Wednesday, April 14, 2010

Episode 25

The rest of our week in Rishikesh was quite a treat, and a nice change from working in hospitals and clinics. We stayed at Parmath Nature Cure, a naturopathic health center designed to provide alternative healing for common disorders such as diabetes, hypertension, arthritis, heart disease, and asthma. We started our day with an hour of yoga and a morning naturopathy class where we learned all about massage techniques, dietary therapy, hydrotherapy, and various other naturopathic techniques. We had most of the afternoon to play tourist, which we did happily. Then in the afternoon, we had half an hour of meditation followed by another two-hour yoga class. Needless to say, I couldn’t walk after about day 2 and was quickly reminded of how tight and inflexible traveling can make you… I loved our week in Rishikesh and relished in learning as much as I could about yoga, meditation, breathing techniques, and even took part in a “cleansing” day. Although I passed on the enema, I did try the “chug warm salt water like a beer bong and then promptly make yourself throw up” technique, as well as the “pour salt water in one nostril and make it come out the other” nasal cleanser. It was well, interesting….

Rishikesh is also a huge hippie-tourist destination and seems to collect more dreadlocks and patchouli oil than Berkeley. It was fun meeting other travelers as we engaged in a few of the touristy activities. Touristy activity #1- Visiting the Maharishi’s Ashram where the Beatles wrote the White Album. (This ones for you Clive!) The Ashram has been long since abandoned and is currently taken over by the landscape. However, it still resonates as quite the place for musical inspiration, as the essence of the Ganga seeps into the old stone structure and feeds the soul with its spiritual incantations. Touristy activity #2- White water rafting down the Ganga into Rishikesh. At first, I thought to myself “no way in hell am I stepping foot near that water” after spending 2 months dealing with water-borne diseases. However after a few days of watching thousands of people bathe by its banks, I decided what the hell, when in Rome!?! It turned out to be one of the most memorable and fun experiences of my trip. Of course, we were put in a boat with 5 of the goofiest Indian guys that they could find. They paddled maybe 50 times total, and spent most of the journey singing, carrying on, and trying to push each other off the raft. Although not much a crew, they were highly entertaining and I don’t think I stopped laughing once the entire 4-hour trip.

Episode 24

After a long week in Dehradun and an interesting weekend adventure, we all bundled into a jeep and headed for Rishikesh, the yoga capitol of the world. Rishikesh is a few hours from Dehradun, and serves as a spiritual hub for many Hindus as well as a tourist attraction for westerners in search of a yogic retreat. Rishikesh is truly breathtaking. Set beside a beautiful stretch of the Ganges River, this little town is filled with an unavoidable sense of spirituality. Its spectacular temples, meditation trails through the Himalayas, and car-less (honk-free) streets made for a spectacular week.

We arrived on a Sunday, and within 20 minuets of getting situated into our Ashram, we saw a large crowd of Tibetans next to one of the religious buildings by the Ganga waterfront. True to the nature of India, we decided to stand around with the crowd to poke our noses into what was going on. We soon found out that the Dalai Lama was about to make his last appearance before leaving Rishikesh. The travel gods were truly on our side that day, and sure enough within 10 minutes of arriving on the scene, the Dalai Lama came out of the building and greeted the adoring crowd. I couldn’t believe it, how on earth did we just stumble into such an auspicious occasion!

We then continued to explore the rest of Rishikesh, and in the evening decided to check out the prayer ceremony at the Shiva temple by the Ganga. As you step foot into the white marble structure, incense fills your nostrils and you are greeted by an enormous Shiva statue. The statue sits with the Ganga at his feet and the vast expanse of mountains and cliffs at his back, another image that I will forever have ingrained in my mind. We came to the temple right before the sun was about to set, and the ceremony had just begun. Hindu prayer ceremonies are extremely musical with Gurus chanting their prayers and thousands of Hindus singing and swaying to the hum of the sitar. The sights, sounds, and smells of this evening were enough to make even the most secular newcomer drift into a mystical state of meditation. Once the ceremony finished, we said goodbye to a flaming pink and orange sun, and spent the rest of the evening listening to Sufi tunes and watching a beautiful Indian dancer enact tales from the Ramayana. I couldn’t have asked for a better start to our Rishikesh adventure….

Episode 23

Although this trip has given me many eye-opening experiences, there is one that seems to deserve its own entry. After a week at City Heart Center, we saw numerous very sick people. The miserable, frail, and dieing congregated to its beds, and although we had witnessed many deaths, I had yet to see someone make that melancholic transition from the living to the deceased.

She was fairly old and suffering from heart failure. The first day we saw her in rounds, they were attempting to put her on a ventilator, as she could no longer breathe on her own. The very next morning we came into the ward to find out her heart rate had plummeted and the only thing keeping her alive were the chemicals maintaining what was left of her heart rate. Suddenly the line that was sporadically dashing up and down the monitor went flat. The attending spent the next 20 minutes trying to resuscitate the elderly woman, and although a few heartbeats would occasionally appear, all in all it was to no avail. The motions were violent and unnerving, and I couldn’t really fathom what was going on in front of me. The difference between life and death appeared to be this arbitrary declaration, as there was no telling from her limp and pale body what was alive and what was not. I guess death isn’t always a definite moment, there is no red flag telling you that the soul has left its fleeting abode, there isn’t always some dramatic production signifying it’s the end. As I watched, terrified behind my clipboard I saw that life can sometimes just slip through the cracks, quietly and unnoticed, and although I knew very little about this woman, her life and subsequent end seemed to shake me to the core. I stepped back into the corner as the family came to say goodbye to a loved one who had already gone. “Mamaji!” the daughter cried as she opened her mother’s eyelids to inspect the hollow body for any signs of inhabitance. The look on the daughter’s face signified that she found nothing, that in those 20 or so minutes the immeasurable breath of life had sighed, and left in its place a stiff and empty shell. I wanted to weep with them, not only for the family and their loss, and for the woman whose life had just ended, but also for the precarious line that we tread between the animate spirit of being and the lifelessness of the remains before me. Although I know there will probably be many more days and stories like this one if I am to have a future in the medical profession, hers will resonate with me for a lifetime.

Monday, April 12, 2010

Episode 22

The past month, I have gotten terrible about writing… It’s not because there is no longer anything to write about, it’s just that after over 2 months of being here (yes I cant believe its already been 2 months!), I have become so accustomed to my routine that I sometimes forget the immensity of some of my experiences. The honeymoon phase drifts into normality, and the once blog-worthy adventures become daily activities. But I will try and recount what I have done for the past few weeks.

After leaving Mussoorie, I spent the weekend recovering from my unfortunate bout of stomach problems and returned to my rotations in Dehradun the following week. In the mornings I shadowed another cardiologist, but decided to do something a bit different for my evening rotation. Before I came to India, I had always respected alternative medicine as a great field, but never really had a profound interest in it. Yet after being here, I have sparked a new curiosity in traditional medicine and decided to spend more time engaging with Homeopathy, Ayurveda, and Naturopathy. Something has to be said for these forms of medicine that have outlived Allopathy by thousands of years and as someone who wants to go into medicine, I think it’s important that I study the field in all its forms. Allopathy and traditional medicine could really learn a lot from each other, and I hope that someday I can integrate their philosophies and methods.

During my week with the homeopath, we talked a lot about the theory behind homeopathy, such as treating both the body and the person, the issues with poly-pharmacy, and how psychological problems manifest as physical symptoms. Not only did I learn a lot about homeopathy, but also I feel the week really challenged my understanding of who the doctor is and what medicine does.

Two friends from home, Kenny and Emilee, also arrived during this week and graced me with their familiar smiles. Over the weekend, we decided to do some wildlife spotting at Rajaji National Park, just an hour outside of Dehradun. We spent four hours in the jeep safari scouring the park for leopards and elephants. We saw numerous animals but didn’t see as many as we hoped. At the end of the safari, we sat joking about how the park should have one of the tame elephants tethered at the end in order to appease disappointed tourists. We eventually gave up on our hopes of seeing an elephant and just as we arrived at the gate, nestled in the thick jungle was a large male with enormous tusks. We all jumped around a bit, rushed for our cameras, and then realized the poor thing was chained to a tree. Ah yes, of course there would be an elephant chained at the end to appease the disappointed tourists….

Episode 21

After a week in Dehradun, I was quite ready to move on to a new site. Our week’s rotations took place back in Mussoorie, and as I had only spent a few hours there the first time, I was quite excited to do some more exploring. We lived and worked in Landour Community Hospital, a beautiful charity hospital set just out side of the bustling Mussoorie area. Landour was by far the nicest hospital I have seen while in India, and it truly provides excellent care at an affordable cost. The hospital serves many of the rural villages and receives a variety of patients, and again was a fantastic learning experience.

This week I was also with a new set of students, both well into their medical training and hence I spent the week badgering them with my questions and interests. Both of the students were excellent friends and teachers, and I felt I learned more about medicine that week than I have in any of my other experiences. In our week in Mussoorie I shadowed a Sonographer, general surgeon, and an Ob/Gyn. I got to learn all about ultrasounds, see numerous surgeries, and experience the inner workings of an Indian charity hospital. It was great to see the differences and similarities between the different categories of medical delivery systems- charity, government, and private.

Yet after three days of being on the doctoring side of the hospital bed, I can now say I have both worked and been admitted to Landour Community Hospital. On Wednesday afternoon, the fates decided it was my turn to experience the gastritis that we had treated so many times before. For twelve hours my digestive tract ejected EVERY last thing in it, and I was left extremely dehydrated and exhausted. I was so impressed with the hospital and their staff, and they managed to revive my withering body and disheartened soul with haste. India- 2/2, Gwen-0/2…

Episode 20

After our long hike to Mussoorie, we went back to Dehradun to spend another week. My rotations in Dehradun have been quite different from my first month, as the Delhi program focused more on public health and broader medical issues. I thoroughly enjoyed the Delhi program and learned some invaluable things, however, I have also enjoyed the more clinical approach in Dehradun. The program is much more hands-on, and although we will re-learn these skills in medical school, the rotations have been an intense and interactive introduction to the medical field in the setting of a developing country. In my week in Dehradun, I interned with an Ob/Gyn, Cardiologist, Family Practitioner, and an Internal Medicine specialist. All the doctors we worked with were patient and insightful, and did wonderful job hosting me for the week.

The pace in Dehradun is much more relaxed, with a bit of a homier feel than Delhi. You begin to feel the tug of a daily routine as certain vikram routes, shops, and restaurants become familiar comforts in what was once a foreign land. Dehradun is rather small, but definitely has its own unique charm and array of quirks and funky smells. This little Himalayan town in Uttarakhand has provided a great home base for the rest of my adventures in the north.

Thursday, March 18, 2010

Episode 19

After a long weekend of traveling and wild-life spotting, we headed to a rural village called Patti. We spent the week in this beautiful little agrarian community, nestled in the foothills of the Himalayas and surrounded by breathtaking views of the mountains. We spent 3 days in the CFHI clinic, helping the doctor in OPD. The clinic serves about 5 different villages, and so we got to see a wide variety of cases and patients. On the other two days, we packed up our supplies and hiked to some of the surrounding villages to set up health camps. These days were probably my favorite, as all the school children would come to the health camp for their check-ups. It was really nice to interact with all the village kids and we helped the doctor check lungs, take temperatures, and tend to those who were ill. Time seemed to slow to a casual crawl while we were in the village, a pace that at first was difficult to get use to. However by the end of our stay, we grew to appreciate the simplistic, uncomplicated nature of village life. The words stress, greed, and gluttony don’t seem to exist in this space between the wild of the jungle and the majesty of the mountains.

At the end of our stay in the village, Dr. Paul took us for a nature walk, where he showed us all the herbs and plants that many of the villagers use to cure common ailments. Jamun seeds for diabetes, peach tree leaves for abdominal worms, or mustard seeds for arthritis are all solutions that seem to have stood the test of 1000 of years of use in these mountainous villages. I loved our walk, but I was quickly reminded of how far removed I am from my environment. I have no clue about herbal remedies in my surrounding area, and here I was pretending I knew something about medicine, when in reality the villagers knew far more than I.

After our week in the village, we took a 4-hour hike to the nearby hill station of Musoorie. This “hike” was really a climb… Up, up, up for four hours, I dragged my out-of-shape butt up this mountain, attempting to keep up with a serious runner and our mountain goat of a guide. A beautiful trek, even though I spent most of it wishing away the college habits that had finally caught up with me. Once we reached Musoorie, we spent the rest of the afternoon shopping and taking in the stunning views of the Himalayan mountain range. Another great week in India…

Episode 18

Once we finally arrived at Corbett National Park, we were tired and disoriented, but still managed to make our way to the tourist office to catch the afternoon jeep safari. The safari was great fun and we loved being out in the middle of the wilderness, and began our search for one India’s last 1000 or so tigers. Fresh scratch marks on a nearby tree signaled that we had entered a tiger’s territorial zone, and we scanned the brush for anything that slightly resembled the rare feline. We then found fresh tiger tracks and passed by something that was stirring in the dense jungle. Yet after a few hours, we had yet to see a real tiger… Although we were a bit disappointed that we did not get to see a tiger, we did get to see numerous monkeys, spotted deer, elk, and birds. The beautiful jungle and open air jeep was refreshing, and we relished in the warm Indian sun as we drove through the park. We decided to try our luck a second time in another section of the park, however this time at an ungodly hour of the morning. We couldn’t even get the security guard of our hotel to wake up to open the gate, so we had to climb through the barbed wire fence to reach our jeep. Although we didn’t get to see wild tigers, we did see a beautiful wild elephant walking through the jungle just as the sun began to rise. I was now satisfied…

We spent the rest of the day lounging around the hotel and hiking around the park. We then sluggishly made our way to take yet another Indian sleeper train. Oh goody… I don’t know if it’s because the train wasn’t as crowded or just because we were so exhausted from the previous days of extensive travel, but either way, we slept quite well and awoke to the sounds of the bustling Dehra Dun train station.

Tuesday, March 9, 2010

Episode 17

With the help of one of the interns from Venu, Alex and I made our way to Old Delhi train station. And I thought New Delhi railway station was chaotic… Even at 10 at night, hoards of people crowded the platform, and we attempted to maneuver our way to the platform over the sleeping bodies sprawled out over the cold, dirty floor. Our train was about 2 hours late, and if it weren’t for a kind man who helped us find our seats, we would have never left that hectic station. One thing I am beginning to love about India is the helpfulness and kindness of so many of its people. Here, if you simply ask for directions or look the slightest bit lost, someone will go completely out of their way to see you all the way to your seat. Multiple times since I’ve been here, kind-hearted people have bent over backwards to make sure that we found our way. They don’t just point you in the right direction or show you the information kiosk; they do everything they can to see you to your destination, even if it means risking their own agendas. People just don’t help like that at home, and the kindness of some of the people here is something that still surprises me every time.

Having traveled quite a bit, I thought that I would be prepared for our night train to Corbett National Park. Wrong again… The train was even crazier than the station… Six tiny bunk –beds fit into the space of a small closet, and of course my seat was the top bunk below an entire car full of smelly, snoring, burping, talking people. The train car smelled of urine and the entire night, the bunks next to me thought it would be a great idea to play Hindi music as loud as they possibly could for the rest of the train. I think the luggage car would have resulted in a better sleep. With my bag as a pillow and earplugs in (my new most beloved item), I tried to get as much sleep as I could. And then on top of that, every single mosquito in the train feasted on my non-Indian, apparently tasty skin. What a night…. However as horrible as that train may seem, I really wasn’t all that bothered. I guess that’s when you know you love traveling; when the sleepless, dreadful thing they call a sleeper car becomes but a funny story from our adventure to Corbett National Park.

Episode 16

Last week was a short week due to the mad holiday they call Holi. We then spent the remainder of the week at Venu Eye Institute, a part charity- part private eye hospital in South Delhi. Venu is another one of those innovative organizations that has used creative ways to fund its philanthropic endeavors. The center is one of the best in India and due to its prestige, brings in many private paying clients and then uses the profits from the private clinic to fund the charity clinic. 70% of Venu’s patients can be funded by this private clinic, and the patients are able to obtain top of the line care at a price that even the poorest can afford.

This was a really fun week for me considering my interest and past experience with ophthalmology. We spent the first day in OPD in the Optometry department, and as much as I love ophthalmology, I definitely DO NOT like optometry. I found that out very quickly, much quicker than the duration of our stay in the optometry department…. However, we also got to see some of Venu’s other services, including their school for the blind, eye bank, and my personal favorite- the operating theatre. Our day in the operating theatre reminded me how much I love eye-surgery. As talk of cataract-removal techniques and retinal diseases brought me such excitement, I could hardly wait to get in the OR. I don’t know if ophthalmology will be the kind of medicine I go into, but it was really nice to wonder about my future and explore my fascination with the human eye.

After our week in Venu, Natalie, Alex, and I met up with one of the other interns and his friend to celebrate Natalie’s last night in India. We all went to a lovely Italian dinner in one of the big western malls in Delhi. I have never appreciated a glass of cheap red wine so much… We then wandered over to a Hard Rock CafĂ© to check out some American rock band that had somehow found its way to New Delhi. Although I had never heard of the band, Natalie spoke quite highly of “Saving Abel”, so we decided to give it a try. And what a night it turned out to be… We of course came straight from the hospital, and looked ridiculous in our collared shirts and khaki pants amongst the head-banging, rock-loving Indian crowd. Despite feeling completely out of place, we had a great time listening to good music and enjoying the company of our new friends. After the concert, one of the photographers asked us to come backstage to the VIP area where we spent the rest of the night sipping whiskey and sharing stories of India with the band. We couldn’t understand why on earth they wanted us to come hang out, but it was really nice to talk to other Americans about being foreigners in India. They even opened the Hard Rock store so that we could pick out t-shirts, what a wild end to a fun night.

We then said our goodbyes to Natalie, and Alex and I said goodbye to Delhi. Month one was officially over….

Episode 15

With the blink of an eye, over a week has passed by since I last wrote. I can’t believe I have been here for over a month, and been out of the states for almost 6 weeks. It’s really quite odd, the transition that happens between about the 3rd week and the first month. A place that once seemed so foreign, so different from than anything you could ever imagine, starts feeling familiar and more and more like a home. Two weeks ago the excessive honking, odd smells, and chaotic nature of India made my days long and difficult, and left me exhausted at the end of the week. But now, I seem to be deaf to the honking and instead, look forward to the smell of spices simmering and that comforting scent of chapatti being warmed over the open flame. You still value and miss all that reminds you of home, but you also begin to love and appreciate the new place more and more and worn out by it less and less.

So what have I done for the past 10 days…

Last weekend, I went with 2 of the other students to Goa, which was absolutely a mid-20’s traveler’s beach paradise. Complete with beautiful beaches, fabulous night clubs, and tons of other travelers, Goa was such a nice break from all that we had experienced in the past weeks. We stayed at the Taj in Panaji, which definitely put any American 5-star hotel to the test, but for the price of a Holiday Inn. None of us wanted to leave, and we even tried to change our flight to stay an extra day. However, the travel gods did not grant us another day in our new-found oasis, so we sadly boarded the plane and went back to Delhi. Although it was a very relaxing weekend, Goan night clubs and bars tend to keep the music going until after the sun comes up, and so we arrived in Delhi sleepless and sun burnt.

As bummed as we were to leave Goa, we got back to Delhi for one of the best holidays of the year, Holi. Holi is the festival of colors and a fantastic spring holiday. The colors reminded me of Easter, but instead of painting eggs with messy bright colors, Indians paint each other. Holi is essentially a full day of eating, drinking, and massive amounts of the messiest, most permanent colors they can find. And let me tell you, we made excellent targets. We spent the holiday with Natalie’s family, and the minute we stepped outside their house we were attacked with buckets of blue and bags full of red, green, and yellow powders. All of us resembled a mix between an avatar and a Jackson Pollock print. Despite being blue for about a week, we had such a lovely time with Natalie’s kind and welcoming family and felt like we had truly experienced something that was uniquely India.

Monday, March 1, 2010

Thursday, February 25, 2010

Episode 11

On Saturday, we had an HIV counseling workshop for most of the day. The workshop was at Sahara, which is an NGO that works with injecting drug users, HIV patients, addiction cases, and battered women. At the end of the workshop we did a bit of role-play, where we got to be the counselors and test our new skills on a few past patients. I volunteered, and of course, got the most difficult case they could think of. He was impossible, argumentative, and thoroughly enjoyed taking a piss out of me. I immediately realized how hard the counselors working at Sahara really have it. When we talk about counseling in the US, it’s usually for things like depression or drug problems. But at Sahara, their kind of counseling is in a league of its own. Try counseling someone who has no family, a serious heroine problem, is HIV +, lives in the underbelly of the slum without a rupee to his name, and dwells in a world where life is cheap and the government doesn’t care…. An entirely different kind of counseling.

After the counseling workshop we went to Khan Market, which is one of the ritzier markets in Delhi. We looked around for a bit, at items that were far too expensive, and ate my new favorite treats- Momos and Papri Chawt. After, we ventured over to this medical art exhibit, where our coordinator’s sister in-law was showcasing her new works. The art was fantastic! Colorful, provocative, and intellectual, the exhibition was a real treat. We then went to “Big Chill”, a restaurant started by an American expat, and filled with delicious American diner food. It was a taste of home in the middle of New Delhi! Natalie and I indulged in a fudge brownie topped with cookie dough ice cream, and I nearly melted…

Episode 14

On Wednesday we worked in a drop-in center for injecting drug users. We went to the underbelly of Old Delhi, where drug users swarm to score their loot and use. We saw how Sahara was implementing their “harm reduction” program, which focused on needle-exchange, counseling, and oral-substitutes for rehabilitation. It was quite sad, as Sahara use to do much much more for this community, but due to a lack of funds, they have had to severely cut back their program to merely “harm reduction”.

Thursday was definitely another eye opening day as we were working with street children. The street kids live in the slums and squatter settlements, have no parents, and generally beg or pickpocket in order to survive. We went with the Sahara outreach staff to one of the freeway overhangs, where underneath, the street kids congregate. I noticed that every single one of the kids had this wad of cloth held up to their nose, and quickly found out that all of them were sniffing some variation of glue, paint thinner, and nail polish remover. They were all completely strung out… We talked to one of them and asked him a few questions. He did not know his age and after showing him a picture of himself, he didn’t even recognize his own face. We asked him where his parents were, and he pointed to a dark corner where a huddle of adults were sitting doing smack. I guess that would explain it…

We then went to one of the centers for these street kids, where many of them would come to play and act like real kids instead of on the street begging for their drug addict parents. Many of the kids had been abandoned or had run away from their abusive parents. There was one girl who sat huddled in a corner, and after asking about her, I found out that she had run away to the center to avoid being sold into prostitution by her father. She looked no more than 12 years old…

We played with the kids for a few hours, tossing a ball around, doing things that kids their age should be doing! They were all so sweet and absolutely loved having their picture taken. The minute a camera comes out, they all jump around, trying to push the others out of the shot. After playing with the kids for a while, a woman came into the center screaming at the volunteers. Apparently she was upset that her kid was in the center playing and not begging on the street for money. She then accused the center of using the children for child labor and spouted some pretty unnerving things. I hope to go back to the center and work with the kids for a while. It was really fun interacting with them and they could even understand some of my Hindi!

Episode 13

On Monday and Tuesday we went to Michael’s Care Home, which is a center for HIV+ patients to receive care and counseling. We spend most of the time with the HIV specialist and he gave us a detailed lecture on HIV in India. We learned all about the different drugs they are using, how long they have been available, and what the government is doing about HIV. We also shadowed the doc and spoke with a few of the patients and heard their stories. Most of them were truckers, and one in particular told us how AIDS had already killed three of his friends. It was really nice to speak with the patients about their treatment and hear about the stigma and discrimination that they face. After watching the doctor, it became very apparent that as a doctor dealing with HIV patients, you cant just be a medical practitioner, but you have to be a healer, repairing all kinds of emotional and physical wounds that manifest from the disease.

On Tuesday afternoon, after leaving Michael’s Care Home, we visited one of the worst slums I have seen yet. We started our visit at what they call “Chicken Street”, where the slum dwellers collect scrap chicken skin, eyes, and carcasses to boil down into something they sell for dirt-cheap. This chicken “meat” is used in cheap street food like kebabs and momos. Needless to say, I will be sticking to veg momos for the rest of my stay… As we walked into the slum, the smell of rotting carcasses filled my nostrils, and I came very close to passing out. Numerous little children came to greet us, treading over the mountains of chicken skin and feathers (barefoot of course), while their parents manually shredded the chicken bits and threw them into pot. I couldn’t believe that people actually live like this. The structures were much dirtier and smaller than the ones we had seen before, and the sewers were essentially open trenches that ran throughout the tiny passageways. This was by far the most difficult site yet, the scent and image of this place is seared forever into my brain.

Episode 12

On Sunday, we decided to do some serious site seeing. We started by going to the government sector and seeing the Parliament buildings, president’s house, and the India gate. It was definitely interesting to see how much the government spends on itself, and how little it spends on everyone else. At the suggestion of our coordinator, we decided to check out the Mughal gardens, which is the president’s private garden and is closed to the general public minus a few days out of the year. Sunday happened to be one of those opportune days… Or so we thought. After being ripped off by an auto, we finally found the Mughal gardens, and the line was nearly a mile long. The hoards of school children and families swamped the entrance, and proceeded with the usual style of Indian queuing, (aka mob). Luckily, one of the coordinator’s from another program was with us for the day, and was well versed in this skill and quickly ushered us through the front of the line. The gardens were a bit disappointing and the massive crowds didn’t help. To make matters worse, it was one of those days where I felt quite out of place. People stare constantly, its something I’ve had to get use to. At home, I am not tall, but in India, I am a giant and taller than most men. My pasty white skin and freakish height makes me stick out like a sore thumb. I generally just look down and find my happy place, but on this day, entire busses filled with school kids decided to point me out yelling “hello! How are you?”, laughing hysterically. Nonetheless, I was ready to leave the Mughal Gardens…

We then went to the National Museum and then to Gandhi Smriti, the site where Gandhi was murdered and now serves as a memorial. It was a lovely memorial and I really enjoyed reading the hallways filled with his quotes and philosophy. There was one that sticks out in my mind and goes as follows:
Those who own money now, are asked to behave like trustees holding their riches on behalf of the poor. You may say that trusteeship is a legal fiction. But if people meditate over it constantly and try to act up to it, then life on earth would be governed by far more love than it is at present. Absolute trusteeship is an abstraction like Euclid’s definition of a point, and is equally unattainable. But if we strive for it, we shall be able to go further in realizing state of equality on earth than by any other method
-MK Gandhi

A quote I continue to ponder….

Wednesday, February 24, 2010

Episode 10

On Wednesday evening, I started feeling a little uneasy after our rural visit. That uneasiness quickly evolved into that famous Indian sickness that strikes down most travelers at some point. I finally got what everyone warned me about... They say Montezuma’s revenge is bad, but let me tell you, Mother India is far more revengeful. After a horrible night of paying my dues to the porcelain god, I woke up exhausted and fluidless. My wonderful auntie and uncle (what you call your host family in India) took great care of me all day on Thursday, and truly made me feel as if I was their own. I really hated having to stay home, but it was nice to finally have a quiet moment to digest all that had happened in the last 2 weeks. Quiet moments are few and far between here, but once you finally get one, you begin to realize the immensity of this experience. I'm sure there will be other quiet moments, where what I think just happened meets reality, and crystallizes into a beloved memory.

I woke up on Friday feeling MUCH better, and was ready to embark on yet another interesting day. First, we visited one of the urban slums in Chandigarh to evaluate one of the women’s reproductive health programs. Sadly, the program was most definitely not working… The program set out to improve maternal and infant health, push for institutional deliveries, and provide pre and ante natal care. After speaking with a number of pregnant women, we found out that many of the women were not having institutional deliveries and had little to no knowledge of reproductive health care. Yet, the most alarming thing was that not a single woman knew about family planning methods. A program meant for reproductive health, and not a single woman knew about family planning. It was really quite tragic to see hundreds of little children running around, playing in trash, with no shoes or pants, no one watching them, and putting whatever they could find in their mouths. Many of the mothers had six or so children, and were yet again pregnant because the six of their children were girls and they were not going to stop until they got a boy. Another tragic reality… 4,5,6 little children with barely enough to eat, no chance of education, and born into a slum with very little hope for the future. What does prenatal or infant care matter if you don’t have family planning? Here was a day where you saw the crux of the perpetuation of poverty and the sad realities of gender inequity.

After the slum visit, we met with the director of the NGO, who really put everything in perspective. He was very aware that some of his programs were not working and told us the main constraint to their improvement, the government. He was a really inspirational person, had this great critical eye, and an uncanny ability to see the bigger picture. I really enjoyed our visit with him.

We then hopped on a train and began our trek back to Delhi. I awoke from a fairly deep nap on the train to the hustle and shouting of about 10 young boys ages 8-16. They had these enormous bags over their shoulders and were scouring the train for any left cookies, water bottles, tea packets, and of course belongings forgotten passengers. If you happen to be one of those unlucky people to leave a purse or cell phone on the train, consider it gone... The street kids live at the train station, and like vultures wait for most of the passengers to get off so they can pick up any left over loot and sell it on the streets. A rude awakening… Welcome back to Delhi. Yet for all its madness, I was glad to be back. Like any other city, Delhi has a pulse, a character; it’s a big playground that I am eager to continue exploring.

Episode 9

On Tuesday, we went and visited one of the truck stops in a very poor area. In India, truck routes are key to the spread of HIV/AIDS. While at the truck stop, we visited one of the centers for female sex workers and had a long conversation with a few of the sex workers as well as some of the peer advisers who work for the NGO. SWACH has set up these centers in order to educate a few sex workers in HIV, STI’s, and safe sex practices so that they may be educators for other sex workers in the area. It was a fascinating day as we got to hear their stories and listen to their struggles. Many of the women live in the slums, were widows and had no other means of providing for their children. After spending a few hours with them, their stories and lives become personal, they are real people with issues that we couldn't even imagine at home. I really enjoyed speaking with them and getting to know a few of them.

On Wednesday we went to one of the very rural areas, where we saw the different programs that SWACH had for adolescents and rural health. The most interesting part was seeing the struggle that these health workers face in the rural areas, where resources and education are lacking. The same systems and programs that work in urban areas can in no way function in some of these rural parts. Providing a meaningful and sustainable health program in these areas takes ingenuity, determination, and an open mind. Again, my respect for those working in this field grew immensely. While in the village, we visited one of the adolescent peer educator meetings, where youngsters would come to learn about a wide variety of issues and would pass the information on to other children in the village. Today’s Topic- Global Warming…. It was so odd coming from a place where we drive polluting cars, waste uncanny amounts of water, and dump countless chemicals into oceans, rivers, and fertile lands. And here I was, listening to these 15 or so teenagers talking about what their village can do to curb global warming. A village who has very few cars and is forced by necessity to use its resources wisely, how can this village help prevent the climate change that people like me have caused. Another one of those irreplaceable reality checks....

Episode 8

On Monday we set out for Chandigarh, which is about a 4 hr train ride from Delhi. It was such a nice surprise when we arrived, as Chandigarh is much cleaner and a bit more modern than Delhi. The air is much less polluted and does not have that distinct odor, the roads are far less congested, and the houses and buildings are quite modern. Although I love Delhi’s character, Chandigarh was a very nice break. For the rest of the day we met with our NGO, Survival for Women and Children’s Health (SWACH), and they gave us a presentation on the different programs that they are running.

Later in the afternoon, we went to the Chandigarh Rock Garden, which at first appeared to literally be just that, a bunch of rocks in a garden. But in fact it was quite neat. The artist made all of the sculptures from trash and waste, such as old plates, used charcoal, old electrical sockets, and even discarded bangles. There were numerous sculptures of animals and people as well as a number of architectural works. A very crafty way of using trash…

We then retired to our guest house, where we met our host family. Our host family also runs their own NGO, providing education to slum children, and they are quite possibly the nicest people you could imagine. They have 2 children and a large house, where they rent out the rest of the rooms to students or young professionals at an affordable price. But most of all they bring you in as part of their family. They have made us feel so welcome, and their work in education is truly inspiring.

Episode 7

Over the weekend, we decided to do some traveling. We first went to Jaipur, the Pink City, which was absolutely beautiful and reminded you of something straight out of Aladdin. After a very foggy drive, we reached the Amber Fort at about 11 30 am and walked around for about 3 hours. Just my luck, we arrived too late to take the elephant ride up to the fort… I was quite disappointed, however now even more determined to get my elephant fix. The fort is nestled in the Rajastani hillside just outside of Jaipur, and consists of an enormous palace that was once for the king and his 14 wives. Each wife had her own apartment and there was a secret passageway that connected all the rooms to the king’s quarters so he could visit them at his leisure…. Crafty bastard. After spending some time at the fort and spending way too much money at the Rajastani craft emporium, we headed into Jaipur and spent the day walking around the dazzling pink city.

The next day, we got up bright and early and drove about 4 hrs to Agra to see the Taj Mahal. Agra itself is nothing special, but it contains quite a gem. Sunday February 14, 2010, Valentine’s Day, and I was standing in front of one of the greatest testaments to eternal love. I don’t care what anyone says, the Taj Mahal really is all its cracked up to be. Standing amidst a garden of greens, pinks, purples, and blues, the Taj Mahal is a glistening white marble structure that serves no other purpose, but to house the slumbering king and his beloved wife. Someone once called it “a teardrop of the face of eternity”… After ooing and awing for a while, we finally decided to wait in the enormous line to go inside. Another thing I’ve learned about India, the concept of the “que” does not exist. Everyone essentially mobs the front of the line, cutting relentlessly without any method or organization. I would have to say that one thing I look forward to when I get home is the ability to wait in a fair and orderly line.

Friday, February 12, 2010

Episode 6

Yesterday we visited a slum in Delhi. The slum sits next to the train tracks in a fairly well to-do government area. The slum has been there for over 30 years and most of those who live there built the structures that they call home. Considering its location, a corporation in connection with the government has decided to put a 5-star hotel on the land that sits right next to the slum. Many of the slum-dwellers work at the construction site and provide an arsenal of cheap labor. Those who do not work on the construction site are mostly trash collectors, and sift through mountains of trash, removing plastic and cardboard that is to be sold to recycling companies. However once the hotel is completed, the entire slum will be demolished, and of course the tragedy is that almost 1000 people will now have no where to go and will be provided no compensation by the government. How ironic, that the people who help to build the hotel will be displaced by its completion.

We walked around the slum for a while with our guide and spoke with a few of the people who lived there. They were all unbelievably nice, and with what little they had offered us tea and bread. We found out that many of them live on about $60/month for a family of four… That’s about 50 cents/day/person. I’m sure those who are building the hotel can relate…. We spoke with one family for about an hour and they told us their story. A woman and her husband moved with their 8 children from a rural village to New Delhi to find work. She explained to us that she was not educated about sexual health, and because she couldn’t afford the hysterectomy, she thought she had no way of controlling her family. The family lived in this tiny brick room with a sheet metal roof; the room was no bigger than 10ftx8ft for her entire family. She explained to us that her husband had been in a construction accident and broke his spinal cord, and now with the hotel they did not know what they were going to do. She was going to have to take her kids out of school so they could all go to work to make up for the lost wage earned by their father. There were numerous stories like this one; I felt simultaneously enraged, saddened, and disturbed.

Today we went to Apollo hospital and shadowed one of the HIV specialists. Apollo is a private/corporate hospital, a sharp difference from what we had seen before. Many of the HIV cases we saw were co-infections with Tuberculosis, and some of them were quite serious. With many of the cases, the patient would begin to feel better and so they would stop their anti-retroviral treatments despite the doctors orders, and their HIV would quickly progress to AIDS. It was an interesting day, but I have to say I much prefer working in the slum. Many of the people who came into Apollo were quite wealthy, as they could afford the expensive treatments, and even with their privilege would not follow the regimen that so many would die to have….

Thursday, February 11, 2010

Episode 5

Pathway to Pune (and beyond).
Episode 5

On Wednesday we worked in a rural medical center with a very inspirational doctor who showed us a day at his clinic. The clinic serves very poor areas of the city at very low cost, and the physician we worked with donates his time and absolutely lives for what he does. We saw numerous cases, most of which were gallstones or kidney stones from the rich-ghee filled food. However, there was one case that absolutely stuck out in my mind.

A young woman, no older than me, came in with a very large kidney stone (probably the size of a quarter). The woman was extremely poor, had two children, and had been left by her husband. She came with her mother who had mortgaged her earrings just to pay the nominal clinic fee of 30 rupees (less than a dollar). The kidney stone had gotten so large that the young woman could barely get out of bed and was in an exorbitant amount of pain. As her eyes filled with tears, the mother of the young woman pleaded with the doctor, as she was in debt and didn’t know how she was going to pay for the surgery. The doctor then handed the technician a wad of cash, and told the woman that she did not need to worry, and that he would take care of it. The mother held the doctors hands, with tears running down her cheek, and thanked him profusely. The look on that woman’s face was priceless, and you realize that with such extreme poverty, dilemmas such as medical problems can make or break their lives. After the woman left the room, the doctor turned to us and said, “Of all the pathologies, man’s greatest disease is poverty”. How true a statement indeed. After a day of seeing such cases, it made me wonder why I was born in this skin and not hers.

After our day in the clinic, Natalie and I decided to do some site seeing. Our first stop was Akshadam, an enormous Hindu temple built for Swami Narayan. The temple was unbelievable, decorated with the most ornate carvings and landscaping. Not an inch of stone went without some elaborate depiction or a story. My favorite part of course, was that almost every carving included an elephant in it…. We also visited a few of the exhibitions at the temple, which recounted the story of Swami and some Indian history. The end of the exhibition had some beautiful words about the need for peace in the world and the uselessness of violence. In particular, one that I liked stated, “Man created war, and so he must also eventually pioneer peace”.

After Akshadam, we had some dinner near the Red Fort of Delhi, and after went to a light and sound show at the Red Fort. It was a bit cheesy, but I still enjoyed the lights and seeing the Red Fort illuminated with color.

Episode 4

The past few days have been very interesting, and seem to have just flown by. The other student, my roommate is great; we are oddly similar and are both very anxious to do some traveling. However, we have started a bad habit of waking up at about 2 in the morning and talking until about 4am. Although we have really started to get to know each other, it also makes for rather long days.

For the past two days we have worked with Sulabh Int, an Indian based NGO (non-governmental organization, like a non-profit) that has taken Gandhi’s vision and turned it into a multifaceted intervention that has changed the lives of millions. The founder, Dr Pathak, took Gandhi’s concept of non-violence and created an organization that truly practices what it preaches, striving for both social and environmental justice. Dr Pathak, a Brahman by birth, started by trying to help some of India’s untouchable caste or scavengers. This group of people was forced to go from home to home and clean the toilet pots of others, and carry the excrement in buckets on top of their heads. They were often forced into the poorest regions of the town, stricken by perpetual disease, and discriminated against in every way. At one point they were forced to wear bells around their necks, so to alert others when they were coming. They were disallowed from all other professions, and in order to prevent contact, food, water, and money were thrown at them. Dr Pathak realized that in order to help these people, he first had to rid of the pots that the scavengers were forced to clean- an indirect approach to a seemingly impossible task. He created the Sulabh toilet, an environmentally friendly, low cost, 2 pot toilet system, where excrement is deposited in one pot while the other is allowed to decompose into manure. These toilets tackled 2 big problems; the social injustice faced by the untouchable caste as well as provided a much-needed technology for proper sanitation. The toilets cost about 1 rupee, and the profits are used to train these scavengers in other professions. Sulabh toilets are used throughout India and in numerous other countries, and have turned into a fully recyclable, eco friendly technology where the gas, solid waste, and wastewater are all fully recycled. The profits from these toilet complexes are then used to fund a school for the scavenger’s children, multiple vocational training centers, and provide small loans for the scavengers to start their own businesses. On Tuesday, we visited one of the first training centers in Alwar, where the ladies who were once forced into such a degrading trade were practicing their new skills in tailoring, embroidery, sewing, and even beautician services. At the Sulabh center, the women also prepared food items such as Papadums and noodles, which they would sell at the market. The people who once wouldn’t even touch these women, now buy food items that they prepare. All the women spoke of their new professions with such pride and happiness, and showed off their English that they had learned in the school.

While in the town of Alwar, we also visited the King’s Palace; an enormous Rajasthani structure nestled in the hills. It was very beautiful and a very nice break from the Delhi urban sprawl. While walking up to the palace, a wedding procession passed us, and let me say that weddings in India are a BIG deal. The procession immediately invited Natalie and me to join and kept yelling for us to dance with them. We were also doused in shaving cream and confetti as part of the ceremony. A fun experience nonetheless.

Sunday, February 7, 2010

Episode 3

I finally got up at about 1pm the next day and met my coordinator. She was immediately very welcoming and whisked me upstairs to meet her family. We talked for about an hour and they helped me begin to start thinking about where I want to travel on my weekends and at the end of my trip. Traveling... My excitement instantly spiked... I then came downstairs and had a fantastic lunch courtesy of my caretaker, delicious Indian veg cuisine. I am really enjoying the food, it’s all very different and has yet to make me sick.

My coordinator has been so wonderful these past few days, as the other student is arriving later, I have been kind of on my own waiting for rotations to start on Monday. She has offered to take me everywhere, and like a wide-eyed three year old, she could say we were going to the dump and I would be thrilled to go. Everything is so new and different; I don’t care where she takes me as long as I get to see a new part of Delhi. Later that evening, she and her husband took me to a local fish market. The fish are quite literally straight out of the water and the chickens are butchered on the spot. In the US, we are so far removed from everything we eat- packaged, frozen, pre-cut. I watched as one of the butchers killed, de-feathered, and boned the chicken into what we know as chicken meat. Yet, the greatest part of all was he did it with the knife between his toes, and carefully used both hands to take the bird apart with utmost precision. After that we went to a shopping market, where I had my first Indian street food- Momo. Little steamed dumplings filled with chicken or veggies served with a spicy siracha-like hot sauce. Delicious. I finally went back to the apartment and fell asleep almost immediately.

The following morning I went with my coordinator and her husband to the local forest/ park in Saket. Instead of designated, pre-planned parks like we have in Western cities, the place was essentially a spot where they let the local vegetation grow wild. We briskly walked through the bamboo forest and watched the orange sun greet the day. I really enjoyed that walk and hope to try and go every morning, a nice ritual, somewhat cleansing and meditative.

After our walk we went to the hospital to meet our medical director, here I also met the other student I will be working with. Tomorrow we start our program at Sulabh International, an NGO that tries to rehabilitate “scavengers”. These people are part of what we may know as the untouchable caste, they collect human feces and carry it out in containers on their heads.

I am so happy that I decided to do this, and am experiencing things that I could never dream of. I can’t wait to see what else is in store for me...

Episode 2

After about an hour and a half of sleep, I said goodbye to the cushy bed in my hotel room and rushed to Heathrow airport. Naturally, given my Davis gene for impulsive earliness, I ended up sitting in Heathrow for about 2 hours before my gate even opened. The laws of aero-transit must have sensed my anticipation and of course, my flight was delayed. On the plane, I sat next to a really nice man who was going home after a business trip in New York. When choosing a film to watch, he pointed me towards the Bollywood film “Wanted”, most definitely an entertaining choice as I watched the Indian version of Vin Diesel beat up thugs with his big muscles and dashing good looks. I was so exhausted that I finally slept a little, and soon we arrived in Delhi.

As I began to see the lights of Delhi and we descended into the urban space, a sudden surge of shock finally hit me. “What the hell am I doing here”… I quickly set aside my anxiety and got off the plane, went through customs, and collected my luggage. I would say the one thing I was most nervous about was meeting up with my driver, who was to collect me at the arrival terminal at 2 am. And of course, I couldn’t find him. Slight panic. But the one thing I am beginning to realize about India is panic will get you nowhere fast. I sat down, called my coordinator, and low and behold a tall young man with “Gwenth” scribbled on a piece of paper found the half asleep girl with the enormous backpack.

We then got in his car and the real adventure began. After jetting out of the airport parking lot, I also quickly realized that there are no rules on Indian highways. Honking is used more frequently than turn signals and there is no “right of way” for anyone. You think that you can mentally prepare yourself for a trip like this, at least a little, but nothing is as shocking as those first 30 min. That first car ride on the dirt roads, whiff of Delhi air, or the first scrap metal structure tucked on the side of the road with a small light peering from the cracks, indicating that people do in fact live in such places. My respect for those actually working in the field of development and global poverty immediately grew- those who have the ability to live at the extremes of two very different worlds, yet are able to imagine a place in between.

When I finally got to the apartment, it was very different from what I expected, but I was pleasantly surprised. It was very simple, but clean, and I went to my room to get settled. It was about 4 am by the time I finally got into bed, and you would never believe the ruckus that was occurring outside my room. Windows in India are in no way sound proof, and you hear EVERYTHING. Thank goodness for the modern marvel they call earplugs.

Episode 1

So as I begin my journey to India, I am filled with a combination of anxiousness, excitement, and intrigue. I am well aware that this trip will truly be a life changing experience, and I look forward to the experiences, people, photos, and memories that will ensue. But first, a little background as to the meaning of this blog. In 1942, my grandfather, a young man of about my age and an officer in the British army, was sent to India as part of his tour. Throughout his journey, he wrote fairly detailed memoirs about his adventures in India and Madagascar and he called them “The Pathway to Pune”. So as I begin my own journey to India about 70 years later, I shall call my blog by the same name. Unfortunately, I never had the opportunity to meet my granddad, as he died right before I was born. Yet through his memoirs, I hope to get to know a man that was so dear to my family’s hearts, whilst blazing my own path to “Pune and Beyond”.

Just as he did, I started my journey in England. After getting picked up by my cousin, we spent a few days exploring London. I have most definitely found my new favorite spot in London, BOROUGH MARKET. Filled with cakes, artesian cheeses, meats, fresh fish, and delicious curries, this bustling market sits below the train tracks in Borough, London. After visiting this market twice and having a few heavy nights out with my cousin, we then took a train up to Sheffield to spend a few days with my Nana, Uncle, and my Uncle’s family. It was really nice to see the family, and they showed me a wonderful time as usual. However, it was also difficult to truly enjoy myself with the real adventure just around the corner. I spent many sleepless nights at my Nana’s, looking forward to, but also anxious about what lay ahead.