In 2018, your social media feed will become more toxic. Modi can take some blame

As the prime minister sets the tone for the 2019 polls, radicalised Indians will – like others worldwide – back what they believe, even if it is wrong.

In 2014, there were those who believed Narendra Modi when he spoke of a new deal for India and all Indians, of sabka sath, sabka vikas – solidarity with everyone, progress for everyone – and reform and hope. There were others who dismissed the makeover, arguing that there could be no fundamental change in a man who once mocked a chief election commissioner by his Christian name (“James Michael Lyngdoh”) and darkly alluded to the alleged fecundity of Muslims with the phrase hum panch, hamare pachees – we five, our 25.

The optimists appeared to have their day, and India embarked on the era of Modi with hope.

Three years later, optimism and the prospects of a new deal appear surreal, as the prime minister, in his desperation to win the Gujarat Assembly elections, gave in to his deepest prejudices and hotly pursued the politics of temple-Pakistan-Congress-Muslims-traitors. Whether Modi wins or not – and it is a reflection of his growing paranoia that a provincial election has become all about him (Vijay Rupani who?) – India is set to embark on an era of toxic public debate and the proliferation of lynch mobs, online and in real life, that target minorities, liberals, independent journalists, intellectuals and democratic values.

Worldwide wave

The only consolation, if you can call it that, is that India’s divided polity and dark, state-sponsored ultra-nationalism, which has now been embraced by swathes of the media, administration and judiciary, mirrors what is happening worldwide. Last month in South Africa, I listened to Ewald Scharfenberg, co-founder of, an investigative journalism website, as he explained how he faced six years in prison for defamation when he returned to Venezuela, where the government prescribes 20 years for what it calls hate messages, primarily those aimed at the administration.

I heard investigative journalist Maria Ressa describe how the Phillippines had gone from a vibrant democracy to semi-dictatorship in 18 months. President Rodrigo Duterte – an abusive man who openly approves and boasts of extra-judicial assassinations – runs an administration that has pioneered “the weaponisation of social media, combined with a populist anti-intellectualism that rejects expertise”, Ressa said. She provided an instance of how 26 fake Twitter accounts allied to the government spread manipulated news, taking a kernel of truth and embellishing it with lies, to three million accounts within 24 hours. The well is being poisoned, writes Ressa, on her website,, by paid trolls, fallacious reasoning and fabricated news – techniques that help Duterte shift opinion on public issues. His spokesperson once tweeted a photo of what he said was a nine-year-old killed by drug dealers (Duterte has allowed the police to kill anyone they say is a drug dealer with no trial or judicial process), accusing “human rightists” and presstitutes – a term commonly used by Modi supporters – of not condemning such brutal acts and undermining “the war against drugs”. The photo turned out to be from Brazil.

In the United States, it is Donald Trump who rants at liberal, democratic values and the media and winks at white supremacy. Despite a vibrant civil society opposed to him and a free press that catches his falsehoods – Trump lied 103 times during his first 10 months, six times as much as Barack Obama in his entire eight-year presidency – the US president’s supporters are largely unmoved, lapping up his early morning tweet storms.

It was a concerted social media campaign by the Far-Right that diminished the new leader of the free world, Angela Merkel, in recent German elections. Russia, Hungary and Poland have all been radicalised by social media, which has given life to the darkest fears and prejudices of citizens, eagerly manipulated by autocrats.

There is growing evidence that social media threatens democratic processes by wiping out the middle ground, pushing people to abandon accommodation and take extreme positions. A former Facebook executive has warned the world that it is “being programmed” to hate. “We have created tools that are ripping apart the social fabric of how society works,” Chamath Palihapitiya, Facebook’s former vice-president for user growth, said last month.


His views were preceded by Sean Parker, one of Facebook’s founding presidents, who likened social media consumption to “dopamine hits” that exploited vulnerability in human psychology. And last year, Vyacheslav Polonski, a network scientist at Oxford University’s Internet Institute, argued that social media was disintegrating the general will, the core of democracy, and providing a loud echo to a loud minority. “People who have long entertained Right-wing populist ideas, but were never confident enough to voice them openly, are now in a position to connect to like-minded others online and use the internet as a megaphone for their opinions,” he wrote, warning that social media was crippling healthy democratic discourse and becoming “a platform for conflict and malicious agitation by Right-wing populists”.

The most forbidding example of what lies ahead for democracies that elect populists and succumb to social media-driven agitation is Turkey, where President Recep Tayyip Erdogan does what Trump, Duterte and Modi would, perhaps, like to. Erdogan’s first term has uncanny resemblances to Modi’s current term. In his first term, Erdogan kicked off some economic reforms, spoke of hope and togetherness and signed a peace deal with Kurdish separatists. But he also stood by – and abetted – the radicalisation of Turkish society, the evisceration of the liberal, investigative media and the switchover of political conversation from secularism to Islamic revival.

These days, in his second term, secularism is embattled, Islam is firmly embedded in politics, the Kurds are bombed whenever the nationalist media reveals so-called conspiracies, and Erdogan’s rhetoric is full of anger, paranoia and conspiracy theories. He manipulates laws and public opinion – using a social media army – and imprisons anyone who does not fall in line. Hundreds of journalists, teachers, professors and bureaucrats are in jail, inconvenient judges and bureaucrats have been purged, elections have been manipulated, and the constitution has been changed.

“They want us to teach the way they like. They want us to dress the way they like. They want us to obey them wherever we go,” Aynur Barkin, a sacked teacher, told NPR, a US radio network. “And we say no.”

The year ahead

Change Muslim to Hindu, and there are uncanny parallels with India, where the Gujarat elections pushed Modi to discard the idiom of development and unleash his sectarian instincts. The timing could not have been better for him. Fringe rhetoric over love jihad, cow jihad, cultural issues and the Ram temple is now mainstream political discourse. A peculiar trait of this majoritarian era is use of the law against those it should protect, especially minorities. As I write this, the police in Madhya Pradesh have detained Christian carol singers whose car was burnt by Hindu extremists and in Uttar Pradesh, the police have filed a criminal case against a Muslim elected official who was attacked by Hindu colleagues after he took his oath of office in Urdu.

Here is what you can expect in the run-up to the 2019 general elections. Expect further weaponisation and more extensive deployment of social media to radicalise Indian society. Expect frenetic efforts to build the Ram temple over the next two years. Expect social and political divisions to be further exacerbated. Expect more fear and marginalisation among minorities, especially Muslims. Expect India to be dragged deeper into the abyss. Expect to live in an era where the word secular is no longer recognised (Rahul Gandhi has already become – politically at least – a born-again Brahmin, visiting temples with growing urgency).

If Modi wins Gujarat, he will become more confident. Social media will reflect his confidence; the troll armies and nationalised media will push discourse further to the Right, in anticipation of the temple and the strengthening of the Hindu rashtra. If he loses, your social feed will become more vitriolic than it ever has.

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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.

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 marketing team and not by the editorial staff.