Healthy Youth, Healthy Punjab

As a reaction to the increasingly high rates of drug abuse, the Punjab government is working to set up a Youth Development Board to tackle issues related to drug abuse. Students at Punjab University will become advocates to help steer their peers away from using drugs. Launching the campaign against drugs under the aegis of the Students Organisation of India (SOI), the message of “No Drugs” would be launched all over the state and would reach out to every school and college of Punjab.

[The] future of Punjab would be bright only if our youngsters will be healthy... big industrial units are being set up in Punjab to provide maximum employment to our youth... in order to provide higher computerized education to our rural youth, institutions are being set up at village level. It will provide special opportunities of education to rural girls.

The goal is to spread this program from school to school and village to village and by doing so, empowering youth to take an active role in tackling the issue of drug abuse.

For this purpose two vans have been specially prepared which will travel in every nock and corner of state to organize against drugs. Documentaries against drugs will be organized and psychiatrist will deliver lectures to enlighten people against the ill effect of drugs. Apart from drugs... a special helpline has been created on which any person can contact SOI cadets on phone or at e-mail these cadets will help him to get medical and psychological help from concerned drug de-addiction centre.

Think BIG!

This past weekend I attended a very informative International Women's Health and Human Rights conference founded by a group of students dedicated to motivating and mobilizing students and community members by bringing attention to issues such as reproductive health, education, violence, and HIV/AIDS.

Our purpose is to demonstrate to students both the need and opportunity to act, as well as to provide direct support to women's groups that are already making a difference. Our goal is far-reaching: to empower women around the world by inspiring our generation to take action.

The two sessions I attended focused on HIV/AIDS and violence against women, respectively. The keynote speaker for the first session was Dr. Stephen Lewis, the former United Nations Special Envoy for HIV/AIDS in Africa. He is an incredible speaker and is able to describe the desperation of the issues in a very eloquent manner. He commented about the differences in the HIV/AIDS pandemic in Africa compared to the face of the pandemic in Asia or Latin America. While HIV/AIDS is considered "generalized" in Africa, impacting predominantly heterosexual couples, in Asia and Latin America the prevalence is highest in high-risk populations such as sex workers and Intravenous Drug Users. An emphasis was placed on how we have to work towards ensuring it doesn't become a generalized pandemic in these places, and prevent the impact we are observing in Africa. It was a very interesting point. One of the panelists in this session works for a grassroots organization called GRACE (Grassroots Alliance for Community Education). She told us the story of a 91-year old grandmother who, despite the loss of 12 sons and daughters to HIV/AIDS, is the sole care-taker of her 16 grandchildren who are all orphans. It was a very powerful story that brought the issue into perspective. An entire generation of people have been wiped out by this pandemic and this has dire consequences on the social fabric and stability of communities and countries. The main argument made was that while these health and human rights issues in and of themselves are important global issues that need to be tackled, we have to keep in mind how they are adversely impacting women around the world and what this means to the stability of communities in all countries.

On a final note, one of the speakers said something which I thought was really important to share, "The first and last task of a leader is to keep hope alive".

A book I am currently reading related to these issues is called From Outrage to Courage: Women Taking Action for Health and Justice. The conference was supported by the Global Fund for Women.

Human Rights, Suicide, and Mental Health

Recently there have been some very interesting posts on The Langar Hall related to health and human rights that I wanted to highlight.

The first post is about the impact of torture on the health of individuals, specifically discussing an article, “The Effects of Torture-Related Injuries on Long-Term Psychological Distress in a Punjabi Sikh Sample” by a group of health professionals from Bellevue Hospital at NYU and Ensaaf. The article discusses the debilitating physical and psychological distress experienced by torture survivors. Many Panjabi Sikhs experienced various human rights violations at the hands of the Panjabi police, yet little information was gathered on their experiences (making it virtually impossible to offer them treatment). The article states that,

These findings emphasize connections between physical and psychological trauma and the importance of an interdisciplinary approach to torture treatment.

Another post highlighted the first People's Tribunal on Farmer Suicides in Panjab which allowed for an opportunity for men and women to openly relate their frustrations around the agrarian crisis leading to their relatives committing suicide. It was suggested that,

Indebtedness is the primal cause of farmers’ suicide in most parts of India, including Punjab.

The third is about how accessible mental health services are for the Panjabi community. It is quite clear to many contributors and readers of The Langar Hall that the prevalence of mental health issues within our community is increasing, and yet there is a disparity in the availability of culturally sensitive services for this community. In the past, our blog has highlighted various mental health issues inflicting our community and it is clear that we are only beginning to see the effects of not providing adequate care to a population at risk.

Another post was about Jaswant Singh Khalra, a human rights activist who I believe is one of the most important figures in Sikh history. Shaheed Jaswant Singh Khalra was instrumental in bringing the brutalities of the Panjab police to the surface. He advocated for Sikh men who had “disappeared” and was a voice for the many mothers and fathers who were missing sons. The blog highlights Shaheed Jaswant Singh Khalra’s final speech. Later that year,

Indian security forces abducted human rights defender Jaswant Singh Khalra because of his work exposing the disappearances and killings of thousands of Sikhs in Punjab. [Link]

He was subsequently tortured and murdered.

I hope you find these posts interesting and I encourage you contribute to the dialogue around these issues.

Bag For Life

Here's a great reason to go shopping! The Body Shop is selling these totes where $2 from every bag sold goes to the National Coalition Against Domestic Violence, an organization working to stop violence in the home.

There's nothing better than shopping for a good cause!

Student Internship: Eliminate Health Disparities

I received this email announcement from a listserv I subscribe to and thought it was a great opportunity to share. The University of Michigan School of Public Health is accepting applications for a dynamic internship program for undergraduates who are committed to eliminating health disparities.

Simply stated, health disparities mean that, in the U.S., people of color and the poor experience lower health status than Caucasians and higher-income Americans. These disparities represent inequalities in that people of color and low-income people should be able to enjoy the same health status as whites and more affluent Americans, but they are systematically exposed to conditions and situations that have negative consequences for their health.

Here's some more information:

These internships are part of the University of Michigan's Summer Enrichment Program in Health Management and Policy (SEP)...The SEP encourages undergraduates (current second and third-year students) to consider health management and policy as an attractive career option through which they can address health disparities in communities of color. Students work in hospitals, health departments, health centers, community-based organizations and other health agencies in Southeastern Michigan during the 8-week program (June 3, 2008-August 1, 2008). They also attend seminars on health disparities, visit a variety of health institutions and agencies, meet with leaders in the health field and complete the Princeton Review GRE Preparation Course. Students accepted by the program receive paid housing, a food allowance, and travel expenses to and from Ann Arbor, in addition to a $3000 stipend. The ultimate goal is to increase participation of students committed to eliminating health disparities in public health graduate programs.

This sounds like a really wonderful opportunity with actual hands-on public health experience (often hard to come by). Please refer to the website for application instructions and let me know if you decide to apply!

HIV in India - A Downsized Epidemic

This week's New England Journal of Medicine has an article on HIV in India and speaks to the recent controversy and disputed numbers of people living with HIV in India. In 2006, the UNAIDS and WHO estimated that 5.7 million people in India were infected with HIV suggesting that India had more people infected with HIV than any other country.

In 2007, however, the estimate was revised downward to 2.5 million (range, 2.0 million to 3.1 million) — a revision so large that it reduced by nearly 10% the estimated number of people living with HIV globally and reinforced ongoing concerns about the validity of methods for producing such epidemiologic estimates.

The revised numbers for India suggest that the epidemic is less generalized than originally thought and thus allowing for the opportunity for it to be more controlled. Most importantly,

The new estimate changes little, however, in terms of prevention efforts geared toward persons at high risk for infection, such as injection-drug users, men who have sex with men, sex workers and their clients, and long-distance truckers. Nevertheless, it should now be easier and less costly than was previously anticipated to provide treatment, including second-line regimens, to those who need it

As in most developing countries, previous estimates were based upon pregnant women attending government prenatal clinics capturing high prevalence areas. The new estimates were based on a National Family Health Survey which examined a nationally representative sample of households.

Domestic Violence Research

The Asian & Pacific Islander Institute is looking for Filipina, Indian, and Pakistani women to participate in research. Here are the details:

18 – 60 years old.
Who have experienced abuse in current or past relationships.
Living in the Bay Area at the time of the abuse.

Participants will be provided $75 token of appreciation for their time. Tagalog, Hindi, Urdu and Punjabi speaking interviewers are available.

Your participation in this interview is voluntary. You will not be identified in any reports on this research study. Your participation will help understand women’s experiences and develop more effective policies and agency responses.

Please click here for more information.

Impossible is Nothing

After reading a recent post on The Langar Hall about Fauja Singh, I was reminded about how important it is for our community to have role-models like him to look upto and to inspire us to get into shape. His accomplishment's are amazing but so is his mentality. I remember an interview with him from a few years ago where he outlined (in Punjabi) his very simple diet and routine. Many people my age found Fauja Singh to be incredibly inspiring and I just hope he had the same impact on our parents' generation since they often need the most motivation!

The global obesity problem should be no surprise to anyone now, as it has been receiving a lot of attention lately. The numbers are staggering:

The World Health Organization predicts there will be 2.3 billion overweight adults in the world by 2015 and more than 700 million of them will be obese.

Whoa, that's... a lot. So I wonder how we, as a community, are addressing this rising concern. A recent study in India found Punjab to have the highest prevalence of obesity among women. Experts are worried that the increase in obesity will lead to more health problems as people who are overweight have a higher risk of heart disease, Type II diabetes and other diseases including some cancers. Clearly there's a need to encourage our community to shed their sedentary lifestyles and rethink their diets. For the time being, we have Fauja Singh and Milkha Singh to keep us on our toes.

Cardiac Program for Punjabi-Speaking Patients

Surrey Memorial Hospital has announced the implementation of an education program specifically for heart patients who are Punjabi speakers. The eight session course is designed to meet the needs of a population at high risk:

Persons of South Asian descent are considered "two to three times more likely to develop the disease than the general population. They are also affected at a younger age."

The pilot program will be tailored to patients who have either suffered a heart attack, had heart surgery, or are considered at high risk. The latter part of this is the most important to me as i strongly believe preventing a heart attack from happening is where we have to concentrate efforts. This program will be aimed at helping Punjabis make lifestyle and behavioral changes to benefit their heart. This program was funded by a $100,000-donation from Sun Life Financial, which is a pivotal point because without the monetary support, many of these program specific to minority and non-English speaking groups will not be developed.

"Top Ten" Most Underreported Humanitarian Stories of 2007

Every year, with the publication of its "Top Ten" Most Underreported Humanitarian Stories, Doctors Without Borders/Médecins Sans Frontières (MSF) spotlights 10 humanitarian crisis that have received little or no attention from the media. Take a look at this amazing slideshow.

The Langar Hall

Take a look at the brand new blog called The Langar Hall. You can participate on this blog via the discussion section.

This is a space dedicated to the experiences, reflections, and interests of a diverse group of young individuals – tied together by our common and varied identities as Sikhs in the diaspora.

Like the many conversations that take place in langar halls around the globe, our blog posts will sweep across a gamut of topics from Gurbani and Seva to Bhangra and Politics. We challenge ourselves to address the myriad of issues we face as individuals and as a community through a progressive lens, and reserve the right to rant, muse, and humor.

Do you have questions or the feeling that some things just have not really been explained? Then join our conversations as we untangle complexities, explore grays, or just share things we find interesting and funny.

Taking A Stand

Taking A Stand, on BBC Radio 4, did a piece on the (dis)honor killing of Surjit Athwal who was killed by her husband and mother-in-law. It's a heart-breaking story...

Fergal Keane talks to people who have taken risks and made sacrifices to stand up for what they believe in. When Surjit Athwal failed to return from a holiday in the Punjab, her brother Jagdeesh Singh was convinced that something terrible had happened. Eventually he discovered that his sister had been murdered in a so-called honour killing after her in-laws discovered that she planned to divorce her husband. Jagdeesh recounts his nine-year struggle to bring Surjit's killers to justice.

Listen here.

You can read more about this case here and here.

To read more about honor killings, see this link.

Health Literacy

The National Health Service in the UK offers health information in many languages, including Punjabi. Their resource site, NHS Direct, has lots of info from Alcohol Abuse, to B12 deficiency, to Exercise tips. One of the most important ways to improve health care is to provide information to patients that they can actually understand. It's about empowering patients and encouraging them to be involved with their care. I just want to post the link:

Health Information in Punjabi

I will say, however, that it's important to provide health information to a patient (whether the patient is English-speaking or not) that is understandable. For example, I was reading through the Punjabi information on the NHS site about high blood pressure. The document used words such as Hypertension, Systolic, and Diastolic. These words are often misinterpreted by patients who speak English, never mind those who speak a different language. The Institute of Medicine says,

Nearly half of all American adults--90 million people--have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with limited health literacy.

So health literacy is a huge issue that impacts quality of care and it's really beginning to get more attention. I just think it's important to remember that when developing health information, to use terms that will be understandable by the average patient. Whatever language they may speak.

Meri Kahani

Here's information about a play being shown in Mississauga about the experience of violence among South Asian Women. Through short stories, the play aims to highlight the plight of the South Asian Woman's experience through a spectrum of voices. It is part of a public education initiative by the Multicultural Healing Project. I look forward to hearing more about it since I won't be able to attend.

Meri Kahani: My Story, is an innovative play addressing the challenges faced by South Asian survivors of abuse in the North American context. Focusing on abuse, the play has served to educate and inspire audiences in resisting ongoing violence and overcoming the barriers that women face in seeking support services. Using theatre as a tool for change, each kahani, or story, is told through the varied perspectives of South Asian survivors of abuse—domestic violence, incest and sexual assault—to capture the diversity of experiences among South Asian women.

Britain's Missing Babies

Worrying new research reveals that between 1990 and 2005, about 1,500 fewer girls were born to Indian mothers living in England and Wales than would have been statistically probable for this group. Indeed, the Oxford University population expert who collated the information insists the discrepancy in birth ratios between boys and girls is too "sudden and pronounced to have a likely biological or environmental cause... the most probable explanation is sex-selective abortion". The revelation follows a three month investigation by a team from the highly-respected BBC Asian Network.

It is almost certainly a very conservative estimate, based solely on records for Indian-born women who moved to Britain, not Indian women born in Britain - for which data is not easily available. Behind the figures are heartbreaking stories of mothers in this country under pressure to have a son, being bullied by their husband and in-laws into aborting their daughters. Indian women in Britain it appears, are also travelling to the subcontinent to use the services of doctors such as Mangala Telang, who does not carry out terminations herself, but for 4,000 rupees (about £49), Dr Telang will tell you the sex of your unborn child and is happy to recommend someone who can terminate the pregnancy. It is illegal in India to use ultrasound scans for such a purpose - even in the UK it is the policy of most hospitals not to divulge this information until after the 24-week abortion limit.

Read more here.

Asian Network Report: Britain's Missing Girls, will be broadcast on BBC Asian Network digital radio.Britain's Missing Girls

Outreach for Punjabi Farm Workers

As a result of an investigative report by India-West on alleged safety and labor code violations at several IndianAmerican-owned orchards in the Sacramento River valley, the California Agricultural Labor Relations Board plans to launch an outreach and education effort in the Indian American agricultural labor force.

According to micro-data samples from the 2000 census, there are about 2,000 Punjabi farm laborers living in Sutter and neighboring Yuba County, and most of them spend at least a few months each year working in Punjabi-owned orchards.

South Asian growers account for less than one percent of the farmers in the California, but records show that they have been the targets of five percent of civil actions

Kulwant Johl, the president of the Yuba-Sutter County Farm Bureau, a trade association of farm owners, and the owner of over 900 acres of orchards, said Punjabi Americans make up approximately 15 percent of the local farm labor force. They cling to agricultural work, he said, because they lack the English language skills required for driving trucks or working in local stores.

ALRB, founded under the California Agricultural Labor Relations Act of 1975, aims to help farmworkers set up secret ballot elections to decide whether or not they wanted to be represented by labor unions; and also to combat unfair labor practices that pose a threat to collective bargaining. Blanco said that Punjabi farmworkers are likely to raise concerns about wage payment, overtime and access to healthcare, which do not fall under his agency's purview. "If we hear of any violations or complaints of discrimination that don't pertain to us, we'll forward that on to the appropriate agency."

CRLA and ALRB will together launch an outreach effort in the Punjabi American community during next year's pruning season in April and May. Although the sites of the outreach efforts have not as yet been finalized, they are sure to include Mahal Plaza. "I've also suggested bringing another person that people would want to talk to, like an immigration specialist who can talk about the citizenship process, or a person who does job skills training in computers or English," Pliscou told India-West.

Previous post: Cultural Isolation A Health Threat to Punjabi Farm Workers

In Loving Memory

ਜਿਨੀ ਨਾਮੁ ਧਿਆਇਆ ਗਏ ਮਸਕਤਿ ਘਾਲਿ ॥ ਨਾਨਕ ਤੇ ਮੁਖ ਉਜਲੇ ਹੋਰ ਕੇਤੀ ਛੁਟੀ ਨਾਲਿ ॥2॥
"Those who have meditated on the Naam, the Name of the Lord, and departed after having worked by the sweat of their brow - O Nanak, their faces are radiant in the Court of the Lord, and many others are saved along with them.||2||

(Ang 8, Sri Guru Granth Sahib)

Punjab: The Enemy Within

The enemy has crept into every village, town and city of Punjab and is destroying the energetic and enterprising Punjabis. Drugs are like an unbreached river which are flooding Punjab. Name the drug and it is avaliable here." - Reema Anand

A new documentary titled, "Punjab: The Enemy Within," was recently screened in Chandigarh to a group of community leaders. The documentary, directed by Reema Anand who has brought us His Sacred Burden: The Life of Bhagat Puran Singh and Sewa: From Paris to Tapovan, brings forth the urgency of the drug abuse problem rampant in Panjab. In the documentary, Anand discusses the impact of terrorism on the state of Panjab and the subsequent reliance upon drugs being trafficked throughout the area.

By now we're all well aware of the presence of drugs and prevalence of drug addiction that exists within Panjab. While there are theories and research behind this, it is clear that a solution needs to be reached through a collaborative effort. Through the creation of this documentary, it looks like Anand has begun to take the productive steps to help bring awareness to this problem.

"The Punjabis struggled hard and fought the terrorists to put Punjab back on the world map, but now they are up against a enemy within."

ER Named After Guru Nanak Dev Ji

The Emergency Room at Surrey Memorial Hospital in Canada, will be named after Guru Nanak Dev Ji:

Guru Nanak Dev Ji's name will adorn the main entrance of the new emergency centre in recognition of the importance of Surrey's South Asian community and its support of hospital fundraising efforts. "The guru reminded us all that devotion of thought and excellence of conduct is our first duty," said Premier Gordon Campbell, who announced the name of the future ER entrance Thursday. "By naming the entrance of this Surrey Memorial Hospital centre after Guru Nanak Dev Ji, we are saying this is a place for everyone." The premier called it an important way to recognize South Asian contributions to society "in a way that's positive and constructive and so people can see that the contributions they've made are important to everyone in the community." The new emergency centre, which will include a mental health and addictions unit and a separate children's ER, will be triple the size of the existing one, which sees 70,000 patients per year – way over its capacity.

Medical Missions for Children

I recently returned from Cusco, Peru where I spent just under two weeks working with a group of nurses, surgeons, anesthesiologists, and volunteers in a small community a few hours away from one of the seven wonders of the world. I'm a member of a global health group based out of Massachusetts called Medical Missions for Children. A group that travels across the globe performing free surgeries for underprivileged children and young adults in about 13 different countries.

My initial exhaustion from the traveling and subsequent catching up at work delayed me writing this post. But I now finally have some time to write a little bit about my experience. First of all, I love traveling and when I can combine my absolute love for traveling with global health work, I really couldn't be happier. It's quite blissful actually...

It was kind of like a 'working' vacation (oxymoron?), and while we were able to spend some time getting to know the city, most of our energy was on reserve for the long days which promised to be...well...long. The majority of the surgeries we performed were to correct Cleft Lips and Palates. However, we also performed a Microtia case and several Rhinoplastys (in addition to other procedures). It's pretty amazing to see the before and after because the results and impact of what the group did was pretty immediate. What was most spectacular was to interact with the patients and families who were the most gracious individuals I have come across in a long time. It was amazing to me how well they dealt with everything and how accommodating they were. A lot of our patients made huge sacrifices to reach our team. Many of them traveled huge distances to reach Cusco and many were from local orphanages who had heard about our group coming from a local radio announcement. Somehow, within a week, you form a connection with the patients and it stems beyond the surgical procedure. You have an interest in providing them with the right advice when they leave, you want to make sure they're heading to a safe place after they leave the hospital. In some ways I wanted to make sure that the circumstances they were returning to were conducive to them living a healthier lifestyle (my public health side was bursting at its seams). It was therefore nice to provide our patients with a new set of clothes to leave the hospital in - perhaps a simple thing, but it meant so much more to them. You could see that the result was beyond an aesthetic change. It was a change in self esteem and confidence which was evident on each of their faces.

Doing this kind of seva is part of who I am, but it's the experience and the people I get to interact with that impacts me in a deeper way. I decided not to write about specific patients in this post out of respect for their confidentiality. But I am definitely still thinking about them on a personal level. It was an amazing experience and it just reminded me how fulfilling this kind of work is for me.