Tuesday, August 30, 2011

Settling into Manali

The first few days in Manali were an adjustment time, especially for the students, most of whom had never been overseas. Arriving in India is an assault on the senses. Manali is a fairly compact, crowded, dirty and polluted city nestled at the foothills of the Himalayas, and is a bustling honeymoon destination because of the scenery outside town and the lovely summer climate.

Pedestrians share the crowded, pot-hole pocked roads with motorcyclists, auto-rickshaws, trucks and buses, as well as an assortment of dogs and cows, and the occasional goat. There is the rank smell of sewage and piles of garbage balanced by spices and sizzling fried dough and meat from the sidewalk vendors. Destitute children and lame beggars contrast with the vivid colors of the rich fabrics worn by even relatively poor women, and the carnival like atmosphere of the pedestrian Mall Road.

Our hotel could euphemistically be described as “modest.” The students quickly adjusted to the spare, but colorful rooms, and to the routine of heating water for bucket baths, but had a harder time with Indian food and difficulties with reliable internet access. By the third day of paranthas for breakfast and some combination of roti with lentils, rice, and paneer in tasty sauces, the kids were ready to riot. Fortunately, the hotel staff were quite accommodating and broadened the diet to include chicken and mutton stews, though the recognizable body parts were a bit disconcerting. The students discovered that if they hiked ~45 minutes up the road to Old Manali, they could go to fancy restaurants catering to tourists with pizza, pasta, crepes, and a variety of ice cream dishes, accompanied by pop music or karaoke. They made a bee-line for “Drifter’s,” “Dylan’s,” and “Bella Vista” every evening thereafter. So much for our plans for evening bonding experiences and cultural activities for the immersion in India experience…

The immediate tasks for the weekend were to obtain Salwar Kameez “suits” for the girls and cell phones or sim cards. Buying clothes in India is a treat for many women. There is such a beautiful array of material, now with many lovely embroidered patterns on them. You walk around town, find the material that appeals to you, barter with the shop owner, then take the fabric to a tailor who measures the suit and sews it for you.

Obtaining a sim card was a bit more complex. Because of terrorist activity, in order to buy a sim card, we had to have additional passport photos taken and show proof of residency, as well as fill out several forms. Fortunately, we had Sunny, who capably guided us through this process and attested to our identities. Every hotel now also required copies of our passport. That reminded me of visiting Hungary during it’s communist rule.

While still exhausting, getting settled in, it was fun seeing kids' excitement and dismay. With the initial mundane tasks accomplished, we settled in for our work and study at Lady Willingdon Hospital and the villages.


Monday, August 22, 2011

Censorship causes Blindness: A Valuable Public Servant has been Silenced

I was shocked to learn that one of my favorite cyberfriends, RenĂ© Najera, aka “EpiRen,” has received a gag order, prohibiting him from tweeting or blogging about public health issues, after a complaint by an aggressive anti-vax tweeter, “cigaRhett,” Rhett Daniels. I won’t rehash the whole unfortunate drama, as the back story is well-described by Liz Ditz, with many subsequent flavorful comments.

I did, however, want to call my reader’s attention to this, particularly since there is currently a heated debate about the value of anonymity on-line. EpiRen’s harassment is a perfect example of the benefits of anonymity—more poignant since he blogged under his own name. Ren was careful to “clarify that none of the views presented in this blog (or anywhere else, really) represent the views of any of Ren's employers. Got it? Good.” Yet cigaRhett complained to Ren’s superiors, prompting them to threaten his continued employment.

It makes me feel ill that Rene has been bullied into silence. Maybe it’s sort of PTSD from similar past events in Cumberland. As I posted in Liz Ditz’s comments, Ren’s Epi Night School has taught me more about epidemiology than anything I learned either in med school or during my Infectious Diseases fellowship. He has a fine gift as a teacher, and the rare talent of being able to explain difficult topics in an engaging manner. The Daily Ren is a valuable news source and helps me keep up to date in my practice. EpiRen’s tweets are similarly an ongoing, real-time source of public health information, and he curates information from multiple sites I would otherwise overlook. Ren writes with humor and with passion about public health. He has been an ardent proponent of vaccinations. I have grown to find a sense of community as he and I and the #HandHygeine Team joust with the #pathogenposse. From my perspective, EpiRen and “The Germ Guy,” JATetro are the lynchpins of my staying current on public health, and this team is much more engaging than just reading CDC or CIDRAP reports.

Yesterday, the new EpiRen posted,

“Last day to print out or cache your favorite posts of the Epi Times. It goes down permanently at midnight tonight.”

As of last night, EpiRen has closed his sites. What a shame.

The response from Ren’s cyberfriends has been heartwarming, and perhaps good will come of this travesty:
anarchic_teapot provided further background perspective with Malevolent stupidity never sleeps.

The Skeptical Lawyer has joined the fray with an excellent post, “Lessons from EpiRen: do public employees have free speech rights?

PZ Myers, “Pharyngula,” has characterized cigaRhett’s posts as those of a litigious bully, who now, having been confronted, is attempting to erase his tracks on the internet. But the best characterization of the bullying behavior comes from Rhett Daniels' own threatening words.

A seasoned veteran of similar wars, Orac, has written about the consequences of blogging under one's own name. This is a timely issue, given the move by Google+ and ScienceBlogs to prohibit anonymity.Before “#Epigate” happened, the need for anonymity was carefully explained by Skepchick in her post, Does Google+ hate women? I highly recommend her article for valuable perspective.

My initial reaction to the breaking news was to want to enlist William Raillant-Clark and Kyle VanderBeek to help, given their recent success with getting internet troll David Mabus’ violent threats to scientists and atheists to be taken seriously by Montreal police. But EpiRen asked to not have a large internet outpouring to his employers and discouraged action.

I’ve been heartened by the support for EpiRen and free speech. I hope that EpiRen’s employers take to heart Skeptical Lawyer’s comments about transparency. And I would tell them that RenĂ© Najera’s posts as EpiRen are not just frivolous social banter. EpiRen provides important, real-time news and an outstanding tutorial series on epidemiology.

As I was rereading the Epi Times last night, I noted an apt quote. To paraphrase Cesar Chavez, “Let us remember those who have been silenced by injustice; For they have given us life.