Wednesday, October 26, 2011

Circumambient World

As I near the end of my current India adventure, I have come full circle – back to where I first believed that someday I would be a Fulbrighter.

I recently returned from Sri Lanka. The US-India Education Foundation has a special travel grant available to Fulbright-Nehru Senior Scholars in India to present guest lectures or workshops in adjacent countries. I was awarded this grant in order to guest lecture at the International Water Management Institute ( in Colombo, Sri Lanka. I also did a retreat at the Nilambe Meditation Centre ( where, 20 years ago, I met a Fulbright Fellow who inspired me to venture on this journey.

Water of Life
I learned a lot more from the folks at IWMI than they did from me. I have been interested in conflict resolution around water issues for a long time, but have only recently been intensely involved in research on the topic. My time at IWMI was an amazing opportunity to learn more from some of the top water experts in the world.

I spent a week living at their Guest House and hanging out at Head Quarters of IWMI learning about water issues, with a particular focus on water conflicts, from the researchers there. About one-third of the researchers are natural scientists, about one-third engineers, and about one-third social scientists, mostly economists. The focus of IWMI has traditionally been on irrigation for agricultural, although this obviously touches on many other related issues. They have four research themes: (1) Water Availability and Access; (2) Productive Water Use; (3) Water Quality, Health and Environment; and (4) Water and Society.

My main host was Mark Giordano, the Theme Leader for Water and Society. Mark is from Walla Walla, Washington, which is near Pilot Rock, Oregon, where my mother spent her early years on my great grandfather’s ranch. He went to Whitman College, the excellent small liberal arts college in Walla Walla. He and his wife Meredith, who also works at IWMI heading a Bill and Melinda Gates Foundation funded project, both have PhDs in geography from Oregon State University where they studied with Aaron Wolf, a globally renowned expert on water conflicts.

While at IWMI, much of my time was spent in dialogues with Mark. He graciously answered my questions and pointed me towards resources he thought would be of interest. I made a point to spend time with all the theme leaders who were in the IWMI offices, plus the Director General, Deputy Director and top researchers on various issues. The opportunity to informally interact with these brilliant scientists – asking them my sometimes basic but often challenging questions – was wonderful!

At the end of my week there, I presented my guest lecture in the Friday Seminar Series. It was titled, “Water Conflicts: A Framework for Analysis, A Case Study and Suggestions for Resolution.” In my presentation, I told the story of the water conflict I had just researched in Gujarat. Using the analytical tool of “nested conflict,” I included many different escalating factors beyond just water. 

We had a rich discussion afterwards. Some of the hard-core natural scientists challenged me on my mostly qualitative methodology, and some of the social scientists were particularly intrigued by the relational, cultural and legal issues that I discussed. My suggestions for resolution were generally well received. I proposed that instead of the western model of “outsider neutrals” as mediators to resolve local water conflicts, it might be more successful to use “insider partials who are known and trusted and understand the local culture, language, relationships, history, etc. In the case study I presented my example was a well-known guru in the area named Morari Bapu who tried, ultimately unsuccessfully, to act as a mediator. During my interview with him he swung in a lounge chair the whole time. Below he is about to present me with a special blessing and this shawl.  

My time at IWMI was far beyond what I had imagined it could be. And it inspired me to do more work in the increasingly important area of water conflicts. While the popular rhetoric of imminent “water wars” may be a bit alarmist, I do think that as the global population grows and as we see more competition for water uses, being able to play a positive role in peaceful resolution of water conflicts will be incredibly important. I thank Mark and the many wonderful people who I met at IWMI for a challenging and stimulating week.

Circle of Life
Twenty years ago, I took off and traveled around the world. I had worked on Wall Street for three years and saved my money for this big trip, my first venture outside of the USA. Turned out that I literally circled the globe, visiting 26 different countries, and traveling as long as my savings lasted, which was a year and a half. About a year was spent in India and Southeast Asia, including six weeks in Sri Lanka.

On my last visit to Sri Lanka, I did volunteer work with the Batticaloa Peace Committee which was tracking “disappeared” Tamils who had been detained by Sri Lankan police and army then never seen again. That long civil war between separatist Tamils, led by the rebel group called Liberation Tigers of Tamil Eelam, and the Sinhalese majority is over. Although there was a brutal end to the conflict, about which some in the international community are calling for investigations, most everyone I spoke to in Sri Lanka was glad it is over and their lives are back to normal without fear of terrorist attacks by the LTTE or others.

Last trip, I also went to a lay meditation center where I studied with one of the truly enlightened beings I have encountered, the late-great meditation teacher Godwin. I also met a man who had a Fulbright Fellowship to study meditation techniques in Asia. This planted a seed. I said to myself, “Someday, I am going to do a Fulbright.” Finally, after 20 years, here I am doing a Fulbright… and feeling like my life has come full circle.

Last week, I made a pilgrimage back to this place. After a short overnight stay in Kandy, where I visited the Temple of the Tooth (Sri Lanka’s most sacred site which houses in the inner sanctum a tooth relic of the Buddha), I returned to Nilambe Meditation Centre. Nilambe is nestled in a beautiful tea plantation high above Kandy, with panoramic views of the surrounding hills.

This majestic setting was the perfect place for me to do a 48-hour silent retreat. For some of my friends and family, it may be hard to imagine Patrick not saying a word for two days straight. But let me tell you, it was a liberating experience to be totally silent for that period. Quieting my mind was a challenge, but sitting in stillness with God was a wonderful blessing and I cherish the opportunity to practice meditation in this way.

I am trying to carry this mindfulness practice back into daily life, but it is difficult to “come down from the mountain,” which is, of course, the case in every re-entry situation from a life-changing experience. There is a Christian method of mediation, called Centering Prayer, which I have been practicing both on my own with encouragement from my spiritual director and with a group at my church.

Part of the challenge of regular meditation, especially for those of us in the “householder” stage of life (that is with children, working, caring for a home, etc.), is that we can’t fit it into our routine. Nilambe helps by providing the space and structure for practicing mindfulness. Plus, everyone there has made a special effort to be at Nilambe to meditate. Here is the daily schedule:

Wake-up Gong
Group Meditation
Tea with the Sunrise
Mindfulness In Motion (yoga/walking)
Working Meditation
Group Meditation
Individual Outdoor Meditation
Rest/Reading (Library open)
Walking Meditation (indoor/outdoor)
Group Meditation
Tea Break (only during this half-hour, those who choose to – which I did not – can practice “Right Speech” which is useful, gentle, timely and truthful, the rest of the day we all practice Noble Silence)
Mindfulness In Motion
Meditation with Nature
Soya Coffee with the Sunset
Chanting and Group Meditation
Dhamma Lecture or Meditation
Preparation for Sleep
Sleeping Time

Light of Life
Now is the holiday of Diwali in India. It is the Festival of Lights. Delhi looks like Christmas in America with strings of lights and flowers adorning many buildings and gifts being exchanged by family, friends and colleagues. I am joining the extended family of my landlady and landlord for a special Diwali dinner.

My prayer is that all in India (and everyone everywhere) will let our inner lights shine and dispel all the darkness in the world! 

Thursday, October 6, 2011

Free Drugs for All

I am just returning “home” to my flat in Delhi after more than a month of travels. I covered a lot of ground and ideas. Highlights include time with the Gandhi scholars in Ahmedabad, a 10 day retreat at Gandhi’s Sevagram Ashram in rural Maharashtra, a short time at the beach on the Arabian Sea in Diu, researching a water conflict between farmers and industry in the remote villages of southern Gujarat, guest lecturing at Sir Padampat Singhania University in Udaipur, and spending three days with a high level Indian Administrative Service (IAS) officer in Jaipur. It is this last experience that I will briefly reflect upon in this entry.

First, a bit of history on the IAS. In the 19th century, the British Government inherited a well-formed public administration system from the East India Company called the Indian Civil Service (ICS), which in 1853 had instituted a competitive examination for highly sought after appointments. After independence in 1947, the IAS was formed and took over the functions of the ICS. There is still a competitive examination for which approximately 300,000 sit annually to win one of 850 positions. Those who don’t make the cut in the top IAS selection can go to other government services such as the Indian Foreign Service, Indian Police Service, Indian Audit and Accounts Service, etc. But in my experiences teaching young people in India, the IAS is, undoubtedly, the place where the best and brightest hope to land a job. Ask why the IAS, one student answered me, “Because that is where I can have the most impact on changing society and making it better.”

In July, I was introduced to Dr. Madhukar Gupta by a friend who suggested that, having written his Ph.D. dissertation on water conflict, he might be a good resource for my research. Dr. Gupta invited me to Jaipur, the capital of Rajasthan State, where he serves as Divisional Commissioner. His wife, Kiran Soni Gupta, an accomplished artist with an international reputation (, is also a high-level IAS officer serving as Principal Secretary of General Administration and Chief Protocol Officer for Rajasthan. Dr. Gupta and his wife both have degrees from the Maxwell School at Syracuse University and Harvard’s Kennedy School of Government. They have a daughter who is studying at Wellesley College in the Boston area (where my wife, Aviva Segall, went to school) and a son in the 10th grade.

Dr. Gupta was a gracious host during my time in Jaipur. He set up meetings with water experts, arranged my accommodations and meals and took me out for a day in “the field” with him. We went to an event at a government hospital, a visit to a district police station, a university celebrating its anniversary, an advance team to where the Chief Minister would visit the following day and a women’s college which Dr. Gupta was instrumental in starting. Being an IAS Divisional Commissioner, he was treaty as a dignitary wherever we went. His jurisdiction includes the metropolitan area of Jaipur and five adjacent districts which have a population of about 17 million people. He oversees all government programs and personnel in this division.

The day I arrived, the Government of Rajasthan launched a scheme in which all citizens visiting government hospitals, clinics and pharmacies will receive free prescription drugs. Over 200 medicines are on the currently approved list. The state government will pay the bill. Some commentators say this is a way for the current Congress-led State government to win the goodwill of voters. There is resistance to this program from some doctors who think that their professional judgment will be constricted by having to prescribe generic medicines as opposed to branded medicines. Critics claim that because doctors are getting kick-backs from drug companies for prescribing their brands, the real resistance is because the doctors will lose that source of income once this program is implemented. There is also obvious resistance from pharmaceutical companies who will lose revenue when cheaper generic medicines are used. And there is resistance from some pharmacists who are making a higher profit margin on branded medication than on generics.

We traveled on bad and bumpy rural roads about two hours north of Jaipur where we met the Gujarat State Minister of Health, Members of the Legislative Assembly for Gujarat and local Panchayat leaders at an event to launch this free drugs scheme. Dr. Gupta used to serve as District Collector, the top government officer, in Sikar District where the event was held, so he knew a lot of people there.

I had an opportunity to interview the Rajasthan Minister of Health, E. A. Kahn (called by his nickname “Durru Mian” by all), after the event. He gave me some history of this initiative to provide free drugs to the people. The National Rural Health Mission was a scheme launched in 2005 as part of the 11th Five Year Plan (India has had these 5-year plans from its independence). Under the NRHM, there were 15,000 medical units supported in rural Rajasthan. Already free medicine is provided for families “below the poverty line,” pensioners and pregnant women.

The expansion of offering free drugs for all at government hospitals the Health Minister estimated will cost the State government about 100 crores Indian rupees (US $20.4 million) although the media reports were estimating expenditures of 200 crores. Rajasthan is the 14th state in India to take up such a scheme, and the Health Minister claimed it has succeeded everywhere. I asked him about the resistance from doctors, pharmacists and drug companies. He said, “I appealed to NGOs and civil society to become more active in pressuring these doctors and corporates to do what is right for the poor people. Some doctors say that generics are no good, but civil society must pressure them to still prescribe these to the patients.” 

I also interviewed Ms. Rita Singh, the District level Panchayat leader, called a Zilla Pramuch. Besides her elected position, she is also working on her Ph.D. on feminist writer Gertrude Stein. She said she was elected because 50% of panchayat seats are reserved for women. Her in-laws are a political family and her husband was an elected official before her. I asked whether she had higher aspirations and she said, “Maybe MP for this district. Then I can really work for the people.” I asked her about the challenges of implementing this free drugs scheme, “How will the government ensure that the right people get the right medicines at the right time?” She answered, “It is my duty to ensure correct delivery.” But I was left wondering how she or her small staff could ever dream of overseeing such a massive job.

Dr. Gupta knew the people and places everywhere we went and was treated like the dignitary he is. There is already a certain amount of traditionalism and formality to much of Indian society and it is greatly increased when dealing with government officials. Many would touch his feet as a sign of respect when they greeted him. He has a full-time car and driver along with a police officer who accompanies him everywhere for security purposes. On four different occasions during our day in the field, caravans of police and lower-level government officers would meet us on the roadway and usher us – with flashing lights and speeding SUVs – to the venues. And at the district police station where we stopped for tea, the red carpet (well, blue carpet) was literally rolled out for our visit.

I asked Dr. Gupta, “How do you keep your ego in check when you are treated like a rock star everywhere you go?” He laughed and answered, “After 25 years of this, I have accepted that this is my duty and there is a particular formality that goes along with this position.” Later in the day, when we were surrounded by two dozen police officers and another two dozen government officials who were reviewing the hospital that the Chief Minister of Gujarat would visit the next day, Dr. Gupta would quietly tell me, “This is really overkill. It is a waste to have this many police and officials here.”

The protocol that was evident in all we did came naturally to this 50 year old man from Punjab, where his father was the Chief Engineer for that state. Dr. Gupta was polished and professional, treating all with respect, from the highest government minister to the lowest chai-wala who served us tea. He was a soft-spoken man who gave public speeches three times that day which contrasted the bombastic politicians’ volume and style. Dr. Gupta’s deliberate cadence and thoughtful words – all in Hindi or the local language – were that of a public administrator. And even in our far-ranging conversations during the six hours we spent together in the car, this erudite man would calmly quote Shakespeare and Indian gurus, speak of macro-economic theory and South Asian diplomacy, talk of art and basketball, and come back frequently to his loving concern for his daughter who he sent away to college in Boston last month and to her future.

I have thoroughly enjoyed meeting the people and going to the places I have here in India. Next week, I am going to Sri Lanka for seven days. I won a special travel grant offered to Fulbrighters to present lectures or workshops in adjacent countries. I will give a paper and guest lecture on water conflict resolution at my host institution, the International Water Management Institute ( outside of Colombo. This is an incredibly exciting opportunity for me to go back to a beautiful country that I visited 20 years ago, and to learn from the top water experts in the world!