Noshir H Antia. A life of change: The autobiography of a doctor.Penguin India Books pp 189 (paperback) ISBN 9780143104261

Noshir Hormasji Antia (February 8, 1922 to June 26, 2007) was a remarkable man. I met him once, when he came to Chennai for a seminar on the World Development Report Investing in Health. For several hours before the seminar, he kept me and a friend spellbound with his experiences and ideas. Many of them, like the banana leaf treatment for burns, find a mention in this book. He came across as a warm, gentle person, with a great sense of humour. He seemed to have a great zest for life, and this comes through in his autobiography as well. For all his brilliance he never lost his empathy for people of all social classes, and his humility enabled him to spot innovative practices and adapt them even from the most humble of his patients. He always sought solutions which were not only technically effective but were also cost effective.

Not only was he a skilful plastic surgeon who made many original contributions in the medical field, he also had an acute knowledge of politics and economics and this gave him an understanding of the social basis of health and illness. In the chapter "Democracy, Panchayati Raj and Health Care" he expounds on his understanding of the political basis of disease. The humanist Dr Antia states "the root cause of disparities, conflicts, and the misuse of human and natural resources is the manipulation of people and nature by an opportunist minority." This understanding of human society shaped his medical career.

One of the organisations he established, the Foundation for Research in Community Health (FRCH), has been an important resource group for the World Bank. It is a different story that the recommendations of the FRCH had been completely subverted by the World Bank. Dr Antia with characteristic candour stated as much in his talk at the seminar in Chennai.

The other organisation which he established, the Foundation for Medical Research, concentrates on medical problems of India, like leprosy, multi-drug resistant tuberculosis and waterborne diseases. Dr Antia recounts, with some sadness, the numerous other organisations which he helped establish like the National Association of Equal Opportunities for the Handicapped, which were taken over by opportunistic people.

Dr Antia writes about how, on many an occasion, he had to break protocol and rules in order to achieve his purpose. I must admit that these sections of the book made me uncomfortable. This is because it requires a man of Dr Antia’s stature and ability to subvert processes in the interest of ordinary people. Dr Antia does not seem to have realised, or at least he does not state as much, that most other people in positions of power misuse this power for their own ends.

Commonly, rules are framed in the interest of the public. Petty people either do not implement the rules or misinterpret them to deny people their rights. Thus it is common in public medical institutions to see equipment and space lying unutilised either out of sheer laziness on the part of the medical administrators, or sheer pettiness in not allowing someone like Antia to grow. But is it all right for a person to break a lock and occupy a building? Or is it better to keep pushing at the doors of bureaucracy till they open? Many a dictator has stated and believed that everything he or she did was in the interest of the people. No doubt Dr Antia was genuinely concerned about the welfare of the disadvantaged, but for someone who seems to have tremendous respect for Gandhi, it is strange that he abandoned Gandhi’s dictum that the means to an end is very important.

The other side of Dr Antia that I am uncomfortable with is a tendency to embrace unproved technology just because it is cheap. For example, he lauds the use of plastic mosquito net for hernia repair. I am sure that the scientist in him would agree that we need a randomised control trial of this mesh against standard mesh before we can accept it. There are several such examples scattered through the book. But these are minor quibbles.

Dr Antia was one of those rare people who combined a great mind with a great heart. His life story is an absorbing read – both edifying and entertaining.