Sunday, March 16, 2014

Weather Forecast and Nepali Healthcare

Radio was our access to the larger world. In the silence of the night when crickets were chirping, in the dull sunny day punctuated by shouting of someone ploughing the fields using oxen driven ploughs, in the evenings when the sun started hiding behind the hill splashing gold in the horizon, or in the mornings on a clear day when mountains at distance glowed in glory, radio ruled. For us kids, music was the lure but we had to endure the news that the older ones prioritised. At the porch, we assembled around the radio. The news from "Radio Nepal" had a fixed format. At the end came the weather. They would quote the "Department of Hydrology and Meteorology" (DHM) and provide weather forecast for different regions of Nepal. Had you asked us kids at that time, we would have recited you the exact sequences of the regions they would forecast. But we would have told you that if the forecast predicted rains, it was almost a guarantee that there would be a sunshine. As I recall, it was hardly ever accurate. We trusted more our elders looking at the sky and predicting based on clouds than our trusted radio for the weather forecast. But the ritual continued unabated. It even continues to date.

How did this ritual come into place and why does it endure despite dismal track record of outcomes?

When I first went to North America, I was surprised by how much weather was common in social conversation. At the end of an interview someone would say, "tomorrow is going to be beautiful, you may want to explore the area." People planned their recreation based on weather forecasts, made sure that they had shovel in their cars if there was a prediction of snow in the evening. The weather forecasts were quite accurate. It was a completely different culture compared to what I was used to. We hardly ever planned things taking weather into account. In summers we were always ready with our rice seeds. We waited for the rain and when it poured down, we ran to our fields. Agrarian life was simple: it revolved around the crops and the activities dictated by whims of the weather. There was no point in planning out things but being prepared to comply with the dictates of the weather.

What must have transpired when the Nepali government decided to adopt the practice of forecasting weather back in 1962? Did someone who had learned about modern governance say, "we need this component of modern governance?" Or, perhaps, they looked at departments established in Indian government and say we need this too. Maybe foreign donors suggested establishing it.

How must they have first started the services? Did they get experts from outside who were used to doing this work regularly? Did they send personnel overseas to get the training? What kind of technologies they must have first imported? Were the initial weather forecasts accurate? Regardless, we know that in the nearly half a century of this exercise, the DHM's weather forecast has not been able to gather people's trust. These days, if we need any information on weather, we would rather turn on our Yahoo weather app than tune into Radio Nepal. Despite its futility and irrelevance DHM's persistence continues unperturbed.

It was an introduction of a new technology to a society where there was no real demand. Over the years it has degenerated to irrelevance. The outcomes are dismal. The whole process is now a bizarre exercise far away from the intent. The weather forecasts' such failure might be benign, but we have adopted many other technologies where the failures are not at all benign.

We lost 18 lives recently to an airplane accident in western Nepal. It is dizzying if we look at our aviation accident data. Every single year since 2010, we have had plane crash taking away lives (See here: 2010, 2011, 2012, 2013, 2014). And this is out of just about 20-30 events in the whole world (that includes incidents as well, not all crashes). European Union has blacklisted Nepali airlines and banned them from flying in Euro zone. Yet, our shamelessness and complacence is unperturbed. We have adopted technology but mixed ruthless incompetency to the operational process. The result is devastating. I doubt the folks running Nepal's aviation industry have any inkling of insight.

This same risky adoption of technology is rampant in medical field that I am part of. In Nepali market-place you can find all the fancy new developments in global medical technology. For some of the medications which required crossing some hoops in North America, you find them here without much trouble. It is very easy to spot a neurosurgeon or for that matter any "specialist" in any field . A single person will claim himself to be an internist, gastroenterologist and endocrinologist without any structured training. With zero (0) fully-trained endocrinologist, a government institution runs an endocrinology fellowship. These poorly-trained "specialists" equipped with scopes, scalpels, injections and drugs experiment on lives; groping in the dark, unsupervised, unaware of how those trades/skills are supposed to be actually used. Unfortunately, there is no bang and fire of airplane crash in these nonchalances. Just voiceless and silent lost lives, sufferings, and hardships. Those who are so eager to adopt things that they don't have much idea about argue that it is a transition for the sake of future. But, in their recklessness, what they should realise is that poorly adopted technologies or authorities (in certain specialised skills) have grave consequences in medical field. Just like aviation industry, Nepali medical field has a lot of soul-searching in order. It is already a terrifying territory now. 

Wednesday, March 5, 2014

Arundhati Roy

"The things I've needed to say directly, I've said already. Now I feel like I would be repeating myself with different details," says Arundhati Roy in an article in NYT piece on her. I dearly hope and wish that Ms. Roy is not swayed away from the details by the apparent reiteration. We will be deprived of unparalleled clear narratives that has come with great personal risks to Ms. Roy, as the article makes it quite obvious.

"Titillating," is the word I attribute to the feelings her fiction "God of Small Things," had incited when I first read the book. The softness of her language cuddled a story that was not so kind. The woman so tender to her story has not been very delicate in her diagnoses of social ills ravaging India and in some cases the world. In the process, she has been a target, an outcast. Speaking truth to the power is a risky venture in these shores. The reactions tend to be visceral, personal, and defiant of logic and reasoning. But I hope we will continue to hear from Ms. Roy.