Book review

Finally, a tantalising YA book (for adults too) that uses archaeology to recount Indian history

‘India Through Archaeology’ wisely tells us history isn’t to be mixed up with ancient oral texts.

As a subject, history is associated with the project of modernity itself, for history enables an objective and conscionable assessment of progress, different in every measure, from the past. Understanding the past, however, is often a contextual exercise, when viewed via the lens of subjectivity and the mistaken use of hindsight. This is where archaeology steps in. Archaeology – a relatively newer branch within history – couples a scientific precision of fact, assessment of material evidence, with an imaginative interpretation of the past and its possibilities.

As Devika Cariapa’s India Through Archaeology: Excavating History tells us, an archeologist combines in her persona the serendipity of an adventurer, the meticulous efforts of a scholarly scientist, the sweeping awareness of a time traveller, and a multifaceted knowledge of various other subjects – philology (an understanding of historical languages), epigraphy (related to inscriptions, for example) and even geology. The book is meant for young adults but it will nevertheless engage readers of all ages.

Serendipity and science

Consider the example of VS Wakankar, who, in 1957, travelling by train from Bhopal to Itarsi, was “struck by the beauty of a series of low densely forested hills they were passing”. The “strange rocky outcrops” set his “archeological antennae twitching wildly”. What followed remade history in every sense, for Wakankar had chanced on Bhimbetka, the “world’s largest open-air prehistoric art gallery”, with paintings and engravings on nearly 700 caves and rock-shelters that dated between 1,00,000 to 3000 years ago.

It would be chance, even serendipitous discoveries, much like Wakankar’s, that would lead to a rethinking and rewriting of the subcontinent’s history – as numerous instances dating from Paleolithic times (two million years ago) to our own times in Excavating History show. The story of how the first major cities of the Harappan culture, Mohenjo Daro and Harappa, were discovered, is now familiar – a saga that involved wandering soldiers, administrators, scholarly “Orientalists” and their abler (and often forgotten) Indian assistants and associates.

The history of the subcontinent was moved back – from what was described in the early Vedas – to over three millennia and even beyond, giving it new perspectives, newer mysteries in the bargain, and then a vital continuity as well, for textual accounts had earlier left large gaping holes in the subcontinent’s narratives of its own past.

Decades before the Harappan discovery, it was archaeology again – involving the combined efforts of philologists, linguists, epigraphers, and others – that was responsible for the unmasking of Ashoka, the ruler, pillars and edicts referred to as the king Piyadassi. And archaeology – as the excavations in Muziris in Kerala begun over the last decade show – continues to bring old stories to light, giving material basis to how the history of the subcontinent needs to be studied and understood. India Through Archaeology wisely tells us and its young readers that history isn’t to be mixed up with what ancient oral texts would have us believe. Rather, history must rely on a wide array of evidence – books, coins, stone tools, constructions – for historical truths to be established, with some certainty and with rational argumentation.

They also made history

It’s a serious, responsible task the book takes on, and the reason always given for why the young don’t find history fun enough. Yet Cariapa’s book, matched with some detailed illustrations and Ashok Rajagopalan’s amusing sketches and comic strips, belies this long falsely held belief as well.

The chapter on the discovery of Kanishka’s headless statue (in a village near Mathura by Pandit Radha Krishna, who was, as Cariapa tells us, an amateur archaeologist and antique collector) is a story richly told. It brings alive the old magic of the Silk Road and its many-hued traffic when people speaking different languages traded in exotic commodities. There was also the skill of sculptors and artisans of the Gandhara and Mathura schools – with their own unique ways of depicting the Buddha – and the wondrous details of how the Kushans introduced a new clothing sense, as shown clearly in their love for peaked turbans and stitched garments.

The chapter clearly highlights that archeology does what textual accounts of the past sometimes miss – a revelation of how ordinary people lived their lives. Hero stones that commemorated local folk heroes, land grants and coins issued by queens, and not just royal consorts, upend many a conventional and widely held erroneous belief that only kings made history. Moreover, just as archaeology resolves mysteries, it also shapes several tantalising mysteries in turn. For example, the construction of megaliths to mourn the dead were common across cultures at a similar point in time in South India and in Celtic Britain. Yet there is no evidence of such ancient cultures ever being in contact.

What lies beneath

Excavating History wears its knowledge lightly and tells its stories well. There isn’t a single ponderous note, nor does the book ever take on a sternly authoritative tone of the all-knowing expert. The timeline from the before present era to the near modern that shoulders every chapter is especially helpful, though an explanation of how evidence and excavations are dated (the radiocarbon dating method for example) might have been helpful, as would have been more details on marine archaeology.

This also leads to the question as to whether recent controversies associated with archaeology needed to be mentioned. But perhaps wisely, this book retains its focus on the riches unearthed thus far by archaeology, and hints also, like the proverbial iceberg, that there’s much more that remains to be excavated, strange and politically motivated controversies notwithstanding.

The story goes that the success of the Indiana Jones movies gave a new fillip to the study of archaeology. In 2015, an archaeology exhibition at Washington DC’s National Geographic museum brought together several artefacts (true and imagined) that featured in the four Indiana Jones movies. It was hugely attended. For its part, India Through Archaeology brings alive in a vividly direct way, the magic, the mystery, and the many methods that make archaeology key to understanding history, the past, and thus, our own stories.

India Through Archaeology: Excavating History, Devika Cariapa, Illustrated by Ashok Rajagopalan, Tulika Books.

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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.

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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 marketing team and not by the editorial staff.