Sunday, April 27, 2014

Week 15: Spice Market and First World Problems

     Saturday (April 19)'s big activity was Audrey and me going into Delhi to hunt down the infamous Spice Market, something I had been looking forward to for a while. The Delhi Spice Market is definitely a sensation for your nose and eyes, but more so for your nose. As Audrey so aptly desribed: Imagine you are in a giant port-a-potty where multiple people start cooking Indian food then someone starts a load of laundry.  The streets are not lined with booths like you’d imagine at a flea market, but rather everyone’s shop spills out into the street. You walk along and pass giant opened burlap bags of lentils, cashews, walnuts, peanuts, turmeric, nutmeg, cardamom, cumin seeds, fenugreek, ginger, tea, mixes (like garam masala), anise, dried apricot...and so much more. Each shop is the same, yet different. In some of them, you walk into the narrow store and there are prepackaged bags of every spice imaginable linining the wall in little labeled cubbies.  In some, there are strictly the burlap bags and the owner will measure out, weigh, and bag the spices before your eyes.  Some stores even have burlap bags of laundry detergent, should you need to purchase some of that (thus the laundry part in Audrey’s description).  Needless to say, I bought some spices; I was not about to leave this glorious road without some.  The price kind of made me wince at first-650 rupees. But then I realized the amount was just under $11 for 100g of cumin seeds, 100g of fenugreek, 100g of garam masala, 100g of channa masala, 100g of kitchen king mix, and 100g of blueberry tea. I tried getting all of the standard spices used in every Indian dish because I knew I wouldnt be able to easily get some of those at home, and they were much cheaper here than I could purchase them in the US for anyways.  Aside from the spices, the street itself had a very “India” feel:  carts, cars, rickshaws, and people were all rushing around at a pace and density that would make New York City jealous.  Horns blared, people yelled, men hoisted sacks onto their shoulders... all in the normal coordinated chaos of India.   And I loved it.  I even got some street food on our way back to the metro station: an interesting egg wrap of tomatoes and potatoes.

     Monday brought a new week, and a new placement opportunity.   Caleb and I were able to go to the Mobile Clinic project, which is a mobile clinic ran out of an Ambulance by an organization called HelpAge India.  The ambulance goes to 10 different small villages and slums in/near Faridabad Monday-Friday, seeing 2 places each day.  Each village knows which day the clinic comes, and many of the patients are regulars who HelpAge has been providing free services for over many years.  HelpAge India exists to provide the elderly (those over 60) who are living in poverty with primary care and medications for free.  Of course I loved everything about this immediately. Normally the ambulance would only go to one village in the morning, but we went to 2 since they are so close. The 2 sites were small villages outside of the busy part of Faridabad, and took a little while to get to.  It was interesting to see the difference in the impoverished between a rural village and a city slum.  While the rural village is farther away from markets and hospitals, it seemed that the standard of living was slightly better out here: people seemed heartier, and their teeth were not as decayed.  I believe one can actually stay healthier in an outskirt village since they are not living right beside open sewage and an abundance of trash.  Food is also probably more easily grown since there is land they can tend in the village, but I did not see any gardens where we were.   It was actually a slow day, and we only saw about 20 patients before heading back to the HelpAge India home base for a lunch break.  After break, we went to a different site, which was a slum colony inside Faridabad. We saw more people at this site, and I was able to take a few blood pressures for the doctor and ask more questions about the patient and the given medications.  Summer is the season for amplified bacterial growth, so those not receiving refils for pain medication or hypertension were usually complaining of loose bowels and intestinal disease.

      The reason this entry is so late is due to the wifi being out all week.... And on top of being bored with no wifi, the heat is getting intense.  The weather is consistently in the 100s during the day, and only cools to the high 80s overnight. In the next few weeks, we will be dealing with the 110s. With no AC. Yikes! Talk about First World Problems. We made it to cafe's a few times for wifi, but with the 9.5 hour time difference it has been impossible to communicate with people instantaneously (as those of you who sent me messages then waited 24 hours for a reply, then replied back and waited another 24 hours know). 

     After Monday at the mobile clinic I did  not go to to placement since I got my poster supplies for my project! I spent a few days drawing out hand washing and tooth brushing tutorials and making reminder posters of ways to stay healthy. It was quite a task and I was pretty tired of the arts and crafts after 12 posters lol.  I also got my lesson plans all laid out, and worksheets created to be printed.  Tomorrow I will go with Dr. Prabhat to print them and also to buy the multivitamins.  SO excited!

Much love,


Friday, April 18, 2014

Week 14: Check-Ups, Slum Camp, and the Elderly Home

    Monday began as a surprise, with Dr. Prabhat telling Karen, Caleb, and I that we were going to go do check-ups at the local slum school for all of the children.  I was totally okay with this.  Karen is a doctor, so this was her first chance to actually do some work while in India. Tagore Public School set us up in a downstairs classroom, where we saw students 3 at a time. Caleb and I each did preliminary check-ups, then sent them to Karen if anything was wrong or needed a second look.  Most of the kids were basically healthy (or at least their normal level of health) but there were quite a few colds and coughs.  Many of the children were also malnourished and stunted in growth, and one girl had a heart murmur that she needs to get looked at.
     Tuesday and Wednesday were the days of this week's mini slum camp that was set up because Karen was here.  We went back to the same area as the last camp, in the shrine building. The day was slower than the first day of the previous camp, but it was very good. We were able to do thorough checkups then have time to then go see how Karen and Dr. Prabhat talked to them and made their diagnosis. Karen would give me tips of other questions I should ask the patient, and signs and symptoms of various problems they were having.

     Thursday, we didnt do anything because Dr. Prabhat got called into work for an emergency then stuck in a meeting.  But Friday, we went to an elderly home and did check-ups for all of the residents there.  Elderly homes are not very common in India since children live with their parents and take care of the parents when they are older. The one we went to was funded by donations, so the residents do not have to pay to stay there. There is a person who runs the home, a cook, and maids to do laundry and clean.  A doctor comes by every week to check on those who need it or take care of new problems.  Residents share rooms, and I believe there are 40 people total.  The facility was not what we would call nice by Western standards, but neither was it in a condition to be worried about.  We had a table set up in the common room downstairs, with the typical stations of blood pressure, blood sugar, pulse, preliminary examination, then Dr. Prabhat.  Most of the residents already saw a regular doctor, but some had new problems or needed more pain medication for various aches and pains.  We were able to see every single resident, which was great :)

     If all goes as planned, next week I will be starting my health classes at the schools. 
    Also... 3 week countdown until Thailand! 5 weeks until Dubai! 6 weeks until I am home. 

Much love,

Monday, April 14, 2014

"Be the Change You Wish to See in the World"

     I have many issues with the current state of the IVHQ Health program. I was feeling very useless, very disappointed, and very frustrated with my lack of helping and interaction with the struggling people of Faridabad.  I still plan on eventually discussing my issues with everyone involved in the Delhi program.  But rather than complaining and cutting my stay short, I decided to make my placement worth staying for. 

     And now I am just about squealing with the excitement of what is before me!

     I just submitted a proposal to IVHQ for a grant to help fund my ideal project.  In the next few weeks I will be traveling to different schools in the poverty-stricken slum areas to teach them about health.  I will be doing seminars that include lessons and demonstrations on how to properly wash hands, properly brush teeth, how bacteria spreads, and basic ways to reduce the transmission of disease.  Knowledge is power. Morgan, who volunteers at an orphanage, shared a story with me that some of the girls were playing with a dead pigeon on the ground last week.  She told them not to because you shouldn't play with dead objects-especially birds that have diseases-and they said to her "why? It's just a bird."   Sanitation is a huge issue here, and if you dont know that drinking contaminated water will make you sick, sneezing on someone will spread germs, or that you shouldnt put your fingers in your mouth after playing in the dirt, then you are going to do it an not realize it is harmful. By learning these skills and making them habits, the quality of life of those in these communities can be increased.  Ideally, if my proposal is chosen, I will be able to create health bags containing a toothbrush, toothpaste, soap, hand sanitizer, and multivitamins for all of the children in the school to pass out after my presentation. It will also help cover the cost of creating posters depicting hand-washing and tooth-brushing techniques as well as posters about covering your mouth when sneezing and coughing.  I intend on making at least one set of posters to bring with me as a visual teaching aid, but with more resources I could make enough to post around all of the schools to remain as reminders for the kids and staff. According to the website, one request is chosen at the end of each month, so I hope to hear back soon! And if I dont get it this month, I will try again next month since I will still be here.   
Regardless, I will be starting my seminars next week :)

Between the possibility of getting this grant, and the fact 4 of us did free check-ups for over 150 students in the local slum school this morning, I am pretty freaking happy right now.

Gandhi once said "be the change you wish to see in the world."  Well, world, here I am.

Much love, 

Week 13: Teaching in the Slum School

This past week was definitely a new experience for me, as I decided to take on teaching in the slum school. Rachel, a fellow volunteer, wanted to teach for a week so Sushma asked me if I would go with her so she wouldn’t be alone.  I figured why not, lets try something new.  It was equal parts rewarding and equal parts stressful.  I definitely understand now why people fall in love with teaching, and I also understand how it is a labor of love that can make you want to rip your hair out. 
The first day went fairly well once we got over “being thrown in the deep end.”  We walked into school, were shown to the class we’d be teaching, then the girl teaching it left! We asked her what we should start teaching them and she just said “as you like.” We were dumbfounded. We had no idea what level the kids were at or what they knew and didnt know. Plus 4 grades were mixed together since it was the end of a holiday and many of the students stayed home.  We decided to start simple and began teaching the different kinds of nouns (common, proper, collective, material, abstract) from a workbook we found in the room.  Then we moved to math (addition and subtraction), then went back to English and  taught them Baa Baa Black Sheep .  All of this was on  large chalkboard only; the students didnt have books to follow along with and most of them didnt even have paper and pencil to copy down what we were teaching.  
The second day we were in the same mixed class, and it went a lot better. Our biggest accomplishment was teaching them fractions! We were able to use the little english they knew and draw on the board to help them understand how parts of a whole fit together. We only did adding and subracting fractions, and didnt teach them how to reduce since there was no way to explain it or have them visually understand equivalency.  We moved on to pronouns in our English lesson, since that was the next logical step after teaching them nouns the day before. We also attempted to teach some division, but that didnt go as well for all of the students.  A few of the girls in the front got it pretty quickly, but most of the class had a rough time. 
The third day we came in feeling pretty great, but they stuck us in a different class that then crushed our hopes and dreams.  All of the children were at school that day, meaning we had a full class of 25 students who wanted nothing to do with learning from weird white girls they couldnt understand.  They knew less English than the last class, and were absolute hellions. We had to break apart multiple fights, yell quite a bit, and went to get one of the older girls to come in and make them be quiet because we just couldnt. I dont even remember what we tried teaching that day, but I do know we left early because we were just done and couldnt take it anymore.  
Thursday was a public holiday due to the elections, so no school or placement for any of us. We decided to make a trip into Delhi to walk around and see stuff since we had the day to ourselves.  We got off the metro at a stop near Pahar Ganj, which was supposed to be a busy area full of shops and restaurants. Instead, the entire street was dead. I suppose we should have figured all of the shopkeepers would be taking the day off as well.  Luckily a few restaurants were still open so we were able to get a seat and eat some food.  By the time our late lunch finished, some of the shops were opening.  But we had more to see before going home for the day, so after buying some jalebi at a corner stand we walked back to the metro. The next stop was at Chandni Chowk, a famous market I had heard much about from other volunteers. I dont know if it was the fact it was election day so the usual affairs werent going on, but it was seriously one of the sketchiest places I have walked through. We were trying to find the spice market, which was supposed to be 2km down through Chandni Chowk.  We ended up not being quite sure if we found it or not since everything was (surprise) dead.  Getting to the spot, though, took us through dark and damp sidewalks and down the road past huge groups of staring men....not a woman in sight.  We stopped a few times to get reoriented and decide which was the best direction to keep walking in, and of course as soon as we stopped the men started taking pictures of us.  The sun was getting low in the sky too, so as soon as we found where we thought the spice market should be we decided to take a tuk-tuk back to the metro rather than walking past the creepers again.  We got home with no issues, and all was normal the rest of the night. 
                Teaching on Friday went as well as it could, seeing as we refused to teach that second grade class again.  We had the 3rd and 4th grade mixed class, who were still rowdy but a lot more respectful and willling to learn.  We went over verbs, subtraction where you needed to borrow, read some English stories, then played hangman with words from the story.  The last hour of the day, we switched classes and all taught alone.  I ended up teaching a computer class to a group of incredibly well-behaved first graders.  Now keep in mind, I am teaching a computer class to children in the slums who have probably never seen a computer before. I ended up drawing a computer on the board then labeling all of the major parts and having them repeat the names (CPU, monitor, keyboard, mouse, etc). Then I erased the labels and we went through all the names again until they could spell them all out and label pieces when randomly called on.  Then I drew a huge keyboard with all of the keys in the proper order (I had a diagram to go off of), drew a smaller monitor, and had the kids each come up and “type” their name by touching the keys then writing their name on the monitor.  I think they get the general idea, though it would be great to actually be able to show them in real life. 

Much love,


Sunday, April 6, 2014

An American Perspective on Indian Life

     I've written entries about my travels and my medical placements, but very rarely have I mentioned my observances of Hinduism, healthcare practices, daily life, or the general culture here in India. So here it goes, an American 12-week perspective:

     In regards to my family, they are Hindu.  It has been difficult gaining much knowledge about how or what exactly they practice because they do not flaunt it nor do they always know how to thoroughly answer my questions about things (For example: why they cant have eggs certain days of the week. I asked and got the response "because its our god's day." When I asked "but why eggs specifically?" My host mom said "It's just our religion.")  They belong to a sect of Hinduism that are vegetarian. Although all Hindus do not eat beef, not all are vegetarian.  Meat cannot be purchased at all in my neighborhood, which is called the Sainik Colony.  My family particularly worships one god, which I have gathered to be Lord Shiva since the Sainik Colony is home to the biggest Shiv Mandir in Faridabad and it is right down the road.  Tuesdays and Thursdays are their particular god's days, and on these days the family does not eat eggs for whatever reason.  On Thursdays they always go to the temple.  The first bit of whatever is cooked at every meal is given as a gift to the gods and placed in the shrine, located in the grandfather's room.  The shrine has a picture of a god in it (probably Shiva, though I havent spent much time looking at the shrine so I am not certain), as well as a picture of Dr. Prabhat's deceased mother.  The grandfather chants every morning in front of this shrine, and an oil candle is always burning.  Since being here, there have been a few holidays.  The bigger ones that I've seen are Shivratri, Holi, and now Navaratri. There have been a few more that we got days off of volunteering for, but the family didnt do anything special on those days.  For Shivaratri, so many people came to worship at the Shiv Mandir.  The street perpendicular to the Shiv Mandir that led to the market had a small festival with a mini ferris wheel for the kids, juice stands, food stands, and a few people selling things on blankets on the ground.  Sam and I walked down to check it out, and saw the line to the temple was ridiculous so gave up our ideas of going there.   For Holi, I already wrote an entire entry: Holika bonfire the night before, then a day of happiness and color play.  For Navaratri, the family fasts for 9 days.  Fasting is different here though, because it doesnt mean no food: they are allowed to eat potatoes, certain vegetables, and milk, they just can't have chappatis or rice or other vegetables (and most likely not eggs either).  On the last day of fasting, my host mom said the family won't eat anything, but will offer food to women on the street to honor females because the god celebrated during these 9 days is female.

     In regards to healthcare, India does have a system of public and private care. From speaking with a doctor at the surgical placement hospital, I discovered that there are public hospitals where the poor people go (but anyone can go), medium-sized hospitals that the middle class normally go to, then large upscale private hospitals where the rich go to.  The "rich" hospitals have the better doctors, better medications, and better accommodations.  The surgical placement hospital (Ghai Hospital) is a middle level one and has some decent doctors and okay accommodations, though they lack the funds for everyone to wear gloves or have other materials we would call standard.  The public hospitals supposedly have doctors with questionable degrees, some questionable sanitary practices, and get cheap items provided from the government.  At Ghai Hospital, there are 40 beds and no specialty wards; some patients do get their own rooms, but there are also rooms with 6 beds.  The doctor was telling us how it is especially dangerous treating tuberculosis patients since they dont wear masks or have any way of quarantining the patient. I would not call the surgical procedures at Ghai Hospital completely sterile, but I do give them credit for keeping things aseptic and trying to be conscious of those practices. The surgeons do scrub in using proper technique, and their scrubs are put on warm after having been sterilized by pressure in large silver cylinders.  Gloves are worn by all involved in the surgery.  The equipment used is sterilized in a solution of Cidex.  The operating rooms get fumigated every 2 weeks.  However, cell phones get answered all the time, the doctors and surgeons drink chai in the OR following the surgery, and its no big deal for people to come in and out. You must remove your boots and put flip flops on in order to enter the OR, and if you are not the surgeon or his immediate assistant then you dont need your hair pulled back, to wear a mask, or wear scrubs.  I have been in one government hospital, working in a lab with a lovely bubbly woman who lets us actually do the tests and draw the blood when needed.  Though she thankfully wore gloves, the methods of testing were ancient, creative, and sometimes questionable.  Basic pregnancy tests were given, and the women had to pee in the little pouches that the tests came in since there werent any sterile containers ( I thought that was pretty creative, working with what you have).  The blood-typing test was the same one I did in lab at school: 3 drops on a micro slide then drop Anti-A, Anti-B, and Anti-D and look for coagulation.  The lancets were all sterile and came from an individual package, which was good. The hemoglobin test especially worried me, though: she used an old method where you drop in 4ml of a HCl solution, add in .02ml of blood, then drop in distilled water until the blood solution matches the color of a tinted tube next to it. The test being old part was fine. The scary part was that she used the same glass pipette to drop in the HCl, blood, and distilled water...quickly rinsing it in the same little cup of distilled water in between solutions. She also used the same pipette for the HIV tests.  This was conflicting for me: is the risk of cross contamination here more dangerous than the help they could provide from the results of this test? The people getting these tests wont get them done unless they are free, but the free facilities dont have the materials to do the test any other way. Its a tough situation.  I personally wouldnt let her do that test. But if I was living in the conditions of many of these people, and this was the ONLY way I could get it done, then would I? Would I even know that there was a risk, or would I assume the water cleaned it sufficiently due to my lack of education?

     Daily life in India is going to be a few paragraphs of miscellaneous things I remember to tell.  The most familiar part I have participated in is transportation. Modes of transportation include walking (yo legs), rickshaws (a small seat-cart pulled by a man on a bicycle), auto rickshaws (the famous tuk-tuks I talk about), bus (crowded, smelly), metro (train through the city with stops every few minutes. mostly aboveground), taxi (usually a van), and train (various classes, for long trips).  A typical trip into Delhi from Faridabad would involve walking to the gate of the colony, catching 2 different tuk-tuks to get to the nearest metro stop, then taking the metro where we need to go and mostly likely having to switch metro lines at least once. A typical long weekend trip would involve all those steps except either getting off the metro near a bus stand or a train station, then getting on the bus or train.  I have not taken a city bus around Faridabad, as I am too nervous to do so. The roads in general are pretty terrible. If taking a tuk-tuk, expect to gain a few bruises and end up with crazy hair. Even the few paved roads are rough and in need of repair, which makes even a car ride quite the jostling experience. And the traffic....oh boy. Road rules are mainly suggestions, the honking never stops, and it seems to always be the other car's fault-even if you're the one in the wrong lane about to hit oncoming traffic. I am both terrified and impressed whenever riding through it because there seems to be almost choreographed chaos amidst the cutting people off, overtaking at any point, and constant near-misses of pedestrians and cars alike.
     There is not much to do for me to keep busy after placement, but my host mom (Sushma) is always busy.  Most women are housewives, though some hold jobs (like Subhi, the lab tech) and some opt to go to school and have a career rather than getting married (like the girls that live on the top floor bedrooms at the IVHQ orientation house).  My family's daily routine consists of the family getting up when the boys have to get ready for school, the boys go to school, Sushma makes breakfast, Dr. Prabhat and his Dad go to work, we manage to roll out of bed and eat breakfast, we go to placement, we get home, lunch gets finished by Sushma, we eat, Dr. Prabhat and his father and the boys get home and eat, Dr. Prabhat and his father leave, Sushma and the boys nap while we amuse ourselves, late afternoon chai, Sushma makes dinner, Dr. Prabhat and his father get home, we all eat dinner, the grandfather watches TV at volume levels causing ear damage, we amuse ourselves some more, the boys might study, then bed time. When a woman gets married, she moves into her husband's house, so that is why the grandfather also lives here. The grandmother did as well, but she passed away years ago.  Some families have large houses where they all live together as multiple nuclear families, but I think its just this small immediate family here since they need room to host volunteers.
     This now brings me to FOOD.  Everyone keeps asking me about how great the food is, or if the food is even more amazing than what you eat at Indian restaurants at home, or if real chai is just as awesome as they imagined it. If you're one of those, please sit down for this.  Food at Indian restaurants is pretty much the same.  The flavors are more authentic of course, but the dishes are the same.  The biggest shock to you, though, will be to know that Indians do not make restaurant food at home. Yup, that's right. Naan, a lot of rich paneer dishes, anything tandoori,'s only something special you order when out.  Food in the home is very simple, though it is spicy as you might expect.  Breakfast is always different for us (toast, paranthas, potato sandwiches, noodles). Lunch and dinner are interchangeable: one will consist of daal (lentil soup) and rice or chappati, and one will consist of mixed veggies with rice or chappati.  Sometimes Sushma will switch it up and make stuffed bell peppers, fry the chappati, or do something different like that. Dessert is not common, but we have been given rice pudding or sweets from a sweet shop a few times.  Sweets are very different here, and contain spices like cardamom or cloves. They are either very pasty, or soaked in a syrup. Cake isnt common, but we have discovered a few Western style bakeries that do cakes and recognizable confections.  Chai is also different: American Starbucks has played up the heavy spices when in all actuality the spice is pretty subtle.  Sushma makes hers using milk, normal black tea leaves, and ginger; that's it.  But it IS still delicious.
     I also feel the need to say something about the clothing. On men, the most common thing to see are pants and a nice long-sleeve shirt.  Very rarely do the men dress traditionally.  Women, however, all almost always in traditional dress: a sari or a punjabi suit.  Some will wear jeans and a shirt, or leggings and a tunic, but it is still mostly traditional.

     As far as general culture goes, I am going to focus this on noticeable progress as well as continued concerns.  Of course I have a pretty narrow view, having not spoken to many people to ask them personal questions, but this is just based on my observations.  To an outsider like me, women seem to be improving their station in life from how things used to be.  India has a long way to go, and this is by no means good enough, but it is a step in the right direction.  On the metro, there is a women only carriage so that they can feel safe when traveling alone; there are also a few seats in every other carriage marked for ladies, which men will sometimes get up to let them sit in.  Dowries still happen even though they are illegal, but ads now exist shaming men into being good enough to support his wife on his own and encouraging him to say no to a dowry.  The caste system is still in place in people's minds, but it is more common for parents to be won over and allow inter-caste marriages for love.  Because of past issues with aborting females, it is now illegal to reveal the sex of a fetus before it is born.  Women can gain a stronger voice in some families: in the case of my orientation host mom, she now just takes the car and goes somewhere rather than having to ask her in-laws and her husband for permission.  I have seen a few girls driving scooters or cars around alone.   I could sit here and be infuriated at the still-present injustices, but even slow progress is something, and all we can do is hope the momentum continues as more independence and confidence is gained among the female population.  
     As for continued concerns, I am beyond infuriated in regards to the treatment of the LGBTQ population.  It is not only taboo to admit you are homosexual, but also dangerous since it is a criminal act to engage in gay sex.  But I have never been more enraged than one specific situation at the small slum clinic: a man dressed as a women came into the clinic. Words were exchanged, then a man (our driver, who speaks some English and is friends with the doctor) angrily drove him out. He turned to me and said "That man is crazy."  I asked him "Does he actually have a disability, or is that just his life choice?" to which he looked at me very confused and said "He's just crazy."  It is absolutely baffling to most Indians that sexual desires can be towards the opposite sex, that gender is different from sex, or that some people simply feel better when cross-dressing.

     I've just hit some highlights here, and I'm afraid I may bore my few readers by continuing.  But feel free to message me asking for my reflections or observations on anything else :)

Much love,