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  Presidental Address by Dr. J.K. Banerjee at the XIVth National conference on the occasion of ARSICON2006, organized jointly by ASRI (9th midterm conference), and ARSI (14th National conference) in association with North Gujarat Surgeon's Association  

Dear Friends,
It is my proud privilege to be able to stand here as the president of ARSI and address you all.I am now standing on the shoulder of a giant. The wonderful giant made by your efforts and that of my predecessors, namely Dr. Balu Shankaran, Dr. N.H. Antia, Dr. Ravi Tongaonkar,Dr. Sitanath De, and Dr. R.D. Prabhu.

I admit that starting as a founder member and wading through thirteen years of active work in the organization I have learnt many things, which surpasses my combined learning and training of India and the UK in the profession of surgery. I have learnt the importance of value education in our profession to make it an effective tool of service to humanity. I have learnt from you dear rural surgeons, the meaning of the word "self respect". Holding conferences in small towns and interacting with our colleagues, seeing them serving the poor and the downtrodden within limited resources and against many odds, innovating appropriate procedures against the dictates of the greedy industry-You have established new standards of human care. Your respectability lies in serving humanity as your God as against the mammon of self-aggrandizement and a slave of the healthcare industry.

Four hundred million of the total 1.2billion of India's population and five billion of the six billion world population today have no access to modern western type surgical care. You are bending down to cover this shameful gap in the 21st century. Many of you could have become corporate hospital high-tech surgeons or big professors in our universities or NRIs minting money and donating snobbishly in some charitable institutions. But instead you choose to become rural surgeons. This shows your strength of mind and character where you use technology as a slave for human service and not become a slave to technology itself. You have cut across the ahankar 'I' inside you and converted it into the holy cross of Christianity. Not 'I' but thou my patient. Prabhuji's logo of the rural surgeon depicts this sentiment beautifully.

And let me tell you, your spirit of service is a great intoxicant. You see our foreign friends forming similar associations in their own countries with the same feelings spending their moneys, traveling, coming to our conferences to network with us and supporting such moves in other developing countries. The only Indian Rotary international President, Nitish Laharry gave the slogan "kindle the light within" during his president ship. You are doing the same through your action, with your lives. The IFRS has been born with its first conference last year.

In the third national conference, we have even been blessed by the WHO. Two regional directors, Dr. Uton Rafei and Dr. Gezairy, himself a surgeon, graced the conference. Dr. Gezairy, as our keynote addressee, mentioned that the rural surgeons experience must be documented and networked with to improve the quality of care in rural areas and developing communities. And this we did and according to his advice, designed and started the CRS course from IGNOU.

All spiritual leaders across the world have preached the practice of Nishkam Karma to enable man to realize his divine self. You are doing this Nishkam Karma in practice. And I bow down to you my dear friends as your president and humbly take this lesson from you.

Swami Vivekananda said "Civilisation is the manifestation of divinity in man". The world put him on a pedestal as it accepted what he said as truth. If that be so, it becomes our duty, as civilizedhuman beings, to serve our brethren with whatever tools we have acquired through our education be it surgery, medicine or whatever. And what Vivekananda said was nothing new. Human society is ten thousand years old and ever changing. In this changing society, certain eternal values of human behavior have stood the test of time. And practice of these values in real life forms the basis of civilization. Practice of these values is the path of man's evolution towards his ultimate goal of life that is the realization of the divinity within, God realisation. The rural surgeons of my country and the concept of rural surgery have led me on this path holding me by the hand.

And now as I stand before you as your president, on the shoulder of the giant, I visualize further the path of salvation. I can see that salvation for ARSI and the true rural surgeon will not be there until every man in our country has access to basic limb saving and life saving surgical care. It is not that I am great and need all the attention and limelight because I am a rural surgeon; it is the spirit of service that has awakened in me the sense of responsibility of carrying the benefit of basic healthcare to the last person not only of my country, but of the entire world. Against all odds, be it political or economic or technological. How do we achieve this. Is it at all possible. A million dollar question.

I would not like to ask these questions. We did not ask any questions when we formed this association. We did not ask any questions when went to the IGNOU to start the CRS course or the NBE for the DNB course. We did not ask this question when we formed the IFRS. Then why should we ask this question now. I would rather pledge my life and the life of the present day rural surgeons towards achieving this target. Whether we achieve this, is for the future to say. We should rather plan out a strategy to go ahead with this aim in mind and let the future take care of the results.

In the Katha Upanishad, Nachiketa, a young boy of 8 sees his father donating barren cows in a yagya to the Brahmins. This corruption led him embrace renunciation. He performs penances to reach Yama the Lord of Death. Being pleased with his penances, Yama offers him three boons. The first two boons he asked and Yama gave. In the third boon, he asks Yama for the knowledge of Brahman (God). Yama tries to dissuade him showing him all the other pleasures of life he can ask for. But Nachiketa sticks to his asking and does not budge. Yama becomes pleased and finally gives him the knowledge. In the process, he recites a shloka

Uttisthata jagrata prapya varan nibodhata;
Ksurasya dhara nisita duratyaya
durgam pathastat kavayo vadanti - (XIII.14)

The meaning is "arise, awake and stop not till the goal is reached. Although the path of realizing this goal is like walking a long distance on a razor's edge in the middle of the night. That is what those sages say".

The poor state of the present day healthcare system in our country created by our intellectual leaders, wading through ten five year plans, the misdistribution of services, the corruption in the systems and the selfishness of approach of those who are in power, have led us rural surgeons into becoming Nachiketas of the present day. While 80% of our hospital beds are in large cities, 80% of our populations live in rural areas and in peri-urban slums. Increasing privatization,structural adjustments", cultural slavery and multinational dominated policies leading to increasing marginalisation of the poor, has polluted the healthcare scene.

Our Association will continue to work against all these evils in silence. The National Rural
Health Mission has come as a beam in our eyes. The DNB in rural surgery is the first step. Our grateful thanks to Prof. Shyamprasad in this regard. We have to support this with all our might. And take it further down the line in creating more rural surgeons for the nation - those who can create and manage small rural hospitals on their own or work devotedly in an already rural setup with devotion. The making of the rural surgeon of tomorrow is now within our reach. Let us now do it with love and care. And towards this end let us frame a set of guidelines for our association members to follow. We have to assure that we are the right examples for them to follow. I venture to say therefore, that the aim of our association in future should be to choose members not only with the right qualifications but also with the right attitudes as well. Let me assure you that a large number of members will not add any extra glory to our association. It is their activity and interaction with the society, which will add glory. It is their contribution to the well being of the impoverished population of our country which will add glory to our association.

For all this we will have to struggle; both externally and internally. Externally, issues like the blood bank (UDBT), nursing care, anaesthesia and nursing home registering legislations etc…and most important of all, training up the future rural surgeon from the younger generation of our colleagues. And internally, getting over our pride, our "ahankar". This is what creates friction and breakdown of any organized movement in society. Many good reforming movements have broken down in the past across the world because of individual ego. Let that not happen to us. Let us be focused on achieving the objective of making basic and essential healthcare facilities available to every individual of our country. Let us stimulate that sense of judgment within each one of us, which will erase our individual egos and make us work united in achieving the objective already mentioned. And thus, reach the salvation of our association. I again repeat, Uttisthata, Jagrata, Prapyavaran Nibodhata, arise awake and stop not till the goal is reached.

Dr. J.K. Banerjee,
President, ARSI