“…and I will move the world”, said Archimedes in 200 BC.

 I debated the modern version of this issue, how to scale organizations, last Sunday at IIT Bombay’s Entrepreneurs Summit. This summit is organized annually to connect start-ups with VCs and mentors.

 The four big challenges that face start-ups when they try to grow are:

- the technical design may not allow scaling- for example a web directory compiled by humans is impossible to do once the web got past its early days; thus the scheme proposed by Brin and Page in their paper “The Anatomy of a Large Scale Hypertextual Search Engine” met success because it used algorithms that worked on inward links which embodied what other users knew about these sites. Business designs which don’t have scalability at their core often lose steam soon. Yet innovation of this kind is not easy to do, not for technical reasons but for organizational or social reasons. I suggested Christensen’s “The Innovators Dilemma” for those interested in studying this more

- Partners and key early employees can be another obstacle. Start-ups are usually filled with Ram Charan and Bossidy in their book “The Leadership Pipeline” call “personal contributors”. When these people insist on writing all the code and making all the sales and doing all the design personally, growth is limited to what they can personally handle. Overcoming this, the authors say, involves introspection and attention to personal growth which allows you to manage other personal contributors first, and then move to managing other managers and so on.

- reaching out to more customers is a tough challenge as well. For tech companies, strategies used by soaps and detergent companies like massive advertising and promotions don’t work, they have to follow the model that Geoffrey Moore proposed in “Crossing the Chasm”- marketing first to early adopters.

- Aligning everyone and everything: the financial goals, the product features and image, the internal processes and platforms and internal culture so that they all work together is best done through Kaplan and Norton’s “Strategy Maps”

Published this week in the Business Standard
 

Here I was in the middle of a working day lying on my back on a worn mattress in a tiny room separated from the next patient by an old sari draped over an aluminum rod, waiting for my turn with the doctor.

The path to this place in one sense was hard to find. I had to push past a shop selling ready-made dosa mix and another one piled high with stainless steel utensils in a part of Bombay that had still to outgrow its 19^th century origins as a housing tract for textile mill workers.

In another sense, my path to this tiny room could have been foretold. It was the middle of 2001 and the last few months had been tough at work. A hard won listing on the NASDAQ stock exchange was now threatened to be undone, the internet economy had plunged into a bottom less pit, and eager advertisers who had vied to be on our home page would now not return calls. I was downing whiskies indiscriminately adding many kilos to my normally athletic frame, there were dark rings under my eyes. And then I was felled by an excruciating pain in the lower back.  My usual ports of call for  health issues, Bombay�s  glitzy hi-tech five star hospitals had no answer other than dark hints about surgery  when a friend seeing my plight suggested ayurveda.

Ayurveda! I am as supportive as the next guy of traditional Indian culture and things. I faithfully wear a dhoti and  sit cross legged on the floor and eat out of plantain leaves at family weddings. When my religiously inclined mother was still alive and needed to visit a temple I�d drive her there and wait patiently in the car outside.  I dutifully sit through Bharat Natyam performances and make donations without complaints when the Ganesh pooja folks come around every year. But how could unscientific, unproven, unlabelled potions be of help when modern medicine had proposed surgical treatment?

The first day�s �treatment� did not do much to reduce my skepticism. After a massage of the back and legs I was escorted into a corner for a �steam treatment� of the affected lower back area:  a home pressure cooker outfitted with a rubber tube did the job. The doctor gave me an unlabelled bottle of multicolored pills.

�What�s in these pills�, I asked

�Don�t worry, they are safe�

�Why don�t you list the ingredients on the label?�

�If I do that, others will copy them�, he said

In the next few weeks, my skepticism slowly gave way to amazement. The combination of massage, the pressure-cooker based steaming, unlabelled secret-potion pills and yoga gradually eliminated my lower back pain. And all for a few hundred rupees a week.

Why did this system, if it so obviously �works� get so marginalized in the modern world?

When I checked  the Indian Government Health ministry�s  website, in the grand tradition of the Indian policy establishment  of blaming everyone but ourselves, it  held  �the advent of foreign invasions� and �the Britishers who did not encourage these systems� responsible.

Dr Deshpande and Dr Ranade  of the Pune Ayurveda  College  go even further in the blame game:  ï¿½The golden age [of Ayurveda] ended�, they  write   �when waves of Muslim invaders inundated northern India between the 10th and 12 centuries. The Muslims slaughtered sages and monks as infidels, destroyed the universities and burned the libraries�.the British [who arrived shortly afterward] denied state patronage to Ayurveda�closed down existing schools��

Yet, the answer may lie elsewhere.

Just as the industrial revolution undermined home �base Indian hand spinning and weaving first by centralizing manufacture in factories and then applying machinery to speed up production, healthcare too went through an �industrialization� in the late 19^th century. Instead of caring for the sick at home, hospitals sprung up in Europe. Instead of making patients cook up their own medicines from herbs, companies sprung up  who identified the active ingredient in herbs and produced these ingredients from cheaper synthetic sources. Instead of depending on undisclosed ingredients and secrecy a patent regime allowed innovators to appropriate for themselves the profits from their innovation.

The Germ Theory of Disease, that great paradigm change, dealt the next blow to Ayurveda. Louis Pasteur in France and Robert Koch in Germany demonstrated that infectious diseases are caused by germs and that specific diseases are caused by specific germs. Based on these insights, drugs were soon discovered for infectious diseases.  Epidemics that had hitherto laid waste to millions of humans were gradually eliminated.  The discovery of antibiotics in the 1940�s dealt Ayurveda its final blow.

Ayurveda�s refusal to use the tools of organic chemistry early enough to make it medicines affordable for the masses,  it s rejection of the Germ Theory of Disease, and the consequent inability to deal with the common man�s illnesses of cholera, typhoid, tuberculosis, and small pox is what marginalized it. Not foreign invasions and colonialism..

Medicine is now in the middle of another paradigm change.  The insights of organic chemistry that drove the last one are giving way to the microbiology driven biotech era.  Will Indian policymakers gracefully incorporate these new insights and allow  ayurveda  to evolve into a living science or will they continue blaming invaders and colonialism. END

Comments from Readers

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Dear. Mr. Balakrishnan,

Read your column in Business Standard today with great interest. Having been associated in past with development of modern herbal drugs and launching a couple of them, I must say that entrepreneurs today are taking some steps forward in taking the science forward.

Apart from the points that you elegantly brought forward in the article, I believe decline or stagnation of ayurveda can be looked from a larger context — decline of science and questioning. Not only ayurveda, but astronomy, mathematics, philosophy, etc., all remained stagnated after Gupta Dynasty. Eventually, our sciences became gospels, beyond questioning. And, before we recovered, the western science was light-years ahead of us.

Even today, acceptance of improved ayurvedic formulations is very limited and use of modern technology in making ayurvedic medicines is not encouraged. Yet, time was never as ripe as it is today for ayurveda. We now clearly understand that diseases happen because of internal causes or because of external agents. Ayurveda doesn’t offer potent antibiotics for acute treatment, but can do a lot in improving the immune system and offer mild chronic treatments.

In context of overall healthcare system, we need a paradigm shift wherein we would have integrated healthcare. Patients would be examined by a panel of experts and appropriate line of therapy recommended. Focus must shift to patients and their well-being, today it is on modes of therapies which don’t talk to each other.

Best Regards,

Mohan

Mohan Pandey

Director, Integrated R&D Management,

Discovery Research, Dr. Reddy’s Laboratories

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Dear Shri Balakrishnan,

I was happy, though not surprised, at your experience with the healing powers of Ayurveda in the Business Standard of date.

I have been working for a long time through various agencies to get an acceptance to use Ayurveda, both as a supplement as well as a separate department in various public hospitals for a long time but without success, if you have the time to see me in my office in Mumbai at Indian Mercantile Chambers, 3rd Floor, 14, R. Kamani Marg, Ballard Estate, Mumbai-1 (if you are a Mumbai resident), I would be happy to show you evidence of several hundred cases of cures of cancer through ancient Ayurveda.

I presume you are a Journalist and would therefore be the right source for spreading the message forcefully.

N.K. Somani, M.P.(4th Lok Sabha)

Email: vindhyapaper@yahoo.co.in

Dear Mr Balakrishnan,
I have been reading your column in BS with great interest. Perhaps  I should have  shared my thoughts with you  when you  wrote about  Hindi in  the English script. May be later on. At the moment , I was  a little surprised  to see no reference  to the novel ,Arogya Niketan, by Tarashankar Bandyopadhyay. To my mind , this novel  convincingly delineates the great battle lost by Ayurved to Allopathy, way beyond  the easy blame game that you  rightly  refer to.Yet another  book , by Claude Alvares  (Homo Faber,I  think) referred to  the invention  of Small Pox  innoculation by Indians and  its immediate  suppression, by Law!, by the Britishers.
It is of course a  mute point whether we in India could ever claim that  we had our own Technological  and scientific future apart from  borrowing the “Techne ” from the west, as describerd or analyzed by Raimundo Panikker a long time ago.
But one of the things that the socalled  PostModern theorization  seemed to offer was the demolition of the Universalistic modes of perception –scientific or otherwise. Hence  the courage in our ,some of,  professors to  reclaim   some  space in the Academia for  Indian Philosophy or political theory, which were never recognized as such until very  recently..
In particular it was only  now that  one could talk of alternative modes of  perception, investigation  and  validation. One began to  hear of  a Hundred different  Pathies,  capable of offering cure etc, with due Legitimacy.
No doubt  modern science has  so many  wonders to  offer based on  its own  analytical modes.But it may yet have to catch up with the  other modes of  therapeutic sciences in India , China and  elsewhere, which got their legitimacy as Science  in some other  ways.What were those ways!
Of course  I am all for adopting the  wonderful  analytical tools offered by  the modern science, which in fact  questioned their own ancient philosophical and scientific   theories. They, the west, in fact have updated themselves   every  now and then, including the postmodern  models  referred to above. The  irony for the rest of the world  is much too obvious to be belaboured– it is again the west   offering the  Other  an  occasion to  claim a  sense of  self confidence!
Yet . I wonder if there can be  modes of  perception  other than  the  dominant ones!
With regards, Girdhar Rathi