Poor communication between doctors and patients is widely seen as a problem in American healthcare. Now more and more healthcare providers are giving patients new ways of accessing doctors to ask questions or express concerns. In the age of email, texting, video chatting and social media, a look at the promise and limitations of digital communication to improve patient experiences and outcomes.
Journalist Katherine Boo spent years covering poverty in the U.S., work that earned her a Pulitzer Prize and a Macarthur “Genius” grant. But when The New Yorker reporter met her Indian husband in 2001, she wanted to better understand the persistent poverty in his country. Boo spent more than three years following several residents of a Mumbai slum: the Husains who made their living scavenging garbage; slum boss, Asha, and her daughter Manju; and Abdul Husain’s friend, Sunil. The result is a work of narrative nonfiction that tells the dramatic story of families striving for a better life in one of the world’s most unequal cities. Diane and her guests discuss “Beyond the Beautiful Forevers” by Katherine Boo.
- Judith Plotz professor emeritus of English, George Washington University and editor, Penguin 2011 edition of Rudyard Kipling's "Just So Stories."
- Miranda Kennedy journalist, covered conflicts and economic change across South Asia for NPR and APM's Marketplace; author, "Sideways on a Scooter: Life and Love in India."
- Arvind Subramanian senior fellow, Peterson Institute for International Economics and Center for Global Development; author, "India's Turn: Understanding the Economic Transformation" and "Eclipse: Living in the Shadow of China's Economic Dominance."
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Novelist Salman Rushdie has called Katherine Boo's true story of families striving toward a better life in modern India a must read. With me in the studio, to talk about this month's reader's review, "Behind the Beautiful Forevers: Life, Death and Hope In a Mumbai Undercity," Miranda Kennedy. She's an author and journalist. Arvind Surbramanian, the Peterson Institute For International Economics and Center For Global Development, and Judith Plotz of George Washington University.
MS. DIANE REHMI do invite you to be part of the program. I know many of you have read this book. It was the winner of the 2012 National Book Award for nonfiction. Call us. 800-433-8850. Send us an email to firstname.lastname@example.org. Follow us on Facebook or send us a tweet, and welcome to all of you.
MS. MIRANDA KENNEDYThank you.
MS. JUDITH PLOTZHello. Thank you.
MR. ARVIND SUBRAMANIANGreat to be here, Diane.
REHMThank you. Miranda Kennedy, you have your own history with India. You've reported for both NPR and Marketplace. You've written your own book about India called "Sideways On a Scooter: Life and Love In India." Tell me what you thought of Katherine Boo's book.
KENNEDYWell, I thought this book was just a phenomenal way of getting out some of the biggest issues in India today. You know, we're all hearing about India's economy, whether it's rising or not rising, whether -- you know, and what Katherine Boo took a very careful look at was something that people had not looked at much before in the nonfiction realm, which was how the undercity was doing, as she calls it.
KENNEDYYou know, we're always looking at the overcity and India's rise, but what this book looks at are the people who are forgotten, the people who live in one microcosm of Indian poverty, in this slum called Annawadi, in Mumbai. And the issues that they face are the issues that define so much about India today. Corruption, criminal justice, the way women are oppressed, the way religious and class tensions define so many peoples' lives.
KENNEDYAnd she does it in this way that can only be called, I think, novelistic, where you are just right in the middle of the stories, right there. Along with them all the time. You believe in her characters, even though there isn't really a hero. Everyone kind of lies. You can't really trust anyone, but you're right there with them the whole time.
REHMArvind Subramanian, I find myself picking up on that word, novelistic, simply because she has created a narrative that really does read as though it were a novel. And I found myself wondering how people in India would read this book, how they would react to the prevalence of, or the concentration on poverty and children living in the worst kinds of conditions.
SUBRAMANIANRight. I think, Diane, it's very interesting, the reaction to this book in India. Because Indians are fairly touchy about foreigners writing on and focusing on India. And this book was just unambiguously praised without, I think, even an iota of, you know, doubt or suspicion about, you know, the motives of the author, or what she was doing. And I think one is the contrast with, for example, "Slumdog Millionaire," the movie.
SUBRAMANIANThat came in for a lot of criticism in India, both from the left, because people said oh, this is purveying this cheap optimism about India, and on the right because, you know, who are these guys to focus on poverty in India, right? But this book had none of that criticism, and I think it has to do with one, what, you know, Miranda said, you know, it's beautifully done. And I think the second thing was people knew how scrupulous and diligent she was in going about all this.
SUBRAMANIANAnd therefore, I think one couldn't doubt her methods or her motives at all. And that's why I think it received such a unanimously wonderful response in India.
REHMJudith Plotz, how did you react?
PLOTZIt is not a novel, but to this book. But this book, I've taught in India and lived in India, and this is the most terrific vision of India I've seen. It has its -- I think the reason that Indians, as well as Americans liked it so much, is that although the book is telling the truth in very graphic form about the pain of the poor, the maggots in the skin, the fungi on the feet, it also has a tremendously empathic characters with whom we feel -- to whom we feel terrifically close.
PLOTZShe's very inward with them. It has a narrative arc that's terrific. It begins with a suicide, and then we know there's going to be trial. And we wait, we're very excited, in the course of the book, to find out what -- how our narrative suspense will be revealed. And it has extraordinary energy, as every character, no matter how poor, is exercising all, mostly her energies, to get out of the trap that is Annawadi.
REHMWould you read for us from the prologue to the book, starting July 17, 2008?
PLOTZAh. Gladly. Midnight was closing in. The one legged woman was grievously burned, and the Mumbai police were coming for Abdul and his father. In a slum hut by the international airport, Abdul's parents came to a decision with an uncharacteristic economy of words. The father, a sick man, would wait inside the trash strewn tin roof shack, where the family of 11 resided. He'd go quietly when rested. Abdul, the household earner, was the one to flee.
PLOTZAbdul's opinion of this plan had not been solicited, typically. Already he was mule brained with panic. He was 16 years old. Or maybe 19. His parents were hopeless with dates. Allah, in his impenetrable wisdom, had cut him small and jumpy, a coward. Abdul said it of himself. He knew nothing about eluding policemen. What he knew about, mainly, was trash. For nearly all the waking hours of nearly all the years he could remember, he had been buying and selling to recyclers the things that richer people threw away.
PLOTZOkay. Now Abdul grasped the need to disappear, but beyond that, his imagination flagged. He took off running, then he came back home. The only place he could think to hide was in his garbage. He cracked the door of the family hut and looked out. His home sat midway down a road of hand built spatchcock dwellings. The lopsided shed where he stowed his trash was just next door. To reach this shed unseen would deprive his neighbors of the pleasure of turning him into the police.
PLOTZHe didn't like the moon, though. Full and stupid bright, illuminated a dusty open lot in front of his home. Across the lot were the shacks of two dozen other families, and Abdul feared he wasn't the only one person peering out from behind the cover of a plywood door. Some people in this slum wished his family ill because of the old Hindu Muslim resentments. Others resented his family for the modern reason. Economic envy. Doing waste work that many Indians found contemptible, Abdul had lifted his large family above subsistence.
PLOTZThe open lot was quiet, at least. Freakishly so, a kind of beach front for a vast pool of sewage that marked the slum's eastern border. The place was bedlam most nights. People fighting, cooking, flirting, bathing, tending goats, playing cricket, waiting for water at a public tack, lining up outside a little brothel or sleeping off the effects of the grave digging liquor dispensed from a hot two doors down from Abdul's own.
PLOTZThe pressures that built up in the crowded huts on narrow slum lanes had only this place, the Medan, to escape. But after the fight, and the burning of the woman called "One Leg," people had retreated to their huts.
REHMAnd that was Judith Plotz reading from Katherine Boo's prize winning novel, "Behind the Beautiful Forevers." If you'd like to join us, 800-433-8850. And Miranda, like a good novel, she really, in that prologue, sets up our expectation not only for the trial to come, but for the kind of lives that these people are living.
KENNEDYYeah, I mean, it's a wonderful portrait of this, this, this Abdul character who, I think, is the closest that you come to a hero, if there is, you know, if you need to have a hero in a book. And he is so sympathetic. You know, he calls himself a traditionalist. He only wants the simple things in life. He, in contrast to some of her other characters, like Asha, he doesn't long for, he's not greedy for power and money the way many people in the new India are.
KENNEDYHe just wants to have a quiet life sorting garbage. And his expectations are so low, which tells -- which, I think, is her wonderful way of kind of explaining how little you can strive for when you live in a place like Annwadi. Although some people manage to strive for a lot more.
REHMYou've seen Annawadi yourself.
KENNEDYI haven't ever been to Annawadi...
REHMYou had never been...
KENNEDYBut there's no way not to see it, though, because if you fly into the airport at Mumbai, it's right there.
REHMBecause that's where it is. It's right there near the airport, Arvind.
SUBRAMANIANExactly. It overlooks -- it's just adjacent to Mumbai International Airport.
REHMAnd the people who go after this garbage use it to be resold.
REHMFor pennies and make a living?
SUBRAMANIANActually, one of the things we shouldn't forget about this book, Diane, is that it also, while it's kind of bleak and, you know, sad in many ways, there's also a lot of hope in this book. As she says in the book, hope is not a fiction because peoples' lives are being improved. And she says it someplace, you know, the people of Annawadi speak of better lives casually, as if fortune were a cousin arriving on Sunday, and as if the future would be better than the past.
REHMArvind Subramanian. He's senior fellow at the Peterson Institute For International Economics. Short break here. Your calls, your thoughts when we come back.
REHMAnd welcome back for our September Readers' Review. We've chosen a book by Katherine Boo. It was of course a New York Times Best Seller. She is the winner of the Pulitzer Prize. It's titled "Behind the Beautiful Forevers: Life, Death and Hope in a Mumbai Undercity." Judith Plotz, why does she title the book "Behind the Beautiful Forevers?"
PLOTZWhat a fabulous title.
PLOTZOn the road -- lining the road to the lush new Mumbai airport are signs advertising ceramic tile, beautiful forever, beautiful forever, beautiful forever. So hiding the slum is the fence that says beautiful forever, beautiful forever. So our people, the people of Annawadi live behind that. And actually as the signs carry on, the airport managers have put up another set of signs saying, we care, we care, we care.
REHMAnd isn't it interesting that in her subtitle she uses not only life and death but the word hope.
PLOTZShe does have hope and of course she points to the economic hope that the riches around these people offer. And there are several lives which do well. There is Sunil who is the scavenger who is growing and who has energy to go on. And there's Asha who has become the slumlord of Annawadi and who it's hope indeed, and through corruption has fixed her daughter Manju up with a piece of the family business, which is corruption, the family business. But...
REHMGo ahead, Arvind. Oh, sorry.
PLOTZ...may consider one thing, but balanced against this we have the lives that don't do so well. We have all these childhood suicides which are just heartbreaking. In the slums of India it isn't guns but it's rat poison. And child after child, three different children take -- young people take rat poison.
REHMAnd then there is the one-legged woman who takes her own life by self-immolation. And it is for that self-immolation that you have the police coming after this young man and his father, Arvind.
SUBRAMANIANYeah, Diane, just going back to the title "Behind the Beautiful Forevers," I think one of the things that's interesting about the book is not just, you know, the juxtaposition of the rich and the poor which, you know, obviously happens. But in some ways, you know, the poor are living off the rich. It's literally trickle-down economics because the waste from the rich provides the sustenance -- not just, you know, sustenance but the means of escape for some of the poor as well.
SUBRAMANIANAnd that's what's so, you know -- and there's also this thing about, you know, how globalization affects the slum dwellers of Annawadi. Because, you know, when foreign tourists don't come there's less waste. And so these people are, you know, consigned back to misery. So it's interesting that, you know, it's -- not all is bad about globalization. And even where it's good, it's good in these perverse ways because it's all about trafficking in waste.
KENNEDYYeah, I think that's a wonderful point. Sunil, who Judith just mentioned, he literally survives -- he makes thriving -- actually the reason he starts to grow -- he's a runt and he starts to grow is because he figures out that he can get the garbage that's the discards from the taxi drivers. As they throw their paper cups they kind of get stuck on this ledge above a precipice. And he's so little he can fit on it. That is how this boy survives.
KENNEDYIt's like the entrepreneurial niche as she says. There's three ways to get ahead in the new India. You find an entrepreneurial niche or through politics and corruption or through education. And it seems to be mostly the first two that we see in this book.
REHMAnd of course you have Manju who really wants an education but her mother is discouraging her because she feels she needs her to help in the home.
PLOTZWell, Manju has this -- and Abdul have this tremendous desire to make something of themselves and to be good. Kate Boo closes the book with a commentary on how difficult it is under these constricted circumstances for a person to be good. And yet we find people like Manju with a hunger for virtue, Abdul who uses this wonderful metaphor, I don't want to be dirty water. I want to be ice. I want to be something pure.
PLOTZAnd Sunil, who talking to Abdul, realizes that no matter who you are you should have a life that is worthy of human dignity. And this is, for me, more than the economic hope, which is a somewhat degraded hope, is what gives this book its strength and human warmth.
REHMHere is an email from John who says, "I'm the only child of an Indian father and a white American mother who never married and separated soon after my birth. My mother Susan gave me "Behind the Beautiful Forevers." She has been to India. I have not. This book meant a lot to me and I remain astounded by Katherine Boo's ability to elicit and tell this tremendous human story." Arvind, I know you know Katherine Boo personally. What is it, do you believe, that gave her what she needed to do this book?
SUBRAMANIANWell, I think three things I think. One, she has an Indian husband so I think in the book she says, you know, I gained -- I married an Indian and gained a country and something like that. So that's I think one. I think second, which I'm kind of possibly experienced with her, the remarkable, you know, persistence and, you know, getting everything scrupulously right. You know, she wrote a piece for the New Yorker just before "Slumdog Millionaire" came out related to the slums. And she had all these numbers on poverty that she wanted to get right.
SUBRAMANIANAnd she really grilled me for several hours, you know, to make sure that I understood what I was saying and so that she could get it right. And I think above all I think she has this phenomenal capacity for empathy, I think. She once came home...
REHMThat comes through.
SUBRAMANIANYeah, she once came home and both our dog and my daughter said -- you know, I'm of course exaggerating -- but they'd never met someone who got them so quickly.
REHMInteresting. Yeah, yeah, yeah. Miranda, what about the self-immolation of the one-legged woman. Why does she do that and how does this involve the young boy and his father?
KENNEDYWell, Fatima with the one leg is such a really tragic figure and, you know, she -- it's clear for -- Katherine Boo makes it clear that Fatima had not been loved by her parents, that she had wonton sex around the slum to make herself feel better. And I think that's something that's very important I know that Katherine Boo wanted to look at, especially the lives of women and children in the slums. And one thing that happens a lot is the use and misuse of sex. And both Asha and Fatima have sort of wonton sex. But Asha has it for a very clear purpose. She always knows what she's doing.
REHMTo gain power.
KENNEDYTo get power and money and it works. But with Fatima it doesn't work. I mean, her attempt to feel better about herself is clearly not working. She's a character who seems to have drowned her own two-year-old daughter in a bucket when she had TB. She's a very angry, complicated character. And she thought she would set fire to herself and not kill herself. I think that's sort of what is to be assumed. But she knew she would be able to blame her neighbors for it who live just on the other side of a flimsy wall. And she did. And thought that then she'd be able to get money or get ahead or get power.
KENNEDYAnd I love how in the book Katherine Boo describes how much bigger she felt as her husband carried her out of the slum. And it was partly the swelling, she writes, but it was more than that. She could see that people were looking at her, that she mattered. For once, she ended up in the hospital and not in the ward where she had to sleep on the floor, but where she had a cot. And only one other person shared her room. She was important suddenly. She had swelled to this stature where she mattered by burning herself. It is really one of the most horrifying passages.
REHMBut what happens to her?
KENNEDYBut she dies. Yes, it also didn't work and that she didn't just burn herself enough not to die. Because she was in a public hospital in India and she got an infection. And we know this because Katherine Boo has gone through and gotten all the hospital records. And it's clear she's done scrupulous reporting and she knows that the reason that she died was not because she had burns on 95 percent of her body, which is what the hospital records were manufactured to say. In fact she only had burns on 35 percent of her body but she got an infection in the hospital and died from it.
REHMHow does she come to blame her neighbors?
PLOTZThe -- what is very interesting in the pathology of this slum is how there isn't as much community as one wants to hope in a romantic vision of poverty. There's tremendous envy because it is so hard to live from meal to meal, so there's great resentment of people who are getting ahead. And the self -- the immolation occurs just at the point in which the Husain family, Abdul's family are hoping to better themselves. They're remodeling their tiny miniscule hut.
PLOTZAnd in doing -- first, doing the remodeling is a dangerous thing because it will attract attention to them. But second of all, it rattles Fatima's house. It disturbs Fatima's house. These are jerrybuilt houses and Fatima's house is disturbed and she gets very, very angry. So it's a combination of envy and spite and sickness at heart, but mostly envy.
REHMArvind, have you seen one of these houses?
SUBRAMANIANYeah, I mean, not in Annawadi itself but in other places, yes.
REHMDescribe it for us. How large are we talking about?
SUBRAMANIANI mean, cramped would be a kind of -- being very generous about this. But I think the abiding memory that I take away from all these places is partly how cramped these things are. But just the lack of sanitation and, you know, the stagnant water with all the malaria stuff...
REHMBut there are 11 children in this one dwelling.
SUBRAMANIANOne room and it...
REHMWell, that's the point.
SUBRAMANIANYeah, and it's shared with actually -- the dwelling is shared with Fatima, you know, the one-legged person. And the whole fight begins because the Husain family wants to put a shelf, which starts knocking on Fatima's side. And she says, there's rubble in my rice and, you know, that's how the whole thing starts, which leads to her immolation. But, Diane, I want to say one thing about what you just said. You know, one of the big themes in this book, I think as it is in several of her other writings, is why doesn't social change happen in these impossibly horrible places?
SUBRAMANIANAnd if you permit me, I would like to read a passage here.
REHMAfter I remind our listeners, you're listening to "The Diane Rehm Show." Now, go ahead, Arvind.
SUBRAMANIANYeah, you know, so I'm reading a passage towards the end of the book. What was unfolding in Mumbai was unfolding elsewhere too. In the age of global market capitalism, hopes and grievances were narrowly conceived which blunted a sense of common predicament. Poor people didn't unite. They competed ferociously amongst themselves for gains as slender as they were provisional. And this under city strife created only the faintest ripple in the fabric of the society at large.
SUBRAMANIANThe gates of the rich occasionally rattled remained unbreached. The politicians held forth on the middle class. The poor took down one another and the world's great unequal cities soldiered on in relative peace.
KENNEDYThat's so wonderful because it's very telling about how this is an India that's changing quickly, an India where, you know, religious divisions and cast matter less than they ever have before. And, you know, an India where it's possible to get away from that. And as Katherine Boo writes, it's still an India that always makes sure that you know your place. So she -- I think she walks this line very carefully between possibility, which Mumbai is teaming with possibility.
KENNEDYYou know, I think it's -- one of the characters says that Mumbai is a horrible place to live but it's better than anywhere else. Because they all come from villages where the land has dried up or where there's very few opportunities where people used to starve to death, you know, 50 years ago. And now there's many opportunities in Mumbai to escape. And yet it's still horrible.
REHMHelp me to understand what these scavengers do with the material they gather. I don't get it, Miranda.
KENNEDYWell, it's a really complex process actually, scavenging and garbage picking. There's all kinds of different layers. So Abdul sorts through -- he is sort of a garbage master as in other scavengers bring the garbage that they collect to him and he sorts it through and then sells it to other higher garbage pickers up on the higher scale, sort of if you were like taking it to a recycling. You know, in India it's something like 90 percent of the garbage is recycled, but not by the state, just by people, by entrepreneurs like Abdul.
KENNEDYAnd so he's sort of on the high end. I think he'll take scraps of plastic and metal and he talks about like the way to bite through something or to feel it with your toes to tell the quality of the plastic and to know how much it will be worth. You know, a polyurethane bag is worth very little. You need to collect hundreds of them. But if you have a higher grade plastic something else then, you know, that would be worth its resale value.
SUBRAMANIANI think his great skill is to be able to separate out the plastic from the foam, from the polyurethane from the tampon applicators because I think there are different people who come and buy -- you know, there's a market for waste in plastic, waste in paper. And that's how he, I think -- and his great skill -- he has great dexterity, his fingers are small and he can just kind of -- he's a master sorter, as it were. That's his great skill.
REHMSo you got overarching themes in this book of certainly poverty, the clash of cultures. You've got the local people versus the ones who are in authority, and they don't come off very well at all. And you've got this sense of competition among these very poor people, the greed, the envy, the sadness, the why-can't-I-have-that and I'm-going-to-make-you-as-miserable-as-I can. Rather than, as you said earlier, Judith, this is not community as we would normally think of it.
PLOTZThere is this wonderful moment that occurs in the book. The -- Annawadi of course is a half acres of hundreds and hundreds of huts and there are a couple of luxury hotels, notably the blue glass Hyatt nearby. And there's one older mad scavenger who keeps saying, Hyatt, why are you trying to kill me or Hyatt, I love you. Why don't you -- why don't you take care of me? And the...
REHMWe've got to take a short break here. We'll be right back.
REHMAnd it's time to open the phones as we continue our Readers' Review for September, Katherine Boo's bestselling book titled "Behind the Beautiful Forevers: Life, Death and Hope in a Mumbai Undercity." Let's go to Tampa, Fla. Jennifer, you're on the air.
JENNIFERHi, I just wanted to say I love this book and what it told us about slums of aspiration. But my question comes from a little different context. Looking at the response to the new Miss America, there's a blog that I subscribe to that's -- it's a bunch of British Muslims, and so a lot of them are from India and Pakistan and know a lot more about India and Pakistan that I do. And the comments that several of them made is as unfortunate as it is to hear the comments that were made about this woman in the United States, had she stayed in India or wherever her parents or grandparents were from, she never would've been permitted to even rise to that level in the first place.
JENNIFERAnd I just wondered what your commentators had to say about that. A new word to me that I've learned in this conversation is shadeism. I'd never heard that before. Discriminating on the basis of skin tone, not just color. And I just wondered if your commentators had anything to say about that, if they...
KENNEDYWell, we were just talking about that. I haven't heard the word shadeism either, but, yeah, it's -- we were just talking about how Manju, who is Asha's daughter, is obsessed with applying fair and lovely cream to her skin so that she'll improve her marriageability, which is just a detail that is absolutely necessary in any book about young people in India. But I was saying how increasingly men are putting it on. And her brothers are always taking her cream and smearing it on their faces. And she is sort of chastising them for using too much because, yes, to be more marriageable, Arvind was saying, wheat complexion is the term that is often...
SUBRAMANIANMarriage adds, you know, I think when -- especially when girls' attributes are being kind of prominently emphasized, one of them is the color of your skin, the shade of your skin and, you know, fair or wheat complexioned is often used. And, you know, it's true in Brazil as well. I think there's different gradations of color are there in society and...
REHMAnd you're saying that they do apply to men as well these days?
SUBRAMANIANWell, Miranda was just saying that, you know, more and more women are seeking of men, what men are seeking of them, so this kind of parody of a perverse sort that's kind of, you know, happening in India where there's kind of, you know, both sides are expected to be fair. But, yes, shadeism is prevalent.
KENNEDYOne of the many, many discriminations in India.
PLOTZYes. And when Abdul goes to the detention center where there are portraits of the founders of India, he especially admires Naru (sp?), not because he's the great man, but because he's so wonderfully fair and lovely.
REHMInteresting. Hope that answers it. To Fort Wayne, Ind. Hi there, Nancy.
REHMHi. Go right ahead, please.
NANCYOkay. I was -- as I was listening to this -- I've taken a trip to India two years ago. And so as I'm listening to this whole talk about this book, I haven't read the book, but it's on my list -- top on my list to get, but it's like seeing it all over again. I was there for three weeks. And I wasn't -- I didn't walk among the people that she's talking about in the book, but I was on the trains where the people just were crammed in. I'm with a translator and this guy said, now, when this train stops -- I was on the train every day almost for three weeks. When the train stops, there's going to be a crowd. I'm going to get behind you and I'm going to push you in. And that's literally what happened.
NANCYAnd as I'm in this train -- I love to write. So as I'm in this train, I'm looking at people and I saw, you know, from all different backgrounds. But yet one day we took the train, they wanted me to see the contrast, so the hotels that were just mentioned on the show. The contrast that hit me was we're coming into the city and I was probably about 90 minutes out of the city. And we're coming into Mumbai. And I can see these beautiful buildings, some going up, and hotels.
NANCYBut off to the side of the train, I was able -- this one wasn't crowded, so I was able to, like, stand by the door. And I saw these homes that were it looked like just made of whatever they could find, and just children everywhere and muddy water. And it's a country after the three weeks I fell in love with the people. But I also had this love hate because much of what they're saying in the book, you see the progression going on, but you also see the poor of the poor.
KENNEDYYeah, and I think it's really hard to -- it's very hard to be a poor Indian now. It might've been easier before, not that it's ever easy to be poor, but it might've been easier to not be surrounded by people who have television sets. You know, now in the slum -- in Annawadi slum there's several people who have TVs. If you don't have a TV, of course you want to have a TV. And, you know, you look outside and there's the Hyatt and then the even bigger hotel down the road. And, you know, she talks about how everyone in Annawadi wanted one of the life changing miracles that were said to happen in the new India. They wanted to go from zero to hero as the Indian saying is.
SUBRAMANIANI think, Diane, I mean, the one thing that, I think, what needs to keep in mind is that, you know, it all depends upon, you know, what your frame of reference is, who you're comparing yourself with. I mean, if you're comparing yourself with your neighbor next door, of course it's kind of a worst place to be. But the point is that there's been so much improvement in India even for people at the bottom. You know, poverty rates have declined enormously as, you know, people are much richer. People's consumption habits have, you know, changed. People have cell phones.
SUBRAMANIANSo while one shouldn't underestimate, you know, the bleakness for many people, I think one has to. And I think that's the point of the book. That's why there's hope in the title as well. And there are several little, little, you know, nuggets where the hope comes through. For example, Asha, the slum lord. You know, midway through the book, her lover, when she -- when he calls her, insists that she wear a particular dress for their evening tryst. But towards the end of the book, again, he comes and says, please wear the pink dress. And she doesn't. You know, she wears the dress that she wants, and she feels empowered by the end of the book.
REHMYou know what's so interesting about what you just said, Arvind, is that the lover the first time calls in the midst of her birthday celebration.
REHMShe leaves her family...
REHM...to go and be with this man who's going to provide her not only with money because of the tryst, but also give her a sense of greater power.
REHMSo I don't know. I wanted to ask you, Nancy, what you meant by being pushed onto the train. I gather it was very crowded and you had to be shoved to get into it. Is that correct?
NANCYYes, that is correct. In fact, there are some videos online that -- not mine, but they're able to see. And this is my take on this, though, as you're talking about hope, the word perseverance comes to my mind as I think of that experience. Because these people -- I was only there for three weeks, and I was thinking, you know, if I had to do this every day. And there were people from all economic levels on these trains. But a perseverance in it. And, yes, there are just so many people, it's just...
NANCY...overwhelming in the area I was in. When you said entrepreneurs, I got one chance to be on what's called a woman's car because I don't speak the language and I didn't have a translator with me. And so I was in the woman's car. And there were women that do their business in the women cars is what they do. They have jewelry that they make that is just beautiful, and they are allowed -- now, I don't how they're hired in or how that works, but they are just dressed beautifully. And they are allowed in these cars to sell their jewelry.
SUBRAMANIANYou know, Diane, I have to say, you know, growing up as a child in India I did these train rides very often. And now I do the Aceler (sp?) from New York to Washington often as well. And I must say, you know, of course the efficiency is better here, fewer crowds, but the romance of traveling by train in India is something that I would never forgo. You know, you get into a train in India, soon within three minutes people -- neighbors are exchanging food that they have. Within five minutes they ask you all kinds of intimate details. By the end of the journey you've exchanged addresses and you've, you know, said we have to meet, we become friends and, you know, it's just, you know, that's the other side to train travel in India, which people...
KENNEDYThere is a sense of community on trains actually. We talk about how there isn't much in the slums, but I think on the train, a lot of times you end up feeling part of a family.
REHMHere's an email from John, who says, "Having been raised in the U.S., I have the tendency to believe poor people were somehow equated with being lazy. But having worked in India and read this book, it becomes clear poor people have to work incredibly hard just to live in India as their survival literally depends on it." Judith.
PLOTZAny tendency to condescend to the poor is taken away by this book. I mean, this book shows such striving and such energy and such ingenuity, and part of the pathos is that the intelligence of so many of these characters, like Asha and the entrepreneurial-ness of Abdul in a different situation or Sunil would have gotten them into Harvard Business School and onto Wall Street. So whatever else this book does and whatever hopes it may take away, it certainly removes any tendency to condescend to the poor. Poverty is not easy.
PLOTZAnother thing I wanted to comment apropos of what the earlier caller and the -- she was talking about so many children being around, which is striking about Annawadi, is how young the population is. The old people have been left behind in the village. And in order to make it in the slums, you have to be reasonably young. And the characters we're dealing with, Asha's kind of a matriarch, but she's only 40.
KENNEDYYeah, and Asha's a wonderful person in terms of defining that point about you can't condescend to the poor. Asha is very aware of what's going on around her. Everything she does she's very deliberate about. And while she abandons her family and has sex behind her drunken husband's back and does all kinds of things that are perhaps not morally correct, she's wonderful because she understands plenty. She says somewhere, the big people think that because we're poor we don't understand much. But she knew that she was part of the game. And the other problems like corruption and exploitation of the weak, she could get in on that.
REHMThat's what I want to get to, her image of the courts, the police, not very happy.
SUBRAMANIANYes. I think one of the nice portrayals in the book is how the Indian, you know, justice system or the police system works. And there are a several pieces here which kind of capture them. One is, you know, she says somewhere that, you know, innocence and guilt, you know, can be bought and sold, you know, that's what the Indian criminal justice system is. Or that, you know, the police station is not a place where you go to get addressal of your grievances. It's basically a market.
SUBRAMANIANAnd I think what it does very well is capture how much harassment, how much corruption and how it's particularly bad for -- because the rich can bribe their way out of these things. It's the poor that feel the most affected by this very arbitrary, costly, time-consuming and not very well functioning, you know, justice system.
REHMAnd you're listening to "The Diane Rehm Show." Let's take another call from Dallas, Texas. Reddy, you're on the air.
REDDYYes, Diane, hi. How are you guys?
REHMFine, thank you.
REDDYI hear you have a panel of three or four people, speakers on the panel very well, you know. I haven't read the book, but I heard -- I heard your analysis on the book, the review. I was just wondering if she covered -- if the author covered anything in detail, anything, you know, elective to the root causes that are causing this problem, as India has grown so much now, has developed so much. Because everyone knows there are so many books written and so many articles written, so many people cover the poverty in India, so it's nothing new.
REHMI think that people reading this book will feel something new and different about the way she has presented it. Is the poverty still there? Are the causes still the same? Has anything changed?
SUBRAMANIANDiane, I think this is a -- I think she actually does a good job of analyzing some of the underlying causes of poverty in this book, which is, you know, the way the government functions, you know, the corruption, the weak governance and so on. I think things have changed considerably, which, you know, she also points out.
REHMBut if I go to India and get off at the Mumbai airport...
SUBRAMANIANOh, you will still see a lot of slums, yeah.
SUBRAMANIANWell, the same is a little bit questionable there, Diane, because...
KENNEDYNow they have TVs and cell phones.
SUBRAMANIANYeah, because now, I mean, in some respects people are considerably better, in some respects they're no better than before. So it's a mixed bag and therefore, you know, it's not -- as someone said about India, you can find someone in India living in each of the last 10 centuries and probably the next few centuries as well. So, you know...
REHMLiving in the same way.
SUBRAMANIANYeah, you know, you can find someone, you know, from abject poverty to advanced technology.
KENNEDYI just want to say about corruption that, you know, corruption is one of the things that we're always bemoaning here in the west about India, that it's so -- I mean, it is absolutely awful, yes. What's happening in this book is awful. Everybody is corrupt and they take advantage of the weak. But inside Annawadi, the weak see corruption as the way to get ahead. It's a delicious irony that Asha has learned how to be corrupt herself.
KENNEDYShe's involved in these antipoverty schemes. She takes that money. She's one of the poorest people in, you know, used to be one of the poorest people in the slums. Now she's one of the richest because she'll take the money from a so-called antipoverty scheme that the government has set up and exploit it and parade people around and, you know, make her -- make good with it.
REHMLast brief comment.
PLOTZIt's delicious but not so delicious in the sense that every government plan we hear of to educate the poor has had most 90 percent of the money skimmed off. The money for the poor and the hospitals has been skimmed off. And some of the beneficiaries are poor themselves. But the book -- in so far -- this is not a policy book, but in so far it's a policy, it's that we have to understand and change deeply.
REHMJudith Plotz, she's professor emeritus of English at George Washington University. Arvind Subramanian, he's senior fellow with the Peterson Institute. Miranda Kennedy, a journalist who covered conflicts, economic change across South Asia for NPR and American Public Medias Marketplace. Thank you all so much.
PLOTZThank you so much.
SUBRAMANIANThanks, Diane, for having us.
REHMAnd thanks for listening. I'm Diane Rehm.
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