Professional Documents
Culture Documents
Editor : Dr. Ranen Dasgupta, Vol. 2, Issue - 2, October - December, 2014, DL No. 175, Dt. 21.8.2012, Price - Rs. 10/- only
Editorial
Gratitude to Bill Gates - Milenda Gates Foundation for
their contribution towards Global Public Health
BILL GATES
MILENDA GATES
ERADICATION OF MALARIA
THROUGH COOPERATION
Rabindranath Tagore
(Presidential address before Anti-Malarial Society,
August 1923 Calcutta)
Translated by Dikshit Sinha
At the outset, let me tell you how I met Dr. Gopal
Chandra Chattopadhyay1 during this work. However,
I myself am not a physician and the opinion that I
have about malaria is of little value. You are all aware
that we have an institution called Visva-Bharati; as
part of its work, we are trying to keep contact with the
surrounding villages of Santiniketan. It is true that in
the ashram we are mainly engaged in cultivation of
knowledge but it has always been my view that if
education, school, and colleges are separated from
Contd. to page 2
The history of malaria contains a good lesson for humanity. We should be more scientific in our
habits of thought & more practical in our habits of government.
Sir Ronald Ross
Recently, Nobel Peace Prize (2014) was awarded to an unknown Indian Kaliash Satyarthi, who devoted his
40 years of life to save children through Bachpan Bachao Andolan, along with Malala Yousafzai, who is the
leading spokesperson for girls right to education. Thus, the rights of the children in this world have been
internationally recognized. Mortality among children due to mosquito borne diseases, Ebola etc. is enormous.
But, right to health for children and pregnant women, especially, is not a priority, in practical sense.
Almost 40 percent of the population of India (about 1.52 billion) consists of children who are below the age
of 18 years. India has no dearth of money to build a 182 meter statue of an architect of united India at the cost of
Rs. 3000 crores but is neglecting public health at the cost of promoting corporate health.
Us Philanthropist Bill Gates has announced he will donate over $500 million to fight malaria and other
infectious diseases in the developing world, saying the Ebola outbreak is a call to action. Bill Gates also said that
in addition to that pledge, his foundation has boosted its annual funding for malaria by 3% (AFP, The Times of
India, 4.11.14)
25 Crore Indians are in great peril due to mosquito-borne diseases. Gujarat (Industrial Capital), Mumbai
(Financial Capital), Delhi (National Capital), Kolkata (Cultural Capital), Bengalaru (IT Capital) are plagued with
mosquito borne diseases the dreaded terrorist to public health. But there is no serious pro-active actions from
corporate NGOs and Governments, corporations.
Once Singapore and Cuba were mosquito ravaged but they defeated the mosquito terror and gained
international acclaim due to best public health service. They prefer health over petty politics.
India, is yet to understand that Health is wealth, Mosquito-borne diseases should not be taken casually,
when Ebola can hit India like U.K. & USA and devastate the whole economy as a bolt from the blue and thus
shattering Indias dream to be a global superpower by 2020. Will Govt. of India listen?
Ranen Dasgupta
ranendasgupta@yahoo.in
General Secretary
Sir Ronald Ross Memorial Centre, Kolkata
Malaria has been known over centuries as a killer, not only in the Far East. In Western Europe it was
variously know as the ague (UK), the sweating sickness (commonly everywhere), paludisme (France) and so on.
I have little knowledge of traditional Indian or Chinese medicine, but I am sure they have specific names for the
same condition. Western Medicine confines its nomenclature of the disease to the symptoms it causes. Ague
was the term used in the Essex marshes and the Fenlands of England. It describes a disease of aches and
sweating with general debilitation, and was almost always associated with low-lying marshy ground and standing
water. The Sweating sickness is obviously descriptive of the symptoms, while the French name, paludisme,
literally means a disease associated with the marshes (after the Latin palus = marsh). The one thing none of
these names does is to make any mention of its cause by, or even association with, insects.
This is perhaps hardly surprising. In England by the mid 1800s, medicine had hardly progressed far beyond
the Hippocratic (Hippocrates of Kos (c. 460 c. 370 BCE), considered the Father of Western medicine) view of
medicine, isonomia, the preponderance of one of the 4 bodily humours - yellow bile, black bile, phlegm and
blood with their associated elements and seasons (yellow bile: fire and Summer; black bile: earth and Autumn;
phlegm; water and Winter; blood: air and Spring). While such ideas arose from speculation rather than
experimentation, observation played a large part. The human internal structures were known primarily through
analogy with animals, inferences from visible external structures, from natural philosophy and function. While
such ideas may seem extraordinary now, they were a great improvement of what preceded them, sacrifices and
the supernatural! However, miracles, sacred magic and the influence of the Church were still practiced in
Europe until their influence was rejected by Paracelsus (1493 - 15421).
The Greek Galen was one of the greatest surgeons of the ancient world who performed many major operations
including brain and eye surgery. These were not attempted again for almost two millennia. After the Roman era,
400 AD approx., the study and practice of medicine went into deep decline. In medieval Europe, Galens writings
on anatomy became the mainstay of the medieval physicians university curriculum but they suffered greatly
from stasis, intellectual stagnation and the stifling influence of the Church. In the 1530s, however, Belgian anatomist
2
and physician Andreas Vesalius took on a project to translate many of Galens Greek texts into Latin. Vesaliuss
most famous work, De humanicorporisfabrica, was greatly influenced by Galenic writing and form. The works of
Galen were regarded as authoritative until well into the Middle Ages.
The beginnings of what we would recognise as modern medicine were to be found in the 13th century when
universities such as Padua and Bologna started teaching on the basis of dissection, but it was not really until the
Age of Enlightenment in the 1700s that science began to ascend and physicians became more scientific. Until
1696 London had only one major hospital, St. Bartholomews (Rosss alma mater) which dated from the 1200s.
This changed with the opening of then Peoples Dispensary and then Guys Hospital in 1721. The practice of
medicine also changed in the face of rapid advances in science, as well as new approaches by physicians.
Hospital doctors began much more systematic analysis of patients symptoms in diagnosis. Among the more
powerful new techniques were anesthesia, and the development of antiseptics. Actual cures were developed for
certain endemic infectious diseases but the decline in many of the most lethal diseases was due more to
improvements in public health and nutrition than to medicine. It was not until the 20th century that the application
of the scientific method to medical research began to produce important developments in medicine, with great
advances in pharmacology and surgery.
In terms of medicine in Europe, one of the disasters for its inhabitants was the suppression and destruction
of the works of Muslim scientists. The Islamic civilisation rose to primacy in medical science as its physicians
contributed significantly to the field of medicine in all areas (anatomy, surgery, pharmacology and so on). The
Arabs were influenced by, and further developed ancient Indian, Greek, Roman and Byzantine medical
practices.The translation of 129 works of Galen into Arabic by the Nestorian Christian HunaynibnIshaq and his
assistants, and in particular Galens insistence on a rational systematic approach to medicine, set the template
for Islamic medicine, which rapidly spread throughout the Arab Empire.
Two things come to mind here. The Muslims were using general anesthetics in ~1000 AD. The author has in
his possession a picture (taken in 2008 in the Damascus Museum of Ancient Medicine) of the physician Abu AlKasim Al-Zahrawi operating on a patient with a general anesthetic, some derivative of the opium poppy, being
delivered over the patients face with a sponge. A further photograph shows how the opium was infused into the
sponge in a clay vessel, the vessel itself being an original. Al-Zarawi was born in the city of Cordoba in Spain in
936 AD. General anesthesia was not used in the Western World until the 1840s.
The next brings us right back to malaria. In a study of the population movements in the Southern Levant,
and the adaptation of local population of agriculturists (Fellahin) and nomads (Bedu) - the population dynamics
and exploitation of the ground in this area from VI - XVI Cent1 , a key concept is that of the rif which may be
conveniently described as the edge of irrigated and cultivated ground where water may stand after the irrigation
process. The authors postulate that this knowledge was why the Prophet Mohammed forbad his bedouin followers
to camp at the bottom of valleys, along the axis of the slopes (run-off slopes) where water was used, the length
of water sources and paths, all rendez-vous des insects nocturnes (the collecting point for nocturnal insects).
Furthermore the poet of the 13th Century, IbnMayyada, reinforced the natural tendency of the calif al-Wahid II
ibnYahid II in his preference for the desert over the rif. Le voisinage des sources ne nous convient pas; les moustiqueset
les fievres nous y dvorent (Being near to water is not good for us; mosquitos and fevers devour us).
Again, terrorised by marsh fever (malaria) which was unknown in the desert, the scribe Al-Jhith (781 - 868/
869) as a spokesman for the Bedouin, warned Gare au rif! En approchersignifie la mort, la perdition court
term (Beware of the rif. Going near it signifies death, perdition in the short term).
Conversely the reason why this problem was not apparently met, or described in regard to the Crusader,
Ayyubid and Mamluk settlements, and castles is probably simple. They were built on hills.
What relevance is all this to the achievements of Sir Ronald Ross? Ross was born in 1857. In 1832 as part
of the world pandemic, a major epidemic of cholera, King Cholera, hit the United Kingdom. A further major
epidemic arrived again in 1849 claiming twice as many lives (14,137 people). During the pandemic of 1851, a
mere six years before Rosss birth, the world-wide scientific community varied in its belief of the causes. For
instance in France the general belief was that it was related to poverty, while the Russians believed it was
contagious but they were not sure how. In Britain, however, there were still some who thought the disease might
arise from Divine intervention!
ROSS RABINDRANATH MISSION VOL. 2, ISSUE - 2, OCT. - DEC., 2014
The causes of cholera were not known but the most widely accepted notion was that the disease was due to
air-borne miasma. Similarly the transmission of malaria was thought to be miasmatic. The word malaria comes
from the Latin and means bad air. Because of the cholera/miasmatic theorys predominance among scientists,
the 1854 discovery by Filippo Pacini of Vibrio cholerae, the bacterium that caused the disease, was completely
ignored until it was rediscovered thirty years later by Robert Koch. In 1854, a London physician Dr John Snow
postulated that the disease was transmitted by drinking water contaminated by sewage after an epidemic centred
in Soho, but this idea was not widely accepted. However, the summer of 1878 was excessively hot and London
fell victim to what was called The Great Stink. The Thames and all its subsidiary water courses and supplies
were open sewers. Even the wells and pumps from which domestic supplies arose were contaminated. A massively
expensive scheme was put forward in 1859 by Joseph Bazalgette to improve the sewers in London. It was hoped
that by relieving the stench, according to the miasma theory, it would also rid the city of cholera. Although the
new sewerage system vastly improved the situation, it was not until 1867, after the last epidemic of 1860, that it was
shown that polluted water was still entering the London water system from elsewhere, and by finally eliminating this
source as well, cholera was beaten in London for ever. The water-borne transmission of disease had been proved.
By 1871, Berlin was becoming a leading centre for medical research. Robert Koch (18431910) was a
representative leader. He became famous, among other things for isolating Bacillus anthracis (1877) - the cause
of Wool-sorters lung; the Tuberculosis bacillus (1882) - consumption, phthisis and the curse of the chests of the
population of London aggravated by the evil London smogs; and Vibrio cholerae (1883) - cholera. He was awarded
the Nobel Prize in Physiology or Medicine in 1905 for his findings on tuberculosis, three years after Ross.
To put all this into context, Muslims had posited that mosquitoes, or certainly nocturnal insects, were the
cause of the fevers they associated with stagnant water (the rif) before the end of the first millennium. It took two
and a half millennia for the doctors of Western Europe to begin to accept the theory basically proposed, that
malaria was transmitted by mosquitoes, in opposition to the centuries-old medical dogma that malaria was due
to bad air, or miasma. Although the first scientific idea was postulated in 1851 by Charles E. Johnson, who
argued that miasma had no direct relationship with malaria, this hypothesis was largely forgotten until the arrival
and validation of the germ theory of diseases in the late 19th century began to shed new light. When it was
demonstrated that malaria was caused by a protozoan parasite in 1880, the miasma theory began to subside. It
was not until 1877 that it was proven that the mosquito could transmit parasites to humans, and Rosss discovery
of the means of transmission of the malarial parasite on 20 August 1897 was the proof of what the Muslims
feared two millennia earlier.
It was a long long journey!
Yet truly can it be said thatA prophet is not without honour, save in his own country (Matthew 13:57 - King
James Version). The present author and his wife, who is distantly related to Ross, both trained at St. Bartholomews
Hospital, exactly as did Ross. The name of Ross was not mentioned to us throughout our training, and speaking
with our contemporaries none of them were aware of him at that time, although some became aware of him in
postgraduate work, although not necessarily that he trained at Barts.
Ross does not feature in the Wikipedia internet article on the hospital either as a notable member of staff,
which, of course, he was not, but not even as a notable Alumnus. And yet he was awarded the first Nobel prize
for anyone with any close connection to the hospital and was one of only three Nobel Laureates connected with
the hospital, the others being:- Sir John Vane - Nobel Prize in Physiology or Medicine in 1982 and Prof Sir Josef
Rotblat - Nobel Prize for Peace in 1995. Ross was, however, the only one to have actually trained at Barts. The
other two were both staff members. He does, however, merit an entry in one of the more authoritative books
about the Hospital The Royal Hospital of Saint Bartholomew 1123 - 1973 ed. Medvei VC and Thornton JL 1974
p 276: ..and Sir Ronald Ross (1857 - 1932), who came to Barts in 1875, joined the Indian Medical Service
and was a pioneer in tracing the spread of malaria by mosquitoes. No mention of a Nobel Prize there! The
authors do not even seem to appreciate what it was that Ross actually achieved.
Rosss name was initialled preserved by the founding of The Ross Institute and Hospital for Tropical Diseases,
opened in 1926 on Putney Heath by the Prince of Wales as a memorial to, and in recognition of, Ross work.
However this no longer exists as a separate entity but has been absorbed as The Ross Institute into the London
School of Tropical Medicine and Hygiene. The remaining vestige of Rosss name is in the title of Ross Professor
Emeritus within the School.
4
Sir Ronald Ross seems to be slowly being airbrushed out of the English version of the history of medicine.
Most of us can remember historic greats from the medical world; Koch, Marie Curie, Fleming, Florence
Nightingale, Pasteur to name but a few. But Ross . . . .?
Ross is certainly more appreciated now in Kolkata where he carried out the majority of his experimental
work, and in India generally, than he has been allowed to become in the country which trained him.
Long may the Ross Memorial perpetuate his name.
I am indebted to Prof. Claudine Dauphin for her help with this section. Prof. Dauphin is Honorary Professor in Archaeology
and Theology of the Universities of Wales, and a member of the French Centre National de la Recherche Scietifique at
'Orient et Mditerane - Monde Byzantin'in Paris. She kindly gave me a copy of an article based on her lecture (the The
Council for British Research in the Levant (CBRL) 25th Anniversary Crystal Bennett Lecture given at the Institute of
Archaeology on 23 April 2013) and subsequently published in Bulletin of the CBRL: 8, 2013.. The title of the CBRL article
is Fallahinand Bedu between the Desert and the Sown: the population Dynamics of a buffer-zone from Byzantium to the
Mamluks. A fuller version in French is published in the technical journal Gomatique Expert: No. 95; Nov - Dec. 2013
entitled Paysanset Pasteurssur les marched du Levant Sud" pp 30 - 53. The sources for the more esoteric Muslim authors
quoted may be found therein.
Eradication of malaria through cooperation : Contd. from page 1
the totality of life, it does not blend well with the inner spirit, it cannot be made part of the life. For this, we are
trying to merge the life process of the villages with the pursuits of knowledge with whatever little resources we
have. This work was going on. Here, in this hall, we discussed about this before. Those who were in the hall
before, know how we are carrying out our work. When we first took up work, we first found a scene of diseases.
We are non-businesspersons; we did not have courage then to appeal to the people of the country who had
experience in eradication of diseases of the villages to come forward to help us. Whatever we could, we did it
ourselves. In this connection, we acknowledge with deep sense of gratitude, the help we received from foreigners.
We got the support of an American woman in this regard2 . She is not a doctor, she acquired knowledge from her
direct hands-on experience by nursing patients during the War. Depending on that, she went from door to door of
the patients, negotiating knee-deep mud; she nursed the poorest of the poor at their huts, provided nourishments
to them. Deep festering sores the sight of which even our gentry abhorred- she herself cleaned all these
bandaged the wounds of low caste patients, gave them nutritious diet. She is working until today; she did not
relinquish her work even when the intense heat exhausted her. When her health broke down, she went to Shillong
for a few days, on her return, once again she is putting herself to her physical limits. We got her help like this.
She will have to go back to her country, but she is continuing to provide nursing and succour to her physical limits
during the few days that remains.
Another benevolent Englishman, Elmhirst, has come bearing his own expenses, collecting fund from the
overseas without keeping a farthing for himself. No word is sufficient to describe how he is working day in and
day out, visiting the surrounding villages, striving hard to alleviate the miseries of the villages. We are working
with the help and support that we received from these two persons hailing from foreign countries.
This much you should understand that it is a fight between insects and men. The vector that carries our
enemy-disease occupies a long stretch of land. It is not possible to get hold of such a small insect within such a
vast territory. At least, it is impossible for one or two individuals to achieve anything unless we cannot work
collaboratively. We were groping, merely trying, at that juncture one of my former students, who is a student of
medical college, came to me and said, Gopalbabu is a renowned Bacteriologist, he is even well-known in Europe.
He is a famous man, earns quite a lot. The fight against malaria that you are about to take up, he himself has
begun this work. He has vowed to work to the extent possible to save Bengal from this formidable enemy even
at the cost of his profession. When I heard this, I got interested. I decided to claim his support in our venture. Not
for the reason that we shall get tool to kill mosquitoes, we realized, we have information about such a rare
person who is involved in the work; not on the basis of anger, envy or excitement, nor was he driven by external
forces but for the sole purpose of saving the people of the country, sacrificing his self-interest, even though it
cost him personal loss. Such examples are rare indeed. A sense of piety arose in my mind, I said I want to meet
him and discuss this. He himself came to meet me - I heard from him how he has begun this work. Then it came
ROSS RABINDRANATH MISSION VOL. 2, ISSUE - 2, OCT. - DEC., 2014
to my mind that we would remain grateful if we could take part along with him in this work, not for success it
would be a matter of great honour if we could join in a work of such a man.
You have noticed that after the war the talent of the people of Germany-Austria was on the decline, this was
because of physical weaknesses born out of starvation. When the blockade prevented reaching food, it resulted
in death of a large number of people but this was not the biggest thing. The children who needed milk, pregnant
mothers who required nutritious food, when they did not get it, children were born on this earth malnourished.
The result is that when they would grow up they would not be able to stand up on the strength of that much of
intelligence. Therefore, from this point of view, mere headcount do not constitute population; we have to find out
how much those who have intelligence are effective. Mere physical counting is not proper. In Bengal, we are not
aware that everything connected with our sources of health is drying up. By carrying the burden of diseases, we
bear a permanent source of debility in our blood. How many people are born every year, how many are dying,
how the number is increasing is not important; whether those who survived are living like a proper human being
is the moot point. Their effectiveness, whether they have the ability to exercise their mind is the vital aspect. If
the majority were, half-dead then the people would not be able to carry this burden. From physical debility,
mental weakness arises. Malaria produces ill health in the blood, and with that, we do not also have strength of
mind. Only those who are full of life can make sacrifice in life. Those who somehow survive do not have an iota
of surplus left beyond their own requirements; no generosity is left in them. If there is no generosity then no
civilization can be built. Where there is stinginess in life there is littleness of spirit. In no other civilization such
enormous decay of life has occurred. One has to keep in mind, distress do occur in all countries. But what
constitutes humanitarianism of a human being? That it is not to accept distress as inevitable, to strive to mitigate
any misfortune whenever and wherever it arises, to keep this resolve in mind. Up to this time, we have said,
malaria is spreading throughout the country, how can we fight them, how can we drive out million and millions of
mosquitoes; government is there but doing nothing what can we do! That cannot be the plea. When we are
dying in hordes many are seemingly dead even though they are not if we cannot solve this by any means,
there is no escape. Malaria is the fountain head of other diseases. From malaria tuberculosis, dyspepsia and
similar diseases arise. The Lord Yama gets through with ease when the main door is open. How can we fight with
them? At first, the door has to be closed, if only that results in saving the Bengali race.
There is another point you need to ponder. If we can drive out the mistrust that we have about ourselves in
anyone area all the misfortune that we have so long accepted as our predestined fate, if we can go against this
grain of thought on any pretext - then great service will be done. Howsoever the great the enemy may be, we will
not accept their dictates, will not keep alive any mosquitoes, by whatever means we will eradicate them if we
can gather this courage then it is not only mosquitoes but we will win over far greater enemy, our own inferiority.
Another point for meeting with people we need various occasions. Many such occasions are necessary so
that people of all ages can come together. Not many understand what does a Country means, and many do not
know what swaraj is. But not a single person is there who does not know the meaning of getting together. But if
in any one village the intensity of the diseases can be reduced to some extent by collective efforts then there is
nothing like this as an occasion for coming together of all the educated and the illiterates. Gopalbabu has begun
this work. The name of the Mandals have been mentioned; I am happy to know that this Mandals stood side by
side on the same ground and collaborated to kill such a tiny enemy like mosquitoes. Nothing can come close to
this as a good omen. For, welfare of others is the responsibility of all, each one is responsible for the welfare of
everyone and others welfare is the greatest good - if this lesson, instilled as much as possible through innumerable
occasions in our country, it is so much the better. A road passing through a village, developed a pothole in one
place caused by the passage of bullock carts not more than 4-5 arms length during monsoon knee-deep
mud accumulate in it, men and women, old and young, negotiate this pothole for going to the market. People
living in adjacent two villages who face the hardship most do not say, let us put one or two spades of soil over it
to make it level because they are afraid lest they are cheated. They think, It is we who will put in the labour and
its benefits will be enjoyed not only by others too, then it is better still that we also suffer. I have narrated before
you another incidence - one village used to suffer every year from fire, there was no well in the village, I proposed
to them, You dig the well I shall provide the masonry part. They said, Babu, you want to fry fish in its own oil.
That is, we will put half of the labours but you derive the whole of the piety. It is better still we die from want of
water on this earth, but we cannot stomach the salvation that you would reap cheaply in the next world.
6
There are other such examples in the country. Even it is present among the gentry in various guises, I do not
have the courage to discuss these. People will understand from the kind of work that Gopalbabu is engaged in;
the mosquitoes that breeds in the shallow pond next door also sucks my blood without any prejudice, therefore
his work of de-silting ponds also is my work.
Gopalbabu is engaged in a great work; a pure good sense attracted him to this work, devoid of any greed,
anger, and jealousy. This example of great humanism is no less important to us than killing mosquitoes. For this,
I pay my gratitude and respect to him.
[Translators note: This was a public lecture. Hence, the sentences were long, syntactically complicated, with little breaks
in paragraphs, giving it an interminable look unlike the poets writings, making the translators job difficult one. However,
we have tried to be as faithful as possible to the meaning and spirit of the lecture. Transcription has been avoided as far as
possible.]
Notes :
1. Dr. Gopal Chattopadhyay (1869-1953), a renowned Physician and bacteriologist by profession, was a pioneer in
instituting Anti-Malarial Cooperative Societies in Bengal from 1917. He began his campaign against malaria from his
own village, Sukhchar, near Panihati, 24 Parganas, and then slowly covered the whole of Bengal, except the hills of
Darjeeling. When exactly the poet met Dr. Gopal Chattopadhyay is not known. Dr. Chattopadhayay delivered lecture
with film show about the depredation caused by malaria in the evening of the Anniversary meeting at Sriniketan on 6th
February, 1924 (Santiniketan, [Falgun-Chaitra(Feb.-March),1330] 1924). Rabindranath delivered his first Presidential
Address before the Annual meeting of Anti-Malarial Society on 29th August, 1923. Therefore, he might have met him
before this. Collaboration between Anti-Malaria Society and Sriniketan began. The Santiniketan journal in its Vol.4(9)
reported that some office bearers of the Anti-Malaria Society and a Doctor visited the villages in 1923.Was he part of
it? In fact, Anti-Malarial work started at Sriniketan from the end of 1922 itself. Santiniketan took up the work even
before this, most probably, on its own initiative.
2. Miss Gretchen Green, a nurse of the Baptist Mission Hospital, U.S.A., came to Sriniketan at the end of 1922. At that
early stage of Sriniketans developmental efforts she provided yeomans service by organizing the health work and
also fought ceaselessly against malaria. She will be remembered for her maternity work and direct medical help to the
needy of the outlying villages. The Sriniketan dispensary at that time was not fully ready. She along with Kalimohan
Ghosh collected medicine from the shops of Calcutta for treating the patients of the villages and was responsible for
laying foundation of the health work ( See Gretechen Green, The Whole World and Company, Reynol Hitchcock, NY,
1936). She left on March 1924.
3. Leonard Knight Elmhirst was one of the architects of Sriniketan. He and his wife Dorothy W. Elmhirst provided nearly
all the required fund for running the developmental works at Sriniketan.
2.
3.
4.
5.
6.
MALARIA IN PREGNANCY
Dr. Sujoy Dasgupta
MS (Obst & Gynae)
Senior Resident, Deptt of Gynaecological Oncology,
Chitaranjan National Cancer Institute (CNCI), Kolkata
(Dedicated to Late Dr. Sundari Mohan Das for his
pioneering contribution on this topic in the world)
Among all vector-borne diseases, malaria
continues to pose serious public health threat in the
developing countries. Malaria affects more than a billion
of people worldwide and is responsible for more than a
million deaths1. The name of the disease malaria (bad
air) was given as far back as 17532. And it is interesting
to note that the treatment of malaria became first
established (in the middle of 17th century) before
anything was known about its etiology. Laveran (1880)
first discovered the malarial parasite in an unstained
preparation of fresh blood. It was Sir Ronald Ross from
Calcutta (1898) who worked out the mosquito cycle of
the parasite2. Four species of the genus Plasmodium
have been recognized to cause human malaria, viz, P.
vivax, P. falciparum, P. malariae and P. ovale. It is
transmitted by the bite of infected female Anopheles
mosquito that innoculates the sporozoites into human
blood. Apart from this, trophozoite-induced malaria has
also been described, that is transmitted by blood
transfusion 1.
Pregnancy, on the other hand, is a unique condition.
No other physiological events in adult life witness such
major changes in all the organ-systems of the body, as
those occur in pregnancy. Any infection occurring in
pregnancy may prove fatal for both the mother as well
as the baby. Again, clinical and laboratory parameters
change in pregnancy; so caution should be observed
to interpret these results. Treatment is also complicated,
because of changes in maternal pharmacokinetics and
concern of effect of the drug on the unborn fetus.
Pregnant women are more susceptible to malaria
due to attenuation of malaria-specific immunity. The
immunity is regained toward the end of the pregnancy
but is lost once again in subsequent pregnancies 3,4.
There is a progressive rise of immunity with increased
parity. Thus, primigravidae are at highest risk 5 .
Parasitaemia peaks during 2nd trimester, followed by
higher incidence of anaemia 6.
Also, pregnant women tend to have more severe
complications than nonpregnant counterparts 7 .
Especially, they are prone to develop hypoglycaemia
and cerebral malaria even at very low peripheral blood
parasitaemia. Apart from them, all the other
10
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
11
t r e a t m e n t g u i d e l i n e s . J . I n f e c t . 2 0 0 7 ; 5 4:
11121
15. Royal College of Obstetricians and Gynaecologists
(RCOG). Green Top Guidelines No.54A. The
Prevention of malaria in Pregnancy; April 2010: 4-8.
13
2.
3.
Ebar Phirao More, Rabindra Rachanabali - Vol.2, VisvaBharati Granthan Bibhag, Posh 1417, P/151.
4.
Samabaye Malaria Nibaran, Rabindra Rachanabali Vol.14, Visva-Bharati Granthan Bibhag, Posh 1417, P/389
15
SICKENING AFFAIRS
MANIK SARKAR, TRIPURA'S BEST KNOWN MARXIST, IS ADMIRED
FOR BOTH HIS PERSONAL INTEGRITY AND ADMINISTRATIVE
ACUMEN, BUT IN THE EVENT OF THE DEATH OF NEARLY 100
PEOPLE DUE TO MALARIA OVER THE PAST ONE MONTH
SEVERAL QUESTIONS ARE BEING RAISED ABOUT THE
STATE OF AFFAIRS UNDER HIM, SAYS NIRENDRA DEV
Editor
Ross Rabindranath Mission
General Secretary
Sir Ronald Ross Memorial Centre, Kolkata
Bill Gates
17
how we litter everywhere without concern, how we spit, blow our nose, pee and defecate in public places. I know
that our cities and metros lack in civic amenities but we must also realise that as long as we consider common
areas of our cities and towns as not of our concern and litter them, we can never achieve cleanliness. Speaking
at a evening Prarthana Sabha during his travels through Bihar, Bapu had once commented about the habit of
carelessly spitting, if all Indians were to spit all together at the same time, India would drown.
Bapu believed that as we were particular about personal hygiene, we had to be responsible about the hygiene of
our neighbourhood, locality, and town or city too. Right from the beginning while in South Africa Bapu took it upon
himself to clean the locality he lived in and did not ever turn a blind eye to filth. He did not like filth or being dirty
and so he took responsibility of both his personal hygiene and for the hygiene of his surroundings and cities. He
performed his civic duties as a matter of regular practice but when an emergency occurred he was even more
particular and volunteered to clean the filthiest of areas. When the Plague erupted in the Indian quarters in
Durban, initially Bapu rushed to the aid of the afflicted people but to prevent the spread of plague he also worked
to clean the quarters. He cleaned the locality cleaned the homes and administered treatment to the patients
even at personal risk of being infected himself. Later on a visit to Rajkot when a similar epidemic erupted there
Bapu took to cleaning the festering cesspits and gutters of the city so that the germs would not bread there and
the epidemic could be contained. On one of his visits, from South Africa he visited Kolkata the Congress Session
was in progress there Bapu went there and was appalled by the filth and unsanitary conditions at the site.
Instead of presenting himself as an important Indian leader visiting from South Africa, Bapu took up the work of
cleaning and ensuring hygiene of the place. He cleaned the drains organised volunteers to dispose off the filth
and personally cleaned and covered the pit latrines. He did not lecture the delegates about the importance of
cleanliness and hygiene he taught the lesson by example, he made it his own responsibility to maintain the
cleanliness of the place. One must realise that the venue of the Congress convention was not his private property,
nor was it the home of a friend, the venue was a civic ground and Bapu could have very well written to the city
council to ensure the cleanliness of the place, but he took responsibility of ensuring the cleanliness of a common
place and ensured that the convention happened in clean and pleasant surroundings. Bapu believed that it
wasnt possible to have good, true and honest thoughts if the mind and surroundings were unclean. Speaking at
the foundation stone laying ceremony of the Kashi Vishva Vidyalaya, Bapu criticised the uncleanliness of the
holy city and expressed anguish that places we considered sacred and holy were so filthy. This was his observation
also when he visited the Kumbh Mela. Bapu was concerned about how we were dumping filth into river and said
that the rivers were like the veins of our country and our civilisation was dependent on the health of our rivers,
but if we continued to dirty them the way we had been doing it would soon be that our rivers would become
poisoned and when that happened our civilisation would collapse. We are at the brink of an ecological disaster
because we have polluted our holiest of holy river Ganga with our filth. Seventy five years later, our new Prime
Minister in his speech to thank the people of Varanasi and the nation, talked about his concern about the filth in
Varanasi and the pollution of the Ganga. Bapu believed that every individual had to be concerned and take
responsibility. Cleanliness would not be achieved by warnings, laws, or edicts, it would be achieved only as a
matter of habit. Writing in Young India in its issue dated November 19, 1925 Bapu said, Cleanliness is next to
godliness. We can no more gain Gods blessings with an unclean body than with an unclean mind. A clean body
cannot reside in an unclean city. What he wrote to an unknown recipient on April 26, 1945, later reproduced in
Bapu Ke Ashirvad Bapu expressed his concern about our habit of hiding dirt, Is it only that unclean which
appears to the eye to be unclean? If there is even a speak of dirt on what is white, we feel annoyed: but the black
may have any amount of dirt on it and we care not at all! a little amount of dirt in an otherwise clean area causes
a lot of concern as well as irritation but many a times we ignore the dirt which accumulates in dark places and in
nooks and crannies. Bapu believed that it was even more important to be particular about cleaning and maintaining
cleanliness in such isolated places. It wasnt only important to clean areas where dirt or filth would be visible, but those
who were particular- about cleanliness should be even more particular about overall cleanliness. Writing in Young
India in its issue dated April 25th, 1929 Bapu commented on our habit of cleaning our homes or ourselves and
dumping the filth in our surroundings without concern We do believe in removing dirt from our rooms, but we also
believe in throwing it in the street without regard to the well being of society. We are clean as individuals, but not as
members of society of the nation of which individual is but a tiny pan. This is the cause of why beyond our doorstep
we find so much filth and dirt. Strangers or outsiders do not come to dirty our neighbourhoods. It is us who live in
those neighbourhoods who dirty it by littering. When we toss a bag containing garbage out of our door or window, we
can be happy our home is clean but our neighbourhood is also part of our habitat and that one seemingly insignificant
act of making it filthy becomes compounded because every inhabitant of the neighbourhood behaves in a similar
manner, unconcerned about how they are making their own neighbourhood, community and city filthy.
ROSS RABINDRANATH MISSION VOL. 2, ISSUE - 2, OCT. - DEC., 2014
19
Corporates too had a responsibility in maintaining cleanliness, writing in Harijan on 16th June 1946 Bapu said,
meticulous sense of cleanliness, not only personal but also in regard to ones surroundings, is the alpha and
omega of corporate life. In their lust for profits companies cut corners and it is generally on the issue of waste
disposal from their production process. Bapu believed that it was the responsibility of every member of the
organisation from top to bottom that they did not dirty or pollute the .environment of the place they functioned
from. Governments and city councils can do upto a certain amount, they have their limitations but if every individual
took it-as their own responsibility and duty, it would-be much more possible to achieve not only a clean India but
also spiritually cleansed Indian? and then they would be proudly able to become examples of a clean nation a
clean civilisation and a clean people. What Bapu wrote in a letter on 22nd January, 1945, later reproduced in
Bapu ke Ashirvad, He who is truly clean within, cannot remain unclean without. This was the cornerstone of
Bapus belief in personal and civic cleanliness. Bapu believed that the habit of cleanliness inside and out had to
be instilled very early in-ones life it had to become part of ones nature and he believed that if one was taught
about the importance of a clean mind, a pure soul and a honest nature then it would automatically ensure the
cleanliness of the body and ensure the cleanliness of ones surroundings too. Writing in Young India in its issue
dated 10th December 1925, Bapu said, Inward cleanliness is the first thing that should be taught, other things
must follow after the first and most important lesson has gone home. If we wish to instil the habit of cleanliness
we must teach our children to hate filth, hate dirt and take responsibility to not only clean the filth but also not to
contribute to the filth. This was how important Bapu believed, both internal and external cleanliness was for
Humans to thrive and progress and for self actualisation and evolution of humans. He did not differentiate
between the self being clean and the cleanliness of the surroundings, he believed that it was essential for a pure
soul to reside in a clean body just as it was essential for a locality, city, state and country to be clean so that
people would in it who were clean and honest. He believed that they were both as important and vital.
We will achieve Swachcha Bharat only after we cleanse our souls and then cleanse our surroundings, this was
the message of Bapus life. The Prime Minister can inspire, but the responsibility is of every Indian.
(Courtesy : Employment News Vol. XXXIX No. 29, 18-24 October 2014)
GENOMES GALORE
Two papers published on 27 November in Science
announced the completion and preliminary analyses of
the genomic sequences of 16 species of mosquitoes,
including those that are vectors for the malaria parasite.
The sequences, which were around 200 million base pairs
each, revealed that mosquitoes were rapidly evolving,
exhibiting high degrees of gene gains, losses, shuffling
and even transmission between closely related species.
Both papers provide really powerful information on
the evolution of different malaria mosquito species, wrote
James Logan of the London School of Hygiene and
Tropical Medicine in an e-mail. Comparisons between
the (species) are likely to reveal the reason why some
mosquitoes are better at transmitting malaria than others,
(which is) vital for the future control of malaria, he added.
Each year, hundreds of millions of cases of malaria
are reported globally that cause hundreds of thousands
of deaths. In 2002, as part of an ongoing effort to
understand mosquito biology and ultimately reduce
disease transmission, the genome sequence of
Anopheles gambiae the major malaria vector of subSaharan Africa was published.
Having one genome is a great start, but its not
enough, said Nora Besansky malaria vector researcher
at the University of Notre Dame, Indiana, who led the
20
21
: Biswajit Dutta
Vice President
: Debolina Chaudhuri
Honorary Advisers
Ms. Jenniefer Phillips, Dr. Benu Bhushon Chaudhuri,
Dr. Badal Paul, Dr. Kanchan Das, Dr. Parimal
Bhattacharjee, Nilanjana Rakhit, Dr. Ranen Chatterjee,
Dr. Subhas Chandra Dasgupta, Prof. Satyabrata
Dasgupta, Prof. Biswapati Mukherjee, Prof. Amitabha
Nandy, Dr. H. K. Mazumder, Dr. Manaspratim Das,
Adv. Rana Dasgupta, Debashis Nag, Md. Abdullah,
Dr. A.Q.M. Serajul Islam, Dipa Sen, Dr. Hannana Begum,
22
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