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Trish Groves on research in India

25 Sep, 08 | by BMJ Group

Trish Groves Just back from my first visit to India, which the Lonely Planet guide rightly says is much more of a continent than a country. Three days in Delhi and three in Mumbai barely scratched the surface, but left me resolved to return there for longer.

The day before we left home Delhi was bombed by terrorists, but our hosts reassured us that it would still be safe enough to come. Like many Brits, Indians have had to become sanguine about such risks.

Peter Ashman (publishing director, BMJ and BMJ Journals) and I were in India to meet researchers at their hospitals. Dr Arun Bhatt, for the Indian Society for Clinical Research (ISCR), and Drs Urmila Thatte and Mukesh Agrawal for BYL Nair Charitable Hospital and Topiwala National Medical College had invited us to take part in a two-day workshop on scientific writing for medical professionals.

As India has become the home for many international trials, the need has increased to build local research capacity and to ensure high standards of quality and ethics. The ISCR is a collaboration between industry and academia that’s helping to do just that, and also to encourage Indian researchers to conduct important local and national research.

With several Indian editors – including those from the National Medical Journal of India and the Indian Journal of Medical Research – we worked with 150 young researchers on how to write papers, how to be ethical authors, how to cope with peer review, and why clinical trials should be registered – including in the clinical trials registry of India.

The workshop was one of the best organised and most interactive I’ve taken part in, with an engaged audience and incisive debate (and, I have to say, superb Mumbai dishes on the lunch menu). Meanwhile, around us, Nair Hospital carried on providing completely free modern healthcare to almost 7 million poor patients a year.

Earlier in the week Peter and I also had the chance to visit another hospital that’s seeking Indian research solutions to Indian health problems. At Sir Ganga Ram Hospital, New Delhi, we met Dr Samiran Nundy (a former member of the BMJ editorial advisory board) and his colleagues, where we spoke about writing papers and publication ethics and heard how the faculty gives high priority to research.

Sir Ganga Ram is an unusual hospital in several ways – not least that it’s been run by a board of doctors (rather than managers) for the past 20-odd years, many of whom have contributed personally to the budget. A fifth of the hospital’s beds are free, for the poorest patients, as are 40% of investigations in the outpatient departments, and outreach services in four distant rural areas are completely free. Yet Sir Ganga Ram has many high tech modern facilities, including Dr Nundy’s department of surgical gastroenterology which has, to date, performed nearly 200 liver transplants.

These words by Mahatma Gandhi, displayed in the hospital’s wards, sum up the hospital’s approach: “The customer is the most important person on our premises. He is not an interruption in our work. He is the purpose of it. We are not doing him a favour by serving him. He is doing us a favour by giving us an opportunity to do so.”

Trish Groves is deputy editor, BMJ

Competing interests: The workshop organisers and sponsors – including Pfizer Ltd and GlaxoSmithKline Pharmaceuticals Ltd as well as seven governmental and academic sponsors – paid for our accommodation and a driver for our stay in Mumbai, for which many thanks. All other costs were covered by BMJ Group. We paid for our trip to the Taj Mahal.

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  • anand

    Sri Ganga Ram hospital?

  • http://bmj.com Trish Groves

    The hospital is named after its first benefactor Sir Ganga Ram, the great Hindu philanthropist (http://en.wikipedia.org/wiki/Sir_Ganga_Ram).

  • D S Goel

    India, once the brightest jewel in the British Empire, has endured as a vibrant democracy in a region where military dictatorships have more often than not held sway over the destiny of nations. Rapid economic growth over the past decade or so has transformed large segments of the country and more people have risen above the poverty line during this period than over the preceding 30 years, though huge disparities still exist and we have a long way to go in respect of critical development indicators like child malnutrition and maternal and infant mortality rates. Also. while India is today a favourite destination for drug trials and medical tourism, these areas remain poorly regulated and, tragically, tainted by corruption at various levels. For a detailed critique of this phenomenon, please refer to Kaushik Sunder Rajan’s seminal paper, ‘Experimental values: Indian clinical trials and srpus health’ (New Left Review May-June 2007, 45: 67-88).

  • D S Goel

    Sorry, erratum: ‘surplus’ (instead of ‘srps’) in the penultimate line.

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