One in Four
We are now Zinda
There is a scene that repeats itself in clinics across the world, in SF, NYC, in Leicester, in Dubai, in Bangalore, so often that it has become almost invisible. A South Asian man, let us call him Raj, sits on an examination table. The paper beneath him crinkles. The fluorescent light hums. The doctor, who is usually kind, usually competent, usually pressed for time, glances at a chart and delivers the verdict: BMI of 24, blood pressure acceptable, cholesterol within range. “You’re healthy,” the doctor says. “Keep doing what you’re doing.”
Raj buttons his shirt. He feels relieved. He should not.
A little over a year ago, I started this blog to understand what I was seeing in my own family.
An uncle who was on top of his health, yet, had a heart attack way too young. A family history littered with cardiovascular disease, stroke, early diabetes among those athletic and active. As a physician, it made little sense to me, until I started reading…and then it made even less sense. The literature rarely covered us. The studies weren’t designed for us. The answers I was looking for didn’t exist.
So I went looking myself. And what I found was an area somewhat undiscovered, but rarely addressed, especially for those of us in the diaspora, where the compounding effects of ancestry and environment collide in ways no one is tracking.
One in four.
That is how many of us there are. South Asians constitute roughly a quarter of the world’s population. We are not a minority in any meaningful sense. We are, by sheer arithmetic, one of the largest coherent biological populations on Earth.
And yet the medicine we receive was not built for us.
The reference ranges on our lab work, the BMI charts on clinic walls, the dosing guidelines in pharmaceutical inserts, all calibrated on bodies in Western nations.
When these protocols are applied to us, they do not merely underperform. They mislead. They harm. They kill, sometimes, while telling us we are fine.
You know this already. You have watched it happen. There is a particular grief in seeing your family members fall, one by one, to diseases that were “managed” but never prevented. In hearing “your numbers look good” while sensing that something is wrong. In knowing that the medical system sees you but does not see the specific body you inhabit.
We are entering an extraordinary moment in medicine. The age of precision is arriving. n=1 care, gene therapies, treatments targeted not to populations but to individuals. Continuous monitoring, computational biology, interventions calibrated to your specific genome and metabolism. For the first time in history, we can move beyond the average.
But here is the cruelest irony: even this revolution threatens to leave us behind. The new tools, the wearables, the biomarker panels, the advanced diagnostics, still interpret your data against thresholds derived from bodies that do not share your biology. You can wear the devices, run the panels, book the scans, and still be told a story about yourself that is not true. A more expensive lie. A more granular lie. But a lie nonetheless.
The technology exists to see you clearly. What has been missing is the will to recalibrate.
We are not waiting for the system to notice us.
The traditional path runs through decades of trials that excluded us, guidelines that will arrive too late for our parents, acknowledgment that may never come. We are building something else.
As a physician and technologist at heart, I truly believe we can build a framework from the ground up optimized for the South Asian diaspora.
Interpretation that begins with South Asian biology as the baseline, not the exception.
Synthesis that connects your data streams through a lens that actually applies.
Medicine that at default, assumes you are unique, and that your uniqueness has a context shaped by ancestry, by evolution, by the specific body you inherited.
This is what precision medicine was always supposed to be. We are building it for us, because no one else will.
Here is what we are working toward:
A new framework for South Asian health. Research that should have existed decades ago. Tools that give you the perspective on your own biology that you deserve, not as an afterthought, not as a subgroup analysis buried in an appendix, but as the foundation.
We are working with some of the best physicians in this space to make it happen. More on this very soon.
What started as a problem I was solving for my own genetics, is a problem one in four face around the world.
This is bigger than a blog. This is the beginning of something we should have had all along.
At zinda.health you will find tools and calculators that give a true picture of South asian health, with targets that actually are normal for our bodies. Our hope is to provide more tools and research which will always be available and published on this Substack.
This is Zinda. The word means “alive.”
It is what we intend for you to be.
One in four human beings will not wait quietly to be noticed.
One in four. Irreducible. Finally, fully seen.
Welcome.
-Omar