Dissecting the -ani

Dr. Kapoor, a famous and renowned Physician wrote an interesting report on Sindhi's after forty years of experience and practice. Fascinating indeed, I decided to take a jab at the article and add my two cents in the form of "agrees" and "disagrees."

By: Dr O P Kapoor: Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

"Sindhis are unusual Indian patients.. They have no state of their own. After the partition many of them have spread all over the world and are living as NRI's, e.g. In West Africa (Lagos and Siereleone), Dubai, Hong Kong, Singapore, Indonesia, Japan, Phillipines, Taiwan, Spain, Las Palmas, Gibraltar, Bahamas, UK, USA, etc. All over the world they continue to remain religious, God fearing and still speak in their Sindhi language. They are possibly the most hard working people in India, though they also enjoy eating, drinking, music, sex and a very good social life. Many of them have turned to various cults like Radhoswamy, Chinmayanand, Satya Sai Baba of Bangalore, Saibaba of Shirdi, Dada Vaswani of Poona, Aasaram and many more cults. To me it appears that they have no secure feeling."

Disagree: I've never actually thought of Sindhi's as being "insecure." While he makes a valid point, most Sindhi's do look for contentment in these so-called "cults," primarily because we feel like the forgotten lot. Some times, I think its because Sindhi's consider it a way to social while simultaneously being socially-religiously responsible. How on earth can we be insecure? After being thrown out of your own state, having to stay grounded and become the epitome of the successful universal Indian- that is hardly insecurity.

"They are taking the help of these cults to maintain their mental health (less commonly Osho, Brahmakumaris and ISKCON). After adopting these cults many of them stop drinking and develop sober habits but continue to eat more. They are so ambitious that it is worth noting that our Home Minister and one of the other Central Ministers were Sindhis in our Indian Govt. It is interesting to note that 2 out of 4 best private hospitals in the city of Bombay are run by Sindhis. Thus the Sindhi man works the whole day and has no time for exercise. This aggressive attitude predisposes them to certain diseases like ischaemic heart disease, hypertension, etc. Most of them will never miss their good lunch and have a hearty dinner and even on the days of fasting which many of them do once a week, the caloric content of the fruits and milk which they consume is very high. Nearly 100% Sindhis offer regular prayers every day. Unfortunately, even the "prasad"which they consume consists of greasy sweet kada (may be followed by a big papad of equally high caloric content). Thus the prasad can amount to as much as a small meal."

Agree: Sindhi's have no sense of fitness or health regimes. The younger generation are definitely more in tune with the idea and the older are realizing the importance of it. The idea of cult's helping to reduce alcohol and smoking is interesting as it the idea of eating more on the flip-side. Advani didn't make it to be Prime Minister, and I personally wasn't rooting for him either, but agree - most successful businesses are run by Sindhi's.

"The Sindhi women continue to be old traditional ideal wives and mothers and most
of the time are home bound, busy cooking and looking after the house. Many of them do not leave their house for days together and continue to eat a good breakfast, lunch and dinner and snacks (specially "tikkis", Fried Potatoes and sweets) in between, thus leading to obesity and predisposing them to diabetes and hypertension and osteoporosis (due to sedentary life). Many genetically transmitted diseases are common in Sindhis. These include ischaemic heart disease, diabetes, hypertension, thalassaemia minor, G6PD deficiency, obesity and possibly gross osteo-arthritis. The following are my other observations : On general examination most of them are overweight. The commonest musculo-skeletal symptoms of "lingan mey soor" is due to a combination of overweight and lack of exercise. Many of them have got a prominent protuberent abdomen, in males often due to alcohol and excessive calories and in females often due to multiple deliveries. This leads to reduced abdominal tone and appears to me as one of the factors of chronic constipation(pet saaf kona acheyto). Most of the Sindhi women complain of swelling and oedema of the feet and slight pitting. On majority of the occasions it is due to salt retention following marked obesity and deep venous insufficiency. Many of these women have very fat thighs, buttocks and calves hidden in their very roomy dresses. Many of them mistake fat on the legs as oedema. The gross osteo-arthritis of the knees and hip joints is possibly familial and some of the most advanced cases of such osteo-arthritis in our countries are seen in Sindhi communities. Most of the Sindhi women do not take any hormone pills after menopause which often occurs around 45 to 48. Thus after 10-15 years, around the age of 60 to 65 they start getting repeated fractures with minimal trauma and most of the doctors do not make the diagnosis of osteoporosis which is rampant in elderly Sindhi housewives. Many Sindhi women appear anaemic on general examination. Most of them will say that they have gone to a number of Doctors in their life time but their anaemia does not respond to treatment. This is because they have thalassaemia minor which they should be told to learn to live with and for which there is no permanent cure. The incidence of G6PD deficiency is very high in Sindhis. Off and on I see rich Sindhi males coming with severe anaemia from far East after having an attack of Malaria for which they are given anti-malarial drugs. This is because of deficiency of G6PD which was missed by clinicians in those countries."

Disagree: Uh.. which Sindhi woman do you know stays at home for days? I definitely don't know any. And illness' occur in all communities - bias, prejudice and too much generalization here. All communities have cults, all communities have wrong foods, all communities have health issues.

"Premature greying of hair in both sexes is universal in this community and they keep on using hair dyes for years!"

Pissed off: Okay this point pisses the crap outta me. What difference does it make? So Sindhi's want to stay and remain young - and if they use a bit of dye so what? Yes, we believe in looking youthful especially the older lot. And this is bad because?

"Most of the Sindhi patients especially women complain of symptoms of "monjh" which is equivalent to ghabrahat (chest apprehension in other Indian patients. Many of these patients have absolutely no heart disease and have nothing else but panic disorder. The incidence of this symptom is so high in Sindhi females that every alternate patient complains of the same not responding to any treatment!! However, ischemic heart disease in Sindhis specially those living abroad is extremely common (like the Asians in UK) and should be excluded before diagnosing functional complaints. Many of the females will complain of symptoms due to so-called "low blood pressure". Most of these symptoms are due to anxiety and tension and not due to low blood pressure. The symptoms of "Saheko" which really means dyspnoea is often present along with "monj" without any organic disease. Diabetes and hypertension are extremely common in this population. Often they neglect the treatment of these diseases and develop ischaemic heart disease (both sexes). Fortunately, because they can "afford", many undergo Angioplasty and coronary bypass heart surgery and then agree to take drugs life time. Even the incidence of "Strokes" due to abnormal brain circulation is more common in Sindhi population (mainly due to negligence and not taking treatment of "detected" or "undetected" hypertension). For the same reason kidney failure CRF is more common in Sindhi population. Regarding diseases of lungs, COPD is still off and on seen in so-called poor Sindhis (from Ulhasnagar) who continue smoking bidis and cigarettes. The modern Sindhis have more or less given up smoking. The standard complaints of most of the Sindhis especially women are "ograai" and "pet saaf kona acheyto" which literary means belching and incomplete evacuation. The belching is so severe that the patients often present with aerophagy syndrome. Belching is not a disease and is not only a habit (which started in this community in childhood) but is associated with over eating. In my experience Sindhis have the highest incidence of belching and aerophagy in the world. Another common complaint is the "Coated" tongue. They continue using tongue cleaners and always corelatetheir coated tongue (which is normal) with their abdominal complaints of distension and constipation. Incomplete evacuation is often due to their sluggish colon and associated poor abdominal tone and flabby abdomen and possibly lack of outdoor exercises. Blood cholesterol and triglycerides are often very high in Sindhi population and are mainly related to intake of alcohol and rich diet. As compared to many other communities, in Sindhi women the symptom of leucorrhoea is very common. In males the symptoms of sexual weakness are more or less universal often due to excess of alcohol, tension, diabetes, iatrogenic causes and more "expectations!" However, the incidence of urethral syndrome and Dhaat (male leucorrhoea) as seen in many other Indian males is more or less never seen in Sindhi males (although they often over indulge in sex). Interestingly like in Arabs, I find that the incidence of AIDS is much less in Sindhi population. Regarding the different sub-communities in Sindhis - the picture described by me above is commonly seen in Sindhwarkis. Although, Hyderabadis and Amil Sindhis have also more or less same illnesses, belching, aerophagy and other gastrointestinal symptoms are less common in them. More often Bhaibandh and Shikarpuri Sindhis join cults like Radhaswamy and after taking "Naam" stop non-vegetarian food and often alcohol, though many of them who were smokers continue smoking. Also many of these types of Sindhi like to retire from sex life around the age of 50-55. Finally, in poor Sindhi population of Ulhasnagar most of the above picture described by me would often be seen."

Conclusion: I really believe, even after my father attempted to convince me that this article was targeted at the "older generation," which upset me even more, that Dr. Kapoor has generalized far too much. My "evaluation" has allowed me to conclude that this report is beyond biased and prejudice. And I had to correct a lot of grammar and spelling within his report. I rest my case.

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