Tuesday, May 14, 2013




Prime Minister Li Kequiang of China, who took over  in March last, is to visit India, Pakistan, Switzerland and Germany during his first round of overseas visits after taking over as the Prime Minister.

2. His clubbing together his visits to India and Pakistan on his way to Europe indicates the equal importance which the newly-elected Chinese leadership attaches to China’s relations with India and Pakistan.

3. The visit to India from May 19 to 21 threatened to come under a cloud following the intrusion by a platoon of PLA troops into Indian  territory in the Daulat Beg Oldie area of Eastern Ladakh on April 15 and their camping in tents there for nearly three weeks.

4.The resulting stand-off between Chinese and Indian troops of the Indo-Tibetan Border Police (ITBP) created trans-Line of Actual Control tensions and led to demands in India for the postponement of the visit of our Foreign Minister Salman Khurshid to Beijing to make preparations for Li’s visit. The stand-off also revived the distrust of China in Indian strategic circles.

5. The two countries managed to avert an embarrassing postponement of the visits by agreeing on the restoration of the status quo ante. The Chinese troops then vacated the Indian territory into which they had intruded.

6. Two questions remain unclear. Firstly, why did the Chinese troops intrude into this area even at the risk of their intrusion casting a shadow on the first visit of their new Prime Minister to India? Secondly, was there an Indian quid pro quo for the Chinese withdrawal? Sections of the Indian media had reported that India had  agreed to remove some temporary infrastructure like bunkers for sheltering patrolling Indian troops from its territory. If media accounts of the quid pro quo are correct, it could ultimately turn out to be to the detriment of our sovereignty claims in that area.

7.While the Ministry of Defence of the Government of India has been a little more forthcoming on the Indian right to build defensive and logistics infrastructure in our territory, the Ministry of External Affairs has been evasive.

8.Ever since Xi Jinping took over as the General Secretary of the Communist Party of China (CPC) in November last year, he has been talking of the need for a border settlement “ as early as possible.” The previous leaderships used to talk of the need for time and patience in reaching a border accord and for not allowing this to come in the way of the development of the bilateral relations in the economic and other fields. India had been going along with this formulation of the past leaderships.

9. From the various remarks of Xi  on Sino-Indian relations since he took over, it would seem that he wants a time-frame for finding a border accord without allowing the pressure for a time-frame coming in the way of strengthening relations in other fields. The recent intrusion, in this regard, could be interpreted as an attempt by the new leadership to press the need for a solution “ as early as possible” without letting the negotiations drag on endlessly.

10. It would be in India’s interest too to work for a border accord “as early as possible.” At the same time, India should not accept the Chinese formulation that the absence of a border accord should not come in the way of the economic and other relations. This formulation has immensely benefitted China.

11.Much of the delay till now has been due to Beijing dragging its feet on exchanging maps of  the line of actual control, which has to be the first step. During the forthcoming visit of the Chinese Prime Minister, we should make it clear that we too want a border accord “ as early as possible”, but this would depend upon the Chinese taking the first step of exchanging maps of the LAC which have to be the basis of further negotiations.

12. We should also make it clear that relations in the economic and other fields cannot improve without satisfactory progress in the border talks.  (15-5-13)

( The writer is Additional Secretary (retd), Cabinet Secretariat, Govt of India, New Delhi, and, presently, Director, Institute For Topical Studies, Chennai, and Associate of the Chennai Centre for China Studies. Twitter: @SORBONNE75  )




(Medical history. Will be 77 in August next )


27-9-2009—Heavy blood in urine after I returned from evening walk. Only one episode.Underwent cystoscopy in Apollo Main, Chennai. Urologist—Dr. Murali Venkataraman.Biopsy result: “ Bladder biopsies superficial and deep and prostatic chips showing features of a high grade carcinoma. The morphology is suggestive of a prostatic adenocarcinoma. Immunobiochemistry is advised for confirmation.”

Gleeson score test was not done. At the time of bleeding my PSA was around 4 only.

Full body PET CT scan was done on 3-11-09. Its conclusion:

“ Known case of high-grade carcinoma of the prostate.

“ Enlarged prostate with hetrogenous increased metabolic activity predominantly in the left half of the gland and in the intravesical component involving the bladder base. No obvious involvement of seminal vesicles. Metabolically active left obturator and internal illac lymadenopathy--- metastasis.

“Hypermetabolic skeletal metastasis involving the right aia of sacrum and left inferior public ramus.”

Severe urinal bleeding on the night of November 1,2009. Stopped on its own

Dr. Murali Venkataraman and Dr. I Raja, Oncologist of Apollo, Chennai, advised me to undergo total androgen blocade. Was given one Lucrin  depot injection once a quarter from November 18,2009. Took one tablet of Calutide 50 daily.

My PSA level, which was already normal, came down below one.Dr. Venkataraman stopped the Lucrin depot injection from November 18,2011. Felt  after two years of injection, it could make my bones fragile. Continued taking Calutide 50.

My PSA level started going up from Feb 11,2012, ( 1.67) and reached 14.28 on November 27,2012

In November,2012, started feeling weak, legs swollen, pain while walking, gasping.

My haemoglobin level was taken in Apollo Main 5.9.

Ultrasound scan in Bharath Scan showed:

“Bladder diffusely thickened measuring 4.8 mm.

“Presence of multiple polypoidal growths noted within the urinary bladder, largest measuring 78 + 50 mm.

“ Significant postvoid residual urine in the bladder vol 205 ml”

“ Volume of prostate is 17 ml.

“It shows altered echo pattern.

“ Evidence of calcification. “

Admitted in Fortis Malar, Chennai, hospital under care of Dr. Pari, Urologist on Dec 3,2012. Cystoscopy , CT scan and biopsy were done. Cystoscopy  conclusion :

 Bladder tumour.

“Prostate fossa—Normal

“Large tumour from anterior wall of bladder 7 cm extending from bladder neck.”

Biopsy conclusion:

“Papillary urothelial neoplasm---high grade.

“Extent of invasion – Lamina propria

“Lymphatic/vascular invasion---Not detected.

“Histological type---Usual.

“Pattern of growth---Nodular.”

The CT scan in Malar Fortis did not indicate any abnormality in liver.

Overall diagnosis of Dr. Pari:

“ CT whole abdomen showed enhancing bladder growth with dilated and thickened perivesial lymphatic.Large hiatus hernia”

On his recommendation underwent 36 doses of radiation in Apollo Cancer Hospital under care of Dr. Ratna Devi, Radiologist, from January 2,2013 to Feb 23,2013.

On her advice, a PET CT scan of the  abdomen was taken in the Apollo Cancer hospital, Chennai, on April 29,2013. Observations:

“Multiple hypodense lesions are seen in both lobes of liver, largest in segment V measures 3.5 + 4.7 cms. No focal lesion seen. Portal vein is normal. Intra hepatic biliary radicals are not dilated.

“Enlarged retroperitoneal, retro crural and bilateral common iliac nodes noted, largest paraaortic node measures 1.9 + 1.4 cms.Ne mesenteric or peritoneal deposits. No ascites.

“Hypodense lesion noted in right adrenal gland measures 2.0 + 0.8 cms.

“ Prostate measures 3.8 + 2.6 + 4.2 cms.No focal lesions.

“ Bladder wall irregularly thickened. The seminal vesicles are normal. No significant pelvic adenopathy.

“Paraoesophageal hiatus hernia noted.

“Multiple subpleural and parenchymal nodules are seen in visualised lung bases.

“Hypermetabolic hepatic, right adrenal, retroperitoneal and bilateral common iliac nodal and marrow metastases.

“ No other demonstrable, significant metabolically active disease in rest of the abdominal and pelvic regions.’

Side-effects of radiation that still continue 10 weeks after radiation was completed:

(a)      Burning sensation while passing urine. Urispass of no benefit,

(b)      Periodic constipation aggravating a long-standing piles complaint.

(c)      Severe flatulence causing discomfort in lower part of abdomen all the time.

(d). Severe & frequent belching. Sucrafil and Domstahl of no benefit

Dr. Sankar Srinivasan, Oncologist, Apollo Cancer Hospital, has been my consultant since May 9,2013.


B.Raman, 11-5-2013. Will be 77 in August.