For A Green Pakistan

Pakistan is loaded with billboards reading a very loud green slogan: Keep your city clean, keep your city green. Now I wanted to work some strategies out for a greener perspective. Since green means more, better and cheaper perhaps much like how to go green. The 3 R’s of environmental protection; Reduce, Reuse and Recycle are to be advocated. Development of ecological intelligence for understanding of how nature sustains life may help us practice sustainable living, which in these times should be of growing interest.

In order to go green, you need to think green; probably greener. Here are a few steps towards the color of new life:

The 3 R’s:                        

Can Pakistan reduce its impact on the environment? I’m thinking deodorants, beef, clothes and gadgets. Reduce waste, for example, reduction in paper consumption. Partners in green are advised to print less, email more and change margins on the word document to reduce paper usage by 5%.  Reduce energy consumption and Reuse. Living in dorms for 4 years has landed me a doctorate in Green Studies. My mother called me the queen of clutter bearing witness to my colossal collection of plastics and various paper goods. Also in the running is Recycling soul. Oprah Winfrey preached how to choose smart off the shelves and recycle goods as much as we can. Some simple ways can help our environment and prevent global warming by convenient implementation without any expense.

Act Green:

Acting green would mean increasing awareness of environmental issues that affect the future of the planet. Spread Green, join a Green program or hold one to educate the community.  Because schools are ideal places to cultivate these Green capacities, ecological education in these settings is very important and more effective. Many Green companies aid schools, communities and other non-profit organizations to educate and empower citizens to make a difference to their environment. Read “Story of the Bottled Water” and “The Story of the Stuff” to channel some ecological inspiration and sense to acknowledge the human impact.

Eat Green:

Eat lower on the food chain; move down a few links and become more of a herbivore and less of a carnivore. A number of chemicals created for industrial use like PCBs and DDT for instance, end up in larger animals. Mercury found in tuna is a classic example of this concern. Consider options by including lots of fruits, vegetables, legumes and grains in your diet. However, organic products are generally more expensive than their conventional counterparts. The organic food supply is limited as compared to the demand.  As for food security, global food production is more than enough to feed the global population; the problem is getting it to the people who need it. Thereby, take only as much as you can eat. Can we change trends at parties and weddings? Go for a seated dinner instead of a buffet arrangement which generates a lot of waste. The caterer always makes more food than will be consumed so it never runs out.

Do Green:

One example to easily employ this strategy is by making it easier for the trash officials by separating plastic goods and paper from the rest of the trash. Therefore, you don’t aim to act green, but also impart green. Also avoid taking away goods. Not only they are more greatly wrapped but surplus packaging wastes resources which contribute to the overflowing landfills. Restaurants and various food joints now practice reusable ceramic plates; cups and silver ware and replacing paper with cloth napkins. Thereby, wash and reuse plastic kits, or consider regular cutlery or portable metal sets. Have your preferred beverage in one of your own ceramic cup instead of plastic/paper cups while travelling. Various campaigns initiated reflect the importance of recycling at the end of a product’s life.

Re-thinking the environmental impact of our decisions and taking into account our plant’s limited resources is an important part of the green education and implementation the Green policy. The strategy can be improvised through the audio/visual networks and newspapers. Turning off lights and appliances when not in use, adopting the use of fans instead of air conditioner in the summers and lowering the thermostat are a few ways towards enlightenment.

Urging the local government to increase sidewalks and bike lanes could prove a positive impact both on the population and the government revenues. Public transportation can cut down on traffic congestion and may lead to improved and more efficient services. Instructing the masses of the benefits of walking and riding which aims to save both money and time could recover health and environment.

Don’t buy. Borrow instead. Being a medical student, I have a made a fortune out of my modest learning by acquiring from used text books as they were stamped with marginal notes and references from previous owners. I passed my legacy to fresh candidates equipped with highlighted segments and additional material. Also, share power tools, appliances and invest in high quality products. They may cost more initially; however, may turn efficient in the long run and require less frequent replacement, consequently less waste. Such thrifty habits won’t cut into your quality of life.

The tap water is treated for safe drinking purposes. Rainwater on the other hand is relatively pure. Therefore, collect rainwater which maybe wholesome choice for non-drinking uses. Supplementing your water needs with rainwater will reduce utility bills and drainage. These attempts may suspend the costly expansion of water treatment services as municipal growth may outstrip supply.

Use Green:

With relatively economical compact fluorescent light bulbs (CFLs) available, Pakistan can use smart lighting which are cheaper and use 75% less energy.  Also, harvest the power of daylight as long as possible. Wind and solar energy have become utility industry’s adoption for the environment’s source of power complimented by countries over the world. Pakistan is currently building solar power plants in Kashmir, Punjab, Sindh and Baluchistan.

Most of the 15 billion batteries manufactured each year are discarded after their span, most of which are alkaline batteries. These batteries have a major share in groundwater leakage when disposed of to landfills. In this electronic era, it makes environmental and financial sense to switch to rechargeable Nickel Metal Hydride (NiMH) or Lithium Ion (Li-Ion) batteries.

Bottled water generates a large amount of waste. Not only it’s expensive, but also verified cancerous with repeated use. Thereby, consider a friendlier approach to drinking by using aluminum instead of plastic bottles while travelling or at work. Also, use a water filter to purify tap water instead of repeated purchase on bottled water.

2 out of 5 of the world population already faces water shortages, and 1.1 billion people in the developing world do not have access to a minimal amount of clean water. So turn the tap off while polishing those pearls. You can save up to 20,000 gallons of water a year, enough to fill a swimming pool!

Avoid using disposable bags. Buy a canvas bag to store purchased items instead of plastic bags. My grandmother always saved and re-used. She carried a large sack which she recovered from flour and rice packaging to the wholesale market. The craftsmanship of an over-sized bag is very captivating coupled with zero stigma attached to its dimensions. So ladies can stash purchases and still manage to look chic.

Expat.com is a renowned Saudi website for practically everything. It offers variety of furniture among other second hand goods. Craglist and Freesharing are a few of the popular spots for hunting down electronics, furniture, books, and other items. One can enjoy almost half of the original price on goodies. Various items casted off from the richer states might hold value to the developing nations and so consumer tendencies of the first class world have created surplus second hand goods. My mother is nature’s best friend. Although she doesn’t realize that she’s taking pounds off earth, she has made useful things out of the useless things.

Think before choosing and the impact of your decision on the planet’s resources. I think the humanitarian efforts would no longer be just a drop in the ocean.

The Social Contract

In Pakistan, medicine is one of the most sought after profession. Admission to medical college is highly competitive like in other parts of the world. Back in the days, a lot of material had yet to be deciphered. Hooray, we wished that it would remain unexplored until we’re out of school, so we wouldn’t have to study that too. It was the same with Fermat’s last theorem and the Riemann hypothesis in Mathematics, cloning animals in biology, and lots of stuff in physics and chemistry were yet to be discovered when I was in school.

 However, it was too late for some things like the structure of the DNA, it had already been revealed, the secret of the nuclear bomb cracked. We had to study the former, but luckily, it was an anti-national or anti-something to teach young students how to make a bomb, the latter was not on the curriculum. A good student got a 63% and a brilliant one scored 72. Anyone who pushed more than that either had his papers re-checked or was immediately made full professor.

 And everyone was guaranteed college admission.  My nostalgia was provoked by a decision by the education committee where the cut off mark for admission was 98%. If you finished your schooling with less than a perfect score, you need not apply. Either we have been creating geniuses in the years since I left school, or high school students have been taking a test designed for nursery school kids. For example, what letter follows ‘C’ in the alphabet?

 I took up the contract along with many students aspiring to become doctors and sat in a Medical Colleges Admission Test (MCAT). Students who failed to qualify for public medical colleges settled for admission in private settings.  Once admitted, we followed a detailed curriculum over the next 5 years appearing for yearly/semester university examination. Success in the final examination granted a degree of MBBS and following registration with Pakistan Medical and Dental Council (PMDC), the graduates were eligible to practice Medicine in Pakistan.

The race began with trying to ensure that wherever the students spend their 5 years of education at either government or private sector; the final product of the dyads is essentially the same. Another argument lies on the student population entering medical school with backgrounds of Pakistani education system (HSC), British (A-Level) and a combination of both with performances in medical college examinations in various years.

Now what leads to an idealistic interest in public service? The heterogeneous foundation of this anticipation ranges from to living the family legacies, intimate contact with the suffering, to set them apart from the common run, or simply, going with the flow. Doctor is one of the most common career choices yet a small percentage enters medical school. Some students abandon medicine because they are told they lack talent; others because they cannot endure the panorama of seven to nine years of education. There are more of others, because they are lured in to multiple academic interests and still others-a significant group – ‘I don’t think I am among them’.

In the course of the social contract, the medical student is less likely to be aware of his own feelings. A decrease in empathic concern including feeling less humanistic and balancing personal life with professional is my personal experience and concern as well. Thereby, despite the potentially serious consequences of a burnout, few interventions exist to combat this problem. Assuming a more partial authority, confronting various aspects of the human condition daily, experiencing substantial vagueness to prevent errors, difficulties in fitting in with the social norms and expectations of the dominant culture of a medical school etc. are only a few glitches a student is challenged with.

Just when our attempts to retain human sensitivity in the modern world weren’t ample, the abuse rooted in medical education took its toll. Despite numerous declarations by the academics, it has shown little amelioration. Therefore, both personal and professional factors appear to contribute to student burnout. Seen from this point of view, this fact should be a subject of research and recognition by medical schools, so they can channel their energies and practice in order to prepare the student for the psychological and physical hazards of his vocation in effort to strengthen students’ sensitivity and social responsibility.

Young students who readily embrace “The Social Contract” experience high levels of pressure during education and training years. The pressure ranges from the large body of clinical knowledge to master and absenteeism, increased competition and demands, inadequate support of health professionals and professional misconduct, financial indebtedness, cultural and minority issues, scarcity of leisure time, poor-self-care etc. This may leave students feeling emotionally exhausted and contemptuous.
So the next Nobel should go to the genius who can perform this crucial housekeeping of our brains – removing the totally useless so there’s room for totally useful; the Medical Schools. Medical schools must train aspiring students to evaluate their personal health and determine its influence on their practice. Another important assessment is support groups for students challenged with personal or professional life events and increase in the humanistic approach in the work force.

Furthermore, medicine’s Social Contract is the profession which receives a variety of public support; thereby schools now encourage their students to complete service work either voluntary or elective. Nevertheless, such a reflective practice may make this kind of learning more fruitful and stable. Thereby, the schools have double function aiming at technical competence and strengthening mental performance.

I think the weighing of the centuries (and the burden of the world) is not upon the old and the ageing. Not if you are a Pakistani Medical Student!

iDoctor

Are you ready to clean up your system? Refresh the nerves, look up your dreams and insert…insert what? Seems that a technophobe student like myself have run out of computer language to continue on my health perspective. In this digital age, I was subscribing to classics like The House of God on my iPhone, casting no less than a 100 songs on my playlist, placing an order at eBay, making online reservations and responding to emails.

From seminar to webinar, episode to webisode, editorial to webitorial and now even webcitations, everyone and anyone can now access the reality of the virtually unreal world from kids to mums and now Doctors. This avenue can take up two paths and I have my reasons to approve and disapprove the use of social media to promote healthcare.

iSupport:

Education and Awareness:

Initially, the primary sources of health information were the doctors. However, using a familiar easy to use interface, patients can have expansive access to quality information; acquiring complete control of their health and lifestyle. Closed communities, as well as open like Twitter and other more public communities, can serve as discussion avenues and learning opportunities. Visitors and registered patients can have full access to the corresponding website and consulting doctor’s portal in order to seek additional information, update health status and follow up in order to ensure privacy and limit misuse of information and identity. Numerous hospitals and famous doctors e.g. Dr Mehmet Oz and the famous reality TV series – The Doctors are experimenting on how to build trust and promote participation in online platforms. Patients can disclose their stories on YouTube and write testimonials on discussion forums to benefit audiences from both parties.

Web-based communication tools will likely enhance e-patient and e-student/doctor education and promote involvement in ways that alter traditional health care interaction and teaching. A variety of complicated surgical procedures and medical interventions previously reputed as “hard to digest” are now easily available as a step-by-step outline stocked with audio/visual enhancements thereby students and young doctors find it easier to adopt and apply to their own practices, leading to enhanced levels of participatory medicine. Doctors can also update regarding details on hospitals/clinics, special cases, drug/instrument retail, educational and exam kits etc. Similarly, webinars, are now being conducted for e-patients and welcome aspiring students and young medical graduates which can be paid/free and are popularized via social marketing for maximum exposure.

The HIVE (Health Innovation Exchange) has been developed as a way to encourage uptake of social media tools by students to support their education at the University of Auckland, New Zealand. A similar interpretation, “mEducator” project is an EU funded initiative of 14 organizations that attempts to establish “best practice” towards the sharing of medical educational.

Communication and Discussion:
Establishment of doctor to patient and doctor to doctor communication via social networking can open doors to new advancements and alleviate some existing problems. Doctors value their relationship with their patients, however are limited by a variety of factors. Non availability, inaccessibly, lack of self-care and education, fragmented follow ups or even consent. Doctors can send instant messages and allow video chats with patients as much as possible. They also can be made available on Facebook/twitter owing to their popularity and a large number of registered users. The synchronous activity can increase availability and access, share information, enable immediate diagnosis and prompt treatment. This facilitates patient empowerment and establishes a friendly relationship with the health care professionals.

Also, the doctors can communicate and share knowledge among themselves in online discussion platforms and the transfer of information can take the shape of any interactive web-based media; especially online videos. Patients can also share and access personalized medical information among themselves and family/peers challenged with similar health problems can benefit from experienced patients via ratings thereby reducing health literacy difficulties.

Feedback, Personal Establishment and Healthcare Marketing:
Web-enabled media require additional research to assess their impact. Social media applications provide convenient web-based interactive communication tools that may promote dialogue between health educators and e-patients. Portals such as Facebook, twitter, LinkedIn, Google Buzz and Foursquare are some of the most followed and sponsored.

The founder of an interactive feedback tool – eyecareScore, Dr. Krefman, is a survey tool known to measure, understand and improve patient feedback. Blogs are a web-based, text-heavy format. Typical blog content on the websites contains health communication messages from medical experts and personal stories from patients. Another hit series are Mobile applications which support health information and messages in a wireless format available through mobile devices like smartphone like iPhone/HTC/Samsung series and web-based tablets such as the iPad/HP/Samsung. Applications include exercises, symptom checkers including Blood Pressure and sugar monitoring, Diet charts, quick drug information, Emergency Dos and Don’ts etc.

Hospitals and doctors may use social media for marketing and public relations attracting both the targets – new patients and recruit physicians. Social media is the most cost effective way to promote a message. It can provide a unique opportunity to position and market brand, add value, differentiate practice from the competitors and benefit health programs. For e.g. Social marketing initiated to de-stigmatize addictions, breast cancer awareness campaigns, eating disorders, health problems of Pakistan like Polio Eradication scheme, Family Planning strategies and Malaria vector control programs were good starters for Pakistan.

iObject:

With several forces converging in the health market to include more digital media, my problems with the social setting are the Privacy Issues, the notion of Consent and Medical Etiquette.

Doctors with bad social media etiquette can indulge in inappropriate patient communication online. Ethics may prevent many physicians from engaging their own patients directly; but they can still serve as teachers to offer assistance. In some hospitals, doctors are being cautioned to avoid interacting with patients on social media; they might try to “friend” you so we suggest you don’t “accept”.  Perhaps they can interact in a professional context and avoid doing so on personal social-media sites; or still they can set up separate professional and private accounts. Later, conveniently, we will be hunted down for another doctor dilemma of handling passwords. “How it’s easier to remember a silly jingle from a commercial and beauty products from childhood but have to go through an entire set of complicated calculations to arrive at a password!”

Technology can threaten patients’ privacy and even their own pocketbooks. A new breed of doctors are identifying medical cases, chasing disease drifts, advertising health campaigns and assessing screening methods via web-generated medical tools. Some doctors are entitled to answer medical questions and voice their opinions via social media, triggering privacy concerns since online anonymity is never guaranteed. Many individuals are not open to talk about their personal sufferings to which accidental revelation might threaten their social and personal lives. For example, breast cancer, HIV, Hepatitis, Legitimacy affairs, or other embarrassing skin diseases. Online interaction undoubtedly limits doctor’s access to important information. Thereby personal questions should still be handled through doctor’s office visits or phone calls; aiming at restoring patients’ values and subjectivities. Patients connect well with the physician; more satisfied with the care and are more likely to follow the doctor’s advice. So, there is a reason why doctors flash lights into your eyes and listen to your breath during an office visit.
Protecting patient confidentiality is important and the standards of behavior and respect for e-patients which are expected from doctors should be observed online; that can’t be on LinkedIn and Facebooked for patient privacy reasons! Consent to publish/share patient information like laboratory tests, photographs and other online confessions can meet public regard thereby defeating the purpose of security and respect. Why are public lashes, medical sufferings and grim images of war of the worlds receiving widespread “likes”?

The open nature that makes social media appealing increases concerns for healthcare organizations.  Social media guidelines application should be made more universal supplemented with stiff penalties. American Medical Association recently released guidance to physicians using social media in their document “Professionalism in the Use of Social Media”

I wonder at times, whether the generated revenue conveniently be spent on a loaf of bread, or an hour of internet…That being said, I think there’s a need for me to be at the hospital!