Surgical Treatment of China

Indo-China tensions mount in Ladakh, Sikkim | Greater Kashmir

◼ DR NITIN JHA

Have just received information about another young surgeon in mumbai, who has lost his battle against covid 19. It’s almost daily routine to see one or the other doctor laying down his life in the call of duty along with numerous equally affected other patients. Doctors from all specialities of medicine have borne the brunt of this dreadful “kung-fu” virus. The surgeons have been one of the most vulnerable groups to get exposed to corona virus due to the high transmission of virus during aerosol generation in any surgery. Will the wilful perpetrators of this pandemic, go scot-free or will they be made to pay the price ? And how does the group of like minded nations, affected by the enormity of this deadly virus, intend to stand up to this new tyrant on the block? Inherent fear :While leaving home for work, it does feel as if we are going to a war zone and not just a hospital. One can only imagine the inside fear, in each one of us ,knowing that instead of safely sitting at home, we have to keep the show running in our hospitals. In the smiles and bye-byes of our families, it doesn’t take a moment to realise the deep anguish and concern for our safety. And imagine the thought of continuing to do the surgical work knowing that we ourselves might become the unwilling carrier of the virus to our loved ones at home and be the cause for their (and off course, ours too !) sufferings.

Daily routine : Everyday there is a fixed routine after reaching the hospital. It usually starts with changing into surgical scrubs immediately upon entering the hospital .Then comes the special masks ( advised for use while operating) similar to the masks seen in old movies for protection against chemical warfare.Next is the face shield +/- eye protective glasses and then you are finally ready to scrub for OT. After having cleaned your hands with betadine ,you finally wear the surgical gown/PPE. Voila – you are ready for action. But wait ,now there is another hurdle — ‘fogging of the eye glasses’.I don’t know how many times during the surgery, all surgeons feel like throwing away the uncomfortable PPE/mask/face shield/eye glasses and getting rid of the heat and perspiration and fogging and just complete the surgery as we used to do comfortably in the good old pre corona days .But thank God, good sense always prevails and after enduring exhausting physical discomfort ,the surgery is finally completed. The mask gets changed from a chemical warfare one to a comparatively bearable N 95 mask. Then almost with the similar but new attire ,all opd patients are seen from behind a glass partition. Examination of area, even if it’s not a ‘natural orifice’, is completed only after wearing gloves. On a lighter note, the patients might always be wondering whether the surgeon they met in OT is the same one who had examined them in OPD and was the same one that they had originally booked appointment for in the first place —— coz’ hey ,they never got to see the surgeon’s face without mask and face shield . Thank God for the surgical safety ‘check list’ used to confirm the patient’s identity before surgery otherwise god knows how many masked patients would have been exchanged between various surgical departments —— coz’ hey, surgeons also usually never got to see the patient’s face without mask.

God knows how many of the doctors have started wearing jeans and T shirts to work instead of formals. No – not because we have suddenly become fashion conscious. Jeans and T shirt can be usually worn even when not ironed…so there you go,the secret is out!! It’s refreshing to have a thorough bath after reaching home nowadays in summer, but I dread to think what will happen when this pandemic stretches till the unforgiving winter of ‘Dilli ki Sardi’.

Collateral damage: The non covid patients are also bearing the brunt of this virus albeit in a different way. In spite of corona situation the need for surgeries (semi-urgent or emergency) cannot be denied to the suffering Patients. Even in these times of calamity, human beings have very religiously found time to stab , shoot or assault each other and thereby keep the emergency department busy. Can a patient of perforated appendix or intestinal perforation or gunshot or stabs or coronary artery blockage or brain tumours and innumerable other surgical problems; be made to wait just because a pandemic is wrecking havoc in the world….. Try imagining yourselves or your loved ones in the position of these unfortunate patients. I bet – didn’t you just skip a heart beat ? But as they say- the show must go on . The healthcare workers have dedicated their lives for this mission and have ensured that the non-covid health problems are not neglected. During this endeavour , many have laid down their lives.

The positive patient : Its worse for a newly diagnosed covid positive patient . Their problems start from day 1. Many might not have heard the words like quarantine, isolation, contact tracing, etc. The journey begins with quarantine, akin to a jail term awarded for no crime of theirs . If they are lucky, they serve the term and escape with intact mind, body and soul.But a few will proceed with hospitalisation, may be shifted to HDU and then maybe even to ICU and if they are very lucky, retrace the steps back to HDU , ward and then finally discharged. But some people might not be that fortunate and their journey will end in ICU—lonely, isolated, frustrated without being able to say their last goodbyes. Yes, we as Indians, have not had the best of healthcare infrastructure but see how the so called developed countries and their world class health care system is crumbling and biting the dust , due to this exported virus.

Final goodbyes : Its gut wrenching to see and hear stories of so many precious lives being lost to this “wuhan virus”. Never in the wildest dreams could anyone have imagined that there will be a time when even during the last moments of their loved ones, the family would not be allowed to hold their hands and comfort them and have an emotional closure .So many families across the world have lost elders without being given an opportunity for a proper moist eyed goodbye. And even a decent funeral was denied .Who would want to be taken on their last journey and given the last goodbye from strangers who have become so aloof after seeing so many deaths that there their eyes are bereft of tears to shed anymore .What can be worse than the case of patient who had to be taken away for burial by healthcare workers only, as all the family members were themselves either admitted in other hospital or were in quarantine. Nation’s collective conscience was shaken by another case of last rites of a child being conducted by healthcare officials as both the mother and father were also on ventilators.

Is this pandemic different ? : Natural pandemics have occurred before too. Pandemics were the only great leveller, when all human beings irrespective of country of origin, black/white or rich /poor suffered in unison .It was the time for the nature to tell us – who is the real boss around here. Always there is a sense of camaraderie during these difficult times. The artificial borders between our countries are helpless in containing the virus. These pandemics have come before and will still continue to torment the human race in future too. So what is so special this time ? Unfortunately this killer pandemic started from china and unfortunately there is no democracy in china and unfortunately the communists rule china with an iron fist with a veil of secrecy around everything,even health, and ‘UNFORTUNATELY’ THAT IS THE DIFFERENCE. Had it started from any other country (maybe except North Korea) , things would not have gone so out of hand as hopefully other governments would not have deliberately tried to use this as a weapon against fellow human beings. Or if any other rogue government, intended to do it, they would not have the required extensive monetary and state machinery to do so.

The origin: Right from the beginning, aspersions were cast on the origins of the virus – whether it was man-made virus, purposefully cultivated in a suspect lab in wuhan . Maybe it came from the so called ‘wildlife wet markets’ in wuhan. Or maybe it was not man-made . But one thing is certain —- its fatality and infectivity was purposefully hidden from the world and was actively encouraged and tacitly transported all around the world shrewdly by the communist Chinese government. Who can forget the disaster that struck Italy in the starting days of the killer pandemic and the role played by the ‘HUG A CHINESE’ campaign launched with the explicit support of the Chinese cash flushed propaganda machine. The same communist government could mould and arm twist the important body like World Health Organisation into submission and could dictate the response of WHO to the enfolding massacre. So much so that WHO , in their advisory, during early days , reaffirmed the Chinese finding — ‘THERE IS NO EVIDENCE OF HUMAN TO HUMAN TRANSMISSION OF THIS VIRUS’ . C’mon — there will never be any more hilarious joke ,than this, in the whole of the year 2020. Was it done purposefully so that the whole world dropped its guard down and virus can be spread to all the corners of the world? Had the WHO played its active, honest, expected role, right from the beginning and alerted the rest of the world regarding the true threat from this virus by honestly narrating the situation unfolding in china ,corrective measures would have been taken on time and so many precious lives would not have been lost .

Conspiracy theory : It’s hard to believe that a country which faced the problem for the first time, when not much was known about the virus and its potential treatment; escaped with just around 85000 positive cases and less than 5000 casualties and this mayhem suddenly vanished in maybe 4 months . Whereas all across the world , countries in spite of having a head start in planning for the pandemic , with much better knowledge about possible treatment options, are still clueless whatsoever about how to tame this virus. The whole world ECONOMY HAS CONTRACTED and crashed whereas the Chinese have registered an INCREASE in their growth rate and improving economy .The world is throwing up positive cases in such huge numbers daily – numbers which are more than the total cases in china, up till now. The total number of people in the world that have succumbed to this ‘wuhan virus’ is more than the number of simple positive infected cases in china — c’mon! This is hard to digest. Either the communist government is very smart/effective/competent (and all other governments are incompetent fools) , and have very successfully managed the pandemic or there is more to this than meets the eye. It’s no secret that they hid the number of positive cases as well as the number of dead. What did they do with the positive cases of corona virus ? — treat them or just clandestinely kill them so as to stop the spread. Well , with the kind of veil of secrecy surrounding any information that comes out of china, the truth might have already been deeply buried. Why did they stop all modes of travel from Wuhan to rest of china but purposefully kept all the international flights functioning from wuhan to rest of the world ! Why did they insist that everything was all right when it was not? Why did they down play the calamity? Why did they initially not agree to a probe regarding the origins of the virus ? Eventually when they did agree , how did a flood come suddenly in wuhan and destroy the documents in that notorious wuhan institute of virology ? Was it a man made virus experiment, gone wrong ? Do they already have a vaccine or treatment and hence have been able to contain the havoc of the virus in china ? (Don’t be surprised if , when some non-chinese company is just about to successfully launch a vaccine or treatment — suddenly the Chinese will also announce that they have also ‘found’ a treatment or vaccine and would be ready for mass production sooner than the competition and claim to be the saviours of the world and at the same time, in the bargain, pocket a huge economic windfall.) Are they waiting for the full potential destruction of the rest of the world and its economy, to occur first , before disclosing how they were able to contain the pandemic ? These questions may forever remain unanswered.

Are we also equally responsible ?:Is the rest of the world also responsible for this pandemic ? —- YES. We have collectively made the NONdemocratic , Opaque , Tyrant , suppressive , expansionist bullying Communist govt of china – all the more POWERFUL. The whole world has to take the blame for allowing this apparently harmless ‘PANDA’, transform into a fire spitting ‘DRAGON’ ,destroying the peace of everyone. During the cold war , Americans were very averse to anything “communist” and all the communist governments around the world were its sworn enemies, be it Russia, North Korea or Cuba. But we fail to understand , why a similar communist government like china was trusted upon so blindly by the Americans with their dollars and economy. Economic gains blinded the basic principles of democracy and governance so much so that they ended up indirectly giving away their trade secrets to these communists . Did it never strike them that maybe, down the line , this same communist government will use this money against USA ? Can you imagine the US allowing the same economic prosperity of North Korea under Kim..Its impossible to accept that, without deploying any devious means, a not so developed country ,overnight, became so scientifically and industrially advanced . Did the Chinese communist government arm twist the Chinese employees in big corporations around the world to steal the trade secrets and give them to indigenous Chinese companies to make cheap imitations of the costly products ? Did they cultivate lobbyists in all the governments around the world to favour Chinese interests and investments? Did they forcefully exploit the poor Chinese people to work in these factories at a very deplorable pay and thereby dole out very cheap products for the whole world to consume? Did they try to scuttle democracy by economic means ? Did the Chinese people trade democracy and freedom in lieu of economic prosperity? UN was at the forefront to impose sanctions against all the rogue governments around the world but it conveniently overlooked the tyrants of Tiananmen square . The whole world including India was in race to do business with china just because they were cheap. —well now China has actually shown, how cheap they can get when it concerns human lives too.

Indo-china History : India has seen the cunning aspect of the Chinese communist party , time and again. In 1962 war, they convincingly backstabbed us in garb of “Hindi-Chini, bhaibhai” . Since then they have been deceitfully slicing away large chunks of our land by their way of ‘salami slicing’ . Erstwhile Indian governments / political family, taking cue from their grand father (who was ‘wise’ enough to plunder the chance of India becoming the permanent member of the UN Security council in favour of his best friend forever – china) never bothered to take a stand against the Chinese communist party government and never stood up to them. In fact , in order to buy peace, they probably thought it was wise to pact a secret deal ,party to party. Can anybody explain the logic of an Indian political party forging a deal /arrangement/association with a foreign country’s ‘not so friendly government’. They try to pass off the deal as a deal between two political parties , but the fact is —it’s a deal between a political party/family and a foreign government ( as in china , no other political party exists other than the CPC)

Is there a Solution ? : Luckily, the world is realising their mistake and are taking some proactive steps to rein in the ‘Frankenstein’ that we all have collectively created. Policy changes have been started by all countries to encourage less dependence on Chinese imports. Maybe these steps will halt the Chinese juggernaut but what about the power it has already attained. We have to do something about that too .Because the money power that it already has ,can be and is being used to fund their military ambitions and help their expansionist policies. All these measures can maybe help manage the disease called ‘Chinese communist government’ .But as we say in medical terms, sometimes the disease cannot just be MEDICALLY MANAGED’ — IT HAS TO BE ‘SURGICALLY TREATED’ Let us understand the difference the difference between medical management and surgical management of a disease or problem .Diseases are of various types. Some diseases require only medicines for treatment, whereas some diseases require only surgery. Third category of diseases, require to be managed initially by medicines but when they become unmanageable or life threatening — SURGERY is seen as the only solution . The problems posed by the Chinese communist party, fall into this third category. For example, if a diabetic patient develops a small focus of infection over his foot, initially its managed by the physician who treats it with antibiotics, good sugar control, etc — ie. by and large, medical treatment only. During the course of the treatment , if there is good response —cure is in sight. But if it doesn’t respond and infection keeps on spreading in the form of gangrene, the same wound spreads upwards and threatens to destroy rest of the vital organs of the body and patient’s life is in grave danger due to septicaemia. This is the time to call in the surgeons to do the dirty work — they will be expected to debride the wound (or maybe amputate that leg) to get rid of dead tissues and decrease the bacterial load for the septicaemia to resolve and the patient’s life can be saved.It is a tough decision to make.Very difficult for the patient initially but in the long term, life saving. But the decision to call in the Surgeons , has to be taken at the right time. Neither too early ,nor too late, otherwise the chances of survival of the patient decreases with each passing moment. It’s time for all the decision makers, policy experts around the world, to realise that this problem of communist party of china, has reached the stage when only surgical management will have any worthwhile affect on the affairs of the world. United nation and other organisations like it, and the Governments around the world, have decision makers, policy experts, subject experts, think-tanks ,etc . Some of them are in favour of less aggressive measures (medical management) to tackle a not so friendly, non democratic government. Some favour a more stringent hard hitting measures (surgical management) for the same. Probably the world has to wake up to the present reality and realise that the medical small measures are not being enough and we all need to take the decision to “call in the surgeons” amongst the decision makers/policy experts/Strategists to take some bold, hard hitting, impactful decisions and rid the world of this problem before it’s too late. What should those decisions be ? Well maybe the policy experts / decision makers with a surgical bent of mind, decide something like this —-

◼ Make it absolutely clear that our fight and grievance is not with the Chinese people per se , but it’s against the ‘communist party of china’ , who rule over them with iron hand disregarding all fundamentals of democracy.In all these times we should not forget that the people of china are the first victims of this CPC. Democratic principles is loved by all. Which citizen doesn’t like the freedom of speech and expression to publically demonise and throw cuss words for their prime minister for the alleged occupation of some tract of land in finger 4 or 5 area of Pangong Tso lake in ladakh ? (conveniently overlooking the fact that their own great grandfather had plundered away half of a huge state, to the chinese) .

◼ Being an irresponsible government which purposefully allowed the virus to spread (if not created the virus in the first place) , the country should be declared a ‘Rogue Nation’

◼ All possible strict trade embargoes should be immediately slapped on the Chinese .No country should be allowed to buy any product from china. Hit them hard with the same thing that built them. Once the Economy suffers in china, the Chinese people will be compelled to come out of their slumber and raise demands for democracy and over-throw their oppressive government, and that probably would be the best chance to weed out the Chinese government without waging a world war III . The only reason the communist party in china has been able to survive for so long, in comparison to already extinct communist governments elsewhere, is by scuttling the voices of democracy and dissent. The Chinese govt has kept the young generation of people ,busy in counting money in lieu of their personal freedom and voive es of democracy .

◼ Such irresponsible governments should have no place in deciding the affairs of the world . Hence throw them out of the U.N SECURITY COUNCIL and other aspects of the UNO immediately. No veto power and no power to shield other rogue countries using terrorism as a national profession and tool for foreign policy.

◼ Officially pass a resolution in the UN ,demanding a compensation from the cash flushed Chinese communist government for the economic damage done to all countries due to the mishandling and sinister intentions of china. — Even though knowing very well that they won’t ever pay.

◼ Obviously , the chinese government will try to arm twist other member nations around the world, who owe money to china , to scuttle any such moves in the United Nations. Their cunning policy of loans with hidden agendas is too well known. Hence Pass a resolution in UN that all those countries that owe money to china can consider those unpaid loan as the compensation from china and those loans can be considered as fully paid. So no need to be arm twisted by china’s muscle power. One country ,even if its china, cannot fight a military war with the entire world if we all are united and have rock solid intention.

◼ Call for a review of ONE CHINA POLICY. Encourage the government-in-exile of Tibet to present its views on international forums without worrying about what china will say or react. Try to put all around pressure on china to free Tibet.

◼ Encourage Taiwan and embolden them to ask for what has been illegally taken away by the Chinese.

◼ Scrap the Chinese amalgamation of Hong Kong for breaking of the original terms and condition of the treaty between the Britishers and the Chinese. The new oppressive laws enforced by the Chinese government on the people of Hong Kong are very draconian and hence they can be aptly used as a reason for action of annulment of the Sino-british treaty. Raise voices for freedom of Hong Kong from china.

◼ All the neighbours of china, be it either near south china sea or across the Himalayas, would have protection of the united nations and any expansionist intentions of the Chinese communist party will be dealt with iron hand by the combined forces of United Nations armed forces.

◼ Keep the communist party of china so busy trying to keep its flock together with it’s internal problems that they have no time and resources to trouble the neighbouring countries.

◼ Hack into the local social media platforms (Weibo,Renren,Baidu, etc) of china and spread the anti communist govt propaganda .We cannot allow the ‘propaganda dumping’ by CPC to go unchallenged. This will definitely encourage the local Chinese population to raise the voices of dissent for pro democracy reforms. Remember , our best bet is the local Chinese population’s revolt against the communists. The reformists and pro democracy forces in china, should be reassured of all possible help from democratic governments around the world in the event of any human rights violation by the Chinese communist party government.

◼ Instead of the world being in the backfoot and trying to catch up with the problems created by china, it should be the other way around. The world with all its legitimate power should make Chinese communist party government’s life miserable and keep them so entangled with numerous problems that they might themselves want to give up and pave way for the democracy to bloom in China.

All these measures and any new ones too , may or may not work. But it’s worth trying. We cannot allow the worlds acceptance of democratic principles and peace loving coexistence be taken as a sign of weakness by the communist govt of china. We need to teach the Chinese communists, that if they threaten us ,we can be a bigger ‘badass’ then them. As explained in Bhagwad Gita, sometimes to ensure the victory of Good over evil, we have to take some unpleasant and difficult decisions for the overall betterment of mankind. Don’t you think that the time has come for the people in the decision making authorities, with a ‘surgical bent of mind’, be allowed to take the control of the treatment of disease called the ‘communist govt of china’ — before its too late ?. But one thing is certain that we all should take an oath to not let anything ‘Chinese’, enter our homes . Not bringing any Chinese products inside our homes may ensure not having to let in unwanted Chinese soldiers inside our home, in the future. We should certainly do this forever or at least till a duly elected democratic government is installed in Beijing and china gives up its expansionist policies for good. The communist party of china has oppressed the people of china up till now. Let us not give them any opportunity to mess with us. People will never be able to meet their near and dear ones, lost in this pandemic, but at least the reason for this tragedy should not be allowed to go scot-free and only then, will their souls rest in peace. WE OWE ATLEAST THIS to the countless patients and thousands of healthcare workers around the world who have lost their lives due to this man made pandemic.

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