Calcutta Must Shine by Vivek Sengupta.

This article was published in Pragati, The Indian National Interest Review. http://pragati.nationalinterest.in/ This free magazine discusses strategic issues related to India. The articles are often very thought provokimg. This article is from its latest edition. The original artilce can be read here.

Calcutta, it bears repetition, was once the second city of the British Empire. In formal terms, its decline began in1912, when the Raj moved its capital to Delhi. Exactly, a hundred years later, the West has symbolically snapped its last link with the city, with Lufthansa, the only remaining western carrier to service it, announcing the discontinuation of its Calcutta-Frankfurt flight. In 1959, Calcutta became the first Indian destination for Lufthansa, ahead of Delhi and Bombay. In 2006, the German carrier re-asserted its faith in the city by starting a Calcutta-Frankfurt non-stop flight, declaring that the city had been identified as a “high growth area with immense potential.” The potential appears to have been belied. Lufthansa has now said, Goodbye, Calcutta— until market conditions improve. The announcement has come as a huge embarrassment to the new state government of the Trinamool Congress, whose representative, Saugata Roy, is also Minister of State for Urban Development at the
Centre. He was all set to inaugurate, later this year, the state-of-the-art new terminals at the airport, which will increase passenger handling capacity many times. All he could say now was “It is an ominous sign… I really have no answer to the question on what do we do with an airport with much better facilities but not enough passengers.” Ominous sign indeed. Once the business and industrial capital of the country, Calcutta, “filthy, gorgeous”, as the New York Times describes it, continues to suffer from chronic decline. In 1985, a neophyte Prime Minister raised a furore by describing Calcutta as a “dying city.” That appellation has stuck and is often recalled by commentators even three decades later.
Calcutta’s obituary has been written many times since 1912: In 1947, when Independence for India meant the vivisection of Bengal and the loss of Calcutta’s jute growing hinterland to Pakistan; in 1956, when the introduction of the infamous Freight Equalisation Policy caused the loss of comparative advantage for the Ruhr of India; in the 1970s, when widespread labour unrest, spawned by left
militancy, caused deindustrialisation and capital flight; and in the ’80s and ’90s, when the Left Front Government in Bengal focused on rural regeneration through land reforms and panchayati raj, turning a blind eye to Calcutta’s woes and causing an exodus over a period of 20 years of middle-class talent
leading the novelist Amit Chaudhuri to write, “It seems that every Bengali bourgeois’destiny is to be a pravasi”).
But somehow, the city has soldiered on. In Ghalib’s classic phrase, Maut aati hai, par nahi aati. Reports of Calcutta’s death, like those of Mark Twain’s demise, have been greatly exaggerated. The dying city refuses to die. In fact, in the last decade or so, there have been green shoots of revival—the upshot of the Left Front’s efforts to right the wrongs of the past. It focused attention on the long-neglected
city. Calcutta saw the mushrooming of high end housing projects, five-star hotels, glitzy shopping malls and flyovers. Perceptions about the city began to change. One Delhi based columnist, who described himself as “an economic refugee” from Calcutta, wrote: “Dead city walking? It’s a lot more than that.
There’s a business-like buzz about the City of Joy.”

But the buzz has not been enough. While the change has been encouraging in many areas, and impressive in some, the overall picture remains dismal and bleak. The city needs help and urgently and while the new Chief Minister Mamata Banerjee promises to “turn Calcutta into London”, the task is so stupendous and the need so pressing that it seems beyond the state government’s ability to deliver.
Calcutta’s death or resurgence, Lazarus-like, is not a cause for concern only to its denizens.
It is a matter of national importance because the destiny of “India’s original economic powerhouse”, as The Economist describes it in a recent issue, is linked inextricably with the fate of its hinterland, which happens to be the entire Eastern India. Its primacy in its hinterland is unmatched by that of any
other Indian metro: By one estimate, the population of Calcutta is ten times that of Patna, the second biggest city of Eastern India. Calcutta has continued to play the role of the pre-eminent commercial hub for all of Eastern India. The Calcutta Port, the oldest in the country and the only riverine one, services
a vast region of over a dozen states, extending from Eastern Uttar Pradesh (Mayawati’s Purvanchal) to the deepest Northeast, as well as landlocked Nepal and Bhutan. This strategic importance of Calcutta is
only going to increase with increased subregional cooperation in India’s northeastern neighbourhood. The Kunming Initiative, or the Bangladesh, China, India and Myanmar (BCIM) Forum, is a robust Track-ll effort for economic and cultural cooperation between these four countries that are geographically
contiguous and economically complementary. Kunming is the capital of the Yunnan province
of China and the initiative is named after it because it all began with a conference for regional cooperation held in that city in 1999.
The broad goals of the Kunming Initiative are substantially improved regional connectivity for goods and people in the region, through a network of roads, railways and waterways, and establishing the Kunming-Mandalay- Dhaka-Calcutta economic corridor. The Kunming Initiative is a shining example of
Track-ll driving Track-l. The best part of the Kunming Initiative is that it is not an effort to create something that has never been attempted before. Trade ties and overland connectivity in the area had
existed since millennia. The fabled Southern Silk Road existed over 2,000 years ago. More
recently, the legendary Stilwell Road (named after General Stilwell of the United States
Army) was built during World War II to connect Ledo, Assam with Kunming, 1736 kms away, to ferry supplies as part of the Allied war effort. The exigencies of the war also led to the building of a Sino-Indian oil pipeline from Calcutta to Kunming and the use of the famous Hump flight route by innumerable Allied military aircraft to transport supplies from India to Southwestern China over the
eastern Himalayas.
Since 2008, Kunming and Calcutta have been reconnected by air and the flights (taking one hour 51 minutes to cover 1487 kms) are always full. Business, tourism and educational ties between Bengal and Yunnan have been growing steadily, thanks to the efforts of another Track-ll initiative, called the Kolkata
to Kunming (K2K) Forum.
However, China appears to have made more progress than India in developing economic ties with both Myanmar and Bangladesh. India has had serious concerns about the growing Sino-Myanmar entente and, as a response, has ignored naysayers to reach out to the military regime in Yangon. Lately, Sino-Bangladesh ties, too, have shown signs of being on the upswing. Disappointed by News Delhi’s tardiness even in delivering on its own promises, Dhaka is increasingly turning to China for economic assistance
and linkages. Already, China, not India is the biggest investor in Bangladesh. The self-same
China, it has been pointed out by an Indian analyst, that had opposed the liberation of Bangladesh in 1971. Most recently, China has agreed to build a deep sea port for Bangladesh and has responded positively to a request to establish direct connectivity between Bangladesh (Chittagong) and China
(Kunming) through Myanmar.
New Delhi must rise to the occasion and ensure that India does not get left behind in this concerted push for sub-regional integration. The good news is that New Delhi’s ostpolitik or Look East policy has the support of the ighest level of government. Not only that, Prime Minister Manmohan Singh realises the criticality of Calcutta as the gateway to the East (Southwest China and Southeast Asia).
Speaking at the Golden Jubilee celebrations of IIM, Calcutta in August last year, he said, “I sincerely believe that a new sun is rising on our East, and Kolkata can once again regain its glory as India’s window to Asia. One of the greatest Indians who re-discovered India’s Asian identity and Asia’s links with
India was Gurudev Rabindranath Tagore, the first Asian Nobel Laureate and a proud son of Bengal and India. His travels to the East helped India reconnect with its civilisational neighbourhood. The time has come to build on this great civilisational heritage and to pool all our wisdom, knowledge and experience to revitalize West Bengal’s economy, polity and society so as to scale new heights of human endeavour and achievement in the service of the people of West Bengal and India as a whole.”
In one succinct paragraph, Dr. Singh reemphasized India’s links with its “civilisational neighbourhood”, spoke of the need to build on those links, recognised the role of Calcutta as the gateway to the East and stressed how the realisation of its potential would mean revitalisation of not just Bengal but “India as
a whole”.
But here too, as with much else in Dr. Singh’s intent, policy-making and policyimplementation,
in Eliot’s verse, “Between the idea / And the reality / Between the motion / And the act / Falls the shadow.”
He has, for instance, reached out to clasp Sheikh Hasina’s extended hand of friendship, but has been unable to deliver very much beyond that. Last September, he became the first Indian Prime Minister in 12 years to visit Dhaka. It was to be a historic visit. Much was achieved, but there was no agreement
on the two most important and contentious issues: river waters and overland transit. The deal on Teesta waters was torpedoed by Dr. Singh’s UPA ally Mamata Banerjee. Since Dhaka tends to link a deal on river waters with transit rights, India will have to continue to wait for an overland link to the Northeast
through Bangladesh.
Trans-border connectivity and turning Bangladesh into a regional transit hub can transform the economies of both Bangladesh and Eastern India. For instance, trans- Bangladesh connectivity will mean that the distance between Calcutta and Guwahati will go down from the current 1300 km to 587
km and the distance between Agartala and Calcutta will go down from 2000 km to 350 km. Once again, transit through East Bengal would not be a novel development. Even after Partition, until 1965, there was free movement of goods and people across international borders through the then East Pakistan.
If it is agreed that Calcutta must realise its destiny as India’s gateway to the East and the engine and principal driver of economic regeneration in the entire eastern India, it must regain its lost glory as an economic powerhouse. Revival of manufacturing industry in its immediate neighbourhood is a must. The ill-fated Nano project in Singur could have acted as a catalyst, but that was not to be. The new government in West Bengal must identify, facilitate and fast-track several such projects if manufacturing has to be revived in Bengal.
But manufacturing industries have relatively long gestation. Knowledge industries can be put up quickly if their modest requirements of land are met. In this area, the previous Left Front Government had done remarkably good work, which is not adequately acknowledged. Calcutta was the city which housed India’s first computer. Way back in 1956, the Indian Statistical Institute, founded by planning guru PC Mahalanobis, had received a computer called Ural from the USSR. Yet, when computerisation took off in other parts of the country in the 1970s and 80s, the Bengal communists refused to countenance
it. Therefore, fostering an IT industry in Calcutta was not on the Left Front’s agenda in the first few terms of its long 34 year rule. It was only in the mid-Nineties that the Left Front Government took to promoting the IT industry. When it did, it did with a vengeance and provided all support to those who dared to invest in Bengal. The communists went to the extent of declaring IT an essential service to keep the 24/7 operations of the IT companies out of the purview of the all too- frequent bandhs in the city. Soon, the IT industry gathered its own momentum and Calcutta turned into one of the leading IT hubs in the country, acquiring many firsts — the most cost-effective, the fastest growing its own momentum and Calcutta turned into one of the leading IT hubs in the country, acquiring many firsts — the most cost-effective, the fastest growing and the one with the lowest attrition rate.
The new state government must go further than build on this solid base created by its predecessor. It should capitalise on the professional talent generated by the state (much of which now migrates to the other metros) and develop Calcutta as a centre of excellence for IT and other knowledge-based industries. This will not only keep the talent home but also draw back such professionals as had migrated to other states in the earlier decades. Over time, this hub will need additional talent, which can only come if Calcutta and its environs are developed as a centre for higher education in the knowledge
sector.
There is more that Calcutta urgently needs. The city had the first Metro in the country, but that has remained a one-line wonder. It needs a network of lines the way Delhi has. The new airport will soon be ready, but work must be expedited in the proposed deep sea port, off south Bengal. The riverfront is
being developed—in part and in isolation. However, as a recent IIM-Calcutta study has recommended, the river, lovely and yet neglected and abused, needs to be integrated with the city—in terms of the citizens’ mindscape and in terms of connectivity and physical landscape. Ms Banerjee may not ever succeed in turning Calcutta into London, but if these changes are effected with the support of the Centre, she will have succeeded in transforming the city into a global megapolis—to use the famous Nehruvian phrase—“not wholly or in full measure, butvery substantially”.

The Gohna Lake

One of my favourite books in the Corbett canon is the “The Maneating Leopard of Rudraprayag” . I still remember the thrill that went up my spine when I first visited Rudraprayag in 1985 and saw the plaque put up under a tree where the leopard that killed hundreds of people in the twenties was finally killed by Jim Corbett.
On rereading the book recently, I specifically noticed a paragraph and I quote it here in full: "Three days’ journey up the left bank of the Ganges and you have reached the ancient capital of Garhwal, Shreenagar, an historic, religious, and trading centre of considerable importance and of great beauty, nestling in a wide, open valley surrounded by high mountains. It was here, in the year 1805, that the forebears of the Garhwali soldiers who have fought so gallantly in two world wars made their last, and unsuccessful, stand against the Gurkha invaders, and it is a matter of great regret to the people of Garhwal that their ancient city of Shreenagar, together with the palaces of their kings, was swept away, to the last stone, by the bursting of the Gohna Lake dam in 1894. This dam, caused by a landslide in the valley of the Birehi Ganga, a tributary of the Ganges, was 11000 feet wide at the base, 2000 feet wide at the summit, and 900 feet high, and when it burst, ten billion cubic feet of water were released in the short space of six hours. So well (warned/expected) was the bursting of the dam that, though the flood devastated the valley of the Ganges right down to Hardwar and swept away every bridge, only one family was lost, the members of which had returned to the danger-zone after having been forcibly removed from it".

I researched the net and some books that I possess for details of this incident and I think it might be interesting to relate the happenings more than a century ago in a remote Garhwali village.
The Birahi Ganga River meets the Alakananda near the Birahi town, around 7 km distant from Chamoli. A huge landslip which is not uncommon in the Himalayas took place in September 1893, just as the monsoons were drawing to a close. This led to a natural dam across the Birahi Ganga river which was of massive dimensions. The Imperial Gazetter of India Vol 12 recorded that the Gohna lake was “A lake of recent formation situated near the small village of the same name in the Garhwal District of the United Provinces, in 30° 22' N. and 79° 29' E. Towards the end of the rains in 1893 two landslips took place on the right bank of the Birahi Ganga, a tributary of the Alaknanda {see Ganges). The side of a steep hill, towering 4,000 feet above the level of the stream, crashed down into the valley, hurling large blocks of limestone against the opposite cliff to the distance of a mile in places, and forming a dam more than two miles long at the base and one-third of a mile along the top, which completely blocked the valley to a height of 850 to 900 feet. It has been estimated that the dam contained 9 billion cubic feet of dolomite and detritus, weighing 800 million tons.” What happened subsequently has also been recorded: “In December, 1893, the area of the lake was about one square mile and its depth 450 feet. By July, 1894, the lake had become a large sheet of water, nearly 4 miles long and half a mile broad, and the level of the water had risen nearly 170 feet, while percolation was freely taking place. .V month later the water was rising about 4 feet a day, and on the morning of August 25 water began to trickle over the dam,”

The local patwari informed the Government ( the Deputy Commissioner actually) after the incident that a “ mountain had fallen” . The DC ignored this missive as an exaggeration. However the District Executive engineer and the Surveyor who were touring the area investigated the matter and made a detailed report. As a follow up an Army engineer Lt Col, Pulford visited the place and opined that there was no immediate danger, but that sooner or later the dammed waters would overflow the dam and then there would be a huge flood in the valley of the Alakananda. Subsequently, T.H. Holland of the Geological Survey of India undertook the survey of this slide on 2nd March 1894.
There were sharp differences of opinion about what the consequences would actually be, But the Colonel’s recommendations were paid heed to and another Assistant Engineer from the Army, Lt Crookshank was sent to keep watch on the lake and to warn when expecting anything untoward took place. To enable quick information a special telegraph cable was laid up to the dam and observation posts were established at regular intervals from Chamoli town to Hardwar. Pillars were placed to mark what the expected danger levels of water were likely to be and the population was warned to remove themselves to above these levels once the warning was sounded. To quote the Gazetteer again: “In December, 1893, the area of the lake was about one square mile and its depth 450 feet. By July, 1894, the lake had become a large sheet of water, nearly 4 miles long and half a mile broad, and the level of the water had risen nearly 170 feet, while percolation was freely taking place. .V month later the water was rising about 4 feet a day”, The flow of pilgrims to Kedarnath and Badrinath was diverted and all the suspension bridges over the Alakananda were dismantled in anticipation of the flood.
Lt Crookshank warned on the 22 August 1894 that the dam was likely to burst in a couple of days. In the event he was absolutely right as the dam burst with a bang at about midnight of 25-26 august. About 10000 million cubic feet of water poured down the hillside and completely washed away Srinagar as Corbett has recorded. The Gazetteer again : “It was found next day that the level of the lake had fallen 390 feet, leaving a stretch of water 3,900 yards long with an average breadth of 400 yards. The depth near the dam was 300 feet, and the bed had already silted up about 85 feet. Immediately below the dam the flood rose 280
feet, but its height rapidly decreased as the channels of the rivers which
carried it off widened. At Rudraprayag, 51 miles away, the rise was 140 feet; at Beasghat, 99 miles, 88 feet; and at Hardwar, 149 miles, only II or 12 feet. The total damage caused to public property was valued at more than Rs. 95,000, but no lives were lost except those of five persons who insisted on remaining just below the dam. At Hard-war the head-works of the Ganges Canal were slightly damaged, but beyond this point the flood had no appreciable effect.”
Astoundingly only one family was lost in this disaster.
Following this there was still a large lake here about two miles lon and half a mile wide and covered 400 acres. This lake lasted till 20 July 1970 when another Alakananda flood was instrumental in draining the rest of the waters of the lake. Today the bed is a grassy bugiyal , very much favoured by campers.
This flood was reported word wide and even in the backwater of Wellington In New Zealand , the Evening Post published on 28th August, 1894 wrote:
A WHOLE VALLEY FLOODED. I SPECIAL.] (Received August 28, 10 50 a.m.) Calcutta, 27th August. A dam at Lake, Gohna, in Bengal, burst and. a whole valley was flooded. The engineers, however, had foreseen the probability of an accident, and were watching the dam. Timely warning was given, and villagers to the number of 1000 were taken out of harm's way by special trains.

Reporting was no more accurate then than it is now!!

Polio: the beginning of the end?

Polio has been one of the worst infectious diseases that have plagued mankind. It has existed from antiquity; there are drawings of children affected by what must have been polio in Egyptian tombs and there are literary descriptions which suggest that the Roman Emperor, Claudius suffered from polio. The disease was however first clinically described by an English physician Michael Underwood in the eighteenth century, but it took till 1908 before Landsteiner identified the poliovirus as its causative organism. In the first half of this century, repeated outbreaks took place, particularly in the USA, which led to many deaths and incidentally to the development of the ventilator to help treat victims of bulbospinal polio.
We were very familiar with polio in our childhood. One of our friends, who lived in the neighborhood had polio and had to undergo a series of operations in order to correct some deformities that the polio left behind. In later life, he walked with a slight limp, but that never prevented him from, playing all games with us and, in fact, he was an excellent sportsman. Unfortunately many victims were not so lucky. Many died, many others were left crippled. A hospital was set up in Calcutta which dealt only with polio victims, the B C Roy Polio Hospital, where we used to rotate as medical students. The children who had residual lesions after a polio attack were treated here

The first preventive vaccine was discovered by Hilary Koprowski. Later the famous Jonas Salk came up with a vaccine that still bears his name, but these vaccines, which were injectable were superseded by the oral Sabin Vaccine. This last named vaccine has some problems and many pediatricians are virulently opposed to its use in India, but it is by far the most convenient and has been used almost universally ever since.
I was one of the first children in Calcutta to be vaccinated by the Sabin vaccine when it became available in Calcutta in the late fifties. I am told by my mother, that I was one of the first 20 to be given the vaccine at the SSKM hospital where it apparently first became available. Of course, my daughter was vaccinated soon after her birth, but the pulse polio cycles only came by in 1994, so that she did not get those vaccinations.
There have been many famous polio victims. One, of course was Arthur Guyton, of whom I have written in a previous post. There have been many others, but nowadays most experts believe that the most famous of them all, Franklin Roosevelt was not, actually, a polio victim.
It was only in 1988 that the first coordinated effort was mounted to eliminate polio from the world. The Impetus came from the successful eradication of smallpox and the WHO, the Rotary International and the UNICEF joined hands in an attempt to eradicate polio. Initially the progress was rapid. Polio was eliminated from the Americas in 1994, and slowly many parts of the world became polio free. Shamefully India was one of the four countries where it was still endemic.
One reason for this was the asininity of some religious leaders who spread rumours that polio vaccination was an attempt to sterilize their community. These madmen probably immunized their children, but left the poor of the community to suffer from the ravages of polio. This occurred in areas of West Bengal, Bihar and UP. Fortunately other religious leaders were much more enlightened and with the help of Bollywood stars, cricketers and others who acted as brand ambassadors, the Pulse Polio programme slowly pushed down the numbers of polio cases. There were setbacks, for instance in 2009, when there was a sudden surge in numbers. However thanks to the efforts of the public health workers, who battled adversities, idiot media men who criticized them, and so called religious leaders, the last polio case was detected in Howrah in 2011. Today, one year after this, India is now officially polio free.

This is not to say that all is done. There is still a chance that polio will recur, by migration form Pakistan and Afghanistan where it still occurs. A wild polio virus may again create havoc, but if the will that all authorities and participants have shown persist, one can hope that we will have eradicated yet another scourge of humanity.
I find it amazing that this event did not find much space in the media. Certainly it was less discussed than Amitabh Bacchan’s health problems., It is pity that while the media are in the forefront of criticism of the health authorities, workers and the government for their failures, they failed to pay tribute to the thousands of nameless warriors in the Indian health system who led and won the fight against polio.
My heartfelt gratitude to all of them. If I could, I would award a Bharat Ratna to those health workers who made this programme a success.

Calcutta Medical College : 1907

In 1907, the British Medical Journal Published an article entitled: British Medicine in India. It is a long article, but full of interest. I am reproducing a part of it that pertains to the Calcutta Medical College.It gives a vivid picture of the College in that year.

"THE CALCUTTA MEDICAL COLLEGE.
The foundation of the Calcutta Medical College marked
the dawn of a new era. All the knowledge and skill of
the West was thrown freely open to the peoples of India,
without distinction of race or caste. How splendidly the,
seed sown by Lord William Bentinck has grown and
fructified is shown not only by the great development
of the Calcutta College itself, but by the others at Lahore,
Madras, and Bombay, which are, at least in a figurative
sense, its offshoots. At present the establishment of a
similar college at Lucknow is under consideration. No
greater thing was done by Lord William Bentinck for
the promotion of the welfare of the many peoples of the
vast empire under his rule than the foundation of the Calcutta
Medical College, which was his parting gift to India.
Among the first results of its foundation was the abolition
of institutions in which the Vedic and Unani systems
of medicine were taught. A report dated 1839 gives us a
glimpse of the College as it then was. It says: "The
buildings comprised a very spacious and handsome theatre,
capable of containing 500 persons, apartments for the purposes
of practical anatomy, a laboratory, museum, and a
library and hospital." The first Professor of Anatomy was
Dr. H. H. Goodeve, -who was also Professor of Medicine
and Physician to the Hospital. Under his personal supervision
dissections were regularly and systematically introduced.
" Since that period," the report goes on to say,
" this most necessary part of medical education has been
pursued with unremitting zeal by the students, and the
dissecting rooms of the Medical College of Bengal are not
surpassed by similar establishments in -any part of the
world. One of the strongest prejudices of the Hindus
has thus been overcome, and the first and most
important step to a rational system of medicine in the
East has been accomplished." These rooms existed till
about 1895, and Sir Richard Havelock Charles, in an interesting
paper read by him at the annual meeting of the
British Medical Association held at Portsmouth in 1899,
tells us that they " furnished a Fad picture of what in 1839
was considered so very fine." Sir Richard, who not long
ago retired after twenty-five years of service in India, was
Professor of Surgical and Deecriptive Anatomy in the
College, and Surgeon to the hospital attached thereto.
Gifted with the breadth of sympathy which makes a
man's heart thrill in harmony with the "s till cad music
of humanity" through all the deadening obstructions of
race, language, and creed, he gained the confidence of
native students and patients in a very unusual degree. It
has been the good fortune of the College that ever since
its foundation it has had among its teachers, such as
Goodeve, Fayrer, McConnell, and the Mac’namaras (to mention
only men of the past), men distinguished not less
for their sympathy with the people of India than by their
scientific knowledge.
One of the difficulties in the way was the Hindu prejudice
against touching dead bodies. The names of the students of
the first class who broke through the bonds of prejudice
and dared to study anatomy in the book of Nature have
been preserved. They were eleven in number, and all
passed an examination for a diploma in 1838. They had to
work under conditions which might have deterred less
eager students. As the methods of embalming at that
time were very imperfect, the rapid decomposition of
bodies produced by the Indian climate made dissection
peculiarly difficult and revolting. From a report pre-
sented by Sir Richard Havelock Charles to the Indian
Government on his transfer to the Calcutta Medical
College from Lahore in 1894, an idea may be formed
of the conditions under which anatomy had -even
at that time to be studied at Calcutta by Babus. The rooms
were totally inadequate for the accommodation of the students.
"The cutting up of the body as carried out is a loathsome
horror, the rooms are charnel houses, reeking with
a siekening stench.- The only feeling a beginner can have
is,how best to avoid this nightmare and scamp his work."
In 1895 the anatomical department at Calcutta was
rebuilt, and an entirely new order of things was established.
As is the lot of all reformers, Havelock
Charles had to fight against the indifference of a
Government which cared nothing about such things.
But, following the example of the importunate- widow
in the Gospel, he gave those in authority no rest till he
obtained grants for the establishment of proper dissecting
rooms and museums in Lahore as well as, in Calcutta.
The Calcutta anatomical department, which cost about
£10,000, is admirably suited for its purpose. The
dissecting room is a lofty, well-lighted iron and brick
building, covering an area of 9,000 square feet. It has awhite glazed tiles. Round the whole building runs a
gallery floored with the same materials as the main room,
and having a similar dado. In the building are three
tiers of windows-one in the lower portion of the building,
one in the gallery, and one just below the roof. They
are covered with wire gauze, and they can always
be kept open. Besides being aired in this way, the
building is also excellently ventilated at the roof. A
plentiful supply of water is laid on, and the floor and
walls can be flushed with a hose as often as may be
necessary. There are six marble lavatories for the use
of students. Running round the walls are brass rails,
from which hang the plates of Ellis, Wood, and Maclise,
-and Braune's sections, all framed and glazed. The
dissecting tables are of white marble and have white
enamelled iron legs, with arrangements for catching
dripping liquids. Attached to the main dissecting room
is a special one for female students; it is equipped in the
same style. There is also a prosector's room furnished
with all necessary apparatus.
Adjacent to this block is the museum, which has an
area of 3,000 sq. ft. It contains an excellent collection of
wax models, plaster casts, and preparations representing
dissections and sections of every organ and region of the
body. There is a bone room, furnished with a very complete
set of coloured osteology, and plates on the walls.
Lastly, there is a collection of skulls illustrative of the
craniology of Northern India. Opening off the dissecting
room is a yard roofed in with netting to keep off crows
and kites; its floor is made of polished blocks of cement.
In this yard is the embalming room, where there are four
marble tables for the bodies. The lecture room opens on
the dissecting room, and can seat 500. The floor is of
marble, and in the area are marble tables for the display
of subjects during lecture. There are the usual skeleton
screens for lecture diagrams, as well as a large revolving
slate blackboard for drawings in chalks. The room is
lighted from the roof. In short, in place of the clumsy
and ill-ventilated structure of 1835, there are lofty, well lighted,
and thoroughly well-ventilated buildings, fitted
up in accordance with the requirements of modern
scientific teaching.
Anatomical work in India is facilitated by an abundant
supplyof material for dissection. The anatomical class in
1899 numbered 410 students. Every one is required to
dissect the whole body twice before he can get a certificate.
Sir Richard Havelock Charles points out that the anatomy
of the Asiatic has not yet been thoroughly worked out.
Thealhaost uncanny- pliancy of the body of the Asiatic, the
-flexibility of his joints, and the deftness combined with a
strength that seems incongruous in the slender frame
qualities which, the British public has marvelled at in His
Highness the Jam of Nawanagar-would seem a priori to
point to some difference of structure. And in fact Charles
has shown that in many bones and joints the Asiatic
4structure differs from that of the European; he has also
made other observations on the muscles and ligaments.
There is doubtless much more to be discovered in this
-almost untrodden field of research; it is a line of
investigation that cannot fail to be fruitful of results of
high importance, not only to science, but to the growth of
better understanding between ourselves and our Indian
fellow subjects. If Kipling's pessimistic prophecy-
Ob, East is East, and West is West,
And never the twain may meet,
is to be falsified, that desirable consummation, will be
greatly helped by fuller knowledge of the frame of the
Oriental and the peculiarities of its mechanism and
working, and of the conditions-climatic, physical, ethnological,
social, and religious-which make up his heredity
and his environment. As Charles says: "The methods
of the Asiatic are not always understood by the European,
and the manniers of the inhabitants of the West at times
stink in the nostrils of the dwellers in Cathay." It has
been well said Tout contprendre c'est tout pardonner,
and medical science, which deals with the elemental
factors of man's being, is the surest way
to such an understanding as will lead at least
to mutual toleration. Charles concluded his paper with
the following words: " I think it will be admitted that the
money Government has spent upon Lahore and Calcutta
will be in the end amply repaid, not only by the influence
for good that a proper course of practical anatomy always
has on students; but will help, by example, in furthering
the building of laboratories and museums for the various
branches of medical study, as the benefits derived in the
anatomical side become manifest even to those who will
not see." The hope then expressed, which at the time
seemed to those in power too ambitious, has already been
to a large extent fulfilled. The College has now laboratories
of bacteriology and physiology equal to any in
Europe, and a magnificent chemical laboratory. As yet
there is none for pharmacology.
THE HOSPITAL.
Attached to the College is a hospital which must be
distinguished from the General Hospital of Calcutta. The
former is attached to a large medical school; it is intended
for the treatment of native and European patients and for
the instruction of students of all kinds-male, female,
European, and Asiatic. The General Hospital is for the
reception of European sailors and poor white patients.
There are clinical laboratories in connexion with each
ward. A surgical annexe with eighty beds is in process
of construction, and will be completed in about
eighteen months. When the Prince of Wales was in Calcutta
in 1901, notwithstanding the manifold demands on
his time, he insisted on visiting the hospital. His Royal
Highness, who was accompanied by Sir Richard Havelock
Charles, showed a keen and intelligent interest in the institution,
Asking questions about expenditure, and generally
showing his familiarity with hospital administration. So
pleased, indeed, was His Royal Highness with what he
saw that he assigned to the hospital a considerable proportion
of a sum which had been given him to be used for
such purposes. The Prince also- expressed a sympathetic
interest in the medical profession and its work,
His attitude was in sharp contrast with the indifference
in regard to medical affairs and the jealousy of the
profession which run through Indian officialdom from
the lowest ranks to the highest.
Within the walls of the hospital the rules of caste in
which the whole system of native life is swathed, as in
mummy bandages, are suspended. There the high class
Brahmin may be seen performing menial offices for poor
sufferers whom it would be defilement for him to touch
elsewhere. Havelock Charles taught his students that
the hospital was to be regarded as a place, like the Temple
of Juggernaut, where all are equal whilst in its sacred precincts.
It is not surprising that the future Emperor of India
should have taken special interest in a place where was to
be seen so wonderful an example of the power of medicine
to break the bondage of immemorial tradition.
A striking proof of the essential unity of medicine
throughout the ages and under all superficial differences
of race and creed is afforded by a tablet which Sir Richard
Havelock Charles had put up in the entrance hall of the
hospital. It occupies nearly the whole of one wall, and is
inscribed, as may be seen from the reduced copy here
given, with the original texts and English translations of
the great codes of medical ethics, Western and Oriental.
The famous Hippocratic (Unani) oath is still accepted as
embodying the fundamental principles of medical ethics.
The Vedic is fuller, and in some respects, notably in
regard to fees and the doctor's dealings with patients,
it preaches a larger humanity. There is, however, a
curious touch of Oriental despotism in the paragraph
which enjoins that medicines should never be administered
to those who are under the displeasure of the King. The
injunction that persons of exceedingly perverse or wicked
disposition are to be looked upon as not entitled to the
benefits of medicine might perhaps be paralleled in ecclesiastical
ordinances of the Middle Ages, when doctors were
forbidden to continue attendance on patients who allowed
the third day' of a serious illness to pass without confessing
their sins, and in the harshness with which sufferers from
venereal diseases were treated in European hospitals even
in modern days. The injunction that medicines are not
to be administered' to those -who are exceedingly poor
appears to be so much out of harmony with the other
enjoining the doctor not even for his life's sake to extort
the substance of his patients, that one wonders whether it
may not have some esoteric meaning.
It has been suggested that courses of lectures on professional
ethics should- be added to the- medical curriculum.
Would not a Table of the Law placed in every hospital where
it would always be' before the eyes of the students-and of impressing on them the great rules of professional conduct?"
Extracted from BMJ 1907; 1 doi: 10.1136/bmj.1.2421.1245 (Published 25 May 1907)
Interested readers can also see my posts here, here, here and here,.

Ekushe February and the Mother Tongue

Today is the 21st February, celebrated worldwide as the International Mother Tongue day. This day was notified by the General Conference of the United Nations Educational, Scientific and Cultural Organization (UNESCO) in November 1999. It Is a matter of pride for all Bengalis and particularly for the Bangladeshis that this day was designated in recognition of the struggle for their mother tongue that the then East Pakistanis conducted in 1952. The history of this day is not so very well known, even among the Bengalis. It will be instructive to recall the struggle for the Bengali language that took place in 1952.
The foundation for this struggle was laid immediately after Independence which left India divided on the basis of religion into a largely Hindu, but secular India and a largely Muslim, but, now almost forgotten, secular Pakistan. Jinnah, the architect of the partition speaking on the occasion of Independence said “You are free; you are free to go to your temples, you are free to go to your mosques or to any other place or worship in this State of Pakistan. You may belong to any religion or caste or creed that has nothing to do with the business of the State “. Unfortunately it was too late to dismount from the tiger of communalism that he had climbed, and Jinnah was ignored by his audience and he died soon after, perhaps at the shock of getting what he termed a “moth eaten Pakistan”. ( Actually he died of tuberculosis)
The glue of Islam came unstuck as early as November 1947. At a Pakistan Educational Conference held in Karachi, called by , the Bengali Minister of Education Fazlur Rehman , it was decided to drop the use of Bengali in all Government stationary and currency notes. It was also declared that Urdu would be the only National language. This was opposed by the representatives from East Pakistan. However their opinions got short shrift and this led to a mass agitation in East Pakistan.

In the meanwhile the first Constituent Assembly met in the then capital, Karachi in February 1948.it was decided that only Urdu and English would be the languages in which the deliberations would take place. This was backed by the Nawab Of Dhaka, who, one must remember was not a Bengali, but a Urdu speaking feudal lord. He claimed to have read the pulse of the people of East Pakistan, who he claimed, overwhelmingly wanted to have Urdu as the only National language. There was strong opposition by East Bengal members led by Dhirendranath Dutta of Comilla who moved and amendment. However this was lost and Bengali was ousted, as I mentioned earlier from the official documents of the new State.
East Pakistan reacted violently. There was a general strike on March 11, 1848 against this decision. The communal elements lost no time in pointing out that Bengali was championed by a Hindu (Dutta) and this must therefore be a conspiracy by the Hindus against Pakistan. Unfortunately, these arguments cut no ice with the Bengalis, who insisted on getting their due. Repeated strikes and agitations led to the Provincial Assembly adopting a resolution asking the Federal Government ot accept Bengali as one of the national languages. The agitation marred the first visit of Jinnah to the Eastern part of his country as a Governor General and though he stood firm in his stand on Urdu, his speeches only inflamed passions. After his death, the Nawab of Dhaka continued his policies .but in 1952, the movement came to head.

In January 1952, the Constituent Assembly finally proclaimed Urdu as the only national language. In response an all Party Central Language Action Committee was formed and this committee called for a protest ands strike on February 21, 1952. . As the Dhaka University students took out processions to the Assembly building they were fired upon and many were killed. This day has since been celebrated as the Bhasha Andolan Day (Language Agitation Day) .
The movement was successful only in 1956, when the demand was finally accepted and Bengali became one of the official languages of Pakistan. The anti West Pakistan sentiments that were spawned led finally to the division of the country barely 25 years after it came into existence.
The day has been celebrated in East Pakistan and subsequently, Bangladesh with great fervour and the Martyr’s memorial, which came up as temporary structure in 1952 itself and became a permanent memorial in 1963, has been the focus of those paying their respects to the martyrs to the language struggle. The Pakistani Army, in 1971 destroyed this memorial, but it was rebuilt in independent Bangladesh

This struggle was recognized worldwide in 1999 when the UNESCO decided that this day would be celebrated as the Mother Tongue Day. It is a day that we salute those who died defending their language.
There have been many song, poems and writings to commemorate those days, but this song is a popular favourite. We in West Bengal, can only bow in respect to those souls who sacrificed so much for Bengali .
(The pictures are of the agitation in Dhaka In 1948, Dhirendranath Dutta and The Martyr's memorial.)

Arthur Guyton, Physiologist: The Cardiac Surgeon Who Wasn’t

There have been many pioneer cardiac surgeons, but this story is of one who aspired to be one but could not. In our student days Guyton’s Text Book of Medical Physiology was the book we all read. Not so say that we did not read Best and Taylor or Ganong, and Chandi Chatterjee’s book became very popular when the exams drew near, but Guyton was acknowledged to be the King. The text book, still published long after the original author’s death, is probably still popular among students, but the story of this pioneer physiologist’s life which is not so well known is an inspiration to all.
Arthur Clifton Guyton was born in the Southern American state of Mississippi in 1919. His father was the Dean of the Medical School of the University of Mississippi and a well known ENT surgeon. He studied at the Harvard Medical School and began his resident training at the Massachusetts General Hospital. He planned to become a cardiac surgeon and was in the final year of his residency training when he was struck down by polio. This was just a decade before Salk’s vaccine made it possible to prevent this infection. This was the second time that his education was interrupted, earlier; he left his studies to join the Navy during WWII. He was paralysed in his left arm, right leg and both shoulders and had to drop out of his training to repair to a health spa where he stayed for 9 months trying to recover the use of his limbs.
This obviously put paid to his dream of becoming a cardiac surgeon, but he turned his abilities to physiology and became the Head of Physiology at the University of Mississippi. He retired from his position as HOD in 1989, but continued as Professor of Physiology until his death in a tragic automobile accident in 2003 which also killed his wife, Ruth.
Dr Guyton became one of the foremost experts worldwide in cardiovascular physiology. His insistence on using mathematical and engineering methods to quantify physiological models enabled him to throw new light on many facets of cardiovascular physiology and helped to bring about the revolution in cardiology and cardiac surgery in the sixties and seventies. One of his major contributions to the field was the number of famous scientists he trained many of whom headed and founded department of physiology which are now well known.
His abilities were not confined to the laboratory. Even when he was on a wheelchair during his illness, he designed a joystick for this wheelchair which became a standard design afterwards. He used to do all repairs in his house himself using a hoist to lower himself into the basement where he happily set about repairing water pipes and electrical lines. He had ten children, all of whom became doctors, and several became professors. Eight of his children attended the Harvard Medical School , definitely a record of sorts.
His college has built a 191000 square foot, eight storied building to house the Arthur C Guyton Research centre at a cost of $60 million to perpetuate his memory.

One story related by one of his students illustrates how he bravely overcame his disability to become one of the finest scientists of his day. “ Elvin Smith, one of Dr Guyton’s students, who later became chair of physiology and executive vice president of the medical school at Texas A&M, tells a story about the time Dr Guyton took him and other members of the department to attend a banquet at which Dr Guyton and Eudora Welty (who won a Pulitzer Prize for fiction among many other honors) received the first Outstanding Mississippian Award. After the ceremony, the students were standing next to Dr Guyton as he was being congratulated. One of the ladies in the line stopped to talk to Elvin and to Jack Crowell, a faculty member and former student, and asked “Isn’t it amazing what Dr Guyton has accomplished with his handicaps?” With little hesitation, Jack looked up and said, “Yes ma’am, it sure is amazing, and Elvin and I are two of his biggest handicaps.” Those of us who worked with Dr. Guyton never thought of him as handicapped. We were too busy trying to keep up with him. “ ( John D Hall)

Perhaps the dedication of his famous textbook says it all : “To My Father for his uncompromising principles that guided my life; My Mother for leading her children into intellectual pursuits; My Wife for her magnificent devotion to her family; My Children for making everything worthwhile.”

Should We Avoid Over Experienced Surgeons?

An important article was published in the British Medical Journal on the 10th January. Authored by a group of French surgeons (the Cathay Group), this study examined the association between surgeons’ experience and their complication rates. In other words they wanted to gather some scientific evidence to prove or disprove the contention that the more experienced the surgeon, the less likely he is to have complications.It can be read here.
To do this, they used the specific instance of thyroid surgery. This form of surgery has not substantially changed for several decades and it is associated with specific complications which can be fairly easily defined. These are, of course, injury to the laryngeal nerve and damage to the parathyroid glands both of which are dreaded complications after thyroid surgery.
The study analysed 3574 thyroid operations done by 28 surgeons over a period of one year. They then used sophisticated statistical tools to examine the relation between the rate of complications and the experience of the surgeon. They tried to eliminate bias that might be caused because, for instance, experienced surgeons operation only on more complicated cases.
The results were not entirely unexpected. It has already been reported that major cardiac surgery done by surgeons more than 20 years in the profession have poorer results that those done by their younger colleagues. This was found to be true in the present study as well. 20 years or more of practice was fund to be associated with a significantly larger probability of complications. Thus the skill levels of surgeons seem to increase over the years, reach a plateau at the 10-20 year practice level and then decrease subsequently. The authors have opined that even very skilled surgeons need to mentally and technically renew themselves if they are to maintain performances over long periods.
This study reminds me of another article that I had read in the New Yorker late last year. Atul Gawande, the Indian born surgeon who has written many superb books chronicling his surgical experiences, was the author of this piece. Here he describes his experience of employing a coach to improve his skill levels as a surgeon. He rightly points out that if great tennis players need coaches to tell them where they are going wrong, there is no reason to believe that surgeons would not be benefited by having a coach who would observe them in action in the operating room and point out to them faults, which might be minor in themselves, but can make the difference between an uncomplicated surgery and a surgical disaster. Dr Gawande used one of his teachers to come in and examine his techniques and found that he had a lot to contribute to improving his skills. The article can be read here.
It seems sacrilegious to the surgical estab;lishment that we could have somebody looking over our shoulders as we operate who would then tell experienced surgeons what he did wrong, but there is no denying that the idea that needs dispassionate discussion and perhaps implementation. This could perhaps overcome the 20 year decline that the authors of the first study have demonstrated!