Sunday, October 24, 2010

Infertility of Indian Establishment

The man who gave the world in vitro fertilisation (IVF) has been awarded this year's Nobel Prize in physiology or medicine. Dr. Robert Edwards (85) was named winner of the Nobel Prize for Medicine on October 4, 2010 for his work, which has helped millions of couples around the world have children, popularly known as test tube babies.

“His contribution represents a milestone in the development of modern medicine,” said the Nobel Assembly at the Karolinska Institute, Stockholm, which selects the Nobel Prize winner for Medicine. "This discovery represents a monumental medical advance that can truly be said to confer the 'greatest benefit to mankind'," it continues. "Human IVF has radically changed the field of reproductive medicine."
Robert Edwards and his obstetrician colleague Patrick Steptoe, who died in 1988, announced the birth of Louise Brown, the first IVF baby, on 25 July 1978. Since then, 4 million babies have been born thanks to IVF, and the method has become routine worldwide, accounting for 2 to 3 per cent of all births. Infertility affects one in 10 couples worldwide, of whom an estimated 19-20 million live in India, according to the World Health Organization.

Yet at the time, Edwards and Steptoe had to fight widespread hostility. Throughout their quest to develop IVF they faced opposition from religious leaders who expressed moral outrage, from politicians keen to reduce the world's population, and from scientists who warned that the technique would be unsafe. Their request for key funding was denied by the UK's Medical Research Council, and only succeeded thanks to a rich donor whose identity remains a secret.
India’s Unsung Hero

This is the time to remember the bureaucratic catastrophe that has ultimately caused robbing of the credit, due to Indian researcher Dr. Subhash Mukhopadhyay, of concurrently working on similar project which ended successfully. Indian scientist had a rightful claim of a share in this Nobel Prize but, instead, he ultimately committed suicide when he failed to convince his colleagues and an inept authority sponsored enquiry board of his achievement.

Dr. Subhash Mukhopadhyay created history when he became the first physician in India (and second in the world) to perform the In vitro fertilization resulting in a test tube baby "Durga" (alias Kanupriya Agarwal) on October 3, 1978, just 67 days after Marie Louise Brown. In this research Mukhopadhyay was assisted by Sumit Mukherjee and S.K. Bhattacharya. As their efforts were concurrent, Dr. Mukhopadhyay definitely deserved the credit for the original success of IVF techniques together with Dr. Robert G Edwards and Dr. Patrick Steptoe. Instead this historic and pioneering feat was mired in controversy generated by jealous professional contemporaries and ignorant and inept bureaucrats in India.

IVF - Cure for Infertility

Dr Mukhopadhyay and Dr Edwards started working on infertility related issue in the 1950s and 1960s respectively. Their aim from the outset was to find a way of fertilising human eggs outside the body then returning them to the womb. However, it is now known that Dr. Mukhopadhyay, on the one hand used much advance technique of fertilization and much simpler technique of ovum removal. It was necessitated due to very rudimentary facilities and support he had from other advanced techniques, which was not prevalent in India at that time.

In his research Dr. Edwards had joined forces with Patrick Steptoe, who had pioneered the technique of laparoscopy in the UK and Steptoe's "keyhole surgery" technique made it possible to extract mature eggs from a woman's ovary. At first they observed the evolution and development of the Ovum for a long span of time and then collected it through a small incision. Ovum thus collected is then fertilized by sperm on a small disc. When it forms into an embryo scientists placed it into the womb. But Mukhopadhyay, without any access to Laparoscopy specialist, collected ovum by performing a small operation in the vagina. He increased the number of ovum collected by using a hormone and developed embryo. Lastly, he placed it in the womb.
Edwards and Steptoe relied on the woman's natural menstrual cycle to get the eggs to mature, whereas Dr. Mukhopadhyay’s used Ovarian Stimulation technique using certain hormones. Today ovarian hyper stimulation is the standard procedure for all women subjected to IVF not natural menstruation cycle followed by Dr. Edwards. It is noteworthy that Mukhopadhyay was far ahead of his time in successfully using an ovarian stimulation protocol before anyone else in the world had thought of doing so. Dr. Mukhopadhyay also used cryogenic preservation of Embryo at very low temperature, a technique which has now become standard procedure.
End of Experiment

Unfortunately, immediately after this historic success, Dr. Subhash Mukhopadhyaya started facing social ostracization, bureaucratic negligence, reprimand and insult instead of recognition from the state government and refusal of the Government of India to allow him to attend international conferences. Frustrated and in failing health, Mukhopadhyay killed himself on June 19, 1981.

Dr. Subhash Mukhopadhyay’s effort was not initially accepted as an IVF procedure frivolously sighting lack of scientific documentation. In November 1978, an ‘expert committee’ was appointed by the Government of West Bengal under the medical association to decide over the fate of a convict named Dr. Subhas Mukhopahyay. His charges were, one, he claimed to be the architect of first human test tube baby named Durga (3 October 1978). Secondly, he announced the report to the media before being cleared off by the Government bureaucrats. Thirdly, he made this impossible possible with few general apparatus and a refrigerator in his small southern avenue flat while others cannot even think of it, although, having all the expensive resources in their hand. Fourth and most important allegation, he never let his head down by the Government Bureaucrats and his straightforwardness always attracted jealousy out of his peers. The expert committee was presided over by a Radio physicist and it was composed of a gynecologist, a psychologist, a physicist and a neurologist. None of them were having any knowledge about modern reproductive technology. “Where did you keep these embryos?” Mukhopahdhyay said “…in sealed ampoules.” Then he asked again “How did you seal an ampoule?” Speechless Mukhopadhyay could only utter “pardon?” From here started a questioning and counter questioning session which need not to be mentioned was utterly meaningless. “Oh! Embryos do not die while sealing?” there were people who never saw embryos in the entire span of their lifetime.

The Committee put forward its final verdict, “Everything that Dr. Mukhopadhyay claims is bogus.” Thanks to his peers and Government bureaucrats he was ultimately handed with a punishment. He had been transferred to ophthalmic department which sealed his prospect to work on hormones.

An insulting silence carried on with every passing day. According to Scientific records, Harsha Chawda, born 16 August 1986 at KEM Hospital, Mumbai, became the first human test tube baby of India. The credit for this achievement went to T.C Anand Kumar, Director of IRR (ICMR) supported By Dr. Indira Hinduja.

Late Recognition

A country's pride was eventually restored after 27 long years when the Indian and international scientist communities had began accepting Dr Subhas Mukhopadhyay's claim and recognising India for producing the world's second test-tube baby Kanupriya Agarwal alias Durga.
Ironically this turn of event is attributable to TC Anand Kumar himself. Kumar took the crown off his own head after reviewing Subhash Mukhopadhyay's personal notes. In 1997, he went to Kolkata for participating in the Science Congress. It was there that all the research documents of Mukhopadhyay were handed over to him. After meticulously scrutinising and having discussions with Durga’s parents, he became certain that Mukhopadhyay was the architect of first human test tube baby in India.
In 2005, The Indian Council for Medical Research (ICMR) officially acknowledged that Dr Mukhopadhyay was indeed the creator of India's first test-tube baby. Dr. Kumar himself took initiative in setting up a research institute in reproductive biology in memory of Mukhopadhyay. And then, Dr. Mukhopadhyay’s name found a place in the ‘Dictionary of Medical Biography,’ published by World Foundation, which enlists names of 1100 Medical Scientists from 100 countries around the world for their path breaking contributions to the medical science.

Collective Failure

While the so called establishment failed to recognize the success of Dr. Mukhopadhyaya, our media also showed a lack of depth and understanding in such issues. Even today our media reports that his success was not recognized due to lack of documentation, which the subsequent ICMR study actually conclusively refuted. Indeed, our establishment created all barriers so that his scientific papers could not be published in reputed journals; he was also debarred from presenting his papers in a major seminar in Tokyo in November 1978. Dr Mukhopadhyay's story was immortalised in the 1991 film Ek Doctor Ki Maut starring Pankaj Kapur and Shabana Azmi and directed by Tapan Sinha.

We repeatedly fail to recognize the bias and injustice to our scientific achievement and always failed to project and lobby for recognition in international forum. So, as a result the pattern injustice has become well accepted even by the victim. Today, like in the past, hardly any Russian or developing country’s scientists get top recognition in science. At the same time, if they change their work place to any western countries, then Nobel and similar recognition becomes quite achievable. This very subtly project that those western countries as the crucible for real scientific development and indirectly turn our scientific and technical image as kind of backward.

Another great instance of ignorance and bias of Nobel committee was shown in case of Italian Guglielmo Marconi who was awarded the Nobel Prize in 1909, while before him Dr. Jagadish Chandra Bose invented and demonstrated wireless transmission. Indeed, during the 150th Birth anniversary of Dr. Bose, in 2009, Marconi’s grand son F. P. Marconi categorically stated that “The real inventor of Wireless or electromagnetic rendition was not Gugliemo Marconi, but Jagdish Chandra Bose”! He also said “Guglielmo Marconi had probably interacted with Sir Jagadish Chandra Bose in the spring of 1899 in London before sending and receiving the first wireless message across the Atlantic in 1901.” The son of D P Marconi, senior Marconi’s eldest daughter, earlier visited the city in 2006 and was “astounded” to find at Bose Institute the detector or coherer that his grandfather had used to receive the transatlantic wireless signal. “The instrument was critical to radio communication,” acknowledged Marconi. Indeed, on the website of the Marconi International Fellowship Foundation, the grandson admits that the senior Marconi “had not invented anything really new… what was new was the use to which he put the old concepts and techniques in order to exploit them for a very practical purpose… He was not a great scientist… but could foresee the commercial potential of wireless telegraphy”.

In the past there have been several other examples. In 1902, Ross was awarded the Nobel Prize in Medicine for his remarkable work on malaria. His Indian able and equal assistant Dr. Kishori Mohan Bandyopadhyay was denied an equal credit and was awarded a gold medal by King Edward VII, as a kind of consolation prize. In 1922, Dr. Upendranath Brahmachari invented Urea Stibamine, the potent drug to cure Kala-azar which saved millions of life in India and rest of the tropical world. Dr. Brahmachari missed the Nobel, though he was nominated for it in 1929. Eminent and path breaking Indian scientists like Homi J Bhaba, the inventor of the concept of nuclear fission energy development, or Dr. Meghnad Saha or Satyendra Nath Bose of Boso-Einstein theory fame were never considered for Nobel prize in the past.
Indian authorities and even the traditional media have shown a lack of empathy and concern in such vital issue. In any other country, the authorities and countrymen would have tried their best to recognize such world beating scientific feats, for improving its own image. In any other modern competitive nations the flow of such recognition and award would have come first from the national authorities itself. So, when we ourselves failed to honour scientist like Dr. Subhash Mukhopadhyay with a Bharat Ratna or a Padma Vibhusan, how we can we expect outsiders to give justice to such genius?

It is time that Indian Intelligentsia starts understanding the importance of the projection and recognition of our scientific achievements. It is also high time that our historians arrange for proper archival of all relevant facts and figures of past successes so that our future generation understands and be proud of their scientific heritage, though many of such scientific achievements might have missed recognition from the western world.

--- by U.Keci