People, Publications, and Perspective

One billion. Your brain can’t even imagine one billion things at once- the number becomes abstract in its sheer magnitude.

India has over one billion residents.


Context: The size of India vs. the size of America

Sitting in a seminar about tobacco control interventions, successfully causing cessation in 1% of smokers sounds small, nonsignificant. But when India has over 100 million smokers, helping “just” 1% means helping 10 million people. (That’s more people than live in all of New York City)

Public health research has an entirely different context here and entirely new issues to work around. For researchers at PHFI, publication is less important. They are not concerned if the journals they publish in are high profile and are far more invested in clinical results. It is a stark contrast to research mindsets in America, where having one’s paper in Nature or Science is considered the ultimate achievement. As one speaker puts it at the 2nd Annual NCD Consultation- “It’s about health improvement, not CV improvement”.

At PHFI, I am working towards developing resources for diabetes education, but any classroom activities conceived cannot involve any additional materials. Rural schools do not have access to the art supplies, wifi and computers, etc. that many American teachers rely on for effective lesson plans.

More so, because of the immense cultural diversity that exists in India advocating a healthy diet means completely different things in different parts of India— our resources must account for this. North Indians eat paranthas for breakfast, where south Indians


A typical South Indian breakfast

eat idli, vada, and sambhar.  

I experienced the range of diversity myself on a visit to Bangalore. The last weeks made me comfortable in North India: I became used to calling drivers “bhaiya”, walking in 100 degree plus weather, beggars knocking on your window attempting to sell you balloons. Even trips to Jaipur felt similar- a pinker, more history focused version of a city I was used to.


But now, the signs around me were no longer in familiar English or Hindi- in fact, English was much more of a language asset than Hindi was. Going to a typical South Indian restaurant, I felt completely out of my depth as the waiter kept placing unfamiliar food on my banana leaf plate.


A sign in the local language Kannada


One billion people means one billion individuals. Logically, I knew that people spoke hundreds of languages in India, that each state was a cultural hub of its own. But regional differences in India extend far beyond how you pronounce “coffee” and what you refer to soda as.

Whenever I pictured India, I have always envisioned Delhi- it was the only India I ever knew. Now, working on national diabetes interventions or researching about adolescent health problems in Assam, I have begun to view India as a nation rather than a singular city.




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About Ila Sethi

Class of 2020, majoring in BBB ||| Public Health Foundation of India in Gurgaon, Haryana