Last week due an acute kidney infection (actually God Only Knows), I had to be admitted to Mumbai’s Hinduja Hospital on emergency. “Your creatinine and potassium levels have gone real high – Dr Modak”. We will hold for a day but I will have to put you on a few cycles of dialysis” My doctor Dr Almeida said.
Dialysis is the artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Our kidneys do this naturally. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly – they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function (renal replacement therapy).
Dialysis may be used for patients who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function
It’s like treatment of polluted waters.
Next night, I was inserted a shunt (catheter) in my neck and in the morning was brought to the AKD (Artificial Kidney Department).
AKD was a great and fun place to be. There were perhaps some 40 “bays” where dialysis was happening to 40 patients at the same time – each bay with a German make dialysis device that looked like a front loading washing machine, except with more buttons; more alarms and more blinking lights
Mr. Phatak who administrated this unit over past twenty years was moving across the bays with all the smiles and humor giving instructions to the technicians on “setting the targets etc.” Most patients were having a good time – some were listening to music or watching their favorite TV show or reading Bhagwat Geeta. Some women had come in a group and were waiting to go for shopping for the Diwali sale right after the dialysis.
I was about to be “wired” to one of the German machines, and just then Mr. Phatak received a call on his mobile phone that I be taken to a special (and secret) room for dialysis and that I will not be dialyzed in the “common area” meant for “common people”.
I was soon moved to another floor through an elevator that had a password like in the movies of James Bond. I had no clue where I was getting wheeled.
The room I was brought in was different – instead of German machines, there were Chinese machines. That worried me a bit (Later I was told that these special machines were gifted by the Chinese Premier to our PM in the recent meeting in Goa and was a joint project between India and China – led by none but my Friend Professor).
And indeed there he was! I saw my Professor Friend standing in between the “bays” of the secret room waiting for me.
“Oh Dr Modak, I just learnt from Dr Almeida that you are to be dialyzed. I then thought of bringing you here so that you come to know some of the latest innovations I am currently working on – All pertaining to India’s sustainability”. Professor said this with some pride.
I knew about Professors deep research on ultrafiltration, nanotech and biomimicry and his numerous visits to Beijing over past five years. But he had not published – obviously on instructions of the PMO.
Well, Professor said, “All these “patients” – who are mostly bureaucrats in the Indian ministries, are really not “kidney affected” but are those who are simply affected by what I call as “policy paralysis” – This policy paralysis is leading to major obstacles in the vision of our PM on India’s Sustainability. Certain “toxic” constituents in their blood (some special ketones, undesirable enzymatic by-products and some variants of creatinine) make these otherwise “powerful” and “intelligent” bureaucrats, indifferent, petty minded and short sighted. They think of themselves first and are least bothered about the National interests – especially on sustainability. Policies they work on are often outdated – and even if they come up with good ones, these policies do not see any implementation. PM is really upset with such a dismal situation. How can India progress?
“I am using advanced techniques of dialysis to correct the situation – dialyze the key Indian bureaucrats to remove the “inhibitants” or “retarders” in the blood and get them out of the policy paralysis. I am also introducing a new generation of stimulants that work on the principle of sustained release for bringing the required attitudinal change”
“My experience is that one cycle of dialysis is generally not enough. Given their “stubbornness”, you need on an average three cycles for these senior bureaucrats (i.e. Joint Secretaries and above) – but then pilots have shown that results have been quite encouraging. Some of the good stories of sustainable governance you might have read recently, are all due to my treatment based on advanced dialysis”
“So, I have designed five machines for this purpose”
Machine 1 focuses on integration of Resource and Residues – i.e. practicing Circular economy. In India, resources are allocated and managed by the Line Ministries and responsibility of addressing residues is left to the weakest ministry that is the Ministry of Environment & Forests & Climate Change. This is not going to work. We need Resources Management Act and not just Water (Act), Air (Act) and the Environmental Protection Act. The resources and residues piece must act in tandem to bring in the circular economy.
Machine 2 encourages bold, scientific, participatory and transparent policies and guidelines for Zoning/Siting of developmental projects. It will lead to “clarify” government’s position on permissible growth, where it could be and how could we blend development and environmental protection by carefully considering the appropriate scale and technology
The third dialysis machine helps to mainstream Environmental Economics where we develop markets that are mature – “price” the resources correctly (with no perverse subsidies) and Polluter (actually) pays
Machine 4 stimulates Sustainable Finance including considerations to climate change e.g. promotion of renewable sources of energy, building pipelines of programmatic projects with Entrepreneurship while capitalizing on climate change adaptation funds and innovations in GHG mitigation.
The fifth and the last dialysis machine is meant for actioning Awareness, Education and Training in Environmental Management – an area most needed but highly neglected.
All this was really inspiring and transformational for bringing sustainable governance in India and removing the so called “obstacles” created by India’s bureaucrats – But I was wondering about the Chinese interest. May be secretly, Chinese want our PM to follow long term development goals (that are actually ideal) but then ensure that in the process we do not “prosper” in the conventional sense. As a result, the Chinese economy will surpass India’s economic growth and influence or even take over the world economy. This will happen over the short term of course – but then who cares? We run 5 year elections. I decided to express my concern.
Someone tapped on my shoulder. “Which machine type would you like to join Dr Modak? The Professor was asking.
“Oh let him go back to Mr. Phatak’s hall meant for common people as of now – I just want to lower his creatinine and not revolutionize India” Dr Almeida said with a smile and asked the ward boys to wheel me down.
Follow me if you like this post or forward the post to your colleagues
Fantastic approach to explain situations and relay a message.
Lovely article!! A novel analogy used!!