Meenakshi, Mahasemam, and Aravind

This is the account of the one of the most wonderful days of my life. I have seen things that have made me really think and done things that I have really enjoyed.

1- Today we went to a Mission Hospital started in 1985. It was advanced in some ways and not in others. Technology was advanced but paperwork/sanitation was not. There were several typos in the paperwork and it was open to the outside in a lot of places. It was pretty hot too, because there was no windows in the hallways. The whole hospital was made with cement.

2- From the time we arrived to the hospital to the time we got back to the hotel (an 8 hour day) our white privilege was extremely apparent. We were adorned with flowers, catered to, and got services other people were obviously not getting. For example, we would get to see a medical operation on someone, while the guards wouldn't even let the own family in, or at any elevator no matter how long the line, we were let in first.

3- I would say 80-90% of children don't where shoes in the slums, and in general, several people on the streets wear no shoes too. To us this would be very scary because there is animal feces, dirt/muddy roads, and trash everywhere you go. There are really no sidewalks and if there are they are just random chunks of cement. You are better off walking on the road and 'dodging' whatever comes your way: cars, buses, auto rickshaws, people, bikes, and people biking their goods around.

4- When we arrived at the hospital there was people waiting to take pictures of us/watch us. There was an elephant with a bright colored long saddle blanket and another over its head also waiting for us. Two men were taking care of it, who also had no shoes and there were women with straw brooms who swept up the poop when it did the deed. We were given beautiful flower necklaces with so many flowers on them that they were pretty heavy and it also went down to my hips. Women on the streets put these together intricately, by each petal. The necklace got around our necks by the elephant. If we fed it 2 bananas (put the banana in the trunks and the elephant puts it in its mouth) it would pick up the necklace and put it around our neck. In the process, we got covered in elephant slobber/snot. I liked it. Then our professor and a few other people climbed up the elephant (it would lift up its foot and you could step on the foot) and rode it down the hospital roadway.

5-Once we got inside, we were led to a conference room and welcomed in by two women who gave us more flowers and put a yellow/red dot on the middle of our foreheads. This is to ward away any evil and keep your energies focused. (I think...) When we got into the conference room, it was set up very nicely, there were caterers there, and big bottles of water. Everyone give us bottled water here because they know we can't drink 'their' water. Another way we have 'white privilege'.

6-There were also kolams made for us on the outside of the conference rooms which is also written on the outside of any opening by women who want to ward away evil. Here is one in which a powder is put on the inside of the white chalk. Most are just this white chalk (actually rice flour) but nicer ones, like the one at the hospital are similar to this: http://www.topnews.in/files/bright_kolam.jpg and others are like this: http://www.auroville.org/environment/villages/images/kolams.jpg

7- We were welcomed by the founder of the hospital and were also guided around by a guard, the assistant head of nursing (Rosemary, I COULD PRONOUNCE THE NAME WITHOUT ASKING TWICE!!! WOOO!), and Oma-who is in charge of helping out get our projects hammered out at the hospital.

8- Speaking of projects, we are allowed to do our project with three different foundations: Meenakshi Mission Hospital, Aravind Eye Clinic, or Aparajitha Foundations. There are so many options just in the hospital. I could spend the rest of my life there, just working on them. There is so much needed to be done here. I can tell it is such slow progress though.

9-The founder of the hospital showed us the meaning of lord Ganesh, which you can find all over the hospital. It made me really appreciate it more. Here is Lord Ganesh: http://www.koausa.org/Gods/ganapatix.jpg, except he should be sitting on a mouse.

10-Thinking of the meaning of the god reminded me of the patience and kindness in general of the people here. For the most part, people are relaxed, happy to help, and interested. Our skin color gets in the way of some of it though. A lot of times we will be waiting inside or outside of a building or vehicle and we there will be small business people, (people who make small bracelets or sell maps) that will just bombard us trying to sell us things and beg us to buy their things. It's almost impossible to escape. At a palace we visited yesterday this woman followed me in the palace and then when I left she was begging for me to buy her purses. Finally after I got into the vehicle and she put them in my lap, I just paid for them. She also put another red felt dot on my forehead for being kind. I wore it for our new years celebration. (Little purses for 25 cents each) She also put another red felt dot on my forehead for being kind. I wore it for our new years celebration. It's so unfortunate because if I give one person begging money, I will be swarmed by others. I have to divide my rupees into different parts of my purse so when I do pull money out, people don't see how much I actually have.

11-Once we got an introduction to the hospital we had a tea break and had coffee and cookies. Even though I am the last person to drink coffee, I had to drink some, to not hurt their feelings. I feel like people try to impress us here. I also eat anything- chocolate etc. that I normally would not eat. I have to to get enough calories. I am still hungry every night when I go to bed. I should have brought more food!

12-We were supposed to only get an two hour tour of the hospital but it was so amazing and everyone kept asking so many questions that we got an hour off track. We got to visit any of the wards of our choice. The hospital works on a sliding scale system, which just means that you pay for what you can, basically. Poor people pay less and richer people pay market price. At the informational session they say they can offer so many free services here because the cost of labor is so much lower here than in the states and the volume of people is SO high. It truly is unimaginable. I told my friend that you guys wouldn’t believe that they really do offer free services to poorer patients because we can’t imagine how that would work because we have never seen such a demand for healthcare in such a large volume of people. For example: in eye cataract surgery village girls are selected to go through a 2 year training program that allows them to work in the operation room. They prepare the patient/utensils etc for the surgery and provide pre and post operative care unless a doctor is needed. Then, all the doctor does is put the lens in the eye and move on to the next patient. The doctor can do a single surgery in 5 minutes or less and his pay is used for a much larger volume of patients (2000 surgeries a year vs average of 200-300). So, if the cost of labor is low for the village girls and the doctor is able to perform 500% over other countries, then a profit can be made while providing care for the poor. The accident rate is nearly half of the United Kingdom too. You would be in awe of what such a large volume of patients can do. 5000 free cleft palate surgeries have been given to children since the start in 1985. When we go into different areas, then, (like the rooms for post operational nuero surgery, for example) there is usually one larger room, that is for the poeple paying less, and it is just a bunch of beds in a big room, and then the rooms get better from there the more you pay. The quality of care is always the same though. We would, of course, beg to differ, but in essence---they all get the same operations by the same doctors, the same amount of time to recover etc. The only thing that was different is that there were 1 nurse for 2 patients in the nicer rooms and 1 nurse for 4 patients in the larger rooms.

13- Some of the things surprising about the tour through the hospital: 1- the hallways had large areas open to the air instead of windows. 2- There were people sleeping, eating, sitting all over the cement floors. 3-We were allowed to use the nice toilets which you can sit on and flush, while others must have been indian toilets 4-The doctors were genuinely interested in seeing us and having us be a part of their work. The ER doctor brought us all into a room the size of our living room with six beds right next to each other and we looked at the injuries and the people. He was so excited to have us come back and work with him. He said that in India, every minute someone dies from a traffic accident. I imagine that a lot of it is from people getting run over, because from interstate type roads to small dirt roads there are people walking on them everywhere. This might be something I do a project on with school children. 5- We walked in the general rooms, which had a lot of beds next to each other and just looked at the conditions of different people. We took pictures, asked questions, etc. and people seemed interested in the fact that we were there. We would have been furious if someone came in, looked at our injury or surgery or whatever and then took a picture. I didn't take any pictures because my camera was broken, but I will borrow from my friends. I also went to a camera shop and found one I will hopefully buy before we go to the mountains

14- The first specialty we went to was cleft palate surgery. Here is what a post operational child looks like: http://stivesau.clubwizard.com/IMUpload/Cleft%20Palate.jpg. This causes issues with feeding, ear disease, socialization etc. We went into the post operational room and visited the children and their mothers. The mothers are mostly housewives and stand and protect their children all day. They are so compassionate. The post operational children are also so proud. Its especially fun to see them be so proud and then also be in awe of our white skin. This was by far the most moving unit I visited. Most of the children were around 6 months of age so that they can get the surgery before their speech develops.

15- I finally found shampoo and conditioner today. No more hand lotion in my hair!!!

16- There are 5 free heart surgeries per moth at Meenakshi. The basis of the hospital is ‘no man is too poor to afford 1^st grade medical treatment’.

17- I got to visit gynecology and think that is where my project will be

18-Everyone here treats us like movie stars, especially the children. All the advertisements have Caucasian people on them, so I think they think we are the people on all of the ads. Even the pictures on the toilet doors of a lady to show it is the ladies restroom is a Caucasian woman. I noticed that pictures are used in posters and signs a lot. The literacy rate is about 60% for the current generation of women.

19- The nurses are dressed in all white saris and the higher ups get to be dressed in colored and patterned saris. They patterns and colors have meaning, but I haven’t figured it out yet.

20- Many places we go it is polite/necessary to take off your shoes. I have walked barefoot in some dirty places in the hospital, but it doesn’t bother me. It does make me think of how much of an issue it would be if a person was in a hospital barefoot in the US though.

21- I’m starting to get down basic etiquette. There are to ways to say yes: a sharp nod of the head and then a wiggle left to right. A no is a sharp shake to the left and right. The two ways to say yes are used in different contexts. To say hello or goodbye or to honor someone you put your hands in the position we would to pray and do the head wiggle. When I rode to the village of women with Dr. Sethuraman, so many people knew him from his vehicle that they did the praying hand thing to honor him. If you could just see the roads, the fact that someone could recognize him from his vehicle is pretty impressive. It also shows how big of a influence he is in Madurai.

22- I found out my professor has 2 boys today. Her husband has also come along on the trip. They are a very cute couple and she relieved my nerves early on the bus trip here.

23- Telemedicine is practiced widely here. We got to see where and how it is done: it is basically like a nurse skyping a patient in a telemedicine center where trained village people are taught how to do basic examinations (using BP, temp, heart rate, etc) The information/complaints are then sent to the main hospital where the doctor can advise a plan of action or give a diagnosis. If further analysis is needed then they come to the hospital by provided transporation. This way medicine is provided free of charge to patients in very rural areas.

24-Today I thought I ordered a veggie burger for dinner. I was so insanely excited to calm my stomach with something it knows, but when it came out it was a ball of something something, and I just couldn’t eat it. I cannot wait to get back to safe food. Don’t get me wrong: I love trying new food and exploring, but there are just times when you just want an egg and toast or a glass of milk. I don’t think I have had a single dairy item since I have arrived.

25- Today when shopping, (got some fun stuff for you all!!!) I saw the Meenakshi temple. This is what it looks like: http://img2.travelblog.org/Photos/90/6084/f/22509-Sri-Meenakshi-Temple-Madurai-1.jpg It was right outside the shop where I got your gifts!

26- After the hospital we went into an area that I would call the slums. Here, women who receive microfinance loans were there for their weekly meeting. Children were everywhere and the mothers were sitting on the ground in rows. They receive loans to begin some sort of business or trade so they can make money to pay back the loan and sustain themselves. The purpose of the organization, Mahasemam, is to bring families out of poverty and teach women self-worth. Here is some of the stories of what the women do: http://www.mahasemam.org/client.html. They were incredibly proud and sat up straight and looked at us with interest. The men who were leading the meeting/checking loan payments took off their shoes to enter where the women were. I think that showed that even though they were on the dirt, they were still deserving of respect. I am hoping to get a translator and have my project be working with different groups of mahasemam women teaching them about cervical cancer screenings and transmission of STDs. It is culturally inappropriate and uncomfortable for women to get examined and even more uncomfortable if they find out that they have a disease or problem. Many women won’t tell their partners if they have a disease. Another project I might do is do a pilot test of a family planning session with the women and explore contraceptives, condom use, partners, diseases, etc. The doctor we are working with has already written a plan and wants us to do a pilot testing to get feedback.

27- It is not at all uncommon to see a lot of shacks near water and a lot of clothes washing in rivers and other bodies of water. When I am on a bridge I have a hard time extinguishing a person from a piece of trash from an animal. There are so many things gathered around the water. http://fotservis.typepad.com/photos/mother_india_calcutta_var/slums.jpg

28-At the meeting with the mahasemam women, I was trying to hear better so I moved and I stepped on this rock. A lot of kids who had gathered around (several did, because they had interest in the white people in their village) giggled when I did. Turns out I had stepped on a god. Oops. Talk about humiliating. I’ll watch what I step over from now on.

29- After the meeting, a man cut open coconuts and put straws in them for us to drink.

30-When we were at the meeting the little kids pushed and pushed to get closer and closer to us. It made them giddy if we even looked at them. Then they would giggle and get in troule if we did… They mostly spoke Tamil but I got two of them to show me their age on their fingers, 4 and 6. One girl and I shared our names. She said I had a super name.

31- The littlest kids just stared at a us. A little boy who had probably just learned to walk was standing by the women after the meeting. I went up to him and slowly touched his hand and let him soak in the difference of our hand colors. I moved my hands around and watched his eyes get really big. When I left he was still looking at either side of his hands in awe. The women thought it was pretty funny. They also thought it was funny when I got a little sweet baby to giggle.

32-There are really no roads in the slums—just enough room to squeeze a car.

33- While there the kids loved if we would take pictures of them. I found out today that most Indian people, except the very high class, really enjoy getting their picture taken. They take it as an honor. I found out because I asked Oma how people could not get upset with us taking pictures of them at the hospital.

34- I told Oma that I can normally make a pretty good judgement of what social class people in the states are from by their clothing, hair, location etc. but that I could never tell in Madurai. He said that you normally can’t. In general he said very wealthy people still dress simply and humbly. People here listen more than talk and are very kind and humble.

35- After the meeting with the Mahasemam women we went to a palace. Here is part of it: http://img527.imageshack.us/i/414752085074e4398e69b.jpg/

36- For new years, which we had the day before you guys, we had a meal, traditional alcoholic drinks, and traditional dancers and music. I got a beautiful salwar and kamez to wear for it. Oma said I looked like a 70’s bollywood girl. Raj, the person who started this program at Iowa, even got out and danced. We tried to balance the things that the women did on our heads. They were unbelievably heavy and hard to balance and they danced with them on their heads. A lot of women walk around with different things on their heads.

37- Today we visited the Aravind Eye Clinic. It was absolutely amazing, but I don’t want to do a project with them. There is so much need elsewhere. What I did take away from it is how much can be done with compassion and hard work. I hope to one day compare my practice to Dr. V’s:

Intelligence and capability are not enough. There must be the joy of doing something beautiful.

- Dr. G. Venkataswamy

38- I am very tired and have to be up early. Tomorrow we are heading to the mountains and visiting the Aparajitha foundation to see what type of modules and things we could do for students. Last year the module made by students was implemented and used in over 400 schools.

39- This trip is emotionally and physically challenging in a number of ways. It is amazing and challenging and fun and exhausting. I am so glad to be here! Seeing what I have seen truly changes my outlook on myself, my life, and my future and what I can do with it.

40- MOM AND DAD SKYPE ME OR IM NEVER COMING HOME!

Please ask me any questions you want!

Peace, love, and praying hands and a wiggle of the head, left to right