Monday, 6 June 2022
Schio's Cosplay Meet
Friday, 20 May 2022
Importance of Alternative Medicine
One of health related channels which I often watch is Medlife Crisis by Dr Rohin Francis from UK. Recently, I came across one of his older videos, which was about "alternative medicine". In this video he had explained about the importance of evidence-based medicine and how this scientific approach ensures that we can truly understand the efficacy of treatments and make rational choices about medicines. The other aspect of his intervention was that alternative medicine lacks this evidence-based approach and thus for him it was mostly hogwash.
Rohin Francis is not the only one who speaks out against wasting money on alternative medicine. Some of my other doctor friends have been very active against quacks and untrained persons masquerading as doctors in India. Some doctors on Twitter regularly rant against homeopathy and alternative medicine practitioners.
I understand from where all these persons are coming from. However, I do not agree with them that alternative medicine is all about non-evidence based quackery. In this post I want to share some personal experiences and some opinions regarding the role of alternative medicine in today's world.
Disclaimer: Quacks & Clowns Peddling Garbage
I know that there are persons who claim to have miracle-powers and who can cure all kinds of conditions. They prey on people when they are most vulnerable and psychologically fragile and they do it to earn money and gain power. Some of these frauds may be mentally ill and may actually believe in their supernatural powers. This post is not about justifying any of them. They do need care and treatment for their delusions and if needed, deserve law-suits and prisons.I also do not wish to say that alternative medicine can cure everything such as conditions like high blood pressure or diabetes or cancer. People who give up their blood pressure or diabetes medicines because of their beliefs in alternative medicine, often end up with irreversible body damage to their vital organs like kidneys or eyes. Conventional (western) medicine is a better choice for most such persons.
Origins of Alternative Medicine
For thousands of years, ancient humans have tried looking for treatments for common health conditions. They did it mainly by looking for plant-based treatments. The plant-based medicines they identified, did not have the backing of double-blind studies on random samples of carefully chosen groups, but to call those "non-evidence based" would be a bit of stretch. Many of our common modern medicines from Aspirin to Quinine and Artemisia come from those traditional experiences. Guys looking for the next blockbuster drugs have often stolen the knowledge of plants and herbs from traditional healers. Scientists carry out experiments with synthetic derivatives based on those same plants and herbs and then do scientific trials to show their effectiveness. Many of them call as quacks the traditional healers in villages who are using those same herbs, simply because they base their knowledge on the oral transmission of experiences and tradional learning.In countries like India, China and Mongolia, people practicing traditional medicine, study in their medical collages just like students studying modern medicine. For example, in Ayurvedic medical collages in India (I have visited 2 of them), students study for their medical degree for 6 years and their curriculum includes all the subjects such as anatomy, physiology, pathology and pharmacology, taught in conventional medical colleges.
However, a part of their studies is based on beliefs which modern science does not accept. For example - the Chinese beliefs about meridians running through the body with the energy points and the balancing of Yin and Yang forces; or the Indian beliefs about the three body humours (vayu, kaffa and pitta); or the homeopathy belief about using "like to counter like" and the power of dilutions of medicines. These beliefs do not fit with the understanding of modern science, because they do not follow the logical-thinking paradigm but follow some other esoteric or intuitive paradigms.
Shaping of Our Beliefs - Personal Experiences
Our beliefs are predominantly shaped by our own life experiences. Scientists say that our experiences are anecdotal evidence and are unreliable and usually biased. So we should only believe in what scientists and experts tell us. However, from personal experience I know that if I have experienced something, I may accept scientific opinions but I will also find a way to keep my own opinion based on my experience, even when the two are contradictory. This seems to be a common human trait.Let me share a few experiences regarding alternative medicine, which have shaped my ideas on this theme.
My first experience with alternative medicine was with homeopathy in 1980s, when I was a community doctor. I had developed a strong pain in my left shoulder and had difficulty in lifting that arm. For many days I had taken anti-inflammatory and pain-killer medicines. In those days my paternal aunt had high blood pressure and I often visited her house for her check-ups. My aunt's husband, my uncle, had retired and taken up homeopathy as a hobby. He gave free homeopathic medicine to anyone who came to him. During one visit, after checking my aunt's blood pressure, I told my uncle about my shoulder pain and that I was tired of taking pain-killers as they were giving me gastric problems. He asked me numerous questions about the pain and then gave me a small dose of small sweet-tasting pills. He also wrapped in an old newspaper, two more doses of those pills and told me to take them after some hours. In less than 15 minutes after the first dose, my shoulder pain had disappeared and I had no difficulty in raising my arm. It was like a miracle and it changed completely how I felt about homeopathy.
My second experience of alternative medicine was more recent. In 2015, while living in Guwahati in India, I developed a severe knee pain. It became so bad that it curtailed my walking. I stopped going out for walks and took frequent anti-inflammatory and pain-killing tablets. In 2016, back in Italy, I went to an orthopaedic specialist for a few visits. A scan of my knees showed myxoid degeneration of Cruciate ligaments. I was given Hyaluronic acid injections in my knees, wore knee supports and took pain-killers. But nothing seemed to help me. After a few visits, the orthopaedic specialist told me that I had to learn to live with the pain as I was too young for knee replacement surgery. I was also told to reduce weight and do physiotherapy. I shared my scan results with an orthopaedist friend in USA and even his opinion was the same. Talking about it with a Catholic priest, who had become my friend in Guwahati, he suggested that I should try Ayruvedic treatment in a hospital in Kerala.
In January 2017, I went to the Ayurvedic hospital suggested by my friend for a one week of treatment. The treatment consisted of daily massages with oils containing different herbs. After a week's treatment, I was advised to rest for a few days. After that one week of treatment, my knees improved greatly and I could again walk without pain. I went back to that hospital for a week in 2018 and 2019. However, in 2020 and 2021, because of Covid-19, I have not been able to go there and lately, I have again started to have some knee-pain after walking for a few kilometres, though the situation is yet not as bad as it was in 2015. I am hoping to go back for this treatment later in 2022. The image below from 2019 shows Dr Vijayan, the chief Ayurvedic doctor of this hospital, together with his 3 students from the Ayurvedic Medical College who were doing internship with him.
Perhaps it was indeed a placebo effect, but I would like to know why I didn't have this placebo effect after treatment in Italy and after the injections in my knees? Are traditional treatments likely to induce more placebo effects? If yes, why?
Finally, a friend from Mongolia told me about her experience with traditional Mongolian traditional medicine. We are working together for a project and communicate frequently. Last week she told me that her mother was very unwell due to Biliary colic caused by stones in her gall-bladder. Her mother is quite old and she was in a great deal of pain. However my friend was hesitating to take her to hospital due to Covid-19 fears, so she was visited at home by a doctor and was given pain-killers. He had suggested that if the pain would not pass, they might need to do surgery for removing the gall stones. After 3 days of injections, her conditions had continued to be serious, so the family invited a traditional healer to visit her. The traditional doctor visited her and wrote some herbal medicines. Due to Covid-19 restrictions, it was not easy to buy the traditional medicines but somehow they managed. That night, after taking the herbal medicine her mother slept well after many days of pain. The morning after, it was the day of Lunar new year, she woke up completely pain free - she got up from bed as if she had not been seriously ill till the previous evening. My friend who had been so worried was overjoyed. She said that it was like a miracle. Once again, I am sure that if we ask, most doctors in the hospital will explain it as placebo effect or some kind of psychological effect.
These are all anecdotal stories without any scientific value, they do not prove anything. But if any of these had happened to you, will you be able to forget them? Such experiences illustrate why so many persons, especially in traditional and rural societies, continue to go to traditional healers even when experts tell us that there is no proof regarding their usefulness.
For persons like me, strongly anchored in the Western Medical Paradigm, alternative medicine may not be the first line of treatment for any problem, but I will seek it if modern medicine are not able to resolve my health condition.
A Role for Traditional Medicine
Even for persons who feel that alternative medicine is not effective or is illogical, I feel that in today's world there are some functions for which it can be very suitable. For example, think of illnesses like flu and viral fevers. Doctors say that these should be given only some symptomatic treatment and not treated with antibiotics because they are not useful. Still a large number of people take antibiotics for such conditions. I think that taking alternative medicines for such illnesses is a good strategy to discourage the antibiotic abuse.There are so many chronic non-infective conditions accompanied by pain, like the ones I had in my knees or in my shoulder, where long-term treatment with conventional medicines can have many side-effects. So if persons can feel better with alternative medicines, why not encourage them to try?
When modern medicines can do little because we have not found treatments for some conditions, I feel that people should be given the option of trying alternative medicines. The image below shows a modern pharmacy plant for making Ayurvedic medicines based on herbs and oils in India.
Thursday, 19 May 2022
Schio’s Old Water Canal
The River-Crossing Canal
Schio’s water canal has one peculiarity, which I think is rare among the water-canals – it comes out from one side of the river, after a few kilometres it crosses over the river in a tube-bridge and then continues on the other side of the river. Have anyone heard of any such river-crossing canal in another part of the world? Do share information in the comments below.Originally there were two water canals on the river Leogra. One was built on its western bank along the little town of Pieve Belvicino, a few kilometres to the north of Schio and it ended in a place called Ponte Canale (canal bridge), which had a wood-bridge for crossing the river. This was the old canal built around 1000 AD. The image below shows this part of the canal.
Northern Part of the Canal in Pieve Belvicino
“Pieve” was the first important urban settlement of the Schio area. It had come up during the first millennium on the western bank of Leogra. It was connected to the settlements of Magre, San Vito, Malo and Vicenza on the south through a Roman road. It had the mother-church, an old fort and a tower. The people living on the mountains around it, came down here to sell their wool and dairy products. It still has an area called Valle dei Mercanti (Valley of the merchants) from those early days. At that time, Schio was a little settlement, cut off from the Roman road by the Leogra river. (The image below shows the Pieve part of the canal)Building the canal must have needed a lot of money – who had paid for it? The church or the Malatraversi family? There are no clear answers to this question, though it seems likely that the costs were covered by the noble family.
Schio's development had suffered as it was located between two rivers, Leogra on the east and Timonchio on the west. It only had small foot-bridges over the two rivers. Probably a carriage-bridge on Timonchio was built in 14t-15th centuries, which allowed it to be connected to Thiene and Vicenza. Thus, In late 15th century, a new cathedral was built in Schio while Pieve lost some of its importance. The arch-priest also shifted from the old St Mary church of Pieve to the new Duomo church of Schio.
The Canal in Schio’s Centre
The water-canal in Schio was built in the 12th centuy CE. Most of the early churches of Schio including the Duomo came up two centuries later along its western bank. The Schio part of the canal starts in the northern end of the city where the Gogna torrent coming down from San Martino merges with Leogra river.Towards the end of 20th century, with the advent of a new phase of the globalisation, the wool factories of Schio gradually lost their markets and closed one after another. With urbanisation of the past 2 centuries, most of the agricultural use of the canal water had also decreased. Thus, the water-canal has lost some of its importance.
The last part of the canal located in the city centre of Schio still has the old “lavanderia”, the community washing space, where a wooden sculpture of a washer-woman remembers those days when women used to gather here to wash clothes.
Southern Part of the Canal
After passing through the Schio city centre, the canal comes out near Via Paraibo and proceeds to the rural part of the periphery along Via Mollette. The old ruins of the Cavedon sawmill are located here. The last tract of Via Mollette running along the canal has been converted into a beautiful walking/cycling area (in the image below).Conclusions
Today the economic and industrial importance of the old water-canal of Schio has decreased, yet it has become important in other ways. Evolution has taught human beings about the importance of water. Schio and its surroundings are full of beautiful walking and cycling areas that are located next to its two rivers, Leogra and Timonchio, and its water-canal. It also continues to supply water for agricultural use.Wednesday, 18 May 2022
Failures in Global Health?
Three years ago, in July 2019 Dr. Madhukar Pai, Associate Director, McGill International TB Centre in Canada wrote an article on "Failures of Global Health". In this article he had written:
In global health, we love to talk about success stories and publish interventions that seem to work. Eradication of smallpox, dramatic decline in polio incidence, reduction in child mortality, etc. But we also know global health deals with huge, complex, challenges. And involves several agencies and stakeholders with their own agendas and political instruments. So, failure is guaranteed. Failure is a powerful tool for learning, and we can always learn from failed interventions and projects.
Then Pai went on to list some of the major failures in Global Health: "I do not see a similar openness about failure in the global health arena. To be sure they are discussed in hushed tones in the corridors of global health agencies in Geneva, New York and Seattle, but not quite publicly, in a way that facilitates learning."
Background
The Failure of Leprosy Elimination in India?
Point number 9 on Pai's list of Global Health failures is about leprosy control in India. He says that it was a failure because, "In 2005, India declared leprosy to be eliminated and scaled-back on its leprosy programmes. Today, according to WHO, India harbors 60 percent of the world’s cases, with more than 100,000 new diagnoses each year." He links his judgement on this point to an article from New York Times, "In India, a Renewed Fight Against Leprosy - Health workers thought they had vanquished the disease in 2005. But it lived on, cloaked in stigma and medical mystery."I believe that this is an unjust and superficial judgement about the leprosy services in India and its achievements. The "failure" in this case, if we can call it that, should be attributed to the World Health Organisation (WHO), which had set up the "Leprosy Elimination Goal - to reduce the prevalence of leprosy to less than 1 per 10,000 population by the year 2000".
Declaration of "Global Leprosy Elimination" did lead to premature closure of many leprosy programmes around the world, but fortunately not in India.
WHO's Leprosy Elimination Goal
The goal of "Eliminating leprosy as a public health problem by the year 2000" was decided by the World Health Assembly (WHA) in May 1991. This goal was aimed at a reduction of leprosy-prevalence to less than 1 case per 10,000 population and was not aimed at reducing the incidence of leprosy (number of new cases). Thus, in this goal, the word "elimination" did not mean how ordinary people understand this term. Everyone involved in setting up the "elimination goal" knew that it was not possible to actually "eliminate" leprosy in the sense of "not having any new cases of the disease".What was the rationale behind the decision of setting up this goal? The official reason was that if we could reduce the prevalence of leprosy in a population, the pool of infected persons would decrease and gradually the disease incidence will also decline. People and organisations working in leprosy control such as ILEP had opposed the "elimination goal" but were over-ruled (some of those discussions never really stopped and even today continue in some form on LML, 30 years after the decision of WHA).
Need for the Leprosy Elimination Goal
International Pressure to Reach the Leprosy Elimination Goal
Fixing international targets and goals can motivate governments and people but it also has some side-effects. For example, for the leprosy elimination goal, once the target was fixed, there was a lot of pressure on countries to reach the goal. If a country did not reach the goal then this meant that their programme was not good or their health staff were not working properly. On the other hand, there were insufficient discussions about the strategy itself, that reducing the numbers in high endemic areas within that period was not feasible because the other instruments to control leprosy (such as a simple serological test for diagnosis or a vaccine for its prevention) were missing.I remember the press-conference during WHA in Geneva in 2005, during which the announcement about "elimination of leprosy as a public health problem in India" was made as a triumph of the global health.
Impact of the Leprosy Elimination Goal
This leads us to the question of the need for goal-setting and international pressure for reaching numerical targets. When your country is lagging behind in reaching an international target, what happens to its health workers? The answer is easy to guess - if they do not show the required impact on the disease condition in their work areas, they will be labelled as a bad workers and their programme will be called a badly-run programme, without looking at the real situation on the ground. So what are the options for them? In many leprosy programmes across the world, when their new cases did not decrease, many of them stopped registering new cases and therefore, manipulated their data.
For example, at the African Leprosy Congress held in Johannesburg in 2005, it had come out that Tanzania which had apparently reached the elimination goal in 2000, had actually manipulated its data for achieving the goal and the actual number of cases was still high.
Failure of Alma Ata Declaration
Pai's list of failures of global health also includes the failure of the Alma Ata declaration and the goal of "Health for all by the year 2000". In his article, he had written that, "Failure to deliver on the Alma-Ata declaration: Despite the 1978 Alma Ata declaration on "Health For All by 2000", nearly half the world's population lacks access to essential health services."Alma Ata declaration on the Primary Health Care in 1978 with its goal of "Health for All by the year 2000" was one of the biggest utopias which has motivated and mobilised the health activists all over the world for almost five decades. Even today, the echoes of that call continue to reverberate among us. I think that a summary judgement that the goal of Health for All was a failure, does not take into account the impact it had and continues to have even today, for example its influence on the discussions about the Universal Access to Health.
Fifteen years ago, I had some opportunities of talking about Alma Ata with Dr Halfdan Mahler, who was the director general of WHO during the Alma Ata conference and one of its main inspiring figures. Dr Mahler, originally from Denmark, had been working in the TB programme in India, before taking up the role with WHO (in the picture below, from left - Hani Sareg/Egypt, Armando/Brazil, I and Dr Mahler in Geneva during a World Health Assembly).
Some Achievements of Alma Ata Declaration
(2) For 30 years, I was involved in Community- based Rehabilitation (CBR) programmes (also known as Community-Based Inclusive Development or CBID) aimed at persons with disabilities in rural areas of lesser developed countries. The CBR approach was a part of the Alma Ata dream, which had developed independently because PHC approach was struggling for its own implementation. CBR also had a positive impact on thousands of lives of persons with disabilities and their families all over the world.
(3) Another related programme, which was inspired from Alma Ata and has been finally realised in the past couple of years is that of Priority Assistive Products list, which brings assistive technology to persons with disabilities and elderly persons.
Impact of Other Factors
I remember many discussions in People's Health Movement during which one reason had come up repeatedly for not having achieved a full primary health care (PHC) services approach across the countries - the decision by UNICEF to implement selected elements of child care because they felt that countries did not have sufficient resources for a full implementation of the PHC approach. Looking back, I don't think that UNICEF was to be blamed because in any case, the idea of providing free primary health care to everyone everywhere was an impossible dream in a world which was controlled by forces that did not see this as important or feasible.
During the debt crisis of the 1990s, the International Monetary Fund (IMF) and the World Bank, by promoting austerity policies, had hammered a big nail in the PHC's coffin. Since then, over the last 30 years, looking at health services purely in terms of numerical calculations of costs-benefits, cost-cutting and privatisation across countries, including those which had a good model of universal health care such as UK and Italy, has further taken us away from the Alma Ata trajectory.
A second Alma Ata conference was held in October 2018, which agained called for universal health coverage and sustainable development goals. However, I doubt that it is going to stimulate the dreams of activists around the world like the Alma Ata declaration had done in 1977. This may be also because today we live in a different world, a world of climate change, AI and internet, where new goals are set and forgotten all the time. The Millennium Goals have gone by, the Sustainable Development Goals are coming and setting international goals is a business strategy and not an exercise in idealism.
Conclusions
Pai's list of "global health failure" provoked me to write this post. As my explanations about leprosy and Alma Ata show, each of these points can be subjects of debates, and the answers may not always be negative. I think that similar provocative statements can be very useful to stimulate us to go deeper, study what had happened and reflect on the lessons we can learn from those expereinces.Friday, 13 May 2022
Liberal Dilemmas
I have always thought of myself as a liberal. However, increasingly I feel confused when I am faced with competing liberal values. Often, I am not sure, which values should be chosen and why. Most of the times, the more I try to read and understand about these issues, the more complex they seem to become. In the end, it leaves me frustrated because I can’t make any decision.
Even a decade ago, if somone had told me that I will be confused about my liberal values, I would not have believed it. It is not just me. Many others I know, face similar dilemmas, while some others, who seem to have taken a position, can't really explain their choices in a logical way.
So, lately I am not very sure, what kind of liberal I am or if I am really a liberal! One thing is sure, compared to some people’s certainties, I feel like a sand-castle whose walls fly off in all directions at the first sign of the wind.
Liberal Struggles in the Past
The identity struggles in the past were simpler. For example, fighting for the LGBT rights used to mean that countries and societies had to accept persons who identified themselves as LGBT, and that they were citizens like everyone else. Those struggles are still not over in many parts of the world. For example, in some countries, to be gay or lesbian or a transgender person can lead to blackmail, rape, prison, torture and even death. In addition to the specific anti-LGBT laws, in some countries, it is socially accepted that families and communities can force individuals into marriages, undergo conversion therapies, get raped or even be killed.Countries which accept the individuals with different sexual orientations, might have other struggles. For example, their right to live with or to get married to the persons of their choice or to adopt children.
Often, most of our liberal struggles were framed in terms of limiting the role of religions and traditions in our lives. For example, when these impacted the lives of women and other marginalised groups such as "lower" castes in terms of where they could go, how they could dress or the professions they could choose.
New Directions of the Liberal Struggles
Over the past couple of decades, in the developed world those fights for the rights have branched out into new directions. Often, in these new fights, the rights of one group of persons start competing with another, and we have to decide which rights and whose rights are more important.One big arena of fight is about the words we use to talk about things, especially in English. Thus, it is no longer about the intentions of the persons, or their histories of work in challenging the oppression and marginalisation of people – the moment they use some “undesirable” or "politically incorrect" words and terms, they can be attacked, sometimes viciously, even to the point of destroying their reputations, jobs and lives. Every time this happens, it leaves me dismayed. People playing victims because their "dignity has been outraged" by the politically incorrect terms are full of righteous anger and can be extremely unforgiving and vindicative. However, this article is not about the use of politically correct language.
Instead, in this post I want to share some of my doubts about some other liberal values - gender identities, religious/cultural identities, women’s rights and the rights of the persons with disabilities. Let me start with the dilemmas about gender identities in sport.
Identities and Sports
In the 2021 Olympics held in Tokyo, the New Zealand’s women’s weight-lifting team included Laurel Hubbard, who is now a transgender woman. 43 years old Laurel had transitioned to become a woman in 2013. In the past, she had participated in other Olympic games as a man. Many women weight-lifter teams from other countries protested against her inclusion since they felt that Hubbard will have unfair advantage. However, she failed to win any medal and in the end the polemics died down.How do you feel about the stories of Laurel, Thomas and Santhi? Should they be allowed to take part in the women's events? In 2006, when I had read about Santhi, I had felt that the organisers had been cruel and unjust towards her. However, when I looked at the pictures of Hubbard and Thomas, I saw broad, tall and muscular bodies, and I could understand why the other women in the championship had felt that it was unfair.
We have separate sports competitions for men and women, because men and women have different bones and muscles because of their hormones. Somewhat similar logic is used for the participation of persons with disabilities in sports – separate sport events are organised for them and they are asked to compete against other persons with disabilities, for example in Paralympics.
So, a person who has grown up with male hormones with a certain kind of bones, muscles and bodies, and who decides to transition to become a woman, should compete against other women or men? Women protesting against Laurel’s inclusion should be seen as persons’ fighting for women’s rights or as trans-phobic?
I have not seen similar discussions around trans-men's participation in sports and they seem to be accepted more easily, which is understandable because other men do not see them as "unfair advantage". For example, Moiser (Lake Zurich, USA) had taken part in the women's team of triathalon in 2009. A year later, he decided to transition to become a man and in 2016 became selected in the men's team.
Defining the identity
There are many on-going debates around the issues of gender and sexual identities. For example, in some countries, transgender persons when they transition, can ask to be legally recognised as a man or as a woman.In many countries, women transitioning to become a man must get operated to remove their uterus before they can be legally recognised as a man, while men transitioning to become a woman must get their testicles removed before they are legally recognised as a woman. This is done to avoid that a legally recognised man can become pregnant or a legally recognised woman can father a child.
However, many transgender persons feel that they have a right over their bodies and being transgender is more about how they feel in their hearts and not about compulsory removing of their body parts. Thus, there are trans-men who have their uterus and trans-women with functioning male genitals, and both these groups are fighting for the right to be legally recognised as men and women.
There are also debates about “real woman” versus “transgender woman”. Last year, in June 2020, a huge controversy had erupted about an essay written by the writer J. K. Rollings, who was called trans-phobic for differentiating between biological women and trans-women. Some weeks ago, Nigerian author Adichie Chimamanda has also been criticised for the same reason.
Religions, Traditions and Modernity
I grew up surrounded by discussions about patriarchy and women’s rights. In those discussions, the traditional Hindu wife, her face covered with her sari or a scarf, walking two steps behind her husband, was a symbol of women’s oppression under the guise of traditions. We agreed that women have a right to dress as they wish, choose the profession or work they like and marry the person they wish to. In those discussions, fights against the traditions were not seen as fights against the religions and in my mind, those discussions applied to all the religions. Thus, the fight for a common civil code, a uniform law that applies to all the persons of different religions in multi-religious societies, was seen as an important liberal value.Over the past decade, suddenly such discussions have become more problematic. For example, the ban on wearing of full veil covering the face among Muslim women in some countries of Europe. The liberal position has sided mostly with the more orthodox groups by insisting that “Hijab and veils are cultural symbols and a free choice of Muslim women”. However, discussions with the cultural mediators working in the immigrant communities show that peer, family and community pressures and expectations play a large role in use of veils and hijabs, and sometimes, young girls face violence for rebelling against those pressures.
For example, Italy has a large Pakistani immigrant community. Last year, a young girl of Pakistani origin went missing while she was rebelling against family pressures. Police suspects that she was killed while the rest of the family went back to Pakistan. Debates among the Pakistani community on this theme underline the difficulties of talking about women's attempts to escape the social control on how they dress and the persons they wish to marry. Some girls insist that modest dressing including hijab is their free choice; others, usually men, at best talk of "not washing our dirty laundry in public because there is already so much discrimination against us" and at worst, threaten the few dissenting Pakistani women's voices about the perils of not obeying the "fundamental values of our religion/culture".
Similar dilemmas face immigrants from Africa. Black persons in Europe are often stereotyped as drug peddlers and criminals. At the same time, many black women face domestic violence. Liberals often refuse to raise the issue of violence experienced by black women for not reinforcing negative stereotypes against the black communities.
Thus, how do we talk about the negative stereotyping faced by Muslims or blacks in Europe, without closing our eyes to the rise in conservative Muslim forces which increasingly force women and LGBT persons into silence or the black women victims of domestic violence? Is there a way to talk about one without negating the other? While talking about patriarchy is encouraged among Christians and Hindus, in relation to Muslim women it is usually seen as Islamophobia.
The Right of Choice and the Right to Life
The women’s right of choice to say no to unwanted pregnancies and to have safe spaces for abortion was another of the progressive struggle with which I had grown up with. When I read about conservative groups, which oppose women’s right to have safe abortion, because their church says so or because Bible says so, I have no doubts about which side I am on – I support women’s right to make the choice.However, over the past decade, increasingly there are groups of persons with disabilities, which fight is for the right of children with disabilities to be born and not be aborted. For example, one of the common reasons for abortion is when tests show that the child will be born with a disability such as Down’s Syndrome.
So, should we continue to support women’s right over their bodies and their wombs and only they can choose if they wish to go ahead with a pregnancy or should we be on the side of persons with disabilities asking for life for children with disabilities?
In the End
There are no easy or blanket answers to these dilemmas. At the same time, I feel that it is important that we continue to talk about them, without being trolled or called names by those who feel that they already have the answers.The moment we say something, there are people waiting to stick labels to our foreheads – right wing, left wing, fascist, communist, follower of this or that. I find this extremely tiring. I refuse to label people and I try to have a dialogue with everyone - when I find that I don’t like some of their positions or opinions, I can always ignore them. My motto is "the world is big and there is enough place here for people who don't think like me."
Finally, I believe in freedom of expression, even of people with whom I do not agree, as long as they are not actively inciting violence. I believe in people’s right to raise questions about every thing including religions, gods, and prophets. I do not agree with trolls and fundamentalists who want to cancel all the voices they don’t like.
*****
Notes
Saturday, 23 April 2022
Meet the Artist - Eva Trentin
Eva Trentin is an artist from Marano Vicentino, a tiny commune a few kilometres away from Schio (Veneto, Italy), where I live. Her art is closely linked to the nature and the natural world, such as flowers, leaves, plants and trees. Her works combine the organic world with UV photography and some special techniques of imprinting on paper and clothes, creating designs which look like rain-washed shadows of fossils.
I am always very keen to meet artists and to understand the ideas underlying their artistic evolution. Recently, I had an opportunity to talk to Eva and to visit her art-studio. This article is an introduction to her and her art-world. Let me start it by showing you an artwork called "289" which had a profound impact on me when I had seen it at the Mutazioni exhibition in Schio in 2021. (Click on the pictures for a bigger view)Meeting Eva
Fortunately, some weeks later Eva saw my article on this blog and contacted me. So, recently I went to visit her home and her art studio in Marano Vicentino, where she lives with her husband and twin daughters. It was an opportunity to talk to her about her artistic journey and the ideas underlying her art.
Eva’s Artistic Journey
Her artistic journey started in an art institute when she attended the G. de Fabris artistic school in Nove (VI), which was followed by a degree in interior design at ISAI Academy in Vicenza. For many years Eva worked in a studio of interior designers and architecture, till about 6 years ago when she started a new phase of her life as an artist, after her husband gifted her some plastic art materials, which led her to taking up art more seriously. Soon, she gravitated towards the use of flowers in her art.During the last couple of years, she has started experimenting with botanical printing inspired by the works of Australian artist India Flint, who uses leaf printing, eucalyptus dyes and botanical alchemy, garment cutting and stitching, paper-folding, bookbinding and a little poetry; and by the Israeli artist Irit Dulman, who makes monochromatic and colour botanical prints on silk and cellulose fabrics.
Thus, Eva started experimenting and combining different techniques which use organic materials such as tree-barks, leaves, flowers and resins for paper-printing and then combined them with photography, cyanotype and fabric-printing.
Art Techniques of Eva Trentin
Eva has developed her own art techniques which I call “delicate imprinting” - it involves organic matter such as leaves and flowers which leave their imprints on paper and tissues such as silk, and which look like fossils drawn in gentle lines and soft colours. These imprinted papers and tissues can then be combined with resins or cut into different shapes, can be placed on different surfaces covered with gold-leaf or cyanotype, sometimes combined in mosaics of hundreds of small pieces, which look like scrolls telling stories like the two works presented above.I am not sure if these techniques of imprinting organic matter (Botanical Prints on Paper or fabrics) to create art have a specific name.
She explained to me about the Cyanotype technique, as I was not aware of it. Later, I searched for it online to understand it better. Wikipaedia defines it as “is a slow-reacting, economical photographic printing formulation sensitive to a limited near ultraviolet and blue light spectrum, the range 300nm to 400nm known as UVA radiation. It produces a cyan-blue print used for art as monochrome imagery applicable on a range of supports, and for reprography in the form of blueprints. For any purpose, the process usually uses two chemicals: ferric ammonium citrate or ferric ammonium oxalate, and potassium ferricyanide, and only water to develop and fix. Announced in 1842, it is still in use.”
Eva’s Studio

Her studio is a workshop where she keeps her collections of leaves, flowers, tree-barks and their extracts. “I am not very orderly, sometimes, I forget to label the things and then I have to throw them away”, she confesses candidly, while showing off a box full of barks of different trees which her father had collected for her.
Actually, her studio, located in the attic of her home, seemed to be in perfect order, everything was labelled and placed in boxes, though the fridge was kind of overflowing with them. A microwave oven and a couple of steam baths are part of her art equipment as she needs to keep her leaves and flowers wrapped in the paper for many hours at a time, while they leave their imprints.
For learning more about Eva’s art and for buying her art works, ear-rings, textiles and kimonos, you can check her Facebook page, Instagram Page and her website.
Conclusions
Meeting Eva and learning more about her artistic process was like opening a door and discovering a new world of conceptualising and experimenting with art. It was a world where nature and natural processes, some what similar to the those which lead to the making of fossils, are used to create art. It also made me think of the prehistoric artists who had left their hand-prints and drawings in the caverns and rocks in different parts of the world.Every encounter with a new artist is a journey for discovering new ways of expressing artistic impulses, sometimes through new materials and/or techniques. That artistic expression can be seen as a continuum on a spectrum, which goes from sparse lines drawn on sand or rock, to paintings using different materials, to sculptures of stones and metals, to new ways of combining emerging technologies. Eva's work are located on that spectrum close to nature where dream like delicate figures in soft colours become manifest through her imagination.
I love meeting artists and trying to understand their specific gaze and thinking which underlies their creative expressions. Meeting Eva was a wonderful part of that journey.
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