Must Have Experience with Camping

What qualities do you think make a good international volunteer? Perhaps determination, openness to new experiences, fluency in another language, a positive disposition, or maybe just a genuine desire to serve? While all of those qualities are helpful (especially the fluency in another language… something I could definitely use about now), they do not touch on one of the common characteristics of international, rural volunteer work: living in the great outdoors.

 

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Our trip so far has definitely been eye opening for Wende and I. It has helped us to see that people are all essentially the same no matter where you go – or as Paul Farmer would say, “The only real nation is humanity.” It has allowed us to accept that even though we criticize some things in America (habitual excess, dominant capitalism, overspending on healthcare etc.), in the end, America is the place that brings us comfort and in all likelihood will always be our home. More than anything, this trip has showed us that while this may be our first venture to volunteer overseas, it will definitely not be our last.

Since Wende and I are habitually enthusiastic over-planners, we have already started to think about what form our next trip overseas may take. There are countless organizations around the world that are in need of medical volunteers, but there is one organization that stands out to us: Partners in Health (PIH). PIH was founded by a physician named Paul Farmer, who has (almost singlehandedly) changed the way physicians think about international medical work.  While he started his career at the age of 20 with the creation of a hospital in Haiti, his organization has expanded to fight infectious disease around the world.

Before coming to India, I knew of Paul Farmer and some of his accomplishments, but I didn’t know much about his life. On our first day at the Gram Seva medical campus, a physician handed us a book titled Mountains Beyond Mountains, and simply said it was an incredibly moving story. The book is written by a journalist named Tracy Kidder, who inadvertently follows Paul Farmer’s journey over a 15 year period.

Since I was still in the middle of some teen-fantasy book (something I’m only slightly embarrassed to admit), Wende read the book first. Now, Wende is usually the type of reader who sits down with a book and devours it, barely pausing to stop for food or others’ company. However, with Mountains Beyond Mountains, it seemed like she stopped every other page to talk with me about a thought provoking quote or some gut-wrenching story. I knew the book must be good.

Paul Farmer’s personal written works are known to be provocative, but dreadfully academic (he is a Harvard professor after all). So I was delighted to find that Mountains Beyond Mountains was the story behind the man, the story that Paul would never be able to tell himself through academic writing. The book is full of hilarious anecdotes with serious moral overtones, and you walk away from the book feeling like Paul may just be a normal person after all. An incredibly dedicated, but normal, person. I absolutely loved the book, and if you are looking for an easy read that will make you think a little differently about the world, go pick this up.

We had known about Partners in Health before reading Tracy Kidder’s book, but his writing had greatly enhanced our desire to be involved with the organization. We started looking around on the website for opportunities to get involved, and we came across a residency position in Mexico (only a few years in the future for us). Many of the requirements for applicants seemed pretty standard (fluency in spanish etc.), but one peculiar prerequisite stood out to us – it said, “You must have experience with camping.”

This line got us thinking, “Would camping have been a good prerequisite listed for our trip?” We started to look back at our experiences of GST through this new lens, and the answer quickly became, “YES.” Here are just a few ways our life in India reminds us of camping:

• Insects:
  • Mosquitoes – I know that you have seen the photos of Wende being eaten alive by mosquitoes in a previous post, which has thankfully gotten better, but I can’t remember having to use DEET insect repellant often inside my house back in the US. It feels like we are in a constant battle between us and the mosquitoes… I think the mosquitoes are winning.
  • Ants – I know I have heard statistics about the absurdly vast number of insects that exist on our world, but after living here for a few weeks, I think those numbers may be underestimates. We are constantly finding new infestations of ants across campus (and our apartment). We can’t leave any food out for more than 5 minutes, or we will return to find we have successfully created a new ant colony.

 

• The sounds of nature: One of my favorite parts of living in this housing complex is the sound of nature right outside our window. Apparently the sound is so ubiquitous, we were told by a friend that they can hear it in the background of all our WhatsApp voice messages. Why, just a few mornings ago we woke to the sound of 20 different bird calls just feet from our window, but when we went to inspect we found that all of those sounds had been made by a single tropical bird on a nearby branch. That beats my IPhone’s alarm any day!

 

• Lizards, lizards, everywhere: What are some of the creatures you expect to possibly find in your own house? Mice, spiders, maybe even a rat. Well, if you lived in this part of India, you would expect 6 inch long lizards.

Upon spotting our first lizard, we tried to chase it out of our room, only to accidentally chase it instead behind one of our light fixtures. We told our neighbor about it, hoping they would have some advice on how to get rid of it, but their only reply was “Oh yeah, that’s one of their favorite spots.” Very reassuring.

 Since that first encounter, we have become pretty comfortable with the site of lizards in our room. How comfortable you ask? Well, yesterday I went to go use our bathroom, but when I opened the door I saw a lizard run down our wall and behind the toilet seat. I just sat down and did my business – my mentality: if you don’t bother me, I won’t bother you.

 

• Camp stove: When you go camping, you do your best to prepare the foods you enjoy at home, but you end up settling a little. Well, without a refrigerator, oven, or full set of utensils, the type of cooking we do here definitely aligns more with camping than with our kitchen back in America. In fact, all of the cooktops in our housing complex are fueled with propane tanks similar to those used for your grill (or Coleman camp stove).

 

• Standard of cleanliness: If you’re camping, and it’s been a couple days since you’ve taken a shower, or your clothes are starting to smell a little, so what? While other people here may feel differently, when I see lizards running around the apartment, my motivation to worry about something like dirt or dried leaves on the floor drops dramatically. What doesn’t kill you makes you stronger right? I think that phrase applies for your immune system as well 🙂

 

• Wild dogs, peacocks, and pigs (Oh my!): I never know what type of animals I may see during a typical day at the Gram Seva Trust. So far I have seen –
  • Pigs roaming around campus – I’ve even seen them wallowing in a mud pit!
  • Wild dogs everywhere – The mentality toward animals as pets is very different in an area where people are more worried about being able to feed themselves. Most of the dogs in the area are wild, and treating them with any kindness is unheard of by the locals.
  • Cows… lots of cows – Cows are a sacred animal in Hinduism, so people tend to treat them with great kindness (similar to how we treat pets). Cows are always standing in the middle of the road here, but I have never seen a car touch one. I have even seen a man pull over and feed his leftovers to a cow.
  • Peacocks – I did not have much experience with peacocks before this trip, but now I see one almost every day on our walks with Nikki (the dog) and Nandini.
  • Snakes – Snake bites are quite common here, and if you are bitten they recommend you try to kill the snake and bring it in with you for identification. That sounds like a pretty intimidating task, but luckily I have only seen one 3 foot snake during my trip (slithering away from me).

These are just a few of the ways our life here resemble my previous experiences with the great outdoors. Now, I will have a better idea of what to expect in my international rural travels, and when filling out applications we can definitely check the box – “Have experience with camping.”

 

 

One of the more intimidating lizards we have seen – in front of our building

A cow that decided to take a nice nap in the middle of the road

More cows strolling down the street

More cows strolling down the street – they have the right of way

A wild pig and its baby right in front of our apartment building

Herd of around 100 cows blocking our path – we ended up driving straight through them!

View from the top of the community health office

Our minimalistic kitchen 🙂

View from the top of our apartment building – those are mango trees!

One of the male peacocks we have seen on our walks – We have not seen one with its tail raised yet though.

A one inch infant lizard on my messenger bag! Very cute 🙂

Another view of the very tiny lizard.

A whole herd of wild pigs that happened to set up camp in the playground next to the hospital

It is so humid here that both this kindle case and a backpack were completely covered in mold within the first 3 weeks of being here.

Our very fancy living room furniture – adds to the whole camping feel

It’s mating season for the centipedes *correction – millipedes*  – so you see small piles of them everywhere. Apparently they mate in orgies.

A Day in the Life

Well we’ve been in Kharel India for 3 weeks now, and we have definitely settled into a comfortable (but very different) routine. Here is an idea of how a regular day might go for us.

 

8AM – Wake up and start our day! Crawl out from under our mosquito net, which was kindly given to us by a neighbor after the mosquito incident of our first post. Take a quick shower, which most people here do one of two ways. They either use the actual shower head (which only produces cold water, due to the lack of sun during monsoon season for the solar thermal panels on the roof), or they fill up a bucket of warm water with the “geyser” [pronounced geezer] point of use hot water heater. The cold shower is tolerable on the hottest days, but not something I would want to sign up for daily. We’ve settled for a compromise where we use the hose from the geyser to just spray ourselves down.

Our beautiful new mosquito net 😀

 

8:30AM – Breakfast at the Canteen: We have a 5 minute walk across campus to the 3-story building of the “Community Health” department. The ground floor (what we call the first floor in America) consists of three different shops – a social enterprise “handicraft” store run by women in the community, a pharmacy, and the canteen. The canteen is kind of like a café compared to the main hospital cafeteria. Every day it serves tea, a variety of breads, and one warm menu item which changes daily.

We are now competent enough in the language to order two teas and read off the hot menu item – that may not seem like a lot of progress, but you have to cherish your successes 🙂 Back in America Wende and I don’t typically drink tea, but here we’ve made an exception for a few reasons: 1) It’s a cultural thing – people here take tea breaks and all sit together to drink tea in the morning, 2) Portion size – the cups are very small, like shot glasses, so it’s hard to feel bad about, 3) IT’S DELICIOUS!! – All of the tea here is like Chai tea, milk based and very creamy, and it has things like fresh ginger ground into it (mmmmm…).

Another thing to note: Since parts of India used to be British colonies, the English dialect spoken here (along with some of the customs) derive from Britain. One of those British habits is calling cookies “biscuits.” That might not seem like a big difference, but it’s amazing how much easier it is to eat a whole packet of cookies for breakfast when you are thinking of them as “biscuits.”

Wende drinking her tea Indian style, out of the saucer

 

9AM – Morning Prayer: After breakfast we head up the stairs to the first floor, where the Community Health offices are located. A huge portion of the population is Hindu in India, so we start every day in the Community Health office with prayer. A large carpet (perhaps 15x10ft) is rolled out and all of the office members sit along the edge facing inward.

First, we sing a prayer song, which changes based on the day of the week. We’ve been provided with a phonetic English translation of the prayers, but because the translational accuracy is only OK it mostly leads to us just mumbling sounds under our breath the whole time. Then we proceed through a series of tonal “aum”s – the kind people associate with meditation (and the monks from pretty much every kung-fu movie).

Fun Fact: “Aum”, which may be confused with “home” when heard during chanting, is actually the name of the symbol that represents the hindu concept of Brahman. Brahman is the highest concept of Hinduism and is thought to be the source of all things in this universe. A quote from Hinduism.about.com on Brahman – “The sustaining essence that gives [the universe] structure, meaning and existential being, yet Brahman is simultaneously the transcendent origin of all things.”

After our “aum” chants, we finish up with some breathing exercises which includes: plugging one side of our nose while breathing and my personal favorite which I’ll call “intentional hiccups.” We basically perform a quick series of breaths through our nose, but on each inhalation we simultaneously sharply contract our stomach up into our chest cavity. The result is something that looks like a very controlled, if not graceful, case of the hiccups.

The “Aum” symbol

9AM – 6PM: Orientation – Since we’re new to the Gram Seva Trust, the first few weeks of our stay are based on getting acquainted to the hospital, its people, and their activities. At the end of our 5 week orientation, Wende and I will have a meeting with the head of the hospital to discuss where we may fit best during the coming months.

We weren’t sure what to expect before getting here, but Gram Seva has pretty much all the departments you would expect in a modern American hospital. I feel very lucky to be at a medical facility that is as comprehensive as Gram Seva, but I know that there are medical facilities around the world (and India) with far less resources to invest in the modern technologies of medicine. I would not be surprised if our next international medical trip landed us somewhere a little worse off – just a fair warning to you parents.

At this point we have visited almost every area of the hospital, including: the dialysis center, the emergency room (ironically labelled as the “casualty” ward in English), the birthing facility, the eye center, the general wards, the NICU, and the ICU. In addition to the traditional departments at the hospital, we’ve also observed a variety of Community Health programs to increase the quality of living in the surrounding areas.

On one day we tagged along to “Self-Helf Groups”, a woman centric crowdfunding program, in which all members contribute to a joint bank account which will then provide emergency funds to group participants when needed. On another day we traveled 7 hours round trip, through flooded roads and mountains, to reach a clinic run by GST in the small village of Mahal. The clinic often sees 200 patients a day, who travel from nearby villages to receive treatment.

My personal favorite program I’ve seen at the hospital has been a one-week sobriety camp for alcoholics in the community. Gujarat is a dry-state, but as we’ve seen with American prohibition, making something illegal doesn’t exactly prevent its production and distribution. 18 local men showed up for the camp and spent over a week in an intensive, anti-alcohol program. In addition to living on the hospital campus, away from their families (and alcohol), the men also attended multiple Alcoholic Anonymous meetings each day.

I personally found the AA meetings comforting, because even though everyone spoke Gujarati, the structure and energy of the meetings was the same as in America – “Hi I’m Ted and I’m an alcoholic…” seems to be an international AA mantra. Observing the alcoholic camp emphasized to me that even half a world away from each other, people are struggling against the same things and supporting each other in the same ways.

One of the AA meetings I attended during the alcoholic camp

 

Meals: We eat both our lunch and dinner in the hospital Cafeteria. The plate always consists of some spin on a few of the same dishes: Daal (lentils/beans) – the protein portion of the meal, a sautéed vegetable dish often containing Okra (called “lady fingers” here), some sort of soup, a small fresh cold “salad” of cucumbers/tomatoes, roti (a delicious wheat flat bread), and a spicy tortilla-chip like bread called paaper.

In India, most people eat everything with their hands, so even if someone gives you a spoon it’s often only meant for serving yourself. You start the meal with the roti by tearing off small pieces and picking up your food with it. You finish the meal by scooping a big heap of rice onto your plate and mixing it together with your soup (and anything else left on your plate). The experience is definitely messy, but it’s kind of enjoyable to walk away from a meal with a hand covered in goop.

Apparently there is a stereotype that white people can’t eat spicy food, so when we first arrived at GST, the kitchen had been instructed to prepare all of our food separately. We were pretty uncomfortable being treated any differently than the other hospital staff members, so we quickly convinced them that we were fine eating spicy food. Despite our reassurance to the cooks, we were still pretty anxious to take the first bite when our “non-special” meal arrived at the table. How spicy were we talking? Was all their fuss legitimate? It turns out that our few years of eating Thai food (and other ethnic dishes) at college paid off, and the level of heat in the typical food here is pretty mild for us.

The hour following lunch is my favorite time of the day. In Indian culture, it is expected that everyone rests for an hour after lunch. That means that the hospital pretty much shuts down from 1-3pm every day. Everyone just takes a nap! If you go into the kitchen at 2pm, you will find 6 happy kitchen workers resting on the floor after a morning of hard work. Nothing like culturally enforced nap time 🙂

In the evening, most people eat meals at home, so the kitchen closes down to the general public. They prepare dinner for the hospital patients, and afterwards they leave out one plate for us (and a couple other bachelor physicians) in the dining hall. At around 9pm we walk over to the nurse’s station in the hospital and get the key to unlock our “private” kitchen. During the day, the dining hall is full of life with people constantly passing through and chatting in jovial tones. But at night, the dining hall is super-spooky. They only leave one light on in order to save electricity, and it’s so quiet that you can hear every little scurrying insect or animal. On the days we don’t feel like enduring the Scooby-Doo like ghouls of the dining hall, we just bring our dinner back to the room.

A standard plate we receive in the cafeteria 🙂 Yummy.

 

6PM Onward: Our evening activity varies, but there is always one commonality – Rain. We weren’t sure what “monsoon season” was going to be like…. turns out, it’s exactly like it sounds. It rains here every day, if not all day, and it can change from cloudy to heavy rain in a moment. We carry our rain jackets with us everywhere, but it rains so much that eventually you just stop worrying about it.

On the evenings that it’s not raining, we take a walk with Nikki the German Shepherd, and her owner Nandini. Nandini is the bubbly 13-year-old daughter of Sharmishta, the head of the Community Health office. Because Nandini attends an English based school, she is one of the few people on campus who speaks English fluently. A few days after we arrived, she told us that she had a German Shepherd in her back yard. Since Wende and I were already in animal withdrawal, we were unreasonably pumped to meet her dog.

After all Nandini had told us about loving animals, I was a little surprised to see that Nikki looked a little unhealthy upon first glance. However, when I realized her situation, her physical condition made more sense. About 3 years before we arrived, Nandini’s father moved into Mumbai for work, and since that time Nikki has been primarily confined to a small back yard. Neither Nandini nor her mother are strong enough to walk comfortably with Nikki, so the dog hadn’t seen much activity for the past few years. I completely understand what it’s like to be uncomfortable walking a dog, especially when you don’t feel you could control her were she to have an aggressive encounter with another canine. That risk is especially high in this area, where there are stray dogs around every turn. Since we’ve been taking our daily walks, which as Nandini says “are good for us and for Nikki”, the dog seems to be much healthier and happier.

After our walk, we may do a number of things. Perhaps we stay-in and watch one of the DVDs we brought with us, or we might go into town with some of the other people who live in our building. We have become particularly good friends with a couple named Nirali and Paresh who live caddy-corner to our apartment. They are about 6 years older than us, but since we’re both married (and Paresh speaks fluent english), we spend a lot of time together.

Another activity that takes up a number of our evenings is doing laundry. We don’t have a washing machine here, so instead we use a bucket and some old fashioned elbow-grease. We start our clothes soaking at lunch time, and then we agitate them throughout the day any time we return to our apartment. In the evening, we replace the wash water and give them another good scrubbing before rinsing them, wringing them out, and hanging them up to dry on our porch. We do this 2-3 times a week, but because of the rain and humidity the clothes can often take 2 days to dry on the line. Since our lifestyle here is very laid back, I don’t mind washing our clothes this way, but you can be sure I’ll have a new appreciation for our washing (& drying) machine when I return home.

After a day full of interesting medical encounters, smiling Indian patients, and frustrating broken Gujarati conversations, Wende and I are ready for a good night’s sleep. Our sleeping arrangements are a little different than in the US, so we had a tough time sleeping when we first arrived. The beds consist of a metal frame/rack covered in a thin pad, similar to a futon with most of the stuffing taken out. The first few nights it bruised our hip bones, but now we have acclimated and sleep like a baby most nights. While lying in bed, we’re lulled to sleep by the sound of nature outside our window, and wake up the next day ready to start it all over again.

Wende and I in front of the door to our apartment – we got the beautiful sign at an Indian festival last weekend

The building that contains the community health office and canteen

The view off the balcony of the community health building during a torrential downpour – even though it’s hard to tell in the photo.

How all of the doors are locked on campus

The first baby I saw birthed – isn’t it cute!

Friendship day at an orphanage run by the hospital and its community health department

An appendicitis surgery of an ruptured appendix – I typically don’t take pictures of patients, but the comical anesthesiologist practically forced me to.

One of my favorite people from the alcoholic camp – he always had a smile on his face.

Making paper bags on the first day of the camp – we wanted some way to distract the men from the thought of drinking.

Pulling weeds on the first day of the alcoholic camp – we wanted some way to distract the men from the thought of drinking.

All of the men playing indoor cricket at the end of a long day – fun, even if I was terrible 🙂

Wende with Nandini, swapping some language knowledge.

On our walk yesterday, I attended to jump a creek.

Key word – attempted. This is my very muddy landing on the other side.

Uh oh – now I have to jump my way back … I should have thought this through.

India bike gang we saw on a walk – the largest group I had seen here.

Neat bridge I found during a walk, constructed out of branches and a discarded support beam

Of course I had to try to walk across it 🙂

Hard to see – but one road we walk with Nikki is populated with peacocks. We see a bushy tailed peacock almost every day!

Group photo of Me, Paresh, Nandini, and Nirali

Getting into the clothes washing groove!

Our first load hanging out to dry… that load smelled a little, but we’ve gotten much better since then 🙂

Our cute kitchen “fully stocked” with an electric griddle, salt and pepper, and a handful of dishes

Our bedpad and frame – getting comfier every day.
I think a regular mattress may be uncomfortable when we return!

The Well Fed Americans

“God gives us humans everything we need to flourish, but God is not the one who’s supposed to divvy up the loot. That charge was laid upon us.” Paul Farmer

 

Walking around in India, I feel out of place. Not only am I white – the only other white person I’ve seen outside of advertisements has been Austin – but I am clearly well fed. This is apparent by both my width and height.

 

Antenatal Checkups:

One of the first days at the hospital, Austin & I observed women receiving free pregnancy check-ups. So many women come for these checkups that hospital staff lay a blanket on the floor in the hallway for the women to sit on as they wait to be seen. Sitting on the floor rather than chairs is a fairly common occurrence in India where chairs, space to put them, and ways to transport them are scarce commodities.

Austin and I sat in chairs that lined the hallway that functioned as a waiting room and observed as the women came in and squeezed onto the rug. Once the staff was set up they invited us to come into the room where they would first weigh the women – this room is larger and less crowded than the examination room. As the women entered it was hard to believe that they were all pregnant. I can’t remember seeing a single woman who had a large belly like the one’s I’ve seen on pregnant women in America. Seeing the women’s actual weight made it even more clear how small (and underfed) these women were.

I’m used to measuring weight in pounds so seeing weights in kilograms (kgs) is already unsettling since it takes 2.2 kilograms to make 1 pound. Nevertheless, we only observed a range of weights from 30-50 kilograms or (66 to 110 pounds).

Outreach:

There’s an entire building of the Gram Seva Complex dedicated to Community Health and Outreach. In addition to going to check up on patients in their homes, organizing 160 microfinance groups, creating jobs through “handicrafts,” seeing patients in the office, helping feed and educate children in the community, members of this office also spend multiple days each week driving out to small satellite centers to give children checkups and provide them with vitamins and extra food if they’re malnourished.

After morning chanting and breathing exercises, two community health workers organize the supplies we’ll be taking: lots of iron supplements and a protein and vitamin enriched, high calorie flour. At 10:30 we climb into what looks like a small school bus painted white. Our drive along no fault (unlined) roads takes us to a one-roomed building filled with young children sitting on a rug on the floor. There is a similar building for every 1,000 villagers that the hospital cares for and each one has two of the villagers trained to help assist with the care Gram Seva provides (empowerment through employment). These two workers prepare a meal for the children before we arrive and help as we weigh the children in what looks like a swing attached to a scale to measure produce before they are seen by the physician Hiral Dave.

Hiral shows me the chart they use to see if the children are normal or malnourished level I, II or III. I had read in Gram Seva’s yearly report that when they started this program, malnourishment in the surrounding villages was 76% and that it has since decreased to 53%. Nevertheless, it was still difficult to see so much malnourishment in person. It was disheartening to see how thin many of the children’s and mothers’ arms are when I know that there’s food in America that’s being thrown away or eaten in excessive amounts.

One of the workers from the hospital waited on the bus to hand out medicine to children after their checkup

Hiral listening to a fussy baby’s heart

Wende learning to measure blood pressure on some very giggly girl volunteers.

 

Shopping for clothes

A young couple that live across the hall from us: Paresh a physician and Nirali who’s 5 months pregnant are the people we’ve explored the surrounding area the most with. They’ve taken us to a Buddhist temple at the top of a hill, to family’s houses or work offices, helped us get screen for our windows, kitchen supplies, and cell phones. On one of these outings to a nearby town we purchased Austin some short sleeve button up shirts to keep him cooler. The store we found was about 15 x 8 feet with a counter running the length of the store. There was no dressing room so Austin tried on different size shirts as we all stood in the small shop. It turns out that while in America Austin is definitely a “small” when it comes to shirt size, in India he’s a “large” or even “XL.” We both knew that I was definitely more well fed than most of the women we’d encountered, but we hadn’t really stopped and thought about the fact that Austin was indeed larger than most of the guys. The fact that he has large bicep muscles doesn’t just show that he has spent time working out, it also demonstrates that he has access to enough food to grow his muscles.

This also made us think about height. In America, I would be considered a tall girl, though there are definitely taller girls. However in India, we both tower over both women and men. Here, height seems as related to how much nourishment one received while growing up as genetics.

 

Nirali, Austin & Paresh picking out handkerchiefs

 

 

Austin in front of a Hindu temple

Nirali and Nandini looking at the view from the terrace on top of the temple

Tree in front of temple

Austin, Paresh, Nandini & Nirali on the terrace

The view from the top

Obligatory temple selfie

On our trip we stopped by to see some of Paresh & Nirali’s family

Paresh took Austin to go get us cell phones one day during lunch break

Wende working on cutting the velcro for the screens for our windows

Austin nailing the velcro to the window – no peel and stick here