UgandAshis 52 The hawk swoops

UgandAshis 52

August 23, 2009

The hawk swoops

The balcony view of this house is great. Just in front of my house is a swamp and a half wild plot of land. It must be teeming with life as hawk, egrets and the ibis all vie to be present there. Just now I had a hunch a hawk had seen a snack. Indeed he landed and about two minutes later he/she took off with a 75 centimeter snake dangling from its claws. Must be a munchy feed for its youngsters.

Rainy season has really started and when it rains it pours down in buckets. It explains why this land is so green and has so many lakes, ponds, rivulets etcetera. Planned to start August 15th it started the 15th. Spot on time.

In the mean time my parents are arriving tonight. And tomorrow I shall surprise them with a barbeque for about 20 of my friends. Somali, Iranian, Baha’i, Ugandan, Congolese and Dutch will be eating side by side. As it is Ramadan the barbeque will start after sundown and not to late as three young girls will be running around. Like Lonneke and Nard I am sure my parents will love the country and the people and after so many years they will finally be able to go and do some proper safaris.

In either a Toyota super custom or a land cruiser we will be off on Tuesday where I take on a multitude of new tasks (next blog) and they will be hopping around from volcanic crater lake to chimpanzee park to botanical garden visiting my different employers, meeting my friends, seeing the patients, watching the bees hum and enjoy the view of Ruwenzori mountains.

The next week professor Ekke, Lynnea, Yogi, Bruno, Emmanuel, Ismail and my parents will be staying at the mansion. It is starting to become a real community. Around the corner is my favorite neighborhood restaurant where we will have Ethiopian coffee and enjerra with the crowd of people.

Our garden is delivering massive quantities of fruits and vegetable. Today we harvested a bunch of matooke (plantain), a jack fruit and saw that the tomatoes are getting there. The hamerkop (http://en.wikipedia.org/wiki/Hammerkop) agrees the strategy and just now flew off. It is time to plant some more trees in the garden and flowers. I am aiming to see the majestic sunbird (http://en.wikipedia.org/wiki/Sunbird) in and out of the garden. Just as in the garden in Fort Portal.
A message for all you birders out there. Uganda is the place to be twitching your heart out. Even those of us who are less inclined to our feathered friends Uganda is the place where you do become interested in ornithology. It is not for nothing Uganda has these phenomenal birds out there to be admired by all of us (http://en.wikipedia.org/wiki/Marabou & http://en.wikipedia.org/wiki/Grey_Crowned_Crane) Oops I am off my parents shall be landing in about 1 hour and 15 minutes. Stroopwafels are on the way!

Namaskar,

Ashis Brahma

UgandAshis 51 Coming and going

UgandAshis 51

August 22, 2009

Coming and going

Over the last weeks and months a steady flow of visitors is coming and going. Dr Nard was one of the first to come and after 5 weeks his girlfriend Lonneke joined us for another three weeks. To shake Nard out of the Western cocoon on his first night I took him to some of the more rough bars in town. It was a memorable night where a culture shock could clearly be felt. After some days we travelled to Fort Portal to see the different institutions I worked at. With his every friendliness and remarkable easy going colleague students and patients warmed up to him rapidly. Even if looking back perhaps the so yearned for clinical hands on experience was not as much as hoped for working in such a different environment with lack of resources (simple dentistry tools and basic medication), a different level of theoretical knowledge and practice made a huge impact.

As I hoped for the Ugandan experience led to promises of future visits –with or without the Smile Train an NGO that send teams out to operate and educate how to operate on children with a cleft palate. This is one of the big motivators for him to start training in surgery of everything between the eyebrows and the clavicles to quote him. Besides the medical side of the story we had a blast. From ‘War craft’ to ‘Marabou Squatting Team’ to ‘Spotted Francolin’ to ‘Gorillas’ to ‘BBQ and wine’ to ‘LINK buses’ I am blessed to have had him here for 8 weeks.

The last three weeks of the journey Lonneke joined us and they had an amazing trip around the country with safaris in ‘Queen Elizabeth’, ‘Bwindi’, Murchison’s Fall and a rafting adventure on the Nile near Jinja. Beginner’s luck or not they saw: chameleons, lions, leopards, giraffe, elephants, long crested eagles, spotted francolins, the crown crane, alligators, hippos, rhinos, kobs, water buffalo, green mamba, green velvet monkey, baboons yet Nard missed out on the yellow warbler. Lakes, savannah, mountains, volcano, rivers Uganda has it all.

Yet beyond all the countries beauty what really matters here are the great people. The flaming chicken of the Persian Boyz had become their second home in Kampala. When they left a host of people queued up and one after the other they had beautiful gifts for the new friends. A sheesha was an amazing gift and given the pleasure with which they both smoke sheesha it must get a central place in their new home in Utrecht.

Luckily we will meet again in one month when I visit the Netherlands. Some things Nard and Lonneke have in Uganda; new friends, a medical library, the chicken/sheesha joint of the planet, opportunity to do well, to learn and enjoy.

At one moment when everything that was arranged seemed to be a hoax – some friends stepped up and I am sure the trip was one not to forget.

Namaskar,

Ashis Brahma

UgandAshis 50 Fort Portal jazz

UgandAshis 50

August 14, 2009

Fort Portal jazz

Over the last weeks I have been talking more and more with professor Ecke about the public health school. For its 4 years a lot has been achieved and a lot more needs to be done. There is a team of about 9 lecturers who all have another full time job to assure proper income. Institutional memory is in the mind of the staff and is not available on paper. As I write this we are one week away from starting a long distance course yet a lot of the teaching material is not yet ready.

Coming in as a foreigner and imposing your way of working without considering the local customs and culture obviously will not work and at the same time some of the western mindset is required to assure a proper learning environment for the students. I shall give an example; to streamline the lectures and modules it is of utmost importance all the lecturers come together to discuss their individual preparation of the topics, avoiding repetition and assuring gaps are minimal. Aiming for common methodology and use of materials yet calling a meeting where all show up is near impossible given the prior responsibilities of other jobs.

It is easy to criticize yet to remain constructive is much more difficult. I did not come to Uganda assuming I know everything better. As much as I learn on a day to day basis there are things I can contribute at the same time. And how do you contribute to a teaching module when you receive the goals and objectives of the module after asking for them for 4 weeks? One can say that things arrange themselves in Africa yet for the quality of preparation of lectures it is of the utmost importance that there is clarity in what is required.

What I am doing is what I love doing – teaching and the topics are near to my heart; culture and health and control of communicable diseases in the first semester. With the help of professor Ecke and the local doctors and lecturers I am sure I will have a blast while lecturing.

The house I am staying in right now in Fort Portal is the base for 4 muzungus helping the university to move forward. It is never to be underestimated how much the university as a whole and the public health department in specific has achieved. It is at the same time a state of mind to wish the courses get better and more elaborated. Eventually the university is aiming for different health science related courses as well as well as a master’s level course.

To achieve all those reachable goals there has to be a strengthening of the way we work. A do-able job and one that at the same time is a process that will need to take place over the next days, weeks, months and year to come.

Namaskar,

Ashis Brahma

UgandAshis 49 Fort Portal blues

UgandAshis 49

August 14, 2009

Fort Portal blues

Zuco 103 is playing in the background and I am reflecting on the day. It started with a ward round on the pediatric ward. One of my patients is a 7 year old girl with chronic osteomyelitis (bone infection) of the right leg. Often we have to ask patients to go to the pharmacy to buy drugs. I never realized that we have run out of canulas (to give i.v. drugs with). Therefore the patient’s family members have to go and buy it. The mother of the child was crying – and as I asked why she told me that she did not have the required 1000 shilling ($0.5) to buy the canula. Clearly I slipped the nurse a banknote so the young child could start her intravenous antibiotic treatment. The girl however has a poor prognosis as the treatment is at least 4 weeks in the hospital and the mother has to hustle for food for the two of them.

Another child has a similar problem. He is crying and shouting while complaining of severe abdominal pain. To rule out some of the possible causes we asked for some lab work to be done. As I returned the next day I realized that the sickle cell test had not been done. To do this test you require a certain chemical which is cheap yet is not available at the hospital. The discussion I had with one of the laboratory technicians was frustrating. He was narrating a story of chronic under supply of many chemicals and supplies. When I then asked him if I could do a blood film myself he became very defensive. It was not really possible unless I would come the next afternoon. In the mean time the patient is not responding to all the different drugs we are giving.

Still in the ward we have an 8 year old girl who had meningitis and is currently suffering from the neurological deficits that have remained after the infection. She has a lack of appetite, cannot swallow properly and is too weak to sit up. Another baby was admitted with failure to thrive, oral thrush and a chest infection. The baby is 1.5 months old and her mother is HIV positive. It is likely the young baby has HIV as well. A large proportion of our patients has malaria with vomiting, convulsions and anemia.

One of the most remarkable things about the pediatric ward is to see how fast children can rebound from potentially lethal disease. With over 100 admissions per week there are 1-3 deaths per week which is a very low number given the late presentation and the severity of the majority of the patients. Every day I visit the ward I learn and aim to teach as much as I can the clinical officers, nurses and young doctors that join me on the ward round. As my colleague is out to a training the work is mine to do and I Love it.

Namaskar,
Ashis Brahma

UgandAshis 48 Online teaching

UgandAshis 48

August 13, 2009

Online teaching

E-learning or long distance learning is high up on the agenda of Mountains of the Moon University. It is to expand the number of students and to respond to a group of students who cannot come to Fort Portal for all the lectures yet wish to do training in Public Health. It was a good day today as I flipped through a DVD to find that the Oxford book of Public Health was available on it. Preparing lectures has become easier. There were also several other books available to prepare lectures with.
Then during dinner all of a sudden an idea came to find. As the online students are not in classes why not record the lectures of all the lecturers and deliver them either by CD or by pod cast format. In this way all lectures of the public health courses can be made an available at any given time and students can revisit a class as well. In an ideal world power point presentations should be added to the curriculum but it seems that many of the lecturers have difficulties creating them.

It will be about 2 weeks more before classes start and I am starting to find more and more material to start classes with. It also helps that I am staying in a house right now with several of the lecturers of different courses of the University. Remember that a proper access to Internet is lacking and that the library for the medical faculty is very limited. Students here are asked to rote learn, are read to from a text book and questions are seldom asked. I heard today we have at least 50 candidates in the first year. It is another 12 days before the first years start and the second and third years will be starting in 5 days.

Professor Ekke and I are hoping to start with several lectures we will do together. I am much looking forward to it. The lectures will be recorded and posted online so eventually all that are interested can see what is happening at MoM University. We also discussed the role that medical students from the USA and Europe could play in the development of the University over the next years. At first we may aim at several knowledge, attitude, practice and behavior studies of the indigenous tribes as to know which direction our future research should take.

In the mornings I go to the hospital to do some rounds and in the afternoon I return to prepare my lectures. The dogs and my lovely house are a good reason to return to Kampala and first I will have Lonneke and Nard come and visit me in Fort Portal. Right now they are enjoying the mighty park of Queen Elizabeth. What a pleasure it was just to drive through the park. And as my parents will be visiting from August 23 I hope to get in another visit to a nature camp.

Namaskar,
Ashis Brahma

UgandAshis 47 Golden monkeys

UgandAshis 47

August 13, 2009

Golden monkeys

The king of the monkeys meets his match. After a two hour climb up the mountains though bamboo forest we find a troop of golden monkeys. Their skin radiates in the sun and as they chew on the leaves we get to look at this habituated group. After about half an hour I end up watching one eye to eye from a distance of about 2 meters. I see in the eyes of this adorable creature peace. He is munching away at his leaves assuring the youngsters in the troop are safe and that the tourists get a good opportunity to take photos a plenty.

The park is one of the smaller wild parks in Uganda and lies on the border with Congo and Rwanda. Three volcanoes are home to wide range of mammals, birds and reptiles. Nard and I have declared to be big fans of chameleons so everywhere we go we look for this well hidden reptile. He climbs trees to find the colorful reptile as I lie in the grass to check out the bushes from my hide out.

Being half monkeys ourselves we managed to yet one of our fellow visitors irate. He was focusing on making photos of the monkeys and did not appreciate our jokes driving the monkeys away according to him. Our theory however is that his bad vibes made the golden monkey disappear all the time. Yet he did make some good photos and we pray we will receive them by e-mail. Great new world.

To help us find the monkeys a morning crew of park guards has gone up to track the monkeys so the tourist can find them easily. Some of the camp guards know a lot on flora and fauna in the park. As far as I can see on the map Uganda has 11 nature parks and having seen three I am sure I want to see the other 8 as well. Each nature park has been so different so far and it gives a longing to see more.

One of the sad things about the nature park is that the original inhabitants of the park, the Batwa (pygmies) have been booted out of their cave home in 1990. As compensation they received homes and lands outside of the park. Yet not being used to houses led them to sell for a very low price to the local population. As it is today several of the families live a homeless existence. Unfortunately the same thing has happened in Bwindi Park. Not for everybody the setting up of a nature park has been a big success. Yet it seems to fall in a tradition in the world where the hunter gather lifestyle is having a hard time to remain on this planet.

One day we will look back and see we have preserved certain groups of monkeys and that the humans that used to live in those areas have disappeared.

Namaskar,
Ashis Brahma

UgandAshis 46 A long journey

UgandAshis 46

August 9, 2009

A long journey

A nine hour drive from Kampala through Mbarara, Kisooro led us to the Rwandan-Congolese-Ugandan border. The park is known for a group of mountain gorillas and several groups of the Golden Monkeys. Once again this country surprises with a variety of natural beauty. Towards the end of the end of the journey we have seen the African eagle, long horn cattle in Muyankole land, impala and the yellow warbler.

The stretch of highway from Kampala to Mbarara is the most deadly road in Uganda. Potholes pop up every 100 meters and the driving of the average driver can be called reckless. Our driver Gad is a well experienced one and luckily so as we are pushed off the road on one or two occasions. The further we drive to the South West the more breath taking our view becomes. The road’s tarmac has disappeared and the last 60 kilometer takes us a long time as the road winds its way up and down through the mountains. We can see volcanoes, rain forest and soaring eagles in the air.

On the road I am reading Dian Fossey’s book: ‘Gorilla’s in the mist’. Most people have heard of the movie with Sigourney Weaver in the lead role. The story is about the region. Although she worked in Congo originally with the war lord’s and the increase of violence she eventually had to flee to Uganda. Her work had to be restarted in Rwanda where she encountered a lot of activity of poachers. Today one of the major sources of income for the three countries in this region is gorilla tourism. There are less than 500 mountain gorillas to be found in the world and all in this region and the neighboring Bwindi national park.

Dian Fossey’s object of study, the gorilla’s eventually where poached and killed. To satisfy the need of certain zoos around the world gorilla babies were captured. Gorillas however protect their youngsters to death so capturing one baby gorilla can easily lead to the death of 10 adult gorillas. It is horrifying but true. Dian Fossey’s live also ended in drama – it is not clear who killed her – but she was killed after having studied her gorilla groups for over 15 years.

Back to the journey I can only say one thing about Uganda – what a magnificent country. From savannah to rainforest to mountain range to hill land, lakes to river land. All is available here. It is not for nothing that one of the highest densities of plants and animals in the world are found in this country. Draped across the equator ancient forest is the home of the varied flora and fauna.

If you have the chance; come and visit this country. As far as the safari goes I have a feeling it is better than Kenya. And if you love birds you cannot miss out. Chameleon lovers – fly in straight away – chameleons are a plenty.

Namaskar,
Ashis Brahma

UgandAshis 45 Three birds

UgandAshis 45

August 6, 2009

Three birds

As I came home yesterday three brown ibises were perched on my roof. I stopped and admired these flying creatures. No bird can top the marabou and yet this one gives it a run for its money. Their conversation felt like the muppet show’s old grumpy men. Haa haa haa aaa – aaa haa haa haa. In Uganda it is whispered that these majestic birds can put children to sleep with their loud yet remarkable sounds.
While observing it was as if one of the birds wanted to fly off while the other two wished to remain longer. Finally after a long discussion – 15 minutes – with decreasing daylight they flew off to their nesting place.

My home in Kansanga also has a kite swooping near the balcony and then a bit further off are the marabous. The birds are in my mind as Bob Marley just sang his ‘Three little birds’ on the computer. Often I have patience for slow Internet connection – these last days however – I have lost it.

Trying to send an e-mail to interested people about my forthcoming tour has been a near impossibility. Let us forget downloading power point presentation or articles on the two topics I will be teaching classes on starting August 17th. Culture and health is class 1 and class 2 is control of communicable diseases. Over the last weeks I have been plodding along to make sure I have some information on a power point format so the long distance students can also learn along.

It seems so easy – Internet is a world-wide phenomena yet proper broad band does not really exist in Uganda. Yesterday’s newspaper did not make matters better. As parliament reviewed the budgets they were astonished to see that the cost of extending the cable that runs under the ocean is three times as high as in Rwanda despite the equivalence in distance to Mombasa. The following was decided as long as the costs are not clarified the budget will not be cleared. This leads to a delay in Internet connectivity.

The digital divide is clear and evident. One of the current things PGHF and its volunteers are doing currently is making video interviews with people who are making a difference in Uganda. There is a website on hold in the USA because uploading information is such a hard pain in the neck.

Complaining does not add to suffering – it can however explain to people why simple things on the World Wide Web are just not simple.

On a high note this time tomorrow we are off to Kisooro and eventually Rwanda to see gorilla’s. It feels like a good time to take a break. A lot of good things have happened over the last months and it is time to appreciate the beautiful nature and landscapes of Uganda. Now things are settling I can plan more trips around this phenomenal country. Beware I may be able to upload some nice photos.

Namaskar,
Ashis Brahma

UgandAshis 44 Bruno and Yogi

UgandAshis 44

August 2, 2009

Kampala, Uganda

Bruno and Yogi

The two mixed Belgian-German shepherds are growing like crazy. Even Bruno is turning into a chubby potato. Of the two Bruno is the one that is more active and who loves to bite all day while Yogi is mellower and also much bigger than his brother. Thanks to the hard work of Nard and Ismail they now have a doghouse to call home. It is labeled as the Yogi house with lotus flowers and on the back of the house is a label of secret society called the Marabou Squatting Team and an L.Y.S.I.A.S. emblem.

The two of them play all through the garden and it is a joy to observe the canines. After about 2 months Amir will come back to Uganda and Yogi will have to get used to being the only canine in the house. As always Nard and I are very busy to find him a Marabou friend. We have offered up to 60.000 shilling and have sent several squads of MST members out to collect the golden Marabou egg. Yet so far we can use some help in our quests.

As to the other animals in and around our compound there are the ever present kites; yesterday one swooped down and caught a rat. After due consultation we were assured that our dogs are too big to catch. Then there are the ever present frogs which have Nard enthralled. To date I cannot understand why and I know that Nard does a victory dance after seeing them. Anecdotal historical evidence shows that there are snakes in the garden, small and to make it dramatically poisonous.

Bruno and Yogi in the mean time rule supreme, adored by all, peeing everywhere, nosing around. Yes these two remarkable fellows are indeed brilliant. They give the house a feeling of a home.

Talking about homes given the fact that I spent about 4 days a week in Fort Portal nowadays I am bound to find myself a nice place there. As it is there are some accommodations for guest lecturers and I shall sign up for them the next time I come. It seems the Internet is ok there so I will give it a shot. Another advantage is that there are great people living there as Prof. Ecke. He invited me to a 2 day walk to the area of the Bakonzo, a tribe of small sturdy people living near the Ruwenzori Mountains. It is a beautiful area and there may be a lot of traditional healing taking place there.

The Bakonzo are also isolated from mainstream Uganda so it will be great to get to know some of the people working there. I was told that at one time in history the hospital was working very well with expatriate doctors but that currently the hospital is out of drugs a lot. If we forge links and connections there we may be able to help.

Namaskar,

Ashis

UgandAshis 42 Newspaper Clippings

UgandAshis 42

August 2, 2009

Kampala, Uganda

Newspaper clippings

Man steals bag from muzungu (white person) and gets 5 years prison versus police high ranking officer steals 175 million shilling ($80.000) from the pension funds of his staff getting 4 years. Talk about class injustice. In the first case the judge reasoned that the thief may bring a bad name to Uganda abroad and therefore must be punished severely. The police officer well...it is as it is.

There is an ongoing discussion in the newspaper about the benefit of the 1.5 bonus scheme on application for females introduced in 1990 at Makerere University for public sponsorship to assure higher percentage of enrollment. From 1990 to today the percentage has shot up from 25 to 49%. However girls still lag in mathematics and science, yet dominate arts courses. (If I recall correctly 80% of the first year law students are females). Critics talk about the discrimination against boys. Positive discrimination or affirmative action has always been scrutinized. Yet on the basic level when a family has 4 girls and 3 boys (Ugandans fertility rate lies at 6.9) and cash is lacking it will be the boys sent to school and the girls kept home. Girls have many more hurdles to jump from primary education onwards to even have a fair chance at education.

The issue of Bunyoro is getting front page coverage. The issue is about the oil rich region which for decades has had influx (migration) of many tribes so much that the original inhabitants (Bunyoro) are now a minority. President Museveni after long deliberation has now come with a report recommending all leadership position in the region to be secured for Bunyoro tribe members. Uganda has 64 recognized tribes (3rd schedule of the Constitution February 1, 1926) and the country is slowly being divided in more and more districts (from less than 20 in 1986 to over 100 today). Intertribal tension in certain districts is on the rise, especially in resource rich or resource poor areas. The report has inflamed the migrants to Bunyoro as they claim it is their constitutional right to be represented as Ugandans where they live by their own candidates.

Elections for 2011: the scene is heating up as the opposition seems to be uniting with as one of their main attempts to propose one presidential candidate for all parties. Also they want to highlight the failed promises of the NRM (National Resistance Movement), the greed and corruption by those in power since 1986.

Kampala lies in the heart of the Buganda kingdom. For years it has function as the seat of both the kingdom as well as Uganda’s parliament. Of late there has been a move to wrest away Kampala from the kabaka (king of Buganda) and make expansions to Kampala City Council. This has lead to tensions between the parliament of the Buganda and the central government. Currently the Buganda parliament is raising a petition hoping to get 1 million signatures.

Namaskar,

Ashis

UgandAshis 41 Exams

UgandAshis 41

July 29, 2009

Fort Portal, Uganda

Exams

Trembling hands, stuttering candidates, patients that escape and marabou’s that disturb the silence. It has been a hectic three days. One hundred and forty candidates in our department have been reviewed. Twenty minutes for a long case (one patient: history taking, physical examination, laboratory and treatment) and fifteen minutes for a short case (any question goes)

The great thing about taking exams of a long list of clinical officers (about 70 so far) is that you get to review the entire history taking process, physical examination and differential diagnostic thinking yourself. Some candidates are confused or nervous and some shine. After a long day of exams questions as: “What is the seat of the soul?” rise. These questions are to the general bewilderment of the candidates.

There is a very serious side to the exams as well. Unlike medical students who after qualifying after 5 years of study need to be supervised for at least a year the clinical officers will be in charge of a health center without close supervision.

That means that the first criteria to judge are: “Is the candidate a risk to the population at general? “ Then we look at the relative strength of the candidate as compared to the others, a mediocre, good or excellent candidate. After that the two doctors discuss what their score of the candidate is.

Some of the students have spent their three years reading their books and rarely came down to the wards. It shows during the exams. Others are so good they present the cases with confidence without reading their clerked notes and that is a pleasure to experience.

Once again reviewing over 50 patients it becomes clear that HIV/AIDS and malaria are major issues in Fort Portal. Despite a government program supported by the international community patients are still without their antiretroviral drugs and essential anti-malarial drugs are often missing.

Our students were examined in a pediatrics, surgery, obstetrics, medicine and public health. This is a healthy and extensive mix of the different disciplines of mother medicine. Friday their exams are over and I know there will be some heavy partying.

As soon as their results are out those that have passed their final exams are off to their respective new posts all over the country. This is a good reason for me to visit them wherever they are and to see more of this beautiful country. I think that at least 130 out of 140 will pass their practical exams. Congratulations to all of them. Tomorrow morning 8 exams remain. A piece of cake and at last rest for our patients, some of them have been clerked by over 6 students. It was also the reason some of our patients ran away from the hospital.

Namaskar,

Ashis

ugandAshis 39 Medical Apartheid

UgandAshis 39

July 27, 2009

Fort Portal, Uganda

Medical Apartheid.

In the LINK to Fort Portal today I read 200 pages of Harriet A. Washington’s book Medical Apartheid: The dark history of medical experimentation on black Americans from colonial times to the present. (ISBN 978-0-7679-1547-2 and www.medicalapartheid.com) It is a lively book and after coming off the bus (reading with my headlamp as the bus had left 2 hours late) I was affected by its wealth of information and calm description of a long history of mistreatment of groups of people. In a way it reminds me of the book ‘Mismeasure of man’ by Stephen Jay Gould. It is sad to see how the powerful position that medical professionals have can be used against entire population groups.

Here are some topics the book addresses:
1. Imaginary black diseases as drapetomania (insane tendency to fleeing slavery), hebetude (laziness leading to mishandling the owners property), dysthesia Aethiopica (desire to destroy slave owners property), struma Africana (so called African TB), cachexia Africana (eating clay, earth, dust)

2. Polygenism or the belief in separately evolved species

3. Dr James Marion Sims who experimented on seventeen female slaves with genito-vesicular fistula without anesthesia despite it being available in the 1830’s to the 1840’s

4. The circus Africanus (showing a pygmy in the Bronx Zoo together with a gorilla and a orangutan and the St. Louis world exhibition as late as 1906 and 1910
)
5. The institutional grave robbing and body snatching for decades for the medical schools (1770-1973)

6. The Tuskagee Study where between 1932 and 1972 at least 399 were told they would be treated for syphilis but in fact where given no treatment to follow up their progress of disease

7. Mississippi appendectomy, an unnecessary surgical procedure leading to uterus amputation (and defacto sterilization) on healthy black and/or mentally challenged women. This was done on thousands of women in the USA until the seventies.

8. Injection of plutonium-239 to unknowing patients to test the most dangerous chemical we know. Done from 1945-1994 by the U.S. Atomic Energy Commission.

It makes me think about how medicine can be used to keep a certain power construct in place. Keep the people barefoot, knocked up and ill. It is a way to control people. Sad thing is that as we speak today vulnerable groups are being used for large scale experiments, testing new drugs in Africa and Asia (remember the Constant Gardener). I cannot wait to complete this book and just wanted to share a tip of the iceberg of problems this book addresses.

Namaskar,

Ashis