Across the border

Shivaji the great to Aurangzeb the terrible: We see in our kings what we want to see in ourselves

India and Pakistan, though always in opposition, are similar in many ways – one among them being how they have appropriated their rules and invaders.

In October, the Maharashtra government approved the construction of a Shivaji Memorial in the Arabian Sea – at a cost of Rs 3,600 crore. Just saying that out loud makes me blush, and when I multiply this figure by two to calculate its worth in Pakistani rupees, it seems even more unreal.

The Maharashtra government’s obsession with Shivaji, a 17th-century warrior who founded the Maratha Empire, is no secret. The city’s airport, Mumbai Chhatrapati Shivaji, is named after him. There is a giant painting of him inside the airport and statues built in his honour in the city. In popular political imagination, he is a supreme warrior, the ultimate rebel who rose up against the mighty Mughal Empire and formed an independent sovereign kingdom and abolished Mughal hegemony by replacing Persian with Sanskrit and Marathi in his court.

For a post-colonial state, Shivaji serves as the ultimate symbol of Maratha nationalism. His rebellion against Emperor Aurangzeb is depicted as a testimony to Marathi heroism that challenged the bigotry of the Muslim fanatic king and re-instated the political significance of the Sanskrit culture.

In many ways, the state sees itself as a political descendant of Shivaji that wants to carry forward the steps taken by him. Marathi nationalism today goes hand in hand with a condescension towards other cultures, including Islamic culture, which is associated with the culture of the other, of Emperor Aurangzeb.

The ‘evil’ Mughal

In its hatred towards Emperor Aurangzeb, Marathi culture is not alone. Last year, the New Delhi Municipal Council renamed Aurangzeb road in the heart of the city to APJ Abdul Kalam Road, in honour of the former President of India after he passed away in July 2015.

The move, which reflected the mood at the Centre, re-enforced the myth of Emperor Aurangzeb as a fanatic Muslim despot who persecuted non-Muslims. There was a reason why Aurangzeb Road and not Akbar Road, which runs parallel to it, was renamed. Emperor Akbar in the modern Indian State is seen as a symbol of secularism, and therefore, a reflection of the state itself. This symbol needs to be appropriated while the other needs to be rejected. The renaming of the road also gave birth to the debate of “good” Muslim and “bad” Muslim. Both Abdul Kalam and Akbar represent “good” Muslim hence they have a space in India. The “bad” ones should go to Pakistan.

But one has to ask: is contemporary idea of Shivaji, Aurangzeb or Akbar an apt reflection of their historical roles, or is it just the product of our-present day political fantasies? Is how we imagine these historical characters just a reflection of how we want to see ourselves?

The other ‘bigot’

I was in Bangalore last year when a debate was raging about the role of Tipu Sultan and there was much opposition to the government’s plans to celebrate his birth. The Congress-led government wanted to celebrate the King of Mysore as a hero for holding fort against the British East India Company for several years and mark November 10 as Tipu Jayanti. The Bharatiya Janata Party, in opposition in Karnataka, vehemently opposed the idea, attacking the legacy of Tipu Sultan by calling him a religious bigot. They accused the government of using Tipu Sultan to appease the Muslim “minorities”, as they are called, and garner votes.

With the BJP in power at the Centre and a debate raging around the time about the purported intolerance in the country under its rule, this issue acquired national significance. At a time when the beef-ban, the Dadri lynching and the subsequent award-wapsi campaign had put the heat on the BJP, the Congress undoubtedly thought that appropriating Tipu Sultan would help project the party as a protector of the minorities. The BJP on the other hand wanted to be seen as a protector of Hindu culture.

The stance of both parties was a reflection of how they wanted themselves to be identified. Historians, researchers and scholars all tried to decipher whether or not Tipu Sultan was a bigot and if he should be celebrated.

Eager to learn more about the issue I asked my host in Bangalore, renowned historian Vickramm V Sampath, what he thought. I knew that Vickramm had expressed his views on the issue at several platforms. What he told me changed my entire perspective.

He said that it does not matter if Tipu Sultan was a bigot or not – of concern was the fact that we were using modern-day standards to judge a historical character, and an absolute monarch at that. The standards of tolerance, rhetoric, political exigencies were different at that time, he said. So, Tipu Sultan was a despot according to modern standards and therefore, the Indian republic, which defined itself as democratic after 1947, has no need to honor an 18th-century king. Let them be historical characters with all their short-comings and absolute power, he said. There is no need to appropriate them in a modern society as they will not fit.

Opposites attract

The Pakistani State, like its Indian step-brother, is no different. Here too, there is a desperate need to appropriate historical kings as part of the project of self-identification. Muslim kings and invaders like Muhammad Bin Qasim, Mahmud Ghaznvi, Mohammad Ghori and Ahmad Shah Abdali are seen as heroes of Islam and their battles are depicted as a fight against the pagans. This coincides with Pakistan’s identity of itself as an upholder of Islamic culture.

These figures are celebrated in school textbooks. Various roads and monuments around the country are named after them. Three of the most powerful short range ballistic missiles created by the state are named after them. And so, stripped off their political realities and transformed into caricatures, these historical characters – be it Shivaji and Aurangzeb or Qasim and Abdali – are celebrated or reviled in these two countries, desperate to project themselves in opposition to each other, but annoyingly similar in their habits.

Haroon Khalid is the author of the Walking with Nanak, In Search of Shiva and A White Trail.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.