Thread: I tweeted about Ekalavya & this Assistant Prof Savitribai Phule Pune University tweeted the reply below.
So let me tell you my own experience. I think 1st person accounts are important.
Disclaimer: I am not a savarna nor am I a Dalit. Honestly, I don't know my caste ++
I grew up in Mumbai in 70-80s studied medicine at G S Medical College (KEM Hospital). Proudly got in there with "merit". Reservations & caste really did not impinge on my life except occasionally when savarna classmates said I had "wasted" a seat by not taking admission++
under OBC category. I didn't much pay attention to it Had many savarna friends. I do remember a group of seniors referring to students who had come in through reservations as "bhangis" & laughing. To me this was all irrelevant. Didn't bother me at all. I had some great +++
Brahmin friends who are friends to this day. After graduating, I left for UK in 1991. In the meanwhile I fell in love, got married ( irrelevant that she was born a Brahmin). Our families never had a problem. We decided to return to India in 2000. India tugged our hearts +++
I settled in Pune & started practice. That's when I first started noticing how frequently caste came up in conversation here. But in our own cocoon, this did not really impact me. One of my wife's relative who was a Dr in Konkan said there are not psychiatrists there +++
& convinced me to start going there once a fortnight on weekends. It was fun, I enjoy Konkan & it's people! Over time we both fell in love with the place & around 10 yrs ago decided to buy a small plot in a nearby tourist town to build a holiday home..+++
Everyone, especially my father-in-law was enthusiastic about the idea. He offered to do the land hunting. That's when the problem started. He would find a local agent, find a plot & we would go to see the property. Almost always owners would ask my surname, then ask his +++
look at us quizzically. One asked me my 'gotra'. I didn't even know what that was! My FIL just would make some excuses & we would leave. One agent finally said listen the only way you will get the land is if you buy it on your father-in-law's name. He's a proper Brahmin +++
My wife & I both detested the idea & refused. Over the next 2-3 yrs I also stopped visiting there to see patients on weekends. I could not being myself to make these long journeys on the weekends. My heart was no longer in it +++
So what is the point of telling this story? First, this has not at all impacted my life negatively. I have had all the opportunities without being impacted by caste.
However...
1. I learnt that caste is structural. How highly educated or how much financial resources one has is immaterial. 2. The fact that one has helped a local population does not mean they will ignore caste. One sympathetic landowner even said, look I don't mind selling +++
you the land, but I have young daughters to marry & I cannot take the risk. 3. This happens not only in small towns 200-300 Kms from Mumbai, but also in Pune. When I was helping draft 🇮🇳 mental health legislation in 2013 , one savarna friend would derisively call me Ambedkar ++
and laugh about it. Again, fool that I am, I never understood this until someone quietly told me what was happening. 4. I had experienced racism in UK - who hasn't - it did not affect my career. I worked with a wonderful Scottish origin prof from Jamaica who treated me +++
like a son & gave me the best work opportunities. I still have many white friends in UK.
Ironically, it was one of reasons to return home. Wanted to live in a place where I would not be discriminated for who I was. Caste is India's equivalent of UK's racism. 5. This isn't +++
about individuals, but about systems & societies.
I haven't experienced even 1% of what Dalits & Bahujans have to experience. I have seen the quiet nods & winks, referring to someone as category walle, to finish off their chances +++
Everyone does this in front of me, bcoz they assume I am a savarna (I am so educated & I am married to one) & are comfortable displaying their bigotry.
I have many wonderful savarna friends who are not casteist at all. +++
However, I am not sure they are aware of the huge impact it has on Dalit lives.
These are structural problems. Merit is a mirage, accumulated caste privilege of many centuries.
Caste is alive, well & kicking in 2021. END.
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Thread: This is a long thread about my wife's grand-father: Vinayak Apte.
Born, brought up & lived in Pune. Aptewada, Sadashiv Peth. Qualified as an engineer in 1920s or so. Married around same time.
I promise you this is worth reading, so settle down with your cup of tea....1/n
Around 1921, young Vinayak writes to Mahatma Gandhi expressing his desire to join Bapu & work for freedom struggle.
Bapu writes back saying sending money for the ticket (₹5) & get your backside up here (not exactly these words, but you know what I mean!).
Bapu adds a PS...2/n
"If you change your mind, please return the ₹5 by money order to Sabarmati Ashram" Typical Bapu, you might say! Careful with money.
Vinayak quits his job & decides to go to Sabarmati. Entire extended Apte clan is horrified. Joining that fakir? Giving up your job? Ostracised.
I find ppl have difficulty understanding #evidencebasedmedicine (EBM) & how Science works.
EBM doesn't try to "prove" anything but is focused on REFUTATION. Let's say u have a new medicine which you believe works better than previous medicine/no medicine. Thats your theory...1/n
#EBM sets out to refute this theory. Hence all trials start with a null hypothesis: New Treatment A is no better than placebo/treatment B.
You then use statistics to find out whether the difference between the two was likely to happen by chance. P < 0.05 only means that...2/n
there is less than 5% chance that the difference (if any) between the 2 treatments was likely to be due to chance, & is a real difference.
In this case, you reject the a priori Null hypothesis ( that there is no difference between 2 treatments) You accept...3/n
THREAD: for academics & researchers wanting to influence policy makers. Mostly India specific advice. Based on my reading & experience of doing this stuff for > decade now.
At the end, I have also given a link to a very useful Nature paper on this subject
So let's begin..1/n
Rule 1: Policy makers are smart people, smarter than researchers/academics/clinicians. In most countries, its harder to become a senior civil servant than get admission to medical college or a proffesorship. Don't be fooled by the dumb look. That's training. So respect them..2/n
Rule 2: Civil servants/policy makers are busy people. If you do not get their attention in the first 5 min, you are never going to make it. So have a very sharp & effective "elevator pitch" ready before you step into their office. I practice in front of the mirror...3/n
THREAD on patient confidentiality bcoz I am asked questions repeatedly. Read this & please stop tagging me on your tweets. My mentions can't cope! These are my opinions so please feel free to ignore! 1. Does confidentiality apply to counsellors/psychologists?
Ans: Yes ...1/n
2. Does confidentiality apply after death?
Ans: I am not aware of any precedent in Indian case law, but see box below. MPS is a malpractice insurance provider to Drs. Last point in Box suggests it does apply after death too. See this link for details ..2/n medicalprotection.org/southafrica/ad…
3. What about "public interest" in the box above? That can be grounds for breaking confidentiality?
Ans: Yes. Even the Mental Healthcare Act makes this an exception to break confidentiality. However what is public interest is open to interpretation...3/n
THREAD on Medical Students #suicides
There are 78333 medical seats across India. Considering a 6 yr course & accounting for recent seat increases, there are ~450,000 students in medical schools at any given time. Dandona et al using GBD data estimated suicide rate...1/n
for Indian 20-24 & 25-29 yr olds btwn 27-33 per 100k. For ease of calculation let's take a middle rate of 30/100k. Most medical students in this age group. Assuming med students suicide rate is same as general population, India has ~ 135 medical students dying by suicide/yr..2/n
Remember India has 78,333 medical seats in 549 med schools which is an average of 142 seats/med school. So each year, we lose approximately 1 medical school's yearly intake to #Suicides
The human cost & suffering is unmeasurable. The financial cost we can estimate..3/n
THREAD: Troubled by many media reports & SM conversations where depression + mental health issues are assumed to be only causes of #suicide
Of course, we need conversations on #Mentalhealth & depression is associated with suicide. Why am I then bothered by this? Read on..1/n
In the West, studies show that ~ 80% of suicides have depression as a predisposing cause. Also in West, suicides peak is mostly older ppl (>60 yrs) + male:ratio is ~ 4: 1.
However India's suicide epidemology is different. In India, only ~50% have some mental illness...2/n
Also our peak suicides are in age group of 18-39 yrs + male:female ratio is ~ 1.5:1. So a lot of young Indian women dying of suicides.1 out of 3 women dying of suicide 🌍 are Indian. For women in this age group, suicides is No 1 cause of death, ahead of maternal mortality..3/n