Judge was made the prime minister of this country, there came a law by which, the undersecretary of the Ministry of Law (Law and Order Departments) could get transferred to any other department, easily, while the same was not true for anyone to get transferred into the Law Departments. corruption – creating a one way valve, for those in ministry of law, by which there personnel could get transferred to any other government department, while not letting anyone new come to there own place. This is some how justifiable by the fact that studying law is difficult.

My question is isn’t anything else, like medicine?

5. Bhatbhateni Superstores in Kathmandu – and the communist led unions in them. – These have created a difficult situation for the consumers like me, where I see the salesperson slacking of, and not on-par with what they should be. Its a ten minutes walk from my place to the nearest BhatBhateni Superstores in Chuccepati, but somehow, even with all the cheap and good stuff available there, I always come out spending less, due to the lack of salesmanship (or womanship) in there. corruption – The communist led union, does not let hire-n-fire rule get effective, and so sales people (mostly girls) are mostly dim-wits who have very less idea on what they are selling. Case in point, on Saturday I had to ask three salespeople three different things, and none could help me. This was with a slight swagger on their part, that they didn’t even looked worried or helpful enough. I also heard (from rumors) that the owner is frankly in a paralyzed state due to this corrupt union, which takes Nrs.100 per month from every staff, for whatever-they-think-is-right stuff. For me, I label it as Maoist Extortion (obviously, this may be my personal clouded judgement).

6. Janak Sikshya Sadan – (or something like that) is the national press in Nepal, responsible for publishing government/public school textbook. Its a huge body of people who have only one job every year – to provide books to each and every school children in government school (public and few private). Every year, there is a huge gap and demand of books that lasts for about two months, well into the new educational year. So a student basically needs to wait at most two month to get books. corruption – The press, has one whole year to print books, manage it, disperse it and make it available in April of every year. Somehow, every year (for the last 6-7 years) they are still printing books in late April and early May. “The commission game” runs big, and the system that takes care of distribution is worn out with corruption.

okay, this was my weeks corruption list. I can write more, but I think, these are the stuffs that disturbs me the most. Hope to find few more, and add up to the list.

barriers concerning standards and interoperability

mHealth in Nepal (part II of IV)

This is part two (of four) of mobile health series, which I am sharing after completing an online education on mHealth. For those who would like to read the Part One – its here.
The following are some of the concept we discussed in online class, and google group. I think this is very reasonable to developing countries like Nepal. Most of the barriers are specifically from mHealth Africa, but I have here tried to include my nepali perspective as well. Here are few of the barriers that I think I see in Nepal concerning standards and interoperability on mHealth.
  1. Language – Nepal despite being a small country, has a huge demographic variability. The mountains and hill terrain has made number of spoken language (culture) variation. “Nepali” is the official language, and English (UK) is taught from primary and secondary school. There are about 123 spoken languages (in 125 different community) and many who still do not speak or understand English at all.
  2. (limited) Mobile Technology – Most of the mobile handsets used in Nepal are under NRS.4000 (rough estimate USD=50  Euro=40). These are not Google Android OS phones, but Java based technology with proprietary OS from local market (mostly – China and India). There are about 5-6 different mobile company that have stronghold in budget feature phone in Nepal. The only technology similar (standard) in these feature phones is Java. However, almost all have Facebook (Java Application) installed in them. Facebook being number one Social Network in Nepal (at the moment).
  3. Lack of Government Initiatives – There is no standard Government based protocols regarding mHealth in Nepal. Although, Nepal Government has recently begun a trial phase of mHealth program in few districts; there is no details about this in government websites (This is something I  am considering to write for my first assignment also).
  4. Internet (Availability and Cost) – Internet access through mobile handheld is expensive; and this hasn’t reached throughout Nepal. As with mobile network, the mountainous terrain in most of the country is hampering the WiFi (WiDi, or WiMax, or LTE) rollout from Government and Private Initiatives. There is considerable progress, but more need to be done.
  5. mHealth education – is very new to Nepal. Health providers have very little knowledge about mHealth. Data Mining and Research are at its infancy in Nepali Health Community, very few if any are interested in mHealth (for this purpose) at present. Medical School (Doctors, Nurse, Health Assistant, Health Volunteers) do not have curricula to teach mHealth. Courses that offers technology (mobile or any) teaching is in Public Health related education. This education is concentrated in Data Entry, Evaluation and Analysis, but not in Health Education. I am a recent medical graduate and I had no proper formal education on Medical Technology. Most of the course work was limited to using MS Excel (2003) and SPSS (v11)
  6. Lack of (active) Open Source Community – There is a huge gap in programming education in Nepal, that most are financed/taught by proprietary holdings like Oracle and/or Microsoft. Most of the health initiatives related to technology are in the form of Outsourced Code writing by multinationals.
  7. Technical Infrastructures – present today in various Public and Private Health institute are scattered, rudimentary and closed source. Many hospitals and health care institution have both handwritten documents and e-records. Most of the time, its the physical documents that gets used, and the electronic records are forgotten. Most of the times doctors, nurses (or any other health worker) does not know how to use the electronic record. There is no inter portability between any two health care givers (both e-records or physical records).
  8. Lack of Adherence – Health providers do not seem to adhere to e-health technologies. Partly due to the lack of electricity or lack of proper motivation, or knowledge, electronic recording is seldom done in Nepal.
what can i explore for my next part?
well there are Ncell and NTC. and there network. There is Ministry of Health and its working, plus community members who love mobile. keep watch.

how religion keeps me sane, although I don’t believe in god.

Christmast ball - Hinduism
Christmast ball – Hinduism (Photo credit: nabeel_yoosuf)

A year ago, I embarked upon a reading spree on Richard Dawkings and Christopher Hitchens. To me, they became both inspiring and revolutionary. Their writings were somehow capable of twisting my religious outlook. My family lineage are among those that believe in Hindu Religion (being Nepali gives me some understanding of Buddhism also). Yet, for better or worse, the present me does not completely believe in the existence of God. I now view Religions as a way of life, rather than believing in the almightily power.

am I atheist?
After spending most of my childhood believing in God, celebrating their birthdays and their great accomplishments, visiting temples, watching and listening to God associated preachings, and reading the epic books of both “Mahabharata” and “Ramayana”, I can firmly say that – Religion is a progressive culmination of a way of life. I can firmly establish (for myself) that, Hinduism has NO fix list of good or bad things to do. Has no hard and fast rules, and no established order of political intervention on my way of life. My answer – I believe in Hindu way of life, but do not believe in the existence of god, but love going to temples. Let me elaborate.

1. no political intervention
Four Thousand years of refinement has made a religion that stays out of my political life. Hinduism, as I see it, does not demand political interventions. I can be a capitalist, a socialist or a communist and still be a Hindu. I do not have to follow laws made by religious figureheads, and what ever laws broken does not entail me to get beaten, burned or buried. However, may be because of its maturity, has tons of examples on good governance. Both the above epic plays has something to teach – something to suggest – but nothing to enforce. It gives me the choice of being right or wrong.

2. not one God/Goddess, but many
I can choose a persona of one particular god/goddess and follow it. Hindu mythology has one of the most elaborated sets of mighty powers. The number of gods in this mythology is said to be “tettis koti” which literally means 33,000 gods and goddess. There are tons of named demons and evil beings also, whom, time and again (as per mythology) have shown greatness and kindness. There are multiple persona (God/Goddess) for every personality type. I can literally choose my favorite powerful being, that I can most relate to. For the record – I love Lord Ganesha. The obese God with an elephants head, a broken tooth, who has a mouse as his trustworthy companion. A God that loves food, well literate, and who loves his parents very much. Kinda like superman and batman of the yesteryears. It even has Goddess of Wrath (Kaali) and somewhat Womanizer God (Krishna).

3. a situational religion that can morph as per time/place/person
Hinduism over so many years got elaborated to fit into every possible culture and society with many geographical variations. A religion that has a set of guidelines (not so rigid) for men and women of all ages. It acknowledges and identifies with third gender, which is still a hot debate in most part of the world (and Nepal too, in recent years). It has provisions for being alone or with family; among society or separated from society; for travel; for happy and sad moments, and well almost all the emotions that I can think of.

4. a culture that gives you options
The best thing about this is, it gives me options. I am not obliged to believe in god. I can be a devil/demon worshiper and still be a Hindu. Somehow will not get kicked out of the Religion, although may be demoted of my social status. For better or worse, there are good amount of Hindu priests who are somewhat negative vibe followers (the evil Tantric stuff). A small clarifications that, there are good Tantras and stuffs too, but I have little or no knowledge on either. Even the demons and devil of Hindu religion worship the Hindu Gods, gain some mystical power, and then go on war with each others and Gods themselves.

oh.. but it’s not all white either
Over the years, with the gradual development and expansion of this religion over our way of living, there have been numerous wicked twisted interpretations as well. Almost every religion seem to have it, and Hinduism is no difference. As I see it, the biggest negativity which developed over the years are – the caste system, and gender inequality. I will write more on these bad habits in due time, but here is one example, which we (me and my wife) are facing recently concerning the gender issues.

example – of gender issue with my religion

(my small personal experience)
I have a small sister, a year and half younger. All our life, in any religious events, as a Hindu unmarried girl, she was (still is) given an utmost respect. She (and all the unmarried Hindu girls) get respect, loads of pooja money, every body bows before them. Girls is treated as Goddess incarnations and it is believed that by pleasing them, one appeases the Goddess of Wealth, Health and Education (among many other stuff).

This was similar to my recently wed wife also, until we got married. As soon after we were married, somehow, the twisted religion breaks this high spirit (which got groomed for years and years) and puts her husband on top. Somehow, I am getting most of the attention these days. An girl never bows down in front of anyone (except may be her elder sister) before she marries, and after that, strangely she has to bow down in front of her husband. what strange culture is this?. Think of the ego that gets hurt.

As a boy/male of the society, I bow down to my parents, my sisters (younger or older) and any other elder, out of respect. Given the dates of festivity, like “Dashain” and “Tihar”, I literally touch my sisters feet with my forehead. And since I have been doing this for as long as I can remember, and since it does not hurt or humiliate anyone, I am glad and know that I will do it for a long time to come. Obviously, her feet should be clean, and with no malodor.

Switch it to my sister’s case who will get married soon (or may be few years later) or my wife’s case who recently got married, they had always received this honor. Suddenly, after this marriage, there is a strict rule, that they must bow down and never receive this honor again. Weird. A girls parent now must respect and appease their son-in-law more, she herself has to touch his feet again and again, she has additional feet-touching-work to her husband’s parents too. It’s difficult to imagine from her(wife) perspective, and as a brother difficult also to imagine from my sister’s perspective. They are two people who were given respect, treated as Goddess avatar all their life, and suddenly post marriage become no one. There ought to be a huge mental disturbance here.

Yes, for all the written complains here, I do not want my wife to touch my feet. I am lucky, that my parents are among those few, who want respect and love not from religious gimmick, but through proper family values. I can proudly and boldly write here, that Dr Aditi has not bowed down to touch my feet after we got married, and neither has touched my parents feet. But, yes, we do love each other, and there is a deep understanding, love and respect from her side to my mother and father. what is my relation with my in-laws?. – this needs another post. A hint – it’s a happy one.

PS – happy Nepali new year – 2070 BS