The Royal pilgrimage of the Goddess Nanda

Once every twelve years, when it is thought that some calamity has taken place because of the curse of the goddess Nanda Devi, a four-horned ram is born in the fields of the former king of Garhwal, an erstwhile Central Himalayan kingdom in north India (see map of Garhwal). This four-horned ram leads a procession of priests and pilgrims on the most dangerous and spectacular pilgrimage in all of India: a three-week, barefoot journey of one-hundred and sixty-four miles, during some of the worst weather of the year, at the end of the rainy season. The procession reaches Rupkund, a small pond located at an altitude of more than 5,000 metres, which is surrounded by human­ skeletons, and from there it goes yet further, to Homkund, the ‘Lake of the Fire Sacrifice’. According to the faithful, the four-horned ram leaves the procession at that point and finds its way, unaided, to the summit of Mount Trishul. As its name suggests, the Royal Procession is closely associated with the ruler of this erstwhile Himalayan kingdom: he attends its inaugural rituals, the bones that litter the shores of Rupkund are believed to be those of one of his ancestors, and the chief sponsor of the event is a local ‘Prince’ who is thought to be descended from the first kings of Garhwal. This Prince traverses the domain of his ancestors and thereby lays claim to it in the name of the goddess Nanda, who is not only his lineage goddess but was also the royal goddess of the neighbouring kingdom of Kumaon, in pre-colonial times. Although the Royal Procession ideally fosters social integration, it was disrupted in 1987 by a quarrel between two factions of priests. The goddess’s itinerary, the culminating date of the pilgrimage, the type of sacrifice to be performed, the order of procession, the participation of previously excluded persons, and the competency of certain ritual specialists—all were subjects of heated dispute between the rival groups. What was the reason for this quarrel? The whole idea of the Progress was to create unity, yet in the event they were torn apart by an acrimonious dispute. So why were they quarrelling if it was ‘only’ a ritual, a matter of mere symbols? Although we often distinguish between the realms of ‘politics’ and ‘ritual’, and although many social scientists would balk at the idea that they are one and the same, in many cases – as the author argues in this article – they pervade each other: ritual is politics and politics is ritual

Performing God′s Body

Bhairav is the central deity in a cult of ritual healing in the Central Himalayas that is closely associated with the lowest castes. This article discusses his embodied form, arguing that it is intimately related to the bodies of low-caste people, whose oppression and suffering it both reflects and ameliorates. This history of Bhairav's body is captured by in local memory and oral history; and its iconography is revealed in songs and rituals. Ultimately, Bhairav's appearance in the body of a "possessed" devotee is his most important mode of embodiment, and one that tells us a great deal about what it means to be a Harijan

Administrative data outperformed single-day chart review for comorbidity measure

AbstractObjective The purpose of this article is to compare the Charlson comorbidity index derived from a rapid single-day chart review with the same index derived from administrative data to determine how well each predicted inpatient mortality and nosocomial infection. Design Cross-sectional study. Setting The study was conducted in the context of the Swiss Nosocomial Infection Prevalence (SNIP) study in six hospitals, canton of Valais, Switzerland, in 2002 and 2003. Participants We included 890 adult patients hospitalized from acute care wards. Main outcome measures The Charlson comorbidity index was recorded during one single-day for the SNIP study, and from administrative data (International Classification of Disease, 10th revision codes). Outcomes of interest were hospital mortality and nosocomial infection. Results Out of 17 comorbidities from the Charlson index, 11 had higher prevalence in administrative data, 4 a lower and two a similar compared with the single-day chart review. Kappa values between both databases ranged from − 0.001 to 0.56. Using logistic regression to predict hospital outcomes, Charlson index derived from administrative data provided a higher C statistic compared with single-day chart review for hospital mortality (C = 0.863 and C = 0.795, respectively) and for nosocomial infection (C = 0.645 and C = 0.614, respectively). Conclusions The Charlson index derived from administrative data was superior to the index derived from rapid single-day chart review. We suggest therefore using administrative data, instead of single-day chart review, when assessing comorbidities in the context of the evaluation of nosocomial infection

Administrative data outperformed single-day chart review for comorbidity measure

OBJECTIVE: The purpose of this article is to compare the Charlson comorbidity index derived from a rapid single-day chart review with the same index derived from administrative data to determine how well each predicted inpatient mortality and nosocomial infection. DESIGN: Cross-sectional study. SETTING: The study was conducted in the context of the Swiss Nosocomial Infection Prevalence (SNIP) study in six hospitals, canton of Valais, Switzerland, in 2002 and 2003. PARTICIPANTS: We included 890 adult patients hospitalized from acute care wards. MAIN OUTCOME MEASURES: The Charlson comorbidity index was recorded during one single-day for the SNIP study, and from administrative data (International Classification of Disease, 10th revision codes). Outcomes of interest were hospital mortality and nosocomial infection. RESULTS: Out of 17 comorbidities from the Charlson index, 11 had higher prevalence in administrative data, 4 a lower and two a similar compared with the single-day chart review. Kappa values between both databases ranged from -0.001 to 0.56. Using logistic regression to predict hospital outcomes, Charlson index derived from administrative data provided a higher C statistic compared with single-day chart review for hospital mortality (C = 0.863 and C = 0.795, respectively) and for nosocomial infection (C = 0.645 and C = 0.614, respectively). CONCLUSIONS: The Charlson index derived from administrative data was superior to the index derived from rapid single-day chart review. We suggest therefore using administrative data, instead of single-day chart review, when assessing comorbidities in the context of the evaluation of nosocomial infections