New town, new assignments, and a whole new world.

 

Before I move on, I never got to recap my last rotation in Dehradun with City Heart Center or share pictures with Dr. Gandhi, his staff, and his residents.

Also, I thought I would share this picture I snapped. X-ray of a very evident fracture: Dr. Gandhi on the right, patient on the left. 

Onto Delhi!

Happy belated Halloween!! In 23 years I have never missed all Hallows Eve, but I suppose it had to happen eventually. I hope everyone had a splendid time, and celebrated enough for the both of us!

A 5 AM bus ride and it was back to the place where my whole trip began. Delhi. Four weeks prior I landed in the middle of the night, with ten weeks of adventure ahead. The city was so dirty, so loud and so overwhelming that at the time I had no idea what I was getting myself into. Four weeks later it didn’t seem so bad. Good thing!

First, lets have a recap of what I did with my weekend in Delhi.

October 30, Sunday

New Delhi mall

We arrived in New Delhi and had time to explore. What should we do in a big city? A little shopping at a small market, and a little shopping at the BIG mall… perfect! Needless to say, since I was in my element it was easy to forget I was in India while inside the mall. Similar shops lined the walls; food stands and kiosks lined the walkways. The only remarkable difference was metal detectors, a pat down and x-ray scanner as you entered the mall and SO many employees in each store! If you entered the store at least 12 different employees knew about it. It was a huge mall, and even in the several hours we had to explore, it wasn’t possible to get all the way through it. 

I watched my first cricket game and even threw a pitch (is it even called a pitch?)

New Delhi Metro rail.

The nicest thing I have seen in India thus far. It is nicer than the New York subway, faster than the Portland Max, underground and aesthetically pleasing. Surprisingly they also have a very efficient ticketing system. I suppose I shouldn’t be surprised as it was only built 7 years ago, but it was a nice change of scenery.

The one thing I was not too fond of was the police and amount of security. Unlike in the states where weapons are more concealed, in India an AK-47 is nothing to be hidden. In the corners of all the station, behind a small blue barrier a man dressed in a tan uniform leans from behind the barrier with a large gun pointed straight at you/towards the general public. It was very intimidating, but after talking with our coordinator we were told that following the terrorist attack on the metro in Mumbai, security has increased substantially.

ALSO---

While at the mall we found out that Lady GaGa was in New Delhi and was doing a show only 50 km away. Although I am not a huge GaGa fan, how awesome would it have been to scalp tickets and see her in India! That would have been an extraordinary ending to my first four weeks in India…… but along with the unpredictability of actually getting tickets, and the long taxi ride getting there--- we decided against it.

Maybe next time.

Now onto the serious business.

This week was set up a little bit different than normal. I mentioned last week about the other participants going home because it was the end of their four-week program. My next program in Pune starts on November 6 so interminably I spent one week in Delhi going through a turbo speed rotation on public health in the big city. Each day is different and covers a weeks worth of material in just a few hours.

The following is a fast-forward of my days.

October 31, Monday

This is where the Whole. New. World. comes in. I was in a clinic for a mere 3 hours and I could fill pages and pages with comments on my experience.

I learned:

Health care is one thing, public health is another.

For one day we were assigned to work with the DSACS Delhi State Aids Control Society. Although the program is coordinated by an aids prevention and management society, the particular location I was assigned focused on needle exchange, harm reduction, drug rehabilitation & counseling, and Oral Substitute Therapy (OST). OST is similar to how the United States administers methadone to recovering addicts; the Indian government just uses Addnonk (Bupronorphrine tablets) to assist patients with withdrawal symptoms in hopes to ultimately pull them from their drug induced addictive cycle.

I saw needles be handed out and exchanged to several clients which not more than 5 feet away were used to shoot up. I was not more than 6 inches away from several individuals shooting smack (heroin) into their veins completely oblivious to me hovering over them taking pictures. A few even posed to smile when I snapped a pic.

The amount of drug use in such a small plot of plant was beyond belief, but with over 15 million people in one city, police matters are focused on other areas. This was just the first of many ‘hot spots’ I would be exposed to in Delhi.

In the end, regardless of my disbelief, providing drug alternatives such as OST and safe, sterile needles as opposed to used, infected ones is better than nothing at all.

Side note:

Right behind the facility runs the Yamuna River. It was a sensory overload in the worst possible ways. First, it smelled—really, really bad. Second, it looked dirty. The color cannot be categorized as blue, green, black or brown just combinations of all of those depending on what angle you are looking from. It was more than just dirty, but littered, filled with garbage, old clothes and other unknown substances.

Even more exciting… there was a crematorium 1 kilometer away that still to this day dumps the ashes of burnt human beings straight into the river. Eww.

Shocking factor #1: Fishes somehow survive

Shocking factor #2: People bathe in it. Not everyone, but the less fortunate clean them selves and their clothes in it.

Yum! I would make an educated guess that this is a large contributor to the lack of clean water in India.

After that we went to observe a government hospital and a corperate/private hospital. The facilities were truly two different worlds.I will never complain for waiting at the emergency room again for 4 hours, in Delhi your wait may be one, or even two days until you are called to see a doctor! People line the streets waiting to be seen. The government hospital looked similar to the Doon Hospital that I experienced in Dehraduun. Rickety, dirty, and crowded….

However the private/ corporate hospital. Which costs around 1000 rps (20 dollars) for treatment as compared to 10rps (20 cents) at the government hospital. The inside reminded me of a hospital at home, and this wasn’t even a new facility. The separation of social classes became extremely evident, even more so than before.

November 1, Tuesday

First stop was the Sahara Women and Children Addiction Shelter, a daycare, safe home and school for both mom and child.

 The womens center sells bracelets to make additional make up. Although I am awful at bracelet making, it was still fun!

Second stop was the Sahara Men’s rehab and addiction center, a shelter and safe home for recovering addicts.

While both shelters provided meals and bed they also double-teamed as vocational training facilities; teaching men and woman how to do remedial work that could assist them in getting a job after they are released.

November 2, Wednesday

SPYM (society for promotion of youth and masses) Sahyog Juvenille De-addiction. A newly opened boys/ juvenile addiction and recovery center, government run and the first of its kind facility in India. Since it is brand new, the next three years will serve as a ‘trial run’. They have the next three years to show their success in hopes of receiving continued funding. Fortunately, since the official opening in April the success rate of rehabilitation has gone up from 5% to 20%! So far, so good!

If I didn’t witness it myself I would have had a hard time believing that these young boys were capable of such heinous crimes. Smack use (heroin) at the age of five and six. Fluid use (inhalation of toxic substances) starting at earlier ages than most of them can remember. The facility has 34 beds, and currently houses 26 boys age ranging from 11-17. After arriving we all sat down in a big circle so each boy could have a few minutes to tell us about himself. The usual details of conviction: age 12, heroin-murder case, age 16 heroin-murder case, age 17-fluid overdose, age 14 heroin-rape case, age 17 heroin-murder, age 14 fluid-heroin overdose. Seems all too surreal for small children to be involved in these types of cases, but again, in a city of 15 million, you cant escape the inevitable.

Sixty percent of the boys are illiterate, and never made it through 2^nd or 3^rd grade. The other 40 percent could read and write, but nothing past that. The center held daily classes to renew and build literacy, and also provided similar vocational training during their stay.  Many of the boys aspire to be dry cleaners and mechanics after getting released. You must keep in mind that these types of jobs are decent and respectable careers that would not usually be available to these boys under any other circumstance--another positive win toward the success of the center. The minimum sentence is 3 months with a reevaluation after that.

Many of the boys shared similar stories of extreme poverty, broken families, and misfortune, but there was one boy who stuck out to me and fell outside the norm. A 17 year old boy who spoke English well, had graduated high school early and was already well into his first year of college. He was put into this India style “juvy” for heroin use. He came from a good family, and didn’t start using drugs due to influence from others, but instead just wanted to try it… so he did, and he became addicted.

Goes to show you, addiction can happen to anyone if you are not wary. Clearly India doesn’t uses any sugar coated propaganda… I enjoy it.

November 3, Thursday

Morning rotation: The SPYM center truck yard.

Similar to the truck stops and rest areas we have in the states but much more ‘sketchy’ and the duration of stay are lengthy. The truck yard is another hot spot, a very high-risk area for multiple crimes, misfortune and wrongdoings: increased HIV/AIDS prevalence, violence, drug and alcohol use and abuse and the number one problem, and the reason we came to observe---sex trafficking and the prostitution of underage woman.  Exploited 10-17 year olds walking around after dark having sex and performing other acts for as little as 20-100 rupees ($0.50-$2.00). The whole problem arises from the movement of cargo, construction and families. Many of the drivers stay for a few nights, see their families, drop off and pick up new loads.  Some also stay to seek extra labor work nearby.

All of this provides the perfect situation for sex exploitation. SPYM provides random on-site sex education and condoms to anyone who is willing to listen.

If you can’t stop it, you might as well do anything to reduce harm and the spread of diseases. The center also simultaneously provides services to the transgender, homosexual and transsexual Delhi community. While gay marriage is legal in some parts of India, similar to the United States it still extremely unaccepted in others

Evening rotation:  Men’s homeless shelter

Another SPYM sponsored facility that offers 134 beds at night at a cost of 8 rupees per night. It is only open from 6PM to 8AM, and for an additional 15 rupees, they provide a hot meal. Most of the men smelled of alcohol and dirt, and openly admit they have made poor life choices throughout their years. The majority make money through odd jobs during the day, and spend their earnings before night fall. A vicious cycle than never allows financial growth.

At least, if nothing else, the occupants made a good decision of utilizing a facility built just for them.

November 5, Friday

Wow! What a nice ending to my rotations in Delhi. This may be difficult to portray in its entirety, as there were many noteworthy events that occurred, but like always, I will do my best. The facility is called Shalebh. It is an organization started by Dr. Bindeshwar Pathak, a man who had a vision of decreasing and eradicating the amount of ‘scavengers’ throughout India.  Scavengers refer to individuals who carry and dispose human waste from around cities and villages. Equipped with only a handmade broom and bucket they would sweep up others feces and excretions; earning a living through potentially the most degrading occupation in the history of man. In India sewage systems are rare. Fun fact: there are more mobile phones than toilets. Public and private bathrooms are only recently being established

Before I get into the detail about the center, I have to comment on the wonderful welcome ceremony they held for us. In a huge meeting hall full of staff, rescued women and random reporters (from CNBC and Entrepreneurs Magazine) our names were announced and we were given a necklace of good fortune and gratitude, a shawl, and lovely greeting from Dr. Bindeshwar himself. I felt so privileged to be apart of this organization.

Now back to the details-

Scavengers, or what society has named ‘untouchables’ have been around since India’s existence. They exist in a social class categorized as beings lower than pigs. They were not aloud to enter households, were not allowed to own property or touch anything that would be remotely considered a humane. If an untouchable were to buy fruit from a vendor, the vendor would either refuse to make a sale or would wrap up their hands and throw the fruit towards him or her to avoid any contact with the fruit, table or seller. 90% of scavengers were woman and children; they were never allowed to have a better life than they were born and maried into. Once you or your family became a scavenger, there was no getting out. It was a vicious cycle that would have never been stopped if it were not for Dr. Bindeshwar Pathak He made it his life mission to remove untouchables from their degrading lives, and reincorporate them into society to finally be accepted. Even until the 1990’s their were million of scavengers, and after all of his dedication, there is now less than 40,000 left in remote areas and villages throughout India. I see his success only continuing. As an American, it is almost unfathomable to believe that this kind of thing exists. That there is a group of people who collect other peoples feces, urine and excretions, carry them on their head for several miles just to dispose of it… usually in the river. Yes, I am referring to the same river as before.

Now the Shalebh is more than a salvation center it is a school, and a vocation learning center but it is also a huge sanitation research center for the cultivation and usage of biogas.

The Sulabh Effluent Treatment Technology: Safe recycle and reuse of effluent form human excreta based biogas plant.

They have utilized waste to generate electricity, and biogas, which can then be used for cooking and heating. They also have developed technology to purify waste into fertilizer, building material and even clean water (not suitable for drinking of course… but I bet it is better than the river!)

Dr. Pathack started his sanitation journey by developing a remedial toilet/ sanitation system. It incorporates two tanks, uses little water, and can be used for up to 5 people, for up to 3 years. Slowly but surely his dream, and this ten dollar creation will spread across India where sewage systems cannot reach.

The center also has a toilet museum! Humor and History!

Fun fact: it also had the nicest bathroom in all of India!!!

We worked a lot this week with SPYM society for promotion of youth and masses. Most all of the organizations this week are funded or connected by the NGO SPYM. They do fabulous social work all across India—addiction, homelessness, boys, men, and woman rehabilitation, sex education to reduce AIDS and STDs, raise awareness to prevent prostitution in underage women…and something tells me it doesn’t stop there. It is refreshing to see a cooperation have such an impact on the whole public health system. I fell as though this week truly did its job of opening my eyes to public health in India. Even with 5 short days, and only a few hours-- my eyes and mind have been opened to so many different things.

Shelane's other random thoughts….

Although India has long since gained its independence. British colonization still shines through in some areas.

Is this the Mattress store?

Not-so 24 hours

Even in the bustling city, the maximum hours of operation are only 5AM-11PM, and that is pushing it.

Noise pollution? Air pollution? Visual pollution? Space pollution? I am thoroughly confused at what type of pollution they are referring to. I can’t figure out if this is a joke or not. I haven’t seen blue skies in a week, and I think the air pollution may have permanently damaged my lungs. It is worth a try.

I learned the real difference between

Auto-rickshaw…

And a rickshaw….

Jewelry shopping is always fun! I had a wonderful time with Mr. Dhir looking at brilliant pieces of jewelry. He is a friend of Dr. Gandhi’s and was nice enough to open up his shop just for me. He even served me lunch and tea. It was lovely! I had hoped to find a special something for myself but I ended up walking away empty handed. I learned I have extremely expensive taste, and with 5 more weeks in India I still have to keep a tight budget! Let’s just say I didn’t fall in love with anything in my price range. I had a great time browsing, but even more eventful-- since he had closed down the shop for a day, I was lucky enough to see a gold exchange! ½ a kilo of gold, and a whole lot of cash!

Carpe Diem

I found out the hard way that although the combination of western and alternative medicines can have remarkable benefits; simultaneously it doesn’t always work out exactly as it should. Unfortunately mixing alternative remedies and western prescriptions can have unfavorable reactions. Turns out that some aruyvedic medicines can disturb your absorption and retention of western pharmaceuticals. Whoops… Had to find out some way.

Oh well…

Life is an adventure so you just have to roll with it.

ANNNNDDDD
I got Hena! Yay!

Flying solo

Unfortunately my partner in crime, AKA Taylor Hansen has decided to return to the states a few weeks early. After our first rotation, India had filled her heart with all she needed. It is sad to see her go, but on the other hand, I see it being a huge learning experience for myself. Taking on a new country, and a new place entirely on my own. I have high hopes for continued personal growth, and I am excited for what my next destination has in store for me. 

India wouldn’t have been the same without ya! See you in a few weeks!

Off to Pune to begin the second half of my trip: Child and Maternal Healthcare

Xoxo,

India and Shelane

Update:

I haven’t had any access to Internet in a while which means I could not post my entry about my week in Delhi. So Surprise I am already in Pune!

I conquered Indian domestic flights with little troubles! Very similar to American travels, only with much more security checkpoints and officers with large guns. I have just gotten settled in my own little guesthouse. My caretakers are Dada, his wife Manisha and her sister. They also have a little 14 month old baby girl! I can tell I am going to love it!

My new adventure has begun! I will keep you posted when I can!

Xoxo,

India and Shelane