Research in a rural setting in India.

I read with great interest the Offline piece about global health by Richard Horton.1Horton R Offline: The case for global health.Lancet. 2023; 4011639Google Scholar I hope that it is an eye opener to scientists and researchers residing in high-income countries. In 2022, in Maharashtra, India, it is reported that 2942 farmers died by suicide.2Marpakwar P Maharashtra farmer suicides shot up in 2022 despite loan waiver.https://timesofindia.indiatimes.com/city/mumbai/maharashtra-farmer-suicides-shot-up-in-2022-despite-loan-waiver/articleshow/97073506.cmsDate: Jan 18, 2023Date accessed: June 13, 2023Google Scholar These suicides have been linked to repeated droughts, untimely rain, excessive debt to money lenders, and a reluctance of the government to guarantee fixed prices for farmers' goods. True science cannot be purchased. However, many academic institutions in high-income countries are in a state of privileged seclusion, where money is prioritised over progress. Institutions are often only interested in getting grants and improving their own facilities. For individual scientists, grants and subsidies are only necessary for funding their research goals, whereas Institutions are interested solely in the fees. Too much of researchers’ time is wasted preparing protocols and applications for getting grants and, ultimately, many scientists lose their passion and interest in the research, which is detrimental to global health. Between 1978 and 2023, I have published 115 PubMed indexed articles related to 15 various medical health issues in The Lancet, the New England Journal of Medicine, the British Medical Journal, and many other national and international journals.3Bawaskar HS Nomination for Nobel Prizes: is it possible for Indian scientists?.Lancet. 2022; 400: 1678-1679Summary Full Text Full Text PDF Google Scholar In this time, fatality from acute refractory pulmonary oedema caused by scorpion stings has gone from 30% to less than 1%—partly as a result of my research into prazosin and scorpion antivenom treatment.4Bawaskar HS Bawaskar PH Prazosin in management of cardiovascular manifestations of scorpion sting.Lancet. 1986; 1: 510-511Abstract PubMed Google Scholar, 5Bawaskar HS Bawaskar PH Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomised open label clinical trial.BMJ. 2011; 342c7136Crossref PubMed Scopus (59) Google Scholar This uninterrupted research over the past 45 years has been done without help from any funding agency and solely from my own personal income. The most immense satisfaction I have felt in this time was from witnessing a person who had been successfully treated for acute pulmonary oedema being discharged and walking out of my hospital. I remember thinking at the time that, although I am poor in terms of money, I am rich in terms of academic currency. Sadly, most world authorities from high-income countries will not visit low-income countries unless their travel and accommodation are arranged and expenses covered. I am sure that many of these individuals would not spend a single penny of their own money towards their work in global health. Working in a rural setting, it is very difficult to be a scientist like myself and make publications in subjects of interest. The biggest challenge that I face is that English is not my first language. Many of the articles that I submit are probably rejected without being properly read. Furthermore, it is discouraging that similar articles are often published soon after by authors from high-income countries. It has been reassuring that several of my Articles and Correspondences have been accepted at The Lancet since 1978.6Bawaskar HS Diagnostic cardiac premonitory signs and symptoms of red scorpion sting.Lancet. 1982; 1: 552-554Summary PubMed Google Scholar, 7Bawaskar HS Ian Munro remembered.Lancet. 1997; 349: 960Summary Full Text Full Text PDF PubMed Google Scholar The Lancet accepts pieces on the basis of their data and not on the basis of the submission authors’ nationality, country of residence, or language. Furthermore, I have not been charged for any of these publications. Even in Open Access journals, some printed articles are not free and submitting authors must pay for publication charges. Many of my articles that are accepted cannot be published because I am unable to pay the publication charges. In the case of private practitioners such as myself, no government or other institute helps with publication. Nevertheless, I am sure that irrespective of scarce resources, individual passion, sincerity, dedication, and practical research directly applicable to global health will be rewarded. I declare no competing interests. Offline: The case for global healthGlobal health has become fashionably unfashionable. The case against global health is strong. Global health is the invention of a largely white and wealthy elite residing in high-income, English-language speaking countries. The discipline claims to be concerned about the health of people living in low-income and middle-income settings. But the resources—human, infrastructural, and financial—underpinning global health are mostly concentrated in those countries already replete with power and money. Full-Text PDF