India is the latest toast of the world's cyber circuit. Her whizkids right from virtual `hot-male' Sabeer Bhatia to Infosys czar Narayan Murthy are at IT, mixing the right spirits and blending the perfect infotech brew. The late NASSCOM chief Dewang Mehta had even envisaged the new mantra for governments: Roti, kapda, makaan aur computer. In other words, the issue is really BASIC (why even JAVA, Linux and what have you!)

However, on the flip side, the issue has `computed' more complex issues, medical, physiological, even social. Indians in general, Cyberians in particular, are now waking up to CRI, Computer-Related Injuries rather than computer-related incentives.

Did you know that:

• A ten-year old boy in Bangalore recently lost the use of both his hands. Reason: Extensive overuse of computer since the age of five. More cases in different age groups, especially among software professionals, are cropping up with alarming frequency.
• CRI often lead to gradual difficulty in mundane things such as opening the door, holding a newspaper, using a comb or even holding a teacup.
• Computer-related injuries, commonly known as CRI, were declared in the West as the epidemic of the nineties, constituting 70 per cent of all work-related disorders.
• A recent survey in Hyderabad conducted on 500 software professionals showed that almost 50 per cent of them already suffer from symptoms of established CRI.
• Another survey in Bangalore, in its preliminary stages, shows that 75 per cent of the software professionals under study have at least one symptom of established CRI.

CRI are now on their way to attain the same dubious distinction in India as in the West during the nineties.  Wait, there is some more bad news. It is now estimated that a large chunk of India's software professionals, students and other computer users, which includes bank staff and government personnel, clerks, cashiers etc, will soon develop CRI in the near future, if things stand as they are. If this is not grim, there is more. Many people have had to leave their bright careers only because they were computer-dependent.

Now, the good news. A Bangalore-based group has taken the initiative to adopt a "holistic, multi-disciplinary approach" to combat the travails that CRI unleashes: Painful, debilitating, sometimes even  disabling body conditions. Meet Dr Deepak Sharan, Consultant Orthopaedic Surgeon, who heads and manages the CRI Prevention and Treatment Programme here.

Having undergone specialised training in the UK and USA for over four years in Hand/Upper Limb Surgery, Biomechanics, Medical Ergonomics, Orthopaedic Engineering and Rehabilitation Technology, Dr Sharan has with him the added strength of trained and committed medical professionals at the premises of Bangalore Children's Hospital in Rajeshwarinagar on the outskirts of the city.

indiamarkets: Why do CRI happen? Who are the potential risk groups?
Dr Sharan: There are many factors which trigger computer-related injuries: Poor posture, prolonged repetitive or awkward hand movements, poorly fitting furniture, cold work environment, poor keyboard monitor and workstation design.
As for the risk group, any computer keyboard user, and that includes even preschool kids, who uses the computer for two or more hours a day, is at risk for CRI. In fact, it is the drastic case of the now-disabled 10-year-old child (mentioned above) that made us sit up and think about CRI in serious terms.

indiamarkets: What are the symptoms that indicate that CRI have set in?
Dr Sharan: CRI can manifest initially as a tingling sensation in the fingers, arms, shoulder, neck or back, and then as a feeling of heaviness and weakness in the arms. The person experiences a constant need to stretch or massage one's arms, but by and by, if neglected, can gradually work up to such a stage that even opening a door or holding a newspaper becomes painful. As a result, we have had quite a few cases when people have had to give up their jobs, even their career just because they had to do with the computer.

indiamarkets: How do you go about the CRI prevention program?
Dr Sharan: Under the prevention program, our main focus is on dealing with the symptoms as early as possible so that the minor problems do not develop into serious ones. Besides, we have also found that in these cases, prevention is much better than cure. It becomes very difficult to treat CRI once they set in.
For this, we have taken up a holistic, multi-disciplinary approach, a program which takes into account visual ergonomics, stress management, ergonomic equipment, acupressure, Yoga, myofascial release etc and forms of alternative medicine practices. We have often found that companies call in, say a Yoga expert, for a month, during which time employees are taught exercises and told to do them every day for an hour. Now this is not feasible and nobody has that kind of time, so the initial tempo tapers off. Besides, there are some exercises in Yoga that are excellent, but may actually do more damage to your back. So there ought to be a trained practitioner who can sort out these exercises and then prescribe them.
We believe that CRI treatment is very specialised and depends on specific symptoms and the extent of damage to the individual. So instead of merely addressing the symptoms like in traditional solutions, we get to the root cause of pain and recondition the entire upper extremity and back. We also look at the way people work, including their posture, stamina, workload and overall health.

indiamarkets: Do you face problems mobilising people to take up the program? What are the usual responses?
Dr Sharan: That is the biggest problem. Most of the people affected by CRI are teenagers or people in their twenties, thanks to the kind of work or the amount of driving vehicles that they do in a day. Even children these days start off with a bad back by carrying heavy backpacks or overuse of videogames, CDROMs etc. Yet, try speaking about CRI to an asymptomatic 25-year-old guy at the peak of his career that he is predisposed to CRI! Or get a collegian to attend a CRI program.  The issue is that no one takes it up seriously unless he/she is hit by it. And then, most often, it is too late. We have youngsters who have now lost use of their hands or jobs, lamenting that "if only we knew that such a thing exists, we would have done anything to stop the damage". The issue therefore is awareness, rather the lack of it. That's why we are planning to get those already hit by CRI to campaign for our programmes.
Most of our 2-3-day seminars/programs are very reasonably priced because we are not out to make profits on it. We just want to make people aware that the problem exists. For instance, a whole lot of bank staffers and government personnel don't even have well-designed ergonomic furniture, but they don't even know the damage they can suffer.
And then, even in corporate offices which care to give good chairs to its people, bad posture may be the culprit. People do not know how to sit on or adjust those chairs; so lets not blame the poor computer every time for all hassles!

indiamarkets: Your brochure points out to workshops at the office/corporate level. How has the going been in these areas?
Dr Sharan: Yes, we do have such special programs where we even visit the facility once a month and train the employee onsite. During the course, we even inspect the workplace to identify hazards from a medical ergonomic perspective and assess change periodically. We even work towards improving work habits and company culture that promotes health and fitness, besides providing individual medical consultation.
But unfortunately, not all companies take to the idea soon. Moreover in these days of recession, IT slowdown etc, HR managers are sceptical about CRI as they have to abide by the company cost-cutting measures and are reluctant to spend that extra rupee. Unlike the West, where it is mandatory for every company to be obliged to pay for the employees' work-related disorders, there is no such legal binding here. Unless it is made obligatory for every company to do so, or the affected employees get together and sue the company, it would be difficult to make inroads. Firms ought to realise that a healthier, fit employee means a more productive company. Ultimately, it is a question of morale, staff retention and productivity levels. Economic progress will automatically follow.

indiamarkets: What is your message then to computer users? What should they guard against?
Dr Sharan: The general rule while using a computer is that your shoulders should be absolutely relaxed; do not have them shrugged up. Have your elbows bent at 90-120 degrees to your forearm. The mouse (hold it lightly and not in a tight grip) ought to be at the same level as the keyboard. Arrange your workstation so that you do not have to adopt any unnatural/uncomfortable posture for your hands/fingers for long.
Another important point. We recommend that a user takes at least a 5-minute break after every 20 minutes of computer use. Get up, stretch out, drink a glass of water and even take a walk if possible. Our bodies were never designed to sit and that too for so long. So sit up and take notice before it is too late!