The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Tuesday, December 2, 2008
What They Hate About Mumbai
By SUKETU MEHTA
Published: November 28, 2008 in the NY Times
MY bleeding city. My poor great bleeding heart of a city. Why do they go after Mumbai? There’s something about this island-state that appalls religious extremists, Hindus and Muslims alike. Perhaps because Mumbai stands for lucre, profane dreams and an indiscriminate openness.
Mumbai is all about dhandha, or transaction. From the street food vendor squatting on a sidewalk, fiercely guarding his little business, to the tycoons and their dreams of acquiring Hollywood, this city understands money and has no guilt about the getting and spending of it. I once asked a Muslim man living in a shack without indoor plumbing what kept him in the city. “Mumbai is a golden songbird,” he said. It flies quick and sly, and you’ll have to work hard to catch it, but if you do, a fabulous fortune will open up for you. The executives who congregated in the Taj Mahal hotel were chasing this golden songbird. The terrorists want to kill the songbird.
Just as cinema is a mass dream of the audience, Mumbai is a mass dream of the peoples of South Asia. Bollywood movies are the most popular form of entertainment across the subcontinent. Through them, every Pakistani and Bangladeshi is familiar with the wedding-cake architecture of the Taj and the arc of the Gateway of India, symbols of the city that gives the industry its name. It is no wonder that one of the first things the Taliban did upon entering Kabul was to shut down the Bollywood video rental stores. The Taliban also banned, wouldn’t you know it, the keeping of songbirds.
Bollywood dream-makers are shaken. “I am ashamed to say this,” Amitabh Bachchan, superstar of a hundred action movies, wrote on his blog. “As the events of the terror attack unfolded in front of me, I did something for the first time and one that I had hoped never ever to be in a situation to do. Before retiring for the night, I pulled out my licensed .32 revolver, loaded it and put it under my pillow.”
Mumbai is a “soft target,” the terrorism analysts say. Anybody can walk into the hotels, the hospitals, the train stations, and start spraying with a machine gun. Where are the metal detectors, the random bag checks? In Mumbai, it’s impossible to control the crowd. In other cities, if there’s an explosion, people run away from it. In Mumbai, people run toward it — to help. Greater Mumbai takes in a million new residents a year. This is the problem, say the nativists. The city is just too hospitable. You let them in, and they break your heart.
In the Bombay I grew up in, your religion was a personal eccentricity, like a hairstyle. In my school, you were denominated by which cricketer or Bollywood star you worshiped, not which prophet. In today’s Mumbai, things have changed. Hindu and Muslim demagogues want the mobs to come out again in the streets, and slaughter one another in the name of God. They want India and Pakistan to go to war. They want Indian Muslims to be expelled. They want India to get out of Kashmir. They want mosques torn down. They want temples bombed.
And now it looks as if the latest terrorists were our neighbors, young men dressed not in Afghan tunics but in blue jeans and designer T-shirts. Being South Asian, they would have grown up watching the painted lady that is Mumbai in the movies: a city of flashy cars and flashier women. A pleasure-loving city, a sensual city. Everything that preachers of every religion thunder against. It is, as a monk of the pacifist Jain religion explained to me, “paap-ni-bhoomi”: the sinful land.
In 1993, Hindu mobs burned people alive in the streets — for the crime of being Muslim in Mumbai. Now these young Muslim men murdered people in front of their families — for the crime of visiting Mumbai. They attacked the luxury businessmen’s hotels. They attacked the open-air Cafe Leopold, where backpackers of the world refresh themselves with cheap beer out of three-foot-high towers before heading out into India. Their drunken revelry, their shameless flirting, must have offended the righteous believers in the jihad. They attacked the train station everyone calls V.T., the terminus for runaways and dreamers from all across India. And in the attack on the Chabad house, for the first time ever, it became dangerous to be Jewish in India.
The terrorists’ message was clear: Stay away from Mumbai or you will get killed. Cricket matches with visiting English and Australian teams have been shelved. Japanese and Western companies have closed their Mumbai offices and prohibited their employees from visiting the city. Tour groups are canceling long-planned trips.
But the best answer to the terrorists is to dream bigger, make even more money, and visit Mumbai more than ever. Dream of making a good home for all Mumbaikars, not just the denizens of $500-a-night hotel rooms. Dream not just of Bollywood stars like Aishwarya Rai or Shah Rukh Khan, but of clean running water, humane mass transit, better toilets, a responsive government. Make a killing not in God’s name but in the stock market, and then turn up the forbidden music and dance; work hard and party harder.
If the rest of the world wants to help, it should run toward the explosion. It should fly to Mumbai, and spend money. Where else are you going to be safe? New York? London? Madrid?
So I’m booking flights to Mumbai. I’m going to go get a beer at the Leopold, stroll over to the Taj for samosas at the Sea Lounge, and watch a Bollywood movie at the Metro. Stimulus doesn’t have to be just economic.
Suketu Mehta, a professor of journalism at New York University, is the author of “Maximum City: Bombay Lost and Found.”
IVF success set to drop under single-embryo policy
IVF success rates will fall by up to 20 per cent because of a UK government policy designed to cut the number of damaging twin pregnancies, research has suggested.
An initiative to limit multiple births by persuading IVF patients to use only one embryo at a time will cause a “significant reduction in treatment success”, according to an analysis of a clinic’s patients.
The Human Fertilisation and Embryology Authority strategy, which aims to cut the twin birthrate by 2012 from one in four to one in ten, would in practice reduce the IVF success rate at St Mary’s Hospital in Manchester from 21 per cent to 17 per cent, the study found.
Daniel Brison, of the University of Manchester, said that the strategy was right to encourage single-embryo transfer because a multiple birth was the greatest IVF risk to mothers and babies, but its implementation needed to be backed by better NHS access to IVF, especially for follow-up courses using frozen embryos.
About a third of NHS trusts do not offer frozen back-up treatment and 85 per cent do not provide the three full cycles that the National Institute for Health and Clinical Excellence recommends.
“Single-embryo transfer is the right way forward, but we have to fund more than one cycle,” Dr Brison said. “It is very difficult to ask patients to accept any reduction in success rates if they have only one shot. Embryo freezing is also crucial, as is careful selection of patients who are suitable for a single embryo.”
IVF produces a higher rate of twins and triplets because multiple embryos are often used to maximise the chances of pregnancy. Such babies, however, are more likely to be stillborn, die in their first year, suffer disabilities or be born prematurely. There are also risks to mothers.
In the study, published in the journal Human Reproduction, Dr Brison and his colleagues Stephen Roberts and Cheryl Fitzgerald constructed a model of what would happen to their clinic’s success rates under the single-embryo strategy.
To achieve the target of 10 per cent multiple births, about 55 per cent of patients would have to have single-embryo transfer. The current rate is about 10 per cent. This would bring the success rate down by about 20 per cent. If women were selected carefully, the decline would be slightly smaller but the live birthrate would still fall to 18.5 per cent.
The paper suggests ways that women could be selected, including analysis of their embryos as well as their age and hormone levels. Such measures would be essential to limit the policy’s impact on pregnancy success, the scientists said.
The St Mary’s success rate is below the national average of 31 per cent for women under 35 who use their own fresh eggs. It is an NHS centre with a waiting list of up to three years, so couples with a good prognosis often conceive spontaneously while waiting for treatment, leaving the clinic to treat harder cases.
Professor Peter Braude, of King’s College London, led the group that drew up the single-embryo strategy. He said that patients could be chosen who would not be disadvantaged by the policy.
“It doesn’t reduce pregnancy rates in women who are most likely to get pregnant, and who are also most likely to have twins,” he said.
“We have never said that a single embryo is right for every woman and the 10 per cent target is an aspiration. A very small proportion of patients give rise to most of the twins and by identifying them, we can reduce multiple births but not the pregnancy rate.”
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