GEN, SC, ST, or OBC?

Recently, a very special friend of mine politely undressed me regarding my nonchalant viewpoint on the use of labels and titles. It isn't so much that I flippantly apply such distinctions to people, or groups of people for that matter, but rather that I simply don't think much about them. I believe the luxury that I have never had to ponder over them much is due primarily to the place in society that I was born into -- that of a middle-class white male.

"Semantics are vital," I was reminded. "The ways we talk about things are the ways in which we create them both within us and in the world. If we walk around being uncareful of our language, we reinforce and support problematic political and social discourses."

As work has been a bit slow lately, I've been investing more time in chai breaks and in discussions with my coworkers. After more than two years in rural Guatemala conversing on little more than agriculture and sex, I find the dialogue here to be inimitably more refreshing. Being at an institute of higher learning, topics of the more intellectual variety are regularly fostered, such as history, culture, science, and politics (Side note: we do not speak much of agriculture here, but sex talk is fair game and quite common).

I stopped in with one of the senior researchers to chat about the various malaria studies currently in progress in the area. He detailed the rationales behind the studies; the studies' objectives; the field site locations and characteristics; the methods of data collection and analysis; and the target populations. He referred a bit to the plethora of tribal people around here and then threw out the word "backward". I assumed his employment of the word was similar to the fashion in which it is cavalierly tossed around in the US: as a descriptor, a pejorative fashion of portraying a group that was, in his mind, lacking in social and/or cultural advancement and achievement.

As he repeated it a few more times, I motioned for him to pause, “Did you say backward?" I asked.

"Yes... The backward castes."

"Achcha (I see)... So which castes are the backward castes?"

"That is it. The backward castes. Other backward castes."

To him I replied, "Achcha" and to myself I thought, "What a dick jerk!"

It is important to note that his (or the prevalent Indian) use of the word 'backward' is not necessarily the same as ours. Regardless, I still felt a bit uncomfortable and shortly thereafter excused myself.

About a week later, I was perusing some of the questionnaires used in local malaria studies to see what information was being solicited. Date. Participant ID number. Name. Age. Caste/Tribe. Under caste/tribe, there were a few options for boxes to check: SC, GEN, ST, and OBC. I approached one of my friends here and inquired as to what each of the abbreviations represented.

GEN = General Castes

SC = Scheduled Castes

ST = Scheduled Tribes

OBC = Other Backward Castes

"Is 'Other Backward Caste' a term that you just use here or is it widely accepted in India?" I asked.

Her response was startling: "Mandate 340 of the Constitution."

The caste system in India is believed to be some 3,000 years old. The ancient Hindu society was initially divided into four exhaustive, mutually exclusive, hereditary, endogamous (in-marrying), and occupation-specific Varnas (translated into English as caste via the Portuguese word casta which means breed or race).

According to the Vedas (Hindu scripture), the progenitors of the four castes sprang from various parts of the body of the primordial man -- he who was created by Lord Brahma from clay. Brahmans (priests) originated from the mouth to provide for the intellectual and spiritual needs of the community. The Kshatriyas (warriors) were forged from the arms to bestow protection. Vaishyas (merchants and landowners) sprang from the thighs and were entrusted with the care of agriculture and commerce. The feet gave rise to the Shudras (artisans and servants), who were entrusted with the care of all manual labor. Conceptualized later was a fifth category, the Ati Shudras or Untouchables, unto whom was bequeathed all menial and polluting work related to bodily decay and dirt.

As the economy became more complex, the varna system morphed into the jati system, with jatis sharing the same basic characteristics as the varnas. The difference in the systems is that jatis are not exact subsets of varnas; and there has also been considerable regional variation in the evolution of specific jatis. Thus, a jati may be considered "backward" in one state but not in another.

Caste divisions are not as dichotomous as they may appear, but the distinctions are simplified by the nature of the available data.

The general castes (GEN) are comprised of those that belonged to the three highest classes in the varna system: Brahmans, Kshatriyas, and Vaishyas.

The scheduled tribes (STs), that make up around 7-8% of the population, are socially and economically marginalized tribal people known throughout India as Adivasi.

The scheduled castes (SCs) are those formerly categorized as untouchables and are composed of 16-17% of India’s population.

The other backward castes (OBCs) form a very large and heterogeneous category (~30% of the population) and are remarkably close to SCs in terms of social and economic "backwardness". Hence, the distance between the SCs and OBCs only manages to understate the chasm between the top and bottom tiers of the caste hierarchy.

Although there are laws banning caste-based discrimination, violence habitually occurs across the country. It must also be noted, that not all forms of violence are obvious or overt. For example, land is owned almost exclusively by members of the dominant castes which allows them to economically exploit lower-ranking laborers and artisans.

In recognition of caste-based inequalities, the Indian government initiated affirmative action as a remedial measure. Every state now has a quota for the SCs and STs that implies reserving 22.5% of seats in the legislature, government-sponsored educational institutions, and public sector jobs. The present-day quotas do not offer opportunities for those belonging to an OBC.

Recently, the government declared its desire to set aside an additional 27% for OBC members as well as a few other disadvantaged groups. The announcement led to widespread backlash from many higher caste Hindus, especially those attempting to matriculate into the Indian Institutes of Technologies (IITs). Graduates of these prestigious engineering colleges have, in recent years, flooded Silicon Valley and triggered India's information technology boom.

I have tried my best to get first-hand information regarding the caste system, but many Indians are loathe to speak of it.

A couple of days ago, I mentioned to some colleagues here that I imagined that lower caste members here were poorer and suffered from worse health outcomes. Some very effortlessly agreed. Others nodded a bit more begrudgingly. A third contingency excitedly stated that it used to be like that but wasn't any longer, and then made it clear that the conversation had reached its end.

Tensions have greatly increased recently due to the proposed quota increase. The blogosphere offers a taste of some voices that may not be suitable for an even-keeled discussion.

A sample:

"I look around me and all I see angry voices protesting, dissents, strikes, suffering of services, all of which tarnishes the image of the India I would like to belong to, one where I am who I made myself into and not what I was born as!"

Another:

"I am, in no way a snob or elitist. I have friends from all walks of life, colleagues who may or may not be an OBC/SC/ST, teachers who I admire and respect for their wisdom rather than where they came from, neighbors with whom I share festivals and events and meals with no thought spared to ‘Are they the same caste as me?’... I honestly couldn’t care less what caste you belong to!" (Editor's note: What caste do you think he belongs to?).

My turn:

I think it safe to say that if you deserve something based on your skills, abilities, and talents, then you should get it. The problem with that, however, is that too many people have been marginalized for too long so that the playing field is no longer equal.

Those in power and those who continue to make up the privileged sections of the country's society have inhibited the empowerment process by denying education and knowledge to the lower castes.

It ain't black and white, though it kind of is. Sound familiar, America?

Data Has a Face? / Detachment

Epidemiology is somewhat of a new field, so definitions of the field itself, quite like the many terms that fall under it, vary widely. One definition from an unknown source (e.g. the depths of my own imagination) is: the collection and analysis of information concerning the distribution and determinants of disease in populations.

When someone in the U.S. initiates a conversation with that oh-so-American inquiry of "What do you do?", I often simply reply that I am an epidemiologist. The most common response is a furrowing of the brow or the question as to whether or not I study skin. If we both choose to pursue the topic further, it is usually not too difficult to convey the concept of health-related data collection, organization, and analysis.

In India, I find the potential for a disconnect to be much greater. Due to limited Hindi and/or English skills, the typical response is a rolled up pant leg or shirt sleeve to expose a previously unfathomable, oft-bearded growth on the surface of the skin. I never utter the word 'epidemiology' in my description, so there is no comparable employment of the 'Latin root' trick. I think it begs more to my inability to provide any valid, understandable descriptors that paint me as anything other than a physician.

I remember in high school, and again during the beginning of my undergraduate studies at the University of Michigan, the desire I had to be a physician. Looking back (I mean now, here, from this particular juncture in time, able to be utterly objective and overly courageous thanks to the miracle of modern narrative technique), I see my folly quite clearly. It was never a tangible desire, but rather just an ideal or, even better yet, just a word. It was a standard, a paradigm to measure myself against, something that served, albeit unsuccessfully, as a means of motivation.

Yet now -- ten years removed from my aforementioned folly -- more than at any other point in my life, I feel that desire more genuinely. Hindsight aside, I don't regret any decisions I have made to place me where I am today. I enjoy the life that I lead now and, more importantly, I am pleased with who I have become. I don't feel as though something in my life has gone unfulfilled. I think it merely a product of moments like this, spending hours staring at data on a computer screen and wishing that numbers had a face.

You can look at morbidity and mortality figures and say that they correspond to real people with real problems, real lives, and real faces. Perhaps it is my way of processing things, but I need to see the affected people to help me bridge the disconnect, for the numbers to shed their inanimate status and transform into real life flesh and blood.

I have not a clue what attracted me to medicine in my youth, but I see now why I find it appealing. Simple human contact is one reason, but I think more importantly still, is the ability to interact face-to-face with the people that you strive to assist. Public health can provide you with that, but the possibility of detachment is real and, to me, a bit frightening. Regardless of whether or not you work in the field of business, health, or whatever, having your client in front of you allows you to minimize that likelihood.

I honestly know -- and know well -- that I do not want to invest the amount of time and energy required for me to become a doctor. I also recognize that I have a difficult time laboring at an occupation that does not foster contact with the people that my work aims to benefit.

Show me the faces of some sick people once in a while and my work as a public health professional will seem a lot more real.

(Update: October 2nd to Ranchi. No more data analysis = Real live people)

Tabula Rasa

It didn't take me long to realize that people here are accustomed to that which I find enchanting. It's probably akin to the sensation, or lack thereof, that a New Yorker has when walking the streets of New York. After years of coexisting with the steel and concrete behemoths that surround them, it's easy to forget they are actually still there. They just are, and you go on with your life without paying them much mind. Clearly there are people that will never cease to be in awe of their surroundings but, for argument's sake, let's leave it at that.

For the past five weeks I have been living on an island of sorts, a figurative one: a lush green campus on the outskirts of a bustling town of a million. In this respect, one could say that I'm not as of yet getting the full living-in-India experience. I do eat curry at least twice a day and drink copious amounts of chai. I speak a bit of Hindi. I watch cricket matches and Bollywood movies. I try my best to use Celsius. However, as I do not live in the center of town, the area in which I usually find myself is actually quite peaceful. Street noise and pollution are virtually nonexistent; what reigns supreme here is nature.

On the expansive grounds of the campus, there are packs of rather hilarious cackling birds that swarm in gangs of ten or so; squirrel-chipmunk hybrids ("squirmunks" as I call them) that paradoxically propel themselves faster as the morning air thickens; swallows and bats that take to the predusk sky in droves; crabs to distract -- or dissuade -- you from strolling the dimly lit footpaths in the evening; and stray dogs that hover near street lights and swat massive bugs out of the air for nighttime snacks.

In the building in which I work, sparrows fly up and down the hallways and staircases; lizards cruise the walls and windows; a family of owls inhabits a small nook just below the roof, directly above the main entrance -- if you're lucky, which I once was (although everyone here told me I was actually unlucky), you can witness them hunting. Despite the fact that I have yet to see one, a monkey has been known to visit work and dangle outside the windows of one of the laboratories.

I live in a small three-room flat located in the workers' quarters of the malaria institute's campus that I share with T.P. (yes, that's a nickname -- for Tej Pratap), a PhD student working on a malaria vaccine project (Side note: the use of the abbreviation, T.P., as it is employed in the U.S. is probably about as common in India as the use of actual T.P. itself). I don't share my bedroom with T.P., but I have been cohabiting with a small gecko that lives on one of my shelves, seemingly guarding my books and toiletries from any six- or eight-legged ruffians; and a trail of mini sugar ants that daily snake in through one window and depart via another, starting at around 5am and abating at almost midnight.

About a week ago, I woke up at nearly 6am and could not fall back asleep. It may have been a consequence of the extraordinarily small bed that I sleep in, one that forces me to lay diagonally yet still fails to provide ample space for my feet. Perhaps it was a product of me watching the flow of mini-ants approach its typical dawn-time viscosity. Either way, I eventually stood up and peered out the window. Like so many other natural phenomenon that I live amongst here, what I beheld was not something I regularly came across in the States. It was hardly unrecognizable; I mean, anybody that has spent more than fifteen minutes on a college campus knew what that was.

When he eventually got up, I said to my flatmate, T.P.:

"You see all these plants?

Just like the times that I excitedly pointed out the cackling birds, and the crabs, and the little ants, and anything else that seemed remotely interesting, he shrugged and nonchalantly replied that he did, in fact, see the plants.

Sometimes I can't tell if he's disinterested, moody, or just plain ornery, so I tried a different tack.


"You know in America, this is illegal."

"Here too, is legal," he returned.

I turned the volume up a bit: "No. Illegal... Not legal."

"Oh," he half-grunted.

Several years back, I entered a kitchen in Nepal and was surprised to see the dried form of this plant in a rather large pile on the table. When I inquired about it, I was informed that it was fed to goats when they had a "bad stomach". At the time, my Nepali was incapable of eliciting from anyone how to tell when the animals were actually suffering. I probably would have pursued the issue further if I hadn't been distracted by trying to figure out how to subtly convey in Nepali that my stomach was feeling a little off.

I continued with T.P.: "This is what sadhus smoke," referring to the orange-bedecked men that wander India barefoot from one holy site to another.

"Oh," he replied again, disinterestedly, "Ganja."

Yes, T.P.... Ganja. I suppose I too would think nothing of it if I grew up with weed in my backyard. Fact is though, I didn't.

No way his lack of enthusiasm was going to dampen my mood. I immediately swore to myself that I would write to all my friends and tell them about it.

And then I did.

The Essence of जुगार

One of the first words I learned in Hindi was जुगार (jew-gaar). At the time, I was cruising around in an auto-rickshaw in Delhi with my new friend, Tariq, beside me. I can't recall how it came up, be he kept saying "जुगार". As I'm not one to disappoint in the hilarity department, even (see: especially) if I have no clue what's going on, I continued to repeat it and he continued to laugh.

Signaling to Gupta, our driver, I bellowed: "Hey Gupta... जुगार."

And we all laughed, though only some of us understood why.

Now, three weeks later, जुगार has resurfaced. This time, everyone gets it.

Take a quick glance over to the right of this text and behold a brand new Rio Karma MP3 player. That is precisely what mine looked like approximately eighteen months ago when it first arrived on my doorstep. Trusty as it proved for the first sixteen of those months, about two months back it began to develop a foul temper. The power button gradually lost its effectiveness, encouraging me to push harder and harder on it each time I needed to turn the player on or off. As much as I coddled it and made disparaging remarks about iPods, its condition continued to deteriorate. A week ago, it failed to power on altogether.

During the week that followed, I continually vowed to fix it, though those thoughts were often tempered by the realization that maybe it was done for.

Eventually, lacking any palpable idea of what I would do should I actually get it open, I went in search of a mini-Phillips head screwdriver. My initial quest, into the IT department here at work, produced only a single slotted tip screwdriver which was undoubtedly too big. One of the computer technicians was insistent that we could make it work with the slotted option. I let him have at it until I noticed the screw getting stripped. Somewhat dejected, I resigned to look again another day.

A second tech then nodded toward a drawer and said: "जुगार".

A third opened it and produced a rather flimsy-looking exacto knife.

A fourth gestured for me to surrender the Rio.

A fifth removed the three tiny screws with the exacto.

The fifth, Tiwari, then separated the machine in two. Catching our first glimpse of the innards, the power button tumbled out on to the table. We -- Tiwari with me watching over his shoulder -- attempted various methods to slide, urge, and simply force the button back in place with no success; the machine would not turn on. He finally asked that I entrust the player to him over night and I gladly acquiesced.

The following day he returned to the office with a soldering kit and wires of distinct colors and sizes. I hovered over him during various stretches of the morning, hoping to witness the reawakening, to see the LCD display flicker anew. Several times while working, he held up the exacto and exclaimed: "This... is जुगार," and whoever was present laughed. Oh yeah, totally... Wait. What?

The beginning of the afternoon was highlighted by a few unsubstantiated "Eureka" moments, with assorted techs awakening me from data work to see the progress. At almost 5pm, about a half hour before closing time, I was summoned by Tiwari himself. He could not suppress his grin.

Before I had even finished opening the door to his office, he burst out: "Now this is जुगार!" and presented me with my Rio.

It looked quite a bit like my old Rio, except for a double-tipped wire that protruded from where the power button once lay; it was affixed to the outside of the machine with scotch tape.


It reminded me of a conversation I had with someone almost two years ago in Havana. When I mentioned how shocked I was that cars there were still running, he replied: "Sometimes we need a brake pad, so we bend some scrap metal and use that. It's not an ideal solution, but it's what we have."

Though probably not as inescapable a situation as what a Cuban car mechanic faces where parts are simply unavailable, there's a certain amount of improvisation here in India that we just don't regularly see in the U.S.

It is precisely that tendency to get more use out of things that is so impressive; it is that ability to improvise that is जुगार.

So what do I do now?" I asked.

Tiwari took the player from me and touched the tips of the wires together. The display lit right up.

I thanked him profusely and he responded with a head wobble. A few minutes later, I headed for the door.

"You know that wire?" he asked.

Before I could hazard a guess, he continued: "It's a phone cord."

Data Analysis & The Mahabharata

We quickly blow through introductions, sit down, and begin to stare around the room. He picks up the phone, says something in Hindi, hangs up the receiver, and proceeds to pick his teeth with a sewing pin. A strange silence ensues. A minute or so later, the actions are repeated: Phone, Hindi, pin, silence. And then again. The only variation I notice, is that with each ensuing phone call his voice grows successively louder. I try a few times to interrupt the awkwardness with questions pertaining to his data, but he doesn't seem interested.

As time passes, the awkwardness morphs into a confusion that borders on discomfort. Just as I am considering the possibility of excusing myself, the door opens.

“I hear you like coffee,” he offers. “And I ask them make it strong.”

I struggle to think of a better way to dispose of the silence than the proposition of satisfying my three-week long coffee fix.

“Theek hai. Theek hai.” (is good), I reply, wishing that my Hindi brain would allow me to dispense a superlative to properly articulate my gratitude.

Within two minutes he finishes his drink. I hasten to follow suit.

He moves over toward his computer and pulls up a chair along side where I then seat myself. He proceeds to open up Excel file after Excel file -- a veritable treasure trove of malaria data –- wasting little time explaining the plethora of letters and numbers flashing before our eyes. A good ten minutes later, he leans back in his chair, sighs, and smiles.

“I do not boast. I am very good researcher. But... but now I have these numbers and I do not know what to do.”

I spent the majority of that afternoon, and many that have followed, helping Gyand Chen familiarize himself with the world of statistics. Our working relationship has developed into a pattern: I expound on the appropriate statistical tests to use, employment of them with various statistical packages, and the interpretation of the outputs; and he feeds me copious amounts of “coffee” (see: Nescafe) and illuminates interesting facts and facets of Indian history and culture.

Toward the end of our third session together, he asks me if I know Arjun. I furrow my brow a bit and run through a full catalog of new faces in my head. I had met so many people in the last few weeks and I was sure one of them must have been the Arjun of whom he spoke. I replied that I wasn’t sure.

“You are like Arjun…” he begins.

“Dhritarashter and Pandu were brothers. Dhritarashter was born blind and although he was the elder, he was compelled to forfeit his claim to the throne on account of his physical defect; Pandu thus became king. Whereas Dhritarashter married Gandhari, Pandu selected two wives -- Kunti and Madri. Gandhari was so devoted to her husband that she bandaged her eyes and chose to remain voluntarily blind for life. She became the mother of the Kouravs, 100 in total. Kunti had three sons and Madri two.



”One day while hunting, Pandu accidentally killed the wife of a sage, who became enraged and cursed Pandu that should he ever have relations with a woman, he would die instantly. Pandu renounced his crown for the life of a hermit and went to the jungle with his two wives, Kunti and Madri. One day, Pandu could not resist temptation, had intercourse with Madri, and died. Madri immolated herself and walked into her husband's funeral fire leaving behind her two sons, Nakul and Sahadev, in custody of Kunti with her three sons, Yudhishthir, Bheem, and Arjun. On Pandu's death, Dhritarashter became the king and the five sons of Pandu -- the Pandavs -- grew up in the guardianship of Kunti. The five Pandav princes were educated along with Kourav boys under the patronage of Dhritarashter. They were taught the art of archery as well as various techniques of warfare.

”Yudhishthir, the eldest of the Pandavs, was so righteous that he was anointed with the name Dharamputr. Bheem was a giant in physical strength. Arjun was handsome and the most skilful archer. Dharamputr was the beloved of the people and being the eldest among the 105 princes, was the natural heir to the throne. Duryodhan, the eldest of the Kouravs, however, was jealous of the Pandavs and tried every means to destroy them. When Yudhishthir was proclaimed king, Duryodhan could not sit quiet and watch. Duryodhan hatched numerous plans plan to kill the Pandavs, one of which eventually forced the five brothers, along with their mother, to escape into the jungle. After their departure, they did not return to the palace but instead roamed about in disguise as priests. Everyone, including the Kouravs, believed them to be dead.

”During that time, they heard of the beautiful Swayamvara of Droupadi. The qualification to marry her laid in the extraordinary skill of hitting a moving target with a bow and arrow. Arjun won easily. The spectators, undoubtedly surprised by the bowmanship of the priest, eventually discerned that it was in fact Arjun. The Pandavs were discovered.

“Arjun took his bride to their hut and called to his mother to come and see what he had brought. Instead of doing so, she answered back: ‘My dear children, whatever it may be, share it among yourselves’. Hence, Droupadi became the wife of all five Pandavs.

“The kingdom they received as dowry was divided into two parts. Naturally, the better half was seized by the Kouravs. Still, the Pandavs built a wonderful city in their own half and named it Indraprastha. Duryodhan, watching the increasing prosperity of the Pandavs, could contain his fury no longer. He openly challenged Dharamputr to a game of dice in which the losers would live in the forest for thirteen years without any claim to the kingdom. The last year of their exile was to be spent incognito; should they be discovered, the thirteen year cycle would begin anew. Sakuni, deceit in human form and uncle of the Kouravs, played for them. Inevitably, Dharamputr lost.

”In the thirteenth year of their exile, the Pandavs and Droupadi went to the palace of the king of the Viratas and stayed there as servants. Duryodhan made frantic efforts to discover them and eventually concluded that the Pandavs must be in the Virata country. The Kouravs then attacked the Viratas. The Pandavs took part in the battle, but by the time they were recognized as Pandavs, the time limit of thirteen years had already passed.

“The hundred Kouravs and their supporters were on one side, and the Pandavs and theirs on the other. The armies arrayed themselves for war.

“The Kouravs had devised a formation that only Arjun knew how to defeat. Shortly before the war is to begin, Arjun has second thoughts about his participation and leaves the battlefield. His brothers become disconcerted and are unsure how to proceed…”

“So you see,” Gyand Chan continues. “You are like Arjun.”

I struggle to make the connection and I think he notices.

“You see… I can enter all this data into the computer, but I do not know what to do with it. I can penetrate the formation but then I can not get out. If I can not get out, what happens? We lose the war.”

As I sit back and attempt to draw parallels between data analysis and one of the most famous battles in Indian history, he lifts up the receiver and barks something in Hindi.

A moment later, the door swings open. This time I know what's coming.