Flag musings

We celebrate 62 years of Independence as a nation today. 62 years since the British formally handed over control of India, and (almost all) got onto their ships and left.

From childhood when I heard the word "August 15th" I would immediately think of the national flag - our tri-colour with the 24 spoked wheel of Ashoka in the centre.

We are a nation which uses its flag somewhat sparingly. A stringent flag law has in the past meant that only on the most public of occasions. For most of us it was the small flag hoistings on the mornings of Independence day and its patriotic twin - Republic day when we celebrate the founding of the constitutional Republic that our nation became on the 26th of January 1950. It has only been in the last decade, after a high profile court case by a young industrialist which gave official sanction for common citizens to use the national flag.

Contrast this to two countries which where I have spent some time and which are awash in flags. One doesn't exist anymore. The 'German Democratic Republic' has slipped, largely unlamented, into the shadows of history. Its shabby buildings were festooned with the red, black and gold tricolour on which was affixed the hammer and protractor and wheat of the Marxist party. As a boy, visiting my grandparents who lived there - not allowed by their socialist utopia to leave the country - I was always struck by how much the flag was waved.

The other nation of flag wavers is of course that colossus of a nation - the United States of America. My first college - marooned in the middle of the flat midwestern corn-fields - had the head-quarters of a medium sized corporate opposite its main gate. The owners of this company had chosen to erect a gigantic flag pole - towering at least 4 floors up into the sky from which a flag the size of a sail from by-gone men-of-wars flapped. I was soon to realize that the venerable stars and stripes would be draped on what seemed any and everything - from ice-cream bars to car dealerships (for some reason especially there) as well anything remotely saleable. In addition, the national flag was displayed prominently in most churches (along with something called the 'Christian Flag' - which conveniently had the same red-blue-white colour scheme). And then there were the innumerable applications small and large on articles of clothing, jewelry, and various belongings. In short a flag-saturated place.

This mornings' celebration was a melancholy one. A few folks gathered in our housing complex around a flag pole where the tri-colour was unfurled. A few patriotic songs, a speech or two. The national anthem sung by a few voices. Looking at the rag-tag gathering dispersing - many wearing the hankerchiefs that are de riguer in our swine-flu season - it seems hardly possible that during the British Raj people died in police firings when nationalists defiantly unfurled the flag.

The price of freedom is perhaps seen in the apathy of the next generation(s). Our comforts and freedoms are usually forgetful of the valour and sacrifices of those who have gone before.

As we lurch towards what is likely to be a massive national famine, we seem to have only few things to celebrate as a country. One of them, however, is the news that last year more baby girls were born than boys in Delhi state. Millions of girls are selectively aborted in our country before birth, thanks to the ability to detect gender before birth and the strong desire that so many have to have a son. Some of the worst gender ratios are in fact recorded in the richest states of India - Punjab and Haryana - which is why the fact that last calendar year Delhi recorded 1004 girls born to every 1000 boys is so encouraging. It is now illegal to find out the gender of a child before birth - but despite a law banning medical practitioners from sharing this information - there is plenty of anecdotal evidence that it still happens. Laws do have their effects though - even if imperfectly executed - as the data on births in Delhi seems to show. The odds are still stacked against the girls who are being born - the 2008 birth cohort (which the news celebrates) will continue to face many challenges as these girls grow up into womanhood.

How does one symbolize a billion plus people? Flags may have their limitations - the nation-state may be a recent invention - patriotism may be the last refuge for scoundrels according to some, but considering things, our tricolour has done a pretty good job.

This melancholy day, as another raft of clouds flies high above us without dropping rain, and as the schools in the 16 million plus greater Mumbai area remain closed due to fears of flu, my thoughts and prayers go out to our nation of India. The Bible tells us that we are to pray for our rulers and those in authority. How often do I really do this? I am so grateful for the freedoms that we enjoy - the largely free press - the 15 successive national elections which have seen many peaceful transfers of power between different parties - the rule of law and the rise of industry and commerce. I am grateful to God for melding such a vast expanse of peoples into one national governance and stand amazed at the very fact that we continue to function as a nation - despite generations of nay-sayers. Now for us to live up to the God-given potential that we are blessed so richly with. To see justice and righteousness flows like rivers. To see every citizen live out their life in a rich and harmonious way.

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P.S. We Eichers celebrate Independence day with great pomp and circumstance for another very good reason - today is Stefan (of Reflection Art fame and now 'Stefan Uncle' to the Thane Eichers)'s birthday! Below the card that Asha and Enoch made (part of a tryptich to welcome Mum and Dad to our home as they arrived here this morning at 4 AM):

Dog tired

The picture says it all. One of our many happy hounds - skinny as a rake - the bane of the urban Indian street - taking a nap.

The slightly crushed 'Ambassador' car - once the symbol of having made it in life (still held on to by the odd politician who has not yet moved up into a Scorpio) provides the shade.

Its a picture of where we are. Dog tired. Bone-deep. When I sit down I inevitably find my eyes drooping. As I write this at the Mumbai 'early hour' of 10.45 PM our whole house is silent by for the rustle of the fans in each room. The kitchen light is the only one on - forming a silent duet with the muted light of the laptop screen as I key away.

Last night we got onto a local train at 10.12 PM at Sion station - and the general compartment was absolutely crammed full. Who are all these people commuting after 10 PM at night? It will be 11.30 at least before they get home. How crazy 'modern life' in the city is...

The dogs outside are silent tonight. Maybe they are asleep? There was a time when their kith and kin were tasty treats for visiting leopards from the National Park we are next to. But we have not heard of any leopard sightings recently.

Ah yes - the yelp of a couple of mongrel hounds to tell us that they are still here.

And now to the blissful sweetness of slumber. That beautiful gift from God - sleep.

As the good Book says "...for he grants sleep to those he loves." Ps. 127.2b

Maximum city - in fear

Nevil Shute's book 'On the Beach' remains to me a classic dystopia. The world has just had a nuclear war - and Australia is basically all that is left. Folks are trying to live their normal lives, but it is clear that things will never be the same. There is no way out, and no happy ending as petrol dries up and (if I remember correctly) the book closes with one of the main characters committing suicide after driving her car to the beach, watching the sun go down.

Mumbai 2009 is of course nowhere near this. But it is fascinating to see a partial shut-down due to the fear of Swine Flu.

Last night Sheba got a call from the school stating that the classes will be cancelled till Monday - even though Thursday was the first day of the latest unit tests.

The municipality has apparently stated that no-one is to go to movies or malls or schools. All are to be shut it seems.

Taking advantage of the unexpected holiday we went into town today. About 10% of people wore some kind of mask. Most were hankerchiefs. I am reminded of how we used to play 'cowboys and indians' as kids - the mask made by the hankerchief was key to our dressing up.

The question that went through my head was this: how does a person decide when to do what? When is it 'safe' to go out? To travel by local train (like we did as a family) tightly packed in with fellow commuters? When should we be wearing a hankerchief on our faces? when a surgical mask (about 1 in 30 was wearing one of them)? And how long will people keep wearing these? When the reports about deaths in the papers dissappear? How long does the public fear things like swine-flu?

What about bird-flu? I got late night SMS messages telling me not to eat chicken then. The prices of chicken crashed - as did eggs. No such luck now - we are in a global food price rise.

And SARS? Papers talked about how people were going to stop shaking hands - but would rather start shaking elbows in an attempt to reduce contagion. Have not seen an article on SARS for months.

Swine flu season it is though. There was a clear thinning in the streets today - but of course not everything shut down - most folks were still going about the gritty business of living. The sandwich wallahs were peddling their wares, the policemen were stopping motor-cyclists as is their wont, the watchmen were sitting bored at their posts, the sweepers and urchins continued to live on the streets.

Most of all, the papers continue to prominently high-light stories of loss. One of them had a shot of a totally 'moon-suited' family hugging each other in tears as the news of their loved one having died of H1N1 flu had just been broken to them.

Fear strikes pretty deep. Not deep enough to keep people fully off the streets - life had to continue in the city that never sleeps - in the city that runs after fame and the big buck over everything else. Mumbai will continue to pump its staccato heart-beat out come hell or high-water.

But scratch the surface and the shiny facade dissappears. Behind the 'bindaas' attitude there is a lot of brittleness. For every couple we see on the streets, locked in earnest conversation as the crowds swirl around them, we see so many families years later in utter relational meltdown as Bollywood dreams dry up in the harsh stream of day to day life together. Most families - if we really take a good look - are pretty miserable places - the outward razzmatazz of being India's money and cultural capital only shabbily hiding the haggard relationships that each family hides from their neighbours.

Swine flu has a least temporarily punctured the vastly self-satisfied bubble that most Mumbaikars blow around themselves. It has made people more aware of their own finiteness - of the effervescent nature of reality around them.

The fear that is evident in the city has its roots in deeper stuff. It speaks of the hubris and arrogance that lies in a city where the crushing poverty of so many is light-heartedly flipped aside for escapist fare and where newspapers think nothing about having their reporters cover restaurants serving meals costing more than the average salary of the watchman at their doors.

When something unexpected shows up - something which mocks our sense of control and self-assurance we have to sit up and listen.

Many moons ago, a regurgitated prophet showed up at a proud and ruthless city called Nineveh. His half-heartedly delivered warning of destruction was unexpectedly heeded by the cruel inhabitants of that great evil city - and God accepted their cries for forgiveness. Would that something similar would happen for our Maximum City of Mumbai.

The family - this month

Amazingly, we will be coming up to 10 years of marriage at the end of this year. How time has run by. Flown by. Streamed by like the billions of photons from our local star, flying out into space.

As I write Asha is practicing her violin. Sheba - after seeing a number of patients in the morning and working with the staff in the afternoon and then cooking dinner is reading a book - in between fielding phone-calls from concerned parents about the swine flu (she is Asha's PTA class representative) and home-work. Enoch was looking over my shoulder 2 minutes ago - but has run off to look at his lego toys.

We are coming to the end of the day. Another day lived together. It is not always smooth sailing, but the what a blessing to live this common life. Or should it be this uncommon life.

(photo by Bobby Zachariah - thanks Bobby!)

Out of your mind

Mental illness continues to be one of those things that it just is not polite to talk about.

Consider this extreme experience that the sister of Lata - one of our JSK staff - is going through. "Vishranti" (as we will call her) got married a few years ago, and soon found out to her horror that the man she had been married off to already had a wife and family.

Vishranti tried to stick it out (not having any option since her widowed mother and angry brother did not want her back) - but just couldn't handle the beatings that she got and slipped into a deep depression.

That set up the background for progressively worse behaviour all around - with Vishranti being physically attacked by the villagers of her mother's village who pounded her on her head, causing severe bleeding - since they did not want 'a mad-woman' living with them. The villagers had repeatedly called the police 'to take her away.' As village policemen are wont to do - they came around to the hut, threatening, seeking hinting bribes from Lata's illiterate mother who was sheltering Vishranti, but eventually not 'taking her away.' Village 'justice' then stepped in as the mob caught Vishranti and beat her mercilessly.

Lata's mother took Vishranti to a local psychiatric hospital. Vishranti was put under heavy sedation and given deep shocks.

One afternoon - overcome with sorrow - Vishranti's mother started to tell the treating Doctor about the suffering that her daughter had gone through.

The doctor listened briefly then took his notebook, and hit the mother in the face! Hard! He picked it up again and hit her again. And again. Using his notebook as a weapon. The old woman dissolved in tears and ran outside.

So much for a compassionate medical care in the mental health field. The man sounds like he needs institutionalising himself, rather than providing mental health care to others. When we asked Lata why the doctor did this, she said that he told her mother that she was not supposed to be talking about the patient in the presence of the patient. Surely there are other ways of expressing this point?

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We are in the process of arranging for Lata to accompany her mother and sister for a full evaluation and therapy at the Christian Medical College, Vellore. It is pitiful to have to send this broken little family half-way across India to get compassionate Chrstian care for mental illness - esp. since we have 16 million odd people in the greater Mumbai area.

I am so grateful for Dr. Marjorie Foyle who was able to diagnose my mother with bi-polar disorder (called manic-depression at that time) in the early 1980s. I remember Dad taking Mum up to Lucknow for 2 weeks when I was in grade school - not knowing why at the time - but later learning she had gone to Noor Manzil. Since then Mum has been on a maintance therapy based on lithium which has been a tremendous boon to us as a family. In exchange for her daily adherence to the meds, I was given the benefit of a stable mother who was there for us and poured herself into us - and many others. Though the journey has not been easy for her, Mum has been able to help many others who have struggled with depression - having known 'from the inside' what it is like. We are very proud of our courageous and giving Mum!

There are no easy answers in mental illness. But there are answers - especially if we take them together. In the past 2 weeks we have suggested 2 other people with long-term seemingly intractable situations explore therapy with the kind doctors of CMCH Vellore. It is not by accident that we have stumbled across this small node of people needing help. And it is a great honour to be part of the healing process. We know that true healing will not just come from taking a pill. We know that we need to include family, prayer, positive steps forward... But we are also very grateful for the various medications that have and continue to be important portions of the healing process.

In the mean-time there remain a vast number of people who continue to suffer the shame of mental illness. This hidden epidemic remains largely out of sight - and out of mind.

Graveyard shift

Two men with HIV haunt one of our local grave-yards.

OK. We don't have many grave-yards. This is really a crematorium. And the men are not 'haunting' it as phantoms of any sort.

We know both of them.

One of the men - we will call him Manoj - works at the crematorium. For a man whose body is being stripped of its immunity it must a nasty reminder to see the dead come and be burned.

Writing about a plague epidemic in which he himself was burning with fever, John Donne heard the bells announcing another death - and realised that it could very well be his own. Having survived he penned these immortal lines: Any man's death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee.

The other man. We will call him Tarun.

He is fed up with life. He is tired of HIV.

He hangs around the crematorium to get away from it all.

Manoj and Tarun know each other and have tried to drink their sorrows away.

Manoj has stopped his ART and TB medications. He had been stabilised at a hospice in Panchgani, and started on these medications, but found them too hard to take.

Manoj came to the clinic today with his wife. He was sick. Sheba diagnosed a pneumonia. We prescribed the necessary antibiotics and hope to see them back on Monday.

We had heard that the two men had given up and had decided to drink themselves to death. Booze may be poison - but it doesn't always work. In the detritus of their lives these two men are still alive. Our staff team had met Manoj recently, and he had prayed a simple prayer.

We remain in active hope for Tarun as well. Trying to encourage him. Its not easy. There are no magic buttons to push. But lots and lots of opportunities to cry out to God.

There is hope as long as people have breath.

Even if they work in a crematorium. Or hang around one.

Hot Haze

For the past 5 Fridays in a row - one of our kids has been sick. Enoch, Asha, Enoch, Enoch and Asha. Interestingly enough we have a Bible study on Friday nights - something that the kids look forward to attending.

This weekend Asha started with a fever. She had it all through our JSK Next Steps Review. While we were planning for in-patient care, we had a sick little one at home. Mercifully we are just next door to our work, so we were able to shift some of the meetings to our home.

Just as Asha's fever began subsiding, Enoch woke up with a fever on Sunday morning. We were due to speak at the Living Waters Community Church in Mulund and have lunch at Peter and Daisy Chettiar's home afterwards. A quick call at 7 AM told Peter that we would not be able to come as a family. Yours truly had to go alone to the fellowship and share. It was a grace-filled time, though hard for me since I knew that Sheba and the kids were at home.

On Monday it was my turn. By the end of the day I was feeling distinctly hot and feverish. The toll of the past few days of planning and the run up to it had taken their pound of flesh. The thermometer confirmed that my good old body was cooking at 100 degrees Farenheit (we are metric in everything other than fever temperatures).

Tuesday was spent working from home. I had to get out a draft of the report on the consultation. Somehow I typed away, increasingly losing focus. The hot haze that a low-grade fever is crowding in on my attention. Nothing earth-shattering, but at the same time disorientatingly unsettling. The slight headache being accompanied by the odd twinges of minor pains across the body, the general feeling of tired giddiness and a nausea that has sent the odd probing finger in. At the end of the day I gave in and sent off what I had - half baked and half done to our collaborators - the product mirroring my mental state.

The next day was a combination of drifting in and out of awakeness. More headache. Much love and concern by Sheba and our two able junior nurses Asha and Enoch. Trying to put a happy smile on things. Frustrated to be in bed. Grateful, ever-so-grateful though for love recieved, prayers offered, the opportunity for rest. Last year we had attended a seminar where Stanley Nelson said: "if you don't take a holiday, God will force you to have one - in a hospital bed.' The truth of that - and the luxury of being looked after by my amazing wife - was very real to me.

As I write this I have been afebrile now for half a day.

What a luxury to be well.

Yesterday's newspaper headlines blared news of the first known H1N1 ("Swine-Flu") death in India.

It was a young girl in Pune. No known contact with anyone who had been abroad. Possibly picked up from a clinic she had gone to for primary treatment for her cough/cold. Over the last month we have had multiple exposures to folks from abroad. At least 7 people in direct contact. If we look into second-degree contacts it would skyrocket.

Having said that everyday with health is a blessing. Though not as deadly as many flu varieties, H1N1 has been spreading so rapidly around the world that the UK govt. has basically admitted that it cannot contain it anymore - and will now merely try to treat new cases. The WHO says that H1N1 is 'unstoppable.' With a case fatality rate of 0.45% it means that 45 out of every 10,000 infected will die. That is still serious, but nothing like the influenza outbreaks of the past such as the 1918 'Spanish flu' outbreak which may have killed between 50-100 million people.

An then there are our dear friends with impaired immunities. In the run-up to helping us decide about the next steps for Jeevan Sahara Kendra, we did a survey where we asked our HIV positive friends about their health in the previous month and previous 3 years.

The figures are sobering. Though a majority of our friends are now taking Anti-Retroviral Therapy, we are still dealing with a group of people who are very sick.

A full 1/3 reported having a fever in the last month. One in three of our friends went through what I did, and that too just in the last month. And the month before? Another 1 in 3. And before that? It is most likely, that another 1 in 3 will have experienced a fever.

We asked about 'long-term' illnesses. 42% of our Positive Friends reported having fever episodes for over a month in the last 3 years. I was febrile for just over 2 days and feel drained. I cannot even imagine a month of fever. And yet that is the reality of what a person with HIV is going through.

Fever is a warning sign. A picture of what goes on within.

As I rejoin work tomorrow I do so with a renewed determination to live out my life for the purpose God has called me to. This small exposure I have had to fever in the family and in me is a reminder of the hidden epidemic we are working with - a secret depletion of immunity from the disease that dare not speak its name.

Statistics only mean something when they bite. I am thankful for this small slice of reality that I have experienced. The hot haze was in no way pleasant, but then far far lighter than so much of what the average HIV positive friend of ours goes through.

Onward.