My "Indian Mom"

Honestly, I cannot believe day I have had. Sometimes, (mostly while I’m sitting in an auto rickshaw driving through the slums) I just take a look around and still can’t believe I’m here in India. I’ve been so blessed and am so grateful that I have the privilege to be doing this fellowship.

Today I went to the Delhi Cantonment General Hospital to do some work with a woman named Rajrani. She really is a beautiful woman- her entire life has been such a struggle, yet she still has the most beautiful smile I’ve ever seen. I sat with her in her office from 11am until 4pm just chatting with her about work, shopping, family, politics- everything (in Hindi!). It felt a little bit like I had finally found an “Indian Mom” thousands of miles from home. She told me in advance, Tuesdays aren’t busy- but I came anyways because, well, I didn’t think I could handle a “busy day.” But towards the end of the day, things started getting a bit rowdy. A woman who had been receiving medical care at the hospital for the past few weeks was coming in for her HIV test. Basically all the doctors had seen it coming- but the test was being done as a formality to prove her HIV+ status. I watched the woman cry as she walked into the clinic, I saw the pain in her face when the doctors told her she had HIV, and I felt the sharpest heartache as I saw her nodding her head as the doctors told her the course of action they would take. She was thin, weak, and barely alive it looked like. Her face had so many terrible marks, and while she said her age was 30- she looked almost twenty years older than that.

Never in my life would I have though that I would be able to experience what I’ve seen here in Delhi. I’ve worked with young girls in the slums- teaching them how to stitch, I’ve taught kids with tattered clothes about geography and dinosaurs, I’ve sat in beautiful houses talking to Indian Doctors about HIV health policy, and I’ve gotten to see the actual impact that policy has on women in India.

With the two remaining weeks I have left here, I plan to use as much time as I can to build my research and find out more about health policy changes by the Indian Government. Maybe health policy is exactly where all the answers to my questions are. We’ll find out soon enough!

P.S. Here is a photo from the BEAUTIFUL Taj Mahal. I got lucky because it was completely empty- which only happened because it was pouring so hard! 

[Marisa] Week 4

The last week has been fantastic, excellent, incredible, and a whole list of positive adjectives! I finished up my work with the Banyan in order to be able to  the psychiatrist who works in Delhi (who I mentioned in my last post) whom I met at the Banyan's round table discussion the previous weekend. I have plans to see him and visit his hospital the upcoming week. I have left Chennai and have been in Delhi for a few days with fellow CSAS fellows, Tessa and Brad!

My last day at the Banyan consisted of one of the most worthwhile experiences that I presume I will have in India. I was given the opportunity to travel with one of the Banyan workers to observe the home visit of a man with a mental illness, who has been coming to the outpatient clinics of the Banyan for some time. At the very least, this one and a half hour experience opened my eyes as I first-handedly observed how the same mental illnesses that are easily controlled in Western populations, spiral out of hand in the homeless population of Chennai due to an immense lack of resources. The entire session I became increasingly frustrated, knowing that though ways to control the illness exist in our world, it is next to completely inaccessible for these clients in Chennai. Though I have now left work at the Banyan, ending with the home visit has really inspired me to want to return to India in the future and help out in any way I can in treating mental illness. The Banyan is an amazing organization and they deserve endless credit for the positive attitude and environment that they have created around mental illness. The Banyan really is one of a kind and after a deeper look into their organization, I truly believe their approach to mental health is healthy and deserves to be examined and implicated on a universal scale.

I have now traveled to Delhi in order to visit the hospital of the doctor I previously mentioned. His hospital is called the Institute of Allied and Behavioural Sciences and I have plans to visit this upcoming Wednesday. Since I arrived in Delhi this past weekend, I have spent a bit of time with Tessa and Brad, who are conducting their research projects in Delhi. Yesterday, we made the trip to Agra to see the beautiful Taj Mahal. Below is a picture of the three of us, as well as the classic “holding up the Taj Mahal” picture, going along with Eric’s picture!

[Brad] Week 4

Although I have learned that many things as we know them in the United States are merely relative conceptions in India, paying attention to time has been really surprising.  Firstly, research takes a lot of it.  Building rapport in a large organizational community is difficult.  Getting to know others and forming trust takes time and exposure.  I realized that it took almost three weeks before the allopathic medicine dispenser let me help dispensing medicines.  I don’t believe this was an example of distrust, but rather, I think that the clinic has very high standards of professionalism for its staff and volunteers, and after having problems trusting other volunteers (being listed in the Lonely Planet guidebook means that a lot of people ask for letters of invitation to apply for visas and then flake out), I think it took some time for everyone to feel comfortable with me helping.  Also, most of the time I get refusals when I offer to help because I am a guess.  I’ve never met people as generous as I have found here.  Setting up interviews is a painstakingly long process, as there is only a narrow window of opportunity during which a researcher can speak one-on-one with staff at the clinic. 

Many locals have a different perspective on time than I am accustomed to in the US.  Everyone at the NGO attended a play about children’s rights at a nearby school from 3-5 PM.  I, along with other volunteers, went at 3 PM, where we sat with the school kids for 45 minutes before the play started.  The play then ended before 4:45 PM.  I guess time is all relative in the basti. 

Setting up interviews is a multi-day affair, as the time you designate is often interrupted by unexpected appointments and quests, pushing data collection back constantly.  I can say that I have learned a lot of patience, and if that’s the only way in which I grow from this experience, that would be enough.

Before the Bronchitis

Apologies that this is my first actual update from India. Thing is, everything was great once I got here, until about 7 days in- when I got bronchitis. Being sick in a foreign country really puts a lot into perspective for you. It makes you vulnerable, tires you out more than usual, and quite frankly- makes you a little depressed.

Upon landing in India, I was warmly welcomed by my roommate and two drivers who took us to our apartment in a black air conditioned SUV. For a minute it felt like I was still in a dream; that I’d wake up in the US. It didn’t actually settle in until a few days later, when my roommates- Andrew and Ashley, along with Brad, and Tessa decided that my first day out would be spent in Chandni Chowk. For those of you who don’t know what Chandni Chowk is, it is one of the most congested and rowdy marketplaces in India. Upon arriving there- about 7 men started pointing out their saari’s to me, doing everything but grabbing me and pulling me into their shoppes. If that wasn’t overwhelming I don’t know what is.

Apart from that, my NGO has been simply amazing to me, they offer so many services that it’s hard to say what I’m even working on here. Maitri provides many underprivileged populations in India with education, healthcare, and food- and has several ashrams around the country. They have travel clinics, counseling services, HIV testing sites, a learning institute for kids in the slums, stitching classes for young girls in the slums, they provide food to widowed women and Vrindavan, and on top of all this, they support women who have gone through domestic violence by individually meeting with them and finding them housing solutions. Upon arriving at work, I had been told it would be a whirlwind (and trust me, it was). Maitri, had just been featured on Aamir Khans: Satyamev Jayate (the Indian version of Oprah) and was receiving public attention from all parts of India. Winnie Ma’am, our Executive Director had kindly invited us over to her home to watch the airing of the show, however, phones were ringing off the hook with generous people hoping to donate, and employees were literally running from room to room trying to ensure the paypal account was properly set up and that donations were correctly coming through. Things are slowly dying down, however marketing from the Aamir Khan show is proving to be one of Maitri’s biggest assets right now. And working there has been a pleasure so far- that is, until I got bronchitis :P

[Marisa] Week 3

The past week with my NGO consisted of two consecutive days of 13 hours of volunteering, a music lesson from two doctors, and a round table discussion with India’s top mental health leaders. Needless to say, this past week of work was one of my favorites.

In the beginning of the week, I met a general practitioner who allowed me to assist her. I immediately became interested in her work as she explained to me that she performed physical examinations on clients with mental illness with physical and bodily complaints. She explained to me that there is a strong relationship between physical aches, anemia, and thyroid problems and mental illness. Sometimes the mental problem causes illusions of physical problems and sometimes physical problems appear before the mental problem. This doctor’s role with the Banyan is to diagnose the difference and decide whether a patient’s physical complaint is in need of medical fix. I plan to work with the doctor again tomorrow and am looking forward to it!

In the Thursday clinic, I was assisting another doctor, Dr. Anbu. In a specific session, I was taking notes when I looked up from my notebook to find everyone in the room staring at me, both doctors and clients. I turned to Dr. Anbu and he explained to be that while he was discussing with the client, he observed the client intensely staring at me. It turned out that the client was confused by my presence and asked the doctor if I was from abroad! Clearly my attempts at dressing in more Indian-styled clothing have not exactly proved successful.

After 13 hour clinic on Thursday with Dr. Anbu, I was getting up to go home when Dr. Anbu turned to me and told me that we were not done for the day. I was confused as all the clients had been helped. He then explained that all of the doctors and social workers learn and sing bhanjans (devotional prayer hymns to Gods and Goddesses) after all the clients leave. I was shocked that these doctors were not rushing to get home and instead were celebrating their culture and enjoying one another’s company! So I sat there for another half hour and learned a hindi bhajan!

This past Friday and Saturday, the Banyan held a round table discussion with famous psychologists, psychiatrists, political activists, and government health officials from all around the country to discuss the issue of long term care for individuals with mental illness, as well as the current status of mental health laws in India. Luckily, I was given the opportunity to sit in this room of the top 40 mental health doctors and officials in India and observe. I even met a psychiatrist who directs an established mental health hospital in New Delhi and talked with him about the possibility of visiting his hospital for a day to see how it works. I am hoping to visit next week! 

Namastey!

From a Wedding in Slovenia to Working in India

I've had a lot of personal experiences since my last blog post and a lot of learning. I traveled to Slovenia for my sister's wedding and have been back busier then ever in India- this trip is the main reason I've been out of contact via blog. Although it might seem completely unrelated, seeing my sister's wedding has made me think a lot about relationships, connections and what drives each of us. Explaining what I've been doing has given me new context and renewed my passion for changing the world through tackling problems at the base of the pyramid. One very important thing to remember is that whatever you do you can't do it alone. In life, as with my sister, it is important to have a partner to travel it with you and it is important to pick the right person. In many ways a business is also like a marriage with the people you work with. You need to pick the right people. Who your team is extremely important, because they can make or break your success. This is even more important when working for the base of the pyramid(BOP), because this a sector that is still being figured out and has, in many ways, a lot more risks than

Because of all of this thoughts of connections recently, my most recent project has been trying to see how other people think and trying to bring people together to share ideas. Before I left I tried to host a small workshop on launching a business with a friend of mine who works for a solar-powered BOP company. It had limited success with only 5 other people showing up, but though that was a failure in a sense we have learned from it and forged a couple of great connections. We are trying another small, focused event tomorrow and I am already certain it will be successful. It is called Make it Happen: Launching a Social Venture (https://www.facebook.com/events/369241823143688/) We are expecting 15-20 people, which is just what we are aiming for- not too big because we want some great discussions not a presentation, but not too small because we want to have a mix of opinions and enough people to direct. I'm partly trying to turn this into a more effective way to pick more peoples brains for ideas that I will use in my paper on the BOP.

I've also been trying to attend a few workshops, the most recent focused on marketing. One of the key points I learned there was the importance of experimentation and monitoring. Again, in BOP, it seems like everything is driven by money -saving money, paying less money, making sure things aren't too expensive for you customer. It is a very underlying theme, but it can also drive innovation. These days most marketing is done through online marketing and is much more interactive. For small companies you can't do blanket marketing, meaning do a little bit of everything- you have to make sure you money counts. One effective way to do this is via the internet. Facebook and twitter have become two of the most successful marketing platforms and are a great way to interact with your customer- if they have internet. This may not be the case directly for BOP, but it is important for donors, as many companies that are BOP are non-profit or are at some point funded by donations/investors even in the for-profit side. The second big way to reach people that Embrace uses as well is word of mouth. This may be hard to measure, but word of mouth and personal testimony is one of the most powerful forms of marketing.

I've continued volunteering and working within the team at Embrace, and I think this has been my most valuable experience. Through working within Embrace, I hear their complaints, their trials, what worries them, what is not so worrying. Going back to relationships and people, one thing I hear constantly is the importance of good management and company culture. Another aspect of people that is important is  understanding your customer and designing for them. You have to design for what you see they need, not always what they say the need for something to be successful. More on this in lessons from Embrace in later blogs and in my report- I could talk for pages, and will make it the main focus of my next blog post. Also over the next week I will work on integrating more pics into all of my blog posts!

On a quick, less serious note, a few interesting wording quirks of India that I enjoy and have been compiling with a few friends

1) "Do the needful" which means "Do what you have to do"
2) "Please revert" which means "Tell me what happened" and is usually used with the above as in, "Do the needful and please revert."
3) Prepone - to move a meeting earlier in the day than previously schedule. Antonym: Postpone.
4) "Wallah" aka that guy that does that thing.  you can pretty much use it for anything - that fruit wallah (fruit stand person), rickshaw wallah (rickshaw driver)...
5) "Parcel" - refers to what we call "take-out" or just taking food away from a particular place.
6) "Mango Milk Shake?".  A common term used in greeting someone, to which the reply is "Yes, please".  A related greeting is "did you eat the last of the Parle G's?", to which the reply is "I have no idea what you're talking about", accompanied by brushing movements to remove crumbs from your shirt.

Every day here is a new learning experience. Thanks to the Center for South Asian Studies and our donor for making all this possible!

[Marisa] Weeks 1 and 2

I’ve finally arrived in India! My housing troubled me a bit in my first few days as the apartment I intended on staying in for the duration of my stay in India proved to be unsafe. I have since moved to a new apartment, however I lack air conditioning and Internet in this apartment. More than the air conditioning, I am finding it extremely difficult adjusting to life without readily available Internet. I am unquestionably learning the value of many things here that are taken for granted in other parts of the world.

My first week of work consisted of meeting nearly thirty mentally ill homeless women in the shelter at Adalaikam. Unfortunate for me, none of the women understand English and only speak Tamil. One of the women kept following me around the shelter and speaking Tamil to me. With the language barrier, all I could do was smile and nod to her. Only after an hour or so, my boss translated the women’s Tamil to me and told me she was saying I remind her of an actress. This made me laugh and wish even more that I could converse with the women.

Another time when the language barrier worked against me at work was during my visit to the outpatient clinic on Thursday, when I observed the psychiatrist’s appointments for the day. I was given the opportunity of copying medicine prescriptions into each patient’s notebook and handing it over to a woman who assembled the medications for each patient. Though this was my favorite experience with my NGO so far, every patient spoke in Tamil to the doctor so I didn’t understand what the problem was. Luckily, the doctor spoke perfect English and explained everything back to me.

What surprised me most about the outpatient clinic was the system in place. First, each patient describes the problem to a social worker and only if the social worker deems it appropriate, the patient waits to see the psychiatrist. After talking with the psychiatrist, the patient must hand over a personal notebook, which serves as a dated record of the past medications prescribed to them. This is the notebook I copied the medications into and handed to the woman packaging the medications. To my surprise, each patient had a notebook when the doctor requested it! The team I am working with at my NGO visits this outpatient center every Thursday and I am really looking forward to going back in a few days.

Yesterday, I rode a motorcycle for the first time ever! However, I rode it in Indian traffic, which proved to be one of the scariest experiences of my life. The autos, buses, and three-wheelers were inches away from me! Needless to say, I was praying praise to God when I made it home safely.

Until next time!

[Brad] Week 3

This week, I had the chance to accompany Hope's Mobile Medical Unit, a "clinic-on-wheels" that serves Delhi's poor.  The van is tiny by American standards and jammed full of medicine and supplies.  The MMU is staffed by a driver who also dispenses medicine, a doctor, and the MMU coordinator who helps assist with patients and logistics.  I was allowed to squeeze in and document the experience, and was amazed at what I saw.

The doctor sees and diagnoses patients from the passenger seat of the van, and if medicine is required, it is dispensed from the side at a nominal cost (~15 rupees per day, ~55 rupees/US dollar).  In the two hours the van stopped, 20 patients were treated.  This was a smaller turnout than was expected, but the coordinator informed me that the day's rain limited the amount of patients who could come out.

As you can imagine, the MMU is a wonderful service that helps many people throughout Delhi, but perhaps most interesting to me was thinking about the excellent example of India's diversity found right inside the car (not even mentioning the diversity of the communities served!).  The driver is a Catholic, the doctor a Muslim, and the coordinator a Christian.  In fact, at one point I was confused to not see the doctor in the car and was informed that it was time for him to take part in one of the day's prayers.  I am simply amazed that so many faiths and backgrounds can coexist so well in the country, especially remembering that as many as 1600 languages are spoken here everyday.  Considering this, it's amazing to think that a Catholic, Christian, and Muslim were able to treat a Hindu temple caretaker.  Only in India, I suppose.

Namaste!

[Tessa] Week 3

On Being White: 

The color of my skin is not doing me any favors here. I draw attention everywhere I go, no matter how hard I try to sport the kurtas and bangles. I have been made well aware that I am a ‘gora’, which means white, or a ‘feringhee’. Miranda Kennedy, in her book Sideways on a Scooter, says that the term “Feringhee stems back to the time of the crusades, when Indian Muslims used the word to refer to Christians: the base of the word is Frank, once used for people of European descent.”

It’s been an eye-opening and interesting experience being a part of the minority. When I am on the metro and there are no other women in the car with me, I quickly feel far more self-aware than I ever have before. 

It is also interesting how early on in life we, as humans, perceive difference. The children in the pre-school, as young as two or three years old, holler when I come in on most days. Yesterday, I walked in and a child started crying. I was speaking with the director for a little while, and noticed that he had stopped crying when I stepped out. As soon as I re-entered, he started crying again. “Why?” I asked. Rajwanti pointed to my face. “Gora.” They had to hide me for the sake of the ears of the whole building. My Mediterranean skin tone is just not cutting it.

That being said, Tanfastic will not be making any money off of me. In India, women and men alike spend money on lotions and creams to make their skin whiter. I guess the grass is always greener on the other side. And for now, I have bigger fish to fry: a research project that is well under way, six more museums to see in Delhi, and a whole lot of butter chicken to eat.

As Salaam Alaykum from Nizamuddin,

Tessa 

[Tessa] Week 2

“Every Indian is a Businessman,” my friend said as we ate chicken tikka masala and paneer butter masala before I left Ann Arbor.

I chuckled at the overstatement.

“No, really” she insisted, “they have to be.”

           

Until Thursday, I shrugged off her words. Now, I think there might be an ounce of truth in them.

Thursday morning was a holiday so Brad and I decided to take advantage of the 48 hours off and go to Jaipur, the capital of Rajasthan, located only 4.5 hours southwest of us. However, everyone could smell our naiveté because one minute we were at the train station, the second minute we were leaving Connaught Place (15 min north) in a car with a private driver and about $150 poorer. The next 24 hours were not our cup of chai: we were sucked into visiting textile markets, and started to feel uncomfortable. To make matters worse, the hotel’s power kept going on and off. We told our driver that we wanted to be driven home Friday night rather than Saturday morning, so we are back home in Delhi.

It is funny how quickly things start to become familiar. Just two weeks ago I was unsure in the basti Nizamuddin (neighborhood in which I am living) and never knew which way to turn. Now I enjoy speaking with the man in my favorite shop and playing with the street children in the morning.

The job in the health clinic is proving to be even more satisfying. I worked in the allopathic dispensary on Tuesday and in the homeopathic dispensary today. The patients that I am seeing are so unique to their environment, and the doctors just as much so. My research is just starting to make headway and I am glad this is true.

Delhi is now in ‘pre-monsoon’. Yip yip hooray!

Cheers,

Tessa  

[Brad] Week 2

This week has been hectic!  I've had to change my research project and city, I am now in Delhi working with the Hope Project, the same NGO as Tessa.  I will be interviewing and observing doctors and clinic staff to understand how healthcare is provided in the clinic and throughout Delhi with Hope's Mobile Medical Unit.  The clinic serves Basti (neighborhood) Nizamuddin's community while the Mobile Medical Unit is a van that delivers medicine to the homeless across Delhi.

As I move around and get acclimatized to Indian life and culture, the one thing I notice is that security is a really big deal everywhere.  I've been told many times that the 2008 Mumbai bombings have meant beefed up security everywhere.  This includes stores. restaurants, shopping malls, museums, and the Delhi Metro.  The Metro's security is particularly intense, requiring passing through a metal detector, wand-ed (and sometimes patted down), and then sending your bag through a scanner, which sometimes leads to a personal search with guards.  I've been pulled aside a few times, possibly because of interference from my mobile phone or camera.  Another fun fact: "gents" and "ladies" have separate lines.  Overall, the security seems more invasive than I encountered at all the airports I've been in.

Speaking of security, I snapped this photo as a fight broke out outside of the India Gate.  You can see police trying to bring order to the situation.  However, it seems to me that restraining criminals is more of a priority in the US than in India, as the police were hitting the fighters rather than pulling them apart and preventing them from continuing.  

On a separate note, Delhi's monsoon is late this year, meaning it is very hot (well over 100 F!).  The doctors at Hope's clinic suggest drinking 6-8 liters of water everyday because you sweat all the time.  I became really sick from dehydration!  Fortunately I'm back on my feet again.  I guess it's all part of the experience!

Namaste!

[Eric R] Final Post from India

I apologize for not posting in the last couple weeks! My computer’s hard drive ended up failing, and getting your computer fixed is no simple matter in India. Fortunately I was in Delhi, where I found an IBM Corporate Office and Service Center! After receiving my computer back, I needed to finish and submit my medical school application (!), which I accomplished on Tuesday, June 26^th!

Since last posting, I settled into a fairly backpacker-centric neighborhood, filled with a number of fantastic little restaurants and a large bazaar. I enjoyed walking around in the cooler evenings to browse the wares being touted. Delhi was HOT! I understand why most people stay inside during the days, and was happy to join them!

My primary focus in Delhi was AIIMS, a very large government-run hospital with multiple campuses. Finding my way around was very much like being on the University of Michigan Medical Campus for the first time! The Delhi Metro, which is pristine and very well-developed, has a stop at AIIMS, so I thought it would be a simple matter of heading into the “main entrance,” visiting the “registration desk,” and asking for my contact person there. Turns out AIIMS doesn’t have a main entrance or a central registration desk, and nobody seems to know anybody else.

My trip to AIIMS was the first (true) government-run hospital; my visit to Tata Memorial Hospital in Mumbai was also to a government facility, but they have special historical status and fall under the Department of Atomic Energy. The stark contrast of AIIMS to every other hospital I’ve been to was astounding. Patients lined the halls, crowded each ward, and overwhelmed the doctors’ and nurses’ capabilities. I’ve come to admire the dedication required of healthcare workers in India, through the simple fact that their jobs seem twice as busy as any US doctor’s.

My stay in Delhi took a turn for the tourist towards its conclusion. I took a two-day trip to Amritsar to see the Golden Temple, the Jallianwala Bagh Memorial, and the Wagah boarder ceremony. This was followed by a day-trip to Agra to see the Fort and the Taj Mahal, of course! It truly is as remarkable as it seems. A trip to India without my picture “holding” the Taj would have been shameful, and I’m proud to include it for you all to see as evidence of my pilgrimage across the world.

I have less than 24 hours left in India. I feel good about the number of things I was able to accomplish during my short time here: riding the trains (local and long-distance, 2AC and 2^nd sitting), riding buses (local and long-distance), having a Delhi Metro Smart Card, visiting monuments, seeing three other CSAS fellows, attending two Indian weddings, conducting around 15 interviews with doctors and administrators, wandering neighborhoods, talking with locals, eating street-food, getting overcharged, bargaining to get a local’s price, getting sick, staying healthy, witnessing a street-fight (crowds, police, and all), visiting newfound friends’ homes for chai and food; the list goes on and on and on. I can hardly believe that my two months has gone by, but soon I will be boarding a plane bound for Detroit, where my grandmother will pick me up to return to my 2-bedroom-2-bath townhouse, with clean running water and fully functioning AC. I will never again take these small privileges for granted. I will hold close the memories of my experiences abroad, and can’t thank enough those responsible (especially the anonymous donor!) for enabling my travels. I look forward to writing up my paper for CSAS and presenting my findings in the fall!

Best of luck to the rest of the fellows, and please don’t hesitate to contact me if you have any problems, concerns, or questions!

-ericr