It’s Fantastic………….

So officially I am now staying at the Sivananda Rehabilitation Home in Kukatpally, Hyderabad. Although I have been eager to share my experience by writing, unfortunately the computer access has been very limited here at the home. For those I haven’t talked on the phone, 15 hrs in the plane did go by fast, granted I did watch “finally” – I am Legend and the Iron Man. Ride over from the airport at 3 am, to the place I stayed for a day, believe it or not, was fast yet bumpy. Traffic in Hyderabad or most cities in India is definitely an experience as there are no rules (that are followed), no dividers, 15 different vehicles, honking every 5 seconds along with the pedestrians, cramped together, walking, slithering, all in a rush – one more than the other, buses making left turns from far lanes, motorcycle stopped in the middle of a road to talk on a cell phone or eat an orange, a scooter undergoing a transaction in a middle of a big intersection with a papaya vendor also strolling in that mess with his 4 wheeled wooden cart while rest of the world trying to weave there way around them beeping incessantly, and my shocking observation, not a single loud curse word heard from any of the drivers. To top it, the most daunting task has been to actually cross the road because NO ONE will stop unless you just throw yourself on the road with traffic coming your way at 45km/hr, stick your hand out to stop them, and if you are not run over, you can make it to the other side. Yes, I have a new respect for the yellow cab drivers in NY now.

Anyways, after reaching home, I slept for a couple of hours and was woken up by an aroma of burning coal outside of my window. Yes, it was the IRON MAN (unfortunately not Robert Downie Jr.) but literally a man who irons clothes for a living. My first day was very relaxing, pleasant and beautiful. That evening we drove around Chaarminar, necklace road, a lake with the Buddha’s statue, and finally a temple down the street ending my first day with the delicious home cooked four course dinner.

On August 25^th – I moved into my room at the Sivananda home. Luckily, my roommate from Chicago, there for the last two months, has been fantastic. She made sure that the room was lizard free, I had plenty of water, volunteered to venture out in the traffic with me for “bare” necessities. Just short of knowing telegu and her appearance, she could easily pass for a native as she is able to finesse her way gracefully through many situations, knows everyone, and seems to be everyone’s favorite.

 

August 26^th – My reason to come to SRH, I made my way to the HIV home for the children. The most amazing thirty children, all HIV (+), abandoned by their family or homeless, most of them appear younger than their stated ages, perfectly happy in their own small world yet seeking attention desperately. They greeted me with so much warmth and excitement, wanting to show me their art work, singing songs and addressing me as “akka” a telegu word for a big sister. Their ages, 5 to 15 yrs, in one classroom, one teacher working to give an individual attention, juggling all subjects and grades till the 4^th standard. Honestly, I have never seen as many children together in such harmony with each other. This is and is going to be the most emotional part of my journey and as to even make an attempt to describe my experience would be challenging and unjust.

Rest of the day was social and educational. I finally met with rest of the group from Case and we all shared our experiences, gave/heard lectures on numerous topics/diseases that we were to experience at SRH. To sum it up so far – a perfect weather, perfect food, perfect accommodation and now I anticipate already a perfect company.

 

Aug 27^th– stay tuned

 

Slumming in Chennai with YRG CARE

It is just past midnight on my most exhausting day yet, but I want to get some thoughts down. Today I left the crew in Pondicherry and headed north. My driver was an hour and fifteen minutes late and brought a vehicle with an empty tank. Gas (“petrol”) can be purchased at petrol bunks along the side of the road as well as at apparently any other stall. We made for such a stall after leaving the MGMCRI campus, then took the coastal highway to Chennai. This is much more picturesque than the faster route we took on our way in, and goes through Kovalam, an area that was heavily affected by the tsunami.

I arrived at the Y.R. Gaitonde Center for Aids Research and Education precisely at noon. It is located on the campus of a hospital called Voluntary Health Services and was started by Dr. Suniti Solomon, the person who, in 1986, reported the first cases of HIV in India. It is a non-governmental organization and boasts one of the most prolific HIV research publication records of any center or institute in India. Aadia has blogged about her time at YRG CARE here. My contact at YRG is Dr. Sunil Solomon, one of the physician/investigators here and the son of the Dr. Solomon. One of my Case students will be spending a few months here later this year for his thesis, and Sunil was kind enough to arrange a tour for me of YRG CARE’s facilities and programs.

I will leave the description of YRG CARE’s research activities to their website. Suffice it to say that they are a model organization, whether it comes to clinical care, research, or humanism. I would prefer to describe my activities after the tour of the premises, lunch with Sunil and his mother, and my lecture to the staff there. I got into to one of the official YRG CARE autorickshaws (Alicia, hope you are paying attention) with Suresh, who heads up many of their outreach activities.

Suresh took me to two slums, then their clinic for injection drug users, then to their community research building. The slum visits were an unforgettable experience. The first one, Jothiammal Nagar was on the banks of a “canal”, which is a euphemism for “large open sewer the size of a small river”. We were to meet in the community hall but it wasn’t ready, so we actually met in one of the houses of one of the CPOLs (Community Pxxxx Opinion Leaders). The CPOLs are nominated by each community, and consisted in this case of 4 men and 4 women. To enter the house, one walks across a wooden plank to cross the two-foot wide open sewer drain running in front of each house. This CPOL’s house was a room about 10 feet by 20 feet, with a curtain dividing the room into sleeping and non-sleeping areas. The kitchen was in one corner near the front of the house, and there were two chairs in the middle of the room, on the dirt floor, for Suresh and myself. The 7 available CPOLs and the YRG outreach worker sat on the ground.

For about 20 minutes, I had the chance to ask them questions about their experiences in their new roles. The center had only been open for about 3 weeks. The focus at this center, as in many others, was domestic violence. The CPOLs seemed confident in their abilities, their training, and their responses thus far to the incidents that had taken place. They themselves identified alcohol as a major contributing factor in domestic violence, and expressed their desire to tackle that problem in addition to what they were already doing. There had not yet been much in the way of referral HIV testing at the center, but this will start picking up soon, I imagine. After the meeting, I said my thanks and namaskaarams to everyone, and was led to the main thoroughfare of the slum by two of the men, along with Suresh and the other YRG CARE worker. Near this tiny intersection was a modest brick-and-mortar structure that would not have made me look twice ordinarily. Its presence in the slum was incongruous. When I asked Suresh about what it, with one or two other similar ones adjacent, was doing there, one of the CPOLs declared proudly that it was his own house. This is an iron man’s house, he said in his English as he thumped on his chest. I am iron man, he continued, pushing an imaginary iron over a matching ironing board. Then he pointed to his biceps and said in Tamil, hard work. I learned that he had put his son through college recently. He and the other CPOLs certainly seem well chosen.

We left Jothiammal Nagar and headed next to Kothavalchavadi. This was different in a couple of ways. It was government constructed tenements, rather than makeshift, inhabitant constructed domiciles. Additioanlly the program there had been in place for a few years, and the CPOLs had had much more experience. Most of the men CPOLs were out working, so I only spoke briefly with the women, but was just as impressed as in my first experience. They were only too happy to allow me to take pictures and told me to spread the word about the squalor in which they lived.

After the slums, we headed off to northern Chennai, to a clinic for injection drug users that Sunil runs. There, Pradeep, who had previously shown me the inpatients at the main YRG hospital earlier, appeared again for his evening shift. He gave me the 5 rupee tour, I took some more pics, and then it was off to another YRG research area. I checked my email, freshened up, and was then dropped off at the Solomon residence, where I was accosted by three large golden retrievers that required constant petting and scratching. Sunil and Dr. Solomon took me out to a typical Tamil meal with some of their close family friends, then sent me to the very comfortable guest house where I spent the night.

YRG CARE is a fantastic organization. I am impressed with their interest in all ID things as well as social issues, and I am sure that my slum experience will stay with me for a very long time.

Gopal’s journey

I am currently completing the world’s most efficient trip to India. I got the upgrade to first class on the CLE to DTW leg of my journey again. Not to look a gift horse in the mouth, but why is it that the only time I get upgraded is when the journey is 25 minutes? In any case, I had just enough time at the Detroit airport to go to the men’s room and get to my next gate before I boarded the transatlantic flight. Slept for a solid 4 hours or so after chatting for the first hour with my neighbor, a nursing student originally from Alaska.

I was looking forward to window shopping and blogging at Schiphol, but had literally just enough time to get to my next gate, where a line had already formed for the next flight. Fortunately, I was in time to avoid being paged overhead. Schiphol is a great airport (cool little museum right in the middle of it) and KLM is a great airline (despite what certain Case med students may think) but the public humiliation of tardy travelers is a bit excessive, in my view. On this final leg of the journey, I started to chip away at the keynote lecture I am giving on Saturday and finished watching Iron Man (again).

After about 4 hours or so, they put up the satellite map. Ah, I thought to myself, I see we have passed the Ukraine. The Ukraine is weak. Now, we are flying over Tbilisi and then will head out over Tehran and Pakistan before entering Indian airspace. Once we are…Hey, wait a second. Tbilisi? Isn’t that the capital of Georgia?