last night i slept well through the night; the past few days i had been sleeping from 9 pm to 3 am, waking and writing for two hours, then sleeping until 7 or 8. it was wonderfully calm in those mid-night hours, and i was alert and able to reflect during those times, though i'm still not sure i have realized i am here in india. it is very easy to feel stuck behind a viewing window when you are in a culture so different and seemingly inaccessible, but i'm hoping (and finding just a bit) that recapping what i've seen makes little cracks in the clear divider; hopefully it will shatter soon!
yesterday was an amazing day. we woke to a delicious breakfast and made our way to the hospital, where we met dr. shobha for morning rounds of the inpatients, stethoscopes in hand. we saw a patient with cellulitis that had spread to his scrotum that was becoming gangrenous. he was referred to a larger hospital because the infection had spread to his blood. we also saw some men who were recovering from prostate surgery, performed at CRHP by shobha; a child who had a parotid abscess (a salivary gland on the cheek near the ear); a boy who was recovering from paralyzing guillain-barre syndrome who, through rehabilitation, has gone from being paralyzed from the neck down to walking! we also saw a woman who had been treated for malaria, several women being monitored for bleeding during pregnancy, and - quite a story - a man who had a scrotum the size of a basketball. in surgery, it was found to be many loops of bowel - a huge, years-old hernia! they are all doing fine.
two nurses in white saris followed shobha, dave, amy, june and me around, writing hospital notes in english, which is surprising because enven in mumbai people speak very little english. i've had to get on with a demure smile and “namaste" (greetings) to everyone. following shobha around the hospital certainly adds to the smile return rate, but in the streets, there are looks – no, staring (i hope just curious). children in the village run up to us and, smiling and laughing, shake our hands and say “hallo” and “what is my name?” the latter means “what is your name,” we’ve learned, so we exchange names and off the children run. other groups of kids wave from a distance and when we wave back, they giggle into their hands. it's pretty amusing to us, too!
after we saw the inpatients at the hospital, we went to shobha’s office to see the outpatients. we saw a 15-year-old girl with an enlarged spleen and liver who we sent to get blood tests (they do most tests at their onsite laboratory); an HIV-positive woman with tuberculosis and an infected wound from a biopsied lymph node that had been enlarged; and a boy who had burn injuries on his hand that healed leaving his fingers unable to extend.
after another amazing meal for lunch, we went to a village wedding that was taking place behind shobha’s house (a site with a stage that is often used for weddings and other village celebrations). they carried in the groom, who was wearing a special turban, and then the bride – covered in a red shawl with gold ruffles on it, and wearing gold jewelry on her forehead and a chain from her earrings to her nose-ring. a hindu priest arrived on a motorcycle, as someone came around spooning into our cupped hands a mixture of rice and orange powder that we would later throw seven times throughout the ceremony toward the stage where the ceremony took place (we were all seated in chairs and cross-legged on the grass in the “audience”). the hindu priest sang a prayer, as did some village girls who might have been relatives of the couple, and the ceremony concluded with drumming. very auspiciously, it rained very hard for just a few minutes right after the ceremony ended, which was lucky for me too, because we all had to run onto the stage for shelter. that's where two village girls grabbed my hand and, introducing themselves and asking my name, dragged me to the bridge and groom to congratulate them.
that afternoon, we went into the village of jamkhed, on the edge of which we are located. i am glad i got another look, because the side streets of jamkhed on a sunny afternoon are very charming and very different from the main drag, muddied and dark in the monsoon rains on which we entered jamkhed on saturday. i bought some shampoo, laundry detergent, a notebook, two outfits, and face wash for about Rs. 800 ($20). they have bangle bracelet shops, bakeries, phone booths, schools, clothing stores (with both ready-made and material-for-fitting saris/salwar kameez), and numerous other convenience store type shops selling toiletries, snacks, jewelry, religious icons, and more. there were cows like the one pictured above everywhere.
tuesday, we awoke early to go to a village when CRHP-trained Village Health Workers (VHW) are working. the VHWs are low-caste females who have once-a-week training here in jamkhed to provide healthcare to their villages. they deliver babies, provide prenatal care, learn how to treat common diseases, counsel women, men and children on how to improve their health, and advocate for their community. the reliance on these women has dismantled the caste system in these villages to quite an extent over the 30 years they have been working, as high caste families must depend on them and have seen that the “untouchables” (the sub-caste group from which many of the VHWs are chosen) are thinking human beings who deserve to be treated equally. seeing that women can contribute so much has improved the status of women in these communities by showing the women how to advocate for themselves.
we arrived at the village with the Mobile Health Team from CRHP, which visits every village with which they have a relationship once per month, ready to provide HIV testing for pregnant women, along with counseling about the illness, which has much stigma here in india (which has the second highest rate of HIV/AIDS in the world, after south africa). we also got to watch a VHW do a prenatal exam using only her hands and a metal funnel-like instrument to hear the fetal heartbeat. she also looked at the tongues and inner eyelids of the women to see if they were anemic, and – if so – prescribed a certain kind of roasted bean with the size and taste of a chick pea for them to eat for the remainder of their pregnancy. we also learned about a lime juice-salt-sugar-water mixture that village women can make as an oral rehydration mixture for their children’s diarrheal illnesses. the number one killer of children under five in the developing world is diarrheal illness, which kills not because of a pathogen, but because the diarrhea dehydrates the children so quickly. the oral rehydration solution restores important electrolytes and water to the children, and improves survival. in the village we visited, only 3 children under five had died in the last fifteen years, and two of those were due to an accidental death and a birth defect that could not be fixed. these local efforts have improved health so much here – seeing all this has made advocacy and education seem like such accessible solutions to many of the world’s problems.
later, after returning to CRHP in jamkhed, we hopped into another CRHP bus to go to their farms where they sell some produce for a profit, but mainly provide refuge for ostracized patients with AIDS, leprosy, and mental illness, as well as teach farming techniques to local communities and individuals. they also have cows to produce milk for CRHP and some of the poorer communities they serve, and they raise chickens.
we sat with dr. arole – the founder of CRHP and father of shobha – in an area of young fruit trees, under a covering that filters out UV light and provides wonderful shade. we discussed the water-saving technologies used on the farm, much needed since this part of maharashtra state (the southern part of the ahmednagar district) is a drought-prone area, and there have been many monsoon seasons during which little rain fell, although mumbai – eight hours to the west – would be flooded.
this morning, a dutch medical student named rinske arrived, who will be here a little longer than us and will be taking the course with us. the four of us spent the morning with a group of korean students who are also here listening to the stories of several women working here at CRHP in jamkhed who have overcome abuse, both physical and social, from being in a low caste, for being women, for bearing girls instead of boys [a sidenote: feticide is common if an ultrasound determines that the fetus is female; it is therefore outlawed to tell families the sex of the child during prenatal ultrasounds, but this goes on illegally anyways.], and simply for being seen as the property of their husbands (their husbands are their gods). CRHP actively taught the women that they are thinking human beings . during this powerful session, i wondered whether we naturally believe that we are worthless or worth something. is there a natural inclination to feel one or the other, or are both taught?
the women who spoke to us were all beaten by their husbands and families, and had been married by age 14. now, they are property-holding entrepreneurs and contributing members of the CRHP community and their villages – no longer mistreated. they are advocates for themselves. one muslim woman was harassed by her community for opening a store when her husband died and for not wearing the veil and for being outside the home. she asked to have a meeting with the muslim leaders and said “if you give me money to live off of and feed my children, i will stay in my house, wear the veil, and stop working to earn a living.” the prospect of having to financially support her was too much for them, and they never bothered her again. the very fact that she could not be bullied brought her a lot of respect, and she does very well in her store today. she and the other women who told their stories have empowered many women in their communities by example.
this afternoon we had our first marathi class with pushba, a wonderful woman who did some of the HIV counseling in the project village the day before. she, like most here, has a wonderful smile and beautiful lines around her kind eyes to show she uses it often. we learned introductory phrases and pronunciation.
after watching wimbledon on tv last night in shobha’s house, we had a spaghetti dinner. what a western evening!
each day makes me quite grateful to be learning so much from these remarkable people – of CRHP and india. i do feel that i am in the presence of greatness here because of what i have seen and read in just a few days about the impact they have on the community.
last saturday, we went to the hospital to see patients with dr. shobha. sunday, as are all sundays here, was a day of rest, and that evening three students from SUNY downstate arrived – alex (who was the arole fellow last year), samar (pronounced summer; a bombayite who has lived all over the world and holds an MSc in computer science and a PhD in neuroscience), and ozzie (a quirky iranian-american with great stories and a reverence for che guevara’s commitment to his ideals). we began the course on monday.
then she took us to her home and gave us tea and sang for us. while we were there, a woman came in who said she felt the spirit of lakshmi, a goddess, in her. she hooted and waved her arms around, joined at the wrists above her head, her whole body moving like a butter churner propelled by an invisible force. but she began laughing when she tried to do it in front of us, so i have to say respectfully that i’m not sure how possessed she actually was!
