Desi detective tales with a twist—Liddle’s sandook of criminals is a delight for both history buffs and mystery lovers

MADHULIKA LIDDLE’S second book, The Eighth Guest and Other Muzaffar Jang Mysteries, is once again based around the Dilli Durbars of the 17th century, at a time when the Mughal Empire had shifted base from Agra to Delhi under Emperor Shahjahan. The main protagonist of the book is “consulting detective” Muzaffar Jang, a young amir, first introduced in Liddle’s The Englishman’s Cameo. In the first book, Liddle did what few Indian authors had done before—placed a detective novel in a historical era. Like with the first, Liddle’s second offering also gives the readers a vivid insight into the heydays of Shahjahanabad, taking them through bustling bazaars, royal havelis, elephant stables and sarais outside the walled city. Unlike the first book—a murder mystery with several intertwining sub-plots—the second book is a series of independent stories of murders, espionage and thefts. Liddle continues to write Jang’s character cleverly, by focusing more on the young detective’s peers than him, and weaving a character based on the difference between them. Unlike his royal friends, Jang often collaborates with the “invisible class” (read: boatmen, servants, mahouts and slaves). He seems obsessed neither with luxury nor leading a decadent lifestyle, is pragmatic and appears more “manly” than his often-effeminate friends (perhaps because our amir was raised by Zeenat Begum; an older sister, often strict, always maternal, moral and yet modern). He is more active than most of his friends and clients who sometimes groan at the prospect of movement. But his tehzeeb is intact, and so is the chivalry. Liddle’s Jang, thus, is quite the maverick of his times and often stands out. As does his creator. Unlike several other Indian authors who write in English, Liddle does not ‘exoticise’ her context or story by adding several layers of explanations or meaning to the text. She presumes that her readers have an understanding of old Dilli, which frankly, makes her style refreshing, less tedious to read and less condescending. Liddle’s language is lucid and her style matter-offact. Though there aren’t many direct references to political intrigues, there are passing references or hints in the sub-plots which make Shahjahanabad more real for the reader. If you are one of those who has been on a steady diet of crime fiction, for you Liddle’s weakest point will be her plots: they are predictable at best. But because the crimes are often not over-the-top or too dramatic, one could be tricked into believing that they could very well have happened— in all times. The book’s strength lies in its details and the manner in which Liddle lays them down. The author’s Dilli is vibrant, alive and very real for the readers. Though the characters speak in English, there is a faint whiff of courtly tehzeeb in the manners of speech. On a personal note, two of her stories did stand out for me—The Bequeathed Garden and The Eighth Guest— because of the kind of characters she has sketched out. The footnotes at the end of the story add a layer of genuine history to the settings of the stories. All in all, Liddle’s style has enough in it to entice not just the whodunit lover, but also the fan of historical fiction. Born in Guwahati, Madhulika Liddle lives in New Delhi at present. Before she became a full-time writer, she worked in the hospitality, advertising and industrial design sectors. Her stories have won several awards, including the top prize at the 2003 Commonwealth Short Story Competition. Her elder sister, Swapna Liddle, is a historian (often helping the younger sister to get facts straight and organising Muzaffar Jang Walks through Old Delhi for fans). Liddle has confessed that she is often drawn to the murkier underbelly of humanity— it could be a result of being a police officer’s daughter. Though the family travelled frequently, her longest stint was in Delhi. “My affection for the city and its considerable historical heritage were directly responsible for my debut novel,” she has admitted. Otherwise, the prolific author spends her time writing about cinema and travel, and penning short scripts for All India Radio.

Sunandini Banerjee makes the cover into a canvas with stunning visuals and digital creativity

One is usually not advised to ‘judge a book by its cover’, but when it comes to the books and catalogues that Seagull Books bring out, that is exactly what one is tempted to do. The artist-designer-visualiser behind these beautiful and gripping designs is Sunandini Banerjee, who is today both Senior Editor and Senior Graphic Designer with the publishing house. A student of English literature from Jadavpur University, Kolkata, Sunandini admits that she “can’t even draw a tree”. But that did not stop her from acquiring a reputation not only as a great designer of book covers, but also as an artist who has three exhibitions to her credit. Today, she designs all of Seagull’s books, book covers and catalogues. So how does an editorial assistant become an expert on the art of the book? With inspiration, vision and the brilliant use of technology. As Sunandini puts it herself, “Pictures—photographs, street-signs, hoardings, paintings, drawings, coloured pages in magazines— all of these fascinated me. Different types of lettering, lettering and image together, all caught my eye. But I didn’t quite know what to do with this, till I started working with books and on the computer.” Distilling a lifetime of observation into practice, she found the combination of the scanner, Photoshop and QuarkXpress a hugely liberating experience. Of course, every budding artist needs a supportive patron or mentor and for Banerjee, that person was Naveen Kishore, Publisher of Seagull Books. Acknowledging his contribution, she says, “He continues to give me the space and the encouragement to do more and be more.” When trying to ascribe a genre to her work, ‘collage’ is the word that springs readily to mind. But if the image you come up with is that of many layers in a particular medium or style, then it would be an incomplete definition. Her work certainly operates at many levels—visual, emotional, literary and often, humorous. But there is more to her art than a simple patchwork of images. Explaining how she tries to fit the cover to the content, Banerjee says, “My covers are not always only about the book in front of me. Other books, other stories, other memories, other places—everything makes its way into a cover. I go with my gut and try to convey both what the book is about and what I think it is about. I think about what it reminds me of, what else I have read about it, a song it brings to mind or a colour that flashes in my memory in response to the words. A cover interprets, talks, laughs, comments, underscores, reminds and prompts.” (Little wonder, then, that readers spend time interpreting the covers for a while before they flip the page). There is no uniformity to Banerjee’s process when it comes to designing the covers. Step one consists of working off a short blurb describing the contents of the book. From that point, like all creative endeavours, it takes on a life of its own. Sometimes the title is evocative enough to bring images to mind. When that happens, the whirl of activity begins as Banerjee looks around for what she can use: a photograph, a newspaper clipping, a line drawing or something to scan. And by slow degrees, layer upon layer gets built as objects, emotions and visuals come together in an impactful whole. At other times, the connection is harder to make as authors ask for something different (once she had to do 39 options for a cover!) and the images don’t come together satisfactorily. When that happens, it is back to the drawing board for Sunandini. Sometimes, if the blurb is not enough to conjure the images, then she reads the book in greater detail, or corresponds with the author for a starting point for her imagination. As she puts it, “There is no formula; it’s all about instinct and spontaneity.” In 2003, Sunandini Banerjee designed her first Seagull Books catalogue, and today their catalogues are as anticipated as the next title. In contrast to designing a book cover, the catalogue is more of a team effort, with a lot of time being spent planning the look and content. Once the contributions are in, the process begins for Banerjee. “Last year, the theme of the catalogue was ‘Loss’ and we requested our publishing friends and colleagues from all over the world to send in their writings, extracts, poems and thoughts on loss. Then I came up with the idea of using old family photographs to illustrate those writings, because, to me, nothing conjures up more nostalgia and affection for ‘the lost’ than old family albums”, says Banerjee, trying to explain the intuitive quality to her work. Though Sunandini does not consider herself an artist in the literal sense of the word, there is no doubt that her work deserves a place in the annals of modern art—as evinced by her shows at the India Habitat Centre. Words like ‘fresh’ and ‘different’, clichéd as they may be, certainly apply to her work. There is no tried and tested formula to her efforts, as she goes seeking inspiration anywhere she can, which in turn lends her work a universal appeal. As she puts it, “Inspiration knows no borders. I am a global citizen, as is the rest of my generation. I grew up reading in English and Bengali; listened to classical and contemporary music from the West and East; and watched Hollywood, Bollywood and Tollywood. A tree is a tree anywhere in the world. I will not use lotuses, peacocks and paisleys because I am Indian. I grew up being at home in the world’s imagination. I would be disappointed if my work did not reflect that magnificent canvas.” Her work does indeed reflect a very broad canvas and many of her designs also have a subtle touch of humour about them. Ask her and she says, “Laughter is a great band-aid for the hurts and bruises that life inflicts upon you. Laughing at and with yourself is essential if you don’t want that swelling ego-balloon to burst. Some of the visual jokes in my work are deliberate, like a ploy to see how many people in the world get the joke and laugh out loud. Some are qu eter; I’m sharing a joke with myself though I’m aware the viewer is eavesdropping. Some are a reminder to myself and to anyone who’s watching: Don’t take this too seriously. I didn’t.”

Uncharted and mostly untouched Borneo is simply breathtaking 

In search of that elusive earthly paradise, uncharted by Google, unmapped by GPS and unchronicled by Lonely Planet, I had zeroed in on the jungles of Indonesian Borneo; inaccessible to all but the most persistent and hardy traveller. So five of us, a group which included two teenagers, set out in pursuit of our Holy Grail, a remote, primordial speck on our denselypopulated planet. Armed with water-purifying tablets, insect repellent masks, knee-length leech-resistant boots, kerosene lanterns, bedrolls, knives and ropes, we set out on our exploratory voyage fancying ourselves modern-day Marco Polos. The chance to spot orangutans in their habitat and not in corralled conservation centres was an added attraction. Borneo—or Kalimantan as it is known locally—is a large island straddling the Equator. It is shared by three countries; Indonesia, Malaysia and Brunei. While Malaysia has burnt down most of its rainforests for palm oil plantations or manicured, accessible tourist spots for dollar-laden tourists, Indonesia, happily, has left nature relatively alone. So there are still pristine rainforests left, though timber and palm oil traders are advancing relentlessly upon them. Pontianak, an hour’s flight from Jakarta, was our first pit-stop. Pontianak’s claim to fame is that it sits bang on the Equator, straddling two hemispheres. And that it trades palm oil to food processing firms that take care of the trans fat content in all those unhealthy fried foods we so relish. It also fancies itself a techno-savvy ‘cyber city’, as a board at the airport informed us. Interestingly, our plane steward could not figure out why a bunch of loony Indians would wish to visit Pontianak when the drop-dead gorgeous Borobudur and languorous Bali beckoned tourists by the droves. No, he hadn’t heard of either Ketapang or Kubang Hill, and didn’t think much of them either. “You are taking all this trouble to see orangutans?” he asked us incredulously. After a night’s halt, we made our way to the jetty on Kapuas River to catch a boat to Ketapang at the edge of the rainforest. If you think over-crowding and filth are endemic to India, think again. Bedlam prevailed at the jetty packed with cargo, scooters, luggage and a mass of humanity. For locals, this is the only transport available to visit villages scattered on the island. Eventually, we managed to get the right boat and flashing ingratiating smiles and our foreign identities, we managed to gatecrash into the captain’s cabin. After seven hours of slicing through the mangrovelined Kapuas, we reached Ketapang, a village on the edge of the rainforest. Our hotel, built with indigenous materials and hoisted on stilts to take care of flooding at high-tide, was a haven. The next day, we hired a guide-cum-cook, stocked up on rations and rode the dirt track winding its way to the edge of the forest. From the moment you enter the forest, you become aware of the decibel level in a rainforest. There is a cacophony of bird calls, insect buzzes, and powerful, screeching winds. More than once, we stopped when we heard something like gunfire, which our guide informed us was rainforest thunder! We carefully picked our way up the forest floor, sodden with metre-high foliage and logs covered with fluorescent toadstools, underneath which lurked all manner of strange creatures. Vines draped themselves around solid tree trunks, and sometimes a lazy serpent as well. As the forest floor grew steeper, we had to pause more frequently for breath, marvelling at the porter-cum-cook who, armed with most of the gear and sporting nothing more than worn chappals skipped lightly up the path. At several places, our ascent was only made possible by knotted ropes tied to trees, by which we would haul ourselves, and our packs, up. Sometimes, the ropes would snap, hurling us down. It was only with the help of our trusty guide that we managed to reach the camp—weary, covered in mud, scarred but exhilarated. When you read camp, don’t let your imagination run wild with visions of resort-style facilities. All we had was a wooden shack raised on poles. It sported a sloping roof, but no walls; leaving visitors at the mercy of the rain, wind and insects. There was no bedding nor toilets; all we could do was sprawl on the planks or huddle together in the middle to escape the spray of the incessant rains. But to our weary bodies, this was paradise. Our porter-cum-cook miraculously managed to convert all the soggy groceries into a delectable meal that would have been the envy of a starred Michelin chef. From the camp, we set out to explore the rich and diverse rainforest—for a worm’s-eye view, literally! The canopy was so high, and the trees so dense, that sunlight hardly filtered through. Chlorophyll of every hue filled our eyes. A cornucopia of insects flaunted their fluorescent poison, warning visitors. Some had small but impressive horns or hooks. Snakes came in varying sizes, as avian fauna of incredible variety, including the gorgeously plumed hornbill with its helicopter-like whir as flew overhead. Gibbons and macaques and proboscis monkeys were all around. Much to our dismay, the ever-elusive orangutan was nowhere to be seen; our guide informed us (as we tromped through the jungle making as much noise as a herd of wild bison) that unless we quickly learnt to trek quietly, we might never get to see one. We did not get to see the simian, but we did spot mushy durian peels and swaying branches. Our guide though, seemed to spot them in glorious detail. So as to not lose face, we nodded sagely, craned our necks and pointed our lenses at swinging branches. The leeches on the ground were delighted by our distraction. They latched on to the unlikeliest parts of our anatomy. Since a leech-bite doesn't hurt, we discovered the bites only when we reached camp. If you happen to plan a trip around the Durian fruiting season, your walks will be enlivened by raucous simians and avians, as they fight over choice pickings. Our next pit-stop was Kubang Hill, draped in misshapen mangroves so scary in their contortions that I was reminded of Noddy’s jungles. We took a canoe with an outboard motor and sailed through Kapuas from the village of Teluk Melano which was festooned with swallows’ nests—a delicacy and a dollar-spinner for the villagers. We shifted to smaller canoes paddled by local boys and went into tiny creeks, darkened by overhanging vegetation, while monster roots blocked our path. The jungle unfolded in all its glory: banks resounded with all sorts of calls, funny-shaped fruits hung from branches and butterflies of brilliant colours fluttered around and settled on our arms. Kubang Hill is another kind of water-logged obstacle race. You don’t know what you’re stepping on until your toes are lacerated by thorny stumps. There are leeches galore and since you’re wading barefoot, they have a field day. (I picked at least four from between my toes.) We sat on fallen logs to have our picnic of goreng wrapped in a leaf. And suddenly, there appeared the silent old man of the forest, his languorous limbs clinging to a pandanna leaf and his child-like eyes scrutinising us warily. Before I could mount my 400 mm lens, the orangutan vanished just as quickly as it had appeared. But, no complaints there. The evening was crowned by a memorable boat ride back to Sukadana, through a gorgeous evening sky—all of 360 degrees— glowing with the surreal and splendid hues of the setting sun.

IT TAKES no calendar to tell you it’s February. There are enough giddy young adults at every café and gifts shop, making it clear that it’s the month of Saint Valentine. However, I wish I could say that matters of the heart plague only the young. They don’t; at least not according to the medical journal I flipped through lately. One such article contained such alarming data that I had to delve deeper into the topic. Figures seem to state that heart disease is the single-largest cause of death in India. Reportedly, heart attacks are responsible for one-third of all deaths caused by heart diseases. Finally, the death knell: according to a joint paper published by the World Health Organisation and the Indian Council of Medical Research, by 2020 India will become the world's heart attack, diabetes and hypertension capital. If our lives were made into a film, then we know who would play the villain. At DW, we believe we know who would play the valiant hero — Dr Devi Shetty. The iconic cardiac surgeon and visionary-cum-entrepreneur behind heart centres and health cities all over India, has been fighting for our health for years now. Not only has he improved medical facilities for those who can afford it, Dr Shetty — and thus he’s twice the hero — has made heart surgery affordable for India’s poor and rural people: a solid 60 per cent of our population. While talking to him, we were struck by his positivity; he’s upbeat about life and people and has an unshakable faith in both. Yet, he’s not just a dreamer but a doer. He takes the economy of scale and makes it work to his advantage — in the face of all cynical questions and raised eyebrows. If there is a man who has democratised the medical sector, it is Dr Shetty. In fact, if the world’s looking for a new Saint Valentine, our vote is with him. Read about his incredible journey and how he sees India’s large population not as a hindrance, but as an advantage. Since we are harping on the heart after all, DW decided to take a closer look at a topic that is causing much heartburn among India’s policymakers: its FDI policy. With the “will-they, won’t-they” game on, Democratic World decided to see if the entry of multibrand chains would create new jobs or close doors for India’s small-time farmers and shop-owners. Join the discussion as we bring you opinions from both sides of the fence. A quick note of thanks for your overwhelming response to the FDI poll we pasted on our Facebook page. And thank you again for writing to us with your inputs; we hope you keep reading and responding to DW. Have a great month and be good to your heart.

‘A letter to 4,000 children with a scar on the chest’ 

"When God sent you to this world it was the best thing that had happened to your parents. Unfortunately, their happiness was short-lived. That very day you started turning blue in colour; the doctors had found a hole in your heart.Your parents could not afford the cost of your heart operation. Yes, when you were 10 days old you had a price tag on your life.Time was running out and your daddy was getting desperate until he came to know about me. The first thing he told me when we met was: “I heard you love children”. Yes, I love children and have four of my own. My profession is giving hope to people suffering from heart diseases — I am essentially a technician who can cut and stitch people’s hearts; they call me a heart surgeon.” This is the beginning of a long letter from Dr Devi Shetty to 4,000 children, all former patients at one of the hospitals he had set up. Intrigued by the idea of a doctor who not only provided free treatment to poor children, but also wrote to them years later, we set off to seek out the man behind the words. We wound up on the outskirts of Bengaluru, and left behind the noisy traffic on Hosur road to enter an oasis of calm. People were milling about, carrying lines of anxiety on their faces, but hope in their eyes. The place we entered had the sounds of vedic chants wafting on the air and we were greeted by a beautiful engraved statue of Vishwarupa — the form that Krishna revealed to Arjuna during his lecture on the Gita. Despite this templelike atmosphere, it was clear that we had entered a hospital, as the doctors and nurses scurrying about showed us. We were at Narayana Hrudalaya to meet the heart surgeon whose story has inspired doctors all over the country. As we walked through different corridors in the hospital, the chants were sometimes replaced by the sounds of an FM radio like God because he was the one who could save our parents’ lives.” He once overheard his mother talking to a relative. She was blessing another woman for giving birth to a wonderful son, a doctor who had saved someone’s life without taking money. The young Devi resolved that he too would grow up to be a son that people would praise and bless his mother for. The seeds were sown early, but the moment of epiphany came in 1967, when a South African surgeon called Christiaan Barnard performed the first successful human heart transplant. Listening wideeyed to this news in a classroom in India, 14-year-old Shetty was inspired. “I made an immediate connect and decided to become a heart surgeon even before I decided to become a doctor,” laughs the man who now has many ‘firsts’ to his own credit. Shetty went on to pursue medicine and channel and at other times by the voice of Kishore Kumar. “The doctors all like to play different music when they operate. I prefer calm, spiritual music, but I let everyone create the atmosphere that suits them when they work”, says the lean and dynamic man who meets us at the door. And with that, the conversation is on.

THE INSPIRED IDEALIST

Devi Prasad Shetty was the eighth of nine children, born to parents who were already getting on in years. With a mother needing surgery and a father who sometimes went into diabetic comas, Shetty remembers that, “As kids we thought the doctor was even though, by his own admission, he was not a brilliant student, he never let go of his central desire to operate on the heart. “I couldn’t dream of getting training as a heart surgeon in India in those days — there were hardly any centres and even the teachers were learning to do heart surgery at that time. Grafting had just started and even in England, not many people were doing bypasses. So I had to go abroad,” says the man whose steps finally led him to Guy’s Hospital in London. In England, surgeons would not see patients before or after operations, since other teams were assigned those tasks. Shetty focussed entirely on honing his skills by doing hundreds of procedures, enjoying each one — even going so far as to operate on weekends. This prompted his colleagues to dub him the ‘crazy operating machine’. Practice makes perfect and Dr Shetty was soon getting the recognition that was his due as an excellent surgeon. But medical procedures were not all that the young doctor was learning. As an intern in England, he was exposed to the dramatic changes taking place in the National Health Service at the time. Cost efficiency was receiving a lot of attention as public services began to go through greater scrutiny. Even though he was not directly involved, Shetty saw that controlling costs was a vital aspect of delivering healthcare and years later, would use this knowledge when facing similar problems in India. Dr Devi Shetty was already set on his path in life — he had a job, he had skills that could bring him fame and fortune, and he had a goal. But there was a tradition in his family that those who went abroad to study finally returned to India, and his wife was keen to head home too. At the very time when he was on the horns of a dilemma, fate took a hand in the form of an offer to start the BM Birla Heart Research Centre. Dr Shetty was on his way to Kolkata, and that marked the start of different sort of journey.

FROM HEATHROW TO HOWRAH

Thirty-six-year-old Shetty came back to Indian shores in 1989 as Director of the BM Birla Hospital, and the medical facilities available in Kolkata at the time were a world away from those he was accustomed to. It took him a while to adjust to what he could and to reform what he could not accept. He remembers, “There were no disposable gowns, gloves or drapes. Sterilisation did exist, but people were re-using things and materials were not available. Nurses didn’t know how to care for patients after surgery because hardly any cardiac surgery was done. So I got a few nurses from Guy’s Hospital to train them; they stayed for nearly two years till we completed the first hundred cases.” Almost immediately upon his arrival in Kolkata he set up a paediatric surgical care unit and set a new landmark — he became the first Indian to perform open-heart surgery on a nine-day-old baby. This was at a time when people in india were just getting used to the idea of heart problems in newborns and his achievement was lauded far and wide. Far away in Karnataka, his sister called out to his mother and she came running to see her son on television for the first time, surrounded by the infant’s family members. Devi Shetty had achieved his childhood ambition to make his mother proud. Coming back to India also marked a departure in his functioning as a physician. Unlike in England, he was not just an ‘operating machine’. He had to meet patients and their families before and after the procedures; he had to face their financial concerns and see the tension on their faces. The surgeon isolated from the suffering was replaced by a doctor who saw the pain of people who were unable to afford good healthcare. He himself puts it best when he says, “It was quite traumatic when I had to start off. If there was a problem during the surgery, what came to my mind were the faces of the wife and children. You try to think of yourself as a kid and think that if something had happened to your father, you would have been virtually on the street. So these things brought in a lot of pressure. But after a while I started enjoying it because this is one of the few professions where you get the chance to become a hero in real life.” The more people he treated, the more Dr Shetty started to ponder the larger questions of healthcare in the country and its impact on ordinary people. Perhaps it was serendipity that resulted in a meeting that set the seal on his convictions — in 1990, he became Mother Teresa’s doctor, a role he was to play for the rest of her life.It started when he was asked to do a house call to see a patient, something surgeons don’t usually do. But he was told, “If you visit the patient, it may transform your life.” Meeting Mother Teresa literally did, as new and exciting things began to happen in Dr Shetty’s life. One day, she saw him examining a blue baby and said, “Now I know why you are here. To relieve the agony of children with heart disease, God sent you to this world to fix it”. To Devi Shetty’s mind, this was the best definition ever given of a paediatric cardiac surgeon; her simplicity and practical approach to life’s problems and their solutions inspired him. Little wonder then, that his office still carries her image.

MAN ON A MISSION

“The health problem of India is not a health problem, it is an economic problem. There is a solution, but it is not affordable. And if it’s not affordable, it’s not a solution.” These pithy sentences sum up Dr Shetty’s assessment of healthcare not just in India, but the world over. He finds it unacceptable that 100 years after the first heart surgery, less than 10 per cent of the world’s population can afford the operations. And this knowledge spurred him on to a spate of activity that has not abated even after two decades. After getting the Birla Hospital up and running in Kolkata, he moved to Bengaluru in 1997 and started the Manipal Heart Foundation. In 2001, Shetty founded the 1,000-bed Narayana Hrudayalaya, which offers many services apart from cardiac surgery. Next door to Narayana, Dr Shetty built a 1,400-bed cancer hospital and a 300-bed eye hospital, which share the same laboratories and blood bank as the heart institute. In December last year, the low-cost healthcare chain inaugurated Asia's largest paediatric hospital in Mumbai. He also founded the Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata. Shetty is fond of saying that “You have just one life and it should touch the lives of as many people as possible”, an idea that he tried to execute in many different ways. He realised that only one per cent of his patients needed surgical intervention. So with the help of the Indian Space Research Organisation he started telemedicine facilities for remote locations via satellite. At last count, he and his doctors had treated more than 55,000 heart patients. Using satellite technology, they also treat patients in 56 African cities. By slow degrees, the ripples spread further. In 2003, Shetty worked with the Government of Karnataka on Yeshasvini, the cheapest comprehensive health insurance scheme in the world. It started at `5 per month (with the government putting in a share of the premium) and today runs without government help at `15 a month. A boon to the farmers, it had 80,000 subscribers in the first year itself. Today 2.5 million people are covered under the scheme and Tamil Nadu and Andhra Pradesh have also adopted it. But all these initiatives are just the tip of the iceberg. With his eyes fixed firmly ahead, there is much more afoot. The plans for Narayana Hrudalaya also include a trauma hospital and an ophthalmology hospital. These are the beginnings of the Narayana Health City, which will include a centre for neurosciences, a children's hospital and a cancer research centre. Health cities are also being planned in Manipal, Gujarat and Rajasthan. With affordability as his mantra, he is planning a low-cost hospital in Mysore, using natural air and light and no air conditioning, but with a fully functional operation theatre. With that, he hopes to push costs of heart surgeries down to within `55,000. Dr Shetty’s near-impossible success rate attracts patients from Africa, South-east Asia, the Middle East and increasingly, from Europe and the US as well. His latest venture is a $2 bn health city in the Cayman Islands, his first international project, that he believes will be a game-changer for the developed world. Once again, the logic behind the move is simple and visionary at the same time. “If you want to transform the way that healthcare is delivered in this world, you have to make Americans change the way they do it. Because once they set new standards, that becomes a standard all over the world. You can’t bring about any changes inside the American boundary. So the nearest country which can be used as a beta-site is Cayman Islands. And we have received close to 1,000 applications from US doctors who want to work there!”

YES WE CAN

Over the years, Dr Shetty has built a huge network of supporters, admirers and friends. At various times, the members of the board have included K Dinesh (co-founder, Infosys) and Kiran Mazumdar-Shaw (Biocon). Krishna Kumar of the Tata Trust helped to start the hospital in Kolkata, a venture for which K V Kamath of ICICI gave him the first loan. Recently, Chief Minister Narendra Modi has also given his company a plot of land to build a health city in Ahmedabad. But this was not the case when he first started to put his ideas on the table. Sometimes the greatest sceptics were the doctors themselves. When he started the Manipal Heart foundation, doctors scoffed at his statement that they could do 10 surgeries a day — at the time they were doing that many in a month. Today, they do 12-15 surgeries a day. Now when he sets targets of 50 surgeries a day, the usual response is, “How?” When he first proposed the idea of health insurance at `5 a month, no company wanted to touch it; today there are people willing to partner with him in the venture. Over time, the scope of his ambitions has begun to seem less like the notions of a dreamer and more the stuff of social revolution. India requires 2.5 million heart surgeries a year and only 90,000 are done on the people who can afford to pay, leaving the majority in the lurch. Shetty laments the fact that a country which produces the largest number of medical personnel in the world should have the healthcare indicators that we do. Visibly animated, he says, “We should be ashamed of these things. It has nothing to do with lack of resources or poverty. Our healthcare is in a mess because of poor policies. They have to understand that there is a solution out there and they should utilise that. Because ultimately what matters is that the poor patients get help.” Dr Shetty concedes that increasing healthcare spending may be difficult, but offers a way out. For him, it all boils down to a change in policy. He believes that if entrepreneurs are encouraged to step into the healthcare sector, it will offset any perceived loss of revenue to the government. For instance, new hospitals with tax exemptions would encourage entrepreneurs to build more. Analysing the situation, he realised that a lot of problems stemmed from the “refusal to think big” that seems to be the bane of policymakers in the country. He saw that with the second highest population in the world, coming up with a 100-bed hospital would only be a drop in the ocean. So, when others spoke of hospital capacities in the hundreds, Shetty spoke in the thousands. When they spoke of a health centre, he spoke of a health city. He has slowly shown not just those who work with him, but the world at large, that increasing the capacity of hospitals and amount of work done in a day reduces the amount that people have to pay. As he says, “I remember talking to a cardiac surgeon who thought that in a few years we'd be able to charge `2.5 lakh for an operation. We have reversed that ambition.” (When he started his work in Kolkata, heart surgeries cost `1,40,000. Today, the same operations cost `75,000).

THE BUSINESSMAN-DOCTOR

“The transformation to offer high-tech healthcare to everyone on the planet can not come from heaven. We have no choice but to bring about change. You can call it business practice or social commitment. One thing we do believe is that charity is not scalable. If you do something free, you will do it up to a point and then stop. Money has to come from a good business model which makes things affordable. And that is scalable.” These are astute words from the man who won the Ernst & Young Entrepreneur of the Year award in 2003 and The Economist Innovation Award for best Business Process in 2011. His ideas on the business of healthcare form a subject of study for MBA students at the Harvard Business School. With 14 hospitals in 11 cities and many more in the pipeline, he has certainly tackled the issue of scale. But as often happens, that raises the twin spectres of quality and accountability. Since he cannot personally be everywhere at all times, keeping track of the daily workings of all centres takes some doing. At such times, technology is his best friend. All administrators get a daily SMS stating the profit and loss (PnL) accounts of all hospitals. They also get reports on the mortality, morbidity and other problems. They have a system where people can call a number and report any shortcomings they observe — from unclean bathrooms to negligence by the staff, all complaints get registered in a central log. Not only does this make people accountable, it gives Shetty an idea of the areas that need improvement. At the end of the week, each department gets a note listing the complaints concerning them. Then, fresh targets are set. No detail is too small to escape this able administrator, who checks the PnL statements of all hospitals in his car on the way home from work. As he says, “We run the hospital with a wafer-thin margin. By looking at the PnL account on a daily basis, you can take remedial measures. Looking at the PnL account at the end of the month is a post-mortem report.” One example of the standards he sets was his handling of the matter of bed sores, a common ailment with post-operative patients. The global average for bed sores ranges between seven per cent and 40 per cent. Three years back, Narayana Hrudalaya launched a programme to eliminate bed sores. The nurses took personal responsibility to ensure this goal was achieved. Now, there are zero incidents of bed sores. Perhaps no other hospital in the world can lay claim to such an incredible achievement. In a testament to good management skills, this was accomplished without spending more or hiring new staff. Unsurprisingly, the attrition rate in his centres is almost non-existent. Only one senior doctor has left the organisation in all these years, and that too, for personal reasons. Healthcare as an industry is sensitive to numbers. The more surgeries his doctors and nurses get under their belts, the more efficient they become. By setting up teams specialising in particular procedures and streamlining the process, he has ended up posting respectable profits — all the while offering cheaper, and sometimes free, healthcare to the poor. His family-owned business group reports a 7.7 per cent profit after taxes, slightly above the 6.9 per cent average for a US hospital, according to American Hospital Association data. Narayana's 42 cardiac surgeons performed 3,174 bypass surgeries in 2008, more than double the 1,367 the Cleveland Clinic, a US leader, did in the same year. Obviously, this surgeon has his management and leadership skills all stitched up. MATTERS OF THE HEART Many of Shetty’s working decisions stem from his personal convictions. Perhaps no other section of society touches Dr Shetty as much as women and children, especially those who are impoverished. The man who can’t see mothers cry over sick children admits, “Surgeons are not supposed to show their weaknesses, but I sometimes find it hard to control myself.” Little wonder, then, that his sense of social responsibility extends beyond the medical. Going around Narayana Hrudalaya, we are struck by the preponderance of women guards and drivers MATTERS OF THE HEART Many of Shetty’s working decisions stem from his personal convictions. Perhaps no other section of society touches Dr Shetty as much as women and children, especially those who are impoverished. The man who can’t see mothers cry over sick children admits, “Surgeons are not supposed to show their weaknesses, but I sometimes find it hard to control myself.” Little wonder, then, that his sense of social responsibility extends beyond the medical. Going around Narayana Hrudalaya, we are struck by the preponderance of women guards and drivers not for us.’ So the aspiration is lost.” Of all the surgeries performed at the Hrudalaya, 50 per cent are done on children, and half of those free of cost. Dr Shetty has personally performed over 15,000 heart operations. He supervises organisations scattered all over the world. He starts early and through the course of the day, puts in over an hour of exercise (surgeons need to be fit), meets countless patients, talks to the media, squeezes in at least one surgery a day and also travels extensively. This would be more than enough work for 10 people to handle, leave alone a single practising doctor. So what has kept the fire burning for Devi Shetty for the past 22 years? “The confidence that India will become the first country in the world to dissociate healthcare from affluence. Ten years down the line we will have a scenario where people will still live in slums with no amenities, but when they are unwell, will have access to high-tech healthcare with dignity. Western countries have proved that a rich country cannot succeed in offering healthcare to the citizens. We’re a poor country, but within our means it is possible to offer healthcare to everyone.” As we leave Dr Shetty after spending over an hour with him, we can’t help but go back to the closing lines he wrote to the ‘4,000 children’ his centres have helped: “I clearly remember your mother’s face when she was handing you over to us. She kissed you and looked at my face with the expression of a person handing over her most precious possession. It was a different sort of love triangle between your father, mother and myself, with you at the centre. It took me six hours of intense concentration to operate upon your heart and many sleepless nights before you started smiling again. One day you will become an adult and probably a very important member of our society. All I ask is, can you spare a few moments of your precious time everyday for someone who needs it? To save your life, a few hundred people worked sincerely without expecting any remuneration other than the joy of making your family and friends happy? And when you do your work just for the joy of brining happiness to others, you’ll realise it is not your hands which do the job, it is the hands of God.”

End of the Junta Rule?

INTERNATIONAL \\ Burmese Opposition leader Aung San Suu Kyi will be running for Parliament in the country’s highly anticipated April by-elections. According to her party sources, the Nobel laureate will be contesting elections from her home district outside of Yanong. The civilian government has approved of her party — National League for Democracy’s (NLD) participation in the elections scheduled to take place on April 1, 2012. This marks the return of the her party into mainstream politics after two decades. For the first time in years, a pro-democracy leader will pursue political office. Her party had won a landslide victory in 1990, but the Junta government prevented her from assuming power. Living under house arrest from that time on, she only gained her freedom in 2010 as the Junta government agreed to parliamentary elections that year. The civilian government has also signed a cease-fire agreement with ethnic Karen rebels fighting the largest civil war in the country. It is hoped that the conciliatory gesture will improve Myanmar’s relations with the outside world.

With elections around the corner, fair polls get top priority

ELECTIONS \\ The Election Commission of India (ECI) announced the dates for the upcoming Assembly elections in five states — Uttar Pradesh, Goa, Punjab, Uttarakhand and Manipur. A code of conduct has also been implemented in these states. Elections in Uttar Pradesh will take place in seven phases, given the size of the state and the number of constituencies. The first phase of UP elections starts on February 4, while the last phase will be conducted on February 28, and votes will be counted on March 4. The decision to hold the elections in seven phases has been welcomed by all parties. Another move that has set many tongues wagging was the ECI's decision to cover elephant statues all across UP. This decision has been criticised by the BSP, but has received appreciation from all the opposition parties. Punjab and Uttarakhand’s elections will be held on January 30 and Manipur and Goa will enter the electoral phase on January 28 and March 3, respectively. As the states prepare for the upcoming elections, a lot of pressure has been laid on them by the ECI to conduct “free and fair” elections. This is more so in the wake of specific intelligence reports, according to which money is entering the state of Uttar Pradesh through the hawala channels from West Asia. (Hawala is the illegal transfer of money into or out of the country.) According to ECI officials, money from Saudi Arabia and Dubai is being routed through illegal channels into constituencies such as Aligarh, Gorakhpur, Saharanpur, Meerut and Muzaffarnagar. However, the money coming in is not for any one party, but for most of them. Soon after the intelligence report came in, the state police department, the income tax department, Directorate of Revenue Intelligence and all border security forces were informed — a total sum of `35 crore has been caught in the state so far. In the country’s biggest state with a total of 403 constituencies, 700 battalions of security forces have been deployed in UP to curb the influence of illicit money. Despite all the vigilance, political analysts believe that this note-for-vote politics will affect the outcome of the upcoming polls. Usually the money laundering begins two weeks ahead of the polls but this time it has begun a good 25 days ahead of the set date. Every party has now started working on its election campaign in earnest. According to the statistics of the declared assets of the Chief Ministers of various states of the country, Mayawati is richest. Her total declared assets are worth `87.27 crore, which, according to her, have been donated by her followers. Interestingly, this figure alone is greater than the sum of the declared assets of the top 10 richest Chief Ministers in the country.

People mourn the death of Kim Jongil, as son takes charge of country

INTERNATIONAL \\ North Korean leader Kim Jong-il died after suffering a major heart attack while on a train out on a “field trip”. According to official reports, every possible measure was taken to save his life, but help did not reach him on time. He suffered a cardiac arrest. Autopsy reports confirmed the cause of the death. The leader had suffered his first heart attack in 2008, he appeared weak and frail in the limited number of pictures released in the recent past. The young Democratic People’s Republic of Korea (commonly called North Korea), which is a communist country, has so far maintained a tradition of hereditary succession in its government. Kim Jong-il had inherited the country’s leadership from his father, Kim II-Sung in the year 1994. Earlier, in 2010 he had declared his son, Kim Jong-un, his successor. South Korea, which shares its borders with North Korea, declared a high security alert after the death of the leader, citing the fact that North Korea is a failed yet dangerous state with nuclear weapons. The country has enshrined Kim Jong-il’s body in the Pyongyang Palace, which also houses the body of his father, who was the founder of the nation.

SPORTS\\ Fourth seed Indian ace Saina Nehwal lost to top seed Wang Yihan of China 15-21, 16-21 in the women’s singles semifinal of the Maybank Malaysia Open Badminton Championship in January. Nehwal lost the match, which lasted for 41 minutes, in straight sets. Nehwal got off to a great start with an 8-4 lead in the first game, but eventually Yihan took charge of the game, scored six more points and didn’t let Nehwal bounce back. In the second game as well, Nehwal was leading 5-2, but the Chinese shuttler once again gained control and never lost the lead thereafter. This was the fifth occasion when Nehwal was facing Yihan and she has lost on all all occasions to the top seed. It was a disappointing start to the new year for the Indian star, as she once again failed to overcome the insurmountable wall of China. With yet another loss, the long drought of Super Series titles continues for Nehwal who hasn’t won a single championship since the Swiss Open in March 2011.

Rajya Sabha rejects Lok Sabha-approved, constitutionally vulnerable Lokpal Bill

POLITICS\\ The Lok Sabha passed the landmark Lokpal Bill on December 28, 2011, but failed to make the Lokpal committee a constitutional body. The Bill came with the amendment that appointing Lokayuktas would not be mandatory for every state. This amendment was made in view of the opposition from the government allies and others. The defence forces and coast guard personnel were kept out of the purview of the anti-graft ombudsman and the exemption time of former members of Parliament was increased from five to seven years. But a number of amendments moved by the Opposition, asking for the inclusion of corporates, media and NGOs receiving donations, were defeated and the amendment to bring the CBI under the purview of the bill was also rejected by the government. Later, on December 29, the Bill was tabled in the Rajya Sabha, where the UPA did not have a majority, and failed to get the Bill passed. The Opposition called the Bill “constitutionally vulnerable”. A ruckus was created in Parliament, which the Opposition called a “pre-planned script”. As the government failed to get the simple majority, the Bill is now likely to be presented at the joint parliamentary session.