tag:blogger.com,1999:blog-64021144103969011672024-03-05T09:54:22.917-08:00Random experiences in DelhiThis is a blog about the experiences of a Kenyan doctor who is on a 1 year Hands on Training in AIIMS within South Delhi. I am with my family. It will try to describe the experiences at the hospital - AIIMS and other social experiences of settling down with my wife and 2 young children, finding a house and dealing with official bureaucracy. Enjoy and I hope it will entertain and inform.Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-6402114410396901167.post-15874310131464773742013-08-03T03:11:00.001-07:002013-08-03T03:11:26.598-07:00Fats that Harm, Fats that Heal…… well almost<div dir="ltr" style="text-align: left;" trbidi="on">
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Many people have asked me about how to loose weight or what
foods to avoid and I have never had a complete answer for them. From intuition
, I would say, “just do everything in moderation!” and the people would go like
“Huh!, what does that mean?” Well, I don’t know what it means but I do know now
that I was partly right and partly wrong. “<span style="color: #0070c0;">Together
with smoking and physical activity, dietary habits form the foundation for the
causation, prevention, and treatment of most cardiovascular and metabolic
diseases, including coronary heart disease (CHD), stroke, and type 2 diabetes
mellitus (DM), as well as sudden cardiac death, atrial fibrillation, heart
failure, and cognitive decline.( Braunwald’s text book of Cardiology).”</span></div>
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<br /></div>
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Did you get that, dietary habits form the….. FOUNDATION FOR
THE CAUSATION….. as in, you really are what you eat.</div>
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<br /></div>
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<span style="color: #0070c0;">In developing countries, the
burgeoning epidemics of obesity, Diabetes, and Cardiovascular disease (CVD)
result directly from rapid social and environmental changes transmitted
primarily through changes in diet and other lifestyle behaviors.<sup>[2]</sup>
Familiarity with the beneficial and harmful effects of various nutritional
factors is essential to mitigate and eventually reverse the substantial disease
burdens caused by suboptimal dietary habits in individuals and in populations.(Braunwald’s
text book of Cardiology)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Translation….. “My people perish for lack of knowledge”
which could be viewed in two ways, either people do not know or they act as if
they do not know.</div>
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So, in view of the above, I will attempt to give a breakdown
of what is considered a healthy diet. Most of it is common knowledge to most
people but some may be new.</div>
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Foods are usually divided into carbohydrates, fats, proteins
and fibres. In primary school, I was taught that carbohydrates are the energy
giving foods. I still remember the teacher saying it and us, the pupils
chorusing it back. I also had the distinct impression that carbohydrates are
white in colour while proteins are brown foods. This skewed my thinking so much
that I did not consider sugar sweetened beverages to be a form of carbohydrate
until<span style="mso-spacerun: yes;"> </span>recently, neither do most people.
Did you know that 600mls of coke has the same number of calories as 2 chapatis
or a good serving of ugali. So, after lunch, when you take a sugar sweetened
beverage, it is like you are taking lunch all over again. By the way, alcohol
is also quite high in calories and 2 bottles of beer can be equated to a meal
of ugali. So, next time you are out on the rave and you want to maintain your
weight, just take the beer, a few pieces of meat and an apple and that will be
your supper right there, complete in all ways. By the way, when it comes to
weight gain, it is not what you eat that matters, it is how much you eat. It is
not where the calories are coming from, it I s how much of the calories you are
taking in. Think of it this way, if you were a mule and were asked to carry a
load from point A to point B, it is not what is in the load that would matter,
it is how much the load weighs.</div>
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However, when it comes to cardiovascular health, it is the
quality of what you eat that is most important. I wonder if there is such a
thing as a “healthy fat guy?” What would happen if I eat too much of all the
healthy stuff? Hmmh… food for thought!</div>
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When it comes to carbs, one should target those that have a low
Glycemic index and low glycemic load. These will usually turn out to be foods
that have complex carbs, not refined and contain lots of fibre (we all know
that, don’t we?)</div>
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Whole grain contains bran, endosperm and germ from the
natural cereal, while the refined grains have the bran and germ removed. Which
reminds me, those who have been on a farm will attest to this, farmers
regurlary buy “maize germ” and “maize bran” to add to the cow and pig feed.
They buy this from the same millers who make our maize flour and wheat flour…………….
Talk about throwing pearls to the pigs.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="color: #0070c0;">Bran contains fiber, B vitamins,
minerals, flavonoids, and tocopherols; germ contains numerous antioxidants and
phytochemicals. Intake of whole grains associates consistently with lower risk
of CHD, DM, and possibly stroke. Whole-grain intake has been found to improve
glucose-insulin homeostasis, endothelial function, and possibly weight loss and
inflammation. Whole-grain oats reduce LDL-C.<sup>[77]</sup> As with fruits and
vegetables, it is not clear that any single micronutrient accounts for these
benefits; the benefits may result from the synergistic effects of multiple
constituents. (Braunwalds)</span></div>
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<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">FATS</b></div>
<div class="MsoNormal">
When it comes to fat intake, the science is not so straight
forward. We had been made to believe that solid fats (hydrogenated vegetable
oils) are bad and that the liquid ones are good. The hydrogenated vegetable oil
companies therefore came up with a campaign stating that their products are
“0.00% cholesterol free”. I remember seeing a bill board like that and I
thought to myself, “ how can it be 0.00% cholesterol free?<span style="mso-spacerun: yes;"> </span>What does that even mean?” I am yet to get an
English teacher to explain that statement to me. In my mind, it is either “100%
cholesterol free” or “contains 0.00% cholesterol”. Anyway, I believe the idea
was to make us think that cholesterol is ingested in the diet ….well it is not.
Dietary cholesterol is so little and of largely no consequence to your health.
What matters is what the liver does with the fats that you feed it. The liver is
actually the major source of body cholesterol and it generates this cholesterol
from the food we eat.</div>
<div class="MsoNormal">
Fats are divided into saturated fats, unsaturated fats and
trans fats. Saturated fats play<span style="mso-fareast-font-family: +mn-ea;"> a
leading part in raising blood cholesterol and factors such as Diabetes, Hypertension,
Smoking and Physical inactivity act only on coronary vessels rendered sus</span>ceptible
by elevated cholesterol. Main source of saturated fats is animal fats and some
dietary oils. Dietary fat (not dietary cholesterol) is the main contributor to
blood cholesterol levels.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGAJ6vzK0fUkXrxLYOIxg2km7rqKMWBx1oSaH8EQ7F2pxKfWq3ty_2oXJMnAUcanMZtiFKYPi7CwjYV_R5PumlfxPf_8SH1yFHJuLYmL1gKSbmhEvRaLIhqpRxaaLXyq3MDPsznh1T8wpY/s1600/fatty+acids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="159" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGAJ6vzK0fUkXrxLYOIxg2km7rqKMWBx1oSaH8EQ7F2pxKfWq3ty_2oXJMnAUcanMZtiFKYPi7CwjYV_R5PumlfxPf_8SH1yFHJuLYmL1gKSbmhEvRaLIhqpRxaaLXyq3MDPsznh1T8wpY/s320/fatty+acids.jpg" width="320" /></a></div>
<span style="mso-tab-count: 1;"> </span><span style="mso-no-proof: yes;"></span><br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">Oils to avoid</b></div>
<div class="MsoNormal">
Coconut oil and Palm oil – contain large amounts of
saturated fatty acids with least amounts of unsaturated fatty acids.</div>
<div class="MsoNormal">
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<![endif]--><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-no-proof: yes;"></span></a><a href="file:///C:/Users/DR0718~1.KUR/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>Hydrogentaed vegetable oils – contain a lot of trans fatty
acids. These are the worst in terms of causing cardiovascular disease. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">Good oils</b></div>
<div class="MsoNormal">
Olive oil, Mustard oil , sunflower oil, canola oil,
safflower oil – have large amounts of unsaturated fatty acids.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-tab-count: 6;"> </span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184; width: 503px;">
<tbody>
<tr style="height: 18.8pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="background: #CC3300; border-bottom: solid white 3.0pt; border: solid white 1.0pt; height: 18.8pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
<b>Oils </b></div>
</td>
<td style="background: #CC3300; border-bottom: solid white 3.0pt; border-left: none; border-right: solid white 1.0pt; border-top: solid white 1.0pt; height: 18.8pt; mso-border-left-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<b>Poly Unsaturated Fatty Acids </b></div>
</td>
<td style="background: #CC3300; border-bottom: solid white 3.0pt; border-left: none; border-right: solid white 1.0pt; border-top: solid white 1.0pt; height: 18.8pt; mso-border-left-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
<b>Mono Unsaturated Fatty Acids </b></div>
</td>
<td style="background: #CC3300; border-bottom: solid white 3.0pt; border-left: none; border-right: solid white 1.0pt; border-top: solid white 1.0pt; height: 18.8pt; mso-border-left-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<b>Saturated Fatty Acids </b></div>
</td>
<td style="background: #CC3300; border-bottom: solid white 3.0pt; border-left: none; border-right: solid white 1.0pt; border-top: solid white 1.0pt; height: 18.8pt; mso-border-left-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
<b>LDL cholesterol Response (mg/dl) <span style="mso-spacerun: yes;"> </span>(bad chlosterol)</b></div>
</td>
</tr>
<tr style="height: 20.4pt; mso-yfti-irow: 1;">
<td style="background: #ECCDCB; border-top: none; border: solid white 1.0pt; height: 20.4pt; mso-border-top-alt: solid white 3.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Coconut oil </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.4pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 3.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
2 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.4pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 3.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
6 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.4pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 3.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
92 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.4pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 3.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
+36 </div>
</td>
</tr>
<tr style="height: 20.15pt; mso-yfti-irow: 2;">
<td style="background: #F6E8E7; border-top: none; border: solid white 1.0pt; height: 20.15pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Palm Oil </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
10 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
<span style="color: red;">40 </span></div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
50 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
+12 </div>
</td>
</tr>
<tr style="height: 20.15pt; mso-yfti-irow: 3;">
<td style="background: #ECCDCB; border-top: none; border: solid white 1.0pt; height: 20.15pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Olive Oil </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<span style="mso-ignore: vglayout; position: relative; z-index: 251654656;"><span style="height: 79px; left: 81px; position: absolute; top: -7px; width: 57px;"></span></span>11 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
<span style="mso-ignore: vglayout; position: relative; z-index: 251653632;"><span style="height: 118px; left: -306px; position: absolute; top: -1444px; width: 63px;"></span></span><span style="color: red;">72 </span></div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
17 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
-15 </div>
</td>
</tr>
<tr style="height: 20.15pt; mso-yfti-irow: 4;">
<td style="background: #F6E8E7; border-top: none; border: solid white 1.0pt; height: 20.15pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Peanut Oil </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
32 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
<span style="color: red;">50 </span></div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
14 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 20.15pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
NA </div>
</td>
</tr>
<tr style="height: 15.65pt; mso-yfti-irow: 5;">
<td style="background: #ECCDCB; border-top: none; border: solid white 1.0pt; height: 15.65pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
<span style="mso-ignore: vglayout; position: relative; z-index: 251652608;"><span style="height: 118px; left: 88px; position: absolute; top: -8px; width: 63px;"></span></span>Soyabean Oil</div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 15.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<span style="color: red;">61 </span></div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 15.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
24 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 15.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
15 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 15.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
-24 </div>
</td>
</tr>
<tr style="height: 24.65pt; mso-yfti-irow: 6;">
<td style="background: #F6E8E7; border-top: none; border: solid white 1.0pt; height: 24.65pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Sunflower Oil </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 24.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<span style="color: red;">69 </span></div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 24.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
19 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 24.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
12 </div>
</td>
<td style="background: #F6E8E7; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 24.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
-30 </div>
</td>
</tr>
<tr style="height: 33.65pt; mso-yfti-irow: 7; mso-yfti-lastrow: yes;">
<td style="background: #ECCDCB; border-top: none; border: solid white 1.0pt; height: 33.65pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 103.1pt;" valign="top" width="137">
<div class="MsoNormal">
Safflower Oil</div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 33.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
<span style="color: red;">78 </span></div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 33.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 58.5pt;" valign="top" width="78">
<div class="MsoNormal">
13 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 33.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 49.5pt;" valign="top" width="66">
<div class="MsoNormal">
9 </div>
</td>
<td style="background: #ECCDCB; border-bottom: solid white 1.0pt; border-left: none; border-right: solid white 1.0pt; border-top: none; height: 33.65pt; mso-border-left-alt: solid white 1.0pt; mso-border-top-alt: solid white 1.0pt; padding: .05in .1in .05in .1in; width: 117.0pt;" valign="top" width="156">
<div class="MsoNormal">
-30 </div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
From the table above, good oils are in red and they
will help reduce our bad cholesterol.</div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzAxkUhCv5TYFhqgWzvHMGGT9pJVAN-5yStiyjJ6ewR0k1_liiUivxcMmlOoVQf-xmNn69CUCc3RXHGA1ArRZj-XoyAemmMnU5jeQ3sLGNQQHlvIgr4ZwbZ7OKR0__2E4HOBVYTb828Nv9/s1600/pufa.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="352" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzAxkUhCv5TYFhqgWzvHMGGT9pJVAN-5yStiyjJ6ewR0k1_liiUivxcMmlOoVQf-xmNn69CUCc3RXHGA1ArRZj-XoyAemmMnU5jeQ3sLGNQQHlvIgr4ZwbZ7OKR0__2E4HOBVYTb828Nv9/s640/pufa.jpg" width="640" /></a></div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
</div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">PUFA –
polyunsaturated FA,<span style="mso-spacerun: yes;"> </span>MUFA –
monounsaturated FA, SAFA – Saturated FA</b></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">The greater the level
of PUFA and MUFA, the better the oil is for your heart.</b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Fish oil is also an important part of dietary cardiovascular
disease prevention. It has been shown to lower cholesterol as it provides omega
3 polyunsaturated fatty acids in good quantities.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">Fruits and vegetables</b></div>
<div class="MsoNormal">
It is recommended that we take in at least 5 servings of
fruits and vegetables per day. Not only do these provide essential vitamins and
anti-0xidants, they are also a great way to aid in digestion due to the
presence of fibre. Higher fruit and vegetable intake is related with lower CHD
incidence.<span style="mso-spacerun: yes;"> </span>Fruit intake is also
associated with lower stroke risk and dietary fiber from fruits with lower
onset of Diabetes. Hey, we all know that fruits and vegetables are vital for
good health, so I will not belabor the point.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Bottom line, we need to watch how many calories we take in
if we want to affect our weight. We should also ensure that the calories are
coming from healthy sources so as to maintain good cardiovascular health.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com1tag:blogger.com,1999:blog-6402114410396901167.post-16733769446510891322013-05-27T11:53:00.001-07:002013-05-27T12:11:41.276-07:00Summer Paradox<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaX_b34o9hjrGzxrMd64oliW1Gw10X5dLU6mv9SY8Xw3fYDUxXQj-tU3XNmHp9fQIsYM2OdRxJd7dl6NTrNcB5OCMXi44qT4DkHphxajNOQwJukpdtrOmUYcK1LmmMiv_DMEVEujah8w3X/s1600/delhi+temp.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaX_b34o9hjrGzxrMd64oliW1Gw10X5dLU6mv9SY8Xw3fYDUxXQj-tU3XNmHp9fQIsYM2OdRxJd7dl6NTrNcB5OCMXi44qT4DkHphxajNOQwJukpdtrOmUYcK1LmmMiv_DMEVEujah8w3X/s200/delhi+temp.jpg" width="200" /></a></div>
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We had been warned about the summer but at the back of my
mind, I thought, these guys are exaggerating, surely it cannot be that bad. We
had been told that temperatures would hit 45 degrees and we thought, “bring it
on, that does not sound so bad.” Little did we know. As January turned into
February, the heavy blankets of winter were quickly packed away. Suddenly, we
all seemed to have lost some kilos as the extra layers of clothes vanished into
the deep recesses of the cupboard never to be used again. I began to wonder
what the hullabaloo about winter was all about and why I had gone out of my way
to buy winter clothes. February turned into March and the overhead fan came on.
Our landlord had told us that by April, we would need an air conditioner ( AC)
– which he was not providing by the way. As the days grew warmer, I began to sympathize
with my very resilient family. I began to marvel at the wonder of childhood.
Despite it getting warmer every day, the kids seemed to just get along with it.
They did not seem bothered at all. M suddenly developed a liking for sleeping
on the floor. When asked why she likes it, she says she just likes it period.
My sixth sense tells me it is because the floor is cooler than her bed sheet.
And, indeed, upon lying down on the bed sheet, it feels like the bed sheet has
just been ironed 2 seconds before your skin touched it, great feeling for the
winter, but not so great when you already feel that your skin is on fire. I
have officially banned hugs in my house. I have warned all the gals to only
give me a hug once a week preferably when it is cool. The kids are yet to catch
on to this concept. My one year old has learnt that it is suicidal to go onto
the balcony while barefoot. It is quite an interesting sight to see her running
frantically through the house in search of her crocs whenever she discovers
that we are about to go outside. Experience is the best teacher I tell you. She
has experienced the feeling of hot concrete on bare feet. Our kitchen is now a
certified steam room <span style="mso-spacerun: yes;"> </span>and my wife is
glowing every time she emerges from it. <span style="mso-spacerun: yes;"> </span>She now has an exercise routine. She wakes up
early, at 5 am and either goes for a walk or does the laundry. After the walk ,
she spends some time in the steam room as she prepares breakfast for the family.
If it’s a laundry day, she gets to spend time in the sauna, then dry up in the
steam room. Beat that for living in a multifunctional, ecological , energy
efficient, space saving neo- environment. The other day, she was annoyed with
me, so she went to the bathroom, poured water on the floor and had a 1 hr sauna
session contemplating her next move. The cooking pots and utensils are hot all
the time. A sufuria hanging on the rack feels like you have just boiled
something in it 5 minutes ago. I bet it takes food half the time to cook as it
is already hot by the time it hits the equally hot pot/sufuria. Which makes me
wonder, why is it that I am baby sitting for longer hours nowadays as she
ostensibly cooks… this calls for an investigation. The fridge has declared
‘siwesmake’. It has refused to cool anything below the upper compartment and
putting food for 24hrs in it is now a pipe dream.<span style="mso-spacerun: yes;"> </span>I can now conserve the towel as it has become
the most unnecessary invention to use after taking a bath. Just put on your
clothes and you will be dry in no time. Bed time has now become a ritual, put
the kids to bed, soak yourself in cold water..clothes and all… until you are
dripping wet, walk around the room to allow the water to drip down to the
floor, pour some water on the bed or better yet, soak the whole bed sheet in
water and wring only lightly, then plop yourself on it before the whole thing
dries up then pray that sleep overtakes you before the bed dries up. Thank God
for sleep. “Unajua kama umerara, ni kama umekufa nusu!”<span style="mso-spacerun: yes;"> </span>When the kids wake up in the morning, the
first stop is the kitchen, to drink up copious amounts of luke warm water.<span style="mso-spacerun: yes;"> </span>Despite all this, I have to carry a sweater
to school.<span style="mso-spacerun: yes;"> </span>The AC in the library and
other buildings is something else. It is like being in a cool box and even with
those low temperatures someone will come and turn on the fan right above my
head. I therefore wear a sweater when I go into buildings and remove it on my
way out. What a paradox!</div>
</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com3tag:blogger.com,1999:blog-6402114410396901167.post-85498857085987577752013-03-11T09:55:00.002-07:002013-03-11T10:00:37.530-07:00Delhiites and their dogs<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="http://geboon.com/system/photos/3713/normal/Pets%20for%20sale%20in%20Delhi,%20Pets%20for%20sale%20in%20Delhi,%20Pets%20for%20sale%20in%20Delhi%20-%20Dogs%20for%20sale,%20puppies%20for%20sale%20Magical%20Snap%20-%202011.08.12%2022.48%20-%20013.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="146" src="http://geboon.com/system/photos/3713/normal/Pets%20for%20sale%20in%20Delhi,%20Pets%20for%20sale%20in%20Delhi,%20Pets%20for%20sale%20in%20Delhi%20-%20Dogs%20for%20sale,%20puppies%20for%20sale%20Magical%20Snap%20-%202011.08.12%2022.48%20-%20013.jpg" width="200" /></a></div>
On arrival in Delhi, one of the things that struck me is the sheer abundance of stray dogs. There is a dog at literally every street corner. Back in kenya, stray dogs exist but unless there is a garbage dump somewhere, these dogs are usually emaciated. Not so in Delhi, the dogs here are fat, very fat and ready to have a heart attack any moment. Some of them cannot even walk, they waddle...... sideways. Ever since I spotted these fat dogs, I became intrigued at how they managed to keep such a hefty physique despite being stray dogs. I also noted that the Delhiites are in love with dogs. Despite living in flats that may be cramped, it is not uncommon to see an old man walking 2 or 3 overweight dogs every morning. There is even a lady I see quite often who walks no less that 4 cute dogs everyday. During winter, all the dogs get to wear winter jackets... even the stray ones. This reminds me of a true story.<br />
<br />
One of our friends is in a club that has alot of Delhiites. During winter, when the cold was really biting and almost unbearable, the club raised an appeal for money to be donated to buy winter jackets for the stray dogs that congregated at a point near where the club would meet. The members gave generously such that the canines all got a jacket and there was left over cash. So the question was posed, "what do we do with this extra money?' It was proposed that they should look around for a street family that is in need of blankets and donate some.<br />
<br />
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The conundrum of how the dogs manage to stay so overnourished was finally answered. It had always intrigued me why sometimes I would find food remains(snacks really like biscuits and chevra)on the porch right outside my landlords house and the gate wide open. One day, we found dog poop on our steps on the 2nd floor and I wondered how the dog got there. Our landlord does not own a pet dog. Another day, I went to the grocery store and I witnessed the shop owner tear open some biscuits and pour them out on a receptacle for the canines around his shop to have dinner. Some will even pour out some milk to quench their thirst after the biscuit feast. That was the eye opener for me. The "aha" moment. Since then, I can't help but notice the receptacles outside many homes that seemingly look like trash but may indeed be performing a role every now and then. There was a day when we witnessed a lady who had stopped her car in the middle of the road at the main market, opened the boot, got out a large plastic plate, put it on the tarmac and proceeded to pour out dog biscuits for the stray mutts........incredible.<br />
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I am yet to understand what the dogs have to do with Indian culture. There are also many monkeys around Delhi that are quite a nuisance. We have been warned that the monkeys even know how to help themselves to the contents of your fridge if you grant them access to the kitchen. We have also been warned not to feed the monkeys. I don't understand why I can feed the dog but not the monkey. The Delhites also have a thing for feeding birds. There is a place near the main market that is always littered with seeds that someone routinely scatters for the birds. There are also containers of water, just in case the seed goes down the wrong pipe. <br />
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Ooops, after writing the above paragraph, I decided to check out wikipedia. Apparently, in Hinduism, it is believed that dogs guard the doors of heaven and hell .... go figure!</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-59777515188256164042013-02-23T09:39:00.000-08:002013-02-23T10:04:13.635-08:00North India by Train<div dir="ltr" style="text-align: left;" trbidi="on">
I am grateful to the Lord that we found a wonderful church in Delhi known as <a href="http://www.biblebhavan.org/" rel="nofollow" target="_blank">Bible Bhavan</a> Christian Fellowship. Before we stumbled upon Bible Bhavan, we had visited 2 other churches and still did not feel at home. On the first day of visiting Bible Bhavan, we knew that this was it. It was like a family away from home where the word of God is explained sequentially and clearly. We looked no further for a church as we now felt at home. At last, we had a family in Delhi where we could fellowship, visit and we lost no time in making friends. Our prayers for a church had been answered.<br />
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Some time ago, we went on a medical mission trip whose main aim was to minister to the needs of our brothers and sisters in Christ serving as church planters, ministers and workers in various Bible Bhavan affiliated centres in North Delhi. Our journey began with a bus ride to the train station at 5a.m. The train journey to Dehradun took almost 6 hours. The train station was crowded even at 5a.m and I shuddered to think what it looks like during holiday season when everyone is travelling to join their families. The journey itself was not too bad. The train was clean with seats that had seen better days but were still in good condition. It was spacious with ample leg room and hot meals were served. The toilets however were nothing to write home about and we were petrified by what we would do if our daughter decided that she needed to use the bathroom. The camp went well and the journey back was better; we knew what to expect and since it took place at night, we slept for half the time. On the third day, we flew to Lucknow and spent an afternoon and the next morning seeing people with various medical issues. The dental team had set out a full mobile dental clinic that was impressive. They were cleaning teeth, doing extractions and even had a mobile 'denture factory' (for lack of a better word). The optical team were diagnosing problems and issuing reading glasses. Thereafter, we took a train ride to Varanasi. We had been warned that theVaranasi train ride would be a difficult one. My wife had immediately taken upon the spiritual dimension on hearing this and could be heard explaining how the "air will be thick, and choking because of all the evil spirits on the way!". Varanasi is where many Hindu adherents go to bathe in the river Ganges. It is also the bed rock of Budhism where it is reputed that Budha gave his first ever sermon. In my mind, I had thought that 'difficult' had a spiritual connotation but little did I know that it was also meant in a very physical way. The first assault to my senses was when the team leader announced that we should carry our water with us from the dining area at Lucknow. I thought to myself, "that is odd. In the previous 2 train rides, water was provided in abundance. Every person had their own water bottle and you could get more if need be." However, I decided to pack a water bottle though half heartedly. On arrival at the train station, I was still oblivious as to what to expect on this train ride. I started to fantasize on the hot dinner and then I would settle down on the wide seats, stretch my legs and nod off for some 5 hrs or so. On boarding the car we were supposed to travel in, I almost turned back, thinking I was in the wrong train. My sense of sight was assaulted by images of very old seats, some of which did not recline, were rusted in some areas and the cabin curtains looked like they had not been to a laundry in a hundred years. The seating space was also narrow. As if that was not enough, alarm bells go off in my nose as I sense the acrid smell of urea that was poorly camouflaged by an equally strong smell of disinfectant. On entry, at the cabin door, my subconscious mind registered that there was no activity at the door of loading food items but at the same time, I wondered how I would consume a meal with these competing nauseating aromas in the air. As I sat down at my seat with a sinking feeling, I observed that the fold down table for my seat was spoilt. As I was contemplating how to eat my food without a table on a moving train, with a toddler balanced on my knee, my memory rushed back to to what I had heard before. Like a movie, the comments came rushing back.....'the train ride to Varanasi is very difficult'......... 'please carry your water with you for the train ride'........... the sight of no food being loaded at the door....... and now.......... no table. It hit me like a thunderbolt......." my goodness, <b>there is no food on this train!!</b>" We had to think fast. We had no idea how much time we had to go out and buy snacks before the train started to move. Luckily, the snack vendors were just out there on the platform and I figured if the train started to move, I could jump on quickly enough. I dashed out and got some snacks then settled down for the ride. By the 3rd hour of our 5 hour train ride, we were all "snacked out". Hungry but unable to force down another snack. Even the kids could not stand the biscuits and crisps. However, our God is merciful and he delivered sweet sleep that ensured that our last 2hrs were spent in blissfull oblivion to the hardships of the train ride to Varanasi.</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-36010408693662750682013-01-20T07:52:00.000-08:002013-01-20T07:52:13.196-08:00Lets arrange some Love<div dir="ltr" style="text-align: left;" trbidi="on">
Arranged love. An interesting scenario when you come from a background where love is allowed to fester on its own between two people before they can announce their intentions to them that would care to hear. I first came face to face with the concept of arranged marriages on a bus ride to Moshi, Tanzania. There was this young looking Asian of Indian origin ( lets call him Abhinit) who seemed very fascinated with one of our daughters. As is expected on a long bus ride, it did not take long for the parents to get involved in the conversation between this stranger and their daughter. It emerged that this guy had had an arranged marriage and was beaming at the experience. He was working in Australia and when he felt ready for marriage, he asked his parents to look for a nice girl, they did, the guy went to India for 2 weeks, got married and went back to Australia with a wife. (of course I don't remember the exact time lines but it was something close to this). In fact, Abhinit's view of 'love marriages' was that the courtship and all that goes into bagging a bride was a great waste of time, resources, very stressing and led to immoral behaviour. I was intrigued by his views because until then, I had always thought that people were forced into arranged marriages and just had to perservere through it.<br />
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Fast forward to Aiims and I meet this guy, Lalit (names have been changed). He is very excited. Next week, he is going to his home area where his parents have arranged for him to meet a prospective wife. The excitement is palpable. He tells me that this is the first time he is going to meet the girl and if he is happy, he will marry her. 2 weeks later, I bump into him and enquire whether he liked the girl. He says he is fifty fifty about her. He says she is young and has lived for a long time in a hostel away from parents while studying and he was not sure. In addition, his family were also not so sure that she would be respectful and perform well as a wife; she may be childish. So, the long and short of it is that he may consider her but first he will look around a bit more.<br />
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In church, we meet this couple, Priya and Narang (not their real names). They have been married for 3 years and have 2 children. They seem very happy. Their marriage was arranged. Priya had had a fair bit of "window shopping" courtesy of her parents and had not found anyone suitable. By the time her meeting with Narang was arranged her mother was fed up with facilitating the 'window shopping'. According to Priya, the previous guys did not match up to her ideals. She had a list of questions that she would use to gauge the the appropriateness of her future spouse and if they did not march up, she would continue looking. After 2 weeks of hanging out with Narang, she knew that this guy was okay. Narang also felt she was okay. They let their parents know, were engaged 2 weeks later and married within 2 months of first laying sight on each other. Incredible!<br />
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Another couple, Suxenna and Ajit (lets assume these are their names) had an interesting story. Suxenna is light skinned and comes from a Christian family. Her dad is a pastor, I think. Ajit is dark skinned. If you know India, you will know that dark skin puts you at a definite disadvantage when you are dealing with Indians of lighter skin tone most of whom consider themselves to be of high caste. So Suxenna's dad tells her, they have found a nice young christian man for her to marry. Only problem is that he is dark skinned. She agrees to meet him, likes the guy and the rest is history.<br />
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Not all arranged marriages end well though. Sometimes, the family really wants to control who joins the family and problems then develop. The family will want to match for level of education, family economic status, beauty, caste, jobs held etc. I read of many suicides comitted because someone has been denied marriage to the person they want. This whole scenario of arranged marriages has made me realise the wisdom of my form 1 social ethics teacher who once declared " Love is a decision !" I thought she was crazy then and had never been in love. Now I know better!</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com77tag:blogger.com,1999:blog-6402114410396901167.post-35268540400209371452012-12-09T08:11:00.002-08:002012-12-09T08:13:09.085-08:00Caught in the Middle<div dir="ltr" style="text-align: left;" trbidi="on">
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You get the feeling of being caught in the middle of two worlds. The longer we stay here, the more we adjust to the situations around us. One gets used to not understanding what people are saying and if I don't understand, I just walk away especially if I did not initiate the conversation. You get used to being overcharged just because you look 'new'. There is so much middle class in South Delhi but occasionally, you will see the signs of opulence with out of this world (at least my world) car makes. The usual Mercedes C class and Baby Landcruisers we like to floss with are not here. When these guys floss, they pull out the stops. It will be a Mercedes E class, S class, Audi 4wd, Porshe. However, these are few while the overwhelming majority are in tiny fuel efficient bugs if not on a two wheeler. However, the signs of poverty are still there. As you pass near a brigde, you may spot families that have pitched makeshift tents and call that home. If you want to put up a building, be ready to have whole families come live at your site until its done. Its like the families must save the little money from the construction work by living on site. Mornings are bath time so you will be walking on the road and a whole group of guys will be bathing right next.... not in the full birthday suit though. In some places, you will find the women doing the hard job of carrying ballast and sand on their heads, while the men do the actual building. On the other hand, I can sit at a computer, shop, order and receive the product within 3 to 5 days. If the product has a defect, I call a number, it is picked up or I receive instructions on how to undo the defect (for electronic goods). Our water filter suddenly stopped working and after alot of fiddling with it, I gave up and decide to call the number on the warranty card. I actually got someone on the other side who took down my details and told me a technician will come in 48hrs. Just like that. I was in a bit of shock. Didn't think I had heard right. So, in a nut shell there is evidence of extreme poverty in Delhi but at the same time, systems seem to work..... somehow. However, as is want to happen, the local person on the street feels there is grand corruption and impunity at the high levels of governance. They feel the corruption is unlikely to end as all the players are thick in the milieu and have dirtied their fingers in one way or another..... Listening to them, one may be forgiven for thinking that our politicians have been teleported to India.</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com1tag:blogger.com,1999:blog-6402114410396901167.post-48338866170039038162012-11-27T07:54:00.004-08:002012-11-27T07:57:33.978-08:00Medical Paramilitary<div dir="ltr" style="text-align: left;" trbidi="on">
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Sometimes I feel like when I signed up for medical school, I inadvertentently singed into a paramilitary force. These feelings are not helped by the fact that my boss back in Kenya would never tire of reminding me that " Medicine is like being in the military". I thought this was just a Kenyan thing until I arrived here. The 'paramilitary force' is even better defined and efficient. Now that I have close friends in the actual military, I think we can easily compare notes. In Medicine, there is a command line that is dictated by rank rather than age. The higher your medical education level, the higher your office. The Non commisioned officers are the medical students who are sometimes unruly due to being uninitiated and not knowing what to expect. They may therefore not follow orders appropriately or just simply ignore them. One can never rely on the medical student to carry out a task in the ward as they will not be held accountable for the consequences of their actions. However, gross misconduct can easily see them remain in that lowly rank for a considerable duration of time as they fail exam after exam despite reading very hard for it. The cadet is the intern. They do the bulk of the work in the paramilitary. They are expected to be responsible for everything that happens in the ward and inform the appropriate seniors as necessary. They will wake up at whatever hour to attend to whoever needs attention. They dare not complain about work load as this may see them stagnate in this position for some time. Thankfully, this stage is only for 1 year before you get promoted to a medical officer. Some people stagnate at this point and never progress. Interns come and pass them by to become consultants and come back to instruct their former teachers. Sometimes this can present quite an interesting scenario. After the medical officer comes the resident, senior resident, specialist, specialist consultant and if you are in academia will come the professor title. What, one may ask has prompted this discussion. The other day, I was invited by one of the consultants here to attend a 1 day workshop on a paediatric heart condition. The workshop is on a sarturday, it was going to take up the full day and I really did not feel like going. However, when, the consultant sent for me, I was warned to tread carefully as this particular person can be quite bad. I therefore feared to say "No" but instead committed to attend at least part of it. You see, the cardiology program here combines adult and paediatric cardiology and one is expected to be equally enthusiastic about both. This morning, the particular consultant announced in class that there would be a seminar and that the students should attend and lend a hand. This is one day notice and the next day was supposed to be a public holiday. I really felt sorry for the Residents as I saw some of them line up to give their excuses as to why they could not make it for the seminar. This brought back memories of the military where the rank is always right. When I talk to a senior ranking doctor, I call him 'Sir' and he may call me 'sir' but the difference is that I will mean it. When a senior doctor is wrong, we say he is old fashioned or I have a different opinion. In this place, this rank business goes a tard further. You should see the commotion that ensues when a senior doctor gets into the room and everyone struggles to get to their feet simultaneously. I always get caught out as I never seem to know what's happening.If a consultant is passing along the corridor and there happens to be a nursing station near the corridor, the nurses all stand up as he passes, like a standing ovation kind of thing. Never mind that he is minding his own business and may not even notice this ovation.... or maybe he does and just ignores it.... sometimes he may be gracious to motion to them to sit by a wave of the hand. If I am seated and a consultant comes and happens to pause near me, I spring up like a porcupine had just found its way into my seat. I guess thats our salute in this paramilitary, we stand up! </div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-53372778213479408082012-11-15T17:51:00.000-08:002012-11-15T17:51:04.239-08:00Delhi Diwali<div dir="ltr" style="text-align: left;" trbidi="on">
I guess if I was Hindi, I could say " its that season of the year again, Diwali". For sure, it is a season marked by many days of celebration. Celebrations start 10 days before the actual diwali on a day called Dusserha. This is the day that Lord Ram defeated an evil King called Ravan who had taken his wife and held her captive. One cyber cafe owner I asked about Dusserha told me Ravan was a very evil King, the worst there could ever be. He was satan! However, some people say that in a way, he planned to take Rama's wife so that he ( Lord Ram) would come after him and kill him and therefore promote him to a better afterlife ( I forget what it is called - the afterlife that is!). So, Dusserha is the day Lord Ram kills Ravan. 10 days later, Lord Rams' (self imposed) exile ends and he returns to his people to great celebration and fireworks.<br />
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Another version I heard recently is that Diwali is really a festival for Northern India. The Indians in Northern India are said to have come down from the Caspian sea ( part of Europe I guess) and they occupied the North that was then known as Vedic India. They pushed the original occupants towards the South. Lord Ram was King of the North while Ravan was King of the South. King Ravan took Lord Rama's wife captive as a way to prove a point to Lord Rama ( sort of a political manouvre of some sort). Lord Ram went after him and with the help of a monkey tribe ( who were humans but with tails and special powers ), he defeated King Ravan and killed him. He thereafter returned home to Diwali. Diwali is therefore not such a big thing in South India as it is the day their King was killed - or so my historian told me.<br />
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Whatever the story, and I am sure there may be other versions, at least they all agree on a few things. Lord Ram killed King Ravan and therefore Dusserha and Lord ram returned home and therefore Diwali.<br />
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In Diwali season, everything is on sale. One custom is that you should wear new clothes on Diwali. There is also a day about 3 days before Diwali when you are supposed to exchange kitchen ware and a day after diwali when brothers are hosted by their sisters and gifts are exchanged. In short, November has more holidays that working days if you include the weekends as holidays. Luckily, not all the holidays are public holidays so work still flows.<br />
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The usual grocery stores and milk shops are transformed into sweet shops. Chocolate and nuts everywhere. If you have a sweet tooth, Diwali is the season for you. Fireworks begin to reverberate through the night well before Diwali. Our neighbours told us we aint seen nothing yet but we could not imagine that it could get any noisier. The last 1 week or so has been like living in a battle zone with staccato outburst of a sub machine gun here, followed by earth shaking 'boom, boom' of heavy artillery complete with the sound of debri falling from the sky. However we adjusted well, until Diwali arrived.<br />
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The day started pretty normal. At around 8.30pm, it was like all hell broke lose. The city was literally on fire with fireworks in every direction. They do it on the street in front of their houses and there will be varied types of firecrackers. By around 10 pm, the air was thick with smoke and dust. It was like walking through a fog of smoke and dust. Cases of asthma actually sky rocket during this time. Every one is so happy and jolly and we were invited to watch the crackers go off. It was quite a show that went on till 1 am. The next morning and upto 2 days later, one can still hear sporadic 'gunshots' as kids find unexploded crackers and do some justice on them. Others are trying to get rid of their stocks. I imagined that if it was a true battle ground, these would be the rear guard passing through and shooting randomly at anything that moves.<br />
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Did I mention, the lights. These people pull no punches when it comes to lighting up the house at Diwali. One may even think the whole estate has been tranformed into a big Mall with flashing lights all over.<br />
In short, Diwali was enjoyable to watch. These guys party like our Lakeside brothers but went to Central province business school.<br />
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The typical estate street during Diwali in this part of India. These are apartments by the way, not shops or malls.<br />
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Fire works on the street</div>
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Above: Fireworks from our balcony... and no, this is not the star that the wise men saw.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgeO_XNHMWKNSMOm1DyMIJonEimNZgw2oarf2wLEU5xHJgJD0Oxz0No_0jkiUj9bJVxruYWAKUizC8GZJz5Z_aYha6XSqeXWtKiHpmuGhI2n0y7C1JnzP8Aj5Y_N7-NDKX98s5BMr7PNCdy/s1600/lit+house.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgeO_XNHMWKNSMOm1DyMIJonEimNZgw2oarf2wLEU5xHJgJD0Oxz0No_0jkiUj9bJVxruYWAKUizC8GZJz5Z_aYha6XSqeXWtKiHpmuGhI2n0y7C1JnzP8Aj5Y_N7-NDKX98s5BMr7PNCdy/s320/lit+house.jpg" width="320" /></a></div>
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Photo taken from our front balcony</div>
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Above: Our flat, 2nd floor, just above the leaves of the tree.</div>
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The house Neighbouring ours<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjz_B24-kDpAJ-syI5POMgyS5amjMbw7O9lhDBExjjZipIRb87X9fB1wa35xrP8SgVKR9p5M14n63tFkL5QFwydgNzqhbDw3N9Za2DiYMzf9SQIkui8xjLv8d2axA_H37QWOZ4w2eu8e5r/s1600/DSC05815.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"></a></div>
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Another residential street</div>
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Demon chasing fire crackers.</div>
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com1tag:blogger.com,1999:blog-6402114410396901167.post-74661438202290069922012-11-06T09:22:00.001-08:002012-11-06T09:22:11.738-08:00Address Proof!!!<div dir="ltr" style="text-align: left;" trbidi="on">
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Do you sometimes wonder, " How is life really like in India?". "How different is it really from kenya?" Well, I can try and give you the perspective of a foreigner living in what I guess is a middle class neighbourhood, probably even upper middle class if we gauge by the amount of house rent which by the way is not commensurate with the quality of the building and fixtures by our Kenyan standards. The rent is way up there with the kites while the quality of housing is down there with the ants... sorry termites that burrow deep down. Once you get over the initiall housing shock, you begin to enjoy a few of the amenities. Practically everything can be delivered to your house. This is because every house has an actuall physical address. Just quote the address and the person will find you. As a matter of fact, there is even no need to go meet someone at the airport if they are coming to your house. Just ask them to get into a taxi and give the address and voila, they will get there. This makes travelling easy because as long as you have the address of where you are going, the only thing you risk is being overcharged by the taxi or rickshaw guys because you have no idea how far the place is, otherwise, the question of getting lost is almost eliminated. The idea of having an address is nice and rosy but can be quite intimidating for some of us who are not used to it. I usually think to myself, "this stranger actually knows where I live". " He/she can creep up on me any time of day and find me." " I cannot afford to double cross them etc etc because they will find me" Thats just me being paranoid, but just think about it, the shop attendant, milk man, cyber cafe guy, where you buy your sim card, the bank... all these people know where you live. The other day, I came home to the news, " there was a guy from the bank who came to confirm where you live"... I almost collapsed.The home is supposed to be an enclave of sorts where you retreat to after a hard days' work. However, with the requirement here for "ID proof, address proof" for any small transaction you do, its difficult to imagine how those guys who are always ducking their creditors survive in this place. You can't hide at home or at work. You can only leave home and go live with a relative or friend. This however has its own complications. I remember my Land Lord saying that even when he has a relative living with him for more than 2 weeks, he has to inform the local police station. I can only imagine the kind of documents that have to accompany that report, " ID proof?, Address proof?, Reason for being in Delhi?, Proof for that reason?, Employers name? Employer proof?, Fathers name? , yaani, there is no beating the system. Criminals must have a very tough time in this place.<br />
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On the upside, the fact that you have an address makes it easy to receive morning newspaper at your doorstep, daily packet milk delivered, groceries delivered if you feel too tired to go to the supermarket, practically anything you buy in any shop can be delivered to your house, usually at no extra charge. Internet connection is good and one is spoilt for choice. Internet at home via wifi is common and so cyber cafes are few and far between at least in this area. I have however travelled to other areas that seem to have many cyber cafes. Because of the address system, you don't have to open a post office box. Just send that letter and it will find me at home. Cooking gas has run out? Make a call and it will be delivered. Internet based companies even offer cash on delivery payment option because its so easy to find a place if you have the right address. So now, I am not sure whether having physical addresses is a good or bad idea. It makes life convenient but on the other hand can be quite disconcerting. I guess it will take some time getting used to it.<br />
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-30777982336756871482012-10-28T10:04:00.000-07:002012-10-28T10:04:20.339-07:00Myth Buster<div dir="ltr" style="text-align: left;" trbidi="on">
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Having been here for a few days there are a couple of myths that I had heard about India that I would like to confirm or dispel:<br />
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1. <b>India is very dirty</b> : I think this is a generalization that may apply to other parts of India. South Delhi is quite clean (by Kenyan standards) and would compare well to Nairobi. If you go to where the poor people live, of course the conditions are different but I would say that the places I have been to in South Delhi are more or less okay. However, I hear Southern Delhi alone is as big as Nairobi, so we have probably visited a very small part of it.<br />
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2. <b>India Smells</b>: This I must say is quite accurate. There is definitely a whiff of something in the air , no matter where you go. I have tried to put a word to the smell but was not able to until I opened a packet of "mixture" - what we call "chevra" back in Nairobi and encountered the same smell only more overpowering. I have therefore concluded that South Delhi smells of "curry".<br />
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3.<b> All Indian food has chilli:</b> This is 'Yes' and 'No'. If your idea of chilli is that sharp taste on the tongue that seems to grab you in the throat and cause you to choke while it just sticks there and refuses to go away like a dog on a bone.... then the answer is 'Yes'. If you are an Indian, chilli is those green or red peppers that we like to call 'pilipili', so the answer is "No". In other words, to an Indian there is a distinct difference between chilli and curry. So, all Indian food has curry, but not all Indian food has chilli. Therefore, the next time you are at an Indian restaurant and you ask, " please don't put chilli in the food, because of the children" and the food comes 'hot' with that grip to the throat, it may be just because you did not communicate appropriately. You should have said "please do not put chilli or curry in the food, because of the children" in which case you will have wasted your money because you will not be eating Indian food.<br />
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4. <b>India has rats crawling all over the place:</b> I have not seen a single rat. This is not to say that there are no rats. All I am saying is that in this part where we are staying, I am yet to see a rat. Maybe in the Monsoon season they might crawl out of their hide outs, so lets wait and see.<br />
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5. <b>India is full of creepy, crawlies:</b> This may be true but there is no need to carry an assortment of insecticides. There are plenty of insecticides in the shops here. Only dilemma is that we don't know which one is the most powerful. We have discovered some tiny black mosquitos... or is it that they have discovered us.... and they are causing us to contort at night to reach many areas simultaneously. Otherwise, roaches and house flies are not as common here in our house. Cats are also a bit rare.<br />
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6. <b><a href="http://www.bloomberg.com/news/2011-04-06/delhi-belly-isn-t-only-india-water-risk-as-resistant-bugs-found.html" target="_blank">Delhi belly</a> is the result of having a rich culinary experience:</b> this may or may not be true. I hope that I don't get to confirm this myth. Everywhere you go, there is food being cooked especially on the streets. This is not the roast maize, occasional roast cassava or boiled maize you will find in Nairobi. I am talking whole meals with dal (ndengu), puri ( something that looks like small mandazi), paratha (chapati) and some humongous mandazi. Only problem is, 'the kitchen' makes my stomach turn just passing by it. The other day, I watched someone making some parathas. He was using a long metal rod to reach into a deep <a href="http://www.google.co.ke/imgres?hl=en&sa=X&biw=960&bih=530&tbm=isch&prmd=imvns&tbnid=C9OTtJ_uxIXCDM:&imgrefurl=http://www.dkengineering.co.ke/images/albums/institutional%2520kitchen/flash/SlideShow.swf&docid=9owM9n6fhjgD3M&imgurl=http://www.dkengineering.co.ke/images/albums/institutional%252520kitchen/flash/energy%252520saving%252520jiko.jpg&w=350&h=380&ei=MeRpUIWRIZCHrAeyl4CQBA&zoom=1&iact=hc&vpx=708&vpy=58&dur=5519&hovh=234&hovw=215&tx=143&ty=133&sig=112194251525291178938&page=7&tbnh=165&tbnw=165&start=69&ndsp=12&ved=1t:429,r:11,s:69,i:340" rel="nofollow" target="_blank">jiko</a> where the parathas were cooking down below. He was also using what looked like a small cushion to 'spin' the parathas down in the jiko. My only issue was that the small cushion looked like it was once white but was now black in most areas. The guy would also occasionally use the metal rod to smack his friend on the bottom as he waited for the next paratha to cook. Delhi Belly..... please Lord just preserve us. On the same issue, I think the Government of India has gone to extreme levels to keep the incidences of Delhi belly down. The tap water here tastes like swimming pool water and when you boil it and let it cool it has some white powder at the bottom.<br />
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7. <b>Clothes in India are cheap </b>: This one caused a mini - riot in my house when I decided that I will not take time to verify this myth. I therefore cannot comment as of this moment due to the prevailing micro-economic climate in my household. Anything I say on this issue should be regarded as hearsay. Having said that, there seems to be a trend towards more affordable clothing but since I have not tested this theory, I cannot comment on the quality of the clothes so as to give a comprehensive assessment. However, my colleague at the hospital once told me that the branded clothes (Tommy Hilfiger, Lee, Marks and Spencer etc) are cheaper than in Europe but they are Indian quality ..... don't ask!<br />
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<a href="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQU6He-RY79dW6zyLMWC-sId1hqH4_C1K_T16Z7J2fmtH1JONfE" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="400" src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQU6He-RY79dW6zyLMWC-sId1hqH4_C1K_T16Z7J2fmtH1JONfE" width="299" /></a>8. <b>Delhi has bad drivers:</b> This is an understatement. A matatu driver from Nairobi's Eastlands would be a novice when compared to a newly qualified Delhi driver. You need compound eyes to see all the traffic around you which includes buses, trucks, 3 wheelers and 2 wheelers. In addition, you need compound ears ( do these exist) to know when a particular hoot refers to you or to the vehicle next to you. In fact, the vehicles here have signs like 'Please hoot' painted on them. At first, I thought that the owner was challenged in English and meant to say 'please no hooting', until I discovered that it is practically impossible to drive without using your car horn and using it often. You also need nerves of steel even as a passenger in a 3 wheeler. It is not uncommon to see a three wheeler cut in front of an oncoming bus as if the driver had a death wish. <br />
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9. <b>India is cheap to live in</b>: Maybe other parts of India but not South Delhi. In my opinion, the rental rates are prohibitive when compared to the quality of the premises. The locals complain that electricity is expensive and we are yet to find out. On the brighter side, cooking gas is regulated by Goverment so a 15kg cylinder is 400 Rupees to refill (approx. 640Kshs). Vegetables are more affordable while in my opinion, other foods are just slightly cheaper than in Nairobi. Public transport is affordable and well organised. Everything else is almost the same price as Nairobi. One nice thing is that you can have a McDonald meal with kshs 800 for 3 people and for those with a sweet tooth ice cream prices at McDonalds start at Kshs 16 for very nice ice cream. So after paying my rent, I will go chill my raging emotions.<br />
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<b>10. The head nod:</b> before I came to india, i was told that indians shake their head sideways when they mean 'Yes' and they shake up and down when they mean 'No'. However, I have discovered that this is not entirely true. I have discovered that they will do a hybrid of up-down movement and sideways movement when they mean 'Yes' and when they mean 'No'. It all depends on the context of the conversation. Sometimes it may just mean...nothing.... For example , a simple question like " Is your name Deepak?" can easily be answered with the head nod.... depending on how he looks at you while nodding, you will know whether its a Yes or No. Sometimes he may go like "Sir" (head nod) in answer to the query then you will know its a yes. <br />
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-53936622353885992842012-10-21T06:58:00.002-07:002012-10-21T09:34:54.121-07:00Of Dengu , Dengue and phantom mosquitoes<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="http://www.medindia.net/patients/patientinfo/images/dengue-fever_print.jpg" imageanchor="1" style="clear: left; cssfloat: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="136" src="http://www.medindia.net/patients/patientinfo/images/dengue-fever_print.jpg" style="-ms-interpolation-mode: nearest-neighbor;" width="200" /></a>Dengue ... ever heard of it? You pronounce it almost like 'dengu'.. those seeds that some of us love to hate after having them as staple for 4 years in High School, but in actual fact the two are unrelated... well not totally unrelated if you consider similar geographical location to be a relationship but thats where the similarities end. While one is potentially deadly and not to be wished on your enemy, the other is well, just sometimes unappetizing and may induce some colon olympics. Having been in Delhi for a couple of months now, we have got used to the dengu but had no idea it had a familiar sounding cousin called dengue.</div>
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The realisation came quickly and was like a thunderbolt. One day, you wake up fine as a fiddle. Then you begin to feel a bit feverish and before you know it, your back feels like a Sumo wrestler just landed on it while carrying a tonne of bricks. Then comes a splitting headache and your eyeballs begin to pain, right inside the sockets. With each movement of the head, you are made aware of the the pain in the eye sockets. You are therefore forced to close your eyes so as to avert your gaze and this seems to help a bit. It however makes you feel wobbly and faint especially if you move too fast. On the second day of this teriffying illness that I could not put a name to, a friend comes to visit and declares, ' you know there has been an outbreak of Dengue fever in Delhi '. They make it sound like the whole of Delhi knows about it and has protected itself and we are the ones who have been caught out... like sitting ducks (I am sure that was not their intention but that was definitely my perception) and I go like "Dengu who?" I suddenly remember some disease like that that we studied in passing because it is not found in Kenya or most parts of Africa. The fever is unrelenting. It is only relieved by paracetamol. Body and muscle aches become the order of the day. It lets you know that they don't call it 'break bone fever' for nothing. When you read the literature, you are informed that it is a viral infection that could kill you, but in the mean time, it has no cure so just continue taking paracetamol for your pain and hope for the best. I would have wished to await my fate in a nice sanitized, air conditioned hospital bed but, as fate would have it, I had neglected to take out a 3 month travell health insurance from home claiming that I would take on a proper health cover upon arrival in India. I had hypothesized that since healthcare is cheaper in India, then health insurance would follow suite. My hypothesis was right but human nature and procrastination had done me in. So, one day drags into the next and after 3 days, I am are thinking , 'I am dead and have gone to some place other than heaven.... this must be that place!' Woe unto you if you begin to vomit. That means dehydration will set in swiftly and without medical attention, death is imminent. The virus causes a form of internal dehydration where the tissues become leaky and fluid leaves the blood compartment into the tissues and may lead to shock if not recognised. Add on to this some actual vomitting and you can see how dire that combination can be. The literature says that the fever can last upto 2 weeks, but I say I will be gone in 2 weeks. It all began when my youngest daughter developed a fever that was otherwise benign. Though my medical mind was puzzled, I was comforted that she was otherwise well, playfull and eating well. After 2 days it disappeared, only to reappear again after 5 days. My other daughter got it next, she however also remained relatively well. Little did we know that the dengue fever was saving its whole armoury for us.... the parents. My wife then complained of a fever and within no time, in a couple of hours, kaboom, she was flattened, in near tears with muscle pains. On day 3, she began to doubt my medical expertise. Despite my keeping a very close eye on the situation, I must say that Jesus was right to say a prophet is never honoured at home. She was trying really hard to believe me but I could see the doubt creeping into her eyes. When she gave me that puppy eyed look that said, "I am sorry for all the hurt I have caused you in the past" I decided enough is enough and to save face, we went in search of a second opinion. The doctor was nice but a bit scary. He seemed to pause just before writing the prescription and make gestures with his hand, as if he was praying or meditating. Only problem is we could not be sure who he was praying to. He suggested admission, we declined politely. He then wrote out more paracetamols and some blood tests which turned out negative. We went home and I think there was a spring in my step as my diagnosis and management had just been confirmed. To cut a long story short, Yahweh was merciful and in 4 days, the fever was gone. However, literature throws in another spin by proclaiming that a haemorrhagic (bleeding) rash begins to appear when the fever is coming to an end, thus giving it the famous name haemorrhagic fever. I can't stop checking myself out in the mirror and now, I am also seeing the offending mosquitoes everywhere I turn. I see them whizzing silently by on the street (Dengue fever is transmitted by a day time biting mosquito). I feel them munching on my bum as I walk on the street, I am constantly swiping them off my back ( never mind that I am wearing a shirt). I think I must be suffering from Mosquito Induced Post traumatic Stress Disorder.</div>
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com1tag:blogger.com,1999:blog-6402114410396901167.post-83009556388804710862012-10-15T03:56:00.000-07:002012-10-15T03:56:51.412-07:00Golgappas....<div dir="ltr" style="text-align: left;" trbidi="on">
The other day, we were discussing with my wife just how adventurous we should be in enjoying the street delicacies that abound on every street corner. She has been longing for some kebabs that she saw being grilled at a corner near where we live. The place looked clean, decent and was pretty popular with the local people. Its like a hang out joint of sorts where people meet after work and just talk on the street. With each passing day, I became emboldened to pass nearer and nearer the stall so I could take a peep at the "kitchen" and possibly the menu and prices. Yesterday, I was bold enough to pass right next to the counter. Though I was feeling a bit peckish, my stomach suddenly did an about turn and demanded to let out some of its contents. It did not immediately register to my conscious mind what the problem was until I came right up to the counter and saw a customer ravenously enjoying some<a href="http://2.bp.blogspot.com/_Dkhm1ZdHICA/So7RlbnMHeI/AAAAAAAAAZs/ro4n1C2mDHk/s400/golgappas.jpg" rel="nofollow" target="_blank"> </a><a href="http://2.bp.blogspot.com/_Dkhm1ZdHICA/So7RlbnMHeI/AAAAAAAAAZs/ro4n1C2mDHk/s1600/golgappas.jpg" rel="nofollow" target="_blank">golgappas.</a> Next to him, stood the stall assistant who was cheerfully dipping the golgappas into a stew and placing them on the customers plate. Only problem was that the assistant was using his hands to dip the golgappas into the stew and the stew looked 'sweaty' with a glistening top layer and was in a big open bucket like container. My stomach just rejected that scene. I tried to suppress images of where those hands may have been, how many people they have greeted, how much sweat they have wiped away, how long has that soup been in that bucket. This is not to say that all golgappas are served this way but I was just amazed that one can even do that..... take a bit of food, dip it in soup for me.... with your bare hands.... then place it on my plate. No thanks. However, I have noticed that maybe I am the one with a problem. It may just be Indian culture. It is not uncommon in the hospital mess to see two men mixing their food together in a plate and eating from it with their hands. I am thinking, "Even if we are best friends and there is no scarcity of food, please get your own plate!" Lets just say that the plans of buying kebabs at that joint have been deferred until further notice.</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com2tag:blogger.com,1999:blog-6402114410396901167.post-49005829543270259582012-10-04T11:34:00.000-07:002012-10-06T11:14:11.029-07:00CPR..... in Hindi<div dir="ltr" style="text-align: left;" trbidi="on">
<a href="http://www.athletics.psu.edu/rec/nat/images/cpr_bw.gif" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="153" src="http://www.athletics.psu.edu/rec/nat/images/cpr_bw.gif" width="200" /></a>Does anyone know the Hindi word for CPR (cardiopulmonary resuscitation)...... well... me neither. How about the Hindi words for "stop" and "start"...... eeehh , I am blank too. Well, that has been my life these past couple of weeks...... drawing blanks. The hospital is really good but with one major shortcoming... they speak Hindi - aaallllllll the time. Morning lectures are in English but the rest of the day is in Hindi. When they (residents and consultants) are discussing a patient, they will do it in Hindi. Never mind that you might also be in that gathering and willing to contribute. Its like you don't exist. This has caused me real turmoil these last two weeks. "Is it that I am black?", "Would it be different if I was white?" " Is it that these guys don't really want us here?" are some of the issues I have been dealing with. Then I wonder, " Why let me come if I am not welcome? Why is it that when I ask a question, I get answered very well and do not sense any negative vibe coming from them?" What is it with all these contrasts. Its like playing a game of she likes me, she likes me not.<br />
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Then comes the light bulb moment. I am in the cath lab observing a procedure when a nurse comes to the door and says something. The operator suddenly stops, tears off his gloves and heads off in the direction of the adjoining cath lab. A patient had just collapsed on table and CPR had commenced. There is pandemonium as instructions are shouted in Hindi. Luckily, some words like Laryngoscope have no Hindi equivalent so when I heard that word, I knew they wanted to put a tube down the patients' throat to assist his breathing. I decided to assist in doing chest compressions. I get up there and begin with all gusto. I hear someone shout something in Hindi. I continue with the CPR, suddenly, everyone shouts "stop stop stop!".... so I stop. After a pause, the consultant says something in Hindi, I am still pausing, suddenly they all go "start, start start!". Had it not been a life or death situation, I would have rolled down in stitches. Imagine this, the consultant shouting the instructions is standing right next to me, he knows I have "no Hindi" yet he speaks to me in Hindi in that situation.<br />
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I have therefore come to the conclusion that this is Rome. Though learning medicine in Hindi is proving to be quite tasteless, like eating salt less food, never the less if one is hungry, even salt less food with satisfy and with time you begin to consider it a low salt diet.</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-73422546549873356172012-09-29T02:03:00.001-07:002012-10-01T11:33:48.565-07:00Broken Heart Syndrome<div dir="ltr" style="text-align: left;" trbidi="on">
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Tako - Tsubo cardiomyopathy is an <span class="util">acute cardiomyopathy that can be provoked by a stressful or
emotional situation or exposure to high doses of catecholamines (sympathomimetic
drugs). This cardiomyopathy is most
common among middle-aged women, appears to be related to catecholamine release,
and in most cases is fully reversible with supportive care. Electrocardiographic findings of myocardial infarction in the
presence of left ventricular dysfunction and absence of epicardial coronary
stenoses should prompt the diagnosis. Endomyocardial biopsy is of value to
exclude myocarditis, which can also mimic acute myocardial infarction, and
demonstrates contraction band necrosis. Enough with the medical jargon......</span><br />
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<span class="util">What this basically means is that there is a form of heart disease that can mimick a heart attack but whose true cause may just be being over stressed leading to release of the fight or flight hormones ( adrenaline). Did you also know that research at Harvard university has shown that one of the ingredients required for one to live to 100yrs is to be optimistic about life. It also compared people who had suffered a heart attack and categorised them into optimistic guys and pessimistic guys based on a questionare they answered. The optimistic guys were doing much better 5 years down the line while a greater proportion of the pessimists had suffered a recurrent heart attack ( with all other things between the two groups held constant).</span><br />
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<span class="util">This gives me a whole new meaning to the verse " Guard your heart... proverbs 4:23)</span><br />
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com0tag:blogger.com,1999:blog-6402114410396901167.post-90169827674460417692012-09-27T11:31:00.000-07:002012-10-01T08:13:09.523-07:00Bureaucratic Delhi<div dir="ltr" style="text-align: left;" trbidi="on">
I am amazed by the level of bureaucracy in Delhi. This is coming from a lowly student who just wants to be here for 1 year and get out as fast as possible. I wonder what business people who want to set up base here have to go through. To get a mobile line, one has to have a copy of passport and passport photo, ditto for a internet modem. If you will be in India for more than 3 months, you need to register with FRRO (<span style="color: black;"><span class="heading">Foreigners Regional Registration Office)</span></span> within 2 weeks of arrival. This will require you to fill an online form, print it out, attach a copy of your passport, 3 passport photos, letter from your employer (in India) or school or something that explains your business in India, evidence of your permanent India address and deliver this to their office on an appointed day that you will receive. Thankfully, if you have all the documents in order, you will be in and out in a couple of hours. Then comes application for gas connection which requires a passport photo, passport copy and proof of residence. The landlord will require passport copy, visa copy, passport photos (like 4 of them), letter from your employer and FRRO certificate. The bank is the most ridiculous. One of their conditions to open an account was that I must make an initial deposit of 10,000 rupees using a cheque drawn from an Indian bank....... I almost pulled my hair out.... thankfully, I had just cut it short the previous day... which is a story for another day. And by the way, I was told about this requirement in 3 different banks. The fourth bank did not have such a requirement so I breathed a sigh of relief and gave them the documents they needed. After 2 days, they call and say they cannot activate my account because I need to take to them a letter from the hospital and a copy of my hospital id. So I tell them I will work on getting the letter. When I request for the letter from the hospital registrar, he gives me a look to suggest I must be very new here then goes on to say "Ve have never received such a request before, no. This is quite unusual. Ve have no protocol for writing such a letter (head nod). I am afraid ve can't help you!"...... as in what is that? Now I am waiting for the bank to be gracious and accept just my hospital id copy The cyber cafes are also a tough cookie to crack. They need to see your passport and probably have a copy with you and sign in a book before you can use their computers. Oh and by the way, all documents will require you to write your fathers name. I understand that this is because the Indian names are so similar that it helps avoid confusion. <br />
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After running out of passport photos, I realised why they have shops that take 45 passport photos for 50 rupees. I thought it was a joke untill I realised just how many passport photos one needs here and had to get my 45 photos done. </div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com5tag:blogger.com,1999:blog-6402114410396901167.post-63776895562840205502012-09-23T12:18:00.000-07:002012-09-29T10:32:36.166-07:00The beginning - my typical day<div dir="ltr" style="text-align: left;" trbidi="on">
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I wake up at around 6 am, to the rumblings of my daughter M saying ' Papa, lets go make breakfast'. She tries really hard to make it a whisper but if I do not respond the first time, it gets louder and louder. My clock is always set for 6.30am but sometimes I wonder, " whats the use?" If its not M trying to get into the covers at 6am, it will be my other gal N, yelling at 5.30am ... listening to her, you would think someone had inflicted severe pain on the one year old tot, only to discover that that is her way of saying " Goodmorning!" and "You better come for me quick or else I will wake the other tot in the room"... its pure black mail I tell you and she has perfected the art. I will usually take breakfast at 7am but because M & N are awake, they will eat half my breakfast ... never mind that there breakfast is on the way. I walk to AIIMS which takes about 20 minutes. In the morning, from 8 - 9 am, there is a sort of lecture where the cardiology student at AIIMS presents a topic and discusses it for about 30min. Then follows questions from the consultants and sometimes these can get so heated among the consultants that the presenter is forgotten and it becomes a face off among consultants. pure nail biting adrenaline I tell you. studies are quoted and experiences expounded. 'Simple' questions are asked that have no 'simple' answer yet the person asking it wants a 'Yes' or 'No' answer but the responder says 'Yes and No'.They turn red in the face and the we (the students) are left wide eyed, reaching for the popcorn, not knowing who to believe. The presenter, meanwhile, breathes a sigh of relief. he has been forgotten for the moment. Soon, the moments will pass and we will move on to the next topic. Woe unto you, if you are the presenter and the consultants are in agreement that you are wrong and they are right.... you become cannon fodder and your presentation is torn to shreds. The minutes don't seem to end as you are called to justify slide after slide, and you begin to sweat...on the nose... then you know its bad. Thankfully, it only takes 30 minutes. Then someone else presents difficult or interesting cases encountered in the cath lab the previous day. Since the case itself will be difficult and the solution controversial, there is always debate at this point in the day. They don't make them better in Hollywood guys. The consultants rip at each others' ideas and opinions and draw blood. Its just spectacular to watch and listen... of course these things also happened when I was training at UON but not at this intensity. Here, there seems to be no fear of who ranks higher in the department, or who is a Prof and who isn't. In fact, they don't use titles, everyone is just plain old Dr. So the intensity and professionalism in the discussions is to be admired.<br />
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We then breakoff to cath lab or other duty stations as per different assignments. I started my rotations in cath lab. One has to dash and try get the scrubs before they run out. The scrubs themselves are old, worn out and torn and just like plain old KNH, the nurses in cath lab seem to have a stash of the good ones saved away somewhere for themselves and their friends. Very annoying this habit. Once I change into scrubs, I begin to observe the different procedures.There are four cath labs and they perform 30 - 40 procedures per day. The work ethic is excellent bearing in mind that this is a public hospital. Though the cardiology students do most of the procedures, the consultant in charge of the patient is always in the cath lab from beginning till the end of all his procedures even if this is 8pm. These guys work hard and its commendable. I have never seen consultants work this long in a public hospital, constantly available and stepping in to make the final decision about every one of those patients undergoing the procedure before they leave the table. I have been observing for the last 1 week and already, I appreciate just how wide the topic of cardiac catheterisation can be. They usually work, sometimes non- stop untill 4 pm , but some may break for lunch for 30 minutes and resume. All cases planned for the day must be completed even if it means that they end at 8 or 9pm. I usually leave at 5pm. I go home to find S has had a rough day with M and N, the house is like an oven and the kitchen is the source of the fire (literally and allegorically). I take the kids out to the park for about 1 hr to let madam cool off and then come home. We have dinner, M is all over the place wanting to be fed and carried. We read the bible, pray and the kids are asleep by 8.30pm. I begin to fill in the knowledge gaps until sleep overtakes me.</div>
Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com2tag:blogger.com,1999:blog-6402114410396901167.post-82467093367247198902012-09-21T11:40:00.002-07:002012-09-29T10:28:56.715-07:00Rickshaw Trickster<div dir="ltr" style="text-align: left;" trbidi="on">
The other day, we took a ride on a rickshaw (a bicyle tuk tuk). Before boarding, we asked how much it would cost and the guy said 5 rupees. So tukaingia. As we are riding, we saw the journey is getting long and started asking ourselves, kweli this journey is only 5 bob. When we arrived we gave him 10 rupees. As I am waiting for change, he gives me back the cash and says "30 rupee!" We try reason with him but he walks away and pretends he does not understand a word of English. His colleagues begin to gather around us. None of them understands english. they start talking among themselves in Hindi.... then they look at us and talk to us in Hindi. We begin to get desperate. The guy comes back and declares " 40 rupee' then walks away again. By this time, any possible escape route has been closed. We look around for someone who knows English to try and explain that the guy had said 5 rupees lakini wapi, if they understood us at all, they were good at hiding it. The last straw was when he came back and declared "25 rupee" while pointing at me and " 25 rupee" while pointing at my buddy. We realised that this price was going to get to 100 rupee if we dont escape fast. We quickly paid the 30 rupees and escaped with our lives. Luckily, one of the his rickshaw friends is the one who told us to pay 30 rupees and walk away. After this incident, i dared use another rickshaw guy. This time, we agreed that it was going to be 40 rupee. Luckily, I knew where I was going so he could not play tricks this time. However, upon arrival, he asked for 50 rupee .... I gave him a very stern look and shouted at him and he hurriedly took the 40 rupees and left. Luckily it was just me and him at that time. Apart from these occassional conmen, it has been okay. <br />
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Kenyan dochttp://www.blogger.com/profile/02591589967257847559noreply@blogger.com1