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03/05/2018

Week-end at Mount Abu

The weekend had started well...

The 11-hour day train journey with BabySamourai had proved less tiring than expected, and we had even arrived half an hour early! (Since this is rare with Indian trains, we were not prepared, and since in most trains, there is no announcement, we almost miss the stop!) Finding a taxi to climb from Abu Road to Mount Abu had been very smooth, even at 9 pm. And after a 40-minute ride, we were at the hotel!

This is where the disenchantment began... The beautiful pictures of a large garden and mountain view on the website did not let imagine a small garden “under maintenance” right next to a busy road. The price of the room did not suggest the lack of a functional shower or clean sheets (the guy had to come back three times to bring us a decent duvet cover). Given the place I fully agreed when my favorite Indian decided to lock the door for the night. Although this did not prevent a guy from barging into our room at two in the morning! It was a drunk neighbor who had been fighting outside with his wife very loudly for more than an hour... When you have spent more than 100 euros per night, you have imagined a peaceful haven. Landing in a shabby hotel is quite a shock! Especially when you learn that breakfast is not included, even though you remember very clearly having selected the option with breakfast.

I did not want to let myself surrender to despair so, as soon as I got up, I looked for things to do in the area – it might be useful to add that I had booked this weekend on a whim, finding the word “Mount Abu” romantic. I turned to the Lonely Planet and Oh My God!

“The town is certainly unlike anywhere else in Rajasthan, a green, serene and welcome retreat during summer from the scorching temperatures and arid beige terrains elsewhere.” So far so good. “Gujarat and Rajasthan’s favourite holiday gateway, Mt Abu is a particular hit with honeymooners and middle-class Gujarati families; unlike the hill stations of northern India, you won’t find many Western travellers here.” Here it is either very good news (I have found a lost paradise) or very bad news (there is a reason why foreign tourists avoid this city). And then this story with Gujaratis... One must know that, according to the cliché, they have money to throw by the windows, nowhere to spend it (so they don’t have high standards in terms of accommodation), and as soon as they leave their native Gujarat, a “dry” state (where the sale of alcohol is forbidden, in tribute to Gandhi), they aspire to get drunk and make noise. The locals accept it, the cash inflow compensating the inconvenience ... And then, according to our local guide, as they do not see many tourists at home, as soon as they spot some at Mt Abu, they are more interested in the Caucasian passer-by than by the monuments. Which would explain all the requests of selfie I got...

“Sunset point is a popular and lovely place from which to watch the brilliant setting sun, though distinctly unromantic unless you find that being thrust red roses, bags of peanuts, or Polaroid cameras gets you into a loving mood.” Not the sexiest description of a place… In one day, we visited the beautiful temples of Dilwara –  where we were not alone! – all in marble, a specialty of the region; climbed to the temple of Guru Shikkar, the highest peak (1,722 meters) of Rajasthan (in the Aravalli range); wandered in an abandoned haveli in Alchagarh; and played Holi with a Gujarati family that was passing by. After this beautiful day just a tad suffocating because of the crowds, back in our sordid hotel, we decided that the two remaining train tickets available for the next day (instead of our tickets booked but not yet confirmed for the next to next day) were a sign of fate, and we shortened our stay ! But we still had a whole day to occupy ...

“Trekking. Unused by most local holidayers who remain firmly enchanted with the pedalo-and-pony attractions of the town, Mt Abu’s hiking trails are many and various, leading you in just a few minutes into untouched wilderness. Here, you will find tranquillity, solitude, wild flowers and birdlife in abundance – as well as the odd snake, leopard or bear.” Everything is there: nature, no Indian tourists. We booked immediately! And so, it is wearing ballerinas and ignoring the age of my son (3), I went on a 4 hour trek. And it was fantastic! A complete reconciliation with the region…

If I was to do it again (and who knows?), I would choose my stay better (perhaps the Connaught House or the Krishna Niwas, or a heritage property: Mount Abu was apparently the holiday gateway of all the kings of the region (Rajasthan and Gujarat) and each king had his own property, leaving behind a total of some 50 heritage places. I did not quite understand if they were coming all at the same time, like full summer party, or if in turns.) I would avoid a long festival weekend, Diwali and the summer (too packed), and the winter (too cold). And I would only go trekking!

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

Inde,Rajasthan,Mont Abu.Abu,Mount Abu,train,hotel,trekking

10/16/2017

When Indians re-invent creativity...

I am often asked to describe Indians. Which is absolutely an impossible task. But there is a trait that I often forget and yet explains so much: that’s jugaad. Of course it is so unique that there is no English translation. But I would translate it by “the art of thinking out of the box and find solutions nobody would have thought of”. Indians are masters of this. Beside them, MacGyver is a debilitating Penguin.

Here are some examples to illustrate.

India,jugaad,creativity,demonetisation,black money,corruption,alcohol,drinking and driving,ruleWhen Modi, the Prime Minister, launched his ‘demonetization’ at the end of 2016, he thought that at least 70% of people would not dare put their black money back in the bank and would rather destroy it, for fear of facing fines, public shaming etc.. He was wrong and had underestimated his compatriots who have found ways to deposit more than 99% of all the notes (source https://www.ft.com/content/7dbe0e14-8d8a-11e7-a352-e46f43c5825d). Including by distributing to the poor around them with incentives (deposit 250,000 rupees (the limit to not attract attention) for me and I will give you 10,000 kind of thing).

India,jugaad,creativity,demonetisation,black money,corruption,alcohol,drinking and driving,ruleAnother example: in December 2016, the Supreme Court delivered a judgment: they banned (Indian authorities have a knack for banning things) alcohol sales within a radius of 500 meters from a main road (national or local highway). This was the result of a 4 year campaign on road safety – ironically enough, the man who led it had been left crippled by a road accident, because his car had gone off-road in the hope of spotting a leopard and he tackled the problem of alcoholism on the road. There is definitely a problem in India, but alcohol remains the 3rd cause of accident after excess of speed and mobile phone.

india,jugaad,creativity,demonetisation,black money,corruption,alcohol,drinking and driving,rule

But let’s move on. The goal of the Supreme Court was to reduce drinking and driving. As a result: 80% of the restaurants in our area have put down the shutter, from one day to the other. But some ‘smart ones’ managed to divert the entrance to the restaurant; something like you have to drive twice around the block to be able to enter, thus covering the legal 500 metres! A weird rule though: 500 meters is not enough to sober up, as far as I know. Anyway on August 23rd, 2017, the Supreme Court relaxed their decision and lifred the ban within the cities, probably in the spirit of focusing on drunk truck drivers, who, surprisingly (or not), are not likely going to get drunk in “pubs” but rather from local dives serving plastic alchohol. Whether the judges were hit by logic or pressure related to the losses of the restaurants who have to shut down and the reduction of collected taxes on alcohol no one knows.

India,jugaad,creativity,demonetisation,black money,corruption,alcohol,drinking and driving,ruleI sometimes face the challenge of explaining Jugaad to the Swiss... For whom the rule is the rule, even if the rule is stupid...

India,jugaad,creativity,demonetisation,black money,corruption,alcohol,drinking and driving,rule

Source : http://www.indiatimes.com/news/meet-wheelchair-bound-harm... ; https://www.theguardian.com/world/2017/apr/25/alcohol-rul... ; http://economictimes.indiatimes.com/news/politics-and-nat... ; http://www.thehindubusinessline.com/opinion/measuring-impact-of-demonetisation-in-india/article9459507.ece

10/09/2017

Fertility, infertility, assisted reproduction and medical tourism in India

Recently an Indian laindia,fertility,infertility,ivf,art,cost,comparisondy came to my office to discuss about about infertility and breastfeeding. Curious, I asked almost immediately what is India’s rank in terms of infertility on a global scale. I had been curious about that for a while actually, as I see more and more ‘infertility centers’ popping up everywhere in the last few years.

Her answer surprised me: according to her, the countries most affected by infertility are Japan and Germany. Who would have thought? I wouldn’t, neither did I believe it…

So I dug a little and soon discovered that it is actually almost impossible to find a clear answer to my question; for one thing the infertility criteria vary from one country to another, making it almost impossible to make any world ranking and also because censuses can only be far from comprehensive – all the people who do not reproduce don’t necessarily get checked for infertility.

What could she mean then? Did she mistake infertility rate (or number of people who can not conceive a child) and fertility rate (or number of births per woman)?

India is a country where women justify their presence in the world only when they become a mother – that is still strongly the case and that’s why we see very old ladies becoming first time mothers (source). Taking this into account, I wouldn’t be too surprised if, for her, when a woman has no child it is not a question of choice but just because she can’t.

But even then, Japan and Germany are not on top of the least fertile countries (see table below).

Where Japan ranks first, however, is in the number of births using ART (Artificial Reproductive Technology). Perhaps she mistook infertility and assisted reproduction?

Both are not the same. One can for instance imagine that in some countries (like Japan) parents rely more on medical assistance than in other countries, not only because they are medically infertile, but also because they do not have sex (no time, no desire (source)), or because ART is affordable or covered by insurances, or because of some other reasons. I make this assumption because if Japanese champion the number of assisted procreations, their infertility rates appear to be even lower than elsewhere (see table below). In short, there is no evidence that the Japanese face more difficulties to conceive, but everything indicates that the use of a medical assistance has become quite common.

But let us get back to our Indian business. The numbers that I’ve gathered suggest that 45% of couples suffer from infertility in India (source) but less than 1% of the affected couples seek medical advice (source).

And yet I see boards at almost every street corner, signaling a clinic specializing in the treatment of infertility. And almost every gynecologist now claims to be an IVF specialists.

In short, it is almost impossible to tell if there are more procreations medically assisted in India because 1. There is an increasing number of infertile couples in India – a hypothesis linked to urbanization rates, obesity trends, number of women with professional careers rising up, hypothesis put forward by the media; 2 Indians are increasingly going past the social stigma associated with the state of infertility and seek more official medical help (because I’m sure there are many cases not reported, we know already that 60% of ‘physicians’ in India have no medicine degree (source)); 3. Doctors have found a honey pot and invest on it – the less ethical ones would not hesitate too much before inseminating or implanting an embryo in Indian couples with non-existent sex life rather than counselling them, other ones focusing on the international patient base who more and more comes to India to make a baby because it is three times cheaper here than in the United States (see table below); Or probably it is a mix of all these factors.

india,fertility,infertility,ivf,art,cost,comparison

A small digression to conclude: India seems to be the hub of parenthood. Apart from the medical tourism of fertilization, there is the adoption business or even the business of surrogacy. India got famous about this abroad in 2007, when an Oprah’s show staged a Western couple going to India and its plethora of surrogate mothers. Because it took too important proportions – foreigners (and Indians) doing their shopping and surrogates being paid peanuts (since agents and doctors keep the jackpot for themselves), the Government tried to put an end to this in 2016. Which means they prohibited surrogacy purely and simply*. It’s easier to ban than to put controls in place. Although it encourages the development of the black market of surrogacy and it is the surrogate mothers who end up suffering the most.

It’s kind of what happened with adoption. Until the 1970s, India had more and more orphans and Indians were reluctant to adopt – because of the social stigma, and the apprehension of bringing someone in the family that they know nothing about, with caste requirements and all (source). But foreigners were keen on adopting. Which obviously led to some derivatives, such as theft and trafficking of kids by some ill-intentioned Indians. Following scandals in the 1990s, India toughened the laws and made every adoption difficult, even for Indians. However it seems that the Government has been making the rules related to adoption easier since 2015.

* After the new law (source) only an Indian couple having tried without success to have a baby for more than five years can have recourse to a surrogate mother, who must be from the family, and they will only pay for the medical expenses, no incentive.

Sources : http://www.prsindia.org/billtrack/the-surrogacy-regulatio...? ; https://www.cia.gov/library/publications/the-world-factbo... ; https://www.palashivf.com/2017/02/21/ivf-treatment-market... ; http://www.ey.com/Publication/vwLUAssets/EY-call-for-acti... ; http://www.dailyo.in/lifestyle/infertility-on-the-rise-in... ; http://www.who.int/reproductivehealth/topics/infertility/... ; http://journals.plos.org/plosmedicine/article?id=10.1371/... ; http://www.ijsr.net/archive/v4i7/SUB156201.pdf ; http://www.aurumequity.com/ivf-india/ ; https://www.researchgate.net/publication/236005514_Adopti...  

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