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Saturday, October 17, 2015

The report card of the millennium

A few weeks ago, on September 25 2015, the world sat down and reviewed its 15-year performance report. This was done with some fanfare, not in the least because the coolest pope in history attended, but the discussion did not receive as much attention as it deserves. Shouldn't the world be talking about this more? How did we do on the promises we had made? Did we meet our targets, did we miss them by a whisker or a mile? The discussions emerging from the UN Sustainable Development summit remind me of the days when I was part of one of the most organised workplaces possible - a consulting company. The same wordy discourses on strengths and 'development needs' which, if someone wanted to simplify them, could be said like this: There are three things you did well last year. There are four things you absolute suck at and you need to get better at them fast if you want to survive. Get to it. And this is how I'd like to simplify the world's 15-year report card:

In September 2000, the world's leaders got together and adopted the "Millennium Development Goals", also called the MDGs, which were time-bound, quantified targets to address the inequity and injustice in the world. There were 8 goals in total, each broken down into targets and indicators. For example, the slightly lofty-sounding Goal 1 -"To Eradicate Extreme Hunger and Poverty", had two targets and five indicators:

Indicators (World Bank ratios):
1. Proportion of population below $1 (1993 PPP) per day
2. Poverty gap ratio [incidence x depth of poverty]
3. Share of poorest quintile in national consumption

Target 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger.
Indicators (UNICEF, WHO and FAO ratios:
4. Prevalence of underweight children under five years of age
5. Proportion of population below minimum level of dietary energy consumption

...and so on for the remaining 7 goals. This internationally agreed framework of 8 goals, complemented by 18 targets and 48 technical indicators was going to address poverty, hunger, disease, lack of adequate shelter, and exclusion-while promoting gender equality, education, and environmental sustainability. They included basic human rights-the rights of each person on the planet to health, education, shelter, and security.

Cut to September 2015, and to my original question: how did we do? We did well in some goals, messed up others. While the proportion of people living under $1.25 PPP a day is lower than it was, the proportion of women dying in childbirth remains unacceptably high and 6 million children are still dying before reaching their fifth birthday. As the MDG dream drew its last breath, it gave birth to MDG 2.0, with bigger and more numerous arms and legs. The SDGs (Sustainable Development Goals) are 17 goals with 169 targets. They are more ambitious and they have greater world consensus. We're now going to have NO ONE living under $1.25 a day by the time we arrive in 2030, we're going to have no one dying of AIDS, and we're going to do all this while taking care of the planet.

The infographic below summarizes our performance on the first six MDGs and their evolution into the first five SDGs.

Next: MDGs 7 and 8 and SDGs 6 through 17.

Sunday, June 21, 2015

A "healthy" lifestyle is a moving target

A couple of weeks ago I stumbled into the keto* jungle: read dozens of scientific papers for and against, wolfed through a hundred threads on Reddit, and decided I was ready. Ten days into the diet, still unsure about how good an idea it has been, I read that Audrey Hepburn lived a long and productive while indulging a pasta obsession - two big plates of spaghetti and ketchup every day. That is probably 200 grams of carbs daily (Keto-ers stay under 20)! Gah, what if carbs aren’t the enemy? I worry that my goal to be fit enough to run half marathons into my dotage is a chimera.It is dependent on many sub-goals, all of which keep shifting. I have nightmares about a wise, handsome physician shaking his head over 70-year old me, saying – lady, if only you had taken more care in your 30s, your bones might have been healthier! Sigh.

In general, this generation is believed to be the healthiest that humans have ever been. And yet, there is so much to worry about. We’re living longer, more active lives, but we also get chronic illnesses far earlier.We're more aware, understand diets/exercise regimens better and have the money to indulge in them.  But we’re also more obese, more prone to getting type II diabetes and less likely to be shocked at thirty year olds getting diagnosed with hypertension. The reasons for our doom are also entrenched in our good fortune (we all know what they are, but let me quickly run through them): easy access to processed food, fulfilling careers that leave no time for exercise, wonderful entertainment options which keep us glued to devices. It’s easy to conclude that people who worked with their hands and ate simpler food easily lived healthier lives, and we’re all going to get coronaries in the next decade.

It doesn’t need to be that simple (or that grim): we can use the advantages of this century to win this round too. And here’s when I finally come to the point of the post after all the rambling – how great is it to turn the technology that keeps us sedentary into the very thing that keeps us healthy? Long before my brother gifted me the Fitbit, long before I saw RemedySocial, I have been interested in measuring health indicators. I recently found a diary entry from the year 2000, which lists my weight, blood biochemistry parameters and says that I can run 5 km in 26 minutes. It is amusing, but I don’t need those notebooks anymore. It has become easier to keep track of your health in this decade.

I've recently learned about RemedySocial, a brainchild of Dr. Purav Gandhi and team, who have developed an algorithm to assess a person's risk of contracting 14 major diseases through an online assessment. The platform gives you a score, compares it to others with similar demographics, and gives you advice on the specific health indicators you should start tracking. He puts it well: “Our health is undeniably a downward curve, but we can change its slope! We can make the curve flatter by making early interventions. Good genes don’t last forever.” I took the assessment which took slightly longer the promised five minutes, but I was expecting that. The detailed report that came through was impressive. My short term wellness scores were good (yayy!) but my long term health risk scores were, well, interesting. I might have underestimated the health risks that I face given my life style choices and family history. The platform suggested targeted lab tests and health tips that I needed to follow – just the food that my data obsessed brain needs.

I’m suddenly noticing a spate of health-related apps; what this one does may not be unique. But I’m happy to recommend them because their approach is fresh and fun, and I was amazed at the sheer number of insights the algorithm was able to extract. It doesn’t matter what health tracker you use, as long as you use one.While I continue to think that perfect health will remain a moving target, it might not a bad idea for us to keep moving in its general direction, to be more aware of our own bodies, and to take control of how healthy our own future selves will be.

Disclaimer: Dr. Purav Gandhi, the founder of RemedySocial, is an ex-colleague and a friend, and this blogpost is partly motivated by my hope to make his venture better known. All the views above, however, are my own.

*Keto is a diet philosophy that says the human body functions more efficiently if it uses fats rather than carbs as primary fuel, but that’s all I’m saying. More on keto in another post

Sunday, May 10, 2015

Ladder of Years

I stumbled upon an amazing book this weekend: Anne Tyler’s Ladder of Years. It’s the story about a forty-something woman who abandons her seemingly well-ordered family life without a clear plan (or even a very clear reason) and finds some great adventures in the process of finding herself. It starts out as a typical - but still interesting - coming-of-age novel, from the point of view of a woman who has spent her life being a homemaker-receptionist for a successful doctor husband. The husband treats her with a mixture of vague disinterest and mild condescension, and you find yourself rooting for her when she walks out of a family vacation on the beach, even as you suspect that there is more to the story than meets the eye. I love this style of fiction - when the narrator is a part of the story, and is hiding critical character flaws, showing people through a less than objective lens, until you learn to see through the clever sleight of hand, and are able to say with glee - Aha! So things aren't really what they seem! Zoe Heller did it in Notes on a Scandal - another book that I read this month with an equal mixture of amazement and unease.

But Ladder of Years is more than just a clever book. It is a winner because of the empathy you feel for the people in the book. It has been a long time since I've had the reaction that I did two hours into this book: I looked down at the progress bar and noticed that I had already finished 30% of the book, and groaned aloud - "Oh no! I was so hoping it was going to be a longer book!" I knew I was going to miss Delia when she starts to walk to the town's small library at five pm every evening to take exactly one book to read in bed. She's very worried the day she realizes that the large font of that day's book would mean that it would not last her till her bedtime; and so she consciously slows down in her reading, and decides to notice the people in the restaurant that she has been eating at for the past several weeks.

I don't want to give anything away; let me just say that the book is full of moments and people that stay with you long after you've sighed over the last page. And I know I will read this book again, more than a few times. But first I'm going to read every Anne Tyler that I can lay my hand on. By a minor coincidence, I read her Noah's Compass last week, and loved that one too. 

Sunday, January 18, 2015

A non-confrontational life

It has been a difficult week. Raif Badawi is getting flogged for creating a website. A lot of loved people are extremely upset about the world's position on free speech and expression. Poor Pope Francis, who I've long admired, is getting a lot of flak for saying that it is important to respect people's religious sentiments, and freedom of speech is not an excuse to be hurtful. My problem, and the reason why this week has been tough, is that I see both points of view. I dream of a world where people can make fun of anyone's favorite religion, country or football team without being killed for it. But I also find myself siding with the Pope; I worry that absolute free speech leads to hate crimes, and I would like freedom of speech to be tempered with generosity, respect and acceptance. But the toughest part of this week is the realization that I do not like long arguments. About anything.

Let’s say we were discussing the two sides in another famous argument: what is more satisfying as a reader - printed books vs books on e-readers? Let's say you take the former side, and I'll take the latter. You would say that the sensory experience of reading the book is as important as the intellectual. The way the paper rustles against your fingers, the smell of the book, the sound of the turning page - there's no way you want to give these up. And I would say that for me, the act of reading is simply a way of communicating with the mind of the writer, and I absolutely do not care about the medium. Whether I'm reading from a phone screen or the paper bag that groceries came in, my pleasure is dependent solely on the content. Sometimes when I read off my tablet in bright daylight, I have to cup my fingers around the screen to cut the light off; even that does not bother me if what I'm reading is interesting. In addition, I enjoy not having to carry books when I'm traveling, and the fact that I'm destroying fewer trees now than when I bought paper books. At this point, you would say that choosing e-readers over real books is impure love, and it's a little like choosing to eat instant noodles over a gourmet meal. This comparison will sadden me, but I will not respond. Not because I don't have interesting metaphors, or because I don't care enough to continue my conversation with you, but because this is about as much debate as I like, and I want to go back to reading or daydreaming. My favorite debate would be about 8 minutes long - let's define our positions, offer two sharp points each, get convinced to the other side or not, but admire each other's brilliant points, and end charmingly, fully respecting each other's right to stay with his point of view.

Is this is cowardly? Maybe. Will people like me never contribute to changing the world? If Martin Luther King, Mahatma Gandhi, and Dr. Nelson Mandela were non-confrontational, would the world be the wonderful place it is? Maybe not. I did some research just now, and learned that the longest debate in the US senate's history took place in 1964, and lasted 57 days "including six Saturdays". Thinking about this exhausts me. What was the debate about? The Civil Rights Act, which aimed to end racial discrimination and segregation in public accommodations, public education and federally assisted programs. So yes, I get it that debates are important; they clearly change the world for the better.

But perhaps, the world also needs people like me, who will teach by example, participate in change-making, do the honest and the brave thing every time it needs to be done, without engaging in a 5 hour discussion about it.

Just like I prefer e-readers, I also prefer a non-confrontational life. And I would like the world to respect this, just like I respect the world's need to debate. So please continue to talk, but please be okay if I walk away.

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