School Trip

I had some artist apply henna to my hands yesterday, and it turned out beautifully (after about four hours of painting, drying, and peeling).  Traditionally henna is done for weddings but I've been wanting to try it for a while.  Oh, and I have IRB approval pending another piece of signed paper I also got yesterday.  I swear, it's taking me longer to get approval for this project than actually doing it is going to.

Today Vania, Julien, and I accompanied the Prenana staff to Dota Ejur (the spelling is phonetic) village for individualized counseling session, history taking, blood draws, vaginal swabs, and urine samples to test for kidney problems, infectious disease, and encourage agency in their own health, and the health of their babies.  They also give out antenatal supplements.  This time the camp was help in an elementary school (all the kids were there, in class).

These are some of the braver ones, who came to say hello :-)

Children (Obviously)

                       

The set up for all the lab work (I actually did some blood typing today).

Us three in front of the school.

At the end we were invited for lunch by the teachers.  It was really good, dol with rice and a crispy piece of bread. 

The First Weekend

Hello, sorry for the radio silence this weekend.  Saturday was a lab day, we observed testing for bacterial vaginosis (not exactly picturesque) and I decided to take the weekend off for blogging.  Sunday was really fun though, we went to Chandani Hills and walked up the 1008 steps to the temple. We woke up really early to avoid the heat of the day, but by the end I was apparently melting. Then we went to see the silk at the Devaraja Market and the outside of the Mysore Palace.  We'll go in another day, and go see it illuminated at night.  Yesterday (monday) was just more IRB prep and ELISA lab work observation.

The View from the Bottom. (Chandani Hills)

Monkeys!

Steps, steps, and more steps.  (The colors a from people marking each step all the way to the top to get their prayers fulfilled)

The Bull (midway to the top), the biggest statue ever carved out of one piece of stone.

The View from the Top. (Chandani Hills over Mysore)

Chandani Temple

Chandani Temple

Chandani Temple

Chandani Temple 

Outside Mysore Palace

The Tribe

Today I went with the mobile van to the village of Nagapura, which sprang into existence when the Indian government incentivized a forest tribe into a different way of life (i.e. asked them to leave the forest) about eight years ago.  Aside from the incredible shift in environment the tribe has had to deal with discrimination and a significant change in health care systems.  The government provides a stipend of food, land, money and social workers to help integrate these new comers into society.  Prenana and PHRII try to begin the transition into hospital based antenatal and general health care, but the cultural divide and discrimination faced in certain communities present a significant barrier.  Today I observed ten women getting group and individual counseling about their pregnancies and blood, urine, and self administered vagina swab tests to test for diabetes, kidney disease, and various infections.  I hope to be able to do more than observe soon.  I also heard troubling stories of two month old infants dying in their second month since they have moved to the village, maybe because of yellow foul smelling breast milk, but no one really knows why.  Overall though I think Prenana is doing a good job of bringing health resources to a community that has difficulty understanding and accessing them on its own.

Here's the group counseling session.

This is the testing station (I'm in the orange leggings)

 Later that night we went to a good restaurant to say farewell to Dwijavanthi, who is leaving for Bangalore tomorrow.  We had a lot of fun.

Left to Right:  Me, Dwijavanthi, Vania, Julien

The Market

So I went to the hospital again this morning, to do some more things for IRB.  Hopefully everything will be ready by next wednesday when I have to present everything.

Afterward Vania and I walked to the Devaraja market, to find sweets, jewelry and silk sarees.  We had a lot of fun but the traffic was murder.  Every time we crossed the street we took our lives I our hands.  It doesn't help that the traffic is going in the opposite direction than I'm used to, but people have really good brakes and aren't going that fast.

The entrance to Devaraja market.

Me in an auto rickshaw with the driver.  (I am not that big, the auto is that small)

Vania in front of one of the many palaces of Mysore. (If you squint really hard you can see the red turrets in the background)

Wonderful lunch. (Thali further away from me, mushroom dish closest to me)

The Hospital

So today I went to meet Dr. Mahesh, my sponsor for the research I will be doing in a couple of weeks, and we had a great conversation on tuberculosis and the guidelines that pertain to its treatment.  On some things we agreed, on others we did not, but the one striking thing was that I realized that no matter how hard you try to take your mind out of the western centric perspective of a disease, there is no match to talking to someone who deals with it on a daily basis and knows the foibles of its treatment and the arbitrary nature of treatment guidelines.  You hope against all hope that the people making the guidelines have the research and the expertise to make these huge decisions, but sometimes that falls short and everyone has to deal with its consequences.  That is the double edge of guidelines; they are a way to standardize standard of care, to level the playing field in a sense, but if they fall short they can do untold damage to patients whose doctors follow the guidelines without question.  On the other hand doctors who do not follow guidelines because it is not the way they where taught can fall behind the times and not give their patients the care they deserve.  So the physician must make his or her own informed decision, and be taught to investigate and evaluate all guidelines for merit.

But enough with the dissertation; today was great but we came back too late to go out with the mobile van, and tomorrow I have to get some paperwork done for IRB so I have to wait until friday to really start my internship.  Julien's going out tomorrow though so he'll report back.

Here's the three of us in the back of a auto rickshaw, now imagine five school girls instead. (It's pretty impressive how many people can fit in these)

The small person in bright orange leggings is me, in the back is a section of the new J.S.S. hospital. (Looks more like a palace right?) 

Settling In

So, the second day in India.  The jet lag's hitting pretty hard, waking me up at four thirty in the morning and making me hungry at odd hours.  But the coffee here in delicious, so everything is ok.  We went to breakfast at the nearby hospital's canteen, which was good (even though the french toast was made with onions and tomatoes).  The rest of the day was an orientation to the SCILs programs at PHRII and shopping.  The SCILs program is an outreach program that helps connect pregnant women in rural areas of Mysore with high risk pregnancies and/or several harmful infections with government help.  I'm going to go out with them either tomorrow or thursday.  In the afternoon one of the administrative staff (Bhavani) took us shopping for traditional clothes.  I bought five salwar kameez in different colors and patterns.  I'll spare you the pictures for now but you'll see them later, promise :-).  Today was the last rest day, tomorrow the real work begins, with an early meeting with Dr. Mahesh at the hospital to discuss my research project and IRB application.

Arrival

The first thing I noticed coming out of the airport was the smell of tropical flowers.  More than anything (except perhaps the jetlag) it's what tipped me off to the fact that I wasn't in the US anymore. The airport itself is of similar design as others I have been in, and so was the parking lot.  When we got out of the airport however and drove the three hours to Mysore, we started to see forrests of concrete apartment buildings, some being torn down, some being built as far as the eye could see.  But startlingly enough once in a while we saw huge stone formations rising up out of the city, seemingly untouched by the civilization around it.

Mysore, at least the area we are in seems very residential, with gated houses on small streets.  We received a very nice welcome by the house guard and by the other boarders.  The apartments above PHRII are very nice, and we haven't seen much of anything else though…having passed out for almost eight hours.  That's going to hurt in the morning.

We went out for dinner, at a hotel restaurant and I got thali, which is a mix of delicious southern Indian foods.  I didn't do it justice but I am definitely a fan of the food here :-) .  I can't wait to try some more tomorrow, and to start seeing the city.

Tada!  Home sweet home for the next five weeks :-)