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Physical distancing, face masks, and eye protection for preventionof COVID-19
Physical distancing, face masks, and eye protection for preventionof COVID-19
The choice of various respiratory protection mechanisms, including face masks and respirators, has been a vexed issue, from the 2009 H1N1 pandemic to the west African Ebola epidemic of 2014, to the current COVID-19 pandemic. COVID-19 guidelines issued by WHO, the US Centers for Disease Control and Prevention, and other agencies have been consistent about the need for physical distancing of 1–2 m but conflicting on the issue of respiratory protection with a face mask or a respirator. This discrepancy reflects uncertain evidence and no consensus about the transmission mode of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For eye protection, data are even less certain. Therefore, the systematic review and meta-analysis by Derek Chu and colleagues in The Lancet is an important milestone in our understanding of the use of personal protective equipment (PPE) and physical distancing for COVID-19. No randomised controlled trials were available for the analysis, but Chu and colleagues systematically reviewed 172 observational studies and rigorously synthesised available evidence from 44 comparative studies on SARS, Middle East respiratory syndrome (MERS), COVID-19, and the betacoronaviruses that cause these diseases.
The findings showed a reduction in risk of 82% with a physical distance of 1 m in both health-care and community settings (adjusted odds ratio [aOR] 0·18, 95% CI 0·09–0·38). Every additional 1 m of separation more than doubled the relative protection, with data available up to 3 m (change in relative risk [RR] 2·02 per m; pinteraction=0·041). This evidence is important to support community physical distancing guidelines and shows risk reduction is feasible by physical distancing. Moreover, this finding can inform lifting of societal restrictions and safer ways of gathering in the community.
The 1–2 m distance rule in most hospital guidelines is based on out-of-date findings from the 1940s, with studies from 2020 showing that large droplets can travel as far as 8 m. To separate droplet and airborne transmission is probably somewhat artificial, with both routes most likely part of a continuum for respiratory transmissible infections. Protection against presumed droplet infections by use of respirators, but not masks, supports a continuum rather than discrete states of droplet or airborne transmission. Both experimental and hospital studies have shown evidence of aerosol transmission of SARS-CoV-2., , One study found viable virus in the air 16 h after aerosolisation and showed greater airborne propensity for SARS-CoV-2 compared with SARS-CoV and MERS-CoV.
Chu and colleagues reported that masks and respirators reduced the risk of infection by 85% (aOR 0·15, 95% CI 0·07–0·34), with greater effectiveness in health-care settings (RR 0·30, 95% CI 0·22–0·41) than in the community (0·56, 0·40–0·79; pinteraction=0·049). They attribute this difference to the predominant use of N95 respirators in health-care settings; in a sub-analysis, respirators were 96% effective (aOR 0·04, 95% CI 0·004–0·30) compared with other masks, which were 67% effective (aOR 0·33, 95% CI 0·17–0·61; pinteraction=0·090). The other important finding for health workers by Chu and colleagues was that eye protection resulted in a 78% reduction in infection (aOR 0·22, 95% CI 0·12–0·39); infection via the ocular route might occur by aerosol transmission or self-inoculation.
For health-care workers on COVID-19 wards, a respirator should be the minimum standard of care. This study by Chu and colleagues should prompt a review of all guidelines that recommend a medical mask for health workers caring for COVID-19 patients. Although medical masks do protect, the occupational health and safety of health workers should be the highest priority and the precautionary principle should be applied. Preventable infections in health workers can result not only in deaths but also in large numbers of health workers being quarantined and nosocomial outbreaks. In the National Health Service trusts in the UK, up to one in five health workers have been infected with COVID-19, which is an unacceptable risk for front-line workers. To address global shortages of PPE, countries should take responsibility for scaling up production rather than expecting health workers to work in suboptimum PPE.
Chu and colleagues also report that respirators and multilayer masks are more protective than are single layer masks. This finding is vital to inform the proliferation of home-made cloth mask designs, many of which are single-layered. A well designed cloth mask should have water-resistant fabric, multiple layers, and good facial fit. This study supports universal face mask use, because masks were equally effective in both health-care and community settings when adjusted for type of mask use. Growing evidence for presymptomatic and asymptomatic transmission of SARS-CoV-2 further supports universal face mask use and distancing. In regions with a high incidence of COVID-19, universal face mask use combined with physical distancing could reduce the rate of infection (flatten the curve), even with modestly effective masks. Universal face mask use might enable safe lifting of restrictions in communities seeking to resume normal activities and could protect people in crowded public settings and within households. Masks worn within households in Beijing, China, prevented secondary transmission of SARS-CoV-2 if worn before symptom onset of the index case. Finally, Chu and colleagues reiterate that no one intervention is completely protective and that combinations of physical distancing, face mask use, and other interventions are needed to mitigate the COVID-19 pandemic until we have an effective vaccine. Until randomised controlled trial data are available, this study provides the best specific evidence for COVID-19 prevention.
Copyright © 2020 Tim Dirven/Panos Pictures
CRM and QW declare no competing interests. CRM is supported by a National Health and Medical Research Council Principal Research Fellowship ( grant number 1137582 ).
References
- 1.
- MacIntyre CRC
- Chughtai AA
- Seale H
- Richards GA
- Davidson PM
- Respiratory protection for healthcare workers treating Ebola virus disease (EVD): are facemasks sufficient to meet occupational health and safety obligations?.
Int J Nurs Stud. 2014; 51: 1421-1426 - 2.
- Chughtai AA
- Seale H
- Islam MS
- Owais M
- Macintyre CR
- Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19).
Int J Nurs Stud. 2020; 105103567 - 3.
- Chu DK
- Akl EA
- Duda S
- et al.
- Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.
Lancet. 2020; (published online June 1.)https://doi.org/10.1016/S0140-6736(20)31142-9 - 4.
- Bahl P
- Doolan C
- de Silva C
- Chughtai AA
- Bourouiba L
- MacIntyre CR
- Airborne or droplet precautions for health workers treating COVID-19?.
J Infect Dis. 2020; (published online April 16.)DOI:10.1093/infdis/jiaa189 - 5.
- MacIntyre CR
- Chughtai AA
- Rahman B
- et al.
- The efficacy of medical masks and respirators against respiratory infection in healthcare workers.
Influenza Other Respir Viruses. 2017; 11: 511-517 - 6.
- Fears AC
- Klimstra WB
- Duprex P
- et al.
- Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions.
medRxiv. 2020; (published online April 18.) (preprint).DOI: 10.1101/2020.04.13.20063784 - 7.
- Guo Z-D
- Wang Z-Y
- Zhang S-F
- et al.
- Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020.
Emerg Infect Dis. 2020; (published online April 10.)DOI:10.3201/eid2607.200885 - 8.
- Santarpia JL
- Rivera DN
- Herrera V
- et al.
- Transmission potential of SARS-CoV-2 in viral shedding observed at the University of Nebraska Medical Center.
medRxiv. 2020; (published online March 26.) (preprint).DOI: 10.1101/2020.03.23.20039446 - 9.
- Lu CW
- Liu XF
- Jia ZF
- 2019-nCoV transmission through the ocular surface must not be ignored.
Lancet. 2020; 395: e39 - 10.
- Hunter E
- Price DA
- Murphy E
- et al.
- First experience of COVID-19 screening of health-care workers in England.
Lancet. 2020; 395: e77-e78 - 11.
- Greenhalgh T
- Schmid MB
- Czypionka T
- Bassler D
- Gruer L
- Face masks for the public during the covid-19 crisis.
BMJ. 2020; 369m1435 - 12.
- MacIntyre R
- Chughtai A
- Tham CD
- Seale H
- Covid-19: Should cloth masks be used by healthcare workers as a last resort?.
https://blogs.bmj.com/bmj/2020/04/09/covid-19-should-cloth-masks-be-used-by-healthcare-workers-as-a-last-resort/Date: April 9, 2020
Date accessed: May 14, 2020
- 13.
- He X
- Lau EHY
- Wu P
- et al.
- Temporal dynamics in viral shedding and transmissibility of COVID-19.
Nat Med. 2020; 26: 672-675 - 14.
- Ngonghala CN
- Iboi E
- Eikenberry S
- et al.
- Mathematical assessment of the impact of non-pharmaceutical interventions on curtailing the 2019 novel Coronavirus.
Math Biosci. 2020; 325108364 - 15.
- Wang Y
- Tian H
- Zhang L
- et al.
- Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China.
BMJ Glob Health. 2020; (published online May 28.)DOI:10.1136/bmjgh-2020-002794
Article Info
Copyright
© 2020 The Author(s). Published by Elsevier Ltd.
Figures
-
Copyright © 2020 Tim Dirven/Panos Pictures
Retreieved with thanks on July 4, 2020 from:
(The artile first appeared on June 1,2020)
Physical distancing, face masks, and eye protection for preventionof COVID-19
The choice of various respiratory protection mechanisms, including face masks and respirators, has been a vexed issue, from the 2009 H1N1 pandemic to the west African Ebola epidemic of 2014, to the current COVID-19 pandemic. COVID-19 guidelines issued by WHO, the US Centers for Disease Control and Prevention, and other agencies have been consistent about the need for physical distancing of 1–2 m but conflicting on the issue of respiratory protection with a face mask or a respirator. This discrepancy reflects uncertain evidence and no consensus about the transmission mode of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For eye protection, data are even less certain. Therefore, the systematic review and meta-analysis by Derek Chu and colleagues in The Lancet is an important milestone in our understanding of the use of personal protective equipment (PPE) and physical distancing for COVID-19. No randomised controlled trials were available for the analysis, but Chu and colleagues systematically reviewed 172 observational studies and rigorously synthesised available evidence from 44 comparative studies on SARS, Middle East respiratory syndrome (MERS), COVID-19, and the betacoronaviruses that cause these diseases.
The findings showed a reduction in risk of 82% with a physical distance of 1 m in both health-care and community settings (adjusted odds ratio [aOR] 0·18, 95% CI 0·09–0·38). Every additional 1 m of separation more than doubled the relative protection, with data available up to 3 m (change in relative risk [RR] 2·02 per m; pinteraction=0·041). This evidence is important to support community physical distancing guidelines and shows risk reduction is feasible by physical distancing. Moreover, this finding can inform lifting of societal restrictions and safer ways of gathering in the community.
The 1–2 m distance rule in most hospital guidelines is based on out-of-date findings from the 1940s, with studies from 2020 showing that large droplets can travel as far as 8 m. To separate droplet and airborne transmission is probably somewhat artificial, with both routes most likely part of a continuum for respiratory transmissible infections. Protection against presumed droplet infections by use of respirators, but not masks, supports a continuum rather than discrete states of droplet or airborne transmission. Both experimental and hospital studies have shown evidence of aerosol transmission of SARS-CoV-2., , One study found viable virus in the air 16 h after aerosolisation and showed greater airborne propensity for SARS-CoV-2 compared with SARS-CoV and MERS-CoV.
Chu and colleagues reported that masks and respirators reduced the risk of infection by 85% (aOR 0·15, 95% CI 0·07–0·34), with greater effectiveness in health-care settings (RR 0·30, 95% CI 0·22–0·41) than in the community (0·56, 0·40–0·79; pinteraction=0·049). They attribute this difference to the predominant use of N95 respirators in health-care settings; in a sub-analysis, respirators were 96% effective (aOR 0·04, 95% CI 0·004–0·30) compared with other masks, which were 67% effective (aOR 0·33, 95% CI 0·17–0·61; pinteraction=0·090). The other important finding for health workers by Chu and colleagues was that eye protection resulted in a 78% reduction in infection (aOR 0·22, 95% CI 0·12–0·39); infection via the ocular route might occur by aerosol transmission or self-inoculation.
For health-care workers on COVID-19 wards, a respirator should be the minimum standard of care. This study by Chu and colleagues should prompt a review of all guidelines that recommend a medical mask for health workers caring for COVID-19 patients. Although medical masks do protect, the occupational health and safety of health workers should be the highest priority and the precautionary principle should be applied. Preventable infections in health workers can result not only in deaths but also in large numbers of health workers being quarantined and nosocomial outbreaks. In the National Health Service trusts in the UK, up to one in five health workers have been infected with COVID-19, which is an unacceptable risk for front-line workers. To address global shortages of PPE, countries should take responsibility for scaling up production rather than expecting health workers to work in suboptimum PPE.
Chu and colleagues also report that respirators and multilayer masks are more protective than are single layer masks. This finding is vital to inform the proliferation of home-made cloth mask designs, many of which are single-layered. A well designed cloth mask should have water-resistant fabric, multiple layers, and good facial fit. This study supports universal face mask use, because masks were equally effective in both health-care and community settings when adjusted for type of mask use. Growing evidence for presymptomatic and asymptomatic transmission of SARS-CoV-2 further supports universal face mask use and distancing. In regions with a high incidence of COVID-19, universal face mask use combined with physical distancing could reduce the rate of infection (flatten the curve), even with modestly effective masks. Universal face mask use might enable safe lifting of restrictions in communities seeking to resume normal activities and could protect people in crowded public settings and within households. Masks worn within households in Beijing, China, prevented secondary transmission of SARS-CoV-2 if worn before symptom onset of the index case. Finally, Chu and colleagues reiterate that no one intervention is completely protective and that combinations of physical distancing, face mask use, and other interventions are needed to mitigate the COVID-19 pandemic until we have an effective vaccine. Until randomised controlled trial data are available, this study provides the best specific evidence for COVID-19 prevention.
Copyright © 2020 Tim Dirven/Panos Pictures
CRM and QW declare no competing interests. CRM is supported by a National Health and Medical Research Council Principal Research Fellowship ( grant number 1137582 ).
References
- 1.
- MacIntyre CRC
- Chughtai AA
- Seale H
- Richards GA
- Davidson PM
- Respiratory protection for healthcare workers treating Ebola virus disease (EVD): are facemasks sufficient to meet occupational health and safety obligations?.
Int J Nurs Stud. 2014; 51: 1421-1426 - 2.
- Chughtai AA
- Seale H
- Islam MS
- Owais M
- Macintyre CR
- Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19).
Int J Nurs Stud. 2020; 105103567 - 3.
- Chu DK
- Akl EA
- Duda S
- et al.
- Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.
Lancet. 2020; (published online June 1.)https://doi.org/10.1016/S0140-6736(20)31142-9 - 4.
- Bahl P
- Doolan C
- de Silva C
- Chughtai AA
- Bourouiba L
- MacIntyre CR
- Airborne or droplet precautions for health workers treating COVID-19?.
J Infect Dis. 2020; (published online April 16.)DOI:10.1093/infdis/jiaa189 - 5.
- MacIntyre CR
- Chughtai AA
- Rahman B
- et al.
- The efficacy of medical masks and respirators against respiratory infection in healthcare workers.
Influenza Other Respir Viruses. 2017; 11: 511-517 - 6.
- Fears AC
- Klimstra WB
- Duprex P
- et al.
- Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions.
medRxiv. 2020; (published online April 18.) (preprint).DOI: 10.1101/2020.04.13.20063784 - 7.
- Guo Z-D
- Wang Z-Y
- Zhang S-F
- et al.
- Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020.
Emerg Infect Dis. 2020; (published online April 10.)DOI:10.3201/eid2607.200885 - 8.
- Santarpia JL
- Rivera DN
- Herrera V
- et al.
- Transmission potential of SARS-CoV-2 in viral shedding observed at the University of Nebraska Medical Center.
medRxiv. 2020; (published online March 26.) (preprint).DOI: 10.1101/2020.03.23.20039446 - 9.
- Lu CW
- Liu XF
- Jia ZF
- 2019-nCoV transmission through the ocular surface must not be ignored.
Lancet. 2020; 395: e39 - 10.
- Hunter E
- Price DA
- Murphy E
- et al.
- First experience of COVID-19 screening of health-care workers in England.
Lancet. 2020; 395: e77-e78 - 11.
- Greenhalgh T
- Schmid MB
- Czypionka T
- Bassler D
- Gruer L
- Face masks for the public during the covid-19 crisis.
BMJ. 2020; 369m1435 - 12.
- MacIntyre R
- Chughtai A
- Tham CD
- Seale H
- Covid-19: Should cloth masks be used by healthcare workers as a last resort?.
https://blogs.bmj.com/bmj/2020/04/09/covid-19-should-cloth-masks-be-used-by-healthcare-workers-as-a-last-resort/Date: April 9, 2020
Date accessed: May 14, 2020
- 13.
- He X
- Lau EHY
- Wu P
- et al.
- Temporal dynamics in viral shedding and transmissibility of COVID-19.
Nat Med. 2020; 26: 672-675 - 14.
- Ngonghala CN
- Iboi E
- Eikenberry S
- et al.
- Mathematical assessment of the impact of non-pharmaceutical interventions on curtailing the 2019 novel Coronavirus.
Math Biosci. 2020; 325108364 - 15.
- Wang Y
- Tian H
- Zhang L
- et al.
- Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China.
BMJ Glob Health. 2020; (published online May 28.)DOI:10.1136/bmjgh-2020-002794
Article Info
Copyright
© 2020 The Author(s). Published by Elsevier Ltd.
Figures
-
Copyright © 2020 Tim Dirven/Panos Pictures
Retreieved with thanks on July 4, 2020 from:
(The artile first appeared on June 1,2020)
Monday, June 29, 2020
"You must train your intuition- you must trust the small voice inside you which tells you exactly what to day." -Ingrid Bergman
சினிமா நடிகைகளை நாம் குறைத்து மதிப்பிடக்கூடாது என்பதற்கு சிறந்த உதாரணம்: இங்கிரிட் பெர்க்மென். அவர் பல ஆண்டுகளுக்கு முன்னால் உலகெங்கும் கொடி கட்டி பறந்த சிறந்த நடிகை. விளம்பரம் நாடாதவர். தனிமையும், நடிப்புத்திறனையும் விரும்பியவர்.
அவர் கூறிய மேற்படி கருத்தை உளவியல் வல்லுனர்கள் கூட இத்தனை தெளிவாகவும், சுருக்கமாகவும் கூறவில்லை. தேர்வுகளில் பொருத்தமான இடத்தில்
இதை மேற்கோள் காட்டினால், மதிப்பீடு எண்கள் அதிகரிக்க வாய்ப்பு உண்டு.
இதை தமிழில் மொழியாக்கம்/ தெளிவுரை செய்தால்:
நீ உன்னுடைய உள்ளுணர்வை உனக்கு உகந்த வகையில் பயன்படுத்த வேண்டுமானால், அதற்குத் தக்க பயிற்சி, நீ தான் அளிக்க வேண்டும். உள்ளுணர்வுக்கு ஒரு குரல் உண்டு.அதை நீ நம்பவேண்டும். அதற்கு அசாத்திய திறமை உண்டு. நீ என்ன செய்ய வேண்டும் என்பதை, அந்த அந்த காலகட்டத்தில், அது பிசிறில்லாமல் கூறிவிடும். அதற்கு தயக்கம், சுற்றி வளைப்பது, தாமதம், ‘ஒன்று கிடக்க, மற்றொன்றை கூறுவது’ போன்றவை தெரியாது.
உள்ளுணர்வு என்றால் என்ன?
அதை பழக்கப்படுத்துவதால், என்ன ஆதாயம்?
அதை பழக்கப்படுத்துவது எப்படி?
அதை நம்பாவிட்டால், என்ன இழப்பு ஏற்படலாம்?
அதன் கூற்றை நம்பி, அதன்படி நம் வாழ்வை அமைத்துக்கொண்டால், அவரவர்க்கு என்ன நன்மைகள் விளையக்கூடும்?
உள்ளுணர்வு/உள்ளக்கிடக்கை என்பவை கட்டுக்கதையா?
இந்த வினாக்களுக்கு விடை அளிக்கவும்; ஒரு வரியும் எழுதலாம்; நான்கு பக்கங்களும் எழுதலாம். சில வினாக்களை பதிலளிக்காமல் விட உரிமை உண்டு.
Saturday, May 30, 2020
Wednesday, May 27, 2020
TODAY IS JAWAHARLAL NEHRU'S MEMORIAL DAY
TODAY IS JAWAHARLAL NEHRU'S MEMORIAL DAY
https://youtu.be/zPaPoTXN2gI
https://youtu.be/zPaPoTXN2gI
Saturday, May 23, 2020
BUDS, BLOOMS & FLOWERS
BUDS, BLOOMS & FLOWERS
INNAMBURAN
‘...Full many a flower is born to blush unseen
And waste its sweetness on the desert air...’
-Thomas Gray
‘...her mother was ordered to withdraw her from school for serfdom at her employer’s house; penniless and roofless, she is terror-stricken ...’
- An SOS in WhatsApp
The State should ensure free primary education compulsorily to all children in a robust democracy. The Constitution of India unwittingly denied it to generations of the poor, women in particular, by dumping this obligation into the backyard called the Directive Principles of State Policy instead of listing it as a fundamental right. The Constitution 86th Amendment Act, 2002 belatedly conferred that right for children in the age group of 6–14 years and a cess was levied from 2004 to meet the expenses; the outcome so far is dismal. The enormity of the cumulative loss over seven decades to the society, individuals, national integration and posterity can be gleaned from the UNESCO Report [October 2017-18]. 266 million adults, a fifth of us all, cannot read or write, says the Report. Our own Census reports show limping progress and alarming increase in absolute numbers in some decades. India is host to one-third of the world’s illiterates.
Education is a time-tested broad spectrum remedy for most social ills as it empowers the oppressed classes and enhances the quality of life for one and all. I searched in vain all along for an avenue that opened exploring pathways.
Serendipity led me to Udayan Care: www.udayancare.org that did open many doors for the vulnerable children in 26 cities across 13 states of India since 1994. On last count, 21,000 children had benefitted. A surprise visit to its orphanage near Delhi was a humbling experience - migrant labour flocking the only dispensary, free data entry classes for tense village girls and a father-figure shepherding them.
Udayan means 'Eternal Sunshine' in Sanskrit. Udayan Care gives home-life to orphans and offers fellowships, professional guidance and handholding to girl-children having the potential but trapped in vulnerable environs. It also reaches out to the villages with Information Technology. It is sunshine, for sure. There is a personal touch also. Udayan, a scion of the Padma Bhushan Gujar Mal Modi -Raizada Dr. Kedar Nath Modi Group, eked out a living in USA on a shoe-string budget as he was feeding the hungry children in Africa from his allowance. We lost him at an young age in an accident. Dr. Kiran Modi, his grief stricken mother, learnt about his noble gesture from his papers and turned his dream for a more equitable world into a modest reality by founding Udayan Care. I trace Udayan’s generosity to his forefathers, who have funded an educational empire as well. An early donation was to the Benares Hindu University.
The Chennai Chapter, whom I joined, rightly chose Chennai North, to start with. The North & South here are so polarised culturally and economically that the former was neglected for decades.
Our Core Committee conceives initiatives and executes them as planned, with monthly reviews. The work is evenly distributed, with one selecting the Shalinis (all our fellows are so named) after house-visits and a fair test, another casts the calendar for the workshop, the convener
Distribution of work and delegation of powers
initialays down and executes the plan, updating it every month. One member visits homes, interviews student and parents and selects the Shalinis (all fellows are so identified) after a test. Another schedules the calendar and the convener oversees the projects. A full time secretary ensures smooth functioning, retaining touch with parents and schools: she is also the librarian. Carefully chosen expert-mentors guide the Shalinis on various professional openings for the long term. My portfolio is mentoring those aspiring to join the Indian Administrative Service (IAS) etc., the elite governance apparatus. The unquenchable thirst for enriching one’s life by the oppressed class is matched by the diligent and empathetic devotion of the mentors to their tasks.
Endnote: Redistribution of knowledge is more urgent than that of wealth. Mentoring achieves that through caring individuals who provide young people with support, advice, friendship, reinforcement and constructive examples. Two success stories: A hawker’s daughter, Alia Tabassum, the first graduate of the family, secured a pay packet of Rs.2 lacs per annum from Cognizant Technologies Pvt. Ltd, Kolkata.
Reena Burman is the daughter of a penurious beedi-maker. She made her community proud by pursuing a Masters degree in Sanskrit tenaciously, securing a first class! She aspires to become a teacher. India needs millions of such Shalinis.
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