Myths and Realities behind ‘Whole Body Check-Up’

– Dr. Nirish Vaidya, MD

Last year, I visited one of my uncles at his home. He had recently survived an Acute Myocardial Infarction, generally understood as ‘Heart Attack’. Thanks to his timely visit to a hospital he was doing remarkably well when I met him. But he had got every chance to pour his resentment to another hospital where he had got the so-called ‘whole body check-up’ performed few months before and was billed almost 10,000 Nepalese rupees then. He said he had an ECG done which was completely normal, along with other tests. He could not actually believe he could ever land up to the emergency room in few months after those normal reports.

My uncle is one of the many people who come across such lucrative advertisements of ‘whole body check-up packages’. With the boom of the number of poly-clinics, hospitals and laboratories in recent years, we are often flooded with such advertisements, and many of us are simply attracted to it as the cost looks reasonable. Sometimes the names of these packages are analogous to the rooms of a resort: Normal, Deluxe and Super Deluxe. And, sometimes, there is a promise that doing one test will make other test free.

Your health cannot be reduced to a package. It is not a vacation. A layman cannot by any means make sense of these packages other than the weight of his pocket. The main reason behind these packages is, if a laboratory performs a specific test in bulk, the processing cost is significantly minimized. There are other reasons, too.

I do agree that many people are eventually diagnosed with many diseases such as Diabetes, thyroid disorders, and kidney diseases, without any apparent symptoms. But larger number of people are actually doing unnecessary investigations. I do not mean to discourage people from doing these tests as a part of regular investigations, but doctors only find investigations useful when these tests are symptoms-driven. A normal blood test report cannot guarantee a finite number of years that one should not worry. Sometimes normal reports would rather create problems. I’ll give you examples. If a chronic alcohol consumer finds his liver function test parameters in normal range, he will never minimize his amount with a belief that his liver is unharmed by alcohol. Yet, he may be a year close to irreversible liver damage. If I tell a heavy smoker that his chest X-ray looks normal, his family will stop pressurising him to quit smoking and he will easily ignore his mild symptoms for the next few months or years.

What does a “super deluxe package” include to a maximum? A complete blood count where it measures the amount of your blood cells, a urine routine test, blood sugar level, thyroid hormone level, kidney function test, measure of blood cholesterol levels, liver function tests, a chest X Ray, an ECG (measuring electrical activity of your heart beat), an echocardiogram, an abdominal ultrasound or may be one or two more investigations. This has covered not more than a dozen of organs. So, how can we get reassured that our whole body has been evaluated? It is not possible to screen some organs by simple tests. Diagnosis of many diseases needs much sophisticated investigations. My point here is, we cannot rule out what is going on in other organs by sending these few investigations making people falsely believe that they are completely fine.

I’ll give few more examples that whole body check-up is just a myth. A cancer in your bile duct will not cause any symptoms or abnormality in blood tests until it is large enough to impede the normal flow of bile. But from the time it is large enough, most of these patients will only be living only for months. No ECG can predict the probability of having a heart attack. There must be at least significant occlusion in your coronaries (heart blood vessels) to get any changes in ECG, and it can be completely normal until a minute before the attack as in the case of my uncle.

Hence, I reiterate that probability of any disease is largely driven by symptoms, the life style, the built, the family history, previous illness records, underlying illnesses and many more variables. It is recommended in many countries to have routine tests only after one’s age crosses 40 or 50. American Diabetes Association recommends screening blood sugar for all asymptomatic patients of age more than 45 years. It is recommended that any lady on her reproductive age group should go for PAP smear test for cervical cancer every three years. A colorectal cancer screening is recommended to all patients crossing 50 years of age. Breast cancer screening mammogram is recommended annually after a woman crosses 45. These tests are seldom included in the ‘whole body packages’.

To conclude, it is always better to consult your GPs or Physician for routine investigations. Always be clear about the symptoms and concern, be honest about the lifestyle habits to your doctor, and keep track of your family history and past medical records. A targeted investigation is far superior to  a random set of tests to screen your health.

[ The author is a Consultant Physician and Lecturer at KU School of Medical Sciences, Dhulikhel Hospital.]

 

On Mentors

– Dr. Niraj Poudyal

By mentor, I mean a person who innately, habitually and unswervingly shows me the path towards mokchya, whatever that may mean. A mentor can see his (yes, my patriarchal mind!) dreams realized in the eyes of his pupils. Hopes of mentor’s heart gets teleported to the steps of his pupil. I rarely prefer using adjectives or prefixes in front of words such as god, mentor, mother and capitalism. This essay is one of those rare moments. At least as a demi-mentor myself, I have seen my dreams sparkling in the eyes of my students. When they take a step forward towards mokchya, I feel a tiny bit of my dream fulfilled. An archaic thirst quenched.

I feel that I have failed to learn certain important lessons because of the lack of a mentor (no adjectives here!). I think I have learned basics of quantum mechanics without mentors assuming that books do not fall under the definition. I have failed to write well even with the help of excellent mentors around. This piece can be taken as my best writing ever. I have failed to learn music. Despite having seemingly good mentors, I have failed to learn using my failures to avoid more failures. Repeating same failures has become my way of life. In the absence of a mentor, I have not been able to figure out the prudent purpose my life. I have not been able to make sense of my “spiritual” experience. I am not blaming everything I have not been able to learn on mentors that I do not have.

Do I need a mentor in my life? I don’t know. Probably, I need a mentor to know. I already had many momentary mentors mentoring me on special skills of mathematics and computing, modeling and narration. Sometimes, I wonder about the first mentor, mentor of all the mentors. Having a rubbish life definitely does not require any mentor. In that sense, I feel we are all at least partially mentored for partially rubbish lives we all have.

I do not know about animals other than humans, but humans I know of definitely are capable of judiciously running their lives and their loved one’s lives with or without a mentor. Assuming of course that they did not have invisible master yogis as their mentors. Can human malevolence be sharpened with the help of a ruthlessly determined mentor? Can munificence in our hearts be revealed and enhanced by an inspirational and enlightened mentor? What roles mentors played when their pupils discovered antibiotics that saved billions of dreamful lives or declared non-violence not just as an approach towards life but a sanctified end in itself? Who mentored Buddha or Galileo to search for something beyond their reach!

Let us assume, we need a mentor to have a good life, however we define a good life. What kind of mentor do I want? Actually, I have a dream to have a mentor who can go beyond the concrete wall of numbers I have been trapped into. I want the mentor to be able to make me find and peruse the temporary meaning of my own life. I have already declared emptiness to be the ultimate meaning of life. I am not worried for the ultimate meaning for I already know it. The net meaning or value of life is zero. I need a momentary meaning. In the midst of such a disastrous conclusion, I want my mentor to either change this zero-sum game of my life into a non-zero sum (hopefully positive sum) game or give me a temporary game having some non-zero sum meaning. I want to play this non-zero sum game once and for all; I am scared if it’s not yet too late to play this unknown game.

I will not focus on who will be the most appropriate mentor. I would rather talk about what characteristics I want for the mentor of my dream. Is the mentor going to be him or her? Being an obvious child of a patriarchal upbringing, I have already imagined a he-mentor. A she-mentor is not even in the horizon of my dream full of he-mentors, appropriate and inappropriate.

Do I want long white/dark beard on my mentor? Do I want a young enlightened laughing guru or an old experienced smiling guru? Do I want a guru who is continuously pushing the limits of human physiology by living an austere life, a life full of pain and yet devoid of suffering? Do I want a guru who renounced ignorance after enjoying all that ignorance can offer? Or a guru who was groomed to be a guru since the beginning? Do I want a mentor who had another mentor or should I just go for a mentor by his own making?

I know some mentors who declare taking the burden of responsibility as key to having meaning in life. Is that the type of mentor I want? Should I scrutinize if the mentor himself is applying this principle in his own life? Or just getting a map of such life is enough?

More questions about mentors than answers!! Someone truly said, questions are always better mentors than answers.

I have not even started talking about mentoring yet. Which is more important: mentor or mentoring? Finding a mentor is actually no more than defining a mentor. Adjusting your definition of mentor and mentoring can give you the mentor you are looking for. If I am not able to find the mentor, it only exposes the rigidity of my definition of a mentor. But changing the definition can have wild consequences. I may end up with a tree mentor, a sky mentor, a book mentor or an experience mentor.

Enough with hanging between the conservative rigidity of my definition and the liberal risk of turning everything with an identity into mentors. Mentoring seems to be a much easier and safer task than finding a mentor. Good luck for those who are looking for their mentors.

[The author is Assistant Professor at School of Arts.]

जीवनको विश्वविद्यालयका कर्मयोगी तेजबहादुर पुरी

– दामोदर घिमिरे

कुनैपनि समाजमा विविध जात, धर्म, भाषा संस्कृति र रहनसहन भएजस्तै सो समाज संचालनको लागि वहुसंख्यक सज्जन र केही दुर्जन व्यक्तिहरू हुने गर्दछन्। आजका कुशल विद्यार्थीहरू भोलिका दक्ष डाक्टर, प्राध्यापक र व्यवसायी हुने भए जस्तै आफू लगायत आफ्नो समाजको आवश्यकता पूरा गर्न सानो उद्यम वा व्यवसाय गरेर बसेको व्यत्तिको पहिचान नेताको तुलनामा कम देखिएला, तर यथार्थमा महत्वपूर्ण अर्थ राख्दछ। कोरिया, जापान चीन अहिलेको अवस्थामा पुग्नुमा त्यस देशका नेता र जनता इमानदार अनि परिश्रमी भएकैले हो। कुनै पनि देशको भौगोलिक वनावट, त्यहॉ उत्पादन हुने वस्तु तथा बोलिने भाषाले त्यस क्षेत्रको प्रतिनिधित्व गर्दछ। जुनसुकै जनावर र पंछिका बच्चालाई जन्मने बित्तिकै हिड्न वा उड्न सिकाउ‘नु पर्दैन, तर तिनले ऑट र प्रयास भने गर्नै पर्दछ। दृढ विश्वास र प्रतिवद्व भएर लागि परेमा जस्तोसुकै कठिन कार्यहरू पनि सम्पन्न हुने अर्थात् सामाजिक र राष्ट्रिय भावमा समर्पित भएर गरिएका जुनसुकै कामले सफलता पाएको इतिहास यत्रतत्र छ। यस लेखमा आफूलाई सुम्पिएका प्रशासनिकदेखि परीक्षा संचालनको कार्यमा पोख्त तेजबहादुर पुरीका बारेमा चर्चा गर्न लागिएको छ।

२०३२ असार ६ गते पिता भोजराज र माता दोलमाया पुरीको कोखबाट रामेछाप जिल्लाको साविक सुनारपानी –१ मा जन्मिएका तेजबहादुरका १ भाई र ५ दिदीबहिनी छन्। घरबाट ४५ मिनेटको दुरीमा रहेको श्री भैरवी नि.मा.वि.बाट ६ वर्षको उमेरमा शिक्षारम्भ गरेका पुरी २०४७ सम्म उक्त स्कुलमा अध्ययन गरेपश्चात २०४८ सालबाट १ घण्टा टाढाको श्री महेन्द्रोदय मा. वि. मन्थलीमा भर्ना भई अध्ययन पश्चात २०५० सालमा एस एल सी को परीक्षामा अनुतिर्ण भएसंगै किम्कर्तव्य विमुढ भएर २०५१ भाद्रमा पहिलो पटक काठमाडौं आए।

‘खाने मुखलाई जुँगाले छेक्दैन, अनि विवाह गर्न जात र उमेरले रोक्दैन’ भनिएझैं कामको खोजीमा काठमाडौं छिरेका पुरी ३ महिनापछि डा.सुरेन्द्रराज काफ्ले मार्फत् काठमाडौं विश्वविद्यालयको केन्द्रीय कार्यालय, लाजिम्पाट काठमाडौंमा २०५१ कार्तिक ३ बाट कार्यालय सहयोगीको रूपमा प्रवेश गरी २०५५ मंसिर १ गते स्थायी भए।  सामान्यतयाः  कुनैपनि कर्मचारीको एक स्थानबाट अर्को स्थानमा सरुवा हुन्छ तर पुरीले काम शुरू गरेको ३ महिनामै काठमाडौं विश्वविद्यालयको केन्द्रीय कार्यालय धुलिखेलमा सरैसंगै उनको पनि स्वतः कार्यस्थान धुलिखेल हुनपुग्यो। पहाडको केटो कामकाजमा जेठो भनिएझैं सेवा प्रवेशसंगै अफिसमा आइपरेका जुनसुकै काम गर्ने आदत भएकैले होला उनले कुनैपनि कामलाई सानो वा भरेभोलि नभनी सम्पन्न गर्ने क्रममा काठमाडौं विश्वविद्यालयका संस्थापक उपकुलपति डा.सुरेशराज शर्मा, रजिष्ट्रार डा.सीताराम अधिकारी, स्कुल अफ इन्जिनियरिङ्गका निर्देशक सुरेशकुमार पुडासैनीको मातहतमा रहेर काम गर्ने मौका मिल्यो ।

आर्मी पुलिशमा जस्तै शुरूमा तल्लो तहका सहकर्मीसंग तालिम कार्य सिकेका व्यक्ति नै २-४ महिनादेखि १-२ वर्षमा आफ्नो विभागीय प्रमुख भएको ३-४ वटा परिवेश खेपेका पुरीको कार्यक्षमता वा कार्यदक्षता उच्च अनि प्रशंसनीय रहेको सोहि विश्वविद्यालयमा वि.इ. देखि अध्ययन गरेर हाल प्रोफेसर भएका डा. विवेक बरालले वताउनु भएको छ।   २०५३ सालदेखि २०७० सालसम्म स्कुल अफ इन्जिनियरिङ्गको प्रशासनमा रहेर काम गर्दा सो संकायका प्रथम डीन वि.एल अनन्तरामु, डा.भद्रमान तुलाधर, प्रो. दिनेश चापागाई, डा. भोला थापाको अविभावकत्व पाएका पुरीले सोही समयमा सो स्कुलको प्रशासकका रूपमा प्रकाशचन्द्र खड्का,  गोपिकृष्ण प्रसाई , यशु न्हसिजु , सुरेन्द्र के.सी. लगाएतलाई ४ देखि ११ महिनासम्म काम सिकाउँने मौका मिलेछ।

सरकारी काम कहिले जाला घाम भन्ने उत्तिको विपरित तोकिएका काम सदैब दत्तचित्तले पूरा गर्ने तेजबहादुरलाई जीवन के हो भनेर सोधिएको प्रश्नमा सुख र दुःखको नाटकीय काहानीलाई जीवन ठान्ने पुरीले बिना उतारचढाव बाँकी जीवन बिताउन पाइयोस भन्ने कामना राखेका छन्। अध्ययनमा अब्बल विद्यार्थीको मिलनसार साथी कमजोर विद्यार्थी नहुने भएजस्तै स्कुल अफ इन्जिनियरिङ्गमा प्रशासन तथा परीक्षा संचालन सम्वन्धी १७ वर्ष काम गर्दा सिकेको सिप र विश्वासनीयताकै कारण हुनसक्छ २०७० सालबाट विश्वविद्यालयको प.नि.का.मा कार्यरत पुरीको कार्यशैली, गोप्यता र सहनशीलता व्याचलर उतीर्ण गरी ५-७ वर्ष काम गरेका शाखा अधिकृतको भन्दा कम छैन।

२०६८ सालमा बुबाको स्वर्गारोहण हुँदा साह्रैनै दुःख लागेको बताउने पुरी आफ्नो जागीर स्थायी हुँदा आफूभन्दा पनि धेरै आफ्ना बुबा खुशी हुनु भएको  दिनलाई सुखको क्षण मानेका छन्।

कुनै पनि निकायले संचालन गर्ने परीक्षा, डेस्क-डेस्कमा रोल न. लेखेर टास्ने पुरानो पद्धति भन्दा हृवाइटबोर्ड वा ढोकामै परीक्षार्थीको सीट प्लान टाँसगरी सोही बमोजिम ५०० परीक्षार्थी हुँदा स्कुल अफ साइन्स र इन्जिनियरिङ्गमा वार्षिक ४ पटक हुने आन्तरिक तथा अन्तिम परीक्षा, पुरीकै पहलमा २०५५ सालमा शुरू गरेको पद्धति हालसम्म निरन्तर रहेकोमा आफूलाई गर्ब लागेको कुरा यस स्तम्भकारसंगको भेटमा व्यक्त भएको थियो।धुलिखेल हाता, स्कुल अफ इन्जिनियरिङ्गको पहिलो दशकमा कार्यरत रहँदाका फ्याकल्टी एवं सहकर्मीहरु भूपेन्द्रविमल क्षेत्री, आनन्दराज खनाल, प्रियराज चालिसे, मदन कार्की, राजेश शर्मा, नर्वेजियन नागरिक काई वेद्रिङ्गदाश सहित रमेश बजगाई, केशव खड्का लगायत सवैलाई सम्झँदा पुरीको मन प्रफुल्लित हुन्छ।

सरसफाई गर्ने दिदीवहिनी दाजुभाईदेखि विश्वविद्यालयमा अध्यापन गर्ने अधिकांश प्रोफेसरहरूले उनलाई नामले भन्दापनि थरबाटै चिन्ने, बोलाउने गरेसँगै गोर्खालीको पहिचान खुकुरी र अढाई दशकसम्म एकै पदमा कार्यरत पुरीको कार्यकौशलता भनौं वा इमान्दारीपन अतुलनीय देखिन्छ। स्कुल अफ इन्जिनियरिङ्गको प्रशासनमा ३ वर्ष सहित काठमाडौं विश्वविद्यालयमा १३ वर्ष कामगरी वि.स.२०६६ श्रावणबाट पाटन स्वास्थ्य विज्ञान प्रतिष्ठानको प्रशासकका रूपमा कार्यरत प्रकाशचन्द्र खड्कालाई  तेजवहादुर पुरी कस्तो व्यक्ति हुन भनेर मिति २०७७ भाद्र १ गते फोनमा सोधिएको प्रश्नमा  उनी तोकिएको जिम्वेवारी समयमै र दक्षतापूर्ण तरिकाले सम्पन्न गर्ने, राम्रो अक्षर लेख्ने, सधै हँसमुख रहने, विद्यार्थी, शिक्षक र सहकर्मीसँग सद्भावपूर्ण व्यवहार गर्ने, परीक्षाको सिटप्लानमा पोख्त अनि पत्रलेखनको व्यहोरा अति राम्रो भएका कर्मयोगी हुन् भन्नुभएको छ ।

निश्कर्षमा भन्नु पर्दा गाउँघरमा हुर्केर दुःख कष्ट खेप्दै मुठ्ठीबाट मानो र मानोवाट पाथीको शैलीमा आफ्नो कार्यशैलीमा निख्खरपन ल्याउने तेजबहादुर हाम्रा प्रेरणाका स्रोत हुन्। काम गर्नलाई प्रमाणपत्र नै चाहिन्छ वा अमुक पदनै ओगट्नु पर्छ अथवा पद ठूलो कि इच्छाशत्ति ठूलो भन्ने कुरा छलफलका विषय हुन्। व्याचलर वा मास्टर्स पास गरेरपनि निबेदन, मेमो लेख्न वा मागफारम, भौचर भर्न नआउने तर स्थानीय वा जातीय ध्वाँस दिनुको सट्टा सिप, परिश्रम र इमान्दारीताको कदर गर्दै तेजबहादुर पुरीले जस्तै आफ्नै देशमा रहेर तन, मन, बचन र कर्मले तोकिएका जिम्वेवारी पूरा गर्दै निःस्वार्थ भावले आफू आवद्व संस्था वा व्यवसाय समाज अनि राष्ट्रको सेवामा सबैले जुट्नु पर्दछ।

[लेखक काठमाडौँ विश्वविद्यालय केन्द्रीय प्रशासनका कर्मचारी हुनुहुन्छ।]

Editorial

Continuing beyond the Ritual

This site has evolved from a blog named Forum for Interdisciplinary Thoughts (KUFIT) initiated in April 2011. Updating the blog was halted for some time for certain technical reasons. But now we have revived it more formal Forum for Interdisciplinary Discourse (FID) with intention to accommodate ideas/scholarship across different domains. We keep intact the initial objective “to envision fresh zeal for collective growth, and to sustain our old values for quality pursuits and services.”

The inception have underlined working beyond the ritual, with emphasis thinking “like scholars and intellectuals experts of particular disciplines” intending to “educate one another by writing perceptions of and perspectives the world as simple essays and stories.” Too big the aim might sound, but that academia should qualify for being focused to wisdom, transcending knowledge and scholarship in various domains.

We reiterate belief here: Academics should think beyond rigid jargonistic scholarships and able to communicate knowledge and wisdom to benefit wider public. Let us work towards, with simple expectations — contribution with writings and comments have some urge for communicating knowledge and wisdom.

This issue of FID features:

May our efforts lead us toward a successful and enriching academic future.
Thank you!

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University-Community Partnership and Critical Public Policy and Management Education in Nepal

– Dr. Purna B. Nepali

Kathmandu University is moving towards critical direction and new institutional values with innovative Vision 2030 (also known as KU Silver Jubilee Initiatives i.e. six initiatives -quality, impact, equity, global engagement, identity, and innovation).  This vision aims at addressing the multi-dimensional needs of the nation and ensure its smooth functioning. The vision is all the more relevant in the present context of the public domain, which is rife with problems, ineffective service delivery to the people coupled with structural poverty, inequality and deprivations.

Realizing the multi-dimensional need of the nation and following the global agenda ‘Sustainable Development Goals (SDGs: 2016- 2030)’ for inclusive growth and transformation, this paper attempts to reorient the traditional teaching-learning approach and institutionalize the newly launched program on public policy, governance, and management education in Nepal with a critical perspective in the landscape of the state and societal transformation. This is an innovative academic program designed to deal with a wide range of public policy and governance issues, and enhance the management, knowledge and skills of the public sector through multidisciplinary and interdisciplinary approaches. These mixed and blended approaches are also known as transdisciplinary approaches which include multiple strategies like critical pedagogy, reflective and experiential learning, impactful professional career, pragmatic analysis, design thinking, human-centric innovation and action, university-community partnership, land grant institutions/missions, student-led engagement initiatives, etc.

Based on the critical perspective and pedagogy of the insights and thoughts of John Dewey and Paulo Freire, the public policy and management program firstly identifies the issues and challenges of public policy, governance, and management for exploring the ways and possibilities of informed and evidence-based analysis and solutions. It would be helpful to think out of the box and be engaged in these issues prioritizing/employing various methods like critical thinking, reflection, arguing ‘help us not only for memorizing, but also for creative and cooperative inquiry’ and scientific investigations. It discourages delivering ‘ready-made knowledge’ and encourages ‘active laboratories of knowledge making’. Inquiry based learning promotes the sense of responsibilities and accountability toward the nation and people.

Secondly, this critical pedagogy equips students to comprehend and analyse how this academic program can contribute to address the aforesaid issues and challenges for societal transformation. In line with KU Vision 2030, this academia program shall be well engaged in societal transformation via innovations, quality and impactful initiatives. Hence, Critical pedagogy equips students to think differently; not only to memorize (what to do) but also solve (how to do/act) problems themselves.

Thirdly, an attempt is being made to craft/recraft the emerging and globally recognized human-centric design thinking and innovative tool/approach called ‘Policy Lab’ so as to ‘Discover, Design and Evaluate (DDE) ’ the ways and possibilities of informed and evidence-based policy analysis and solutions, decision making and implementation for ensuring effective public service delivery. The lab attempts to bridge the gap between academia and public policy mainstream and provides opportunities for students, professors, scholars of each university and college/campus to undertake research on peoples’ concerns and their livelihood considering policy avenue. All university family would learn, teach, support and engage community people in policy formulation and its effective implementation, thus making the universities and their campuses/colleges not only like an ivory tower but also the agencies to learn from the community, teach and support the community, as well as enjoy and celebrate with the community.

Fourthly, the program also focuses on establishing the policy outreach center and networks outside the universities which would bring together all stakeholders (students, faculty, activists, and legislators) committed to policy activism.  It would seek to build on their knowledge, cooperation, justice and integrity devoted to growth and development of the nation and consider the need-based engagement of civil society, business entities, and political actors in the program.

Also, prioritizing the students led engagement in the public domain, this program is key for preparing students, who would be tomorrow’s policy leaders and managers in the public domain. It is a student-centered program that exposes students in the policy mainstream to understand the environment- how to handle the complex situations. It fosters experiential learning, and an impactful professional career.

Next, the diversity and inclusion within and outside the university is one of the instrumental areas of contribution the University needs to focus on for these endeavors. For example, Harvard Diversity and Inclusion Efforts titled ‘Pursuing Excellence on a Foundation of Inclusion’ reveals that academic excellence requires diversity and inclusion in every affair of university. Justice and excellence require a foundation of inclusion and belongingness. A university achieves excellence by fostering the learning, creativity, and discovery of its members. Building a deep culture of inclusion and belongingness require people in every corner of the University to participate. University’s values of mutual respect, integrity, pursuit for excellence, accountability, and trust-building deepens the culture of inclusion and belongingness through shared academic and professional norms. Ultimately, the university is the synthesis of orientation, leadership, community engagement, and cultural transformation that creates an environment in which all of us can — and feel that we can — take full advantage of the rich opportunities. This in turn would enable each of us to flourish. Hence, the combination of institutional and cultural work promises to increase our comfort with a continuously growing and transforming campus community.

In a short period of time, we have been expanding our network regionally and globally with similar policy schools and new public management related programs in varying forms and intensities, such as Heller School of Social Policy and Management Brandeis University (with USEF Fulbright Specialist Program), Central Michigan State University (CMU), Columbia University, The New School, North-South University, University of Bergen etc. Moreover, Massachusetts Institute of Technology (MIT) JPAL South-Asia and Harvard Evidence based Policy Design (EPoD) teams have already committed to mentor and coach us on evidence based policy making and evaluation of policies and programs focusing on their engagement in the context of Nepal and the global context as a whole..

I would like to recount my personal experience while pursuing postdoc at Heller School for Social Policy and Management and Harvard Kennedy School (Malcolm Wiener Social Policy Centre) and Hutchins Centre with support of Fulbright Fellowship.  These academic institutions are well engaged in expanding the thoughts of  William Edward Burghardt (W.E.B) Du Bois , and Bhim Rao (B.R.) Ambedkar in regard to questions on social justice and social policy. I got an insightful learning on how the university is engaged in the overall social transformation and student led activities can lead the transformation of the state and the society. It gave me a lot of insightful thoughts on how university is to be engaged on public domain outside the university and schools.

Moreover, the US government initiatives on Land-Grant University Model and Historically Black Colleges and Colleges and System established by US President Abraham Lincoln under Morril Act 1862 and its amendment 1890 have contributed a plethora of exemplary initiatives and works: Establishing universities beyond classical teaching/academic excellence, community-college relations, outreach and cooperative functions to serve African-American farmers and their social and racial justice in the 21st century.

Thus, all these consolidated efforts ultimately are anticipated to contribute (through informed and critical analysis of issues and challenges, creating program, public policy analysis, and management) for transformation of state and society through different levels of University-Community partnership.  The KU Vision 2030 will also explore the possibilities of mutual collaborations and learning between national (Nepal’s KU) and globally established institutions for their cross-cultural learning and mutual cooperation in the days to come.

Finally, the critical pedagogy is a dialectic thought that has challenged issues of public policy, governance to think about all aspects to pursue a transdisciplinary education for inclusive transformation. This program has its own culture, pedagogy, and a way of thinking to break free from the traditional approach of teaching and learning. It seeks to network and work in tandem with a wide variety of disciplines for planning elation to issues of justice and emancipation. With the aforesaid innovative actions and results, this paper proposes the collaborative solutions and contributes to the SDGs processes in general and through evidence-based innovative solutions for larger societal transformation in particular.

[Dr. Nepali is Associate Professor and Director of Master of Public Policy and Management (MPPM), at School of Management, KU]

Ruminating Posthumous Me

–  Dr. Niraj Poudyal

I sometimes wonder what it would be like to experience the moments right before and after death! I think I would definitely feel emotional pain at the least just before death knocks the door unless the death accomplishes what it wants in a blink of an eye without prior notice and expectations or if I go unconscious long before I die.

I fear death for life is too tempting. But what about the exact moment of death and after the death? No one has been able to give a convincing answer yet. I think the finding of near-death experience (NDE) studies just makes us think about the definition and meaning of death itself. The NDE experience is not evidence of life after death; rather it’s the evidence of our ignorance on the meaning of life, death and the border that separates the two.

Even if I feel something at the moment of death, I won’t be able to come back and tell my story. If, somehow, I come back alive, then the experience I had would not be of death but of something else. I would never be able to write my experience of whatever pain or pleasure I might endure at the moment of death.

Having empirical nihilist position, I believe in death as an end of me, my conscious existence and whatever constitutes me being alive. My body will disintegrate into strands of atomic and subatomic particles and quantum pockets of wave functions. My death will constitute a tiny spec of the ultimate demise of this universe, ironically known as heat death, into cold zero density stretch of space. My purposeless existence will cease to exist purposelessly.

Reincarnation is the last thing one would want if the goal is to feel death. If reincarnation is true in any sense, Judeo-Christian or Hindu-Buddhist, we will lose the opportunity to experience death. Reincarnating into a non-life would be contradictory to its own definition. If we are going to reincarnate into another life, some form of us must stay alive until we reincarnate. If everything is dead, then there would be nothing to ensure continuation of our lives. Ironically, if something of us is not dead fully, we are not dead at all. Alas!! We were supposed to experience death that does not exist in the universe that allows reincarnation ! This path does not lead to proper experience of death, I think.

I wonder if I can guess how it feels after death if I contrast it with feeling of life, reverse image of death. I define life as a set of limits. In a sense, existence itself is a set of limitations on non-existence. Without limits, nothing would exist. Even nothing needs limitations to exist. Life, as it exists, prohibits from happening everything. Most of the things that we might want to happen will not happen because of this limitation. Pain itself is the immediate result of this limitation. Had we possessed to cross the boundaries of these limitations, I wonder if pain would make any sense. In this sense, life is a pain or suffering, as Budhha puts it. Moments of pleasure are just some random and rare spikes in the sea of suffering. Being the reverse image of life, death may feel like sea of pleasure with rare painful cavities. No heaven can match this after death experience. At the end of the day, we all strive for days full of fun with tiny bits of suffering and life not only full of joy but also with tiny bits of painful moments so that we can shed our tears down.

People have dream life. This is my dream death.

Life is not a dream and nor is death. I know there won’t be anyone to feel my death with any accuracy whatsoever. The neurons of my brain that can feel the dark cold universe will break apart and turn into lifeless electrons, protons and neutrons. The meaning of pain and pleasure will cease to apply after my death. I will feel exactly like what I might have felt before I was even fertilized. The end of things will feel exactly like there was no beginning. People are scared of death. But no one is scared not to be borne into this world. Entropy is the only thing that makes them different in physical sense. But for me, it’s the same.

Of course, I suffer now thinking about my untimely death. I am worried for my kids and my loved ones. In my absence they will suffer. And this is painful for me. I suffer too. But this is a suffering for living me. This is not the feeling of death. This is a feeling of living a life and imagining a difficult future of my loved ones without me. They will see me dying, or maybe not. They might know my death, or maybe not. But I will not feel my own death. I will not know my own death. I will not live to see and judge my death.

[Dr. Poudyal is Assistant Professor at School of Arts]

A Letter to James Dewey Watson

– Bharat Sigdel

Dear Watson,

I am writing to you today to tighten some bonds of our relation. Yes friend, being two humans from a seemingly vast different professional life, I find too many common grounds between you, a scientist, and me, an academic writer. I always get confused whether you are a scientist or an academic writer. Similarly, in my case as well, I inquire with myself whether I am an academic writer or a scientist. In this letter today, I will be focusing on our common grounds.

Writing is a common activity in every dimension of life. In formal as well as informal settings, we regularly write. We write in different contexts, for different purposes, for different target readers, through different mediums and with different messages. But obviously, writing of daily use is different from what students and academicians write in schools, colleges and universities. The special variety of writing which is called academic writing goes commonly in schools, colleges and universities. As academic writing, in many ways, is what science is and is not what science is not, we can take it as science. As I have already mentioned, to some extent, you are an academic writer and I am a scientist.

Academic writing is a skill-based writing in academia which ranges from assignment of students to expert works of researchers and professors. In the beginning, academic writing may be so frightening and disgusting to the learners, it “may turn your stomach or turn your nose.” Difficulties come when we cannot reach to a particular context. As L. Lennie Irvin says, “Writing resembles having our eyes blindfolded and our hands tied behind our backs: we can’t see whom we’re talking to or where we are. Separated from our audience in place and time, we imaginatively have to create this context.” Yes, we imagine and create a context. Through writing we try to establish a rhetoric that creates a common ground to writer and readers to meet and communicate.

Academic writing is such a vast skill that it can be taken as and compared to many dimensions of philosophy of life. Therefore, we say academic writing is discourse, politics, pedagogy, network, scholarship, science, and many more. It carries its dominant features from all these various fields. As we create the context of communication through our writing, all academic writings are discourses. The writer openly argues on the raised issue. The entire project of writing from selection of the topics to publication or even to the point of readers’ response/criticism is engulfed with politics. Academic writing is solely a skill and artifact of academia. It is deeply rooted in pedagogy. Similarly, academic writing is considered to be enriched by network and scholarship. It helps to form a network of scholars and their profound scholarly knowledge. And can academic writing be taken as science, too?

Yes, of course. The enterprise of writing can be said to be similar to that of science. As defined by Wilson, E. O.  (1999) “Science is the organized, systematic enterprise that gathers knowledge about the world and condenses the knowledge into testable laws and principles” (58). So is academic writing.  Academic writing has its own norms, rules, regulations or format specified by concerned university or constructs of long practices. Academic writing follows the format which has been in long practice and has universality in its pattern. For example, a five paragraph essay format is universally accepted. The University of Sydney has introduced academic writing thus: “Academic writing is generally quite formal, objective (impersonal), and technical. It is formal by avoiding casual or conversational language, such as contractions or informal vocabulary. It is impersonal and objective by avoiding direct reference to people or feelings, and instead of emphasizing objects, facts and ideas. It is technical by using vocabulary specific to the discipline.”

Dear Watson, normally, science is understood as a discipline in which they first find an issue or problem, then they go through careful and systematic observation based on any suitable method and finally they reach an answer or a solution. We can take example of your discovery of the molecular structure of deoxyribonucleic acid (DNA). Though the discovery was announced in 1953, you had started your study and observation from your virus research at Indiana University in 1950. I have come to know that you became convinced that the gene could be understood only after something was known about nucleic acid molecules. Study was also focused on protein molecules with the help of scientists working in the Cavendish Laboratory at the University of Cambridge.

After working on research at the Cavendish Laboratory continuously for two years (1951–53), yes, the discovery was made to be possible, in the spring of 1953. Certainly, academic writing also has some similar traits. Academic writing, specially research work, takes its journey to one or multiple conclusions started from and across statement of problem, finding a research question, setting hypothesis, going through data collection and data analysis. To quote Anne Whitaker (2009) here: “In an academic writing assignment, you will start by asking a good question, then find and analyze answers to it, and choose your own best answer (s) to discuss in your paper. Your paper will share your thoughts and findings and justify your answer with logic and evidence” (2).

Science has reliability, validity and credibility because conclusion it draws is tested. The discovery of DNA is universally accepted without single question. Similarly, academic writings, except some, have all these qualities. As Gina L. Vallis says, “Academic writing uses a style that tends to offer a question, in an implicit or explicit manner, and then to move, step-by-step, to a conclusion, through reasoned argumentation” (20). So, they have wide acceptability.

Science finds new avenues for further study. In academic writing, too, we can find curiosity, knowledge gap and new concepts that trigger readers to go with further research or further writing. That is what we mean by writing inspires writing. The references mentioned create a network creating connection with almost unlimited link of the readers to the world of academic writing.

Academic writing is similar to science not only with what science is but also with what science is not. First of all, science is not just accumulation of facts. Nor is academic writing. Academic writing is not pile of data or crowd of corpus only, it is entire task of mining out valuables through analysis of variables.

Science does not try to forcefully claim something to be true. Rather it establishes truth through its own way of observation and testing. similarly, in academic writing we derive answer/solution/conclusion based on analysis of the variables and related data.

Science does not deal with supernatural, magical elements or occultism. Nor does academic writing. Supernatural, magical elements or occultism can certainly be subjects of writing, but not evidences of supporting details.

Academic writing follows an established format, goes across a reliable procedure, uses observation, analysis and logical reasoning to reach to one or multiple answers. It can be compared to science. Also, it does not believe in untested matters and supernatural as well as occult power as science. So, by now we come to the point that academic writing is science.

Dear Watson, many congratulations once again to you on your discovery of DNA for which you were awarded with the Nobel prize for Physiology and Medicine in 1962. I like to conclude my letter here today but please do not forget to reply. I am looking forward to hearing your response on my analogy and any of your recent discovery.

With best regards,

 

References

[Mr. Sigdel is pursuing M.Phil. in English Education in Kathmandu University]

स्वास्थ्य चिन्ताले हैरान पार्न सक्छ

– माधव प्र. खतिवडा

महेश (नाम परिवर्तन) लाई १५ वर्ष अघि भााँचिएको दाहिने खुट्टा दुखेको जस्तो लाग्न थाल्यो । नभन्दै त्यही खुट्टाको पैतालामा खिल निस्क्यो र दुखाइ झन् असह्य भयो। दर्द कम गर्न पेनकिलर समेत खानु पर्न थालेपछि उनलाई क्यान्सर भएको शंका लाग्न थाल्यो।  हुँदा हुँदा उनी राती निदाउन छोडे। घरका परिवारले सम्पूर्ण शरीरको जाँच गर्न दिएको सल्लाहले उनलाई झन् तर्सायो किनकि जाँचगर्दा ल्याव रिपोर्टले उनका महत्वपूर्ण अङ्ग एउटै पनि काम नलाग्ने गरी बिग्रिसकेको देखाउँछ भन्ने शंकाले उनको भोक निन्द्रा गायब भएको थियो। बाँच्ने दिन धेरै छैनन् भन्ने विश्वासले गर्दा उनले काममा लत्तो छोड्दै जान थालेका थिए। एकदिन परिवारका सदस्यहरुले उनलाई जवर्जस्ती अस्पताल पुर्‍याए। जाँच गर्दा उनका सम्पूर्ण अङ्ग स्वस्थ्य रहेको पाइयो । महेशलाई तत्काल मरिहाल्छु भन्ने लाग्न छोडे पनि कतै ल्याव रिपोर्ट अर्काकोसँग साट्टियो कि भन्ने शंकाले अझै छोडेको छैन।  आफूलाई डरलाग्दो रोग लागेको छ भनी विनाकारण तड्पिने महेश स्वास्थ्य चिन्ता (हेल्थ एन्जाइटी) बाट पिडित व्यक्ति हुन्। यस्तो समस्याबाट पिडित मानिसहरुको सङ्ख्या अहिले विश्वव्यापीरूपमा नै बढिरहेको छ।

स्वास्थ्य चिन्ताबाट सताइएका अधिकांश मानिसहरू आफूभित्र एड्स वा क्यान्सर रोग छिप्पिइसकेको छ भन्ने आशंकाबाट पिडित हुन्छन्। प्रायजसो क्यान्सर रोगको स्याहार सुसार गर्ने आफन्तहरूमा कतै आफूलाई पनि त्यही रोगले गाँज्न त थालेको छैन भन्ने विश्वास मजवुत हुँदै जान्छ। यसको साथसाथै रोगहरूको बारेमा वारम्वार पढ्ने र सुन्नेहरूमा पनि पढे सुनेका रोग आफूमा नै भएको भान हुन थाल्छ र गर्दा गर्दै शंका बानीमा  बदलिन बेर लाग्दैन। इम्पोरियल कलेजका प्राध्यापक टाइरेरका अनुसार पछिल्लो समयमा इन्टरनेटको बढ्दो प्रयोगले पनि यो रोगलाई चर्काउँदै लगेकोछ। मानिसहरू विराम लाग्नासाथ इन्टरनेटमा रोगका लक्षण र उपचार बारेमा खोज्न थाल्छन्।  नेटमा चाहिनेभन्दा पनि नचाहिने कुराहरू बढी हुन्छन्। हेल्पलाइन च्यारिटी अफ एन्जाइटी युकेका ओलिन भन्छन् “तपाँइले कम्प्युटरमा खोकी मात्र भनेर टाइप गर्नु भयो भने पनि एच आई भी एड्सदेखि क्यान्सर सम्मको फेहरिस्त देखा पर्छ जसले मान्छेलाई थप चिन्तित बनाउँछ ।”

डाक्टर,साथीभाइ या आफन्तबाट पटक पटक आश्वसान खोज्नु यो रोग लागेका मान्छेको अर्को विशेषता हो। तर केवल फोस्रो आश्वसानले कुनै काम गर्दैन। ओलिन भन्छन्, “मान्छेहरू आफ्नो मस्तिष्कमा एैजेरु पलायो भन्ने चिन्ताले  त्रस्त हुन्छन्।” उनीहरू अस्पताल गएर टाउकाको स्क्यानिङ  जाँच गर्दिन अनुरोध गर्छन्। जाँच गरेर डाक्टरले तपाँइको मस्तिष्कमा एैजेरु सैंजेरु केही पनि छैन भने पनि उनीहरूलाई कतै स्क्यानिङ गर्ने मेशिन नै बिग्रेको पो थियो कि? एैजेरु सानो भएर डाक्टरले नै देख्न पो सकेन कि ? रिपोर्ट जाँच गर्दा डाक्टरले देख्नै पो छुटायो कि भन्ने तर्कनाले पिरोलिइरहन्छन्। उनीहरू बारम्बार फोन गर्छन र मलाई कतै क्यान्सर त भइहालेको छैन नि हगि ? भन्दै आश्वसान खोज्छन्।  ओलिन थप प्रष्ट पार्छन्,  “हामीलाई थाहा छ आश्वसानले काम गर्ने केही समय मात्र हो। पुनः चिन्ताले गाँज्न बेरै लाग्दैन।”

पहिला पहिला हाइपोकोन्ड्रीया भनेर चिनिने स्वास्थ्य चिन्ताको आम समस्यालाई गभ्भीरतापूर्वक नलिई  ठट्टा मजाकको विषय बनाउनु पनि हो। अरुले जिस्क्याए पनि, उडाए पनि पिडित व्यक्तिको मनमा मन्द मन्द मडारिने चिन्ताले उसलाई भित्र भित्र खोक्रो बनाइरहेको हुन्छ। मरिहाल्छु भन्ने तर्कनाले जीवनका राम–रमिता खुशीयाली फिका तुल्याउनाले पिडित व्यक्तिको जीवन नारकिय बन्न थाल्छ।

त्यसै गरी गार्डियन पत्रिकाको एक लेखमा लेखिका एमाईन स्यानर मार्कको भनाई उल्लेख गर्दै लेख्छिन्,  “स्वास्थ्य चिन्ताले सताएपछि जीवन त्रासदीपूर्ण बन्छ। मृत्यु आफ्नै सङघारमा पिङ्ग खेलिरहेको देखेपछि अरु कुरा सोच्नै सकिन्न। काम दाम र सामाजिक सम्वन्ध  चौपट् बन्छ।”  टाइरेरका अनुसार संसारभरि १% मानिसहरू यो रोगबाट पीडित छन् भने केवल १०% ले मात्र उपचार पाएका छन्। पीडित हुनेको सङ्ख्या सालिन्ने वढ्दोछ ।

अध्ययनहरूले देखाए अनुसार संज्ञानात्मक व्यवहारिक थेरापी यो रोगको उपचारमा लाभदायी हुन सक्छ। यस उपचार पद्धतिले मान्छेको सोचाइको शैली रुपान्तरण मार्फत व्यवहार परिवर्तन  गर्ने लक्ष्य राख्ने हुनाले स्वास्थ्य चिन्ताको उपचारमा यो विधि अचुक हुनसक्छ। यस पद्धति अन्तर्गत टाउको दुखाइलाई मष्तिस्कमा ऐंजेरु पलाएर हो भनी ठान्ने मान्छेहरूलाई त्यसदिन विहान टाउको दुख्दै उठ्नेहरूको सङख्या कति होला भनी कल्पना गर्न लगाइन्छ।  उनीहरूले  जलविनियोज,रुघा, माइग्रेन, थकान, अत्याधिक रक्सी या कफी सेवनजस्ता टाउको दुखाइका सम्भाव्य कारणहरूलाई वृत्त चित्रमा उतार्छन्।  चित्रले मष्तिस्कमा ऐंजेरु पलाएर टाउको दुख्ने मान्छेहरूको प्रतिशत नगण्य देखाउँछ। यसरी चिन्ताको समस्या भएका मान्छेहरूले  प्रत्येक लक्षणको निदान घातक नै हुन्छ भन्ने होइन रहेछ भन्ने स्वयम् महशुश गर्दै जान्छन् र बिस्तारै यस समस्यालाई हेर्ने ढङ्गमा परिवर्तन आउन सक्छ।

तर प्राय मानिसहरू यस्तो लक्षण एक मनोवैज्ञानिक समस्याको उपज हो भन्ने कुरा मान्न तयार नहुने हुनाले मनोचिकित्सक या मनोपरामर्शकर्ता कहाँ जाने कु्रा ठाडै अस्वीकार गर्छन्। उनीहरू आफू पिडित भइरहेको समस्या मनोवैज्ञानिक नभई शारीरिक हो भन्ने कुरामा विश्वस्त हुन्छन्। त्यसकारण स्वास्थ्य चिन्ताको उपचारमा समस्यालाई समाधान गर्ने संज्ञानात्मक र व्यवहारिक सहयोगको तालिम पाएका स्वास्थ्यकर्मी र मनोपरामर्शकर्ताको भूमिका अब्बल हुनसक्छ।  प्राध्यापक टाइरेरका अनुसार संज्ञानात्मक व्यवहारिक थेरापीपछि आफ्नो जीवन  कसरी कायापलट भयो भनी सबिस्तार पत्र लेख्ने विरामीहरु थुप्रै छन्।  हृदयाघात हुन्छ  भनी एक वर्षसम्म घरबाट बाहिर ननिस्कने मानिसहरू छुट्टी मनाउन गएका छन्।

त्यसैले मान्छेलाई भित्र भित्रै सिध्याउने स्वास्थ्य चिन्तालाई कम नआँकी र रेला ठट्टाको विषय नबनाई समयमै उचित ध्यान दिनुपर्छ। यदि संज्ञानात्मक व्यवहारिक मनोविमर्शका लागि आवश्यक जनशक्ति र  दक्षता  बढाउन सके अस्पतालमा हुने अनावश्यक जाँच पड्ताल र भर्नाको खर्चलाई न्यूनीकरण गर्न सकिने थियो र महेश र ऊजस्ता कैयौं मानिसहरूको जीवन थप नारकिय बन्नबाट बँच्ने थियो ।

 

                                                                            (लेखक काठमाण्डौ विश्वविद्यालयमा मनोपरामर्शकर्ता हुनुहुन्छ)

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