first haircut

I feel like I know so many locals now that I have been here for a month. The funny thing is they all know me too, I guess it’s not hard to recognize one of six white girls walking around town. Everything time i pass my favorite shops or restaurants they say hi and offer me tea. I love the people here and they treat me so well, I feel part of it maybe because I work at the mission hospital or maybe it’s because I’m one of the few white people they have ever interacted with. The other day I got invited to a local party. It was called a mundi which is a celebration of a baby’s first haircut. I had never been to one let alone every heard of one. I didn’t realize how big of a celebration this was until I realized that everyone in town was going to it. My friends and I got dress up in our traditional Indian clothing and jewelry. Getting ready for this party was comparable to getting ready for prom. Really exciting, you wear your nicest clothes, and a lot of pictures were taken.  The family had an entire building rented out, along with a DJ and someone to cater.  We were served a 9 course meal on banana leaves and we had to use our hands to eat. I was so full!!!! Later that night I practiced my Indian dancing.

Dr.Sanjay

Last Monday we had this amazing discussion with Dr. Sanjay. He was a guest speaker that came from Varanasi and is also a friend of Liz. He is a huge women right activist in India. Sanjay is actually his first name and only name. He dropped his last name because he no longer wanted to be identified by his cast. In India you can easily identify the cast a person belongs to by their last name. The cast system is technically illegal but it is so deeply imbedded in the Indian culture discrimination still occurs. He held a class to talk about his campaign and I loved it. I really feel this man is way ahead of his time concerning human rights in India. He started the class with everyone hold hands tell us we are all equal both men and women. This was so nice to hear because being in India as a female  really makes you revaluate your importance in this world as a female . He then separated us into two groups, male and female. We then talked about the different issues we face as separate sexes. Dr. Sanjay then explained his life story as to why he is so passionate about gender equality. He talked about the male ego and how it is hegemonic and dominating. He talked about dowry burning, rape and other acts of violence that occur in India against women. He said educating  women is only the beginning to gender equality.  In the Indian society were males are so dominate we need to educate men as well. He said we need to stop promoting gender difference and that men and women need to be able to coexists peacefully. I loved listening to him because he was so passionate when he spoke. He said his family does not support him or his wife on their quest to fight gender inequality. He said his family harassed his wife and child because they are all feminists.  The last thing he said was gender inequality needs to stops and we need to support the men and women who protest it. Dr. Sanjay was such a breath of fresh air.

temples

The other day I visited all the Temples in Manali. I really enjoyed being allowed in the Temple, I got to see all of their different god as well learn how to pray to their gods. I had to wear a shawl over my head to go inside, once you were done praying your head was marked with red paint. It was really cool and great exposure to their culture and religion. I also went to the biggest temple in old Manali, I had to wait in line to get in and once you were allowed to enter the temple you went up to god at this temple and touched her feet. Touching a gods feet is a sign of respect and acknowledgement of her power. After visiting this temple you are then required to go to the open tree temple to make your visit count. If you go to both temples then this god will grant you one wish! The only catch is you must go to both temples and you have to desire your wish with all your heart.  I only had one wish so I had to think about it for a while to make sure it was good enough. In the end I think I made a great wish.

: (

I had another really sad experience last Sunday, it made it even worse since it was Fathers Day. I was at the hospital and all the people were gathered around the court yard. Immediately I questioned what happened because the only time I have seen so many family members gathered in the same spot is if someone died. A woman walked out of the hospital hysterical being guided by her husband, the whole family looked very upset. The man walked back into the hospital. While he was gone the nurses were blessing the family members. A few minutes later the same man walked out of the hospital with a white body bag in his hands. You could tell he was carrying a very small body. He then got in the car with all of his family and they drove away. Later that day I found out that the same car the family drove away in was the car his daughter died in. They had been in a car accident t. Looking at the car i would have never guessed that, it only had a few dents. I asked how his daughter could die in such a minor accident. Apparently his daughter had her head hanging out the window at the time of the crash. Everyone in the car survived and was unharmed including the little girls twin sister. I imagine this family was out for father’s day vacationing in Manali and then this terrible thing happened.  Life can just be ripped away at any moment.

snake charmer

My life is so crazy right now i never want to leave India! This past week I went on a 5 hour hike to a beautiful waterfall, I went to karaoke bar and once again made a fool out of myself with my lack of singing ability, went to several temples and hot springs and finally was entertained by a snake charmer. Literally the scariest thing I have ever seen in my life. By the end of his performance I had a cobra on my head and a python around my neck. I was shaking… I never realized how afraid i am of snakes! Thank goodness for pre pressure because I just had another amazing experience!

c section

This past week has been absolutely perfect. I was given free rein of the hospital. I saw so many different and interesting cases; it’s amazing with such a small staff that the Mission Hospital can basically handle everything. The most common injuries I saw where those due to car accidents and TB. Probably the most memorable cases were the most bloody or heart wrenching. I saw a man get his finger reattached in the ER, another man who literally broke his jaw and spine in half because he fell from a tree drunk, a family lose their loved one, a little girl that was hit by a car, several surgeries both major and minor, and finally what I have wanted to see my whole life… the birth of a baby!!!! I was so fortunate to see a child be born here because it’s very uncommon for women go to a hospital to give birth. Many of them don’t understand it is a lot safer to give birth in a hospital than in a village. I was so lucky because I just happened to be in the right place at the right time. I was doing round with sir when I saw a lady taken into the OT. I asked what was going on because all surgeries are on Tuesday or Thursday, a med student told me that this patient had gone in to labor and they needed to do an emergency cesarean section.  I ran over to the OT so I wouldn’t miss anything.  LOL I ended up beating the doctor there. The lady was screaming in pain… I became a good hand holder!!!The surgery lasted 2 hours but it only took about 5 mins to get the baby out. This birth was the most beautiful and yet most disturbing thing I have ever seen in my life. I was so excited by this birth I can’t even imagine what it would be like to be a parent in this situation. It was incredibly disturbing because it was the bloodiest thing I have ever seen in my life.  So fortunate to have the experience of witnessing a healthy birth!!! Next thing on my list, witness a vaginal birth.

so fast

This trip is flying by : ( here are a few of my favorite moments so far!

surgeries

I know I say everything is insane here but every time I see something new it blows my mind! Every Tuesday they perform major surgeries.  Being the overly excited student that I am wanted to see them all, therefore I stayed for everything. I ended up seeing four surgeries, two open removal of the gallbladder, one laparoscopic removal of the gallbladder, and an open removal of one ovary and several cysts. All of the surgeries were so interesting but my first surgery of the day I had a really hard time with… I can give you graphic details if you want! I think it was the initial shock, sights and smells is what really took me by surprise.  Thank god my friend Garave was with me or I would not have been able to make it. The three remaining surgeries when well for both me and the patients, all the patients are stable today. Something different about all of these surgeries that you would never see in the United States is all the patients were awake throughout their procedures. If that was me laying there with my guts hanging down to the floor I would be freaking out!!!!!   Another thing that is different is after your surgery is over your family comes to get you and from the surgery room carries you on a stretcher to your hospital bed. Once again the only word for this is insane but I honestly do respect everything they do and how they treat their patients.  The staff at this hospital is so amazing it’s too bad they have such limited resources. Honestly I would rather have these doctors cut on me before I would let any doctor touch me back in the United States. It’s astonishing how well these doctors work together and help each other out.  I love knowing that their work is not about the money or the prestige; if it was they would have left to go somewhere else and actually make money.

mission hospital

Finally I am out of the villages and seeing hospital patients. Today was my first official day and it was a GREAT DAY! Although I had a mixture of emotions, working at the Mission Hospital excites me even more about my future and everyone I can help. The Mission Hospital is a Christian based hospital that starts off every day with a devotion ceremony. I have never been a big fan of attending church but devotion this morning was truly touching. Devotion was led by the lead doctor, Dr. Philip. Devotion was in English and in Hindi which was perfect because I could understand. The most amazing part was when everyone sang songs in Hindi. They also talked about how as doctors they are led and given the strength by god to do what they do but untimely they can’t control the decisions he makes. I often wonder how doctors and nurses have the drive to continue every day, Dr. Philips answer is god gives him the strength. The service was amazing and so touching but immediately after it ended I was rushed into ICU with Dr. Philip. There was a patient there that had congestive heart failure, liver failure, and emphysema. She could not breathe on her own and was her heart rate was plummeting. I stood there with Dr. Philip watching this lady and her family. My first patient of the day died right in front of me. I can’t even describe the emotions I felt. I was in devotion 10 mins before listening about how god does what he wants to do and then I was watching someone die. I guess that was my official welcome to nursing.  When the doctors told the rest of her family they were hysterical, they then took the deceased patient home (most likely to be cremated). Without skipping a beat the rest of the day continued. I spent the remainder of my day in and out of the antenatal clinic. At the antenatal clinic I learned how to use a Doppler and for the first time in my life I found the heartbeat of a baby. Once again I can’t describe how I felt, I feel nothing can describe the sound and the emotions that go along with finding life. My day has been insane, literally I saw death and then I was blessed with finding life.

bday

Celebrated birthday, so much fun!!!

TB father

Sorry my posts have been sad lately but I had another heart wrenching experience.  Lately I have been seeing very malnourished children, women losing their unborn babies and extreme poverty but this particular experience really affected me. This past week I have been doing so much TB research, which means hiking to villages, finding your way around and with the use of a translator find the patients that have TB. Once you find the patient the questions typically go as followed. What is your name, what is your age, the medication you use, where you received treatment, have you relapsed, do any of your family members that have TB, and do you know anyone who you could have gotten TB from? I have seen so many TB patients in the last 2 weeks all the cases are starting to blend together. But this one particular patient has stuck out so graphically.  He was a forty year old but looked about 70. He was very thin, and extremely frail. He had to walk down the stairs to talk to me and his body looked like it was going to fall apart. He seriously looked like her could die any minute. Once he made it down stairs the interviewed began in the usual way. From his interview I learned that he was forty, previously had TB but relapsed and currently has TB. He told me how he received his first treatment at a government hospital. When he got TB a second time he said he started his treatment at the government hospital but stopped because he no longer trusted the government. Now he is getting treatment at a private hospital. A private hospital can literally mean anything in India but regardless a government hospital would be able to provide him a more effective treatment. The interview was almost over when a young boy came to the house. We began to have a conversation about his relationship with this man. He said he was his son and he was sixteen years old. I asked him if he or any in his family had any TB symptoms. He said both his younger siblings were fine and he was fine as well. I asked what about your mother. The boy said his mother had died a couple years back. I then encouraged him to convince his father to seek treatment at the government hospital because it father was very sick and would die if he did not receive the adequate treatment. Right then staring at this young boy it slapped me in the face how similar we are. He is the oldest of three and had lost his mother a couple years ago. All the boy had left was his father. I empathize with this boy; I know he is probably scared to lose his father. I’m sure he thinks if he loses him what will he do, what will his two younger siblings do? Although he lives in a small village in India and I live right outside of DC in the U.S. It’s amazing how people can connect over similar experiences.

This is my religion

I like to think of myself as having a very open mind when it comes to religion. One thing that annoys more than anything in this world is when people fight or argue over religion. Fighting over religion is stupid and not worth it. Fighting over religion has caused hatred and war. The only reason I am ranting over this is because I feel regardless of your religion… no matter what it is you have a right to practice it and no one should have the right to tell you it’s wrong. Most of the people that I am on this trip with are Jewish, which is fine, I love them all! But one of the instructors on this trip is also Jewish. She constantly complains about how back in the United States she worked for a Catholic Hospital but she didn’t agree with the religion they practiced, the fact they had morning prayers, and that since they practiced Catholicism it prevented her from practicing the type of medicine she wanted to. Granted Catholics don’t agree in abortion and contraceptives but she is an infectious disease doctor not a gynecologist. If she didn’t agree with Catholicism then she shouldn’t have taken a position with a Christian hospital. She then proceeds to say every day that this hospital drove her out of practice.  Also the hospital here is a Christian hospital and she always makes in my option offensive comments toward Christianity and how she thinks that they are pushing it on her. Religion here has to do with the way these doctors practice, the hospital mostly caters to Hindus. The cast system dictates more the way people are treated.  I don’t consider myself a bible thumper but I was brought up a Christian and for the first time in my life I am offended with someone telling me how bad it is. I respect her religion and I expect mine to be respected as well.

baby

The other day something happened that made me think about how the issues I have are so meaningless compared to others. Recently I extended by trip so I could travel south with a few of my friends. Very exciting, but in a way stressful because it requires planning.  Some of them have not changed their flight yet which frustrates me because I don’t understand what they are waiting for. I want to start planning so I everything would be set up by the time I leave Manali. Also I have been frustrated by the food here. I eat rice, bread and bananas everyday which leaves me hungry and also none of this food has any fiber in it. I feel my stomach is distended with food. Needless to say my friends and constipation (lol sorry) were driving me crazy until the other day. There was a lady at the hospital, she was in the neonatal room having a check up on her soon to be born child. She was surrounded by other healthy expecting mothers. The doctor went to check her baby’s heart beat and it was not there.  Her child had died. She was a very submissive women and her husband did most of the talking. Apparently they had not been able to have a child yet and this was her fourth miscarriage. The husband was very angry and he blamed his wife because she was unable to have children. He asked the doctor if there was anything that the doctor could do. The doctor said i can’t bring a dead baby back to life. He said they could run tests to see what is wrong but he explained to the husband that his wife needs to come to doctors before there is a problem not when something is seriously wrong.  The man yelled at his wife and they left to make an appointment to abort the dead child. In the Indian culture it is very important that a woman can bear children, especially a male child. In traditional families without being able to have children you are worthless. I would hope that because they are husband and wife he would stay with her but in reality I know this is probably not true. She has had four miscarriages and men have this mentality that if you cannot give me a boy then there is no point in me supporting you. I don’t know what happened to this women but I can guess she will soon be without a husband, without a home and without someone to take care of her.  Puts life into perspective.

female health workers

I had an opportunity to meet with the female health workers from the local villages. This was an extremely moving experience because we were able ask question about their health care and culture as well as answer questions about our own.  For the first time I felt like a source of usefull knowledge to someone. I was especially moved by the fact that all of these women took the initiative to educate themselves about how to provide health care in a society that is very limiting to women.  Although these women may have different cultural views and options than I do I have the upmost respect women who take an active role to achieve an education to benefit their community.

gender equality

While in Jibhi the goal was to hike to the surrounding villages and with the use of a GPS, map the village and the location of its TB patients. The only way to get to the villages was by foot, not one was assessable by road. Keep in mind all the villages are tucked away in the mountains with no organization as to where they are located. Because the clinic was at the base of the mountain every village required an uphill hike. It was a great experience but exhausting. Once we reached the villages we mapped distinguishable points of the village such as a school or a temple. After we mapped we met with the locals, all of them were very nice!!!  The biggest village I saw was about 200 people, the smallest about 20. Most villages are in between but regardless they are small. Each village was laid out about the same way. You would enter and there would be a temple, a town center which is usually distinguished by a cement block, a preschool, an elementary school, very modest houses made out of wood and then a lot of land to farm. Not one village I went to had a middle school or high school, the older kids have to climb down the mountain to get to school.  Also education is a lot different than in the United States. All the children wear uniforms, they go to school six days a week, are off on Sundays for religious reasons and finally you have to pay to send your child to school regardless if the school is private or government run. One of the things I find so sad here is because you have to pay to send your child to school the sex ratio in the schools are uneven. Mostly boys are sent to school and girls are left at home. Not all Indians but many have a very traditional way of thinking when it comes to gender equality. A female is viewed as a burden to the family, basically another mouth to feed. Unlike men once a women is married off they leave their families leave their home and are considered her husbands and her husband’s families problem.  A man stays in the family, supports his parents, will carry on the family name, be able to inherit land and handle the money. A female can’t do this therefore why invest in her education. Because of sexism recently India has passed a law making it illegal for a doctor to tell the parents the sex of an unborn child because the government is trying to prevent female feticide. Thankfully India is making some progressing toward gender equality but in my option they have a long way to come. Everyone, male or female should have the right to an education.

Jibhi

Spent the past week in Jibhi. Jibhi is a small intersection that is surrounded by villages. Leaving for Jibhi I was so scared because Heather described it as small village where we would have to “rough it”. I already have been sleeping on a slate of wood and taking a shower bath. I didn’t know how it could be any different than Manali unless I had to sleep in a tent!!! It took me three hours to get there even though its only about 60 miles away… like I have been saying it takes forever to go anywhere or get anything done here. Once we arrived in Jibhi I was so relived, it is probably one of the most beautiful and relaxing places I have ever been in my life. We stayed at a clinic that was right on a stream in the middle of the mountains. The only thing I found weird was the clinic was not accessible by roads. The air was fresh, there were very few people, no car horns and best of all a sky full of bright stars, So different than Manali. I am so in love with this place and its beauty that I would totally leave Salisbury to live here in the mountains.

monkey

Today was defiantly the best day so far. I went trekking through the mountains. The trek totaled about 10 miles and was amazing. We had a guide that took us through a small village in the mountain. The cows and dogs look a lot healthier there. For once they were eating grass and not trash. While in the village I watched a women make a shawl. It amazed me how much effort and time is put into something small that wraps around your head. Made another friend today, it was another dog. The dog followed me from the village up the mountain and the whole hike. When the taxi came to get us at the end of the trek the poor dog ran after the car. In a way I feel like the dogs are like the Indian people, they love foreigners and follow them everywhere. After the trek I ate lunch with a few friends in Old Manali… I broke down and got pasta, im already ready to eat something other than Indian food. While in Old Manali I saw a monkey YES!!!! Coming back from Old Manali we were late for class so we hitched a ride with someone driving down the mountain, the man driving was very nice to drive a bunch of American students around.

TB

Been working on trying to map the TB cases. Originally I thought most of the cases were in Manali or the surrounding villages but I was wrong. I didn’t realize how much TB was a problem in India. I learned something interesting as well. India is having a large problem with patients having TB that drug resistant and because of lack of resources doctors are unable to identify if their patients have this type within a timely manner. Therefor when patient comes in with TB regardless of what type it is the doctor immediately start them on antibiotics. If a patients goes four months without responding to the antibiotics then the doctor knows its drug resistant. This is a terrible way to go about diagnosing TB because first of all having a patient on antibiotics for so long is costly, can hurt them more than help, and finally now other bacteria can build up a resistant’s as well from repetitive antibiotic use therefor in the future this particular antibiotic will be ineffective and it will be harder to treat patients. Issues like this frustrate me, not because towns like this lack the knowledge or even the ability but because the lack of money. In the United States all we would have to do is take a sputum culture and we would know if a patients TB is drug resistance within hours. In developing countries is not so simple.

Where is the monkey?

Hiked back up to old Manali where I bought two pairs of pant for 400 rupees… so cheap!  Then went hiking to a ridge because I heard that is where the monkeys live. Did not see any. I have made it my personal goal to see a wild monkey before I leave India. Stopped at a Café and had Litki. Litki is a fruit in India that is commonly used to make juice, it was delicious. Decided to go hiking some more and found an apple orchard but unfortunately it was closed. While hiking to the apple orchard I made a friend, it was a little dog. I’m terrified of the dogs here because they are all strays and can me either really mean or in this case really nice. He followed me up and down the mountain.  The same day as the hike I got to meet Dr. Alexander, he is the main doctor I will be working with while I am here. He showed me around the mission hospital and explained how this hospital sees most of the Manali patients and nearby villages. It’s the biggest hospital around with the capacity to house 50 patients. He showed me the ER, delivery room, OPD and ICU. He made a few comments about how I could help with a delivery if wanted, remain on call during the night, choose to manage the emergency room or observe surgery. So excited!!!! Hopefully he is as serious as I am because I am willing to do it all! After meeting the doctor I made a few more friends. This time is was with local children. Once again I tried to talk to them, they asked if I was Hindi, I don’t know if they were serious but as soon as I opened my mouth to speak to them they knew there was no possible way I could be from their country. They then made fun of me because of my accent and my inability to pronounce their names. Its ok though… they make me laugh when they try to pronounce Bre.