Nonsmokers breathe in the same toxic chemicals in tobacco smoke as the smokers do, with similar, although smaller effects. The smoke nonsmokers breathe is known as secondhand smoke and the process of breathing secondhand smoke is called involuntary smoking or passive smoking.

The smoke contains thousands of toxic chemicals, including benzene, cyanide, cadmium, lead, radioactive polonium, benzo(a)pyrene, ammonia, carbon monoxide, and nicotine. These chemicals cause many diseases.

Secondhand smoke (or ETS) is a very serious form of indoor air pollution. For example, in the USA secondhand smoke causes about 3,000 lung cancer deaths a year, compared to less than 100 lung cancer deaths per year from traditional forms of outdoor air pollution.

Secondhand smoke causes and aggravates asthma and other breathing problems, particularly in children. It is also an important cause of sudden infant death syndrome (SIDS).

While most discussion about passive smoking have concentrated on lung cancer and breathing, the effects on heart disease are more important. The chemicals in secondhand smoke poison the heart muscle, interfere with the ability of blood vessels to adjust themselves to control blood pressure and flow, increase the buildup of blockages of blood vessels (which lead to heart attacks), and make blood stickier. The net effect is that there are about 15 times more deaths from heart disease caused by passive smoking – 35,000-62,000 deaths annually in the USA – as lung cancer.

While the tobacco industry continues to claim that the evidence that passive smoking causes disease – particularly lung cancer – is controversial, every independent authoritative scientific body that has examined the evidence has concluded that passive smoking causes many diseases. Moreover, the evidence that passive smoking causes disease is not new.  Source : https://www.who.int/tobacco/research/secondhand_smoke/about/en/

How tobacco endangers the lung health of people worldwide

The multiple ways that exposure to tobacco affects the health of people’s lungs worldwide include:
 

Lung cancer. Tobacco smoking is the primary cause for lung cancer, responsible for over two thirds of lung cancer deaths globally. Second-hand smoke exposure at home or in the work place also increases risk of lung cancer. Quitting smoking can reduce the risk of lung cancer: after 10 years of quitting smoking, risk of lung cancer falls to about half that of a smoker.

Chronic respiratory disease. Tobacco smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a condition where the build-up of pus-filled mucus in the lungs results in a painful cough and agonising breathing difficulties. The risk of developing COPD is particularly high among individuals who start smoking at a young age, as tobacco smoke significantly slows lung development. Tobacco also  exacerbates asthma, which restricts activity and contributes to disability. Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.

Across the life-course. Infants exposed in-utero to tobacco smoke toxins, through maternal smoking or maternal exposure to second-hand smoke, frequently experience reduced lung growth and function. Young children exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia and bronchitis, and frequent lower respiratory infections.

Globally, an estimated 60 000 children die before the age of 5 of lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.

Tuberculosis. Tuberculosis (TB) damages the lungs and reduces lung function, which is further exacerbated by tobacco smoking. The chemical components of tobacco smoke can trigger latent infections of TB, which around a quarter of all people are infected with. Active TB, compounded by the damaging lung health effects of tobacco smoking, substantially increases risk of disability and death from respiratory failure.

Air pollution. Tobacco smoke is a very dangerous form of indoor air pollution: it contains over 7 000 chemicals, 69 of which are known to cause cancer. Though smoke may be invisible and odourless, it can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function. 

How to Improve Lung Health ?

The most effective measure to improve lung health is to reduce tobacco use and second-hand smoke exposure. But knowledge among large sections of the general public, and particularly among smokers, on the implications for the health of people’s lungs from tobacco smoking and second-hand smoke exposure is low in some countries. Despite strong evidence of the harms of tobacco on lung health, the potential of tobacco control for improving lung health remains underestimated.

Call to action

Lung health is not achieved merely through the absence of disease, and tobacco smoke has major implications for the lung health of smokers and non-smokers globally.

In order to achieve the Sustainable Development Goal (SDG) target of a one-third reduction in NCD premature mortality by 2030, tobacco control must be a priority for governments and communities worldwide. Currently, the world is not on track to meeting this target.

Parents and other members of the community should also take measures to promote their own health, and that of their children, by protecting them from the harms caused by tobacco. Actionable points could be as follows :-

• Do not allow any form of tobacco within your house.
• Get your Office / Society to ban smoking in “Public Places”.
• Display “No Smoking” signs as per specifications.
• Designate Smoking areas for those unfortunate people who are enslaved by tobacco.
• Encourage your friends and relatives to quit smoking completely. Always keep in mind that there is no such thing as cutting down on smoking. You have to QUIT.

The time to act is NOW!

Did you know that India is a signatory to the Framework Convention for Tobacco Control Read more here…… https://www.who.int/fctc/about/en/

The Govt of India has issued various public notices on the promulgation of various Tobacco Control legislations, since 2004. (available from http://www.tobaccocontrollaws.org/legislation/country/India)  The provisions of the relevant Act and the various Rules thereto are intended to safeguard the health of the general non smoking public, as it is scientifically proven that passive smoking is as dangerous (if not more) than smoking itself.

As per the various laws in India, there is : –

• Prohibition of smoking in public places.
• Prohibition of advertisement of cigarette and other tobacco products.
• Prohibition of sale of cigarette and other tobacco products to a person below the age of eighteen years.
• Prohibition of sale of tobacco products near educational institutions.

Vide various Gazette of India Notifications, smoking is strictly prohibited in a public place, which is defined as any place to which the public has access, and include auditoria, hospital buildings, educational institutions, restaurants, public offices, libraries, public conveyances, open auditoria, railway stations bus stops, etc.

Tobacco products under the Act include cigarettes, beedis, pipes tobacco, hookahs and chewing tobacco.  Snuff, pan masala, gutkha and tooth powder containing tobacco are also listed.

We all are aware that the consumption of tobacco in any form is extremely harmful to the health of an individual directly , and secondarily to those in his immediate surroundings, i.e women and children of the family. This passive smoking affects all Non-smokers, with women and children being the most affected by this indirect smoke pollution.

For the reader’s information, it is mandatory to display at all public places including community facilities, a board of a minimum size of 60 cm x 30 cm in English or Hindi as applicable, with the warning “No Smoking Area – Smoking Here is an Offence”.

This board should also contain a circle of no less than 15 cm outer diameter with a red perimeter, of no less than 3 cm width, with a picture in the centre of a cigarette or a beedi, with black smoke, and crossed by a red band. The width of the red band across the cigarette shall be equal to the width of the perimeter.

While smoking or consumption of tobacco is an individual’s choice, hence it is presently not banned in a democratic system. However smoking indiscriminately is what is banned, i.e in front of others (who may not have a choice in inhaling the smoker’s second hand smoke). This is in the public’s interest. We must understand this nuanced statement. A non smoker has a right to breathe clean and untainted air!

Hence the approach that we should advocate is that simultaneous with the banning of public smoking, specific areas in office complexes, community facilities etc be designated for smokers to use, and signposted as such. These sites are not to be near thoroughfares or be common rooms frequented by others or be near AC / cooler fitted windows. As a strict rule, all air-conditioned spaces are to designated as “No Smoking areas”.    

It must also be appreciated that the masses consume copious amts of gutkha, which is far more harmful to their health. As it is, further to dirn of the  Supreme Court, it is illegal to sell gutkha in plastic sachets, which is still the norm. Hence we do periodically read news reports of seizures of large consignments of this banned item.

It is requested that the readers of this post may please reach out to those in their circles of influence and solicit their participation in the “Say No to Tobacco” initiative currently underway in the country in the interests of promoting of health of our people and their families, both the smoker minority and the non smoker majority.

SMOKING : THE ROLE OF THE HEALTHCARE PROFESSIONAL

For those of you who are medical practitioners, please know that when it comes to tobacco use, health professionals have the opportunity to help people change their behaviour. Their involvement is key to successfully curbing the tobacco epidemic. For example, if dentists warned all their patients that smoking causes excess plaque, yellowing teeth and contributes to tooth decay, as well as a five-fold increased risk of oral cancer, the impact on smoking would be dramatic.

Studies have shown that even brief counselling by health professionals on the dangers of smoking and importance of quitting is one of the most cost-effective methods of reducing smoking. Please refer to Cochrane Reviews website for the meta analysis based recommendation on this. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000165.pub4/full

“Does advice from doctors encourage people who smoke to quit

Advice from doctors helps people who smoke to quit. Even when doctors provide brief simple advice about quitting smoking this increases the likelihood that someone who smokes will successfully quit and remain a nonsmoker 12 months later. More intensive advice may result in slightly higher rates of quitting. Providing follow‐up support after offering the advice may increase the quit rates slightly.”

Ideally, health professionals should lead by example and should act as role-models for their patients, by ceasing to smoke, and by ensuring their workplaces and hospitals are smoke and tobacco-free.  The message to be conveyed to all patients in clear terms is :-  “If you use any form of tobacco ….QUIT. If you don’t, then don’t start”.

Doctors and Dentists must utilize every opportunity afforded to convey the “SAY NO TO TOBACCO” message, and must endeavour to question every patient about tobacco usage and offer advice and counseling on giving up tobacco during every professional interaction, irrespective of the nature of reason for seeking healthcare.

A simple model for interventions applicable in all patient care settings to be adopted by healthcare professionals  is the “4 A approach” https://www.nature.com/articles/4810266

• Ask for tobacco use  (at every med consultation)
• Assess degree of tobacco use
• Advise on cessation (at every patient contact)
• Assist / Arrange in quitting (when patient requests)

If you are a Doctor, go on, Ask your patient and help him / her!

If you are an interested individual, what are you waiting for ? Go ahead change the world one person at a time.

If you are in the Corporate environment, you can get in touch with me at drcariappa@deltazuluconsultancy.com to help you design and develop a customized workforce oriented Company level Tobacco Impact Mitigation Policy that is aligned with International Best Practices and fully compliant with the law of the land.

Even a child in school today, knows that malaria is caused by the bite of an infected female Anopheline mosquito ! https://www.who.int/features/qa/10/en/

Today, we know of what causes malaria, how it is transmitted, its diagnosis, treatment etc etc…. We know the contribution of Ronald Ross https://www.cdc.gov/malaria/about/history/ross.html

But does this child or that child’s parent know tales of field workers who are out there, toiling relentlessly to reach out to people who are affected, people whose lives are impacted by that tiny parasite, the Plasmodium that is at the root cause of untold human suffering, possibly even before a mysterious ailment termed “Mal’ aria” (literally meaning bad air) along the swampy marshland around the River Tiber in Rome, led to much thought about this many centuries ago. Malaria has indeed been affecting a major chunk of humankind since times immemorial.

The story behind this blog post is to highlight some of the efforts being undertaken to address the problem of malaria, in one of the states of India.

Odisha, is located along the Eastern Coast of India, and has large tracts of tribal dominated lands (https://en.wikipedia.org/wiki/Odisha) scattered across  an underdeveloped , difficult to access terrain. Odisha has the largest number of tribal communities in India, (62 tribes including 13 primitive tribes) with a population of 8.15 million constituting 22.3% of state’s population. In addition to the tribal population, there are many other marginalized sections of society, who do not have easy access to health care services – all these populations are at high risk of malaria infection (Source: State Govt DAMaN guidelines).

The intensity of malaria transmission in any given area largely depends on two main factors:-

Firstly, the local environment and ecotype that determines the dominance of a malaria vector species and its vectorial capacity ( did you know that each vector species behaves differently , in terms of where it likes to rest, where it breeds, when it bites etc ?)

Secondly, access of an affected community to effective diagnosis and treatment along with preventive measures.

Communities living in isolation in natural forested habitats are at risk for being affected by malaria, more than their more affluent semiurban / urban brethren, progress in the field of diagnostics, curative and preventive health notwithstanding.

The Odisha State Govt, launched a visionary program “DAMaN” (Durgama Anchalare Malaria Nirakaran) being implemented in inaccessible areas of high endemicity districts http://www.newindianexpress.com/states/odisha/2018/apr/14/odisha-becomes-model-state-in-malaria-control-1801609.html

The rationale behind this program is that preventing malaria infection and averting disease manifestation would potentially have a positive effect on the health and well being of the population residing in remote, inaccessible and underserved areas.

DAMaN  is presently being implemented in high malaria endemic Sub Centre areas of all Blocks of the following eight high malaria endemic Southern districts: Koraput, Malakangiri, Nawarangapur, Kalahandi, Rayagada, Gajapati, Nuapada & Kandhamal. These districts reportedly have only 20% of total population of the state, but used to have a very high malaria incidence and contributed around 50% of the malaria cases and 47% of the deaths due to malaria in the past (Source : State Govt DaMaN guidelines).

The Tata Trusts in partnership with the Govt of Odisha , through the Livolink Foundation have been working on a project in the remote fastness of the South Odisha region since 2016-17 to eliminate malaria as a public health problem. https://www.livolink.org/eliminating-malaria/genesis-of-the-program/ Partnering with Community Based Organizations and with another local NGO had been ongoing in the region since 2010. However, the work achieved full steam ahead impetus after the formalization of the interventions in 2016-17.

Presently, under the aegeis of the Livolink Foundation , the Malaria Control Project (due to various historical precedents in the chequered story of malaria, it is more appealing to me, to refer to ‘control’ rather than ‘elimination’ of a disease such as malaria!) is functional  in five Blocks (Th. Rampur, Lanjigarh, Muniguda, Bissamcuttack and Kotagarh) of Kalahandi, Rayagada and Kandhamal districts of South Odisha. Over the past years, this Project funded through the Tata Trusts / Livolink Foundation has benefitted nearly 50,000 households across 263 underserved villages in the region.

Hard working Cluster Coordinators of the Project, have toiled selflessly , day in and day out, walking their way across hilltops and landslides, braving the sweltering heat and in the monsoons even wading across streams, to reach the villages (nay, hamlets actually) in their Areas of Responsibility.  The hardy tribal folk have nominated amongst themselves, enthusiastic young people to work within their fold, as “Village Health Volunteers” , mentored by the aforesaid Cluster Coordinators. Providing a doorstep service of onsite early diagnosis of fevers using Govt provided Malaria Rapid Detection Kits and collecting Peripheral Blood Smears for later examination at distant microscopy centres, the Village Health Volunteers also provide supervised standardized Malaria Treatment to those diagnosed with malaria. For those with unmanageable fevers, referral is the only recourse, which is facilitated by the Project personnel through their liaison efforts. Please note that there is almost no cellphone connectivity in the hilly hinterland. And it takes a few hours of walking through hostile territory to reach the nearest roadhead, with a patient often having to be carried on a makeshift cot.

This simple system of mentoring a network of village level health volunteers, is what is making the Project tick ! Reaching out to thousands of impoverished folk in this tribal belt, and making an impact by lowering the incidence of malaria……

The determination and the dedication being exhibited by the frontline workers of the Project under the inspiring leadership of Dr Govind, a local lad, giving his best back to his home turf, is what is so refreshing to have witnessed first hand, in a recent visit to the area.

“Odisha Government showed political commitment by allocating resources and working with development partners in looking at the big picture and ensuring last-mile connectivity”

https://www.business-standard.com/article/current-affairs/world-malaria-report-2018-led-by-odisha-india-reduces-cases-by-3-million-118112300064_1.html

If you would like to know more about how this Malaria Control Project is coming along, please contact me for updates.

If you would like to learn more about malaria prevention and control , and what you as an individual can do , please contact me for further guidance.

This could very well be the slogan of those nameless faceless entities out there, who are plotting to blow up civilized society as we know it……. Or maybe even shoot at , one group at a time…..

Most of you would have read about the grenade casually tossed into the crowd at a crowded bus station (where else do you expect there to be crowds in India?….. how about movie halls, shopping malls, open areas, wherever…. we have people!) https://timesofindia.indiatimes.com/india/jammu-grenade-blast-police-apprehend-another-suspect/articleshow/68337984.cms

You might also have been horrified about the ‘terror’ attack on mosque(s) in New Zealand (https://edition.cnn.com/2019/03/19/asia/christchurch-attack-intl/index.html) . While this may be an isolated act or a portent of an unstable future , what is real , is that these kinds of incidents will happen, and maybe will happen more frequently, anywhere and everywhere in the world, whether it is the isolated act of a ”madman” or the planned unleashing of terror by quasi religious fanatics.

Let me ask you to have a quick look at an earlier post of mine dealing with Personal Emergency Preparedness
https://deltazuluconsultancy.com/2019/02/27/personal-emergency-preparedness-are-you-ready/

…. Ask yourself at this point …. “Is my family important to me?” , ” Do I have loved ones, people that I care about ?”……. ” Can I do something to prepare myself and my loved ones?”…..

Its as easy as A, B, C , D …….

A – Always be Alert.…… Be conscious of your surroundings…. Be aware of unattended objects , baggage, cars , two wheelers……

B- Be Cautious.….. when dealing with suspicious strangers, or with unidentified objects…. Call the Police or the Emergency Response personnel in your area. They are trained to deal with “situations” , you are NOT.

C – Be Cool…… If you have a plan , you can be “Cool”… Even if you dont have a plan, if you have thought about it beforehand, if you have discussed emergencies with your loved ones, you can play it “Cool”

D – Deal with it.…. Respond… in the best way that you can. Remember you are not trained to deal with Emergencies or Crisis situations… however, you can deal with your family, you can deal with taking care of your loved ones…. Make a plan, and rehearse it, and stick to it.

Or even as simple as 1, 2, 3……

1. Each family member should memorize the mobile number of one local contact and one out of town contact and preferably the landline number too.
2. Each family member should understand the importance of sending an SMS (not a whatsapp message) in preference to a “call” at the time of a crisis.
3. Each family member should know of a pre-decided “safe place” to rendezvous, within the area of residence, within the city , and outside the city……

It goes without saying , that you need to Rehearse, Repeat, Reinforce and Practice .… may sound difficult, however if you truly care about your family and your loved ones, its worth the effort. Remember , the “bad guys” are out there…. and they dont care about you or your family…………………..

YOU have to do , whatever it takes…….

For concerned individuals, those who care about their loved ones, you may reach out to me directly for assistance and guidance, gratis…..

For Corporates / HR Depts / Institutions…. this is a paid service that is worth every bit of the money you will spend on safeguarding your employees!

Contact me at drcariappa@deltazuluconsultancy.com

For those in earthquake prone areas, a simple, easy to read book available at this link is worth a quick look-see, preferably to be shared with all your family members….. https://toolkit.ineesite.org/resources/ineecms/uploads/1057/Basic_Disaster_Awareness_Handbook.pdf

The time to act is ,,,,,,…..,,,,,,, NOW!

There is a jingoistic fervour in the air with exuberance and the thrill akin to hounds baying for blood. It is indeed aptly said in modern times that “War is where young men die on the battlefield and where armchair warriors tweet and post on Facebook”.

However , this is also the time that is apt for taking stock of the situation post 9/11….. the world can never be the same, with the “War on Terror” having virtually made us prisoners in our own society…..

I am certain that some wise folks must be wondering who is winning, and who is being inconvenienced……

Without coming off as a Cassandra fortelling a bleak future, it is certain that the future of the world as we know it today, will be paved with painful episodes where civilized civic society will be torn asunder by seemingly isolated acts of terror , by the Hydra headed monster of disruptive forces. Without ascribing religious hues to these perpetrators of violence , irrespective of their “cause ” or allegiance, the outcome is devastating for the victims of dastardly actions wrought by these misled and misguided unknowns (the reality being that they are well led and well guided, by their benefactors and controllers).

For a detailed overview of the potential spectrum of threats that we and our loved ones, face as a society, please click and skim or read through as per your choice https://www.ready.gov/be-informed

With the easy access to various forms of explosive materials, and the knowhow to concoct Improvised Explosive Devices (IEDs), terrorists will target gatherings of people as they have been doing in the past, with no intent other than to spread terror. Be Aware at all times of the potential threat to life in crowded spaces, in a vitiated atmosphere. You can click https://www.ready.gov/public-spaces for a detailed outline of actions or you could simply glance through my suggested action list.

Do remember that in times of crises its your training and conditioning that kicks in…… so you need to consciously rehearse and discuss with your family the following….. Repeat and repeat again…. That is the reason why the military everywhere invests so heavily in training …..

What should you and your family members do in case of Mass Attacks in Crowded & Public Spaces ?

While the threat of mass attacks is real, we can all take steps to prepare, protect ourselves, and help others. What are Mass Attacks you may ask?

Bombings in public spaces like the various incidents that happen across the country off and on, 26/11 Bombay style attacks………

Well, how do we Protect ourselves and our families against these incidents?

• STAY ALERT– always be alert to your surroundings and the people around you. Be wary of suspicious movements…. if you train yourself to be aware and alert, you will learn to recognize gut feelings …..  
• “If you see Something , say Something” 
  Report suspicious behavior, items, or activities to the relevant authorities. DO NOT handle any unknown / unidentified objects!!!
• Observe what is going on around you and avoid distractions such as texting, listening to headphones or being on your cell phone.

• SEEK SAFETY – Have an Exit Plan always……
• Identify exits and areas of protective cover for the places you go such as at work, at school, and community events. When you go into any closed spaces, condition yourself to look for exits and position yourself accordingly. Movie Halls, Auditoriums and any similar places, may have exits. You would be wise to mentally make a note of these, and also check if they are not locked.

• RUN TO SAFETY  – wise is the man who lives to fight another day…… do remember that  you are more important and precious to your family alive, than dead. A dead Hero is a photo on the wall…… Leave the heroism to those who are trained and equipped for countering terrorists.  
• If there is an accessible escape path, attempt to evacuate the building or area, regardless of whether others agree to follow.
• In case of an explosion, hit the ground….. Remember also that sound travels slower than light….
• Do not come back to the scene to check…..
• However, if you are cornered, and see no exit path….. Never Give Up. Attack with whatever you have at your access, and give it your all….. thats all you have . Do what you must, to survive. There is no reasoning with an unreasonable person.

• SEEK COVER AND HIDE In case of any incident, remove yourself from the site of the incident as fast as you can.
• Dont stop to take photos , selfies, etc etc…. You can update your FB status from safety….
• You dont want to figure as collateral damage for the next IED do you?
• Map out places to seek cover. Place a barrier between yourself and the threat using solid objects, walls, and locked doors as protection.

• PREPARE NOW   Organize and participate in safety drills in places where people gather like home, school, and work.

Ask yourself this simple question now……. “What if?”……

“What if ‘something’ happens and I’m not with my family?”

“Will I be able to reach them?”

“How will I know they are safe?”

“How can I let them know I’m OK?”

Do you have a Personal Emergency Plan (PEP) ?

So how do you make your family PEP ?

First and foremost, Make a plan today!! Dont postpone to the last Sunday of the month, or after you finish off that pending assignment or after your child’s birthday. The “bad guys” out there are not waiting for you to make your plan……

Your family may not be together if terror strikes, so it is important to know what could affect you. Know how you’ll contact one another and reconnect if separated. Establish a family meeting place that’s familiar and easy to find.

Step 1: Put together your PEP (Personal Emergency Plan) by discussing these four questions with your family, and friends, TODAY , to start your emergency plan.

• Q. 1. How will I receive emergency alerts and warnings?
• Q. 2. What is my shelter plan ?
• Q. 3. What is my evacuation route?
• Q. 4. What is my family/household communication plan?

Step 2:  Consider specific needs in your household.

As you prepare your Personal Emergency Plan , tailor your plans and supplies to your specific daily living needs and responsibilities.

Discuss your needs and responsibilities and how people in your network can assist each other with communication, care of children, business, pets, or specific needs like medical equipment that you or your dependents may need. Create your own personal network for specific areas where you need assistance.  Keep in mind some these factors when developing your plan:

• Different ages of members within your household
• Responsibilities for assisting others
• Dietary needs
• Medical needs including prescriptions and equipment
• Pets
• Location routines, such as school or work locations and timings.

Step 3: Fill out your Personal Emergency Plan – Soft copy and Hard Copy.

You can see a template online and use as a guide to create your own. https://www.fema.gov/media-library/assets/documents/133447

Step 4: Practice your plan with your family and friends. Do this at least every six months….

So, ARE YOU READY…….!!?

Nota Bene: Your Personal Emergency Plan has to have a communications component……

During any terrorist related event or even a disaster, you will need to send and receive information from your family.

Communication networks, such as mobile phones and computers, could be unreliable during such events , and electricity supply could be disrupted. Planning in advance will help ensure that all the members of your household—including children —know how to reach each other and where to meet up in an emergency.

Planning starts with three easy steps:

• Step 1. COLLECT. Create a paper copy of the contact information for your family and other important people in your life, along with emergency services such as medical facilities, doctors, or other service providers. Type or write in indelible ink or in a laminated card format.
• Store emergency contact personal numbers under the name “In Case of Emergency” or “ICE” for all mobile phones and devices. This will help someone identify your emergency contact if needed. Have at least one out of town contact in your ICE list.

• Step 2. SHARE. Make sure everyone carries a physical copy on his or her person , in their bag, purse, or wallet. You should also post a copy in a central location in your home, such as your refrigerator or key tray.

• Step 3. PRACTICE. Have regular household meetings to review and practice your plan. Do this at least every six months. Practice texting and calling. Have each family member practice sending a text message or calling your out-of-town contact and sending a group text to your mobile phone group list. Discuss what information you should send by text. You will want to let others know you are safe and where you are. Short messages like “I’m OK. At xyz Location” are good.
• Talk about who will be the lead person to send out information about the designated meeting place for the household. Practice gathering all household members at your indoor and neighborhood emergency meeting places. Talk about how each person would get to the identified out-of-neighborhood and out-of-town meeting places.
• Discuss all modes of transportation, such as public transportation, rail, or even by foot , for all family members. Regularly have conversations with household members and friends about the plan, such as whom and how to text or call, and where to go.
• To show why it’s important to keep phone numbers written down, challenge your household members to recite important phone numbers from memory— now ask them to think about doing this in the event of an emergency.

Re-learning using your phone ! Use SMS for emergency communications .

If you are using a mobile phone, a text message may get through when a phone call will not. This is because a text message requires far less bandwidth than a phone call. Text messages may also save and then send automatically as soon as capacity becomes available.
Make sure all household members and your out-of-town contact know how to text if they have a mobile phone or device, or know alternative ways to communicate if they are unable to text .

For more detailed info please click on https://www.fema.gov/media-library-data/1440520833367b485ed4517c86bc824061197319f4999/Family_Comm_Plan_508_20150820.pdf

So, ARE YOU READY…….?!!

Understanding Tyre markings

Tyres have an alphanumeric code system printed / embedded into their sidewall which allows the common man to understand the technical capabilities of the tyre, irrespective of its manufacturer. 

Being able to read this information will help you maintain your tyres, and choose new ones when the time comes.

Needless to say, you would not be reading this if you didnt understand the basic fact that tyres save lives….. Remember noticing those shreds of tyres you see on our highways….. BLOWOUT ! the ever present danger to our lives on highways….. 

(Image Source : ATMA website) 

 

This code provides information on the tyre‘s construction (e.g. radial), its size, its load-carrying capacity and its speed rating.

For example, the code commonly seen on most cars may be such as this below :-

P 205 / 65 R 15 95 H

P or no letter at all indicates a passenger car tyre.

205 – Section Width

indicates the nominal section width of the tyre in millimeters (i.e 205mm).

65 – Aspect Ratio

indicates the tyre’s aspect ratio, a comparison of the tyre‘s section height with its section width (65 indicates the height is 65% of its width).

R – Radial

indicates radial ply construction.

15 – Rim Diameter

the nominal diameter of the wheel rim (15 inches)

95 – Load Rating

a symbol indicating the maximum load capacity at which the tyre can be safely operated.  95 represents a maximum load of 690 kg per tyre; 

Load Index	81	82	85	86	87	90	92	95	96
Max Load/tyre (kg)	462	475	515	530	545	600	630	690	710

Personal Experience

I have survived (with the blessings of the Almighty), two tyre bursts in succession, on a traipse across Northern Botswana in 2007. At high speeds that too…. 120kmph was the prescribed speed limit there.

My second burst tyre was “brand new” to look at, but possibly had nestled in the comfort of the dicky of the car in the sweltering clime of Singapore for all of three years!! Trivia nugget  – most second hand cars sold in Africa are from the South East Asian region, where it is apparently uneconomical to ply cars older than three years….!  To cut a long story short, in the succeeding paras, I shall endeavor to convey the essence of my recommendations from the Public Health perspective…. Anyway, you could invalidate your insurance when driving on ‘worn tyres’! 

A worn tyre will also reduce the effectiveness of your brakes, acceleration and steering. The deeper the tread the more grip you have. It is not just unsafe to ignore the minimum tyre tread depth, it is illegal in certain countries such as South Africa ! There is a legal minimum tread depth of 1.6 mm, for all four tyres on a car, and this can be checked and a fine imposed in South Africa. The way to check it crudely is to put the head of a matchstick in between the treads and if it stays put , the tread depth is ok. 

When buying a car second hand, always assume that the tyres are as old as the car is , however “new” they may look…… Rubber has an expiry date, a parallel example would be other household rubber goods, which are usually marked ” use before expiry and protect from sunlight and excessive pressure”! Your car tyres see a much tougher life in their journeys.You could also use the example of condoms, which when old get brittle and crack! Accordingly please consider buying new tyres as per the rating specifications of your car (check the Car Manual). The rating clearly indicates the maximum speed that your tyres can bear. 

For city driving you can soldier on with your old tyres, but when going on a long drive, consider the change of tyres as an investment in safety, for your family and you. The old info about tyre pressure and balancing / alignment still rings true…. so check your pressure  ( car tyre, and maybe once a year, your Blood Pressure too) regularly.

And get your tyres rotated and aligned / balanced every 10,000km. Tyre experts recommend changing tyres every 80,000 km or 2 years, whichever comes earlier, if you drive on highways. However please refer to your car manual for further info. 

While concluding , I must take this opportunity of advising you to “Buckle Up !!” that includes the passengers in the rear…..Research has proven that seat belts save lives, thats why these are there !  Children must never be allowed to sit in the front of a car without seat belts properly positioned, and just because it is not legally enforced, do not ignore child restraints in the rear of passenger cars. Safe motoring !

At times, I let fancy take flight, and think that maybe I should become a “Life Coach”. But then who am I to fancy this….. Life itself is the best coach that there can be. Provided of course one wants to learn, to adapt, to improvise and to overcome, the slings and arrows of outrageous fortune…..

Over the course of the past few decades, I have often parted freely with advice, solicited or otherwise, and always considered that the person who take advice is far wiser than one who gives such…..

What follows is a message I composed for WhatsApp , to send to my friends….. piggybacking on the ever popular concept of eat all you can Buffet meals , which pile on the calories and satiate you guiltily.

And lest you think that it be original…. Well, is there anything original on the Internet?

I will gladly acknowledge the source, if I can find one….or if someone wants to lay claim to these.

So , dear reader, here is a buffet spread for you to indulge in!!

A meaningful life …. the style – choice is yours.

We start with the premise, that you agree that Health is actually the only true wealth. 

Starters: (pick any 2)

1.   Get up early (you can accomplish 20% more during the time frame of 0500h to 0800h)
Do note that to get up early you have to sleep early! So switch off your smartphones at least half an hour before your intended bedtime, and your TV too in case you are the kinds who keeps these TVs in the bedroom.

2.      Exercise for at least 30 minutes on most if not all days of the week (you have no choice with this)!  Do anything that counts as exercise. Install an app that monitors your steps in the day, on your smartphone. I personally use Pacer (available on the app store).

Try to aim for at least 10000 steps a day. Studies have found that having an app installed on your phone makes an individual competitive, in trying to achieve the 10000 steps per day challenge. 

3.      Meditate /pray/ visualize positive things/do yoga for 30 minutes every day. Breathe deep, breathe long….

This is your ‘me time ‘ don’t relinquish it for your phone or for the TV …. try not to check your phone till you finish with ‘me time’. 

Main course (pick any 6)

1.   Dress well at all times along with having good shoes and proper socks  (this is mostly applicable to men, as the ladies usually dress and adorn themselves well enough…. Dont have ‘home clothes’ !
2.  Outsource everything, which is not your core competence .
   You cannot do everything… let someone else do for you what you cannot or should not. For example, let a CA do your tax returns, let a cook make food for you, let a maid clean your house for you.  
3.  *Reduce your mobile time by 30 % * The new IoS 12 has a feature which monitors your screen time for you. Delete all unnecessary apps and unsubscribe from Notifications and Alerts.  
   Exit all unnecessary WhatsApp groups and don’t forget to Switch off the phone , at least half an hour before sleeping
4. Take bold decisions!  Do what you have always been scared to do . (No one wants to die with regrets – do you?)
5.  Train your brain to think creatively every day. Try to do different things to exercise your brain~ start playing some new sport, go to new restaurants, visit a garden or a park  and look at other people, listen to different music genres, watch others playing, spend time with senior citizens and those older than you ! Dance if you can, sing if you must. Read the newspaper every day. 
6. Do good for others, anonymously if possible. Give of your time to others! Be a part of something bigger than yourself ! When you are a mere dusty picture on the wall, what will people , your family , remember of you, 10 years along the road? 
7. Start completing things left undone. Discard unwanted & unused stuff from your house and your mind.

Accompaniments (Must have)

1. Watch one movie in a cinema hall/ play in an auditorium every month (get off your phone and meet real people)
2. Read at least one fiction book in a month and one self improvement book every six months.     Donate your old books to school or college libraries
3. Take at least 2 vacations in a year       Go on…. for whom are you working or saving money for? Travel enriches the soul, and contributes to the economy. Travel in style, eat frugally, drink minimally, shop less, see more.  

Desserts (pick all)

1. Devote at least one hour a day for family and friends

                Give people your time

2. Smile at all possible times and especially if no one is watching you … make it a habit

3.  Every month get in touch with one old friend or batchmate with whom you have not spoken for years

Paan 

The sweetest of all Paans—– Laugh often!!

Hope you had a lovely meal!

Have an Awesome Life!!  It’s your choice , remember! You can eat as much or as less as you like . You have already paid for the buffet that life is,. 

Nota Bene :

This is not just another of those copied forwards….. it’s edited , proof read and value added!

With love and best wishes to y’all ! And to your loved ones…

Cari

As I have spent a considerable time in the Himalayas, this may be considered as the gyaan of penance.

Adulteration of food is defined as “the addition or subtraction of any substance to or from food so that the natural composition and quality of food substance is affected”. Adulteration can be deliberate by either removing substances from food items or varying the existing natural properties of food intentionally.

Adulteration can also be unintentional due to ignorance, carelessness or lack of facilities for maintaining food quality.

Either way, Adulteration of food is something that will directly affect the health of your family and you! 

Any person who “adds an adulterant to food so as to render it injurious for human consumption with an inherent potential to cause his death or is likely to cause grievous hurt, irrespective of the fact whether it causes actual injury or not, shall be punishable for a term which shall not be less than 7 years but which may extend to imprisonment for life and also fine which shall not be less than Rs 10 lakh,”.

https://www.businesstoday.in/current/economy-politics/fssai-proposes-life-imprisonment-for-food-adulteration/story/279601.html

The top 10 foods which are prone to adulteration in India

http://www.scind.org/183/Health/top-10-food-products-prone-to-adulteration-in-india.html

Some additional links to give you inputs that indeed Food Adulteration is a problem and that we need to be aware of it. 

https://www.dw.com/en/food-adulteration-a-rising-problem-in-india/a-5958444

https://mediaindia.eu/social-vibes/the-menace-of-food-adulteration/

You are invited to have a look at a YouTube video on Food Safety testing prepared in a collaborative project by a very talented colleague. (Scroll down to the bottom of the page which opens up when you click the following link…..)

https://deltazuluconsultancy.com/consultancy-services/food-safety-management-systems-consultancy/

What is a Mass Gathering ?

(WHO)

More than a specified number of persons (1000 people to > 25 000 people)

• at a specific location.
• for a specific purpose. 
• for a defined period of time.

A modified definition by-Polkinghorne et al :-

Events attended by a sufficient number of people and of sufficient duration to strain the planning and response resources of a community, state or nation.

If your interest is piqued enough….read more about Mass Gatherings 

http://www.who.int/ihr/ith_and_mass_gatherings/mass_gatherings/en/

https://www.thelancet.com/series/mass-gatherings-medicine

https://www.ijidonline.com/article/S1201-9712(17)30334-X/fulltext

A presentation on the fundamental concepts of Mass Gathering Medicine in the context of the Kumbh Mela was recently given to students of a premier Science Education Institution in Pune (no guesses).

The students were very receptive in their attention and the questions were indeed thought provoking. The future of Science and the Country seems to be in safe hands with these young people , given their interest and curiosity.

If you would like to have a look at the detailed presentation, given elsewhere as a Webinar for the World Association of Disaster Medicine, with a target audience of Public Health and Disaster Medicine Professionals, just click on….. (its about an hour long)

After this tremendous opportunity to lead a Study team from the Armed Forces Medical College Pune, India, to evaluate the preparedness status of the Kumbh Mela , first at Allahabad, India in 2013 and then at Nashik, India in 2015, a comprehensive, layered module on Mass Gathering Medicine, with an extensive interactive component including table top exercises, was developed and rolled out for Undergraduate and Post graduate students of the AFMC, as also for MPH students of the University.

I am indeed grateful to my then HOD, Dr Mahen and the overall Head of the Medical Services, Dr Joshi, to have afforded me the opportunity to witness and study at close quarters the spectacular spectacle of thronging humanity.

As an aside, I did not bathe in the waters during the Kumbh Mela, maybe in the mistaken belief that I had no sins to wash away, or maybe I was sceptical in my faith about the quality of the water.