How Arunachal tribe helped pathbreaking study on tuberculosis
RITU JHA
In research that is making waves, Bikul Das, a postdoc- toral scholar at Stanford University, found it was diffi- cult to completely eliminate the tuberculosis bacteria
even after rigorous treatment.
“It could recur years or decades after the initial treat-
ment,” he told India Abroad. “We still do not know why.
Our findings suggest that one potential reason is that the
TB bacteria has evolved to hide in the bone marrow stem
cell niche and so drugs cannot enter that area. Additionally,
stem cells express a drug pump that can spit out many
drugs. So hiding inside those stem cells, the TB bacteria
might be able to escape treatment.”
Basic research of this kind is very difficult, he said, particu-
Dr Bikul Das at work
-larly to design in vitro and animal experiment to find out
the particular stem cell population where TB can hide.
Once the population is found, he added, the clinical part of
the study is relatively easy.
Speaking about his research in India, he said after compiling invitro and animal results, he realized it would be
better to look at a genetically homogeneous population for
the clinical study. Because a homogeneous population provides uniformly enriched samples of bone marrow stem
cells.
“I wanted to avoid drug-resistant TB, because my focus
was on dormant TB only,” he explained. “(India’s) northeast is a great place — a highly homogeneous tribal population living in a remote area, especially Arunachal
Pradesh, and Bhutan. I sought permission from Bhutan,
which was refused. I sought permission from Arunachal
Pradesh through a local nonprofit, and got permission for
the study. They were reluctant at first because they thought
that I was doing the study on behalf of a professor at
Stanford. But when I showed my status as the main princi-
pal investigator of the study, they were convinced and I got
the permission for the study.”
The biggest challenge in his 16 years of study on TB, he
said, was to conduct the clinical study in a remote area of
Arunachal Pradesh.
“The state is itself remote, and I went to the remotest part
of that state,” he said. “I was expecting to have a negative or
some modest result. I thought that I would find most of the
dormant bacteria inside the macrophage cell — a cell-type
widely believed to shelter dormant bacteria — but I just did
not find any dormant bacteria within macrophages.
Instead, I found a majority of the dormant bacteria within
the stem cell component. So it was a big surprise.”
Das, a native of Assam, left India for higher studies in
1998-1999. He wanted to return for research, especially in
northeast India. He wanted conduct cancer research, but it
was difficult, because most northeastern Indian institu-
tions were not interested in granting him permission, due
to which he focused his research on TB.
“I saw the TB bacteria in the bone marrow while working
in Bhutan as a clinician back in 1996-1997,” Das said. “So
while doing a PhD in Toronto, I learned the skill of stem
cell culturing, and so wanted to confirm what I saw in
Bhutan. When the Gates Foundation came up with the
grant competition, I proposed my idea, and they gave me
the grant.”
He immediately made a plan to conduct the clinical part
of the study in India. He founded the Kavikrishna labora-
tory in Guwahati, Assam, in 1994 to prepare for the clinical
study.
Tracking modern-day slavery
ARTHUR J PAIS
Siddharth Kara’s new book, Bonded Labor: Tackling the System of Slavery in South Asia (Columbia University
Press), has taken him to campuses and
think tanks.
Recently, the investment banker-turned-award-winning author also testified before
a Congressional committee on the universal dimensions of forced labor.
Kara, who holds a dual appointment at
Harvard University’s FXB Centre for
Health and Human Rights and at the Carr
Center for Human Rights Policy, says the
book is the result of 11 years of research into
human trafficking and modern-day slavery.
“It focuses on South Asia, including
Nepal,” he says, “but India being the largest
and most complex of the countries in the
region got most of my attention.”
He believes between 18.5 million and
22.5 million people are in debt bondage
worldwide, most of them in South Asia.
According to studies, bonded labor gener-
ated profit exceeding $17.6 billion in 2011
alone.
“I examine the root cause of this slavery
going back to the very ancient times in
India growing as a result of perpetuating
the caste system,” Kara says. “Even today
most of the bonded laborers come from the
so-called untouchable castes. I look at how
bonded labor continued under the Mughals
and the British. The period of the British
Raj directly expanded the system of
bondage, and in Independent India,
despite the laws against bonded labor. And
because many of these laws are weak,
bonded labor continued growing in every
sector.”
Kara traveled from cyclone-wracked
southwestern Bangladesh to the Thar
desert on the India-Pakistan border and
studied the brutish realities of industries
like hand-woven-carpet making, tea and
rice farming, construction, brick manufac-
ture, and frozen-shrimp production.
Siddharth Kara speaks to laborers in Faridabad, near Delhi
he said, because it is a form of feudal servitude.
‘Sometimes,’ he explained to The
Economist, ‘an entire family can endlessly
work off a meager loan taken years before.
More than half of the world’s slaves are
bonded laborers and the products made by
them permeate the global economy.’
He told India Abroad: “There should be
laws to protect the workers from this kind
of exploitation. And the existing laws
should be tightened and enforced.”
He also urges a rapid environmental dis-
aster relief plan.
“(When such calamities strike) money
lenders and other exploiters step in quickly
and a new bonded labor situation arises,”
he says. “There should be rapid interven-
tion teams across the country. People do
not have to go from one disaster to anoth-
er.”
He says he is “deeply impacted and dis-
turbed” by the scale and vastness of the
hopeless situation in urban areas, even
cities like Mumbai.
“The condition of the laborers can indeed
be worse outside the system,” he says. “The
landlords and other employers justify this
kind of servitude by saying that the laborers
would be worse off. It is disturbing and sad
to realize that because of lack of opportuni-
ties for these workers, servitude is better
than freedom for them…”
“I don’t see how India can be considered
a legitimate global economic leader so long
as it allows these types of offences to per-
sist… Anger (at being exploited) can… lead
to striking back and revolution… It is easy
to call Maoists terrorists and anti-national.
But do we really ask why are people strik-
ing back, and do something about it on a
sustained basis?”
