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On Monday we were posted back at the Babhaleshwar rural clinic to complete our three day rotation. Our new posting started on Tuesday and we were able to join the mobile clinic team for the next three days. Right now PMT (Pravara Medical Trust) is in the middle of an HIV/AIDS screening project for the migrant working population. The mobile clinic reaches these migrants workers in rural areas that would otherwise not seek out healthcare. Migrant workers in India are often from out of state some traveling even farther from places such as Nepal to find work, often to send money back to their families. These migrant workers range from construction workers, hotel workers, sugar cane farmers, factory workers and more. Currently the rate of HIV/AIDS in the migrant working population is 5-6% which is much lower then the rate before the implementation of the mobile clinics services to this population. HIV/AIDS in this area is spread primarily through sexually contact, recreational drug use has been a problem in other areas but not in this target area. Therefore the goal is to not only screen for HIV/AIDS but also educate the migrant workers on safe sex practices.
On Tuesday we left for our first day in the mobile clinic along with three nurses and Dr. Patil. Along the way we made a few stops picking up a lab technician and the medical intern that would be joining in the screening efforts. Our first day was spent screening construction workers in a near by village. Each individual had their blood drawn which would later be screened for HIV/AIDS. They were then able to bring forth any other health concerns to the doctor on site. We saw many minor complaints such as general pain and common colds. Check-ups and referrals are free however medicine comes at small a price, what the mobile clinic charges is very cheap compared to anywhere else the patients would go. The simple medication prescribed that was able to be given at the mobile clinic cost around 10-20 rupees (15-30 cents). For anything more serious including testing positive for HIV/AIDS the patents would be referred to PMT for medication and counseling. One aspect to the mobile clinic that I was so impressed by was the educational counseling that was provided to these migrant workers on site after the screening. One health educator would sit down with the group of workers and give a seminar on safe sexual health practices. They even had a model of a penis with condoms to visualize, as the health educator demonstrated proper use and disposal of a condom as well as different ways to promote the prevention of STDs or STIs. As simple as this may sound many of these people are uneducated and being counseled in this way can be all the difference between contracting a life threading illness such as HIV or not. It was very eye opening to watch the registration of the patients and seeing their education being listed as no education at all. The first day the highest level of education I saw was fifth grade. When I asked Dr. Patil what their children’s future looked like he explained to us that the government has expanded schooling to even the rural villages so that every child is getting an education, improving the next generation to succeed and have opportunities that would otherwise not be possible.
On Wednesday we drove the mobile clinic out to three different hotels which are found everywhere on the side of the road. These hotels are actually just roadside restaurants, with small housing in the back which the migrant workers live in. At the last hotel we visited we met a man who had already tested positive for HIV however had not been taking his medication for 7 or 8 months. When he was asked why he had stopped taking his medication he said because he had run out of medicine and did not have the time to go to the hospital and get more, because he had to work. After some counseling from the staff the man agreed to travel to PMT the following day in order to get his medication.
Thursday we did very similar things as Tuesday and Wednesday, taking blood samples and providing simple check-ups to those who had minor issues. Thursday the migrant workers we screened were factory workers at two different paper mills. At these camps there were a lot of women as opposed to the other two “camps” we visited which were entirely male. These women, many elderly work so hard in the hot sun, for many hours. However many of them left with a giant smile, thankful for the services the clinic provided. One of the last women to be screened gave me the biggest smile and extended her hand to mine, although the thought to not shake this women’s hand did cross my mind, I reached out for her and held her hand with both of mine. As she said what I am assuming was thank you in their local language, I said you’re welcome in english. Although there was a major language barrier, it was a special moment for me.
On Friday we were able to observe one of the Center for Social Medicines current projects, the School Health, Hygiene and Environment Program also known as the SHAPE program. Here we were greeted by sweet kids and smiling faces. The shape program aims to reach the children in rural areas implementing health promotion in the schools with different health models. There were two students from the nursing college, two from the dental and one from the physiotherapy department to teach the children simple health straggles such as hand washing, oral hygiene and different exercises to improve spine development. The SHAPE program is being implemented in nine selected remote & tribal villages.
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As I dive into the third week of my internship I am finally letting the fact that this will be the place I call home for the next 8 weeks sink in. The excitement of the unknown has slightly subsided and I am starting to get use to the way of “Indian life”. I have created my own little sanctuary in room 203 of the Silver Jubilee International Hostel. My air conditioned room, cable TV (only my room has cable and I am currently watching friends while writing this blog post),“American toilet” (as opposed to a squat toilet) and my shower that is a refreshing escape after a long day keep me humble and thankful for these simple pleasures. I am missing food from home at this point, a cheeseburger, salad and sushi have been my most recent cravings however I have brought enough snacks from home that I am not completely deprived from familiar food yet. Other then food cravings and obviously missing my family and Taylor I am really enjoying experiencing a culture completely different from my own. Throughout each day something will randomly hit me, and I will think “I cant believe I’m in India”.
This weekend Kylie, Peyton and I ventured out of Loni to spend a weekend exploring the Ajanta and Ellora caves. Our first weekend trip was an adventure to say the least! Our only struggle we had over the weekend was our driver because he spoke little to no English and had a bit of a wandering eye problem. Needless to say we have spoken to our director Dr. Soma and Mr. Nana (yes his name was Mr. Nana) will not be driving us anywhere again. As far as our hotel, food and of course the caves everything went extremely smooth. Our first stop was the Ajanta caves which date back to around the 2nd century BC to the 6th century AD and are among the earliest monastic institutions to be constructed in India. These caves were all intractly designed and constructed by Buddist monks who ate, slept and worshiped in these caves. After being deserted, the caves were reclaimed by the wilderness and were later discovered in 1819. We were told that when the Ajanta caves were discovered there were bengal tigers living inside among the ancient painting, carving and pillars. Seems like something that would be out of an Indiana Jones movie. These bengal tigers still live in this area and are sighted regularly around the caves in the evenings coming out around 6pm. There are 30 caves that make up a horseshoe-shape bordering the Waghore River.
On the second day of our weekend adventure after staying the night in Aurangabad we set out to explore the Ellora caves. However we first made a pit stop to visit the Bibi-qa-Maqbara or the baby Taj Mahal. After visiting this monument we continued on to the Ellora caves. Our previous day at the Ajanta caves completely exhausted the three of us and because the Ellora caves are spread out so far (some a coulpe miles apart) we decided to just visit cave 16 also known as the Kailasa Temple. This temple was breathtaking and is known as the worlds largest monolithic sculpture. The detail of the rock-cut architecture that was constructed over five centuries was like nothing I have ever seen and the whole experience was surreal. This rock cut temple was built by King Krishna of the Rashtrakuta dynasty in 760 AD and was built to represent Mt. Kailasa.
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This week we had our first official postings which were at two different rural health clinics. For the first three days Monday-Wednesday we were posted in Rahata and for the second two days Thursday-Friday we were posted in Babhaleshwar.
At our first day at the Rahata clinic we were given a tour of the facilities including, a patient check up room, a lactation consultation room, a room for patients who need to use a short term IV and finally a lab. We were briefed on the process used for blood typing and checking hemoglobin and assisted the lab tech in filling out forms when the patient was present as well as putting on the arm cuff before he drew blood for testing. I also was able to help conduct a pregnancy test (similar to the ones in the US). The patient gave a urine sample and with a dropper I placed 5-8 drops of urine in the well of a plastic test, just like in the US if there was one line the patient was not pregnant, if there were two she was. This patient was in fact pregnant and the lab tech ask if I wanted to tell the mother the news. After finding out the mother wanted this pregnancy I excitedly agreed. When I passed the news on to the mother saying “yes you are!” in Hindi I did not get the reaction I was expecting. After words were exchanged with the lab tech and the patient I later found of that the mother actually did not want the pregnancy and was asking what route she could take to abort the baby. This made my heart hurt a little only because I was expecting to tell a mother she had life inside of her only to find out it was unwanted. However that is part of life and part of working in healthcare.
A medical student who was interning at the clinic explained most of what we saw in the clinic and as time went on we got to know him and found he was very nice and also helpful in explaining to us local places to eat, what the names of dishes were and local places to visit. The intern explained to us as he was briefing us on what the clinic offers, that there is a campaign in India called “save the girl child” the campaign was set in place because families especially in small villages still have the mindset that a male child is what is desired. This mindset resulted in girls born into families who did not want them being abandoned, even cases of female babies left in garbage cans or on the roadside. Often times these families would also continue to have children until the had a male, increasing the family size and creating a situation where the families could not afford to care for all of the children. When I asked about adoption agencies the intern explained that although there are many of them, the people in the rural villages often times would not go and seek them out. This raised another question, about the abortion rate. We then found out that in India it is a law that you are not allowed to find out the sex of the baby until birth because so many woman would abort the baby if it were female. We were told that there were certain cases of Dr.’s who would tell the patients if they were having a girl and perform the abortion. These Dr.’s that were caught obviously would loose their medical license. I was surprised to hear of these stories but could understand that in a lot of rural areas there are un-educated people, and backwards ideas such as this still exist. It is very encouraging however to hear about initiatives such as the “save the girl child” campaign as well as efforts made by other institutes such as PMT to fund programs that go out into the communities and offer scholarships to specifically girls who want to further their education giving them the same opportunities as males.
On the second day and third day of our posting at the Rahata clinic we were able to not only observe patient care in the clinic but also visit schools in the surrounding area. Again we were warmly welcomed especially by the children who were both curious and excited for us to be there. During a school visit while sitting in the teachers office a family from a local villages behind the schoolyard had seen us through the window. When we stepped out side we were asked to come over to their village and have chai. After the approval of the lab tech who was with us we ventured into a small village with him. The people were so incredibly kind and gracious asking us questions which had to be translated and offering us chai which was delicious.
It is overwhelming how well we are treated when visiting the homes of strangers and how kind they all were. It was an amazing experience and the highlight of my day.
Thursday and Friday we were posted at Babhaleshwar which was a much slower clinic. However we were still able to observe patient care and met a new medical officer and two more medical interns. We were able to tour the village that the rural clinic serves, we stopped at a specific location that acts as a government funded daycare which offers educational classes on health to the mothers and children and well as providing nutritional supplements if a child is undernourished. We learned that there are 8 similar locations throughout the village itself which has a population of around 8,000 people. It was exciting to hear that these government funded facilities are in every village in India. I am blow away by how much government funding goes toward healthcare in this country. All of the clinics we have been to or have herd about have been completely free other then the medication, which is very cheep if you are to get it from one of the clinics. At some locations even the medication prescribed is completely free.
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Saturday the 21st was our first day in Loni. After 26+ hours of flying and maybe one hour of sleep we started our day. We first were given a tour of the Pravara Institute of Medical Sciences the campus we will be interning at and living by Mr. Jana. He showed us where the hospital, mess hall and canteen was. The canteen is where we will be buying all of our bottled water.
Sunday the 22nd was a day of rest. In India Sunday considered a holiday, we were able to organize our rooms and catch up on some much needed sleep.
Monday the 23rd we finally were able to meet Dr. Somasundaram (or Dr. Soma) which we have all heard so much about. Dr. Soma is the director of The Center for Social Medicine (CSM). He gave us an overview of India, and the community of Loni specifically. We watched a documentary on Padmashri Dr. Vitthalrao Vikhe Patil highlighting many of the accomplishments I have mentioned in an earlier blog post.
Tuesday the 24th was packed full of touring and embracing first hand what the “Pravara Integrated Rural Development Model” really is. We did this by touring the sugar factory that this town was built upon as well as the Chemical and Biogas Plants and Dairy Factory. I am blown away by the self-sustainabilty of the sugar factory in particular, nothing seems to go to waste. How brilliant to optimize all levels of productivity using biogas and fuel and other byproducts such as molasses and liquor as a separate resource of income. Finally we were able to visit the Pravara Public schools where the children completely stole our hearts. I think India has the most adorable children. During the second half of our day we were able to visit two colleges, PVP College and the Home Science College. Both campuses were beautiful and I am continuously impressed by the accomplishments that have been made by these universities as well as the Pravara school district as a whole. The success of these schools and the level of education that these students are getting is amazing.
Wednesday the 25th we were accompanied by Mr. Jori to the Co-Operative Society and the agriculture center where we were briefed on what the scientists were doing in efforts to research the chemically enhanced as well as organic bio-pesticides. These scientists are working with the farmers developing a personal relationship by helping and educating them on what to use on what crops and different ways to optimize their success in farming. We were then able to visit a farm first hand where we walked through just a small part of the 60 acres of land learning about the different fruit grown there including pomegranate, guava and mangos which we ate right off of the tree. It was such an amazing experience and I am so grateful to have been welcomed to the farm. One of the highlights of my Wednesday was when we visited the “deaf, blind and dumb” school. I am so throughly impressed by the intelligence, talent and joy that each one of the children illuminated. In one of the last classrooms we visited a blind boy sang us a song that brought me to tears. I was taken back by the beauty of each one of these amazing children. The second half of Wednesday we visited a trade school where we were able to first hand work with some of the boys in the mechanic shop as they were working with different motors and parts of the car. Finally we visited the little flower school where we toured a beautiful campus with some wonderful children, at this school they we at recess so we were able to watch them play sports and interact with each other rather then sitting in a classroom doing school work which was fun to see.
Thursday the 26th we visited the College of Engineering, College of Pharmacy, the College of Agriculture and Biotechnology and the Institute of Business Management and Administration once again I was so impressed by the level of intelligence and accomplishments made by each school. At the college of Engineering we were given a bouquet of flowers. We were told that in India guests were treated as Gods. The kindness and generosity of this country has blown me away and I am so grateful be here learning and growing amongst some amazing people. The Institute of Business Management and Administration had equipment was high tech, class rooms that were architecturally gorgeous and a extremely kind facility. It was very interesting to tour the College of Pharmacy and get a better understanding of what goes into not only the creation and testing of pharmaceuticals but also the packaging, such as how tablets, capsules and injectables are packaged and tested for quality control. At the college of Agriculture and Biotechnology we were greeted by very friendly Dr.’s that did a great job of explaining and showing us first hand the efforts being made in bio-pesticides and insects that are our “friends and enemies”. The advances in research being made to identify what insects are wanted to protect the plants and those that need to be eliminated were impressive, but to find out that many of their efforts in insecticides were 100% organic was very exciting.
Friday the 27th we were able to join in a yoga class put on for a group of woman who are community health workers. CSM has started a program called the “health bank” where they are training woman from 8 different villages on different health models that they can learn and then bring back to their villages to introduce and implement. For example the first health model was how to dress, clean and treat simple wounds. The model the yoga model is the third. CSM brought in a yoga instructor to introduce simple and effective moves that the women can teach the members of their village. This was an awesome experience and with the help of some Indian students translating what the yoga instructor was saying we were able to participate. I feel so blessed to be here and to be experiencing everything that I am. I can now say that I have done mind and body yoga in India, how cool is that.
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This first week has been our orientation to the campus, and a time to understand the history of the town of Loni itself. The real success of Loni, is due to man and a visionary Padmashri Dr. Vitthalrao Vikhe Patil. (Padmashri is the 4th highest honor bestowed on an Indian citizen from the Indian government due to their efforts/success in certain areas.)
Padmashri Dr. Vitthalrao Vikhe Patil was born to an ordinary peasant family and was deeply moved by the poverty, illiteracy and disease that he saw in his community. Along side of the poverty he saw great potential for the community and sought out to make a difference and create a movement to empower and uplift this rural community. Although he was only educated through fourth standard he was not discouraged and continued to follow his path and see what he had envisioned turn into a reality. Eventually with the help of some people who believed in his dream as much as he did, a small rural town was built into a strong and unified community. Padmashri Dr. Vitthalrao Vikhe Patil used the resources that were available within the rural community (sugar cane) and is responsible for the first industrial co-operative venture in Asia which was started in 1949. This co-operative venture unified the farmers in this rural area and the Pravara Co-operative Sugar Factory was born. By involving the local farmers into this co-operative venture the power that was once in the hands of the private factory owners now lay in the hands of the farmers. No longer did these people suffer from oppression from money lenders and exploitation of big factory owners. He went on to establish the Pravara Medical Trust in 1972 which was meant to improve the health and health education of the people in Loni as well as the surrounding villages. Along with the establishment of the Sugar Factory and the Medical Trust, Padmashri Dr. Vitthalrao Vikhe Patil felt it was vital to establish other schools in the surrounding area to empower the children to reach higher education and to improve future generations.
All aspects of this vision are based off of the Integrated Rural Development Model. This community is run off of a self-sustaining model by which each community member encourages and helps one another. For example the sugarcane factory give farmers control over their crops. We learned while visiting the sugar cane factory that the factory itself is completely self-sustaining using the by-products of molasses, alcohol used as a separate source of income and bio-gas which is recycled and used to power the plant. I was impressed when visiting the schools that they run off of this model as well. Students who can-not afford to pay the fee receive a free education and those who have financial trouble can pay a low-cost fee. At the agricultural center farmers are encouraged to come and learn what will be the most beneficial for each individual crop and they have built a relationship with those who work at the agricultural center.
This community has built itself to be full of bright minds with a continued vision of improvement for the future.
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I can’t believe that I am finally here after so much anticipation! This past week has been a whirlwind of spicy food, colorful clothing, crowded streets and new and exciting experiences. From eating fresh mangos off of a tree at rural farm to the most adorable children stealing my heart at the public schools, I am overwhelmed by the wonder and beauty of this country. I have a feeling that this place will only continue to leave me in awe.
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In 20 short days I will be departing from PDX and flying around the world to Mumbai. I can not believe this idea of an international internship has turned into a reality and I will be in India in less than a month. With finals, graduation, packing and moving in the near future I am surprisingly very calm and ready for the next chapter in my life. I have a sense of peace and confidence in what lies ahead for me. Over memorial day weekend I read a book that completely captivated my heart and spoke a sense of encouragement and positivity into my life. The book “Love Does” by Bob Goff is a heartwarming story about a man who lives his life through action instead of words.
“Living a life fully engaged and full of whimsy and the kind of things that love does is something most people plan to do, but along the way they just kind of forget. Their dreams become one of those “we’ll go there next time” deferrals. The sad thing is, for many there is no “next time” because passing on the chance to cross over is an overall attitude toward life rather than a single decision.” -Bob Goff
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Loni is such a small town that it does not show up on the larger maps. I am using a map a past intern created roughly marking where Loni is located in the Maharashtra province. Loni is near the western border of India and will be a six hour drive from Mumbai, where we will be flying in. Image
Facts and Figures
- Population – 1,210,193,422 people
- Total Geographic Area – 3,287,263 sq. km
- People per square kilometer – 368.2/sq. km
- Electricity voltage – 220/240 volts
- Exchange rate – 1 US $ = 51.4 Indian Rupees
- Emergency number – 2611
- Time zone away from home – +12 hours
- Main cultural groups – Caste system: Brahmins, Kshatriya, Vaisyas, Shudras, and Untouchables
- Main religions – Hinduism, Buddhism, Sikhism, Jainism, Christianity, Islam
- Year of Independence – Declared from the UK on August 15, 1947 and became a republic on January 26, 1950
- Type of Government – parliamentary system of Government with a bicameral parliament and three independent branches: the executive, the legislature and the judiciary
- Current Ruling Party – Indian National Congress
- Head of Government – Pratibha Patil, President; Manmohan Singh, Prime Minister
- Domestic Issues – Overpopulation, pollution, poverty, caste/religious violence
- International Issues – Kashmir situation with Pakistan, Unrresolved territorial conflict with China
- Election Date – 2014, but can occur earlier if the Prime Minister choses so
- Major Political Parties – Indian National Congress, Bahujan Samaj Party, Bharatiya Janata Party, Communist Party of India, Communist Party of India (Marxist), National Congress Party
- Popular Sports – Traditional indigenous sports (kabaddi, kho kho, pehlwani), chess, field hockey (national sport), tennis
- Popular Local Teams – Indian national hockey team, Indian national cricket team, Indian Davis Cup team
- Famous celebrities – Rohan Bopanna, Kunjarani Devi, Nvya Nair, Maju Warrier, Vadivelu
Posted in Spain | Tagged barcelona, Festes de la Mercè, Sitges, Zaragoza |
Wednesday was the last day of Festes de la Mercè, a festival held annually in Barcelona. Activities for all ages can be found in the streets, parks, and plazas throughout the city. I saw Castells and one of the many Parade of Giants that went on this week. It baffles me to think just where all these people come from! The entire population of Barcelona, along with the many tourists, gather in these plazas. I felt like a duck heading into the metro, waddling and taking baby steps to avoid stepping on the toes and heals of the people inches in every direction.
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Wednesday night I went to the firework show and projection at Plaça de Espanya where even more people crowded in to see a, mostly political- as everything in Catalonia is, musical video depicting Barcelona’s history. I think I sometimes forget that I’m living in a big city. I’m living in a city that has one million more inhabitants than Oregon’s biggest city! Just walking down the street on any regular day in Barcelona I don’t feel like it’s that big. Sure it has it’s moments, usually when I walk past the Gaudi museum, or wander into Plaça Catalunya, and see all the tourists bustling about with their shopping bags, backpacks, and cameras. It is going to be so weird to come home and drive ten minutes to get to town, a town that is one thirty second the size of Barcelona. I’m grateful for game days, festivals, and crowded tourist attractions, they remind me where I am. When I get onto an exceptionally crowded metro car I remember that I am living in Europe. This is my home for the next twelve weeks.
Okay, enough about festivals! That’s not all we do in Spain, though it sure does seem like it :) This week I went to Sitges, a city on the sea twenty miles south of Barcelona. It was beautiful! The sand was smooth, just like it is back home, but the day we went, the water was about like it is back home too; needless to say, our sun bathing was unsuccessful!
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Friday morning I went, with some of my study abroad group, to Zaragoza. Zaragoza is a city almost two hundred miles west of Barcelona in the Aragon community. On our overnight trip we took several tours of the city and its Roman ruins. I ate too much, made new friends, and saw the worlds third largest fresh water aquarium. I love big cities. I love the easy public transportation, good food, culture, and entertainment. However, there is something about smaller towns that makes them special. I don’t know what it is, if you have any ideas let me know ;). Not that Zaragoza is small…. it still has sixty seven thousand more people than Portland! It just has that smaller city feel compared to Barcelona. I thoroughly enjoyed my time in Zaragoza and I can’t wait to see more cities in Spain! I never have been good at conclusions… so, the end. El Fin, Elani
Posted in Spain | Tagged barcelona, Burrito, Festival, La Mercè |
This weekend/week is La Mercè festival in Barcelona. The big day will be this Wednesday, most people get the day off and there are concerts, performances, traditional dance, and more castells! These events have been going on since Friday. It is such a different feel to be out on the streets this week. Normally the metro closes at midnight and all but a few of the restaurants and shops are closed by then, but this week the metro is open all night and there are people everywhere! It’s not hard to find food at 3am and the streets are filled with music. Every night they do a firework show by the water, I haven’t had the chance to see it yet but I’m sure I will tomorrow. I know every night when the show starts because my neighbors dog is not a fan!
Each week I see more of the city, and I’m beginning to realize how walkable it is. On Sunday I went for a stroll and I found a street with several Mexican restaurants! I cannot tell you how ecstatic I was to finally find a burrito!! They even sold hot sauce there, which is not so easy to come by in Spain. They don’t eat a lot of spicy food or sauce here, so hot sauce is nearly impossible to find! I have really enjoyed trying all of the food here, especially our home cooked meals. Even when I don’t like something I’m glad I had the chance to try it. That being said, it sure was nice to have a little taste of home yesterday!