Dr Gulshan K. Sethi who has been in the University of Arizona Heart Centre for the past 13 years says there are so many patients in India with `end stage cardiac disease' that more is expected than ordinary bypass surgery here. But transplants are rare here for want of hearts. Sethi who is advisor to the Food and Drug Administration in the US was in Delhi to attend the ongoing conference of former alumni of the All India Institute of Medical Sciences.

Talking of health care facilities in India he told Express Newsline on Saturday that the basic problem was population. And there is garbage everywhere one looks. The minimum that can be done to improve the health of citizens is to clean the streets, for illness here is preventible to a great extent, he says and recalls what Dr A.P.J. Abdul Kalaam said at the opening of the AIIMS meet about thousands of patients contracting tuberculosis every year in India. ``When I retire I will come back and clean the streets of Delhi travelling on a truck,'' he says, quite carried away.

``All I have to say is that I am available for Indians to make use of. I have been including one Indian surgeon among the seven fellows in our department,'' he says. The fellows are paid a salary of $ 40,000 per year. As for jobs for doctors in the US, he says he cannot help. ``US is not taking in any more foreigners because they have too many doctors already,'' he says.

Speaking on heart transplants earlier at the AIIMS conference, he said the basic criteria for the patient are a good body and a bad heart and the patient should have insurance so that the doctors bills are taken care of.

And after transplants 33 per cent of patients in the US go back to their former occupations, another 33 per cent take money under the table, that is work without the knowledge of the insurance company; and another 33 per cent do not work and just play golf, he said. As for sex after transplants, he said patients got were more sexually active after transplants as they were less sick. Besides a certain drug they took made them high.

Later sitting in his car he muses that he did not see a single cardiologist from AIIMS. ``Maybe it is their egos that make them act so. But I don't care. I would traverse the world if only I can spread awareness in even six people,'' he says.

As the car moves on he sees a board that indicates the number of deaths in city road accidents. ``Those could have been heart donors,'' he says, going back to his major concern.