Saturday, November 28, 2009

Discrimination

I have grown up with the luxury of never having been discriminated against for the color of my skin, my sexual orientation or religious views, etc. The only sense in which I am a minority is that I am a woman and I have personally felt that this has not been a huge (if any) hinderance to me. (I know that this paragraph alone might cause great debate but I urge you to keep reading and get into semantics later.)

It was not until I reached India that I gained any appreciation for what it might be like to be discriminated against for the color of your skin. Here, the way I am treated by a large percentage of the population is largely dictated by the fact that I am white. Because I am white the immediate assumptions are I am: 1) rich (which I am not), 2) naive (which I might be) and 3) to be taken advantage of (which infuriates me).

In the past week I have been closely examining myself and my own emotions in relation to the (different) way in which I am treated. Perhaps the worst thing about India, or the thing I loathe most, is the fact that I can't get an honest deal on anything...ever. The minute I am seen is the minute the price shoots up by 5 or 10 times the amount it would be for anyone born here. I go to join a gym and the price is 5,500 Rs per month (about 110US$). I have my roommate who is Telugu call them and she gets a price of 1,300 Rs (about 20 US$). I try to buy food at the market and one cucumber costs $2. Someone else goes out and gets it for 25 cents. The examples are limitless but the point is not really in the examples.

The point is that I am beginning to understand how and why something like discrimination breeds anger and frustration and eventually rage. Why...because these things make me angry and frustrated. I am angry that false assumptions are being made about me (and my wealth, etc) and frustrated by the fact that I can't seem to find someone who will give me an honest answer to anything and I fell rage toward myself for feeling these things as well as toward the people who are doing them.

Then I find myself thinking back and imagining what it must have been like to have been African-American during Jim Crow laws or even now. Or how it must have felt to be Japanese-American after the bombing at Pearl Harbor when the internment camps were formed. The examples are likely endless but the feelings of helplessness are the same.

I feel helpless and exhausted by this experience which repeats itself everyday and which will continue to repeat itself everyday while I am here. Perhaps the saving grace is that I, unlike others, have individuals like my roommate who are willing to negotiate gym fees for me. These people become guardian angels as they allow you to navigate this culture. These are the people which allow you to love the culture despite the fact that you can't get a fair shake.

C-Section, I Saw

Hello Everyone, sorry for the delay in postings here but just got a little busy and a little sick. I figure the cold is to be expected when you travel half-way around the world.

On Wednesday night, November 25th I witnessed my first Cesarean section (c-section) and thus live birth. I don't think I am going to do this one justice by words but I am going to give it a try.

To begin, the whole experience was a weird combination of beauty and gore. I don't know how many of you out there have had the opportunity to witness a surgery first hand...for me, this surgery was my first. Let me begin by saying that for any who's major reference is Grey's Anatomy or ER or some other 'doctor' show...you haven't seen anything. Those shows do not, in the the least, prepare you for what real surgery looks like.

A couple of other thoughts before I go into some detail:
1) Witnessing a c-section is the best medicine for convincing someone that a c-section is not a good idea. The procedure is incredibly invasive.
2) It would be my guess that witnessing a c-section (or perhaps any surgery) is also a great way to argue the detriments of obesity. In this particular surgery they had to cut through quite a bit of fat...and it makes a big difference.

"Have you ever seen a surgery before?" the doctor asked me.
"No."
"Do you think you are going to faint?"
"No" I reply, confident that I can handle anything...how bad can it really be - right?

The particular patient had a lung infection so it was too dangerous to put her under general anesthesia. The whole evening began at 10:15 PM with a spinal tap which, already, made me squirm. Watching someone who is seemingly awake have a 2 inch needle bore into their spinal cord is no easy thing. All you can think is: "Are they feeling any of this? They can't be, they would be screaming."

The moment I was least prepared for was the initial cut, I don't know if anyone who is virgin to the operating room could ever be prepared for this. The scalpel hits the skin and slices through it like butter (or ripe melon), and you realize how animal we all are underneath that skin. How all the moving parts are just that..moving parts. The first 4 inches or so are fat...yellowish with tints of pink and coagulated together. It takes several long slices to hit the first layer of muscle. Here, the surgeon slows for a bit and cuts a bit more carefully and the muscle gives way to more muscle. As the opening gains depth clamps are added to stop the bleeding. Her stomach is now a gaping hole. It takes what seems like about 6 inches before they hit any organs. Now, the cutting is slow and purposeful.

The slice in the uterus is about 8 inches long. The surgeon reaches in with her gloved hand and the doctor standing at the head of the women begins pushing down hard on her stomach from the top. The push and pull continues for about a minute.

And then, the doctor's hand emerges slowly with the infant. The baby is received by a nurse who brings it immediately to a pediatrician in the room next door.

The next hour I spend between watching the baby, who is in duress and watching the surgeon close up the mother.

It was not really until witnessing this surgery and the birth that I fully understood the magic or miracle behind child birth (the thing everyone talks about). It is not just the size of the newborn, in fact, I don't know how much of it has anything to do with the size of the newborn. What it is about is this feeling of endless hope and potential. As you look down at this tiny shriveled little thing all you can think is how much life they have ahead of them and how much they could do with that life...and you can't really think about anything else. It is joy and hope. That is what I felt. You begin to understand the celebration of life.

Back in the operating room the placenta has been removed as one large slab of bloody goo. The uterus has been pulled outside the body cavity and is laying on the women's stomach as the stitch shut the 8 inch opening.

The pediatrician is with the baby who is not breathing well. He has tubes going down the baby's nose attempting to suction out mucus from the lungs and allow for more crying and better breathing. The baby is tiny 2.25 kilos..about 5 lbs.

When I get back to the operating room the doctor is putting in the second set of stitches at the muscle layer over the uterus. The final set of stitches is the top layer or initial incision.

I go back to see the baby and it now has an oxygen mask on. The pediatrician informs me that the baby's lungs are in duress because the mother didn't have enough fluid in her uterus.

He lets me touch the baby now. I reach out and put my finger on the palm of its little hands. She seems so fragile and vulnerable. Her eyes are shut and when I touch her hand and stroke her arm she seems slightly soothed. Her skin is soft and brand-new. Her hands are still wrinkled from the watery world from which she just emerged. She is pretty damn cool!

The night ends as abruptly as it began and I am left sitting at the hospital trying to digest what I just witnessed. I call my sister and try to put into words what I just saw. How gruesome the surgery was paired with how beautiful the baby is.

I feel very lucky to have had the opportunity to have seen this. I am now committed to witnessing a natural birth as well...which I have been told is actually much more difficult to witness.

All in all, an experience I wouldn't trade in for the world. It is my intention that I will have many more to come during my year here.

Happy Thanksgiving to everyone.

Thursday, November 26, 2009

The Missing Photos from Field Visit and a bit more











Happy Thanksgiving everyone.

Holidays are always a bit tough when you are abroad - particularly when they come so shortly after you have left. However, I did go a Thanksgiving party here which was pretty amazing. Now, it is Friday morning and I am getting ready to head back to work!
I have much to write about but will have to be doing it over the weekend since I don't have time now.
For now....some nice pretty pictues.
To follow: my first ever c-section and birth, my day at a public hospital, general thoughts.
Keep Reading.








Tuesday, November 24, 2009

The Photos...Shoot Me

Photos & Video for Last Post..

For some reasont things did not show up with the last post. Here are the photos, etc I wanted to add.

My camera is dead...the battery is out. I have called in for back-ups. If anyone has a camera they want to send to India let me know. Things be super expensive here. Bummer!!

LifeSpring Hospitals: Why I'm Here

Some of you may be uncertain why I am suddenly writing a blog from India. The reason I am here is to work for LifeSpring Hospitals which is a chain of maternal and child health clinics in India www.lifespringhospitals.com The reason I am at LifeSpring is because I was awarded a fellowship through the Acumen Fund www.acumenfund.org

A quick education: India's healthcare situation lags behind other countries that have experienced similar economic expansion and GDP growth, namely the group of countries with the fastest growing developing economies, known as BRIC (Brazil, Russia, Inda, China). The poor situation is reflected on all health indicators from immunization among 1 year olds to high disease prevalence. India suffers from a crippling shortage in the healthcare workforce, a growing social inequality and a country-wide infant mortality rate of 57 deaths per 1000 live births. India has the highest IMR (infant mortality) and MMR (maternal mortality) among BRIC countries (2008 data).

LifeSpring's Role
LifeSpring Hospitals has developed a business which serves only poor women and their children. The model is proving to be not only sustainable but scalable. In 2010 LifeSpring plans to build 9 hospitals (with my help!). The hospitals are small (25-30) beds. In a country where maternal and child health is a massive issue LifeSpring Hospitals is providing one working solution.
Alright...enough with the plug.

Perhaps the most interesting thing about LifeSpring is their approach to marketing. Here, pregnant women are considered customers and not patients (pregnancy is not a disease!). Today, I spent time in the field with the Outreach Workers (on the ground marketers) for LifeSpring. The experience was rewarding and intense.

To begin I have never felt more tall, white or LARGE in general. (see photos of nurses with me today as well as video of them refusing to do the nod!)

The customers of LifeSpring are poor. They are not the poorest of India but near the bottom. Seeing where they live was eye-opening and educational. In these parts of India it was very clear that white people are seldom seen. From the start I had children and families following me through the dilapidated neighborhoods. Everyone was extremely curious about my presence and what I was doing. Children came up to me to touch me and stand in lines to introduce themselves.

The native language here is Telugu and few understand Hindi at all. Communication was pretty much non-existent. That being said, it was very clear everyone was basically saying: “come over here and meet the white lady.”

The children were beautiful, shy and curious. The women were cautious and luminous. (see photos)

The households here are not ruled by the young pregnant woman, but by the older woman of the household (typically the mother-in-law). Imagine that! These women were the gatekeepers.
What we did was essentially sell maternal and child health care door to door. I know this sounds crazy (and it was!). The fact that this is possible gives you an idea of the sheer number of pregnant woman in India.
What is important is that without a service like LifeSpring these women are forced to go to government hospitals where care is poor, not free (although promised this way) and without dignity. LifeSpring is offering them a choice and these women are listening.

Today I learned a lot about dignity and how it is maintained in the settings which seem hopeless. The areas we serve have no running water, animals running rampant and garbage laying in the streets. Despite the dirt and poverty what I did find was a beauty and dignity: the henna hands and painted toe-nails of even the youngest girls. The ever-lasting brilliant colors of India – The way women sat together braiding one another’s hair into ropes of ebony.
Most interesting to me was the way they were all finger painting their houses and ‘sidewalks’…this is difficult to describe. When you go to these homes you realize that they are all decorated with red, white and blue designs around the doorways, bases and entrances to the homes. This is done by the people who live there. They essentially paint it on by wetting colored powders and finger-painting (see photo). The beauty and uniqueness of each home does not go un-noticed.
I also saw dignity in the way they swept the paths between the homes. Despite the relative squalor the street was clean.
What I do know is that being pregnant in these settings cannot be easy, but somehow these women make it seem that way.

On a lighter note - I got serious hazing because I had been dating someone for 3 years and not married them. These ladies think I am incompetent as a woman. I was also offered a child by one of the women in the village.

Cat's Got My Tongue

So, a quick post before I get into a longer, more serious one. It should be known that I am getting some serious push-back on the issue of the large cats...it seems particularly from Hyderabadies. For this reason, I am making it my mission to get a video of the thing. I maintain that it was XXL.

Monday, November 23, 2009

Believe It or Not, Nov. 23, 2009

Things to know and master about India: Lessons from my first 3 days.
1) Always carry a roll of toilet paper or package of baby wipes in your purse/on your person – at all times. In India you can not assume there will be toilet paper. The typical Indian toilet is something you squat over not sit on and the floors are often wet and dirty. The traditional way of cleaning yourself after using the toilet is to spray yourself down with water from a hose on the wall. The idea is not a bad one but it leaves you with the issue of having a very wet nether region….hmmmm. Please see video of toilet - I thought it was a picture but apparently I was too jet lagged and took a video instead.
2) Get used to cold showers – I have yet to take a warm one! I believe this is likely due to the fact that right now it is WINTER in India and the average temp is about 70 degrees. Come February the temps should jump to about 100 and saturated. I think a cold shower will feel good then.
3) Master the NOD. If you have ever read Shantaram or know anything about Indian culture you have likely been informed about the infamous Indian head wag/nod. Please see attached video which provides a classic example. The head wag/nod is actually far more difficult than it appears. It involves a certain relaxation of the neck which I have yet to master. You will not be seeing a video of me doing the nod until I have mastered it.
4) The cats here are HUGE. I am not kidding. Today, I saw one for the first time. It was across the street prowling on the roof tops and from across the street I thought it was a panther of some sort. HUGE. These are the house cats in India…I am second guessing my thoughts on getting a cat. But, pretty cool when you think about it!
5) Barter, barter, barter: When you are white every price shoots up by about 20 rupees. Walk away from the rickshaw…walk away from the rickshaw. Someone else is always waiting.
6) Surrender your personal space – there is none in India. Period.
7) Cross the road with confidence. Breath and tell yourself that they will not hit you (they shouldn’t –right!). Put your hand out in a sign to STOP and they usually do…but prepare yourself for the last second swerve.
8) Don’t wear shorts.
9) Learn to eat with your hands - its fun!
10) Let go of the NYC black….colors are beautiful.

Sunday, November 22, 2009

Burden

Saturday, November 21st, 2009 – Posting Two
In America I grew up working poor. In India, it seems, I will live a life which is somewhat privileged. I find myself struggling with my class identity and personal judgments and fears around being privileged as well as the sheer poverty of India.

Of all the amazing training I received, no one prepared me for the shame I feel of being white and privileged in a city and country where poverty is very real, very sobering and very aggressive.

During my adventures yesterday we stopped late at night to try to get food. The minute we stepped out of the car begging women circled us - trapping us against the car itself.
It never ceases to amaze me how universal suffering and helplessness are. This language has no barriers.

They are pulling at my sleeves and pleading , open-handed, 5 – 10 all around me. Some are missing teeth while others are blind and their closeness is suffocating and intimidating.
In India, begging is often a profession and rigged game. Many times, giving these women money means you are putting money into the hands of someone who is paying them to beg and then taking most of the money for themselves. The rumors and stories surrounding this ‘profession’ are endless (think Slumdog Millionaire).

I make the mistake of giving one of them a one rupee coin (50 rupees equals 1 dollar). My shame has become visceral. Eight pairs of hands thrust at my face, demanding equality. Is there dignity here?

Now, on the verge of tears and completely overwhelmed I crawl back into the car – escaping the reality outside.

In the next moments the police arrive with whistles and a paddy wagon to clear the beggars from this street and corner. I witness this through the tinted glass of the rental car.

I look out as this part of India looks in. I am blessed to be here.

Let It Snow, Let It Snow, Let It Snow







Saturday, November 21, 2009 – Posting 1
Today was my first full day in Hyderabad, India and I think I might have spent it doing some of the most random things possible.




Two Words: Snow World.




Yes, as it turns out there is a Snow World in Hyderabad. Where Indians and Expats (well actually just me and 4 others) alike gather to play in artificial snow generated by machines which likely use more power than half of Hyderabad combined.




I can only describe it as slightly ridiculous and I have pictures to prove it.




I could not help smile at the irony of Ms. Wisconsin playing in snow in India on her first day in the country…how did this happen. Not just snow but a slide and rock climbing wall inside the winter wonderland. I think only the pictures can do this justice – they will be attached.
My ticket to snow world was a package deal in which I also gained entry into a mirror maze, rainforest walk and haunted house.




Snow world was followed by a 2 hour drive into the middle of nowhere in bumper to bumper traffic to go go-carting and play laser tag. Seems very American to me!




By the end of all this I had been up from about 5 AM – midnight. I crawled into bed exhausted and wondering at the many commonalities I have already witnessed – sometimes the world feels so small.

How Did the Chicken Cross the Road?

November 20th 2009

I am beginning to believe that my most difficult task in India will be learning to cross the road. It is a full-blown war out there!

This morning, I got bored and proceeded to go for a walk hoping that along the way I would find an ATM, phone card, kaftans and perhaps even a new phone – (since blackberry messenger is free anywhere in the world!)

It should be noted that I found none of these things but instead returned home with my tail between my legs. But I did make it a half-hour or so.

During this half-hour I was followed for at least 15 minutes by one rickshaw driver who wouldn’t leave me alone, yelled at forcefully by a group of begging women, nearly run off the road by several walkers and saw my life pass before me as a bus of screaming school children nearly ran me over. Needless to say, I am not only a bit unnerved but also appreciating New York.

Have you ever seen the Seinfeld episode where George starts playing frogger?…crossing the streets in India is just like this. Dash..pause…wait..go…breath. There are no lights, there are no rules and absolutely no concern for the sanctity of life.

I am now afraid one of you will die when you come to visit me.

Last night while riding home from the office in my state of sleep-deprived delirium a large bull with huge horns came charging down the freeway against traffic. This was not a hallucination…totally real. No one even flinched…just kept on going. A large bull, charging traffic…if that can’t create pause I don’t know what will.

Other than that I am starving, without phone and internet and ready to get things sorted out so I can live with a bit more peace.

With Love,
Meghan

How Did the Chicken Cross the Road?

November 20th 2009

I am beginning to believe that my most difficult task in India will be learning to cross the road. It is a full-blown war out there!

This morning, I got bored and proceeded to go for a walk hoping that along the way I would find an ATM, phone card, kaftans and perhaps even a new phone – (since blackberry messenger is free anywhere in the world!)

It should be noted that I found none of these things but instead returned home with my tail between my legs. But I did make it a half-hour or so.

During this half-hour I was followed for at least 15 minutes by one rickshaw driver who wouldn’t leave me alone, yelled at forcefully by a group of begging women, nearly run off the road by several walkers and saw my life pass before me as a bus of screaming school children nearly ran me over. Needless to say, I am not only a bit unnerved but also appreciating New York.

Have you ever seen the Seinfeld episode where George starts playing frogger?…crossing the streets in India is just like this. Dash..pause…wait..go…breath. There are no lights, there are no rules and absolutely no concern for the sanctity of life.

I am now afraid one of you will die when you come to visit me.

Last night while riding home from the office in my state of sleep-deprived delirium a large bull with huge horns came charging down the freeway against traffic. This was not a hallucination…totally real. No one even flinched…just kept on going. A large bull, charging traffic…if that can’t create pause I don’t know what will.

Other than that I am starving, without phone and internet and ready to get things sorted out so I can live with a bit more peace.

With Love,
Meghan

First Impressions Matter Most

November 19th, 2009
India is chaos and beauty all rolled up into one festive, unruly and unforgiving ball of spice.
India offers no remorse or apologies.
Poverty is butted up right against polish here: Slums on the painted tip toes of mansions. Oxen line the roads while limos take expats to the Google headquarters.
People are everywhere, traffic is manic and the sound of horns, hammering, screaming and talking never stop…EVER.
It is also beautiful. The spirit of the people is captured in their colors. The city is blooming. Saris decorate the rubble and women workers dot the road-side in greens, indigos and bright yellow. Even the poorest are vibrantly dressed.
The slums are unnerving and vast. Blue tarps dot hillsides where strip-mining rules. The city moves seamlessly from slum to shops to wealth to slums. It is an endless cycle of random plots. Men are standing welding in the streets as cars weave around them. People crush rocks and sell anything imaginable.
The place is bubbling with entrepreneurs and determination. It seems to be growing and developing far too quickly for any sort of over-sight to take place. The randomness of it all is uncanny.
I am exhausted and hungry but strangely awake.
I am missing my family and the normalness of home but appreciating that this is all part of the process.