SPEAKER_02 0:00

Welcome back everyone. Today's guest is Dr. Niraj Mystery. I've said it right, Doc.

SPEAKER_00 0:06

Perfect.

SPEAKER_02 0:07

Perfect. Have you ever Googled yourself?

SPEAKER_00 0:11

Uh yes, I have on occasion.

SPEAKER_02 0:13

Okay. Let me let me tell you why I asked this question.

SPEAKER_00 0:16

Okay.

SPEAKER_02 0:17

So by the time our viewers and listeners tune into this episode, it'll be the the second time that my cousin Dr. Yak Lindy is is a co-host on the show. I explained how difficult it was to get him on as a co-host in the previous episode. And this is the first episode where Dr. Yak has been given free reign to call one of his friends and colleagues in, right? So I don't know you from above, so right.

SPEAKER_03 0:46

Okay. Now you made five minutes ago. Alex, yeah, we we literally Yeah, you made five minutes ago.

SPEAKER_02 0:52

Yeah, so we we literally met five minutes ago or ten minutes ago. And it's a long story, I know, but I'll just tell it, right? So when I have guests that I don't know personally, because I have had had those guests in the past, right? What I do is I out of respect, I prepare like quite thoroughly. So I'll go and stalk them on LinkedIn and Google them and um you know do my research with them. But then I recently watched a podcast with um Simon Sinek. You probably know him, a lot of people know him as an inspirational speaker, business leader, and all that types of things, right? And a podcast host. And he was interviewing a guest and he said something very interesting, which which uh sort of played on me. He said he hates listening to podcasts where the host is so prepared that the questions are like rehearsed and ready, and you don't get to actually find out about the real person that he's interviewing. So I said, you know what? Screw it. This episode Yak you know, Yak linked up with you and has brought you on as a guest, which I'm grateful for. I said, screw it, I'm not gonna prepare. I'm gonna I wanna give Simon Sinek, listener, type of the the experience that a Simon Sinek would want, right? So I said, I'm not gonna prepare. But then half an hour before my neuroticism kicked in. And I said, No, I can't go into this thing like fully unprepared.

SPEAKER_00 2:22

You know those people you can talk to, right? I know.

SPEAKER_02 2:24

Yeah, no, I you'll give me some advice, maybe on camera or off camera. And I was like, no, I have to at least so I said, Let me check Chat GPT. I want to ask it about you. Right? And here's an experiment that I did. So I made it do a deep search on you. And all I put in was, I said, I'll tell you exactly what I said. Let me read it out. So I say, and this look, I'm scrolling a lot. I say, I'm preparing for my next interview. Tell me everything I need to know about Dr. Niraj mystery of the Fatty Liver Foundation. That's what I said, right? Then it asked me, it said, to make sure I get the most useful, blah, blah, blah. Do you want stuff on his professional background and all that? I just said, I said, just Oh, so it gave you prompts as well. It gave me options. That's how clever this thing is getting, right? So I said, just interesting things about his professional background, education, etc., which can give me an idea of how to interview him or uh for why did I become a doctor podcast. Then it gave me this whole thesis, right? And I'm scrolling, scrolling, scrolling. I don't want to read the whole thesis out because already I'm speaking a thesis out here as an intro. And I said, can you I said just give me a short what did I say? I'll tell you exactly. I said Do me a brief intro which covers the interesting things which I can read as the intro to my podcast, right? Now I want this is going to be interesting for you to see what ChatGPT is. I'm gonna read it out verbatim. Actually, let me get Yak to read it out.

SPEAKER_03 3:46

Okay. Podcast intro. Today's guest is someone whose career spans continents, disciplines, and some of the biggest public health challenges of our time. Dr. Nehruj Mystery was born and raised in South Africa, trained as a doctor at VITS, and went on to work in both rural clinics and urban hospitals before pivoting into global health. He's held held leadership roles in the fight against HIV, TB, and neglected tropical diseases, helped launch the world's first private fund for diseases like intestinal worm and river blindness, and advised governments, the UN and the private sector on health strategies. Now, as chief medical officer of the Fatty Liver Foundation in the US, he's leading the charge against one of the fastest growing yet most silent epidemics, fatty liver disease, using innovative screening methods and patient advocacy to change lives. He's also returned to South Africa working at the University of Pretoria's Future Africa platform to solve big complex problems through interdisciplinary research. This is a conversation about impact, purpose, and the many parts a medical degree can take you. And then it says, I'm so excited to share the journey of Dr. Neuroit mystery. That's a part you don't put in in your essay. So did Mr.

SPEAKER_02 5:07

Chatterjee, which is what I affectionately call my chat GPT, did Mr. Chattergy get it right?

SPEAKER_00 5:12

Uh I'd say about 90, 95% right of what they did say. It's not the full picture, but I think uh it's it's a reasonable uh summary.

SPEAKER_02 5:24

Okay. So the name of this podcast is Why Did I Become a Doctor, right? And what we do is we we we go all the way back to childhood. Like, you know, growing up, what did you do? What what were you what was growing up like as a kid? How did Dr. Mystery end up with Dr. Mystery? Yes, back to source. Um can you tell us about that? Where are you from? What was it like growing up?

SPEAKER_00 5:45

Um absolutely. Well, firstly, thanks for having me here. And uh kudos to you, Yash, for trusting uh uh your faithful uh uh cousin here. Um so uh I grew up in Durban and uh very interesting upbringing because uh I grew up in an area of Durban that was not zoned according to the Group Areas Act. Uh so uh the Group Areas Act meant that Indians, colors, blacks, and whites lived in different areas. But because this was in the CBD, the central business district uh of Durban, uh it wasn't zoned. And I grew up in uh an apartment building uh flats. Uh um uh and it was at the heart of the city for people of color. So there were all the bus stops, there were taxi ranks, there was the train station, um, and uh the harbor was not too far away. Um and uh in the building itself were people of different ilks. So it was everything from Christian, uh Hindu, Muslim, etc., to then different races. And uh one of the interesting things is that um Billy Nayer and um Satz Cooper and even Steve Biko for a short while lived in that building. Uh so the exposure was just phenomenal. It was kind of like a kibbutz. We grew up running in and out of uh neighbors' houses. Um every Sunday I used to go with my neighbors to the church, come back and have a bacon and egg breakfast. Uh during Ramadan, I would want to break fast and feast with my other neighbors. And so um I would fast and so then I could go break fast with them. Um and so it was uh just a very um multicultural, diverse, integrated um um uh upbringing. Uh and I think the word integration is important because very often when there's diversity, it's juxtaposition of different cultures as opposed to really different cultures interacting and integrating. And so that was a um a beautiful part of uh my upbringing. Um I couldn't have planned it. Uh it was serendipitous, uh, but hey, it turned out okay.

SPEAKER_02 8:13

Just want to uh you mentioned diversity. Diversity except white people, right?

SPEAKER_00 8:18

Or so it was interesting because they did open some shops around, like uh liquor stores. Um and also my parents who were in retail business opened a store in La Lucia Moor uh back then. And in order for them to open a shop there, they had to get a white person as a nominee to sign the lease because a person of color couldn't sign the lease. And so they had to put a someone on a retainer just to be the lease uh signatory. Um and uh uh and so so going to the store to the shop over the weekends and hanging out in La Lucio at that time was just a lot of white people. Uh and so it was all part of the enrichment of our experience and uh exposure to diversity. Um yeah. And are we talking about West Street in Durban?

SPEAKER_03 9:11

Is this CBD West Street?

SPEAKER_00 9:13

Uh no, this is Warwick Avenue, the Warwick Avenue Triangle. Okay, right? And if you're driving into Durban, um there's this highway uh coming uh off the entry in and that goes into Durban and then there's a highway coming out. And between those two highways, the building, Himalaya House, that's the building I grew up in.

SPEAKER_03 9:35

Wow, I actually know exactly where you're talking about. But it's subsequently become very notorious that that junction there, it's well became Warwick Junction. But it was quite a um upmarket at that stage trading of sort of facility with regards to spices and clothing and whatever else it is. But now it's a it's a taxi rank, I think.

SPEAKER_00 9:57

So there's taxi ranks. The the taxi ranks were there before, but the the fruit and vegetable market was close by. The macheni or the fish market was also close by. And then the uh Durban Indian market, which was also the tourist market where they used to sell spices. My uh what was the famous one? Um Mother-in-law's Hellfire or something like that, right? Um so all the spices were there as well. So it was really quite a it was just a hubbub of of uh things happening. Um the notoriety of it was the fact that Warwick Avenue was the middle ground between uh uh warring gangs, right? And they were the TDKs, which were the terrible Dashin kids, and then the Victorians, which were from Victoria Street. And uh and they would sort of have their little spats or big spats uh around the Warwick Avenue area. Um but it was residential, commercial, transit hub, uh retail, flea markets, everything in one.

SPEAKER_02 11:08

So did you have any siblings or only kid?

SPEAKER_00 11:11

Um no, I have two siblings. Uh I have uh two sisters. Uh I'm a middle child, uh, but uh I'm an only son, so uh for whatever that's worth. Um it was quite interesting because my parents had three kids in three years, two in the first year. So I'm an Irish twin. Sure. Uh my sister's in February, I'm in December. Um and uh I mean, just to sort of add to the conversation on diversity, uh because we were so close, we were all three at university at the same time. And we all were up here in Joburg at Witz. Um, but my older sister was in art, uh, she's a filmmaker, and uh then I was in medicine, and my younger sister was in commerce. Um, and so dinner time discussions, and we all lived together with mum and dad uh as flatmates, kind of while we were at university, was like the basis of any civilization is art, and I'd be no, it's science, and my younger sister, no, it's commerce, you know, and uh and so uh getting to the point of slamming doors and like, no, shut up, I can't talk to you anymore. Um uh as we are all quite idealistic in our fields when we're at university. But then my folks were like, well, it's all about the energy of the like environment. So they were quite spiritual and universal in their uh out of the Ross.

SPEAKER_02 12:34

So it sounds to me like you don't come from that stereotypical Indian family that we hear about where the parents say you must do medicine or law or engineering, or I mean what what were your folks and what did they encourage or discourage? Um like professionally, occupationally, I mean So they gave us free reign to choose what we wanted.

SPEAKER_00 12:54

Um and uh I had applied for architecture, engineering, and medicine. I did drawing telemetric and I loved drawing. Um uh and then lo and behold, I got accepted for all, and I was fortunate because I also got scholarships for all. Uh but I I still hadn't decided what I wanted to do. And so um uh so chatted with mom and chatted with uh mom and dad and chatted with different people and uh still couldn't quite figure it out. So um mom said, Okay, I'm done here. And she had a friend uh who was actually quite a prominent uh psychologist in Durban. And she she said, You go speak to Debbie and uh uh, you know, maybe she can help you. So being the astute psychologist she was, she said, Well, let's do an aptitude test and uh see where your uh strength and forte lies. Um and so we I did the test and it came up strong on many different aspects. Uh scientific, artistic, entrepreneurial, uh humanitarian, et cetera. And so I was like, That doesn't help. Well, how does this help? Right? And then she said, well, let's flip it around and look at the professions which check most of these boxes.

SPEAKER_01 14:11

Okay.

SPEAKER_00 14:12

Right? And when you look at medicine, it it actually has that range uh to appeal to those various uh attributes that uh an individual might have. And so that's how, on a very rational basis, I chose to do medicine. Uh and uh and and I think it was the right choice. I really loved it uh or love it. Um but I made that decision a week before medical school started. Yes. Uh and then came up to to Vitz uh for that. Uh interestingly, when I do counsel students on uh who are thinking about medicine, you know, it is so I I draw on that a lot, that it has every field and faculty within medicine uh that you can think about. But it also uh is adaptable to personality types. So if you don't like people, you become a radiologist or pathologist. Uh if you if you like people but you don't want to talk to them, you go become a surgeon. Kind of kind of thing, right? So so within the field, there's a lot that uh um who who are the doctors that like people? Um you know it was interesting because uh one of my professors used to say you take a donkey and you put it through medical school and you get a doctor. And and essentially he was saying that the the journey to become a doctor is conditioning to the extent that you know it molds you to actually fit that particular role. Yeah. Um yeah.

SPEAKER_02 15:38

Okay. So you you you you carefully navigated that question and you haven't committed to a specialty that's uh people-centric. But I'll I'll let you off the hook, I guess anyone unless you want to say something.

SPEAKER_00 15:49

But well, uh you know, I I think it's I mean, by nature we as a species are gregarious, right? Uh it's that social engagement that's the I think the basis of life, right? Um I agree. But we we uh uh we have this little saying at home where everyone's on some sort of spectrum, right? Yeah. And it's a spectrum of engagement that we choose. And within the medical field, if you really like people and want to hear their stories, you go into psychiatry. Okay, right? And if you just want to get the gist of what people are going through, you go into general practice. Six to eight minutes per patient and you like crank it out, you know? Uh so I think within medicine there's there's varying degrees of engagement.

SPEAKER_02 16:37

Yeah. So we we skipped a lot because what I like to do usually is find out how how these these doctors were in like school, you know? Like high school, primary school, even high school. Were you one of these naughty kids? Or I mean, because you you're growing up in an area where there's potential for you to go anywhere, right? You can be influenced. You can be in a gang, TDKs or whatever.

SPEAKER_03 16:56

You wasn't.

SPEAKER_02 16:57

You might might might or might not have been in one.

SPEAKER_03 17:00

Um So what were you what these model students that just put you had your head in the books uh and you know, your parents had to try and encourage you to do extracurriculars or yeah, well, first of all, for to the to the viewers and listeners, uh Yash and I sharing our mic because we had some technical difficulties. So you'll see us um handing this over. But I just wanted to rule out first and foremost, you were not part of any gang, neither the the TDKs or the Victorians.

SPEAKER_00 17:28

Uh no, no, I wasn't part of any gang. Okay. That's that's cleared up. That's good. Yeah, so tell us about you know. Would it make it cool if I said I was arrested at that point?

SPEAKER_02 17:39

If it's the truth, yeah. You tell it. Tell us, tell it how it is. But yeah, what was it like?

SPEAKER_00 17:42

It was quite interesting. Um so I loved school, right? I mean, you got to hang out with your buddies. Yeah, right. That was the best part of it, right? And um I also found the schoolwork quite interesting and you know, it had a um uh natural flair for for some of the subjects. So I I really had a good time uh with it. Um but um I don't know if you know Gandhi Desai. No, no, I don't have heard of it. Oh, you youngins. Uh so back in the day, Gandhi Desai was like the top Indian school in the country. Okay. Uh and it was there by Greyville Race Course. And we were nuts because Gandhi Desai was there and it went from class one to Matric, grade one to grade twelve. Next to it was Orient High School, which was a Muslim Indian school. Oh I yes, I know that. Right? Um Orient Islamic School. That's right. On the other side was St. Augustine's, which was a colored school. Okay. Uh, and then there was a white boys' school uh on the other side, then there was Girls High, which was an Indian girls' school, then there was St. Anthony's, which was uh an Indian Christian primary school, and Hindu Tamil, which was a Tamil primary school, and Surathindu, which was a Gujarati uh primary school, um Anjuman, which was a Muslim primary school, um, and uh uh um Epsom Road, which was another colored school, etc. etc. It was nuts, right? Yeah. And when you look at parallel duplicators, and uh uh and and this was the the fundamental principle of a ponte, which was separatist development. Um and and when you think about it, it's kind of nuts because the government hadn't mandated that we needed separatist development among the Indian community, right? And yet it feels like it was a self-selection. But um but the whole premise of divide and conquer uh was I think what caused within the Indian community to go into their camps because it was a survival mechanism, right? And so it was easier to take care of your own community than to think in a more integrated way. And I think this is an important point that we'll get to. Um in South Africa, we we still haven't crossed that uh that threshold to think in a more inclusive, expansive, integrated way. We still very much think in our silos uh and individualistic as opposed to communal, uh, which is I think one of the critical factors we have to uh deal with in a South African context.

SPEAKER_02 20:24

Okay, yeah, that's super interesting. I'm glad you broke it down for the listeners and for me, it's an education for me also. So you ended up at Gandhi Desai then?

SPEAKER_01 20:32

Yeah.

SPEAKER_02 20:32

And so you were shooting out the you know, sh the marks are brilliant. Were you a sports sportsman or not really?

SPEAKER_00 20:40

Yeah, I was uh swimming captain and uh sports captain and head boy.

SPEAKER_02 20:45

Right. Okay, okay. Yeah.

SPEAKER_00 20:48

Matt's Olympia debate and like yeah.

SPEAKER_02 20:51

Well, this explains the bursaries and all that stuff that you Yeah, it was fun. I mean, I I I was lucky. Okay, cool. No, don't be humble. I mean, you were not lucky. Well, maybe why were you lucky? Why do you think you were lucky?

SPEAKER_00 21:03

Uh what's that lovely formula for meritocracy? Talent plus effort, right? Okay. Uh so um school, however, high school and all of that didn't require much effort, but the effort needed to come after when when one goes to university. It doesn't matter how smart you are in university, you have to put in the time, right? Um But um yeah, no, I was an all-rounder and I had a good time.

SPEAKER_02 21:27

And you weren't hell-bent on the medicine. You you made a very rational choice. You had your options. So it's not like you got into it for the doctor title or for the status and all that stuff. You you'd gone to Devi. Who's Devi? Uh what's her surname? Is she still uh uh alive?

SPEAKER_00 21:40

Yeah, yeah. Uh Devi Rajad.

SPEAKER_02 21:43

Yeah, she's a psychologist uh in in Durban.

SPEAKER_00 21:45

She's actually quite a prominent figure in the Indian community.

SPEAKER_02 21:48

Okay. Maybe we can get her on the show uh w once uh eventually. So Well set that bar high, guys.

SPEAKER_00 21:58

So then you go to Vitz, you mentioned. Uh yes, I did go to Butz. Why the hesitant response there? Well, I wanted to get out of Durban. Yeah. I wanted to uh uh experience a different place. Okay. Um and uh I love Joburg.

SPEAKER_02 22:17

Yeah.

SPEAKER_00 22:17

So you didn't you didn't apply to KZN and I did apply to KZN and UCT and uh all of that. And you had options. Um I had options. Um uh I love I mean Joe Burg is a pan-African metropolis. Yes. Right? Yes. And you either like that or you don't.

SPEAKER_03 22:36

I fully agree with you. You I mean, did you know this before coming here?

SPEAKER_00 22:39

Uh yeah, I had come up to Witz for interviews and uh had visited before.

SPEAKER_02 22:44

Okay, but you wouldn't have experienced being a Joburg. Not a bit of a lot the way you're describing Joe Burg, you wouldn't have experienced it at that age at 17, 18, right?

SPEAKER_01 22:52

Yeah.

SPEAKER_02 22:52

Yeah. So okay, that's interesting. You had choices, and the folks didn't say to you, no, no, you stay in Hattel, university, whatever it's called. Okay, you go spread your wings. So you want to call quits. What are you thinking?

SPEAKER_00 23:03

Um You know, it's interesting. As a parent now, uh I have this feeling all the time when I look at my kids. Yeah. Uh you're raising them to fly.

SPEAKER_01 23:16

Yeah.

SPEAKER_00 23:17

Right? And and that's how my folks raised me. Okay. Uh and Khalil Gibran has a lovely saying in the Prophet where he says, Your kids are not yours, they're just born through you. And and my mom was a huge fan of Khalil Gibraltar. And and so I think that was part of her thinking. Um so fly, yeah, but always be tethered to home in some sort of way. And and no matter, you know, over the past 25 years following an international career, mom and I chatted every day.

SPEAKER_02 23:45

Okay.

SPEAKER_00 23:46

Uh on the phone. Almost every day. Yeah.

SPEAKER_02 23:48

Okay. So what w what was the motivation behind going to Witz for you personally?

SPEAKER_00 23:52

I just wanted to experience a different place and I wanted uh uh greater diversity and exposure. And I felt that uh Natal was still quite uh restricted.

SPEAKER_02 24:04

Okay. And and you mentioned us being young, and so I don't I I I feel comfortable aging you here by asking you when was this exactly? Um when was your first year in medicine?

SPEAKER_00 24:14

This was before the fall of apartheid.

SPEAKER_02 24:16

Yeah. All right, you you don't want to commit to another.

SPEAKER_00 24:18

No, this was uh 1989.

SPEAKER_02 24:20

1989. Okay. Sure, this is way before apartheid. Like five years, I mean before it ends. Before it ends. Five years is a long time.

SPEAKER_00 24:27

Yeah, yeah, absolutely. And it was a really interesting time to be at university. And and I'll give you one example related to medicine.

SPEAKER_01 24:36

Yeah.

SPEAKER_00 24:37

So um when I had started at medical school, so after first year on main campus, you then go to med school, but there was a big issue because we had segregated hospitals, right? Okay. Um, and uh students of color um or non-white students were not allowed to go to uh the so they were excuse me, allowed to go to white hospitals, but they were not allowed to go to OBGYN wards. Okay. Uh Obzing Ghani wards in white hospitals. Yet white students could go to any wards in black hospitals.

SPEAKER_02 25:15

Interesting. So what they protected the dignity of the woman, or what was the thinking behind that?

SPEAKER_00 25:19

Uh oh, it's anatomically different.

SPEAKER_02 25:21

Oh my goodness. Oh wow.

SPEAKER_00 25:24

No, no, I uh that's just doctor humour, right? Okay. Um uh yes, it was the about the sanctity of their woman and like all of that.

SPEAKER_02 25:34

Yeah, we're gonna cut out that reaction, I'm joking. I'll leave it in because it that that joke flew over our heads. Like we should have gotten that immediately. I'll leave it in just to show that we can be idiots. I'm gonna I'm gonna leave that in. Okay, yeah, yeah. I I need to I need to read your your sense of humor better.

SPEAKER_00 25:51

I do like uh the fact that you're a dentist and you second guessed your understanding of anatomy. Yeah.

SPEAKER_02 25:58

Oh brilliant. Okay, so but but it was different cavities, guys.

SPEAKER_00 26:01

But it still makes no sense. It's my speaker. Speaking of which, do you know what vagina dentata is?

SPEAKER_02 26:06

Uh well if there's st it I mean if they can be inference, I guess. Teeth. Yeah.

SPEAKER_00 26:13

Yeah, yeah, yeah. Absolutely. Uh there's a whole mythology around that, but that's for another discussion. Yeah.

SPEAKER_03 26:18

It's also a movie.

SPEAKER_02 26:19

That's right. That's right. Okay, so uh yeah, I'll keep it in. We the the the joke flow over our heads. We so yeah, it's embarrassing, but I'll leave it in. Okay, right. But it must have been what it's just they're trying to protect the dignity of their woman, or what is it? Uh I don't understand. You unless I missed it.

SPEAKER_00 26:33

I don't want to say dignity, I want to say. You know what I mean? Yeah.

SPEAKER_02 26:38

I'm not saying that by you look by a person of colour looking at a woman, you are, you know, uh making them in uh undignified. I'm just saying that's what the government provides.

SPEAKER_00 26:48

And this is all very relevant in this day and age where there is a distinct white supremacist agenda being pushed.

SPEAKER_02 26:56

Okay.

SPEAKER_00 26:56

Right? Not just by the US administration, the current US administration, but we're seeing the shift in other parts of Europe. Okay. We're seeing the rise in South Africa once again of uh that very conservative uh uh perspective on things. But the interesting thing that happened um is the black students then said, hey, if we can't go to all wards in white hospitals, yeah, we're not gonna let the white students come to any of our black hospitals.

SPEAKER_02 27:25

Okay.

SPEAKER_00 27:25

Right? And so the white students also all of a sudden said, well, if we don't go to Hillbrow and Baraguanath, et cetera, we're not gonna get a good exposure to a wide variety of cases, right? And so they stood in solidarity then with the black students to say, hey, we should just open uh all wards for all students, kind of thing. So uh it was interesting how that happened. I also lived in my first year uh at university, I lived at Men's Hall of Residence. And traditionally, what would happen at university residences is you would have a white students committee and you would have uh have uh a black students committee, and this is to oversee the governance and running of the residents. Um the black students committee was a sort of side thing, unofficial. Yeah. The white students or house committee used to be involved in the formal governance and they used to vote, and it used to only be the white students could that could vote and um uh and and hence vote their people in, and we couldn't vote. So what we suggested, and this was around 1990, uh, we said, well, why don't we just have one election? Everyone can vote, and like all of that. And the white students were actually quite comfortable with that because they were in the majority in the residence. Right? And so what we did is they had like about three or four candidates that they put forward. We chose to put in one, all right? And we all, as people of color, voted for that one person, whereas they increase your lights, right? Right. We block voted, right? And and they their vote was distributed among the four or five. And lo and behold, we got in our person of color uh in the residence. And um uh and it was an interesting shift. And all of a sudden, we became the first, not multiracial, but non-racial residents in the country. So really, really interesting times. Um, and it's funny how things happened because then you saw white guys who you would drink with all of a sudden say, Hey, I'm out of here. And then you would see guys who you drank with and were like, Okay, yeah, let's figure out how we do this together.

SPEAKER_02 29:35

Wow, that is super interesting. Like most of the viewers, as far as I understand it, of this and listeners to this podcast are either students or potential students or past you know, qualified. So you know, this is interesting for me as a young and I'm sure it's gonna be an eye-opener for a lot of the listeners and viewers, right? But so you get to uh you get to the big smoke, Johannesburg, what's it like? Like like what do you do that's different to Durban? How's university? Were you still a star student, or did it humble you like it does a lot of us star matriculants?

SPEAKER_00 30:10

Oh, I failed dismally in my first job.

SPEAKER_02 30:12

Okay, good. Yeah, yeah.

SPEAKER_00 30:13

Right. And and it was just um I w wouldn't say for academic reasons. Um uh because you had the aptitude to pass. Right. But I was just so curious and hungry for so much more in life, you know, dating and dancing and trying different foods and exploring different places. The live music scene in Joburg was amazing. Jamisons and Kippies and uh uh tananas were big then, and uh Dr. Victor uh Byron was coming up. So it it was a really, really fun time in South Africa, super hot sticks, etc. Um uh so there was just so much more to take on. Um uh and and that's what I was interested in. Um, you know, it was interesting you were talking about your career choice and how sort of you just followed a path that was laid out for you rather than really being reflective and thinking about it. What does an 18-year-old know about choosing and making life decisions? Um and and so I'm a huge advocate for a gap year, or I do like the American uh college system, which in your undergrad you can do a wide range of courses, and only after that you choose what you want to do. Uh, you know, you could do art history and and uh nuclear physics uh in your in in your undergrad.

SPEAKER_02 31:37

Aaron Ross Powell Agreed, agreed. Fully agreed. Uh I wish I had a Devi at my life at that stage. Um I also we used to we had a guy that came and studied. Sounds like a goddess, right? You might just find religion, yeah. Yeah, if you just take that out of context, somebody will think that. Yeah. Um we had a guy from America who came and did an elective here because he wanted to upskill himself on HIV and stuff, and he told us how the their college system works. And you you go to college to find yourself and then you decide what you want to do. Whereas here in South Africa, we don't really get the luxury of being able to find ourselves. I mean, it's you've got to go study and try and get a job, right, in most people's cases. So you know, it is a luxury here and a privilege to be able to do the gap here and find yourself and things like that, I think.

SPEAKER_00 32:21

Aaron Ross Powell And a lot of that was about um social mobility, right? And and particularly with the Indian community, there was the doctor, lawyer, engineer kind of thing, right? Uh good, solid professions, high return on investment, et cetera. Um and and and get into it as fast as you can, get out of it as fast as you can so you start earning, take care of the family and and get things secure. And I think we we're in a fortunate situation now, uh not just as the Indian community, and I I don't even know what that means anymore because we're all quite integrated now, um, but as South African community, um uh where we don't have to like crank it just for money. We can express and explore in ways of arts, culture, music, commerce, etc.

SPEAKER_02 33:12

Yeah. Um uh and your family was living that in those days, because I mean, filmmaker, doctor, and what's the other one?

SPEAKER_00 33:20

Uh commerce uh marketing MBA, yeah.

SPEAKER_02 33:23

Exactly. So it's quite unique for that time. I mean, now that's what I I would think we'd aspire towards, you know, let your kids do what they want to do. And just well, and uh look, I must I must make this clear. Like my old man said to me when I asked him what I want to do, what I should do, he said, go play cricket in the UK because I was good at cricket. So I didn't come from that typical type of family either. Um but yeah, it's interesting to see how So look you put it very well about your first year and you were exploring and all sorts of things. But if I had to sum it up in one colloquial term, I said I would think you were you were catching a bit of a draw in first year, or you were enjoying yourself, or how did you Oh, I was having a great time.

SPEAKER_00 34:00

Yeah. I mean, the last thing I was interested in was in my studies.

SPEAKER_01 34:04

Yeah.

SPEAKER_00 34:04

But but sort of looking at the trajectory after that, um the first three years of medicine uh sucked.

SPEAKER_01 34:16

Yeah.

SPEAKER_00 34:17

Right? Because it was a lot about rote learning and memorization, right? Yeah. Very interesting stuff, but it just felt like you just needed to like absorb stuff, right? Facts and data. Um the clinical years, I came into my own. Oh. Right. And I'm talking about like from the bottom uh five percent of the class to the like top. Because you started you know, when you would write a test in in your pre-clinical years, uh you could almost picture your page or from your notes or the table, right? And you're writing that. In your clinical years, what would happen is you would well for me, is you would picture a patient and you would see organ systems interact and engage and manifest with different things, uh, signs and symptoms, etc. So it all started coming together. And I really enjoyed that. Uh, you know, how how you put it all together.

SPEAKER_02 35:14

And with that dynamic of, you know, separate races and all that stuff in those days, what was it like? Like your, you know, the actual experience of being you know, what were your lecturers like? Let me put it that way. Did they you know, did you have like white, black, Indian lecturers or just white, and was there favoritism? And did the white kids know all the the questions that were going to come out in the exams?

SPEAKER_00 35:39

And um did they get special treatment or how did you I so I think it was a really good solid education.

SPEAKER_01 35:48

Yeah.

SPEAKER_00 35:49

Uh and I uh I have to say, uh from primary school all the way through university, the ethic of teachers back then, our professors and lecturers at med school and everything, to our um elementary school teachers um was just beautiful. They were so committed. And so I that's the feeling I have when I walked out of or was at medical school that um people were really passionate about their subjects. And it didn't matter color or anything like that, they were doing it for the love of that particular discipline or subject. Um and that's how they responded. And if someone showed uh a flair or an aptitude towards something, they would push that person, uh, you know, irrespective of color. So I I do feel like that was the academic environment that we had. Uh, you know, subsequently I did work in academia, and then when you start seeing what's going on there, whew. Uh Henry Kissinger was the uh uh US uh uh Secretary of State uh and and a notable diplomat, he said he learnt all of his politics in academia. Um so it can be a really toxic environment, but from a student point of view, um it was wonderful.

SPEAKER_03 37:08

One last question on that, not to labor the point, but I mean you're one of the first people, like professionals that I've met, that started pre-94 and probably qualified just after 94. Am I correct? Yeah. When did you qualify? Uh yeah, 95. Yeah. So so what was it like? I mean, 94, I mean, we were quite young, but I still do remember um, you know, what my parents are watching stuff on TV and things on the news and people being all worried. You were living away from home now at this stage. You were living at here in Johannesburg, and then the Parthi government got disbanded. So what was it like? Can you remember?

SPEAKER_00 37:49

It was amazing. Oh, it was amazing. Just the energy, the buzz, the vibe. I remember uh the days specifically when I was walking on Jorison Street in Bramfantin, and I got news that Mandela was released. And and talking about the rest that was when we were protesting uh as as students, you know, and and you're standing in a group of three, four hundred students and you think, ah, they can't arrest us because there's too many of us. And they would come in with their Caspers and put us in buses and like all of that. I don't have a wrap sheet, I don't have a record. So they did release us without I I didn't I didn't sort of get jailed or anything like that, just arrested and then released. Um but then you realized your vulnerability to the system. Um and and so we were all very conscientized, politicized, aware of what was going on uh back then. And and so we had skin in the game. It was our game kind of thing. And and so I remember clearly that day that just that feeling of elation, this this uh this this cloak being lifted, this burden just like melting away. Uh even, you know, we didn't even f know the details of how this was gonna work out, how we were gonna get equity, etc. But but just Mandela coming out was you know uh amazing. Um yeah, it was a special time, and then I remember in '94, the first time we voted, we went as a whole bunch of students and friends, uh, and just standing in line and different people of different walks of life, all you know, and and we were in tears. I mean, it was just a really, really moving experience.

SPEAKER_02 39:41

That's amazing. Any any moments that um stand out to you from university, from undergrad days, um that stick out in your mind? I mean, I can think of one where the first day that that I was gonna see my first patient clinically in the ward for for a subject called prostodontics, which is basically dangerous, false teeth. I'm so nervous because um it's gonna be the first time I'm gonna lay my hands on a patient, right? So I'm stressing like crazy about this. I'm thinking about the procedure that I'm gonna have to do for the first time ever, everything. And before I can set foot in the ward, the lecturer comes to me and he says to me, Mr. Naidu, here's a shaver, here's some shaving form, go down the passage and go shave. I'll never forget that. So I it threw me off completely for that first interaction that I was gonna have with the patient. I'll never forget that. So do you have any moments like that, or even something good or bad or ugly, or not really, or you must have plenty.

SPEAKER_00 40:39

Oh, yeah, yeah. Exactly. Um so I you know, I think once the clinical year started, you you were constantly in the wards. So whether you were shadowing someone or having a ward round uh uh with the professor or consultant, um so uh there was a gentleness to the patient exposure, right? Until you had to then examine the case yourself. And and uh the nurses were always really, really kind uh to us. Uh our registrars would come and introduce us to a patient and say, hey, here's a student, they're gonna uh ask you a lot of questions and and examine you. So um so there was, you know, the adage uh see one, do one, teach one, and and and that was the culture. But I remember in, I think it was in fourth year when um I was in OBGYN and we had to catch babies, right? Uh deliver our babies. So I was at Alexandra Clinic. Um and uh and so you had to observe uh uh a few and then you you had to uh be supervised to to deliver the babies. And I remember the first one I watched, and and then the the matron or the nurse was there, and they said, Doctor, can we get you a chair? Are you all right? And I just remember breaking out into the sweat and like my ears turned like red, and I felt this heat and like brilliant pulse pulsatile sort of uh dynamic throughout my body.

SPEAKER_03 42:16

Yeah, I'm assuming it's because you had lack of OBGYN training because they kept you out in um and and that's our first exposure in fourth year, right?

SPEAKER_00 42:36

And and and to see it the first time uh was just like wow. Yeah, yeah.

SPEAKER_02 42:42

So you knew obstetrics wasn't for you. Never gonna think. No, after that it was it was quite all right.

SPEAKER_00 42:49

You know, um uh I mean uh doing the first rectal examination, or you know, like all of these things. And reason uh the professor was like, hey, you don't put your finger in it, you put your foot in it, you know, uh kind of thing. Uh like it was such an important part of uh the uh clinical examination. And one of the things that was really, really drummed into us um uh, you know, 80% of your um uh diagnosis comes from uh history. Okay. Fifteen percent of it comes from special investigations, and five percent, I mean fifteen percent from your examination and five percent from special investigations.

SPEAKER_01 43:30

Okay.

SPEAKER_00 43:30

All right. And and so you were taught to be a clinician, to look and observe and uh and and then examine and palpate and like uh it was putting all those pieces together. Um and now, you know, practice is like, well, let me just run a battery of tests, see what comes up, and then go from there.

SPEAKER_02 43:50

I find it fascinating um your experience of because you mentioned just now that the nurses were also really great to you guys, right? And you know, previously you mentioned that the work ethic of all the lecturers and in your experiences and like if you show your interest they'll give you the you know the um attention that you need because a previous guest I've spoken with who I think also studied a similar time mentioned to me some really really fascinating really uh a story that stuck out in my mind where she mentioned that when she was a junior doctor at one stage you know the uh the interns who are white would question her uh ability you know so they would double check what she did even though she was senior so it's it's quite a it it juxtaposes your experience juxtaposes hers and it's interesting maybe well she was at KZN so it might be slightly different there but I just find it fascinating that your experience is like that. I don't want to you know can we move on to past university now? What happens after?

SPEAKER_00 44:51

Yeah yeah sure or if you have any other interesting stories please feel free but yeah what happens afterwards um so I did my uh internship at Hillborough Hospital and I drove into Hillborough on the first of January nineteen ninety six and uh sort of driving between refrigerators and wardrobes and everything that were thrown from the tops of buildings glass strewn all over. That's a New Year's Eve tradition you know this yeah yeah yeah yeah it's uh it's nuts um and uh and then there's a whole backlog from the night before uh and you know just dive straight into it and we were exposed to trauma and uh all of that um as students um so that was my internship I think it did mess with me I think the level of responsibility one had to take um without enough support structure um we were understaffed uh and and everything um and paid uh oh geez I think my f for the internship it was something like four thousand or four thousand five hundred Rand a month.

SPEAKER_02 46:00

And that's uh you know some people might think because it's nineteen ninety six that's probably a lot in nineteen ninety six but it's not right? No it wasn't a lot before that OSD thing came in occupation specific dispensation or whatever where the doctors fought for you know decent salary decent ish sales right and and I was I was a doctor in training so I wasn't a a fully fledged you know medical officer or senior house officer or anything like that.

SPEAKER_00 46:26

So um uh but what was fun for me is I used to moonlight in private uh in theater so at Brent Earth Park Lane with some prominent surgeons in the was this even allowed um it's fine it's done well I think there might be a moratorium on any of my misdoings at the time. But uh no so not during my office hours. So this was on my own time that that I used to do that and um uh and I was sort of assisting rather than doing anything on my own. Uh but it exposed me to a whole other world of uh private medicine uh and all of that and back then the interesting thing is a lot of the doctors in private were also in the state hospitals and they would rotate they would run clinics in private and run clinics in in in the public sector and and we wanted that because you kept up with a really solid academic standard because your time in state was usually university affiliated hospitals. Okay. Job Jen Helbrau et cetera and so people would sort of do the dual track. I mean even to the extent that if someone you were seeing in with uh in private ran out of medical aid or health insurance, you would tell them come see me in the in the state hospital. Okay. Uh kind of thing. So um so it it it it was actually working uh well we were making the best of it. Yeah. Trying to maintain academic standards, uh provide as much coverage as we can and access to services. And um yeah um you know be efficient. So it was good. Yeah and then I finished my internship and that's two years, right? It was one year.

SPEAKER_02 48:18

Okay, at that time.

SPEAKER_00 48:19

At that time and I think it was two years after I finished that they introduced National Community Service.

SPEAKER_02 48:26

Oh okay so you didn't have to do ComSurve at all?

SPEAKER_00 48:28

I didn't have to do it but uh a couple of mates of mine we uh we liked the bush so we went and worked in the bush. Yeah tell us more and um uh and it is interesting how much uh service you can provide in uh general practice out in rural areas. Okay. Uh and even when you know we had mobile units you would go and out in the middle of nowhere this kid with a rash or a snotty nose comes running to you and he pulls out a medical aid card.

SPEAKER_01 48:58

Yeah.

SPEAKER_00 48:59

Right? Because his father is a mine worker or working in the city that's covered with insurance that covers the family as well. So so there were ways of providing services all out there. So in Puma Langa uh and then I also did some locums uh on the mines in occupational health and safety um that was in Rustenberg in platinum and then East Rand proprietary mines and it was interesting then because the government had introduced red tickets and red tickets were mini x-rays uh of the chest audiometry uh visual assessments uh and just a general physical to assess for disability and then uh make claims for workmen's compensation so there was a backlog from apartheid days um that the government was then catching up on okay but hold on so internship after internship you go straight into private practice you go to the uh where do you go to what do you do so I started just locuming in different places in Pumalanga uh in Pumalanga Rustenburg uh down in Cape Town Oh so you're all over the place yeah but you fly and travel or you drive everywhere and drive and yeah that sounds chaotic I mean is it Oh it was fun yeah yeah yeah you loved it you've single foot loose fancy free you experiencing different patient cohorts different you're seeing the country um uh and then different diseases how long was it was it l like part of a a group of private practices how would you find these so you would find uh there would be a lot of practices that would advertise locum positions and then you would apply for it and yeah and then you start getting known on the circuits and like all of that.

SPEAKER_04 50:43

Yeah.

SPEAKER_00 50:44

And then the government was also looking so they couldn't employ doctors fully but they needed to catch up with the backlog of um uh red tickets so then they just started hiring doctors uh as locums yeah so I might be skipping uh jumping ahead yeah for ahead of Yasha's schedule but is that where you found your your love and desire for community medicine we previously had this discussion because I didn't know what you do I I mean I knew that you were a doctor but I knew that you were not treating patients.

SPEAKER_02 51:14

No before you answer that how do you two know each other? Can I ask that question?

SPEAKER_03 51:19

Yeah you can. So Niraj is um well considering he's a friend now but he was a referred to me um as a patient.

SPEAKER_02 51:26

I think I did your was it a wisdom tooth that I had to remove once is Yak uh inadvertently breaking doctor patient confidentiality here or are you comfortable with it?

SPEAKER_00 51:35

No I see one of his colleagues now. Expanding that relationship transitioned here okay all right okay no no carry on Yak you Oh yeah so do you think that's where the love of uh community medicine um came came in so I and we'll go into what the medical journey uh became afterwards but uh it wasn't quite a community medicine specialization but um uh I am all about primary healthcare and uh rural access uh and you know there's a lovely uh term in economics called or concept called uh perito optimality which essentially says that your greatest gains are made when you start off with those that are worst off first because no one else loses. You know in economics we talk about opportunity costs. When you do this for this person this other person is missing out. But when you start off with those that are poorest then you're not actually taking away from anyone right um because it is for an incremental investment a huge return. And and those are the rural communities we need to deal with periurban settlements, uninsured people, primary, secondary, tertiary level prevention, all of those sorts of things. And so that's where my heart is right um uh I do like advanced medical advances and like the technology stuff but uh but um yeah that's uh the the sort of area I like uh most um and then there was a lot of uh infectious diseases in those contexts neglected tropical diseases but I think the other thing that's really important is that a lot of the conditions we deal with in rural areas uh are amenable to social determinants of health. So more often it's not a medical intervention but a social infrastructural investment that we need to do in order to address that. Interestingly about community service uh and doctors did feel singled out. So we would treat food and waterborne diseases and um and then people would go back and come back with the disease again, et cetera and we were like where's the plumbers bringing water sanitation to these communities? Where's the electrification so people don't have to burn fires in their houses which is giving them respiratory infections or or conditions. And so we felt that this was something that needed to be expanded to other disciplines not just doctors in order to be more sustainable and not excuse the pun put a band-aid on a gaping wound right uh but how do we shift that whole infrastructural thing?

SPEAKER_03 54:32

Yeah. So take us on that journey. I mean you were done with locuming around the country and private private sector.

SPEAKER_00 54:42

How did you get in I mean because Chatterjee uh said uh a whole host of things about you being in America and you know you you you're quite formidable with um primary health care so what's that journey like you gave up gave up Oh you're missing out the most titillating part of my uh one of my practices in South Africa yeah um I um as I was exploring locums I did get a locum in um uh at one of the clinics in South Africa and then went on to become a full-time employee and then the medical director and this was uh the men's clinic um dealing with male sexual dysfunction and this was pre-viagra so we were using in injectables of vasodilatis um and as you probably know there is significant pathology and erectile dysfunction is an early sign of maybe some underlying vascular cardiovascular issue um uh but a vast majority of men it's more psychological or performance anxiety related right um but that interestingly uh and it was great because it was well-paying job so you know uh that was like ah this is what it is like you know to sort of uh get to a different level of income um but that's where I learned all my bedside manner because none so fragile as the male ego when it comes to his sexual performance. I mean we're talking medically yeah we expect women to lie in the lithotomy position and do a pap smear and like that's just what we do. But all of a sudden when you're dealing with male sexual dysfunction it's a whole other level. So it was a really really interesting time uh you know and um uh I can't say it's something that uh uh so a lot of my colleagues would have a chuckle uh kind of thing and uh then they'd hear about how much I was earning it's like oh no I want to get a job like that I'm like you think you could? And and they would think about it and like no I'm not sure. But but that's what my um my journey in medicine was. It was an exploration. I was just always curious and uh and one of my advice to young doctors or even to students is hey if you if you're curious about something or if you have an itch go scratch it. What's the point of having the itch if you can't scratch it? You know and so so the moment something tickles your fancy, go out and do it.

SPEAKER_02 57:16

But how did you it seems like a bit of a pivot if you're going around the country and then you end up at the men's clinic.

SPEAKER_00 57:21

How did that happen? That was in Santon and um and uh so I was like okay let me try that out for a while.

SPEAKER_02 57:28

Okay you've answered my next question because it was going to be this is probably in an upmarket area.

SPEAKER_00 57:32

Yeah yeah yeah it was and now I mean there's like uh clinics all over the country and then I started training doctors and what was also really interesting so um then I started sort of going into not just clinical practice but health management or management of health uh and and health administration as well as capacity building and training uh figuring out processes and like all of that so it just exposed me to a whole lot more um but then clinics also started opening in Botswana and Zimbabwe uh Mozambique uh so it's it's quite uh uh widespread and it was started off by a group of doctors in Australia and and so there was a a bit of international collaboration so that was uh quite interesting um but then at some point oh uh I did um explore being a ship's doctor on the symphony okay right yeah he's been on the symphony right and that's a party boat right and and as the ship's doctor you sit at the captain's table and like you know uh but uh the and it feels like it's uh it's like a pilgrimage that every South African doctor does to go to the UK yeah but I did go to the UK and uh uh instead of going uh being the ship's doctor um but it was also a curiosity to see what was medicine like in uh first world countries right and I got to work in the good old NHS um but I also uh um drew on my sexual health experience and worked on Harley Street which is kind of like Park Avenue medicine right uh and to see me was like 450 pounds an hour and this was way back when right um uh and it was obviously the clinic fees but um uh so I worked in public and private uh in general practice and then also very specialized um but something happened then um where you like to think that what you're doing as a care provider whether physician or dentist etc is evidence based based on the latest and greatest evidence but when you start digging deeper those decisions aren't necessarily evidence driven. I'm not saying there isn't evidence but I'm no I'm saying it's not the best evidence and there's other influences on that. And this is where in in health we have uh quality safety and efficacy of interventions but the fourth hurdle is cost effectiveness right um and and so I got really curious about that why is certain drugs on the formulary and certain aren't why are we approved to do these interventions and not and that's when I went to the London School of Economics and pursued an economics degree uh with a specialization in health policy and health economics. Hold on so you stopped practicing for a while uh no I was still practicing and I was uh yeah um and uh and so I do like uh weekend calls and go to Bath or go to like Dorset or Edinburgh and be there for 48 hours on call and then come back and hit the books and so how many years was this in the UK? UK was about uh two years yeah um and uh the master's at LSE was uh yeah all right and London School of Economics was just bloody brilliant. Really? Oh man it was what an environment. Yeah and you know there's the ox bridges yeah right but LSE is just in the class of its own okay and then what makes you come back to good old Mzansi or you oh no and then from no from London I um landed a gig with Mug. Uh you gotta get into the belly of the beast big farmer. Yeah um and so I went to New Jersey to their headquarters in Whitehouse Station and I so this is around 2000 2001 and um and it was an interesting time in medicine right we call this the heyday of global health and development uh international development um so I was in external affairs for Europe Middle East and Africa at Merck um and uh you know uh everyone has the perception that big pharma are evil profiteering uh companies pharmaceutical companies big pharma are big they're huge and they're not a homogenous entity so when you speak to someone in community relations or research and development or marketing or business strategy they are all very very different and it's almost like having like community engagement is kind of like an NGO within a farmer you know uh marketing is like an advertising company and um and this is where the executive office with the CEO that's where the big brains are because they put it all together. But it depends on which part of the company you're talking with and you get a very different perspective of them. So it was really really interesting but it was around the time where um um we were kind of hitting our peak of the AIDS epidemic right globally. And so I I went to Merck to actually do a study for them on health targets uh and how important it is or what the impact of targets are. And that's a whole other conversation. But as I was then looking at what my next move was um you know I was speaking with my boss at Merck and and uh he's also a phenomenal character in global health and development and and I said I'm so now I'm a doctor and I have an economics degree as well and I've worked in the global south and I've worked in the global north in the public and private sector um what do you think I should do next right and so he looks at me and he says well what are you interested in so I said well um AIDS is very close to me right growing up in South Africa uh seeing AIDS patients and we didn't have antiretrovirals at the time right uh do I think it's the most important issue in the world no but I think it's the most important politicized springboard issue that can help raise awareness to a whole lot of other things right and then I said and I don't believe that every any single sector can actually take on a global challenge like HIV on its own not government not business not NGOs but we have to work in partnership right this is the middle child in me coming out right um and so he said oh uh I know this guy who's been asked to set this thing up let me put you in touch and it so happened that Richard Holbrook I'm gonna drop some names here um was the former US ambassador to the United Nations right and he very interestingly sharp sharp guy he took HIV not to the UN Health Council or anything he took HIV to the Security Council and he said HIV is a security risk because if HIV infects your army and your armed forces and decimates it you are vulnerable right and that's how he raised the profile and so you can start see the sort of uh multidisciplinary interdisciplinary stuff uh setting in for me um and so when he finished uh Richard finished his tenure at the UN Kofi Anan who was the Secretary General at the time asked him to set up a platform on business engagement in HIV right and so uh he set up the Global Business Coalition on HIVAIDS and he then had someone seconded from UNAIDS to the That. And so Ben, who was seconded, needed to set up a team. And so Richard says, Well, how can we be an AIDS organization without a doctor, and especially a doctor from South Africa? So just by chance, I stumbled across it. And then there were four of us that set this up. And what we did is we worked with multinational companies to get them involved in HIV. And I'll give you a couple of examples. So Big Pharma, for obvious reasons, they were manufacturing drugs for HIV as well as opportunistic infections and everything. But in order for doctors and drugs to work, you need logistics, distribution, management support, all of that, right? The biggest distribution of anti-malarials across East Africa is DHL and FedEx. Right? So those are the types of things that allow service delivery and access. And so we started working with all these different companies. I remember sitting with MTV and Viacom, and I'm like, I'm a doctor, I can take care of the physical body, but you guys get into the hearts and minds of people, right? And when you talk about HIV, it's all about behavior change, right? No one wants to listen to a doctor in a white coat.

SPEAKER_02 1:07:17

This group of the four of you that are doing all of this, what do you call yourselves? Or what is it, what is it called?

SPEAKER_00 1:07:22

It was called the Global Business Coalition on HIV 8.

SPEAKER_02 1:07:25

Okay. And then you so you're meeting with MTV, you're figuring out how to distribute things, you're figuring out how to make um get into the hearts and minds of the of people, young people. Carry on. I just wanted to just check what the name of that entity was.

SPEAKER_00 1:07:40

Yeah. And and it was nice because we were meeting with these companies at principal levels. So like CEOs and EVPs, uh executive vice presidents, but there was also a lot of media and marketing companies, fast-moving consumer goods, the Unilevers and uh proctor and gambles of the world. Um the big one was the mining and engineering companies. Uh at one point, Anglo-American was hiring two workers for the same miners for the same job on the premise that one would get sick from HIV. And uh and they did so it became a business interest for them to respond to HIV. So the the four categories of engagement was um uh uh the their workforce, right? So those companies that had operations in hard-headed regions uh across Africa, Asia, Latin America. Then it was um their core competencies, things like logistics, distribution, et cetera. Um then it was um um advocacy and communications that was really, really big.

SPEAKER_01 1:08:45

Yeah.

SPEAKER_00 1:08:45

Because when Tony Fauci stands up and talks about HIV, his congressmen and senators and everything, yeah, sure, he'll talk about that. But you bring in a business leader who is the CEO of a company like Richard Branson or Jürgen Schemp, who was the head of Daimler, et cetera, yeah, and they say HIV is important. Well, okay, tell me more. People listen, yeah. People listen, right? So uh it was um um And celebrities, I guess.

SPEAKER_02 1:09:10

Also people listen to celebrities.

SPEAKER_00 1:09:12

Well, you know PEPFAR, right?

SPEAKER_02 1:09:14

Yeah.

SPEAKER_00 1:09:14

PEPFA, the president's emergency plan on AIDS relief that was announced by George Bush.

SPEAKER_02 1:09:18

And the thing that Trump just recently chopped and then it came back.

SPEAKER_00 1:09:21

Yeah. Absolutely. But Bono was a huge factor in getting that passed. Uh, you know, and and we were quite enamored when we took CEOs of companies to the hill and how the congressmen and senators and appropriators paid attention to them.

SPEAKER_02 1:09:38

Were you involved in that product red thing?

SPEAKER_00 1:09:40

Yes. Yes, yes.

SPEAKER_02 1:09:41

Because like Apple is big on product red.

SPEAKER_00 1:09:43

I so I was just cleaning out my wardrobe and the original t-shirt, red t-shirt from Gap, which was the first product, I still have it. I mean goosebumps. Yeah.

SPEAKER_02 1:09:54

What is product red? Well, I'll tell you how I know about product red.

SPEAKER_00 1:09:58

Yeah.

SPEAKER_02 1:09:58

I'm an Apple fanboy. I will I'm a recovering Apple fanboy, right? I don't no longer fanboy. But every now and then, Apple would release a special iPhone which is red, and it would be called a product red iPhone edition, whatever. And then I would always see this sign, which is two brackets or parentheses, and it says red, and then at the bottom it says proceeds from this will be will go towards the fight against HIV and all that.

SPEAKER_00 1:10:23

So this actually started at Davos, and there was a side meeting, and Giorgio and Marni were there, and Bono and uh Converse and a few other companies, and they committed to saying, well, we'll use our brand uh to um to help raise awareness and raise funds for HIV. So that's how they came up with Product Red, that they would dedicate a particular line, and Gap was the first to come up with a red t-shirt. Uh, but there was Converse and there was uh um uh iPhones, uh, et cetera. Um and then the proceeds of that would go toward the global fund to fight HDB malaria. Um uh it was interesting, um Mac cosmetics, right? They had a line called Viva Glam. They didn't do any advertising for Viva Viva Glan besides the fact that Viva Glan was a dedicated line where all the proceeds went to the MAC AIDS fund, which then went to support AIDS programs, and it was their best seller. Wow. And you know, Rue Paul to Pamela Anderson and everything were ambassadors for this. So it was so interesting at the time working with all these different companies.

SPEAKER_03 1:11:38

And if if I can if I can get it uh correct, my interpretation of this as your role was basically like a translator to get the information of what HIV and any of these epidemics at that stage was to translate it to someone like Bono to be made aware of why it would affect his populace of support.

SPEAKER_00 1:12:02

Oh, yeah, yeah. So so my challenge to my teams were you give me any company anywhere in the world um uh from any industry, and I will find a way of making HIV relevant to them. Right? And and it was a really, really creative process. Um I mean, one of the big things, so you saw that Trump had um uh restricted imports or put tariffs on imports from Lesotho. Right? 50%.

SPEAKER_03 1:12:31

Yeah.

SPEAKER_00 1:12:31

Right? And what had happened is the United States had put quotas on imports from China and all branded lines like Levi and Gap and uh um uh Banana Republic, etc., are manufactured by Chinese companies and then imported to the US, right? By these brands. Now, because the US government put quotas on China, uh Chinese exports, Chinese companies relocated to Lesotho. Right? And uh and then their exports were technically from Lesotho, yet it was the same Chinese company. So we started working with these companies to um uh to look at how they can protect their workforces uh and then also get involved through uh things like product red. Um it was interesting because you know, from working with the mining guys where they had policies like Total Sustainable Mining, and I went to Alberta, Canada, where there's the annual mining conference and the whole world congregates on that, to like the multi-fiber agreement forum that the clothing and apparel industry has, etc. So it was just like for you know, my ADHD tendencies, it was just like this was like candy for me, you know, like exposed to everything. Everything. And and what happens is the more you're exposed to, the more building blocks you have to creatively put things together in a different way. Right? And and so it just became a lot of fun for me um in order to uh you know uh uh in advising these companies, uh but found it very stimulating.

SPEAKER_02 1:14:11

Aaron Ross Powell I mean you've mentioned the term creative quite a few times. I mean, are you a creative at heart or I'd like to think so.

SPEAKER_00 1:14:18

Yeah.

SPEAKER_02 1:14:18

Okay. That's so cool. But then clearly even that you got tired of doing because you've you you've obviously moved on to something else, right?

SPEAKER_00 1:14:28

So the interesting thing about that is when you speak to uh okay, so when you're mobilizing a business sector response to a public health issue, you have to do this reciprocal mobilization of uh international NGOs, UN agencies, and governments to say, hey, these guys are here as a partner and here's what they can contribute. Right. Um and so from speaking to oil and gas to marketing to consumer goods, and then speaking to UN agencies, and then speaking to a medical institute, and then speaking to government, you had to translate complex scientific information for different audiences, and you had to speak in a way that everyone understood. So when you use a term like cost, right, cost means so many things to different people. Okay, right? And so you had to find a way to speak, you know, uh that was accessible and easy to understand. Yeah and lo and behold, I had I had uh an inclination to that, right? I could do that. And that's what then led me to Washington, DC.

SPEAKER_01 1:15:38

Yeah.

SPEAKER_00 1:15:39

Because when you speak the language of Joe Public, that's the language that senators and congressmen speak.

SPEAKER_01 1:15:45

Okay.

SPEAKER_00 1:15:45

Right? And so when you start doing advocacy with governments, you have to be able to take information and say, here's why this is important, here's what the data says, and here's why you should invest in this kind of thing.

SPEAKER_02 1:15:58

So what was your what was your title actually at that stage?

SPEAKER_00 1:16:01

Did you even have a title or you just uh So I then joined um strategic communications company in Washington, D.C. And these companies uh can spin anything.

SPEAKER_02 1:16:14

Okay, yeah. Stratcom. They call them Stratcom.

SPEAKER_00 1:16:16

They call them Stratcom, also known as lobbing firms. It's a derogatory term, right? Stratcom. Yeah, yeah. It's a euphemism for what they really do. Um and there's some companies, you know, that um um created the communication strategy for the tobacco company. Yes, yes. Uh like those sorts of things. So there are some sinister things and it's responding to the needs of the client. Um but when you think about it, and and this is interesting to put out to you guys, especially us sitting here on a podcast, is well, you take the professor at some uh hospital affiliated to university, right, who's an expert in his field. Yeah. And you think about the impact he's having, you think about the impact then that Sanjay Gupta is having.

SPEAKER_01 1:17:04

Yeah.

SPEAKER_00 1:17:04

Right? Sanjay Gupta is reaching more audiences with messages in which they can understand and change their behavior.

SPEAKER_01 1:17:11

Yeah.

SPEAKER_00 1:17:11

Right. He's the CNN guy, right? Right. He's the CNN doctor, right?

SPEAKER_02 1:17:15

And and so Because you know the term Gupta in South Africa. Yeah, I just want to make it clear to viewers and listeners. Yeah. It's not a good thing. Yeah, they don't dynamo that kind of thing, right? Sanjay Gupta is a medical doctor. Yeah, Dr. Sanjay Gupta.

SPEAKER_00 1:17:28

So he's the CNN medical con correspondent. Yes. But the fact that he has such a captive audience around the world, and he's distilling a study or saying what the implications are and what the impact on you is, et cetera, and how you can actually uh change your life to uh based on the study, that has much greater impact than an advanced researcher. And so that's what sort of also got me interested in strategic communications. How can you use that pulpit or that uh that platform to actually have that impact?

SPEAKER_02 1:18:02

We we need to get him in touch with Elton because that's right up Elton's alley. Um one of our if you're watching this now, he'll be uh the previous guest on this podcast. Oh, the guy the guy that you just met, right? And it's uh you know, his uh uh goal is to try and maximize somebody's potential. Now you mentioned, you know, the professor that's a brilliant mind that is uh has a very limited reach because he's just he or she is just touching those people that they educate. Whereas Gupta has got that global audience and it's all about he's got a platform and he can change not just some people's lives, but change a lot of people's lives. So strat that's what StratCon allows you to do, also, right?

SPEAKER_00 1:18:44

Absolutely.

SPEAKER_02 1:18:44

Okay. So what what happens? You get into DC and then what's next? Or Yak has something to ask?

SPEAKER_03 1:18:50

Yeah, I'm I'm interested now in the personal aspect of uh yeah. I mean, we're talking about medicine and everything there. So we want to also bore the audience. A lot of people that you know are gonna be watching this. So how did you This is super interesting, by the way. So I'm just saying we just diversified a bit. Okay. So who is Alison first of all? And then how did you um how did you meet her? Wow, go right there, Zach.

SPEAKER_02 1:19:13

Was then Allison that was mentioned? Uh no. I've been paying attention this whole time. I never heard Allison. Over it? Well, he'll explain. We are listening.

SPEAKER_00 1:19:20

Um so so it was interesting because um um I was single footloose, fancy-free, traveling voraciously. When I lived in New York, I I traveled 80% of the time and all over the world. Um so that was a lot of fun. Um but um uh uh you know, dated widely, had a really good time with it. I didn't think to Did you say widely or whitely? Widely. White Yeah, yeah. Absolutely. Uh this is white, by the way. Uh we we're an equal opportunities engager here. Um So I didn't and living in New York City, like there's no incentive to settle down. It's just, you know. Um and it's interesting when you're in New York because like when you're going out for dinner with friends and you're walking around and you haven't made a reservation, you like walk down a street and like, ah, I know this restaurant here. And someone says, around the corner, there's this other restaurant that's better. And and like it keeps going like that. That's exactly how dating in New York City is. Like, like there's always something better around the corner, there's no incentive to settle down. So it was a shift in context from uh that New York environment when I moved down to DC. Uh, and I always thought I was gonna go back to New York, that Allison and I were introduced by a mutual friend. And um and so for my career story, it's like I moved to DC, get involved in Stratcom. This is at the 2008 recession uh that hit. Um and uh and so the everything's disrupted. Um and then boy meets girl. Uh and and we just had a great, great time. Uh, you know. Um you guys have a similar sort of academic background, if I'm uh yeah, so she's a science policy analyst and she's uh she's quite uh something uh in her field. She's also a nice to look at. Um that always helps, right? Um uh but it was interesting because um um and and and you know people go out, they date and they enjoy but uh and there's always this quest of like the one, right? And and so one there's there's not always just a one, there's many, right? That one could potentially settle down with. But I I think what happens is people don't pay attention to a shift that happens when there's a potential one, right? Intrinsically, intrinsically, but also in your engagement, in your expression of that intrinsic shift that happens. And and so uh what was interesting is I'd finish work and I'd call Alison up and I'd like, hey, what you doing tonight? And she's like, Oh, I haven't planned anything. I'm like, uh maybe we get dinner. And so we'd meet um at like a Trader Joe's and we'd buy a few things uh at the grocery store and and then go back to her place or my place and cook up this meal and have a nice glass of wine and just hang, right? And that comfort of not needing to uh be on a date which is kind of performative was a shift that happened uh for me. And that was really, really interesting, that ease and that comfort with which it happened. Um so that was quite nice. Um and then uh and then professionally, what happened at the time, I know Za uh Yak wants to dig deeper into all of that, but professionally what happened at the time was um there was the Global Network for Neglected Tropical Diseases that was looking for a director, and I applied for that, and it was near and dear to me. And you know, people are like, what's an NTD? And uh right? And so let me ask you this how many people do you think in the world are living with HIV out of six billion people on this planet? How many do you think are living with HIV, diagnosed or undiagnosed, our estimate? Three, four percent of six billion. Right?

SPEAKER_02 1:23:46

My math's not give a number, yak.

SPEAKER_00 1:23:48

So I would say ten percent would be six hundred million, three per uh divided by three would be two hundred million.

SPEAKER_03 1:23:58

That sounds high now that you said a number.

SPEAKER_02 1:24:00

If that's the if that's the math, that's the matter I'll agree with it.

SPEAKER_00 1:24:03

But um So our estimates are anywhere between thirty-six to forty million people of the six billion people on this planet are living with HIV, right? And you walk out on the street now and you ask anyone if what is HIV, and you do this in Mumbai or or New York, and people will know what it is. Yes. Right. How many people do you think are living with a neglected tropical disease?

SPEAKER_02 1:24:31

Look, I'm guessing it's gonna be much bigger figure than 40 million.

SPEAKER_03 1:24:36

Um I I don't even know what is a neglected tropical disease. What I'm talking about malaria, I don't think it's neglected, being neglected at the moment. They give us shots for it every time we go across the border doing most. Tell us the number.

SPEAKER_00 1:24:49

So it's about uh one and a half billion people. Sheesh. Right? 160. Uh yeah, about 1.2 billion people, right? So it's a one in six people on the planet, right? Uh did any of you have a neglected tropical disease?

SPEAKER_02 1:25:03

Probably. I don't know. I I doubt it. I'm not sure.

SPEAKER_00 1:25:06

So uh COVID count. I I remember growing up as a kid and you guys playing or playing in the dirt and everything with your friends, and then uh all of a sudden you're craving sweets and you've got an itchy bottom, and you maybe break out in worms, right? So intestinal worms are one of the commonest, right? Um and then what would happen is all the mums would get together and give every all the kids deworming worm marks, right? So that's a neglected tropical disease, easily treatable. But when you don't have the treatment or you live out in the sticks, right, it is uh debilitating, right? And and you take Woolworth's food and you give it to this kid, and and there's was actually a study that showed the caloric rob that the worms do for the food that's given to these kids, right? So firstly they're undernourished, then even if they get good nourishment, the world's that worms are eating the food, cognitive decline, school absenteeism, so everything is affected by that. But also uh bilhatia or schistosomyasis, trachoma, oncosychasis, river blindness, uh lymphatic fluorasis or elephantiasis, uh, all of these are neglected tropical diseases, right? Uh there's 17 according to the WHO, and and even snake bite is included in it. Um there's been a push to have uh pediatric HIV as a as an NTD. But this affects the poorest people in the world, right? And so this is close to my heart. Uh sorry, uh as we were talking about. And so so when this opportunity arose, I'm like, yes, this is where I need to get involved. And it's interesting because the we have treatments for most of these NTDs, and the global response to NTDs is actually built on the backs of pharmaceutical donations.

SPEAKER_01 1:26:59

Okay.

SPEAKER_00 1:27:00

Right, albendazole, mobendazole, um azithromycin, uh DEC salts, etc., that are used to treat all of this. So once again, it was like public-private partnership stuff, uh, and then a lot of advocacy. So working with the Bundestag, which is the parliament in Germany, to uh the Norwegians and the Dutch and the Belgians, uh, but then also Nigeria, India, uh, all of that. India was fascinating to work in. Um did you like travel there and oh plenty of times. Yeah. Uh with some Bollywood styles too.

SPEAKER_02 1:27:35

Yeah. Oh wow. Can't you drop some names?

SPEAKER_00 1:27:43

Um with uh with India, um it is probably one of the largest public health programs in the world, the l uh they call it uh philaria, uh phyloriasis, right? Yeah. Uh and uh so um Um they do about 450 million treatments a year. Like accessing 450 million people. That's huge. Like the the scale by which they operate is just something else. But we went to one program um uh with this community-based organization, and uh and and so um everything was working well. They were getting treatment, they were getting uh sanitation, they were reducing morbidity from those who had it, they were preventing infections in people who didn't have it, etc. And uh so it all worked very well. Uh and then we were sitting down and we were having lunch. There's all these women in saris and we're under this top, and it was in Orissa State, uh, which is uh very beautiful, and and uh I was really impressed uh uh socially and culturally when I engaged there. And so I'm sitting there, and um so here I'm brown, right? And I'm this hotshot doctor from Washington, D.C. And I'm bringing money to the program and and supplies and everything.

SPEAKER_02 1:29:12

With a South African accent.

SPEAKER_00 1:29:13

Well, yeah, and and I'm talking through a translator. Yeah. And uh and and they can kind of I can understand them. Yeah. Uh like my Hindi and Gujarati understanding is rudimentary, but I can sort of get by. Um and and so at some point I said, okay, you're happy with everything, and they were like happy, all that. And then I said, now I need something from you. And and so all these women in saris, well, gender, I'm a male, right? And then uh like this doctor from DC and like everything, and they're like, What on earth could this guy want from us? Yeah. And then I said, How many of you are mothers or parents? And they all raised their hands, right? And I said, Well, um, I'm freaked out because I have two kids and we're pregnant with our third, and I'm like, I don't know how we're gonna manage, right? And and I I showed and opened my vulnerability, right? And the conversation all of a sudden shifted. And they were like, Well, uh, your first two kids were and like two girls, and they were like, Oh, you're gonna have a son now. I'm like, I could do with 17 daughters, but hey, if you bless me, lo and behold, I got a son and everything. But when the conversation changed, um, I then realized there was a sadness about these women. Right? And so we probed a bit into this, and they, while the program was working really successfully, the reason why they were sad is there was a social stigma that because these women, mothers, had elephantitis and infectious diseases, their daughters would get it. And many of them had daughters of marriageable age and were not able to get their daughters married. And it was such an important life goal to get their their daughters married.

SPEAKER_02 1:31:08

So did they open up to you after you'd shown your vulnerability exactly how you're gonna be able to do that?

SPEAKER_00 1:31:12

Right. And I use this as a really important, not use it in a manipulative way, but in order to connect with people, you have to show your vulnerability.

SPEAKER_02 1:31:22

Do they train you on this at s in StratCom circles, or is this just you?

SPEAKER_00 1:31:25

You know how to I guess it was my journey as it as it unfolded, right? And and so I'm like, shit, are we really doing success in this program if ultimately they can't meet their life fulfillment goals? Yeah. Right? We're taking care of health in a very superficial way, right? So what do I do?

SPEAKER_01 1:31:44

Yeah.

SPEAKER_00 1:31:45

I call my contacts in New York and DC, and we figure out how to get to a bodywood star.

SPEAKER_02 1:31:50

Yeah.

SPEAKER_00 1:31:51

Right? And I get to Abhishek Bachan.

SPEAKER_02 1:31:54

Right. Wow. Right. Even I know that person. Right? Yeah.

SPEAKER_00 1:31:58

I couldn't quite get to the big B, right? Uh the big Bachan.

SPEAKER_02 1:32:01

Yeah. That that's Amitabh right.

SPEAKER_00 1:32:02

Right, Amitab. And and so we then have a meeting at uh Amitab's house, and you know Abhishek and uh Ashwarya live at the house. Okay, Ashwarya right, yes. Right.

SPEAKER_03 1:32:14

His son and his daughter-in-law.

SPEAKER_00 1:32:16

Right. Um and so I go to the house, right? Yeah. And and so we get the meeting and everything, and um and then uh sort out all the logistics, figure out the program, and then we fly on a jet from Mumbai to uh Orissa, right, Bhubaneshra, um on a private jet with Abhishek, right? Really nice guy, right? Very down to earth and all of that. And we get on film and pictures of him washing the feet of someone with lymphatic fluoresis. Okay. He's down on the floor, this woman's sitting on a stool, and he's helping to pour the water and wash the feet. In order to break the stigma that was around this, right? And so that sociological intervention.

SPEAKER_02 1:33:08

Was that you also?

SPEAKER_00 1:33:09

Uh well, me and the team. So uh we we like figured out how do we tackle the issue of stigma. And this, you know, I mean, the success of the polio program in India to a large extent is with uh Amitab, where it's the peace sign, but it's uh representing two drops. And it's the two polio drops. Wow. Um and so we launched then a program called Hati Pau Mukparat, which is uh philoriusis free India. Hati Pao is elephant foot.

SPEAKER_01 1:33:38

Yeah.

SPEAKER_00 1:33:39

Right? Elephantiasis. Uh so that was just like I mean it's a surreal.

SPEAKER_02 1:33:45

Yeah. Sure. It would it would either have to be a Bollywood star or a cricketer, right? That would have been next to the list.

SPEAKER_00 1:33:52

Uh Ajay the uh Jadeja. Yeah, yeah. He got involved.

SPEAKER_02 1:33:55

Uh he's a Sri Lankan, I think, or not.

SPEAKER_00 1:33:58

No, no, it's Indian.

SPEAKER_02 1:33:59

He's Indian. Yeah, yeah. From the South, right? Okay, okay.

SPEAKER_00 1:34:02

Um so there were some uh uh cricket players, um uh although we should get a Kabadi guy.

SPEAKER_01 1:34:10

Yeah.

SPEAKER_00 1:34:10

Do you know Kabadi? No. Oh my god.

SPEAKER_02 1:34:13

What's that? Dude, what's that? Yak, you know.

SPEAKER_00 1:34:15

I I I don't know, I want to guess, but no, I don't know. So um uh Kabadi is probably one of the biggest sports in India and it is kind of like um uh handball and touch rugby all in one.

SPEAKER_02 1:34:33

Okay, right?

SPEAKER_00 1:34:34

NKBHT, does he play that? No, no, no.

SPEAKER_02 1:34:36

He plays he plays ultimate frisbee, yeah.

SPEAKER_03 1:34:40

No, we don't know. It's like a thing, like you throw it and another guy catches it.

SPEAKER_00 1:34:44

Yeah, so and when we were in primary school, we used to play a game called Hoopoo. I don't know if you know hoopoo, right? Um, but it's an exaltation, you shout hoopoo when you cross a certain line and everything like that. Okay. And Cubody is a game that you uh and it's also touch to get out and like all of that, right? Um and I think hoopoo actually derived from that. Um uh but uh there's like leads and everything in India and teams and like all of that. But the the the coolest thing, well, I mean, uh, from a lot of uh uh Indian women that I've spoken to is the coverty guys are like built Indian dudes. Look, like you don't see built Indian dudes, right? These guys are like well framed and like toned and like all of that. Uh so uh and and it's so big in India, but it it isn't like a global sport. I mean, even South African Indians like don't know about it.

SPEAKER_02 1:35:50

If it was in America, that would have been an Olympic sport by now because Americans only, right?

SPEAKER_00 1:35:58

Yeah, exactly. Um so yeah, so that was uh um uh quite an interesting and and when you start seeing sociological interventions that can have a health impact, I think that's when you start thinking in a much more uh transdistant player. Uh in Brazil, I you know I got to work with uh the Erchin Center Foundation, which his sister runs. And so it's it's been it's been quite an interesting journey.

SPEAKER_02 1:36:26

That's really cool.

SPEAKER_00 1:36:27

So how how many countries have you lived in? South Africa, the UK. Oh no, I mean traveled to uh uh I I lived uh the UK, uh the US, New York, and DC and South Africa, but traveled extensively. Oh, okay. So you traveled, yeah you traveled there quite. Uh spent a lot of time in Paris because that was a nice hub and helped set up a French office of the Global Business Coalition. Okay. So fast forward all of that.

SPEAKER_03 1:36:56

What brought you back to South Africa? And initially, as you said, Johannesburg was like, you know, such a wow factor for you. Um you want to be seen and not heard. Oh. Um I mean, you you traveled to the most phenomenal places on earth, lived in in the UK and the States and well, Paris now, as you say. But Johannesburg has brought you back. What what made it bring you back? Because how long have you been here for now?

SPEAKER_00 1:37:29

Uh it's been four years since we returned. Okay. Um oh, just to finish, DC, after the Stratcom and then after Global Network for Neglected Tropical Diseases, um I became a professor at Georgetown. Yeah. Um university in the Department of International Health. And that was nice because uh, and I was literally a proverbial sort of tweet jacket, riding my motorcycle down to the university, teaching my courses, engaging with colleagues. But it was nice. I didn't have to travel much, and the babies were there, uh, all three of them, and I just wanted to spend time with them. Um but that's when I uh um also uh started a a new master's, uh, and that's in Ayurvedic medicine.

SPEAKER_01 1:38:19

Oh.

SPEAKER_00 1:38:20

And so I finished that uh three years ago. Did what you've been did you just get bored? Or that's ADHD mind, man. Um so are you genuinely ADHD or are you just using a DD? No, I'm not on treatment or uh or diagnosed. Uh and and as I read up more about it, I don't think I am on I think I'm just curious. Yeah. Um but um So it's curiosity then. Uh yeah, and just like uh wanting to know about stuff, right? Um but when you start looking at health, right? And it was uh good old Hippocrates that said uh uh food is the best medicine. You can um uh oh, somewhere along the line I did half a master's in liberal arts at Johns Hopkins. Um but then the baby started coming, and so I needed like uh uh six courses. I did like three. Okay. But one of them was in uh ancient Greco-Roman and Egyptian medicine, one was on cosmos and cosmology. Like just exploring the liberal arts is so much fun. But um prior to Hippocrates saying food is the best medicine, it's written in the Vetas, right? That food is the best medicine. And so a lot of disease that we understand in the world, whether it's diabetes, metabolic syndrome, cholesterol, etc., even cancers, are related to our diet.

SPEAKER_01 1:39:46

Okay.

SPEAKER_00 1:39:47

Uh uh, or the imbalance that we create in the body as a consequence of the diet. And so I looked at all these diets from Atkins to Palio to um um even blood group-based diets, right? And I was like, how do we figure this out? We're all quite different uh constitutionally and all of that. And and that's when I got interested in Ayurveda to say, well, do they have an approach? And uh and so that's when I did this master's at uh the Maharishi Institute in uh International University in Fairfield, Iowa, um getting into this entire field. And I think there's a lot of parallels and similarities with allopathic uh Western medicine and our understanding of the physiology, but there's also a different lens and configuration with uh the way the Ayurvedic approach is and and the interventions. And so it's been it's been quite interesting having that perspective as well. But coming back to Zach's question, after COVID, uh or in 2020 at the end of the year, we we we moved back here.

SPEAKER_02 1:40:57

Yeah.

SPEAKER_00 1:40:58

But in April You were listening in the kids. Uh yeah, yeah. Is she American? She's American. Okay. Um and uh in April I was chatting off 2020, I was chatting with my sisters, one's in the UK and one's in Sweden, and I said, um I don't know if we're gonna see mum and dad again.

SPEAKER_02 1:41:16

Oh, that's deep. Yeah.

SPEAKER_00 1:41:18

Right? Yeah. Because there were the lockdowns and COVID was taking the elderly. Right. And so um uh so by the end of the year, we were like, okay, this is our window to go see them. And I was speaking to them every day and trying to manage them and the care they were receiving. Uh uh Joburg. Yeah. Um and uh and so December 2020, when we got a window to travel, we came down here.

SPEAKER_01 1:41:48

Okay.

SPEAKER_00 1:41:50

And this was after a year of school shutdowns with three elementary schoolers learning online. Uh and uh uh Their first time to Africa. Um Nena had come before, but it was the first time for Zayn and Rahan. Um uh and and so we go into a shutdown in South Africa, and then January schools open in South Africa in person.

SPEAKER_01 1:42:16

Yeah.

SPEAKER_00 1:42:17

And we said, well, let's see if we can get them in schools and they can at least get some in-person schooling. And they got into schools here.

SPEAKER_02 1:42:23

So this wasn't planned.

SPEAKER_00 1:42:24

Uh no.

SPEAKER_02 1:42:25

Okay.

SPEAKER_00 1:42:26

Right. Um and and and they started online schooling, and the weather was amazing, and they're playing field hockey and like all of that. And then the thought of them going back to school uh or online schooling in the US was just like, we can't subject them to this. Yeah and so I was still teaching at Georgetown, yeah. Uh and I completed teaching that semester online. So there were two courses that were uh one was at like six in the evening, but one was at midnight to 2:30 a.m. Uh, but you know, that was a small sacrifice to make. Um and then I finished my master's while I was here online uh in Ayurveda, and we just decided, okay, well, it's working out. Let's stay. Yeah, it's the best place to live. Uh it's hard to argue with nine months of summer in the year, right? Yeah, yeah, yeah.

SPEAKER_03 1:43:26

Um, not right now.

SPEAKER_00 1:43:27

But but it is it is interesting because it's not a choice on like in a rational way to say what's the best and what's the worst and like all of that, but it's um how you're feeling and make the best of it, right? And and that's sort of become a life um almost philosophy, like um uh you know uh my little joke is people are so preoccupied with what their destiny is or should be that when it sort of shows up and smacks them in the face, they're too blind to see it. Like your destiny is what's happening now, right? As as your journey unfolds. Um because it was peak load shedding at that time.

SPEAKER_02 1:44:10

There was a lot of load shedding in South Africa. You know, people were not keen on it. Lots of people were thinking I need to leave.

SPEAKER_00 1:44:18

But we were also just coming out of Trump back then, right? Yeah. And so when people often said to me, Wow, you chose to come back.

SPEAKER_02 1:44:27

What's wrong with you?

SPEAKER_00 1:44:27

What's wrong with you, right? Um and then uh and I was like, well, it's not too bad, yeah. And well, we have this load shedding problem. I said, you know, we came from DC, we had the Trump problem there. Yeah. Yeah. Take the load shedding problem any day. And you Sure, it's inconvenient, right? But it doesn't it's not soul crushing. It's not morale deflating uh in that sort of way.

SPEAKER_03 1:44:51

Load shedding seems like a a very community problem here. Yeah. Whereas in in in the States, you what you see going on right now is very divisional. There's a lot of people, whatever the problem might be.

SPEAKER_02 1:45:13

And hold on, doesn't Joburg have like the best people in the world? Or is it No, because you're living in Joburg now, right?

SPEAKER_00 1:45:21

Yeah, yeah, yeah, yeah. I love Joburg. I love it. When people tell me they don't like Joburg, well, I'm like, well, you don't like that Pan-African metropolitan. Do you know Time Out magazine?

SPEAKER_02 1:45:30

Yeah.

SPEAKER_00 1:45:31

They did uh the ten best cities to eat in the world.

SPEAKER_02 1:45:34

Okay.

SPEAKER_00 1:45:34

And Joburg was number one? No, number one was Naples.

SPEAKER_02 1:45:37

Yeah.

SPEAKER_00 1:45:37

Number two was Joburg.

SPEAKER_02 1:45:39

I I I heard about this somewhere, and some people were like, Good, yeah.

SPEAKER_00 1:45:42

I'll give it that. There's nice restaurants, the value for money is amazing, the diversity is phenomenal. Uh we have huge West African, pan-African influence as well now. We have the best of Western Europe. Uh yeah.

SPEAKER_02 1:45:56

Look, at one stage we didn't have functional traffic lights, but I'm telling you, it's the people here. You you Joburg has a reputation for. I guess if you're not from Joburg, people elsewhere in the country think that it's like the big smoke, it's very it's a rat race, they're stressed out people, but they're the friendliest people I've been.

SPEAKER_00 1:46:13

They say that and you must tell them to go back to Peter Maritz, but I never said that.

SPEAKER_02 1:46:19

I've never said that. That's a digger yak, right?

SPEAKER_03 1:46:21

Okay, so I'm from the burgs.

SPEAKER_02 1:46:24

You're from Maritzburg, aren't you? No, I I love I think Joeberg is the best. I mean, I've lived in three provinces. I've lived in Petoria, lived in Joeberg, lived in Durban, lived in Pumalanga. So obviously not all over the country, but Right.

SPEAKER_00 1:46:42

And the nice thing is you can escape the city like in half an hour, 45 minutes, right?

SPEAKER_02 1:46:48

Yeah. Okay, so then you come here, you move, you you settle down. Is this it now? Where what's next?

SPEAKER_00 1:46:54

Well, I don't know. I mean, when you look at the trajectory, like the whole notion of settle down and forever is like like yeah. Um but I I do uh feel this is home and this is where we are now. And the kids are comfortable, the wife is happy. Um and um yeah, I mean, I don't uh I I'd be cautious to return to the US. Uh you know.

SPEAKER_02 1:47:25

But you can always go back if you want, right? You've got that.

SPEAKER_00 1:47:28

Um I think there are many options uh open. Uh you know, uh during his first tenure, I did spend a lot of time with uh Ibrahim Rasul, Ambassador Rasul.

SPEAKER_01 1:47:42

Yeah.

SPEAKER_00 1:47:45

He he was uh uh uh classified as persona non-grata and like all of that. And that's a much more deeper conversation uh um uh to have. But but I would be cautious to return to the United States now and with everything that's happening.

SPEAKER_02 1:48:03

I probably got ahead of myself by asking what's next because what is happening now? What are you up to now? I don't know.

SPEAKER_00 1:48:11

I'm just having a good time with my dentist. Either my dentist is really cool or my dentist thinks I'm cool, but anyway, we're hanging out.

SPEAKER_02 1:48:24

But um yeah are you practicing or what's what's the situation now? Yeah.

SPEAKER_03 1:48:29

Yeah, that's what I what I wanted to ask. Are you are you affiliated with Pretoria at any? I mean that's what Tatcher G said.

SPEAKER_00 1:48:35

So I just um finished a three-year stint and finished off in Pretoria in November. And that was a transdisciplinary platform. And and so fr from the story about my career and like what I've done, um transdisciplinarity lends itself very much to that sort of much broader lens and integrated thinking. Uh so one of the things So transdisciplinarity is almost, I want to say, a cultish part of universities. Because the way we've organized our study at a tertiary level is in these disciplines, right? And transdisciplinarity is saying, no, if you want to really tackle big issues, you have to start thinking in a much more integrated way. Um and we're not saying that at the cost of our disciplinary uh approaches. Um but each discipline is an entity, a universe onto its own or on on its own, right? And um and to break those silos is actually quite hard. It's a cultural shift, it's a mindset shift, it's a different lens uh type of thing. And so transdisciplinarity approaches is about saying how do we look at that in a more broad way. My favorite example. Example to talk about this, uh Zach, I may uh Yak, I may have mentioned is uh as a doctor you ask people to wash their hands. Only a few people wash their hands to prevent germ transmission. You bring in a priest, and the priest says cleanliness is next to godliness. Everyone washes their hands, right? I'm agnostic to why they do it. I just need a particular outcome, right? Um so we we have to think about things in a in a more um sort of global, multi-uh perspective way. However, one of the tenets of transdisciplinarity is that it needs to involve an extended stakeholder group.

SPEAKER_01 1:50:42

Okay.

SPEAKER_00 1:50:43

So it's not just academics and PhDs deliberating the stuff. We have to have civil society, indigenous knowledge systems, business sector, nonprofits, all of that involved. That's when the magic happens. But the problem with the study of transdisciplinarity, and I corrected myself to say practice, right, is that it remains in the university environment. Okay. And knowing the hierarchical nature of universities means that it doesn't create a welcoming or uh equitable platform for multi-stakeholder engagement. Right? And I think that frustrated me to a large extent. Uh and and I'm not a traditional academic by any stretch of the imagination. And so for me, it's about I'm I'm more of a practitioner. And how do we get things done? How do we bring the people uh type of thing? And um so I think there's a lot of potential for it, but I think sometimes uh they they it's hard for university structures to get out of their own way.

SPEAKER_02 1:51:54

Okay. I see you as That was actually quite diplomatic. I see you as well, you know, well, well, well, what an ask. Well that's great tiptoeing. Yeah, yeah. I I s I see you as a strategist and an influencer. Like if I had to sum you up in two words, strategist and influencer. Um but what are you doing now? So are you up to anything or are you just chilling? Come on, Yar, what about you totally cool dude? No, yeah, that that too. That's fine. I mean, you're pretty cool. Yeah.

SPEAKER_00 1:52:18

So it's nice to break out into an Indian accent every now and then.

SPEAKER_02 1:52:21

Um on accents, it's it's interesting that you haven't. I mean, you've got the South African accent. You don't go and twang there in the US and then come back here and speak like a South African.

SPEAKER_03 1:52:29

I had a bit of the British accent. You know why?

SPEAKER_02 1:52:30

Because Yak is a twanger.

SPEAKER_03 1:52:32

Oh gosh.

SPEAKER_02 1:52:32

Yeah. I'm gonna keep on this is gonna be the he's a twanger. We said it in the last episode.

SPEAKER_00 1:52:37

Like uh residual sibling rivalry, uh cousin brothers.

SPEAKER_02 1:52:40

Yeah, but he's we are like cousin brothers, but he's a twanger. We'll see. He's got a podcast.

SPEAKER_00 1:52:44

No, but I do find that it depends who I'm speaking with, uh just in in in a way of being more understandable. So not just uh the twang, but you would use phraseology that uh dialect. See, it's about connection.

SPEAKER_02 1:53:02

That's another diplomatic way of saying you're twanging, but now that it's code switching. I get it, I get it. Okay.

SPEAKER_03 1:53:07

All right. I just wanted to say before we move on from that point and and close off, I I can relate to what you're saying about you know, that translatable MO of having something from academia or developing something and then getting it translated into just a man out there that actually needs it. For example, like recently I've been exposed to um the public enterprises department. And they want to do a whole host of different stuff with regards to amputees, especially, because I'm an amputee. And I bought this machine here sitting behind us, it's uh it's a 3D printing machine, and we get all of these STL files coming in where there's our developers that are sitting in the States and Dubai and whatnot, and they send us these files and we 3D print it, we tweak it ourselves, but we 3D print it and we kind of test it out on ourselves, and the functionality that it gives me, for example, holding this cup, for example, it allows me to hold this cup and drink with it. But obviously, I want a lot more than that, being me. But that that amount of at or that advantage that it gives me just by enabling myself to hold this cup, 80% of the people that are waiting in the public sector for an authorist to get this done for them almost doesn't exist. And that is because it's all stagnant in the academic phase of the processing. Private sector hasn't gotten involved to buy someone a 3D printer that will lower those costs to get this technology available out there to the people in order for them to go in, get a little scan done, a 3D printed scan done, and print something that's made out of a STL, I mean uh PRF material that's gonna cost about 20 cents on the on the rant to print. But that is where now I'm starting to see all of these different aspects of um society coming in and playing their part in your order to create a uh uh end goal.

SPEAKER_00 1:55:08

That's beautiful. And I I think there are a lot of private investors and philanthropists in South Africa that would put money behind that.

SPEAKER_03 1:55:19

Um the unfortunate part is oh, maybe we shouldn't mention this on the podcast, but the main the biggest philanthropist that's trying to um well propagate this whole um uh how do you want to call it technological advancement is the same guy that's uh kind of stagnating uh America right now. And it's it's it's it's or ex-South African if you want to call him that. But it's yeah, it's unfortunate that that is where it is right now. But at the same time, you can see the technology behind it. You can see that there's good trying to be done. It's just that it's a little bit misguided at the moment.

SPEAKER_00 1:55:59

So I that's not an opinion. And and there's there's uh a lot of other philanthropists one can look at, and and I I do think you know, there's there's a lot of people enamored by technology, right? And uh uh there's the appropriate use of technology, right? Not technology for technology's sake. But that only comes from engaging a wider or wider audience. Speak to amputees, speak to that mind worker who lost his arm or mom who's taking care of a kid with with an amputation, and that um uh innate knowledge, that instinctual knowledge is so important that informs our use of technology. Um and and many a time there's been here's cool technology, let's find what we can use it for, as opposed to let's look at our problem and what we're trying to solve and find technology that will suit it. Um, you know, and uh uh so so I think that lens is important. One of the things I think that's really um an important consideration for us in a South African context. So we're at an all-time, all-time lower trust, right? And and it's not just South Africa, you look at the United States or other places in the world. And what we need to think through is what is a new form of governance? And this is what I've been sort of pondering a bit now. And and so, yes, we have government and we have a GNU, and and the GNU, I think, is making good progress because when you look at coalition governments around the world, there's some good success stories, right? They're forced to collaborate. They have to figure this stuff out. But that's just government. Then we need to bring in the business sector from different industries and civil society and the layperson and people living with disease, right? And this is one of the most important lessons we have from HIV. You cannot form any HIV committee, council, organization if you don't have a person living with HIV involved in it, right? And so when you start looking at all of that, and I think one of the big things in South Africa is uh it is a country of faith, right? People take their religion seriously in South Africa across all religions. And we need to bring that into the governance process. And I mean, you look at one of the most important transitions that we had was the Truth and Reconciliation Commission. And if the good Bishop Tutu wasn't chairing that, would it have had as good an impact or success as a process? Um, so we need to think creatively about all uh societal actors and how we configure it in a way that re-establishes trust, that promotes good dialogue, right? We've stopped having conversations or talking with each other. That's right. We talk at each other, right? Uh online and through forum, but we don't sit down and have the conversation type of thing. So so I think there's a lot of opportunity for that. And just the simple example of the prosthesis you're talking about, you know, that's the principles, the same principles apply.

SPEAKER_01 1:59:24

Yeah.

SPEAKER_02 1:59:26

Sorry, I expect a bit. I I liked it. I liked it a lot. I only realized that this country was very religious when I moved um to work in a company that's in Pretoria. It was just an eye-opening experience for me. I just never realized it. But you make a very good point there. Faith is a big thing in South Africa. If you can tap into there, yeah. Anyway, let's not go there. But what uh this is the third time I'm asking this question now. What's currently happening? Are you chilling? Um is it a no-go question? Um no, I I think it's a fair question. Um Are you registered here to practice or do you practice and all that uh HPCSA?

SPEAKER_00 2:00:07

So yeah, I have all my registrations up to date uh and all of that. Um so I have a few different roles, and I think uh uh oh, I have a colleague in the US who calls himself a polymath doctor.

SPEAKER_01 2:00:20

Yeah.

SPEAKER_00 2:00:21

Um and uh uh and I think for people like myself, yourself included, uh well, uh Zach is uh uh Yak is not too far behind. Um it's it's about a portfolio of work rather than a job.

SPEAKER_01 2:00:39

Okay, right? Yeah.

SPEAKER_00 2:00:40

And that's what keeps it interesting. Uh and it's the cross-pollination of ideas. Yeah. I think that's uh that's important. And so um uh at the moment I'm consulting. Okay. Uh I have a trip coming up later this month to um uh Kerala, yeah. Uh where I'm going to be in uh an immersion uh environment with Ayurveda. Oh uh Is that the home of Ayurvedic medicine or not? Uh yeah. The South and and Kerala particularly, there's parts of Gujarat and all of that uh uh also have uh little foci offered. Um you gotta love South Africans because we love our cheesy puns.

SPEAKER_01 2:01:29

Mm-hmm. Yeah, of course.

SPEAKER_00 2:01:31

Right? Then when you become a father and you get a dad's sense of humor together with a cheesy pun, you just take it to another level.

SPEAKER_02 2:01:37

Dead jokes at another level, yeah. Yeah.

SPEAKER_00 2:01:39

Um but it's it's it's I'm sort of incubating this are you medical approach to things.

SPEAKER_03 2:01:48

That's a good play on a right.

SPEAKER_00 2:01:50

And uh how do we bring the best of both worlds? Because they are complementary, um uh they not uh on an equal or equitable engagement level. And and uh how do I create a practice and a learning academy uh that um uh embraces both in a way that's a bit more structured. Um and so I'm I'm looking at that now. And uh I also want to see, and this is where my uh advocacy past uh always comes back to me. This is also an important collaboration for South Africa and India as part of a big BRICS platform to ensure that we bring our indigenous understanding and knowledge to things and at the same time be contemporary in the world that we are to uh today. Um there's uh one of my favorite philosophers, uh, or two, uh one is J. Krishnamurti.

SPEAKER_01 2:02:56

Okay.

SPEAKER_00 2:02:57

Love him to bits. Um and then the other is uh guy called Jacob Needleman. Jacob Needleman wrote a book called The Way of the Physician. And uh it is it's it's just a beautiful read. Uh it's a tough read because it's like a philosophy book, but uh but it's beautiful once you get into it. And and Ayurveda also talks about this, where um they say the number one priority you have in this life is to take care of your physiology. You take care of that, everything else will fall into place.

SPEAKER_01 2:03:32

Okay.

SPEAKER_00 2:03:32

You're understanding spirituality, your engagements, life fulfillment, uh self-actualization, whatever you want to call it, right? But it starts off with taking care of the physiology. But in understanding of how you take care of your physiology, you have to have uh a spiritual worldview. Okay, right? Uh because that's the basis of your physiology. And it's not chicken or egg, it's circular, right? It's it's it's reinforcing. And so I I do think that it has um a reflexive action to say, well, to what end? Why do you want to live longer? Why do you want to live without disability? Uh, which comes to my last point on on global health.

SPEAKER_01 2:04:22

Yeah.

SPEAKER_00 2:04:22

We look at two metrics in global health, right?

SPEAKER_01 2:04:25

Okay.

SPEAKER_00 2:04:26

Morbidity and mortality, life expectancy and living without disease, right? And I've been toying with the third M. So morbidity, mortality, and meaning.

SPEAKER_01 2:04:38

Oh.

SPEAKER_00 2:04:38

Right? Yeah. So what is the life purpose and what are we supposed to do here? And so that's kind of like there's no one answer, and each person finds that own answer for themselves.

SPEAKER_01 2:04:51

Yeah.

SPEAKER_00 2:04:52

But I feel we don't place enough emphasis on the asking of the question and the self-questioning to figure that out.

SPEAKER_02 2:05:00

This is so such a coincidence. My five-year-old asked me today, Dad, why do why are we living? And I said, I don't know. Why? I said, then my wife says, Why are you it's an interesting question? Why do you ask that? And she doesn't explain why she asked it. And I said, Because you're a philosopher, aren't you? And she says, Yeah, I'm philosopher. Um, but yeah, she literally asked that today. Why, why, why are we living?

SPEAKER_00 2:05:23

Right? And and we don't need a PhD or a dissertation. You need to be able to have that conversation with a five-year-old.

SPEAKER_01 2:05:30

Right?

SPEAKER_00 2:05:30

I just said, I don't know. That's how guttural, that's how instinctual it is. And and we get so caught up in the life cycle of attainment and achievement that we forget that core human instinct to say, well, what does it all mean? And to what end?

SPEAKER_02 2:05:49

Okay. So when you're I always ask every guest this question, and I'm gonna frame it in this way, because you've got three kids. I don't know when they'll get to this age where they're gonna ask you the question or come to you and say, Dad, I'm thinking of doing medicine. What do you have any advice for me? What would you say to your kids if they come to you and say, I want to do medicine? How would you answer that or guide them?

SPEAKER_00 2:06:11

Well, the best way to deal with kids is to answer a question with a question. Why do you want to do that? Where do you self see yourself going with this? How do these subjects resonate with you? Okay. Um how do you feel about engaging with people? What about the science enamers you? Uh you know, um uh lovely Indian So there's an entire genre of Indian doctors who became writers. Okay, right? Uh one of them is Abraham Virgise. Right. Um and uh his uh he he wrote a book during the AIDS epidemic called uh My Own Country. One of my favorites is cutting for stone. Okay. Uh cutting for stone was actually a phrase that was used for removal of uh renal calculi, kidney stones, right? Um but he's a beautiful writer, uh but he's been pushing this agenda at the Columbia Medical School on narrative medicine, right? It's how we talk to our patients. Yes. Not and it's beyond just bedside manner, but it's journeying together.

SPEAKER_02 2:07:15

Yes, what does cancer mean to you? You bit me, what does it mean to you?

SPEAKER_00 2:07:18

Exactly, right? And then uh the other uh really amazing writer and his past now is uh Paul Kaliniti.

SPEAKER_02 2:07:25

Right.

SPEAKER_00 2:07:26

He wrote uh When Breath Becomes Air. Ah yes, my sister said I must read the You must read it, and and uh besides being an amazing book uh on the subject matter, his writing is literary of literary value. Um Atul Gawandi's uh Um Being Mortal is also really nice. Uh complications and checklist and all that is also good. But being mortal is is starts getting to those questions. What does all this mean in the life journey? So I think it's um it's quite the exploration into those questions, coming back to if your child says you they want to do medicine, but I do think the uh emotional maturity that we have to enable and foster in children of that age where they start thinking about careers is also really important. And I would say gap years, doing general undergrads before getting to medical school, all are self-exploration before deciding on a career. I think job shadowing is also really important. So they start to feel it. And then there was something interesting I read many years ago that people don't think about the study of medicine as a career unto itself. Okay. It's six or seven years, right? And and you have to think about that journey as well. Uh two very interesting facts in the South African context. Um uh the highest rate of dropout from the medical profession in South Africa, which cohort?

SPEAKER_02 2:09:03

Uh probably just after univers just after university?

SPEAKER_00 2:09:07

Um uh yeah, after graduation. Yeah. Right? Yeah. But which group of people? Yeah.

SPEAKER_03 2:09:12

Um you mean uh from a demographic perspective. I'm gonna say uh Indian female.

SPEAKER_00 2:09:19

Yeah, and Indian Muslim females, right? Uh and and so their life journeys, uh right, and I'm not judging right or wrong, it's subjective, right? Uh means that the the practice of medicine in the hospital setting, etc., doesn't gel with that. Um what's the second biggest drama part?

SPEAKER_03 2:09:45

I don't know, they would need the money. Oof, I shouldn't think out loud, yeah. Um uh maybe Afrikaans.

SPEAKER_00 2:09:53

No, you're close to it, actually. It's African men, black men in South Africa, because medicine offers a huge credential and an opportunity to accelerate income, right? But it hits a ceiling. Yeah, right? Right. So as doctors, we're not gonna be corporate lawyers or investment bankers, you know, uh type of thing. But we'll be an above average income. But once they have that credential to get capital and everything, it's uh opening up franchises and chicken liquins and like all of that, which become much more lucrative in the longer run. Uh and then it requires supervision and all of that. I mean, what is frightening about uh uh um our field is that um uh university application rates have gone down over the years. Oh, is it? Right. And people, not just in South Africa, I'm talking globally, but people want to go into finance and banking and all of that. And the way we portray and present these professions on social media and and the way they are presented is well, this is how you make big money, which buys you the fancy car and this makeup to use, et cetera.

SPEAKER_02 2:11:06

Also, medicine has a very bad reputation. It needs PR in this country because people are talking about unemployed doctors and you're gonna be slavery away, and you whereas the investment banker will be bawling and making millions. Um it doesn't have the good PR. So okay, but you'd probe the kids, you wouldn't just say don't do it. That's the point. Because a lot of doctors have that tendency to tell their kids, nah, don't get into it.

SPEAKER_00 2:11:30

Um Yeah, uh so um uh it was just this afternoon I was talking to my 15-year-old. We were having a conversation, and and she said, Well, if you if you say that or if you're gonna go that way, you know I'm gonna resist. Right? And um uh and and that was an age-appropriate answer. Yeah. Um and so so I know better than to say no, don't do it, right? Because that's gonna push them more. But I I do think that um part of being a parent is about how we help them explore about themselves, right? And it's through questioning, it's through uh uh presenting yourself and making yourself vulnerable that sort of gives them those insights and uh and helps them sort of question those things a bit more.

SPEAKER_02 2:12:24

Fascinating. Yeah, I like that answer. That was a great answer. Yeah. Any closing questions?

SPEAKER_03 2:12:30

Yeah, well, maybe not uh maybe not a question, it's a request for free consult for the Ayurvedic medicine part of my Ayurvere Med, yeah, my vegan and gluten-free diet that I've uh that I've gone on this journey with. But uh yeah, that's a request, free consultation once you come back from Kerala. But it's been great having you, Niraj. Uh, thank you so much for greeting us with your presence. And I didn't know about 80% of what you had spoken about, and this is why I wanted to find out. But I'm so pleasantly surprised that we uh we had this chat because yeah, you think you know a guy. You think you know a guy. Yeah, but thanks for for being here with us.

SPEAKER_02 2:13:12

Yeah, it was fascinating. I enjoyed it. I I'm actually honest to be honest with you, I'm cutting this conversation short because we're running out of memory. Um, and that's why it's might seem like an abrupt end. I want to talk longer, but I appreciate you being on the show. People are gonna love it, I think. Yeah.

SPEAKER_00 2:13:28

Well, uh happy to be here and always happy just to chat and connect with people. That's what we're here for, right? Thanks so much. Absolute pleasure.

SPEAKER_03 2:13:36

Cheers.

SPEAKER_00 2:13:37

Yeah, yeah. Sante. Cheers.

SPEAKER_02 2:13:42

We press stop here.

SPEAKER_03 2:13:44

We'll have a part two when we come back from Kerala.