Durango Herald Family Planning Population Public Health

Haunted in India

The image of Varanasi that stays with me is not the chanting and bell ringing while seven saffron-robed priests gesture with incense and flames. It is not the nine clouds of smoke as bodies are cremated on the steps beside the Mother Ganges. It is not the press of dense crowds of people-whom I found to be more comfortable than those in New York City. I am haunted by the lepers.

This is written on a long-awaited trip to India. My invitation came over 40 years ago with a chance meeting with a man from this country. I told him that I was going to medical school because of concern about overpopulation. He responded “Come to India, we need you.”

Varanasi is the heart of Hindu India. Pilgrims have visited there for centuries because of the cleansing water of the Ganges. Believers go there to die, since it is most auspicious to have your soul released by cremation beside this holy river. Perhaps you have seen images of this in glossy magazines. But the pictures leave out an important part of Varanasi.

India’s population more than quadrupled during the twentieth century. Yet during this same period the number of children a woman bears during her lifetime has halved, from 6 to 3. This seeming paradox occurred because of falling infant mortality. In the past, a huge proportion of children died before adulthood. Although medical care has helped, the most important factors for this welcome decline in childhood mortality have been improved nutrition and hygiene.

As a medical student I was curious about Hansen disease, as this scourge is now called. The bacterium that causes it lives in amazing harmony with human nerves, but gradually causes them to fail. Injuries are common because affected people cannot feel pain. Worse, at night rats nibble unprotected fingers and toes.

Cure of the infection is possible, but prolonged and expensive. Often treatment is limited to little more than bandaging and protection of the affected part. Tradition has forced people with Hansen disease to live separate from the rest of society. There is still a strong emotional reaction to the word “leper” even though most people in the USA have never seen one. Perhaps Hansen disease was the first use of quarantine, although the disease isn’t very contagious. What I didn’t learn in medical school is that it is very much a disease of poverty and malnutrition. As proof, well-nourished health workers seldom contract the disease even with constant exposure.

Leprosy still thrives in India because of poverty. Malnutrition is too common here, although less than a century ago. This month the India Times reported the sad results of a national health survey. Only a quarter of newborn babies are given the breast within an hour of birth. This lessens their chances of successful breastfeeding, which could substantially reduce infant mortality. Half of all children under 3 years are underweight, and one in five is stunted by lack of food. Three quarters are anemic, due to parasites or iron deficiency. Another article pointed out that girls are more likely to be starved than boys. In contrast, there are many rich people in India. One woman in seven is overweight. This is a country of contrasts.

To quantify this huge gulf between rich and poor, compare the income of the richest fifth of the world’s people with the poorest fifth. Worldwide this ratio in 1960 was 30 to one. Now it is more than 80 to one. The rich are getting richer-often at the expense of the poor.

Why should we care that this chasm is widening? There are two reasons. First is altruistic-it is sad to have people suffer from poverty. The other is that poverty threatens the security of rich people. Indeed, some feel that the real reason for terrorism against the USA is economic.

The image that sticks with me is of people lining our path to the Ganges. Squatting with quiet, upturned stolid faces, they held empty begging bowls with mutilated hands.

Part of my personal attempt to narrow the chasm between poor and rich has been to help support children in developing countries. For the first 35 years we sponsored a series of boys in Columbia. Filimina Mallik, our current child, lives in a remote part of India, too far from our tour. I believe that she is healthier and better educated for the small donation we make each month through Plan USA.

© Richard Grossman MD, 2007

[The article above may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at:]

Environment Global Climate Change Population

Anticipate Industry’s Aid with Global Warming

A friend avoids anything with General Electric’s name on it because he thinks the company is environmentally unfriendly. When our younger son was considering working for GE I tried to persuade Bryan to look elsewhere. Now it appears that GE may actually be wearing a white hat!
The world’s corporations have driven the industrial revolution and economic growth. Without capitalism we might still be back in the dark ages, burning very little fossil fuels. We would still be traveling by horse and buggy, heating with wood and reading by firelight. Not a comfortable thought!

It is shocking to think that the coal and petroleum that we rely on are causing climate change on an enormous scale. Our temperate world with good growing conditions may heat up and dry out. According to some, our home will be transformed into a desert within this century. Certainly we cannot succeed in stopping global climate change without stopping our population growth.
Shortly after Bryan started working for GE he told us about their “Ecomagination” program. We were dubious at first, thinking that this program was probably just “greenwashing”—marketing by an industry that is environmentally unfriendly.
There is strong evidence that GE’s program is serious, however. In 2005 the Ecomagination program had $10 billion in sales. This includes household products such as my favorite energy saver, compact fluorescent bulbs. GE also makes power-saving refrigerators and clothes washers. Their larger ticket items include green electricity generating windmills and solar panels.
Energy saving procedures at GE kept a quarter million tons of greenhouse gases out of the atmosphere in 2005. The company’s objective is to cut greenhouse gas emissions by 30 % by 2008—a reduction that is much more stringent than the Kyoto protocol. These are significant achievements and goals.
GE has become aware of the importance of environmentally friendly products. It has realized that it can make money from being “green”. I am also sure that it is preparing for the future when companies that emit excessive greenhouse gases, or make products that do, will be penalized.
Xcel Energy is another company that is turning green. Xcel supplies electricity to over three million customers in eight states, including parts of Colorado. Fifteen percent of their generation is greenhouse gas free; it comes from nuclear reactors, hydro, wind and refuse. But they generate the majority of their power with coal. Not only do coal fired power plants release untold tons of carbon dioxide, but they are responsible for spreading other poisons, including mercury.
Xcel is taking two commendable actions. The first is planning a unique coal fired power plant. Most power plants shove CO2 plus toxics such as mercury, particulates and sulfur dioxide up smokestacks into the air we breathe. Legislation has forced power plants to include scrubbers that remove some of these toxics. Other laws would have required additional measures to remove mercury. Unfortunately, the Bush administration has deferred these rules.

Xcel has committed money to design an Integrated Gasification Combined Cycle (IGCC) generating plant here in Colorado. Not only is this design very efficient, it also allows capture of CO2 before it is emitted into the atmosphere. A portion of the CO2 from this proposed plant will be sequestered—pumped underground into depleted oil wells. This will be the first IGCC plant at high altitude, and the first in the USA to capture carbon.

In 2007 Xcel will build the country’s largest solar power plant in the San Luis Valley. On a more personal level, Xcel will reimburse part of our own home’s photovoltaic system that has been generating electricity since May. Through their Renewable Energy Credit program, they are buying credit for the renewable energy that we produce, as required by Colorado Amendment 37. Harnessing the sun’s energy directly, rather than through fossil fuels, decreases greenhouse gas emissions.

Insurance is the latest industry to combat global warming. Because global warming increases the risks that insurance companies underwrite (such as the damage caused by Katrina), they are taking measures to decrease greenhouse gas emissions. For instance, several companies give incentives for ecofriendly cars and buildings by reducing insurance premiums.
It remains to be seen whether industry’s efforts will be sufficient to stave off global climate change. Those who believe this seem to think that improved technology will allow people in developed countries to continue our profligate lifestyle. I find it difficult to believe that the same attitude that is causing global climate change will also save us from global calamity.

© Richard Grossman MD, 2006