Sunday, January 30, 2011

Our first Village Visit

So, you’re probably wondering when we’re going to start doing some learning around here. Fear not, the reason I’m so behind on the blog already is because our days are full (as is my brain!). As the week has progressed, I’ve gained a better understanding of the Jamkhed story and history so I’ll give you the two-cent version in instalments over the next few blogs.

Dr. Raj and Mabel Arole met at an Indian medical school and wanted to do something to change the dire health outcomes in rural India. Knowing a western stamp would help them gain acceptance from funders, they travelled to the US and studied public health at Hopkins (among other things) before returning to India and eventually settling on the current site for their visionary project, that of improving the health of the locals in rural India, receiving a land grant and funding from various NGO’s, many of them Christian, in line with their Christian faith. Btu they do not proselytise and they serve people of all faiths, rather their Christianity informs their strong values and sense of justice.

Originally they tried to get nurses to come to this remote area of Maharashtra. The nurses were afraid they would never find husbands if they came here, so the Arole’s even arranged marriages for them. But when the nurses started families, they didn’t want to stay to raise their children so they soon realised this model was unsustainable. Dr. Raj , when in a village and seeing how a woman was responsible for caring for the family and for handling the delivery of babies, realised that someone without a medical degree could meet many of the basic health needs of the village. This brainstorm led to the idea of engaging Village Health Workers; that is, local women from each village who would be trained by the Aroles to provide basic medical care. The idea for the project was born and over the next few blogs, you’ll learn, as I have, how this simple idea has changed over 200 communities and in addition to dealing with health issues, has addressed such issues as gender discrimination and caste-ism as well as economic sustainability.

For our part, we spent Tuesday morning on our first village visit, which meant that we drove about 30 minutes to a village and once there, divided into small groups, each with a translator, and had a walk around, with a chance to chat with the locals about their lives. We got to witness firsthand their infrastructure, including the large wells they had and a collection of toilets in the centre of town, just waiting to be installed somewhere. We saw the kinder, which provides protein formula for children up to age 6 and the school, which also has a lunch program. We saw the variety of houses in the village, from rudimentary huts a man told us he sleeps with his family and his 5 goats all in one room, to larger 2 and 3 room cement blocks with satellite dishes on top. We saw lots of healthy babies, smiling, shy girls and boys angling to have their picture taken.

We learned at the end of our visit that this is a village that is part of the CRHP, with a Village Health Worker. There is no TB and virtually no leprosy in the village and all of the children are well nourished. This doesn’t mean there is no poverty and we saw ourselves that there is still a discrepancy between the haves and have-nots in the village. We also saw women working very hard, cleaning, scrubbing, fetching water, carrying things on their head, while a large portion of the men were drinking tea in the town square.

It wasn’t perfect by any stretch of the imagination. The toilet blocks were a good example, as Dr. Arole told us one of his greatest failures is teaching people to use toilets, even if they have access to them, because defecating in the street is simply the cultural norm, and obviously, poses a great sanitation and hygiene risk. But the children are in school and the babies are fed and the Village Health worker told us no babies had died in her village in 6 years. That is a start.

I’ll leave you with a few photos of the village so you can see the happy children yourself!

These girls greeted us shortly after we arrived, when we were in a poorer section of the village. Then, their teacher came out to scold them for missing class!

This is the man who told us about his goats and explained he was worried about theft and predaotrs and thus, the livestock slept in the family home.

We saw this woman carrying these sun-dried Chilis. Before we could photograph her, she had to fix her dot, which demonstrates that she is married and her husband is alive.

These boys were all hanging out in the kinder-though some of them look a bit old for it. The teachers were proud to show us the protein/ grains that are part of a government scheme but promoted by the Village Health worker.

This was the youngest boy at the kinder and he kept getting pushed out of the way as the other kids jostled to have their photo taken. He was in tears before we left for the day- I think the excitement was a bit too much for him.

Friday, January 28, 2011

An Indian WEDDING!

So now that you have a vague idea of where I’m sleeping, I can tell you a little bit about our first days at Jamkhed. I know it seems like I’m posting a lot, but a lot is happening, so please, try to keep up. It’s only a three-week course and if you fall behind, you might not catch up. I won’t have a chance for private tutorials. The good news is that in a few more days, I’ll have to start studying and working on my group project and my short paper that is due before we leave so I’ll have to stop sharing so much with all of you. Can’t promise things will get any less exciting though.

On Monday, we had a tour of the compound, including the new hospital, which is about 2 years old. Most of my fellow students are staying in the old wards of the old hospital. We saw the surgical ward, children’s ward and labour and delivery unit. I haven’t spent that much time in Western hospitals but could tell that this was more rudimentary. However, it is comparable to something you’d find in Mumbai or Pune and considering how remote we are, that’s pretty impressive. It’s a 50-bed hospital with only 7 full time nurses because the philosophy is to train family members to care for patients in order to be able to send them home as quickly as possible. This is both for budgetary reasons and in line with Indian cultural norms. Every Thursday, an Ophthalmologist comes and offers free eye screenings and twice a month on weekends, they perform up to 200 free eye surgeries for cataracts, glaucoma and such for the surrounding villages. We’re allowed to witness the surgeries this weekend but I think I’ll pass…years of watching Hedy put in her contacts has convinced me that I am not up for watching a scalpel pass through a cornea!

In the afternoon, we went into Jamkhed town, about a 15-minute walk- or 5-minute drive- away. We went to check out town but also to buy some traditional outfits so we could go to villages dressed appropriately. There are 22 people on my program, 21 of whom are women. This is a shop that sells showra (the pant/long top/scarf combination- I'm sure I’m spelling it wrong) outfits starting at 450 Rps, which is about $10AUD. We went into the shop, up the stairs where they have literally hundreds of these outfits in packages and they start pulling them out and throwing them on the counter…it was like a Wal-Mart with the last Bratz doll the day after Thanksgiving.

I grabbed a few I liked but as most Indian women don’t have the same body type as me, I didn’t expect them to fit across the hips. I had a bit of a struggle in the dressing room and never got to find out if they fit across the hips since I couldn’t get them past the boobs. Instead, I went for the custom-made look where I got to select my fabric and I go back in a couple of days to pick up my finished product. I was a little disappointed to not have immediate gratification like most of the other folks, but I haven’t had a made-to-measure outfit since September, 09 and that one cost a little more than the $30 I spent on this one…plus I think I’ll wear this one more than once!

One of the reasons most people were so anxious to find the perfect outfit was because we had been given THE MOST EXCITING NEWS that afternoon. The grand-daughter of one of CRHP’s benefactors—the man who donated all the land that the compound is built on- was getting married…and WE WERE ALL INVITED TO THE WEDDING! THAT NIGHT!

I can only imagine how thrilled my mum would have been had someone from Dad’s office called 3 hours before my wedding to say there were 25 folks from another hemisphere who wanted to stop by the wedding, was that okay? I’m sure she’d have been as enthusiastic about our attendance as this person was. To be fair, the guest list for this wedding was over 1000 so what’s another 25 guests?

We returned from our shopping trip and changed into our outfits- luckily I had a nice (Indian, no less) dress I’d brought with me- and were on the bus by 5:30 as the wedding was about 90 minutes on the same bumpy dirt road away. But it was worth every bump in the road.

We arrived in perfect timing, just as the groom was doing his procession into the reception. There was a huge band playing Indian music you could hear in all directions. Young people had candelabras atop their heads to light the path and the groom was literally perched atop a white stallion.

As we entered the outdoor reception grounds, it felt like we were going to a festival. Everywhere we looked was another catering station. We were with Dr. Arole, the founder and director of the Comprehensive Rural Health Project (CRHP) whom I’ll be talking about a lot in the coming blogs. After we greeted a gaggle of relatives with “Namaste” and smiles, we stood and stared in awe at the sheer enormity of what lay before us. Soon, Dr. Arole ushered us from station to station, letting our plates be filled again and again with dahl, paneer, various curries, dosa, pakora, and a bunch of things I can’t even name, each more delicious than the next. We had fried to order naan thrown onto our plates, roti, pappadam, and more and then we were led to the sweets table where there was a delectable dessert that was a sweet apple custard of some sort, basically sweetened condensed milk with some fruit in it that was AWESOME!! Had I known my fellow students better, I would definitely have had seconds of that one! Alas, I had to show restraint. There was a popcorn machine and cotton candy (aka fairy floss for you Aussies) for the kids and we barely scratched the surface. I thought Jews knew how to eat at wedding…and they were catering for over 1000!!!

Then it was time for the ceremonial part, so Dr. Arole instructed us all to the seating area and the bride and groom went up onto a huge stage where bride and groom each had a floral lei-type thing in their hands. They walked out onto the front of the stage, which then rose up about 20 meters high so everyone could see them as they wrapped the lei’s around each other’s necks. The bride’s sari was so sparkly and shimmery, it was like she had diamonds all over her. She looked like a bedazzled disco ball and I wanted to see it up close…and it was as if Dr. Arole knew my wish because as soon as the ceremony was over, we were all ushered up to the front and brought up onstage where we were posed for a photo with the bride and groom! (We don't have a copy of the photo of all of us with them, but this is a photo one of my colleagues took of them when we were onstage)

Apparently, it is a sign of status if you have westerners at your wedding so we made them look good, even as we stood with our mouths agape at the whole process.

As we were leaving, a guest asked us where we were from. When we replied “Australia”, he said, “oh, so this is like, all EXOTIC for you and stuff, right?” and we all laughed.

It was a great night, one that put every Indian wedding I’d seen on film (Monsoon Wedding, Bend it like Beckham, etc.) to shame. The ride home didn’t seem nearly as bumpy, perhaps because we were all floating from the unique cultural experience.

Wednesday, January 26, 2011

Life at the CRHP compound

It’s only Tuesday and already my brain is overflowing and I am exhausted. I thought I’d post a quick update about the living arrangements before I get to the meatier stuff so here goes….

Our days have been so full we didn’t have a chance to have our introductory administration meeting until this evening and we arrived on Sunday afternoon.

But I’ll back up. Sunday we all met at the Pune train station to take the 4+-hour drive on bouncy rutted dirt roads to the Jamkhed Compound. There are 22 students and our two tutors (who are married) plus their two children. Of the students I’m the third oldest, which is a strange place to be. Especially when I learned that two of our group are undergraduates, one of who is turning 21 next week! That makes her younger than the kids I took to Israel!! But how refreshing to be in a vehicle that was older than me! Luckily there was none of that new-fangled air conditioning to chill my old brittle bones on the drive and we bounced and bounded along on road only slightly wider than the bus, with oncoming traffic and cars passing on either side the whole time. The experience was good since I hadn’t had time for a cardio workout in the morning.

Upon arrival we were shown our rooms. Because of my advanced standing in a community that still respects the elderly, I’ve been given one of the luxury rooms. I’d been expecting to share with as many as 3 other people but instead, I’m in a suite with just one of the other oldies, Karin, and we are next door to the tutors and their family. We have two bedrooms and 2 bathrooms as well as a lounge room with a television and a fridge! It’s quite odd as some of the others are4 to a room with a single bath so I’m not sure how it’s been divided.

The only drawback is that we’re about a 5 minute walk away from the others, who share a common courtyard so we’re a bit out of the social hub, but we’re obviously welcome to go hang out there any time we like. And it doesn’t seem like there is much free time anyway!

The room itself is great. I hung my mozzie net from my metal wardrobe and I’m using my second bed to supplement my cupboard space. I have a desk which is serving as a vanity and my bathroom is simple but has a western toilet and shower that has really good water pressure and plenty of hot water as long as I turn on the hot water heater 10 minutes before I want to use it. My only complaint is the mattress. Having just spent a week on an air mattress at camp, which was a bit too soft, I feel like Goldilocks but this mattress is too hard. I don’t know what it is about developing countries but they do love their firm mattresses! I tried taking the mattress off the second bed but that just made it a higher-up firm bed, it didn’t make it softer. Oh well, it’s probably good for my back.

It’s quite cool at night but I’ll run the ceiling fan anyway to discourage the mozzies, though there really don’t seem to be many. But they’ll find me, even hiding under my canopy so I’m taking every precaution. Speaking of that canopy, my bed is calling me now, so tune in soon for details of our first excursion into Jamkhed town as well as other excitement!!

Saturday, January 22, 2011

I'm Right Side up in India!

Yes, it has been a while. A year, in fact. Turns out, working full-time while going to grad school is enough of a procrastination tool! Well, and facebook...I have played my life out in 290 character bits throughout the last year.

Most of you know I have a new job, which I've been meaning to post about (short version- I love it, it's great). But I've gathered you all here today because I'm embarking on a new adventure for the next month, in India and while I doubt I'll much time, I wanted to use this forum to share a little bit about what I'm seeing because I'm anticipating it's going to be pretty amazing.

This does relate to my last post of a year ago because I've come to India for a 3 week class (aka subject for you Aussies) in Primary Health Care in a rural setting. I'll be travelling to Jamkhed, a village near Pune, tomorrow, with 19 fellow Melbourne uni students (not all MPH students, though some are) and we'll spend the next 3 weeks at the Comprehensive Rural Health Project. The project was started in the late 70's by 2 US-educated Indian MDs who wanted to do something for their home country upon their return. What began as an initiative to provide clean drinking water (and this was in the days before the term community development even existed) led to the training of local women to educate their fellow villagers on pre- and post-natal care, bringing the infant mortality rate from over 200 deaths/1000 births to below 14/deaths/1000 births in about 20 years which is quite an accomplishment (although India was also undergoing vast developmental shifts during that time that probably also contributed). This in turn led to other projects for the men in the community, micro-fund projects for the community health working women and an adolescent girls program I am particularly keen to learn about.

Over the years, the project has grown and their numerous successes have led them to receive $ from OzAid and USAid to build a training centre so folks from around the world (like our group) can come to learn how they do what they do and then replicate elsewhere. So in the coming weeks, I'll be learning much more about the project and all of it's varied components, so I won't go into that much more now.

I'll just share a few of my initial reactions to India, having been here for about 20 hours so far.

I arrived to Pune at 4:30 Am local time, having travelled for about 27 hours door to door. This is after spending 5 intense days at camp for work- for the new job I love-- so needless to say, I'm exhausted!

I flew Melbourne to Perth to Singapore to Mumbai and from there took a 4 hour car ride to Pune. I had hoped to sleep in the car but I had underestimated the constant braking and honking that would accompany us throughout the whole journey. I dozed a bit but it was hardly relaxing so I was thrilled to lie down on the hard wooden block that is serving as my bed. I feel a bit like goldilocks, having spent the last week at camp on an air mattress that was a bit too soft. I suppose when I get home I'll find my mattress is JUST RIGHT!

I forced myself to rise in time to grab the end of brekkie and set off to run a few quick errands...or so I thought. It was time for my first auto-rickshaw adventure. Pune is a smaller Indian city but certainly no place for the weak. I've decided that you should have to demonstrate a certain number of passport stamps before they let you into the country because I'm feeling overwhelmed a bit and I consider myself a fairly seasoned traveller. I can't imagine what it must be like if this is someone's first stop on their gap year tour!

Traffic rules are more like gentle suggestions and it took me about 20 minutes before I felt confident to cross the street. My tactic is to find locals who are crossing and just draft off of them, muttering a quick Sh'ma under my breath as I go.

I won't bore you with the 2 hour challenge of buying a phone card, only that I had to find a place to get my photo taken and my passport copied...sim cards are very serious business here. I got back to the hotel- this time with a metered rickshaw and realised the previous driver ripped me off (though he did invite me to his kid's birthday party so I'll forgive him) and had a hugely filling and delicious Channa Masala for about $2. Have plans to meet up with a few people from the course for dinner so just have to stay awake until then.

Hope you'll enjoy this journey with me...and I'll try to spare you any details of toilet adventures!!