Sweet tongue to Iron hand: The paradoxes of the banking mode of conduct

May be this is an exaggeration. But I felt many times that there is only one place in the world where we find a strange combination of sweet tongue and intelligent deception followed by cutthroat action. That is the banking sector.  We would also see the greatest paradoxes there. While the multibillionaire who evades the repayment is treated with soothing drinks and cookies in the chamber of the chief manager, the goons of the bank threaten the poor farmer with auction notices for his hut, driving him to suicide. Such banking mode of conduct is not limited to the private banks, but to the public sector, the scheduled and the co-operative banks as well.

Image: 123rf.com

Who will render justice in an unequal banking world? It was sad to hear that a poor farmer was imprisoned in Kerala for the delay in repaying an instalment of the loan taken to pay his daughter’s fee. A few days back a farmer who stayed in Kundapur in Udupi who owned 1.3 acre of rubber plantation committed suicide when he could not repay a loan from a co-operative society.

For a ‘favored’ customer, loan conditions are either waved or compliances fabricated. But, the banker will look at a small customer who is in dire need of a loan as a potential cheater who might run away with bank’s money and insist for compliance to stringent and outdated terms and conditions. Apart from farmers, another category of victims of highhandedness of banks are the students. Not very long ago, a hapless nursing student committed suicide due to the harassment of bank officials. Impractical, complex and discouraging approach of the bank authorities force people to fall in the hands of unscrupulous and greedy money lenders.

When I got my job, I approached the manager of a scheduled bank for a car loan. Apart from the hypothecation of the car, salary certificate and an agreement to debit the EMI from the salary account, the manager wanted original deed of at least 2 acres of land as security to grant the loan, that too at an exorbitant interest rate.

It looks like most bank managers are trained to do anything for the sake of results. They are committed ‘utilitarians’.  They believe in the end, not the means. So much we hear about promotion of start-up companies these days. But ask any young, bright and enthusiastic innovator who wants funds for her venture about her experience while interacting for a bank loan.  Most bank managers are hesitant to support young entrepreneurs like her in spite of a collateral security. Even if their actions lead to shattering of dreams of a farmer, entrepreneur, or a student, the officials go by rulebook if the customer is not a big fish. However banks and their legal teams close their eyes on the benami properties of large defaulters who ran to BIFR (The Board of Industrial and Financial Reconstruction) or other similar agencies. Banks in turn treat the outstanding as irrecoverable bad debts and cry to the government for schemes in the budget to rescue their stressed assets.

Bank managers are never shy of illegal or slush money (I don’t like to use the world ‘black’ to refer to unaccounted money as the world has inherent racial bias). In those days when banking was not computerized, bank managers used to keep the account pass books of the large depositors of money not disclosed to tax authorities in their cabin or in their house. These accounts were known only to the manager or his one or two trusted staff. They still do that albeit in different ways. Not only swiss banks, many desi banks too are notorious for money hiding. They will receive any sum with widely stretched hands and lips. Financial institutions are supposed to send ‘Cash Transaction Reports’ (CTR) and ‘Suspicious Transaction Reports’ (STR) to the Financial Intelligence Unit of the country (FIU-IND). However, detection of huge unaccounted income by enforcement authorities indicates that the reporting mechanism has been flouted in such cases. Immediately before the serial bomb blasts in Coimbatore in 1997, it was noticed that crores of rupees were transacted through the bank accounts of an STD booth owner from a branch of a scheduled bank in Mumbai to its branch in Coimbatore. Funds related to drug trading, terrorism and other illegal activities are transacted through KYC-non-compliant accounts and it is extremely difficult to nab the criminals and beneficiaries and to ascertain the character and purpose of the transactions.

Some bank officials double up as tax consultants too. Many managers are experts in giving dubious tax advices to those slush money holders and tax evaders who want to pump them to respectable domains. They suggest different strategies based on the quantum of the amount. If the amount is only a few million, they suggest them to deposit the money in multiples of Rs 49999/- or less to escape quoting of PAN number. The mangers are very benevolent by giving them blank Forms (15G/15H)  to sign which contain a declaration that the taxable income of the depositor from all sources is below taxable limit and therefore no tax be deducted from the interest income. Some mangers would open accounts in various names (they themselves will suggest the names, if the depositor is in short of names to open SB accounts: Ramasamy, Chinnasamy, Munisamy, Narayanasamy, Rathnasamy etc. with many permutations and combinations of names ending in Samy, Sami, Swami, and Swamy ). Some co-operative banks in the country are dens of illegal deposits and therefore they oppose the rules related  to quoting of PAN and deducting tax on the interest income. People spend huge sums to get elected to the boards of such banks for obvious reasons.

Some banks aid in money laundering in grand scale globally. Recently, a few banks including one in the public sector were found to be aiding an organized racket of money laundering in the guise of remittances related to export and import. As per reports, many domestic help, rickshaw-pullers, drivers and unemployed youth were made directors in fake companies (by giving them a few thousands of rupees) as part of Rs 6000 cr ‘banking-hawala’ scandal. The scam came to light when an internal audit team alerted the top managements about a fraudulent trade circuit wherein exports were made through inflated bills and duty drawback claimed through fake import bills by a few businessmen. Case is being investigated by CBI, ED and SFIO (Serious Fraud Investigation Office).

If you thought that only persons like Satyam’s Ramalingaraju can show huge deposits out of thin air to mislead the investors and potential collaborators, you are mistaken. Some of the bank mangers in interior Kerala could certify that their branch deals in huge foreign currency to aid the black money launderers. In one case it was found by the concerned enforcement authorities that a bogus certificate was issued by the manager of a scheduled bank that a particular NRE account maintained in the branch contained huge amounts in foreign currency and a cheque was issued to a tax evader by the account holder as a gift out of ‘love and affection’. Everything was strange here: Donor and donee didn’t know each other; foreign currency was not actually deposited by the customer, but by an agent dealing in such currencies; and donee paid the money in Indian rupees including an attractive commission to the agent. The bank manager and the NRE account holder got their share of commission for illegally ‘renting’ out the bank account for such transactions. How could such transactions escape the internal audits and statutory audits? (That is another issue of concern. The present system of statutory audit is marred by corruption, nepotism and inefficiency. Read this article).

Thousands of cases of cyber money frauds are happening across the globe. Lakhs of people are cheated by the fraudsters who operate as insurance agents, telecom tower installers, multilevel marketing firms etc. In all these cases money is ultimately withdrawn by the fraudsters through bank accounts opened by violating the KYC (Know Your Customer) guidelines and hence police is unable to track the funds or the criminals. Banks cannot absolve their responsibilities in such crimes perpetrated with the connivance of their officials.

Banks are also unjustly enjoying thousands of crores of unclaimed deposits without taking any action as per the circulars issued by RBI directing them to find out the whereabouts of the depositors or their immediate heirs, nominees or introducers. They are reluctant to treat them as inoperative accounts. There is a likelihood that such inoperative accounts are used to aid the fraudsters and launderers since these accounts are already KYC compliant. Unless such inoperative accounts are separately categorized and audited, these would be used for dubious purposes with the collusion of officials.

Banking business ethics

Management institutes have reluctantly incorporated Business Ethics as a course for the MBA students. When it was an elective, there were no takers for this course as students thought that any credit received for that course would not increase their bargaining power (for higher pay) in the job market or during the campus placements. After witnessing thousands of scams all over the world, a course called Corporate Governance and Business Ethics has been introduced as a compulsory paper in management schools. But many banks are yet to give priority to teach their officer trainees lessons in ethics in marketing, finance and accounting. Obviously some managements don’t want their officials to be too much ethical when it comes to increasing the bank’s profits. Their definition of honesty is limited to protection of bank’s assets and their brand value and nothing more.

(This article is not intended to generalize the situation to all banks. There may be a few banks and their officials who are rule abiding, ethical and vigilant.)

       © Sibichen K Mathew                            Views are personal

Shaming JNU: Go beyond Kanhaiya and Umar – Views of an Alumnus

I am a proud JNU alumnus.

Let me give three disclaimers before I write what I want.

First: I don’t intend to support anyone who ‘by words or by signs or by visible representation, or otherwise, brings or attempts to bring into hatred or contempt, or excites or attempts to excite disaffection towards the Government established by law in India’.

Second: I don’t believe that every student enrolled in JNU and every human being found in the vast JNU campus is patriotic and not anti-national.

Third: I don’t wish to judge the rationale of law enforcement authorities. They may have their own reasons unknown to me. I have faith in the judicial system.

There are twin objectives for this article. One is to say that JNU is not what is projected in the media today. The other is to tell that all is not well with the student community in JNU in the recent years.

What is real JNU?

I am deeply pained at what I keep hearing about JNU in the last few weeks. What real JNU is? Is it just a few individuals who have been accused of anti-national activities? I thought of writing this after seeing the misplaced generalizations of not the media or of its viewers and readers about JNU, but of some of the brilliant people from the academia and bureaucracy.

I have studied in thirteen institutions in the country. But no institution has influenced and shaped me so much the way JNU did.

Train Number 2625, Kerala Express from Kottayam to New Delhi, used to carry not only my bag full of cut-mango pickles, dry coconut chutney and banana chips, but also a lot of dreams. I was privileged to get selected in this prestigious university after qualifying the UGC Research Fellowship examination, All India JNU Entrance Examination conducted across the country in all major cities and an equally tough interview by the best professors in the country in the chosen subject.

It was a very hot day in the month of July that I joined JNU. That was my second visit to the northern part of the country; first being at the time of interview. I stepped into the vast campus with a lot of apprehensions.   I didn’t get accommodation in the hostel initially for about three months. But, in JNU that was not an issue. There were hundreds of seniors, who irrespective of the course they were pursuing or region from which they were coming, were ready to accommodate the new students in their rooms. I met a Bihari gentleman who was pursuing MPhil in Life Sciences through a Keralite senior and he gave his room all to me for most days when he was on field work. When he stayed in the room I comfortably slept on the floor. Though I was in an unfamiliar environment (the weather, the diet, the language, the lifestyle etc.) it took me only a few days to assimilate well to the rich, diverse, and inclusive academic culture in JNU.

Room No. 123 E, Brahmaputra Hostel was allotted to me on my birthday and I wrote on the wall of my room the lines of Ralph Emerson: ‘Nothing great was ever achieved without enthusiasm’. I realized that I need to jump out of the narrow and inward looking walls that separated Indians in the name of caste, language, region, religion and diet. Hundreds of posters on the walls across JNU campus were my first lessons on topics such as democracy, free thinking, dialogue, nationalism, patriotism and development. I started loving my country much more than before. For the first time I understood that I should think and act as an Indian and a global citizen, rather than basking on my primodial glories and ethnic sensitivities.

JNU gave me pleasant surprises unlike what I was used to. Teachers behaved as friends and lectures were meaningful conversations. Student could walk in anytime with a mug of coffee and join the discussions. None bothered about marking attendance. The learning was more substantive than procedural. I was amazed at the extent of academic expertise of the teachers on the subject. I was equally amazed at the sharp thoughts and the intelligent expressions of my classmates. Classroom sessions were just the beginning of learning and the discussion continued in the corridors, canteens and hostel rooms. 

JNU was vibrant in the nights. While we queued up to pick up our dishes for dinner, there would be a number of leaflets and cyclostyled handouts on various social, economic, political and international affairs kept on the table. We used to read all those materials while having our hot chapatis served on the table.  After dinner, intellectual discussions used to happen in the mess halls and at various locations in the campus on various national and international issues. As a student, I considered those events as great learning experiences rather than political brain washing. One is not coerced to follow even remotely any party, association or ideology or to subscribe to any views. There was space for every type of dissent, opinion and suggestion on the topics debated in the campus.  Mediocre and vulgar minds accuse JNU as the den of anti-nationals and the campus as a yard of liquor bottles, contraceptives and cigarette butts. Those who say that has not lived in JNU.

Dhabas in JNU campus are said to be the nocturnal hot spots of students who discussed and debated issues that mattered to the world over a cup of tea and samosa. It is an unwritten rule in JNU that those who receive fellowships and scholarships pay for the refreshments of those who do not have any funding to support their studies. JNU students were not just armchair theoreticians. There were many who worked with farmers and other disadvantaged communities during the semester breaks. In my role as the University Secretary of the National Service Scheme, I could gather several students to organize various social and charitable activities within and outside the campus.

I have learned the lessons in democracy and responsible citizenship not from my school or college text books. It was in JNU that I observed and got trained in conducting free and fair elections. The Jawaharlal Nehru University Students Union (JNUSU) elections are designed and executed in such a way that money does not play any role, but unique ideas can. The JNUSU election campaigning includes a night long Presidential debate just before the elections, similar in style to the one held during the presidential elections in the United States. The entire election process is managed by students.

All students associations, big or small, had equal rights and freedom to present their ideas and garner sympathizers. Festivals of all religions and ethnic groups were celebrated in hostels. Students from the North East regularly joined together for their prayer fellowships. Catholics had occasional Mass in the famous Parthasarathy Rock. During the entire Ramzan, special food was given in the mess before sunrise to all Muslim students who were fasting. Non-believers could speak their mind with their logic and rationality. Everyone learned from each other. None tried to suppress the views of the other.

Feathers in the cap

Following are some of the feathers in the cap of this great institution of excellence:

NAAC has accredited JNU with the award of Grade 'A' and CGPA of 3.91/4.00, the highest in the country.

It produces around 600 doctorate holders every year which is one of the highest in the country.

More than 80 per cent of JNU students get fellowships/ scholarships from various sources based on their merits and means.

There is an excellent teacher-student ratio of 1:10.

The campus is spread over 1000 acre and the beautiful greenery is maintained well.

There was no violence within the campus in its entire history

The University admits students through an entrance examination which can be taken at 70 Centres in various parts of the country and at one Centre outside India, i.e. Kathmandu, Nepal.

Its students are shouldering important responsibilities across the globe as social scientists, scientists, civil servants, literary critics, media experts, foreign language experts, journalists, political leaders, social activists, technologists, and entrepreneurs.

Following are some of the quotes of a few past students of JNU (given on earlier occasions)

“JNU most certainly provided me the best opportunity to participate in all sorts of debates and to think in a different way. I must say that JNUites do things differently, wherever they are and that's how they stand out.” Nirmala Sitharaman, BJP Leader and Hon Minister of state (Independent charge) for Commerce and Industry, Govt of India.

“On leaving JNU, the students confront the reality that there is no fraternity in citizenship and all the other ills of society, like the power of capital in politics. While some succumb to all this, JNU equips most to confront these challenges in a better fashion. I meet police officers, journalists and administrators from JNU who have carried forward the values they learnt here.”  Prakash Karat, (CPI(M) Leader and JNUSU President in 1973-74)

“The dining hall discourses, where everything from the Vietnam War to former Prime Minister Indira Gandhi was discussed, our professors had unconventional ways of teaching, they were passionate about making new minds, and they were not just there to teach in front of the blackboard and leave. Their sudden presence did not make you throw away your cigarette and they were politically active.” (Prof Anand Kumar, JNUSU President 1974-75)

“My initiation in public life, in fact my understanding of politics, dates back to my JNU days…. In JNU, I remember, those who spoke of caste were considered the most retrograde people.” (Yogendra Yadav, Former leader of AAP and noted Psephologist.)

“There are many changes taking place in the country and JNU cannot be removed from these but I still think that JNU is the best university in India and I am not saying this because I am from JNU. There are reasons for that, firstly it's a national university, It's a residential university; the teaching is direct and more practical rather than bookish, self study. (D P Tripathy, Member of Parliament)

Prominent JNUites include S Jayashankar, Foreign Secretary, Ali Zeidan, former Prime Minister of Libya, Aditya Jha, Canadian philanthropist, Ahmed bin Saif Al Nahyan, Founder and Chairman of Etihad Airlines, B Bhattarai, Prime Minister of Nepal, H R Khan,  former Deputy Governor of RBI, Amitabh Kant, Secretary to Govt of India, Arvind Gupta, Deputy National Security Advisor, Syed Asif Ibrahim, former Intelligence Bureau Chief, P Sainath, eminent journalist, Sitaram Yechury, Secretary General, CPI(M) and hundreds of bureaucrats, academicians and social activists.

The misusers and the deviants

Notwithstanding what I wrote above, let me share frankly a few plain truths. I am not here to vouch for all those who pursued or pursue courses in JNU as sincere learners and committed nationalists. There are three categories of misusers / deviants in JNU both then and now.

First category is the so called self- styled revolutionaries without a clear ideological lineage. There are a few pseudo radicals for whom state-bashing is a fashion and a passion. They spread seeds that harm the unity and integrity of the country. They hide within all the organizations in the university without exception. It could be within the ‘right’, the ‘left’, the ‘center’ or in the ‘extreme’ organization.

Second category is those who are not interested in completing the courses and dissertations on time. They waste the valuable resources provided to them, seek extensions to complete the courses, overstay in the hostels and that hamper fresh enrollments.

Third category is the ones who ignore the academic course work and dissertations totally in the name of preparations for the civil services and lose focus on both. They end up in depression when they don’t get to any career because of sheer laziness or avoidable diversions.

Regain the fame of JNU

“A university stands for humanism, for tolerance, for reason, for the adventure of ideas and for the search of truth. It stands for the onward march of the human race towards ever higher objectives. If the universities discharge their duties adequately, then it is well with the Nation and the People” (Jawaharlal Nehru)

In order to fulfill above mission and vision, it is necessary to extend the ideological debates in the campus to actionable proposals with a spirit of collaboration than conflict. The first step in this is to be committed in their studies and utilize the resources given to them for productive purposes. Hollow ideologies can get instant applauses but they can’t bring long term solutions for the masses. Apart from ideological battles, let JNU students invent and design solutions through systematic studies and research in order to alleviate the miseries of the people and to bring in peace and prosperity within and outside the country. For this, apart from sloganeering, a little bit of empathy, a lot more social intelligence and commitment to studies are necessary!

        © Sibichen K Mathew      Views are personal

Sexual abuses, Bosses and the Bathsheba syndrome

King David is a character depicted in the Old Testament of Bible. He was an ordinary shepherd who successfully confronted the nine-foot, bronze armoured Philistine giant Goliath with a sling and a few stones. He became the king of Israel by defeating exploiters and enemies of the people of the nation. He was a very efficient administrator and was committed to delivering justice to his people. It is written that he was also a man of integrity. However, one single act of succumbing to his lust resulted in his downfall.

While his men were at war, he spied a beautiful woman, Bathsheba, from his rooftop. Though he found that she was married to one of his army men, he forced her to be in a relationship with him. He sent her husband to the front lines of battle where he got killed. David then married Bathsheba and was severely rebuked by the Prophet Nathan who said, ‘sword will never depart from thine house’. David cried to God for the rest of his life in repentance: ‘For I acknowledge my transgressions, and my sin is always before me. Against You, You only, have I sinned. And done this evil in Your sight’.

Incidents of abuses

There are many bosses who would like to have female companions. Some of them even invest in expensive houses to maintain absolute privacy when they are with such friends. DL, who used to host a popular late night show, had to apologise publicly after news of his affairs with female staff members came out. In an interview with Oprah Winfrey he said, ‘I hurt a lot of people. I have nobody to blame but myself. I am looking to find out why I behaved the way I behaved.’

Bhavya, a senior level executive in a large IT company said, ‘I had to leave my first job due to sexual harassment - not by one guy, but by multiple bosses. Another lady and I were the first women sales employees in the company, employed by management to deal with the activities of the union in the sales department. So the union guys decided to drive us off or make us conform by harassing us wherever we went. My immediate boss purposely gave me evening jobs so that he could accompany me and say uncomfortable things. But I couldn't speak up. I quit the job finally.’

Jacinta, who worked in a company at UAE, shared an incident: ‘One of my colleagues, who is Lebanese, was reporting to our HR director; she was his executive secretary. Every day he would call her for closed-door meetings inside his cabin. Initially the relationship was healthy; he would say that he was like a father to her. Over time however, he started commenting about her looks and dresses and passing vulgar comments. He also started sending her obscene texts. One day, during a meeting, she switched on the recording system in her mobile and recorded the conversation. With this, she escalated the matter to the CEO of the company. But the outcome was totally unexpected. She was the one dismissed from service. She went to the labour court and the police arrested the HR director. Finally, the matter was settled outside court and the HR director had to pay huge compensation to the employee.’

The President and CEO of a multinational company that provided full-spectrum consulting, technology and business process outsourcing was shown the door after an investigation by a counsel engaged by the Board, where they found that he had a relationship with a subordinate  employee; there was also an allegation of sexual harassment. He had demonstrated outstanding leadership skills during his 10-year tenure. In a media release, the company admitted that he worked hard to establish the company as a leader in the IT industry. The gentleman had earlier headed the global operations of another IT giant till he was asked to quit on allegations of sexual harassment there as well. He was widely credited for his crucial contribution in making the company achieve a turnover of over 700 million dollars from a meagre 2 million dollars, all within a few years. The company had to pay the employee a whopping 3 million dollars in an out-of-court settlement.

There are several such incidents reported about successful leaders. The Director General and CEO of an International agency with a 1.2 million membership had to resign on an allegation that he sexually abused a child more than thirty years ago. He was a person with excellent leadership skills and led the organization very efficiently for several years. In another case, an organization accused the head of a premier intelligence agency in one country, stating that he was in the habit of hiring a prostitute every three days.

A former minister of railways in a country was accused by the government of taking favours in the form of women, including actors, for sanctioning contracts for high speed rail projects and transportation of coal. The heads of some international regulatory and funding organizations have also faced allegations of sexual misconduct and have had to resign pending an investigation into the allegations. After a hotel maid accused the head of an international financial institution of sexual assault, it took months to get the charges cleared, and even then he struggled to regain his image. Though some people tend to forgive leaders’ sexual transgressions, such incidents usually devastate their career at least for a few years.

BD, the CEO of a multinational retail company, had to resign because the company found that he had an inappropriate relationship with a female employee. In another incident, after 31 trainees complained about the sexual misconduct of GP, an efficient Air Forces Colonel, he was relieved of his duties.  Recent incident is the accusation against RKP, a very senior scientist of a prestigious energy research institute.

Why only the powerful and successful people are accused?

All incidents reported may not be truly cases of sexual harassment. Many leaders at the pinnacle of success have been brought down because of charges of sexual misconduct. In most cases, allegations are aimed at making such persons give up their grip on the organization. Efficient and disciplined bosses have often had to leave organizations simply because of suspicion, even when such allegations are not proved. There are many incidents were women use such accusation as a ploy to corner a tough boss.

Power corrupts senses too

There are two factors common in the above cases: all the accused were in powerful positions and were successful leaders who had turned around their respective organizations. No organization would have liked to terminate them. Power and success can thus make people overconfident about their acceptance in the organization. In an excellent analytical article in the Journal of Business Ethics way back in 1993, Ludwig and Longenecker  pointed out how successful people fail ethically at some point. They said that success makes managers complacent and lose focus.

With large teams and resources at their disposal, they may begin to have a tendency to indulge in excesses. Further, people who depend on them become vulnerable to their actions. Also, in spite of their strong position as superiors, they may become weak before attractive women in the team.

The success and power do not intoxicate a person who is emotionally mature, ethically conscious, socially responsive and morally strong. There is a need to draw lessons from the experiences of people who are fallen from grace due to avoidable aberrations.

  © Sibichen K Mathew.   Views are personal. Some incidents illustrated here are sub judice and hence not aimed at passing a judgment against the persons involved.

 (Above content is partly based on a chapter on the subject written by author in his book ‘When the Boss is Wrong: The Making and Unmaking of the Leader within You’’. Read the book published by Rupa Publishers to know about more interesting stories on ‘Bosses and the Bathsheba Syndrome’. Available in your nearest books store or Amazon or Flipkart). 

നോവ്

                                                            കഥ

പ്രിയപെട്ട സുഹൃത്തേ

ഞാന്‍ വീണ്ടും ഒരു കഥ എഴുതാമെന്ന് വിചാരിച്ചു. അതെ, വളരെ നാളുകള്‍ക്കു ശേഷം. നീയാണല്ലോ എന്‍റെ എല്ലാ കഥകളുടെയും ആദ്യ വായനക്കാരി. ഞാന്‍ ഓര്‍ക്കുന്നു. വായിച്ചതിനു ശേഷമുള്ള നിന്‍റെ നീണ്ട മൌനം. നിന്നെ ഞാന്‍ എപ്പോഴൊക്കെ വെറുത്തിട്ടുണ്ടോ അതെല്ലാം എന്‍റെ കൈയെഴുത്തു പ്രതിയും വച്ച് എന്‍റെ ക്ഷമ നീ പരീക്ഷിച്ച നിമിഷങ്ങളിലാണ്. നിന്നെക്കുറിച്ചാകട്ടേ ഈ കഥ?

ഒരു കഥയെഴുതുവാനുള്ള മൂഡ്‌ എങ്ങനെയെനിക്ക് ഇപ്പോള്‍ ഉണ്ടായി എന്നു നീ അദ്ഭുതപ്പെടുന്നുണ്ടാവും. മൂഡിന്‍റെ പേരുപറഞ്ഞ് പൂര്‍ത്തിയാക്കാതെ വലിച്ചെറിഞ്ഞ എന്‍റെ കഥകള്‍ കണ്ടിട്ട് എന്നോട് ‘ഗെറ്റ് ലോസ്റ്റ്‌’ എന്നു പറഞ്ഞ നീ ഇപ്പോള്‍ വിചാരിക്കുന്നുണ്ടാവും ഞാന്‍  ഇതാ വേറൊരു കുറ്റകൃത്യത്തിനു മുതിരുന്നു എന്ന്‍. നിന്‍റെ വാക്കുകള്‍ ഞാന്‍ മറന്നിട്ടില്ല: ‘നല്ല ഒരു കഥ പാതി വഴിക്ക് വലിച്ചെറിയുന്ന നീയും, ഗര്‍ഭചിദ്രം ചെയ്യുന്ന സ്ത്രീയും തമ്മില്‍ എന്താ വിത്യാസം?’ എനിക്ക്  ഒരിക്കലും ദഹിക്കാത്ത നിന്‍റെ അതിശയോക്തി കലര്‍ന്ന ക്രൂരമായ താരാതമ്യം!

ഈ കഥ എന്‍റെ പഴയ കഥകളില്‍നിന്നും വേറിട്ട വഴിയിലുള്ളതാണ്. എന്‍റെ മനസിന്‍റെ അഗാധതലങ്ങളിലെവിടെയോ നിര്‍ജീവമായികിടന്ന ഏതാനും ഓര്‍മശകലങ്ങളില്‍ ചാലിച്ച കഥയാണിത്. ആദ്യമേതന്നെ വൈരുദ്ധ്യം കടന്നുകൂടിയതായി നീ ഇപ്പോള്‍ വിമര്‍ശിക്കുന്നുണ്ടാവും. നിന്നെ കുറിച്ചുള്ള കഥയില്‍ എങ്ങനെ എന്‍റെ ഓര്‍മ്മകള്‍ക്ക് പ്രസക്തിയല്ലേ? നിന്‍റെ പാട്ടുകളെക്കുറിച്ച് ഞാനും എന്‍റെ കഥകളെകുറിച്ചും നീയും ഓര്‍ക്കുകയും സംസാരിക്കുകയും വിമര്‍ശിക്കുകയും ചെയ്തിരുന്നെങ്കിലും നമ്മുക്ക് രണ്ടുപേര്‍ക്കും തമ്മില്‍ വലിയ ഒരു അപരിചിതത്വം ഉണ്ടായിരുന്നു.

Another fatal infection in your backyard:Scrub Typhus! Beware!

My family and me spent a few days during our Christmas-New Year holidays at my in-laws’ house. It was a happy time as we celebrated their wedding anniversary and the birthday of Father-in-law (Daddy). Just a day before we left, Daddy complained of slight fever. As per the physician’s advice, he took paracetamol for a few days. Since the fever was not coming down, paracetamol was given as I.V.  The blood test was repeated to verify attack of any virus and nothing adverse was noticed.

We constantly enquired over phone as we lived in a different city. Temperature became normal for two days and then again went up. He was admitted to a nearby hospital and mild fever continued for a few days more and doctors there had no clue about the disease. They said, it could be a urinary infection and started giving medicines for that. They also put him in ICU to check his cardiac status as his BP shot up. As they found the ECG and Echo normal, they told mummy that the fever will go once the urinary infection is reduced.

Meanwhile my wife took the night bus and reached the hospital in the early morning and found Daddy almost collapsed in his bed, unable to move or speak. The transition to this stage was in a matter of a few hours. Till the previous night he was moderately active and was speaking to everyone. My wife who is also a doctor asked the physician of the hospital about the status of the patient. He said, ‘he is suffering from dementia’. My wife did not believe the physician’s story of urinary infection and dementia and told him so. She said she is taking him out of the hospital to get him readmitted in a better hospital. The physician didn’t like someone questioning his theory and angrily disappeared from the scene.

Daddy was rushed in an ambulance to a nearby multi speciality hospital (SUT Hospital). By that time his kidneys and other internal organs had malfunctioned. It did not take more than a few minutes for the physician Dr Dhanya to zero in on the most probable infection: Scrub Typhus. She immediately started the appropriate antibiotic without waiting for the blood results which confirmed the disease after 24 hours. Daddy was put under life support in the ICU.

What is Scrub Typhus?

We need to be aware and beware of this as it is fast spreading all around.

Let me summarize below what WHO tells about the infection:

Scrub typhus is an acute, febrile, infectious illness that is caused by Orientia (formerly Rickettsia) sutsugamushi. It is also known as tsutsugamushi disease.

How it is transmitted?

Scrub typhus is transmitted to humans and rodents by some species of trombiculid mites (“chiggers”, Leptotrombidium deliense and others). The mite is very small (0.2 – 0.4mm) and can only be seen through a microscope or magnifying glass. Humans acquire the disease from the bite of an infected chigger. The bite of the mite leaves a characteristic black eschar that is useful to the doctor for making the diagnosis.

 In India

Scrub typhus is prevalent in many parts of India but specific data are not available. There have been outbreaks in areas located in the sub-Himalayan belt, from Jammu to Nagaland. There were reports of scrub typhus outbreaks in Himanchal Pradesh, Sikkim and Darjeeling (West Bengal) during 2003-2004 and 2007. Outbreaks of scrub typhus are reported in southern India during the cooler months of the year. Scrub typhus is a reemerging infectious disease in India. It occurs more frequently during the rainy season. However, outbreaks have been reported during the cooler season in southern India. Certain areas such as forest clearings, riverbanks, and grassy regions provide optimal conditions for the infected mites to thrive.

What are the clinical symptoms of Scrub Typhus?

The chigger bite is painless and may become noticed as a transient localized itch. Bites are often found on the groin, axillae, genetalia or neck . An eschar is often seen in humans at the site of the chigger bite. The illness begins rather suddenly with shaking chills, fever, severe headache, infection of the mucous membrane lining the eyes (the conjunctiva), and swelling of the lymph nodes. A spotted rash on the trunk may be present. Symptoms may include muscle and gastrointestinal pains. More virulent strains of O. tsutsugamushi can cause haemorrhaging and intravascular coagulation. Complications may include atypical pneumonia, overwhelming pneumonia with adult respiratory distress syndrome (ARDS)–like presentation, myocarditis, and disseminated intravascular coagulation (DIC). Patients with scrub typhus often exhibit leucopenia.

Image: Medscape.com

How to differentiate scrub typhus from other diseases?

Differentiating scrub typhus from other forms of typhus as well as from fever, typhoid and meningococcal infections is often difficult during the first several days before the Scrub Typhus initial rash appears. The most common signs are similar to a variety of other infectious diseases (typhoid fever, murine typhus, leptospirosis and dengue fever, etc.) which should be taken into consideration. The geographical location of scrub typhus, the initial sore caused by the chigger bite, and the occurrence of specific proteins capable of destroying the organism (antibodies) in the blood, provide helpful clues and are useful in establishing the diagnosis.

What diagnostic tests are available for confirmatory diagnosis of scrub typhus?

The diagnosis may be confirmed by a laboratory test such as serology. The cheapest and most easily available serological test is the Weil-Felix test, but this is notoriously unreliable. Fifty per cent of patients have a positive test result during the second week. This test is now being replaced by a complement-fixation test. It is a serological test to detect specific antibody or specific antigen in a patient’s serum

What is the effective treatment against scrub typhus?

Scrub typhus is treated with antibiotics. The drug most commonly used is doxycycline; but chloramphenicol is an alternative.

How to prevent it?

It has been shown that a single oral dose of chloramphenicol or tetracycline given every five days for a total of 35 days, with 5-day non-treatment intervals, actually produces active immunity to scrub typhus. There are no effective vaccines for scrub typhus.

In endemic areas, precautions include wearing protective clothing. Insect repellents containing dibutyl phthalate, benzyl benzoate, diethyl toluamide, and other substances can be applied to the skin and clothing to prevent chigger bites. Do not sit or lie on bare ground or grass; use a suitable ground sheet or other ground cover. Clearing of vegetation and chemical treatment of the soil may help to break up the cycle of transmission from chiggers to humans to other chiggers.

Measures to prevent the infection

The early diagnosis of acute scrub typhus can greatly reduce the chance of life threatening complications and guide optimal therapy. Awareness and education activities should be targeted at schoolchildren, teachers and women groups in endemic areas. Involvement of community-based organizations in prevention and control of scrub typhus is important.

Rodent control is a multidimensional activity that requires multisectoral cooperation. Different control strategies such as trapping, poisoning and use of natural predators are in practice. Allowing weeds to grow around buildings also encourages rats and mice. Good sanitation in and around buildings creates an environment that is less suited for rodent populations. Proper sanitation may not eliminate rat populations but often can prevent them from flourishing in high numbers. Repeated increase in rodent population even after the use of poisons is a good indication that habitat modification is needed.

 (Source for information http://www.searo.who.int/entity/emerging_diseases/CDS_faq_Scrub_Typhus.pdf)

Daddy recovered

The late diagnosis had resulted in the failure of internal organs. With systematic treatment and repeated dialysis, he could be revived. He had to be in the hospital for about two weeks. Though he is back home, it will take a few months for him to recover fully to good health.

A few points to note!

Never delay a blood test if the fever continues for more than three days.

Make sure that the patient’s tests are done in a reputed Lab with all facilities.

Don’t think of saving money by going to a small hospital with inadequate facilities. It will be fatal! It was a big mistake that Daddy insisted on getting admitted to a small hospital (advertised by them as speciality hospital) where there were no proper medical assistance.

Never completely trust your medical insurance company! They will promise to give you money and will vanish at the time of billing!

                 © Sibichen K Mathew