Patient safety

Our first speaker, Uma Nambiar, noted that clinical engineers have to make their value obvious in the medical hierarchy. She suggested that one way to do this would be to make clinical engineering patient oriented, specifically to assert that clinical engineering is about patient safety. Another speaker mused about how the Indian clinical engineering profession might get there, given that he thought Indians had a cultural problem with safety, using the way Indians drive as an example. This gave me pause for thought on the basis of what I had already concluded about Indian driving. There are two ways to approach safety. One is to prevent accidents happening, and the second is to deal with the consequences. Our second speaker mentioned people not using safety belts and cycle helmets – that's minimising the consequences. There is some evidence that minimising consequences actually makes people drive less carefully as they begin to believe they will not get hurt. My view is that it's not a cultural thing so much as an economic thing – safety features in cars, good maintenance of buses, proper replacement of tyres, rebuilding of roads all prevent accidents but don't happen unless they can be afforded. In terms of culture, if anything it goes the other way – Indians, possibly because of their culture, are, in my view, better drivers than people in the UK are.

In terms of patient safety that made me think that there is probably an Indian way of doing patient safety. It will be different from the western way, it will have different strengths and different weaknesses, but it will work better in India becvuase it will be specifically Indian. Western patient safety is based on two principles which are not encessarily the most effective. The first is the highly materialistic Judaeo-Christian life model of western culture in which everything that can be done must be done regardless of the cost in money or the patient's dignity. The second is that a lot of safety features, devices and practices are not about patient safety so much as about doctor safety – there for the purpose of vitiating litigation. It may even work against patient safety in the long run. I would not like to see either of those features replicated in other countries.

India

My first impressions of India are of a country that I really enjoy and that will continue to grow on me. I've been here two days and seen only urban India in Delhi and Pune. Many things strike me; it's not as hot as I expected – I came at the right time of year. The food has been good, and I have found so far, as I expected, that Indian food in India is very different from Indian food in the UK. All the Indian people I have met so far speak to each other in Hindi, and to us in English. All of the big advertisements round about are in English. I have found some things quite disconcerting. I haven't been bothered about the juxtaposition of poverty and wealth; that is so well known already that direct exposure to it is not a surprise. The way in which streets and spaces are organised was a bit disconcerting but I am getting used to it. I can't quite get my head round the sudden appearance of a shack or a sales pitch in the middle of rubble.

I have had just a surface view of India so far – I have seen a small group of students, professionals and intellectuals. I have mixed with hotel and restaurant staff, and I have seen life on the streets – the driving, the way people walk, the selling of wares on small scales in Hindi and large scales in English.

I feel a clear sense of Indian identity very present to me. I have not been able to define it but there seems to be something very specific and Indian about the way everything is – the way they dress, particularly the colours, the way they talk, the way children behave, the language they use in advertisements and newspapers and on television, their sense of their own history, their sense of themselves, a certain way of mocking their own weaknesses. The history was also very present and real to me, in the tourist places I visited. At Qutb Minar I felt I could see how it would have been when it was built, how the whole place would have been when alive and functioning. At India Gate I felt a sense of profoundness at the guarding of the memory of those who have fallen in India's wars. The memorial was so like others in Britain, France, Germany, the USA, and yet it had an Indian stamp. At best I can express it as a certain sense of warmth and centredness about the people I see all around me. It made me wonder about the relationship between India and the force of globalisation. It seems as if cultural globalisation has just bounced off the surface. The McDonalds, the Costas and the Dominos Pizzas are there but they haven't wormed themselves into the Indian identity the way they have done in some countries. So there is a very different relationship here, it seems, one in which the Indian identity is maintained and vibrant. Some things are the same all around the world. People in India want to get rich and want to have a good time. They are attracted towards certain western products, and lifestyle – I see it in the apartments, the clothing, the cars, the lifestyle that is offered on the big advertisements, but I see no danger that it will ever suck their soul away.