From enlightenment myopia to intellectual thaw: Negotiating rationality in V.S. Naipaul

FROM ENLIGHTENMENT MYOPIA TO INTELLECTUAL THAW: Negotiating Rationality in V. S. Naipaul In this thesis I examine V.S.Naipaul’s rationality as it is reflected and foregrounded in his fiction and non-fiction. Naipaul’s texts reveal a consistent valuing of a coolly rational outlook and a fear of the irrational. I argue that before 1983 Naipaul’s attitude is governed by an instrumental rationality that serves the political interests of the empire and justifies the cultural violence that has been committed in the name of Enlightenment rationality. Enlightenment reason — read here as an instrumental application of reason —and to be distinguished from “ideal reason” was used in the imperial project as the justificatory imperative for the West’s civilising mission. This notion of rationality is in fact an instrumental rationality directly related to the dream of success and progress at the expense of the cultural traditions and historical integrity of the colonised. In the hands of nineteenth-century thinkers like John Stuart Mill, this instrumental rationality developed into the linchpin of the imperial project. What I attempt to prove in this thesis is that it is this flawed reading of Enlightenment rationality that Naipaul accepted for a large part of his literary career. During this period he becomes an apologist of instrumental rationality proper. I have probed Naipaul’s works and have identified specific ways in which an apology of instrumental rationality operates in his travel writings and fiction. In examining the material I came across two distinct phases of his episteme which I call Enlightenment myopia and intellectual thaw. I have, therefore, thematically divided his works into two distinct categories: a first group in which his apology of instrumental rationality speaks for itself (here I deploy the counter-hegemonic cultural politics of Bhakti (India), Islam (Iran), Calypso (Caribbean), Jazz (American South) to rebut his homogenizing discourse); and a second group beginning with Finding the Centre (1984) in which an intellectual thaw sets in. The second phase marks Naipaul's self-reflexivity and a broader, lateral vision that transcends the boundaries set by instrumental rationality through a greater concern with what Habermas has called “communicative rationality”. At this stage Naipaul explicitly becomes conscious of the fact that he had been party to a narrative that was not his own. He becomes cognisant of how this unconscious reliance on a flawed notion of rationality had induced him to such a massive misreading of diverse cultures, their traditions, and histories. The focus of the thesis is on demonstrating that Naipaul employs instrumental reason in his early travel and this aspect of his approach gets in the way of a more open and critical engagement with peoples and cultures he examines. Furthermore, the distinctions made in this thesis allow us to distinguish (as postcolonial theory so far has failed to do so) between “ideal” and “instrumental reason”

Treatment outcome of new smear positive pulmonary tuberculosis patients in Hamadan, Iran: A registry-based cross-sectional study

Objectives: Treatment outcome of Tuberculosis (TB), as a key determinant to evaluate the effectiveness of TB control program, remains a public health challenge in many developed and developing countries. This study aimed to assess treatment outcomes of new smear-positive pulmonary tuberculosis (PTB). Methods: This retrospective cross-sectional study was conducted on 510 registered new PTB patients in Hamadan province, Iran during 2005–13. The data were extracted from the National TB Program (NTP). The main outcome was treatment success. The results of evaluation of the associated factors with successful treatment were presented as Odds Ratios (OR), and bootstrap method was used to obtain 95% Confidence Interval (95% CI). All statistical analysis was performed at 0.05 significant levels using the Stata 12 (Stata Corp, College Station, TX, USA). Results: Overall, successful treatment outcome was 83.1%, and 9.4% of the patients died during the study period. In univariate logistic regression, only hospitalization history was associated with successful treatment (OR = 2.02, 95% CI: 1.25, 3.24). After adjustment for age, weight, and delayed diagnosis, the factors associated with successful treatment were gender and having HIV risk factors and hospitalization history. Conclusion: Treatment success rate in our study was 83.1%, which is slightly lower than the success target set by World Health Organization (WHO). Key determinants of poor treatment success rate, such as male gender, and not having hospitalization history during the treatment period, should be considered in efforts aimed to improve the treatment outcome in the management of TB

Determinants of delay in tuberculosis diagnosis in Hamadan province, 2006−2014

Introduction: Identifying factors that delay diagnosis of tuberculosis (TB) are important for the health system when timely patient treatment and reducing TB transmission are desirable goals. Aim of this study was to investigate the prognostic factors that delay TB diagnosis. Material and methods: This retrospective cohort study used National TB Program (NTP) data from 1056 TB patients during 2006–2014 in Hamadan province, western Iran. The Cox regression model was performed to determine associations between baseline explanatory variables and survival outcome with Hazard Ratio HRs (95% CIs). Results: N (%) of delay in TB diagnosis more than 90 days was significantly higher in male patients, new case patients and pulmonary positive cases. After adjustment for covariates, HR (95% CI) in relapsed TB compared to new cases was 0.67 (0.53, 0.85) and these figures for positive pulmonary cases and extra pulmonary cases in compared to negative pulmonary cases were 0.80 (0.68, 0.94) and 0.84 (0.73, 0.98) respectively. Conclusion: A high proportion of patients had delays in diagnosis exceeding three months. Our findings suggest that male gender, new cases, positive and extra pulmonary cases might increase the risk for delayeddiagnosis among TB patients