Thursday, August 28, 2008

Carrrying Loads

If you stick around til about 5:30PM, you'll see how the villages come alive. The sun settles beyond the fields and people mull around in the streets as the air begins to cool.Children play with sticks and old tires in the dirt roads; city buses arrive with daily workers; farmers return from the fields on rickety bicycles with loads of foilage strapped behind them; cows, sheeps, goats, and oxen stroll ahead of women carrying huge pots of cleaned kitchenware or clothes on their heads. This past week, I decided to give it a go, this whole balancing baskets on your head thing. This lady was on her way home from the bus stop, so I asked her if I could borrow her bag for a minute....one nimsha, ma?
There were only three coconuts in the basket, an odd number (never good for balancing) and the bottom was flimsy. Two strikes against me. We continued on to the next village where I took this picture of Mercy and a pack of kids who tagged along for our home-to-home survey. Now mom dukes over here jumped in the picture with that huge pile of sticks on her head as she was returning from the fields. So I admit. She looks a bit more steady than I did with the coconut bag. But... any physics student will immediately recognize that her sticks essentially form a uniform rod with a sturdy COM (center of mass). Much easier than balancing three coconuts. You know?
After finishing up for the day, Mercy wanted to buy some fresh vegetables. So these same kids led us out to the fields to gather cucumbers. They got some fresh snacks while this nice lady cut long, ridged vegetables i'd never seen before.




Sure did make for a bomb diggity curry the next day at lunch, thanks to Fazila.

Sunday, August 10, 2008

Traditional Birth Attendants

I feel some sort of kinship with these hard-working, village-born old ladies, wise in a way that only decades of living life can bestow. Their spirits, just like the tattered saris wrapped around their aging bodies, have retained their vibrancy and uniqueness despite years of field work, child rearing, & village life. Here, Praba, one of my co-workers, sits to interview one of these village midwives, known as a traditional birth attendants (TBA). We had originally set out to interview TBAs in all of the villages surrounding Mysore City to investigate rural birthing practices. The idea was to use these TBAs as community links to identify pregnant women in each community and ultimately help increase access to HIV testing and counseling in these hard-to-reach populations. While our strategy has shifted slightly, given the relative inactivity of traditional birth attendants in the past several years, through these interviews we have gleaned some very interesting and useful information. Take, for instance, this lady here. We sit in her house on a woven mat, and Praba begins the interview. As we cover issues regarding antenatal care visits, problem-solving during dangerous deliveries, and post-partum practices, I find myself enthralled with this woman. At first, she inspects me with inquisitive eyes. I can see the questions in her mind churning. But as the minutes pass, skepticism lends itself to warmth. There's a solidarity speaking woman to woman about these issues. Her deep creased lips open, exposing a mouthful of broken and expressive teeth. Glassy, yellow eyes meet mine. I didn't think it possible, but the creases on her dark brown skin deepen as she smiles. Around her eyes. On her forehead. And cheeks. Her earlobes droop down low from the gravity pull of golden earrings.
She tells us about 30 years of delivering babies in her village. She recounts many techniques we have heard before. Mucous in the eyes, nose, and mouth of the newborns are sucked out by mouth or wiped down with an index finger. After delivery, she places the baby on the mother's stomach. With a string and unsterile blade she then ties and cuts the umblical chord. Wrapping the other end of the umbilical chord around her big toe, she waits for the placenta. If the placenta does not come out, she shoves some of the mother's hair down her throat to induce vomiting and stomach heaving contractions, thereby expulsing the placenta. When an infant doesn't cry after delivery, he or she is layed down in cool cow dung to awaken the baby. After the interview, she pinches the shit out of my cheek and kisses her hand. The Indian way of saying: so much love. Really, the kind of love-pain only old ladies can get away with. Then to top it all off, Praba decided to buy a chicken. As I'm bracing myself to watch a chicken killing, she motions for me to follow her outside. But no killing ensues. Her grandson grabs a chicken and then she makes me assist in packaging up the goods (picture me holding a plastic bag and this woman shoving the live chicken into the baggy: I'm screaming, she's laughing).

At the end of each interview, we give the traditional birth attendants birthing kits. The same ones that came with me through airport customs. Each kit contains: a pair of gloves, soap, a string, and a blade. Above Selvi, PHRI's driver (fun fact: Selvi is the ONLY female professional driver/taxi driver in the State of Karnataka), places gloves on one of the TBAs. Usually, we end these village outreach trips around 5pm and, inevitably, the rain starts coming down. Time to head back to Mysore and wave goodbye to the kids:

Monday, July 28, 2008

Anganwadi Centers

There is nothing - and I mean nothing - cuter than these kids, sitting in identical cross-legged positions, shouting in unison, "Hellooo, miss!" as I walked into their pre-school room. Often, during our village outreach trips to interview traditional birth attendants about home-delivery practices, we make a stop-over at the local anganwadi centers. Meaning "courtyard shelter" in Hindi, these government sponsored child-care centers serve as day-care & pre-schools for children ages 0-6. As part of the Integrated Child Services program in the mid 1970s, the Indian government developed anganwadi centers in a two-fold effort to: (1) help curb child hunger and malnourishment as well as infant mortality, (2) launch child vaccination programs across the country. Nationwide, an estimated 650,000 anganwadi centers provide child-care services at the village-level including: supplementary nutrition via monthly rations of food, non-formal pre-school education, and vaccinations against Poliomyelitis, TB, Diptheria, Tetanus, Measles, and whooping cough. Off-loading food supplies: Each center is run by a local anganwadi teacher and her helper who receive a salary of 1,000 and 700 rupees / month, amounting to approximately 80 cents and 55 cents / day, respectively. These teachers are often well-connected to members of the community, particularly young mothers. Here at our PHRI project, we have an overarching goal of identifying pregnant women in the community to increase uptake of HIV testing and PMTCT services (prevention of mother-to-child transmission of HIV) in both rural and urban settings; to this end, these anganwadi centers serve as an integral link to the rural population.

Last week a group of us visited one of Mysore's villages to speak with several mothers in the community. As we walked into the anganwadi center, two kids started crying hysterically, in corporeal fear that strange people = needle prick time. At least the immunization campaign is, indeed, reaching these children. So as we sat, waiting to speak with several mothers, Paul, Purnima and I were faced with making sure the kids warmed up to us. First, we gave out chocolates: who wants chocolate? I do. I do.

Then we started snapping photos and letting the kids look at their faces on our camera screen. Eventually, a few smiles appeared, and soon therafter, some major giggle attacks and a lot of heads smushed together to see the camera. After a makeshift game of duck duck goose and tickle monster (my limited vocabularly in Kanada, I admit, does not include avian species), I had a dedicated crowd of several kids. Somehow this game of counting to 5 ensued... here's a short video clip:

Adorable, these kids are, I know. Eventually, we spoke with some mothers and visited the health center next to the anganwadi center. Many of the women in the community are now delivering their babies at this village center with the help of an auxiliary nurse midwife (ANM). The women deliver here (picture below), bringing and extra set of their clothes to place above the table to soak up the blood during childbirth.The supplies closet was equiped with one pair of gloves (expiration date June 2006), a metal box with rusty tools, and a sterilization kit that still had its plastic wrapper on. Clearly, none of these supplies are being used. Most of these mothers are receiving little, if any, care during pregnancy. HIV testing is scant. For this, we continue working, day by day.

Tuesday, July 22, 2008

Portraits

Old men with leathered skin sitting on stoops; barefoot children playing in the street; breathtaking women working in saris. All these people, beautiful in their own ways, set against a backdrop of colorful house paint, stunning rural life, or a charged city skyline. This post is dedicated to their portraits. Snapshots of the faces of India and the still lifes of city and village summer days in the Mysore Taluk.

Thursday, July 17, 2008

Sunday afternoon

There's a school down the road from our house. It's on the way to a nice park where I was headed for an afternoon jog. The day before, I ran for about 20 minutes before the combination of morbid obesity and terrible air pollution did me in. So, I was quite excited when I caught sight of some boys playing volleyball on a dirt court in front of the school. I stood watching for a bit, until one boy yelled over, "you come play?" Sure, I said.So 11 high school boys and I played volleyball for a good two hours, six on six in the dirt. They were pretty good, I was impressed.

The game ended (my team lost, rude I know), and it started pouring rain. It's monsoon season here in southern India. The newspapers say it's been a tame season thus far (one town this past week performed a traditional ceremony of frog marraige to cultivate the rain). Evenstill, when it rains, it rains. So we moved to a place under a bit of roof (picture above) to wait out the strong but brief rain burst. Meanwhile, I learned how to write my name and "rain" in Kanada, the local language of Karnataka State. Dipping our index fingers in murky rain puddles, I traced their markings on the school wall in Hebrew-like swirly symbols, left to right.

That evening, Naomi and I ventured to the Mysore Palace. A specatacle in its own right during the day, at nightfall the palace is lit up by 5,000 light bulbs. Commissioned in 1897 and completed in 1912, the Palace of Mysore is a spectacular blend of Hindi, gothic, and Muslim style of architecture.


A walking tour of Mysore

I decided to get lost in the city.









Brilliant colors, crazy drivers, fruit vendors, milling cows. I stumbled upon the Mysore flower and vegetable market in the heart of town, which I later learned is one of Mysore's famous attractions for its explosion of color. I stayed at Devaraja Market for a long while, sitting with a boy and his uncle selling Indian oils and drinking chai.

This colored powder stacked in conical heaps below is known as Kumkum. When mixed with water, forms a washable paint. A Mysore staple, it can be used in rituals, wall painting, body painting, or even canvas.

I left the market and continued exploring. Ate some delicious pomegranate and enjoyed India.


Wednesday, July 16, 2008

Badshar Bazaar

What a magical place.
Sipping on little chai teas. Rows of amazing, colorful Indian fabrics. Sparkles. SF girls: where are you?


On my first day in Mysore, Naomi and I walk to breakfast. I'm wearing 3/4 length pants and a T-shirt. Everyone is staring. It's like the real life version of the "I'm naked at school dream" we've all had once. Or maybe just me. Anyway. In India, women are to cover up their legs, arms, and especially shoulders. Crop-tops exposing the belly and sides, on the other hand, are totally fine. Don't ask me. I'm burning with embarrassment that the bottom part of my legs is showing. After breakfast, I realize that the stares also probably had a lot to do with my blonde hair and the fact that i'm, you know, a solid 6 inches taller than the norm.

Regardless, it was time to go shopping for Indian clothes. We venture to downtown Mysore where the streets are bustling. There, we walk into Badsha Bazaar, and up the steps to the second floor where hundreds of tunic garments are pulled from the shelves for viewing. Meet Shoib: business man, garment seller, cultural guru, Leo rising.

And then he tells me, "Jana. You're in India. You should express yourself from the inside out. Wear what makes you feel good." Right on, Shoib.

The double nose ring

One time, in Myrtle Beach, things got wierd. I also got my eyebrow pierced. Now, all who have ventured to Myrtle Beach for Yale's graduation week know that it does not count as real life. In hearing of my facial piercing, my conservative Jewish father, however, was less than understanding. "If you don't take that thing out," he deplores, "there are two people who are not going to be at your college graduation: one of them is me; and the other one is you." Good one, Dad, good one.

Here in India, facial piercings abound. Nearly every woman has a nose piercing with a gold stud. There are the elaborate saris and the ankle brancelets, then the bengals, the necklaces, the bindi (the dot on the forehead), earrings, and lastly, the nose ring. Or my personal favorite, the double nose ring. Of course, I'm into all of it. This cultural style knows no age bias, exemplified by the lady in this picture. Is she awesome, or is she awesome?

So, Dad. Let's talk. It's time to be culturally sensitive and accept my double nose piercing. And for both piercings, I got the gold chain from my nose to my ear for free. What do you think? Kidding, maaaan. Love ya. Happy birthday!

Tuesday, July 15, 2008

The long awaited arrival

After an epic 36 hour journey from LAX through Tapei and Kuala Lumpur, I arrived in Bangalore, India, slithering past customs despite carrying 500 "birthing kits" equipped with a myriad of small razors. Don't ask me how. I then took a 2.5 hour bumpy taxi ride in the Indian night, arriving at the steps of Public Health Research Institute (PHRI) at 3AM, our work place and humble abode. The security gaurd, Rongay Gota, shuttles me in, leads me up the marble steps, and opens the door to my room. There, my two roomates, Paul and Naomi, Berkeley MPH students, are sleeping peacefully. Rongay Gota hits on all the lights, shines his flashlight in their eyes and starts screaming, for his own pure amusement... hello hello hello!! And with that, I hopped into bed. I was sad to see Mom go at LAX airport, but I have this gem to watch:

Welcome to the house. The first floor consists of a few PHRI office rooms and a marble entry hall with a water-less foutain. A couple bedrooms are located upstairs. The shower is a bucket and water system which brings me back to the good old days in the Belizean rainforest. Sometimes it just feels so good to dump a bucket a water over your head. You know?

I found my morning spot. At the top of the steps, behind that left grey column, my back against the white wall. Rongay Gota makes "super deluxe" chai tea (pictures to come) which consists of (no exagerations here): 1 part chai and 8 parts sugar. Intense. So there I sit, drinking sugar tea and reading my book. Sometimes the monkeys play in the yard, which is nice.

A peaceful beginning to each day.