last week was fantastic. we explored child health and women’s status in class, then prepared to go to ellora and pune for the weekend.on saturday morning, we left at 6 am to go to the ellora caves, which are spectacular hindu, jain, and buddhist temples and schools cut into a mountain. these are not spelunking caves, my friends. these are spectacular, cathedral-sized caves cut from the top down without scaffolding, thus they are cut from solid rock – not in pieces. the most amazing was a buddhist gathering hall with 50 foot high ceilings, all made of stone. our tour guide went behind the giant buddha stupa and starting chanting, and the sound reverberated throughout the entire temple. i could feel the vibrations.
after being hassled by vendors, i bought a beautiful garnet-colored beaded necklace for 100 rupees (2.50 USD). we piled into our jeep and went to the bus station to go to pune.
pune would be a major city if mumbai (bombay) weren’t four hours away. it has a population of 4 million people, universities, a banking center, malls and everything else that, coming from the rural areas, is shocking to see. of course there are beggars galore, and they are the most aggressive i have yet seen in india. they grab your arm if you ignore them, and i simply don’t tolerate that. even if you give them money, they continue asking for more, and many of them are professional beggars. it is clear that those who need alms most are those who are disabled or mothers with children, but those who are most in need aren’t as aggressive as those who beg professionally. i had to whip around once because a woman grabbed my arm tightly. another student with me in the course speaks hindi, and understood when a professional beggar woman said “i curse you” to her. we were able to buy some food to give to a woman and her children, and we did give to some of the poor and disabled, but it’s so difficult to think that 1) it doesn’t make much of a difference and 2) if you do give, twenty more beggars materialize.
we went to a german bakery and had masala chai and apple danishes. then we visited a broadband internet café, which was a relief after working on the spotty dial-up in jamkhed. rinske, the dutch medical student who i have befriended, and i split from the group to explore for the afternoon and had a fantastic time weaving through the streets and markets. the following morning, sunday, we went to have a half-hour ayurvedic massage. we stripped down to our underwear and got on the bed under a towel, thinking that they would fold the towel down to expose our backs. they pulled a curtain between our two beds, and each attendant took one of us. mine pulled the towel down as expected, but then pulled my underwear down in one quick motion and began kneading my buttocks!! i didn’t know what to do, so i just enjoyed the massage, which – soon after – moved up to my back and re-covered my pale and previously unhandled derriere. the massage was wonderful, though, and rinske and i jumped into an autorickshaw to hurry back to our hotel to check out.
the autorickshaws in india are basically motorcycles with a cover and a double seat behind the driver, so that you sit side-by-side with your fellow passenger. rinske and i sat there smiling as bollywood music blasted from the speakers installed behind our heads (the equivalent of the shelf-like area in a sedan under the back windshield). a ride across town costs less than a dollar.
that afternoon i presented my research proposal to the maharashtra association of anthropological sciences ethich committee. as at mount sinai, it didn’t get passed, but once the course finishes, i will work with dr. shobha in the outpatient department and in the hospital, and will document how alternative therapies are used in the hospital in a very informal way. it should be wonderful, and at least i had the enlightening experience of presenting to an indian ethics board!
today, i gave a presentation on taboo and superstition as barriers to healthcare. i focused on pregnancy, delivery, and childhood, and got to interview some village women about their experiences. one interesting belief is that women who die during childbirth do not go to heaven or hell, but become owls and watch over new babies and mothers in the hopes of cursing them because they were not able to have a child. in an effort to stay out of the sight of an owl, mothers and children stay in a hut built especially for childbirth for 12-40 days after delivery and all possessions of both mother and child do not see the light of day because the owl might take them and use pieces of their belongings in a spell to curse them. this view is no longer common due to the counseling of CRHP in these areas, and of course some degree of modernization; how isolated these villages are should not be underestimated, however. i am continuously surprised by how closed and cut off from society these communities can be.
we have been talking about water-borne illnesses and other communicable diseases over the past week, which has been really stimulating. last night i got to attend a c-section. the poor mother, 25 years old, had a high-risk pregnancy with high blood pressure and protein (albumin) in her urine, which indicates some kidney problems. after many hours of labor, the baby’s head was too big for her cervix, so they went into surgery. a beautiful baby boy came out after 3 minutes, then they closed her up and all was well. she had a seizure at 7:30 this morning – a complication of her previously high blood pressure, and was close to comatose when we checked in on her at 10:30 am. dr. shobha gave her a 50/50 chance of surviving. but we received word that she woke up and was breastfeeding this afternoon and looks as though she’s in the clear.
it's pretty incredible to be privy to these people’s lives in the hospital, and to see the successes of medical interventions. in the OR, i felt again the rush i have gotten before partaking – even passively, as i was last night – in the surgery. perhaps, despite thoughts of a public health career, i do belong in clinical medicine. the interactions with people here in the hospital have been overwhelmingly positive, and the simple things a doctor can do – things i understand after even one year of medical school – can change lives.
i have been thinking since i began medical school and opened the cadaver gifted to me and my classmates how little the average person knows about how our bodies work: what’s inside them, how they function, how they malfunction. here we have spoken much about education of village health workers, who in turn educate their fellow village people on simple remedies and diagnostics so that they can be in charge of their own health. i have been thinking about the lack of education about our health in schools and how only part of tenth grade biology actually covers biological systems. i think a national curriculum should be developed to teach about health in every school (along with my old idea and strong view that foreign language should be required in american schools starting in first grade).
this weekend, i will pick up the blousepiece that was made for me at the tailor’s; it is the belly-bearing shirt worn under a sari. the rest of the weekend i anticipate will be spent attempting to put a sari on, as it truly is an art. i'll let you know how it goes…
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