On Harold Pinter

Harold Pinter died yesterday at the age of 88. He was one of my favorite writers.

I came to know about Pinter about a decade ago when I traveled from Bucharest to New York. I am a vegetarian and the cabin crew had mixed up my food with something I do not eat. The perceptive Israeli woman sitting next to me remarked that such stupid errors cannot happen in her country. That was the beginning of an interesting talk about kosher food, Jewish institution of kibbutz and Jewish contribution to human civilization. We also talked about the place in the history of mankind of great Jewish names such as Albert Einstein, Sigmund Freud, Henry Bergson, Franz Kafka, and other timeless celebrities.

She asked, “What do you think of Pinter?” Like an ignoramus, I blurted, “Pinter? Who is that?” That was the beginning of my acquaintance with Harold Pinter. She gave me a brief oral backgrounder on Pinter. From that day on, I grabbed any book written by Pinter. The more I read his works, the more I fell in love with them. My admiration for the great writer grew exponentially as time passed.

Pinter had a lower middle class ancestry. He spent the formative years of his life in a London Grammar school. The friends he made in those days, like Henry Woolf, Mick Goldstein and Morris Wernick remained an integral part of his emotional life.

This is not an obituary of Pinter. It is a just my personal tribute to one of the greatest literary figures of 20th century. In his acceptance speech of Nobel Prize in 2005, he said “There are no hard distinctions between what is real and what is unreal, nor between what is true and what is false. A thing is not necessarily either true or false; it can be both true and false. I believe that these assertions still make sense and do still apply to the exploration of reality through art. So as a writer I stand by them but as a citizen I cannot. As a citizen I must ask: What is true? What is false?”

That was perhaps the essence of wisdom coming from this great man. It placed him along with Kierkegaard, Sartre and other great existential thinkers.

He was as fond of Noam Chomsky as Chomsky was of him. And like Chomsky he was fearless, formidable and utterly honest. He was a leading critical voice against violation of human rights all over the world. His defense of Kurdish people against the Turkish repression will remain memorable in the contemporary history. He talked in simple language and spoke the truth with devastating effect. Nobel Prize did not add any additional glamour to his name. It only served to make his name heard repeatedly at the dinner tables of bejeweled high-society ladies.

The Grand Architecture of Nuclear Disarmament

The World War-II ended in 1945. However, there was no peace in the world. Only the actors and mode of hostilities got changed. Allied and Axis powers were replaced by the new two super powers: the USA and the USSR. The hostile interaction between them was called Cold War. The activities in the theaters of war were replaced by open political hostilities and often by proxy wars. Some people called it a war between capitalism and communism. It had all the fanaticism of medieval religious battles. Both parties were preparing for a hypothetical supreme clash on a gigantic level. Each of these two superpowers believed in the inevitability of such a conflict. They went on arming themselves with nuclear weapons of increasing firepower and deadly accurate delivery systems. With time their inventory of nuclear weapons grew to monstrous levels. At one point it was said that either of them had more than adequate number of nuclear weapons to blow off the world seven times over.

However, at some deeper level there existed feeling of unease in both the countries. The leaders of the Soviet Union and the USA also felt that it was a mad, mad race with no end in sight. Various attempts, some half-hearted, some sincere, were made by them to halt this inexorable march towards catastrophe. The leaders of these two powerful countries at some point must have realized themselves to be utterly stupid. But the situation was like riding a tiger. It was difficult to get off it.

United Nations was the only international body which could initiate talks on nuclear disarmament. The effort began in a modest way. First there came a 10-Nation Committee on Disarmament in 1959. It was followed by the 18-Nation Committee on Disarmament in 1962. It attempted to organize a dialogue between the USA and the USSR at the height of so-called Cold War. The 18-Nation outfit also failed to deliver any result, although it lasted till 1968. It was only in the year 1979 when the United Nations set up Conference on Disarmament (CD) located in Geneva. It was a unique, multinational platform for conducting negotiations on disarmament.

In the due course of time, a number of international agreements came about out with a view to realizing the dream of a nuclear-weapon-free world. First to come out was Limited Ban Treaty (LTBT), also known as Partial Test Ban Treaty (PTBT). It entered into force on October 10, 1963. It proscribed testing of nuclear weapons anywhere except underground. Subsequently, Nuclear Non-Proliferation Treaty (NPT or NNPT) came into force on March 5, 1970. It aimed at preventing development or acquiring of nuclear weapons by those states which did not have them already as on January 1, 1967. Next was Threshold Test Ban Treaty (TTBT). It entered into force on December 11, 1990. Under the treaty no signatory of the treaty was allowed to have the maximum destructive power of a nuclear weapon more than 150 kilotons of TNT. The ceiling sounds ironical in face of the fact that the atom bomb dropped on Hiroshima had the destructive power of only (!) 15 kilotons of TNT.

The most important treaty, however, is the one which has yet to enter into force in spite of it having been signed more than 12 years ago. It is the Comprehensive Test Ban treaty (CTBT).The treaty bans all the nuclear tests anywhere and for all times. It carries forward significantly the Partial/Limited Test Ban Treaty (PTBT/LTBT) which bans all such test explosions, except those conducted underground. The CTBT will come into force immediately as soon as the USA ratifies it. Hopefully, the Obama Administration will give priority to the ratification of CTBT by the Senate. Once the nuclear tests are abolished by the force of CTBT, it is very unlikely that any country, signatory or non-signatory, will have guts to violate it. CTBT, after it has entered into force, will be an iconic landmark. It will reinforce international morality. It will say “so far and no further” to the development of nuclear assets. It is a matter of great credit to Russia and the USA that they have not conducted a nuclear test since 1990 and 1992 respectively in spite the CTBT having not entered into force.

It is hoped that Pakistan and India will also sign CTBT for the simple reason that they each have adequate deterrent nuclear power. It will be stupid on their part to go for a fresh nuclear test and earn world opprobrium without any advantage. India has already voluntarily declared moratorium on fresh nuclear tests in addition to their No First Use (NFU) policy. Pakistan has neither declared moratorium on fresh tests, nor they have a NFU policy. They do not have a well-defined, transparent nuclear doctrine and they seem to suffer from a chronic inferiority complex vis-à-vis their eastern neighbor.

No First Use (NFU) is a formidable weapon in the non-proliferation campaign. So far only China and India have declared that they will not be the first to use a nuclear weapon. If all the nuclear weapon countries enter into a treaty that they will not be the first to use their nuclear weapon against anybody, the world will be a safer place. At this point of time it is only a pipe dream.

Yet another treaty of tremendous importance is Fissile Material Cutoff Treaty (FMCT). Presently, the world is awash with uranium and plutonium, the two well-known fissile materials. It is estimated there exist globally about 1600 tons of highly-enriched uranium and 500 tons of weapon-grade plutonium. If an FMCT sees the light of the day soon, all this uranium and plutonium will become legally unusable for producing nuclear warheads. The treaty is yet at the proposal stage. Underlying logic of CTBT and FMCT is straightforward. CTBT will put a halt on all test explosions of nuclear weapons, and thus will prevent development of fresh weapons, and stall attempts to upgrade the existing ones. FMCT will slash the jugular of the nuclear monster. It will prevent production of the enriched uranium and plutonium without which a nuclear device cannot be produced. It is a thousand pities that FMCT is still at the proposal stage and even the negotiations for its formulation have not begun.

In between these international treaties, which have come into force, and which have yet to come in force, and which are yet to be formulated like FMCT there have taken place bilateral agreements like SALT-I and SALT-II. The acronym SALT stands for Strategic Arms Limitation Treaty. SALT-I was signed between the USA and USSR in May 26, 1972. It significantly restricted the so-called Anti-Ballistic Missiles (ABM) systems. It froze the total number of strategic missile launchers at the existing levels pending further negotiations of a more comprehensive treaty limiting strategic missiles and bombers. It boosted the morale of all those people who were campaigning to dismantle the nuclear infrastructure. It was a landmark agreement in those days.

SALT-II was to follow in June 1979. It was signed by the USA and the Soviet Union at Vienna. It provided that each signatory party shall have the same level of strategic weapons. This included strategic bombers, strategic delivery vehicles, and strategic missiles. It was to be reviewed and negotiated for further mutual reduction of nuclear weapons. However there was no follow-up due to Soviet invasion of Afghanistan in 1979. SALT-II was also not ratified by either party. But it redounds to the credit of both the superpowers that the major constraints laid down in SALT-II were scrupulously observed by both the sides. It was, I think, because both the countries had realized that it was the stupidest thing in the world to go on wasting their precious resources on acquiring and developing nuclear arms which would never be used.

Another monumental agreement Strategic Arms Reduction Treaty-I (START-I), (called at that time SALT-III) was signed by the USA and the Soviet Union on July 31, 1991. This agreement provided that either party shall not have more than 6,000 nuclear warheads on either side. It also provided, inter alia, that each party shall not have in aggregate more than 1600 deployed Intercontinental Ballistic Missiles (ICBM), Submarine-launched Ballistic Missiles (SLBM) and heavy bombers.

START-I was followed by START-II. It was signed by President George H W Bush and Boris Yeltsin on January 3, 1993. It banned the use of Multiple Independently targetable Reentry vehicles (MIRV) on ICBMs, and is often cited as the De-MIRVing Agreement. Both the countries had MIRVs which were dangerous because they put a premium on first strike. For example, if the American President puts 10 MIRVs on one of his ICBMs and fires it towards Russia, each MIRV will carry a nuclear weapon and deliver it on a pre-specified target. Hence 10 targets might be hit in Russia in a single go. Same scenario applied to America if the Russian President became wild earlier.

START-II was ratified by the United States Senate unconditionally in January 26, 1996, and the Russian Duma ratified it on April 14, 2000 but only conditionally. Net result was that it never entered into force. On June 14, 2002, Russia announced that it would no longer consider itself bound by START-II.

The third Strategic Arms Reduction Treaty, or START-III, was negotiated between the USA and Russia. It aimed to significantly diminish their nuclear inventories. The negotiations of the treaty were kicked-off in 1997 at Helsinki between President Bill Clinton and President Boris Yeltsin. They agreed in principle that each party reduce nuclear stockpiles to 2,000 to 2,500 warheads. But there were insurmountable political problems to formalize the agreement. Russia was opposed to eastward expansion of NATO and building by Americans a missile defense system, which would need American withdrawal from the Anti-Ballistic Treaty. There was a stalemate on the issue of the proposed missile defense system. The treaty finally got killed when the USA withdrew from the Anti-Ballistic Missile Treaty on June 13, 2002.

START-II was officially replaced by Strategic Offensive Reduction Treaty (SORT), which was signed by George W.Bush and Vladimir Putin at Moscow Summit on May 24, 2002. Each of the signatories agreed to reduce their operationally deployed strategic nuclear warheads to 1,700-2,200 by the year 2012. SORT entered into force on June 1, 2003.

There were other important bilateral treaties signed between the two superpowers. The Soviet Union and the U.S. signed the Intermediate-Range Nuclear Forces Treaty (INF) on December 8, 1987. The agreement came into force in June 1, 1988. It did not specify any time frame. It is said this treaty landmarked the beginning of the end of Cold War. The treaty sought to destroy nuclear and conventional ground-launched ballistic and cruise missiles with ranges of 500 to 5,500 kilometers. The treaty specified a deadline of June 1, 1991 to do so. Adhering to the deadline, 846 and 1846 intermediate range weapon systems were eliminated by the U.S. and the Soviet Union respectively. What a hugely precious achievement for mankind! Imagine how many Hiroshimas and Nagasakis were saved!

An important element in nuclear disarmament is to put curb on delivery systems of nuclear weapons. Hiroshima and Nagasaki were ruined by atom bombs dropped on them from planes. That was way back in mid-Forties. Beginning in the Fifties the USA and the Soviet Union wasted their large technological and financial resources on the development of formidable ballistic missile systems. These systems were capable of delivering nuclear assets on the enemy territory or ships with incredible precision. As part of the Strategic Arms limitation Talks, the USA and the USSR negotiated a treaty to curb the menace of big-ticket ballistic missiles. It was signed on May 26, 1972 and entered into force on October 3 of the same year. It prohibited both the countries from deploying nationwide defenses against strategic ballistic missiles. In the treaty preamble, the two sides asserted that effective limits on anti-missile systems would be a "substantial factor in curbing the race in strategic offensive arms." It also banned the transfer or deployment of ABM systems or components outside the United States/ Soviet territory. The protocol attached to the treaty in 1974 allowed specifically one regional defense of 100 ground-based missile interceptors to protect either the national capital or an ICBM field. Soviets selected Moscow. Americans selected Grand Forks Air Force Base located in North Dakota. The treaty remained in force till June 13, 2002 when the USA unilaterally withdrew from it due to political reasons. It was the first time that USA unilaterally withdrew from a major international obligation. It was argued by the Bush administration that withdrawal was in their national interest, as without withdrawing from the treaty, it was not possible to build National Missile Defense to protect the USA from nuclear blackmail by a rogue state. However, many analysts felt that death of the treaty was a formidable blow to the campaign for nuclear non-proliferation.

This is the brief story of nuclear disarmament campaign. The story is not yet over and there have been glitches and hiccoughs enough to give impression to the cynic that the world will never be free from the scourge of nuclear weapons. For example, in the 43rd Munich Conference on Security Policy held in February, 2007 President Putin publicly suggested reconsidering the Intermediate-Range Nuclear Forces Treaty between the USA and USSR. The Russians asked as to why only the USA and the USSR should be the countries not having small and medium range of missiles, while other countries like China, India, Pakistan, and many other were freely developing them. Similarly, there was the unilateral American withdrawal from the Anti-Ballistic Missile Treaty on June 13, 2002. The very next day, the Russians declared they did not consider themselves bound by the START-II treaty. But in spite of all these negative developments, the worldwide sentiment against the nuclear weapons is prevailing and is strong. It is hoped Obama administration will advance the cause of nuclear disarmament by ratifying the CTBT, and by committing to the No First Use of the nuclear weapons.

The Intriguing Story of Intraocular Pressure (IOP)

Glaucoma is a serious eye disease, which may cause vision loss and ultimately result in blindness, if not treated in time. The common way to determine whether Glaucoma is round the corner in your case is to get your eyes tested for Intraocular Pressure (IOP).

There are many ways to determine IOP, but applanation tonometry is considered to be the gold standard. Once the IOP or tension exceeds 20 mgHg in the eyes of a patient, doctors immediately prescribe appropriate treatment to lower the tension.

The normal value of IOP is essentially based on the data collected meticulously by a large number of investigators. In most of the studies, the mean value of IOP has been found to be 15.5 mmHg with standard deviation of 2.5 mmHg. The distribution of IOP values is not normal in the statistical sense, and the eye pressure in healthy people has been found to vary between 10 and 21 mmHg. The values of IOP taken over a large number of people are skewed towards higher values. It means more people have pressures higher than 15.5 than those having lower than it. Doctors, trying to hunt for glaucoma get concerned if the IOP of a patient exceeds 21 mgHg.

From January 1985 to November 1988, an epidemiological eye study was conducted in East Baltimore, Maryland. More than 5000 persons aged 40 or more were subjected to comprehensive testing for glaucoma. They were screened by all the available diagnostic tools available at that time. The investigators found that in case of a glaucomatous eye, its IOP being more than 22 mmHg was 8.6 times higher than the likelihood of its having IOP less than 22 mg. That showed a strong positive correlation between glaucoma and the IOP being more than 22. Hence, the figure of 22 mgHg got stuck in the collective memory of the physicians as the cutoff point. To further simply, the figure of 22 was rounded off to 20. Things became simpler: if your eye shows IOP more than 20 mgHg you are having either glaucoma or at least a high risk for this disease.

That was the scenario till 2002 when a large American study called Ocular Hypertension Study (OHTS) was published. It found a statistically significant correlation between the central corneal thickness (CCT) and IOP. The study showed that CCT is a reliable predictor of development of glaucoma. If your cornea is thin, that is, less than 555 microns, you have three times greater risk of developing glaucoma than those fortunate people whose cornea is more than 588 microns. The implication was that thin corneas should be viewed with greater respect by the physician as they have a more nuisance value as far as glaucoma is concerned. Of course, it does not mean that the thin cornea is a causative factor in the development of glaucoma. The OHTS implied, inter alia, that the role of thin corneas is to blow the whistle in conjunction with high IOP.

OHTS has conclusively shown that a thicker cornea tends to inflate the value of IOP, and vice versa. For example, your IOP may be 24 mgHg and yet it may not be alarming if your CCT is 587 microns. Conversely, your IOP may be 15 mmHg but it may be alarming if your CCT is 470 microns. The practical problem in the prevention and management of glaucoma is that an ophthalmologist, who is trained in the eighties or earlier, might not be familiar with the newly found relationship between the CCT and IOP. He still goes by the rule of the thumb that more than 20 mgHg pressure consistently shown in the eye by applanation tonometry calls for preventive or curative measures for glaucoma.

Of course, it may not be always fair to blame the ophthalmologist for it. In the villages and small towns of India, there is hardly an ophthalmologist who is equipped with the instrument for measuring corneal thickness. Sometimes he does not have even a slit lamp or an applanation tonometer. In those conditions it is very difficult for him to correlate corneal thickness with IOP and reach a satisfactory value of IOP for diagnostic purpose. I have seen that even in the USA, the 20 mgHg rule of the thumb is often applied. I specifically know a dear friend of mine whose glaucoma was discovered when it was too late. During his routine eye checkups, his IOP had been consistently within the normal range for many years. However, they did not care to check his corneal thickness. Had they checked up his corneas for thickness they would have found them relatively thin.

Before 2002, ophthalmologists knew that some people do have glaucoma even when the tension in their eye is normal. They called it normotensive glaucoma. However, they did not understand the why of it. Even now, they are not sure about the whole story. But After the Ocular Hypertension Study in 2002 they now at least know about the part played by the corneal thickness in the diagnosis of glaucoma. Pachymeter, which measures corneal thickness, is a powerful weapon in the arsenal of eye-care specialists who are waging a relentless war against glaucoma.

Mumbai Carnage: A Wake-up Call for the Civilized World

Condoleezza Rice is visiting India to express solidarity with the Indian people in the wake of the terrorist attack in Mumbai. Americans are worried that any armed conflict between India and Pakistan at this point of time will be a setback to their efforts to finish off Al Qaida and Taliban.

It is a wake-up call for them. Not only to them, but to the entire civilized world. A similar thing can happen in future anywhere in the world. The terrorist training camps churning out terrorists by hundreds are not India-specific. They have visceral hatred for Americans as well as all the people who are not Muslims. It is in the long term American interests to destroy the training camps in Pakistan. India can do it also, but that may lead to war between the two nations with unpredictable consequences.

India should immediately ask for a meeting of the Security Council and demand immediate dissolution of the terrorists training camps in Pakistan. India and the USA should try that the Security Council pass a resolution authorizing a consortium of the USA, UK, France, Russia, and China to take all measures, including military if necessary, to wipe off the terrorist training camps in Pakistan. In the present political climate, none of the Security Council members are likely to oppose the resolution. China, the best friend of Pakistan, is unlikely to veto it. In fact, they may support it enthusiastically. They have been having sufficient trouble with the Uighur separatists in their Xinjiang province. Uighurs are Muslims. A Chinese foreign ministry warned sometime back of the danger of an Islamic terror network. "These people have links with the Bin Laden clique and have been infected with the jihad mentality. We should regard cracking down on these terrorists as part of the international struggle against terrorism" it said in a statement.

A strongly-worded resolution will send an appropriate message to Pakistani defense establishment, which is training terrorists with or without the support of its government. It is possible they may dismantle the entire training network. If they do not do it they stand serious risk of being bombed out by the consortium of big powers.

Pakistan has already rejected the demand of Indian government to handover to them a number of criminals who are directly or indirectly linked to the recent carnage at Mumbai. Political temperature in the subcontinent is rising. It certainly calls for a meeting of Security Council. If India does not call for it somebody else will do it. It is not in the American interests that their plan to eliminate Bin Laden and his gang gets knocked out because of a needless war in the Indian subcontinent.